Venous Thrombosis and Thromboembolism - Part 2

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are relatively common diseases and are amenable to therapy, but with a potentially fatal outcome if untreated. The diagnosis can be made in most patients using noninvasive imaging tests, but limitations exist. The standard first choice of investigation in patients with suspected DVT is compression ultrasonography (CUS). Pre-sonography evaluation – including clinical assessment of patient history and physical, Well’s Score and D-Dimer Assay – is important in clinical screening, as well as for medical and interventional disease management. This course will provide attendees with details of advanced diagnostic protocols and interpretation and updates on medical and interventional disease management.

Target Audience

Cardiologists, Sonographers, Physician Assistants, Nurses, Nurse Practitioners and Respiratory Therapists (Personal Growth). 

Learning Objectives

  • Apply the proper protocol for lower extremity duplex ultrasonography.
  • Describe compression sonography imaging.
  • Examine spectral Doppler imaging and recognize why groin (CFV) waveforms are important to accurately interpret.
  • Define critical testing values for lower extremity venous duplex ultrasonography. 
  • Identify aging deep venous thrombosis: acute and subacute DVT vs. chronic venous fibrosis.
  • Describe lower extremity duplex ultrasonography, examine its possible use as a primary screening tool in the diagnosis of PE and recognize its limitations.
  • Identify interventional PE and DVT disease management: lysis and extraction.
  • Review the updated criteria for the use of lysis and extraction.
Additional information
Bibliography: 

Wells PS, Anderson DR, Rodger M, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003, 349(13), 1227.

Needleman, L., Cronan, J. J., Lilly, M. P., Merli, G. J., Adhikari, S., Hertzberg, B. S., ... & Meissner, M. H. (2018). Ultrasound for lower extremity deep venous thrombosis: multidisciplinary recommendations from the Society of Radiologists in Ultrasound Consensus Conference. Circulation, 137(14), 1505-1515.

Horner, D., Hogg, K., & Body, R. (2016). Should we be looking for and treating isolated calf vein thrombosis?. Emergency Medicine Journal, 33(6), 431-437.

Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.00 Florida Board of Respiratory Therapy
Course opens: 
09/01/2020
Course expires: 
08/31/2021

Brian J. Schiro, M.D.
Medical Director, Noninvasive Lab, Baptist Hospital
Vascular and Interventional Radiologist, Miami Cardiac & Vascular Institute
Miami, Florida

Brian J. Schiro, M.D., speaker and conference director, disclosed that he receives grant/research support from Medtronic and that he is a member of the speakers bureau for Penumbra and Sirtex. Dr. Schiro has also disclosed that his lecture will include discussion of off-label or unapproved product usage.

Elliott J. Elias, M.D., conference director, disclosed that he is a member of the speakers bureau for Abbott Laboratories, and his participation will not include discussion of off-label or unapproved product usage.

Muhammad Hasan, moderator, has indicated that he has no relevant commercial relationships to disclose, and that his participation will not include discussion of off-label or unapproved product usage.

Non-faculty contributors and others involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.00 Florida Board of Respiratory Therapy
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