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Related Experiment Videos

Venous thrombosis in children.

A K Chan1, G Deveber, P Monagle

  • 1Department of Pediatrics, Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.

Journal of Thrombosis and Haemostasis : JTH
|July 23, 2003
PubMed
Summary

Pediatric venous thromboembolic (VTE) events, including systemic and cerebral types, are rising. More research is needed to establish optimal diagnosis and treatment for these serious pediatric conditions.

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Area of Science:

  • Pediatric Hematology
  • Vascular Medicine
  • Neurology

Background:

  • Venous thromboembolic (VTE) events are increasingly diagnosed in children, both systemically and cerebrally.
  • Advances in pediatric critical care have led to improved survival, increasing the incidence of VTE.
  • Central venous lines are a primary risk factor for systemic VTE in children over 3 months old.

Purpose of the Study:

  • To review the current understanding of pediatric venous thromboembolic events, including systemic VTE and cerebral sinovenous thrombosis (CSVT).
  • To highlight diagnostic and treatment challenges and identify areas requiring further clinical research.
  • To emphasize the urgent need for well-designed clinical trials in pediatric VTE and CSVT.

Main Methods:

  • Review of international registries and existing clinical studies on pediatric systemic VTE.

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  • Analysis of data from the Canadian Pediatric Ischaemic Stroke Registry for childhood CSVT.
  • Identification of diagnostic methods and treatment approaches based on available literature.

    • Main Results:

    • Teenagers represent the largest group of children over 3 months old experiencing VTE, with central venous lines being the most common cause.
    • Ultrasound and venography are effective for upper system VTE, but optimal methods for lower system VTE and pulmonary embolism (PE) remain unclear.
    • CSVT diagnosis is improving due to better imaging and recognition of subtle symptoms; however, evidence-based diagnostic and treatment guidelines are lacking.

    Conclusions:

    • There is a growing need for robust clinical trials to establish best practices for diagnosing, treating, and managing pediatric systemic VTE/PE and CSVT.
    • Current treatment studies for VTE are limited by small sample sizes and inadequate power.
    • Long-term outcomes like post-thrombotic syndrome are reported, underscoring the importance of effective management strategies.