The National Day to Fight Thrombosis (17 April) is the starting point for presenting the activity of theNon-Invasive Vascular Diagnostics Clinic of the Cona hospital, belonging to the Unit Operational Hospital Internal Medicine 2 (Acting Director, Dr. Piergiorgio Gaudenzi). The service deals with thrombotic, atherosclerotic and vasculitic vascular diseases at the multi-specialist Day Hospital at 2E2. Doctors Lisa Giusto, Carmine Costantino and Daniele Deplano are part of the medical team.
The clinic takes care of cases of suspected deep vein thrombosis (DVT) of all patients referred to the Emergency Department (General, Orthopaedic, Obstetric, Pediatric) and also of inpatients throughout the S. Anna.
DVT is a pathology that requires prompt instrumental confirmation of the diagnosis and equally rapid treatment. All this makes a rational and coordinated evaluation process necessary which involves multiple professional figures, from the Genera Medicine Doctor to the emergency room doctor and finally to the angiologist. In Italy the global incidence is equal to 1-2 cases per 1000 people per year and increases with age.
This pathology, with the thromboembolic complications that can derive from it (pulmonary embolism), constitutes a potentially fatal disease, which often complicates the clinical course of patients suffering from other pathologies, but which also affects subjects in apparent good health. The clinical manifestations of DVT of the lower limbs are multiple (spontaneous pain or pain caused by muscle stretching, skin erythema, increase in skin temperature, increase in limb size and other symptoms). However, the clinical diagnosis is often not accurate, because it is based on symptoms and signs which, considered individually or as a whole, are neither sensitive nor specific. For this reason, the definitive diagnosis must be entrusted to the confirmation of an instrumental examination with a venous color Doppler ultrasound of the lower limbs.
The main diagnostic criterion for the presence or absence of DVT comes from the compression ultrasonographic (CUS) test. The venous thrombus tends to persist for a long time and in fact the ultrasound (US) examination is still abnormal in about half of the patients a year later. For this reason it is recommended to carry out a color Doppler ultrasound check when the anticoagulant treatment is suspended, in order to record the presence, location and diameter of any thrombotic residues. In fact, the Cona clinic provides appointments dedicated to the Coagulation Centre, currently managed by prof. Gianluca Campo of Cona Cardiology (directed by Prof. Gabriele Guardigli), for the TVP path.
“The timeliness and adequate diagnostic path of deep vein thrombosis – reports Dr. Giusto – constitutes a fundamental factor in reducing mortality associated with its acute manifestations and the incidence of relapses. Furthermore, the speed of diagnosis is useful for counteracting long-term sequelae, represented by post-thrombotic syndrome, often highly disabling and with high social costs.“.
“Deep vein thrombosis – declares Dr. Gaudenzi – complications are of greater concern, and more precisely pulmonary embolism. Therefore, an adequate diagnostic therapeutic process and possible clinical observation through hospitalization in an internal medicine environment are essential. In our department, Dr. Elena Satta deals with the problems of venous thromboembolism in hospitalized patients. However, the activity of the Vascular Diagnostics Clinic is not limited only to the diagnosis and treatment of patients with venous thrombotic pathologies. I am pleased to underline that Dr. Giusto was recently invited as a speaker at the XXII National Course in Vascular Ultrasonology and Ferrara will be one of the national tutoring centers for the clinical part of this Course”.
The Vascular Surgery Unit (Acting Director, Dr. Luca Traina) and the “Cardiovascular Diseases” Program (Director, Prof. Paolo Zamboni) are also involved in the treatment of this pathology.
In the photo, from left: Elena Satta, Daniele Deplano, Piergiorgio Gaudenzi, Lisa Giusto