Phlebology, consultative work in a polyclinic (RAKI_025)
About Study Course
Objective
Venous disease is the most common vascular condition to affect the lower limb. Chronic venous insufficiency (CVI) deep vein thrombosis and pulmonary embolism (PE) - are unresolved problem of medicine.
Learning outcomes
1.1. US, Duplex scaning, D-Dimer test, indication for invasive methods.
2. Conservative treatments: compression, sclerotheraphy, application of drugs: anticoagulation, flavonoids.
3. Surgical treatments: high ligation and stripping, dissection of perforating vein.
4. Alternative treatment: endovenous laser, radiofrequency oblation, transluminal flebectomy, thrombolysis.
5. Surgical, combined surgical/endoluminal treatment of venous thrombosis, include thromboablative: percutaneous mechanical, surgical trombectomy, catheter - directed thrombolysis, stent placement; venacaval interrupotion.
6. Anticoagulants for theraphy and prophylaxis of DVT.
1.1. To know
* a first line treatment of acute DVT, pulmonal embolism,
* length of anticoagulant (warfarin, thrombin/ Xa-factor inhibitors) treatment in DVT cases, INR ratio, in pulmonal embolism,
* Compression pressure fo stocking duration of treatment,
* Indication for screening the coagulation system, D-Dimer test and Doplerography middle - and long - time period after DVT.
2. Indications of Thrombolytic thepary: systemic/ local - regional (catheter directed).
3. Percutaneous mechanical thrombectomy.'stent implantation.
4. Surgical thrombectomy, venacaval interruption.
1.Prevention of venous thromboemolism in patients undergoing surgery. Patients can be stratisfied into risk levels based on * type of operation
* age
* presence of additional risk factors and
thromboprophylaxis given accordingly.
Indication for surgical thrombectomy, endovenous thrombectomy with a stent implantation.
Extraanatomic veno-venous bypass(Palma operation) with a GSV.
The role of compression therapy.
Congenital aneurysm, malformation, multiple A-V fistulas.
