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I hope you all don't mind my putting my two cents. I don't admit all patients with DVT, unless the larger veins are involved and the clot appears mobile or incompletely adherent to the vein wall. Many patients can be managed by putting them on Lovenox and Coumadin simultaneously and told to limit activity until PT and INR are at therapeutic levels. They are also put into good graduated compression support hose. Obviously there are occasionally those patients that are thought to be noncompliant and these need to be admitted and observed until PT/INR are in therapeutic range. For the real bad ones i've had our interventional radiologist stick a catheter in the popliteal vein and infuse TPA to dissolve the clot. Although there is a possible risk of causing a PE, I've not had this happen--yet.
 
Dr.Szarnicki
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