![]() ![]() ![]() It is because of this confusing nomenclature that many identify the CFV and SFV as just the femoral vein. The DFV is a smaller superficial structure and therefore is not part of the deep venous system. The CFV and SFV make up the deep venous system in the upper lower extremity as they are the larger more central vessels in the leg. It is important to note the use of the correct anatomic nomenclature of lower extremity vasculature can be misleading clinically. After passing through the adductor canal, the SFV becomes the popliteal vein, which subsequently trifurcates into the anterior tibial, posterior tibial, and peroneal veins. After these branch off the CFV, the CFV becomes the superficial femoral vein (SFV), which is the main deep vein of the lower leg. The greater saphenous vein and the deep femoral vein (DFV) branch off medially and laterally, respectively. The common femoral vein (CFV) starts at the inguinal ligament and bifurcates twice. Two-point compression has been widely accepted as a rapid way to assess for DVT in patients with a low pretest probability, making this an even more rapid way to assess for DVT than the complete assessment at the bedside. If this is possible, this would significantly be able to improve emergency department throughput times for the most common type of DVT. Recently, a few studies have demonstrated that well-trained emergency and critical care physicians can complete bedside ultrasonography for lower extremity DVT with sensitivities and specificities of 95% and 96%, respectively. The classic method is elective ultrasound performed by trained ultrasound technologist and read by radiology. There are two main ways that ultrasound can be used to diagnose a DVT. However, ultrasound is the most accurate non-invasive test to diagnose DVT. Venogram remains the "gold standard" for diagnosis of DVT. However, empiric treatment with anticoagulation also comes with a high risk and cost to the patient. When a patient presents with findings consistent with DVT, it is important to make an accurate diagnosis, as the risk of failing to treat the condition involves pulmonary embolism (PE), superior vena cava syndrome (SVCS), and associated complications including death. Clinical diagnosis is unreliable due to the infrequency of the classic findings of edema, warmth, erythema, pain, and tenderness, which are present only in 23% to 50% of patients. Deep venous thrombosis (DVT) is a common condition that appears in the emergency department and outpatient settings. ![]()
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