Thrombosis and Thrombo -embolisms

Publish in

Documents

4 views

Please download to get full document.

View again

of 9
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Share
Description
Thrombosis and Thrombo -embolisms. Megan Connolly Block 2 6/2011. How is a thrombus identified ultrasonographically ? B-mode U/S exam Doppler- helps evaluate the degree of vascular compromise
Transcript
Thrombosis and Thrombo-embolismsMegan ConnollyBlock 26/2011How is a thrombus identified ultrasonographically?
  • B-mode U/S exam
  • Doppler- helps evaluate the degree of vascular compromise
  • Acute phase thrombi typically appear anechoic. Some faint echogenicity within the vessel may be seen as color flows around the filling defect when using Doppler.
  • After several days the thrombus organizes into a visible structure with intermediate echogenicity.
  • Older thrombi may contract resulting in visualization of flow seen around it.
  • How to evaluate a thrombus
  • 1. Use Doppler to identify an acute thrombus
  • 2. Evaluate the extent and location of visible thrombi
  • 3. Check for peripheral flow with color Doppler
  • 4. Look for evidence of neoplasia
  • 5. Assess for the sequelae of thrombosisischemia, ascites, etc.
  • Thrombosis- formation of a clot/thrombus at a site of blood stasis or vascular injury.
  • Thrombo-embolus- obstruction of a vessel downstream of the site of a clot formation.
  • Common sites of thrombo-embolus formation:
  • Aortic trifurcationaortic-iliac bifurcation
  • Caudal vena cava
  • Renal arteries
  • Pulmonary arteries
  • Mesenteric arteries
  • Pulmonary ThromboembolismComplication of many systemic diseases that predisposes the patient to a hypercoaguable state
  • Heartworm disease
  • Pulmonary artery thrombosis pulmonary thrombo-embolism
  • Glomerulonephropathies
  • Loss of antithrombin III through glomerular basement membrane hypercoagulation
  • IMHA
  • Hyperadrenocorticism
  • Secondary to erythrocytosis, hypertension and hypercoaguable state
  • DIC
  • Intravascular deposition of fibrinthrombosis
  • Neoplasia
  • Caudal vena cava- most common tumor that invades this vessel is an adrenal tumor (pheochromocytomas); tumor thrombus travels down phrenicoabdominal vein to reach the vena cava.
  • Sepsis
  • Clinical signs of PTE:
  • Acute respiratory compromise and a ventilation-perfusion mismatch that can be mild or subclinical depending on the degree of embolization.
  • Difficulty breathing (tachypnea and hyperpnea), coughing (can be productive), wheezing, anorexia, vomiting, lethargy, weightloss.
  • Cardiac Thrombi and Aortic Thrombo-embolism
  • Can occur with both HCM, DCM and Restrictive CM.
  • Stasis of blood activation of clotting factors thrombus formation in left atrium, ventricle or both.
  • Thrombus can dislodge and form an emboli that may obstruct aortic branches (most commonly at the aortic trifurcation). “saddle thrombus”
  • Clinical signs: Pain, cold extremities, cyanotic extremities, lack of palpable femoral pulse, signs of CHF.
  • If obstruction is partial may observe neurological deficits in the hindlimbs or unilateral paresis.
  • Clinical Signs of other Thromboembolisms(difficult to identify via ultrasound)
  • Cerebral TE
  • Change in consciousness, seizures, weakness. If the brain stem area is affected, then cranial nerve dysfunction, cerebellar signs, coma, or weakness may result.
  • Mesenteric artery TE
  • often found with GDV, will cause gastrointestinal signs and abdominal pain.
  • Renal TE or thrombosis leading to renal infarction :
  • decrease in renal function, pyrexia, back pain, proteinuria and hematuria or anuria if bilateraland potentially renal failure.
  • Related Search
    We Need Your Support
    Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

    Thanks to everyone for your continued support.

    No, Thanks