周围血管疾病.ppt

Peripheral Vascular Disease (周围血管疾病)
Peripheral Vascular Disease
Peripheral Vascular Disease
Diseases of blood vessels outside the heart and brain
Disorders of the veins
Peripheral arterial disease (PAD)
Peripheral Vascular Disease
Acute Deep Venous Thrombosis
急性深静脉血栓
Acute Deep Venous Thrombosis
Venous Thromboembolism (VTE)
Acute deep venous thrombosis (DVT)
Pulmonary embolism (PE)
Post-thrombotic syndrome
Acute Deep Venous Thrombosis
Risk Factors for Acute Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE)
RISK FACTOR FOR DVT OR PE
ODDS RATIO
95% CONFIDENCE INTERVAL
Hospitalization:
With recent surgery

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Without recent surgery

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Trauma

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Malignant neoplasm:
With chemotherapy

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Without chemotherapy

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Prior central venous catheter or pacemaker

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Prior superficial vein thrombosis

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Neurologic disease with extremity paresis

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Varicose veins:
Age 45 yr

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Age 60 yr

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Age 75 yr

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Congestive heart failure:
Thromboembolism not categorized as a cause of death at postmortem

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Thromboembolism categorized as a cause of death at postmortem

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Acute Deep Venous Thrombosis
Risk Factors for Acute Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE)
Primary Hypercoagulable States
Pregnancy
Oral Contraceptives and Hormonal Therapy
…
Acute Deep Venous Thrombosis
Signs and symptoms
Symptoms
Absence of symptoms
Massive swelling
Calf pain, edema, erythema, fever
Cyanosis with impending venous gangrene (phlegmasia cerulea dolens,股青肿)
Signs
Prominent superficial veins
Hypertonia and tenderness of calf
Homans’ sign (pain with passive dorsiflexion of the foot )
Acute Deep Venous Thrombosis
Vascular Lab
Venography (“gold standard”, historically)
Duplex Ultrasonography
Computed tomography venography (CTV)
D-Dimer Assays
Acute Deep Venous