Última revisão: 25 Jan 2021
Última atualização: 27 GUA 2019

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • inchaço da panturrilha
  • dor localizada ao longo do sistema venoso profundo

Outros fatores diagnósticos

  • edema assimétrico
  • veias superficiais proeminentes
  • edema da perna inteira
  • flegmasia cerulea dolens

Fatores de risco

  • internação hospitalar nos últimos 2 meses
  • cirurgia de grande porte nos últimos 3 meses
  • câncer ativo
  • trauma nos membros inferiores
  • trauma grave
  • idade mais avançada
  • gestação
  • fator V de Leiden
  • mutação do gene da protrombina G20210A
  • deficiência da proteína C ou S
  • deficiência de antitrombina
  • síndrome do anticorpo antifosfolipídeo
  • comorbidade clínica
  • uso de medicamentos específicos
  • obesidade
  • viagem aérea recente de longa distância
  • história familiar
  • tabagismo

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • escore de Wells
  • nível quantitativo de dímero D
  • ultrassonografia duplex proximal
  • ultrassonografia do membro inferior
  • razão normalizada internacional (INR) e tempo de tromboplastina parcial ativada (TTPa)
  • ureia e creatinina
  • TFHs
  • Hemograma completo

Investigações a serem consideradas

  • teste do fluxo venoso por Doppler
  • tomografia computadorizada (TC) do abdome e da pelve com contraste
  • rastreamento para trombofilia

Algoritmo de tratamento

Colaboradores

Director

Thrombosis Clinic

Intermountain Medical Center

Murray

Professor of Medicine

University of Utah

Salt Lake City

UT

Declarações

SMS’ institution has received financial support for his conduct of investigator-initiated research from Pfizer/Bristol-Myers Squibb.

Director

Thrombosis Clinic

Intermountain Medical Center

Murray

Professor of Medicine

University of Utah

Salt Lake City

UT

Declarações

SCW holds two investigator-initiated grants from Bristol-Myers Squibb/Pfizer paid to his employer Intermountain Healthcare for which he receives no compensation. He has been invited to serve as co-chair of the American College of Chest Physicians guideline on antithrombotic therapy for venous thromboembolic disease ('AT11') and serves as an invited panelist for the US Centers for Disease Control and Prevention venous thromboembolism risk assessment model systematic review and guidance panel.

Clinical Coordinator

Critical Care Pharmacy

Advanced Clinical Pharmacist

Neuroscience Critical Care

Intermountain Medical Center

Murray

UT

Declarações

GVF receives consulting fees and honoraria from Portola Pharmaceuticals for clinical consulting and speaking engagements.

Dr Scott M. Stevens, Dr Scott C. Woller, and Dr Gabriel V. Fontaine would like to gratefully acknowledge Dr Geno Merli, Dr Taki Galanis, Dr Luis Eraso, Dr Geoffrey Ouma, Dr Richard White, and Dr Windsor Ting, the previous contributors to this topic. GM has received grant or research support from BMS, J&J, Sanofi-Aventis, Portola, and Janssen; he has served as a Scientific Consultant for BMS, J&J, and Sanofi-Aventis. RW declares participation in numerous multicentred clinical trials sponsored by companies: Agenix, Boehringer-Ingleheim, Amgen, Bayer, Bristol-Meyer-Squibb, Novartis, Hemosense. TG, LE, GO, and WT declare that they have no competing interests.

RevisoresVER TUDO

Professor of Thrombosis & Haemostasis

King's College

Consultant

Departments of Haematology, Pathology & Rheumatology

Lead in Blood Sciences

Guy's & St Thomas' NHS Foundation Trust

London

UK

Declarações

BH declares that she has no competing interests.

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