May involve LV Peripheral arterial Older age Intermittent claudication Ankle-brachial index Lifelong aspirin tx disease Male gender Muscle/limb weakness Treadmill exercise arterial Meds African American Absent/diminished pulses studies Angioplasty Smoking Poor hair growth Duplex US Stenting DM Resting limb pain Segmental arterial pressures Radiation tx Hyperlipidemia Paresthesia Angiography Percutaneous transluminal HTN Poor healing CT angioplasty MRI/MRA Arterial bypass Amputation Acute arterial ischemia: immediate heparin tx or embolectomy Peripheral venous Swelling, tightness, discomfort Streptokinase (not for DVT) disease in one or both Les Vena cava filters – prevents Unilateral = DVT PE, stroke Stasis dermatitis, stasis ulcers Varicose veins Older age Dilated tortuous veins Ligation Female Often none Stripping Obesity Sensation of heaviness, Laser therapy Jobs w/ prolonged standing tiredness, itching Radiofrequency ablation of Low-fiber diet Visible during pregnancy or vein Smoking menstruation Wear compression stockings HTN Recurrence after venous sclerotherapy Pregnancy Avoid venous pooling Injury Walking program, weight loss DVT Immobility – SCI, paresis Virchow’s triad: Duplex US Early ambulation as tolerated Fx of pelvis, hip, long bones Venous stasis Venography Elevate 10 to 20º above level Multiple trauma, burns, sx, Damage of endothelium CT and MRI of heart infection, inflammation Hypercoagulability Venous duplex imaging Moist heat Hypercoagulability states Asymptomatic until PE Photoplethysmography AVOID MASSSAGING Previous DVTs, PE Unilateral pain, edema, warmth, Ambulatory venous pressure Graduated compression Malignancy tenderness stockings MI, HF, respiratory failure, Slightly puffier than other leg Anticoagulants (heparin, sepsis, ulcerative colitis Homan’s sign thrombin inhibitors, warfarin) ICU admission Venous thrombectomy Age >40 Percutaneous interruption of Obesity vena cava Immobility 3 days or more AROM, PROM Varicose veins Avoid prolonged sitting, Pregnancy, PP standing, crossing legs Oral contraceptive use Intermittent pneumatic
May involve LV Peripheral arterial disease Older age Male gender African American Smoking DM Hyperlipidemia HTN Intermittent claudication Muscle/limb weakness Absent/diminished pulses Poor hair growth Resting limb pain Paresthesia Poor healing Ankle-brachial index Treadmill exercise arterial studies Duplex US Segmental arterial pressures Angiography CT MRI/MRA Lifelong aspirin tx Meds Angioplasty Stenting Radiation tx Percutaneous transluminal angioplasty Arterial bypass Amputation Acute arterial ischemia: immediate heparin tx or embolectomy Peripheral venous disease Swelling, tightness, discomfort in one or both Les Unilateral = DVT Stasis dermatitis, stasis ulcers Streptokinase (not for DVT) Vena cava filters – prevents PE, stroke Varicose veins Older age Female Obesity Jobs w/ prolonged standing Low-fiber diet Smoking HTN Pregnancy Injury Dilated tortuous veins Often none Sensation of heaviness, tiredness, itching Visible during pregnancy or menstruation Recurrence Ligation Stripping Laser therapy Radiofrequency ablation of vein Wear compression stockings after venous sclerotherapy Avoid venous pooling Walking program, weight loss DVT Immobility – SCI, paresis Fx of pelvis, hip, long bones Multiple trauma, burns, sx, infection, inflammation Hypercoagulability states Previous DVTs, PE Malignancy MI, HF, respiratory failure, sepsis, ulcerative colitis ICU admission Age >40 Obesity Immobility 3 days or more Varicose veins Pregnancy, PP Oral contraceptive use Virchow’s triad: Venous stasis Damage of endothelium Hypercoagulability Asymptomatic until PE Unilateral pain, edema, warmth, tenderness Slightly puffier than other leg Homan’s sign Duplex US Venography CT and MRI Venous duplex imaging Photoplethysmography Ambulatory venous pressure Early ambulation as tolerated Elevate 10 to 20º above level of heart Moist heat AVOID MASSSAGING Graduated compression stockings Anticoagulants (heparin, thrombin inhibitors, warfarin) Venous thrombectomy Percutaneous interruption of vena cava AROM, PROM Avoid prolonged sitting, standing, crossing legs Intermittent pneumatic
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