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Deep Venous Thrombosis (DVT) is common due to the phenomenon of Virchow’s Triad. Therefore, it is very important to closely monitor for DVT, especially in first year following SCI or any time patient is admitted to hospital. Secondary complication of DVT can result in Pulmonary Thromboembolism (PTE) and death.

  • Patients with a SCI often present atypically or with an unreliable physical examination. The standard of care is now to initiate subcutaneous low molecular weight heparin for prophylaxis following SCI. Venous Doppler ultrasounds are commonly performed for screening.
  • If there is concern for a PTE, either a CT Angiogram, spiral CT scan, or nuclear ventilation/perfusion scan can be performed to diagnose with a chest x-ray

Treatment Considerations

  • For acute DVT/PTE, subcutaneous low molecular weight heparin is used initially with the transition to oral Warfarin if there are no contraindications. The duration of anticoagulation may be increased based on an individual’s risk factors. Continued reassessment of the timing of appropriate addition of anticoagulation in this setting is warranted. Inferior Vena Cava filter is indicated when anticoagulation is contraindicated. The inferior vena cava filter is NOT a substitute for thromboprophylaxis.
    • Treatment of DVT is for at least 3 months
    • Treatment of PTE is for at least 6 months
    • Monitor for upper extremity DVT
    • Always recheck Doppler ultrasound after discontinuation of prophylaxis and treatment

Venous Thromboembolism (VTE)
PM&R Knowledge NOW Topics from American Academy of Physical Medicine and Rehabilitation





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The University of Alabama at Birmingham Spinal Cord Injury Model System provides this website as an auxiliary resource for the primary care of patients with spinal cord injury.The contents of this website were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SIMS0020). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.