Table 3 Management of patients with venous gangrene

   • Full Blood Count looking at the platelets count

   • INR

   • D-dimers

   • Anticardiolipin antibody levels

   • Protein C & S levels

   • Venous doppler/venography

   • Arterial pulses (palpation or by hand-held doppler)

Treatment

   • Stop warfarin

   • Start LMWH or DTI is cases of proven HIT

   • Limb elevation to decrease the swelling

   • Good nutrition and hydration of the patient

   • Treatment of the underlying malignancy

   • Venous thrombectomy or intrathrombus catheter-directed thrombolysis