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Surgery Vascular surgery a2491e4f

The initial therapy of documented deep venous thrombosis in a post-operative case is:

A
Subcutaneous heparin therapy
B
Intravenous heparin therapy
C
Thrombolytic therapy with urokinase
D
Aspirin therapy
High-Yield Explanation
AntiThrombotic Therapy in DVT: Any venous thrombosis involving the femoropopliteal systemis treated with full anticoagulation. Traditionally, the treatment of DVT centres around heparin treatment to maintain the PTT at 60 to 80 seconds, followed by warfarin therapy to obtain an INR of 2.5 to 3.0 This initial therapy usually is continued for atleast 5 days, while oral Vitamin K antagonists are being simultaneously administered. Unfractionated Heparin UFH therapy is most commonly administered with an initial IV bolus of 80 units/Kg or 5000 units. Initial bolus is followed by a continous IV drip, initially at 18 units/Kg per hour or 1300 units per hour. The half-life of IV UFH ranges from 45-90 minutes and is dose dependent. Level of antithrombotic therapy should be monitored every 6 hours using aPTT, with the goal range of 1.5 to 2.5 times control values. Ref: Sabiston 20th edition Pgno: 1844

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