A survey of deep venous thrombosis management by consultant vascular surgeons in the United Kingdom and Ireland

Objectives: the aim of this study was to detail the current consensus among st vascular surgeons in Great Britain and Ireland regarding their investiga tion and management of patients with suspected or proven deep vein thrombos is (DVT). Methods: the database of the Vascular Surgical Society of Great Britain and Ireland (VSS) was utilised to send coded postal questionnaires to all cons ultant surgeon members. Results: replies were received from 281 (65%) consultants. Duplex ultrasoun d is used alone to confirm DVT by 69% of respondents. A thrombophilia scree n is always performed by 14% of consultants, for patients with proven DVT, and is more commonly requested by consultants based in a teaching hospital. The majority (57%) of consultants treat DVT with unfractionated heparin (U FH) and warfarin, whereas only 38% utilise low molecular weight heparins (L MWH) and warfarin. A management policy for DVT is reported to be in place b y 59%, and a set policy for the specific management of calf vein DVT by jus t 20%. Conclusion: new diagnostic modalities and treatments have been developed fo r DVT that are more convenient and cost-effective. Although clinical guidel ines for the management of patients with DVT are beginning to emerge, there is still a wide discrepancy in many areas of DVT management, and practice at variance with the current evidence base, amongst vascular surgeons in th e United Kingdom and Ireland.