SUSPECTED DEEP VEIN THROMBOSIS (DVT)

SUSPECTED DEEP VEIN THROMBOSIS (DVT) Calculate Clinical Probability Score Low: < 2 PointsHigh: >= 2 Points Suspected DVT STOP Negative D-Dimer Positive D-Dimer Negative Leg U/S Positive Leg U/S Positive Leg U/S Negative Leg U/SSTOPTREATTREATNegative VenogramPositive VenogramPositive Leg U/S at 1 WeekNegative Leg U/S at 1 WeekSTOPSTOPTREATTREATWell's Criteria for for DVT Active Cancer (1) Paralysis, paresis, recent immobilization of lower extremity (1)Recently bedridden for > 3 days, or major surgery in last 4 weeks (1) Localized tenderness along distribution of the deep venous system (1) Entire leg swollen (1)Calf swelling by > 3cm compared to asymptomatic leg (1)Pitting edema (greater in symptomatic leg) (1)Collateral, nonvaricose superficial veins (1)Alternative diagnosis as or more likely than DVT (-2)Wells, P.S. et al. (2003). Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. New England Journal of Medicine; 349: 1227-1235.