TY  - CHAP
M1  - Book, Section
TI  - Venous and Lymphatic Disease
A1  - Jundt, Jason P.
A1  - Liem, Timothy K.
A1  - Moneta, Gregory L.
A2  - Brunicardi, F. Charles
A2  - Andersen, Dana K.
A2  - Billiar, Timothy R.
A2  - Dunn, David L.
A2  - Hunter, John G.
A2  - Matthews, Jeffrey B.
A2  - Pollock, Raphael E.
Y1  - 2015
N1  - 
T2  - Schwartz's Principles of Surgery, 10e
AB  - Thrombolytic  therapy,  surgical  thrombectomy,  and  placement  of  inferior  vena  cava  filters  are  adjunctive  treatments  that  may  be  indicated  in  patients  with  extensive  and  complicated  venous  thromboembolism.Deep  vein  thrombosis  (DVT)  and  pulmonary  embolism  are  frequent  complications  after  major  abdominal  and  orthopedic  procedures.  The  risk  is  further  increased  in  patients  with  malignancy  and  a  history  of  venous  thromboembolism.  Options  for  DVT  prophylaxis  include  intermittent  pneumatic  compression,  use  of  graduated  compression  stockings,  and  administration  of  low-dose  unfractionated  heparin,  low  molecular  weight  heparin,  fondaparinux,  and  vitamin  K  antagonists.  However,  prophylaxis  should  be  stratified  based  on  the  patient's  level  of  risk.In  patients  with  established  DVT,  unfractionated  heparin,  low  molecular  weight  heparin,  and  fondaparinux  are  options  for  initial  antithrombotic  therapy.  The  duration  and  type  of  long-term  anticoagulation  should  be  stratified  based  on  the  ­provoked  or  unprovoked  nature  of  the  DVT,  the  location  of  the  DVT,  previous  occurrence  of  DVT,  and  presence  of  concomitant  malignancy.Saphenous  vein  stripping,  endovenous  laser  treatment,  and  radiofrequency  ablation  are  effective  therapies  for  patients  with  saphenous  vein  valvular  insufficiency.  Concomitant  varicose  veins  may  be  managed  with  compression  therapy,  sclerotherapy  (for  smaller  varices),  and  phlebectomy.The  mainstay  of  treatment  for  chronic  venous  insufficiency  is  compression  therapy.  Sclerotherapy,  perforator  vein  ligation,  and  venous  reconstruction  may  be  indicated  in  patients  in  whom  conservative  management  fails.Lymphedema  is  categorized  as  primary  (with  early  or  delayed  onset)  or  secondary.  The  goals  of  treatment  are  to  minimize  edema  and  prevent  infection.  Lymphatic  massage,  sequential  pneumatic  compression,  use  of  compression  garments,  and  limb  elevation  are  effective  forms  of  therapy.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1117747159
ER  -