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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
Deep vein thrombosis: a clinical review
Emeka Kesieme1, Chinenye Kesieme, Nze Jebbin
1Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria;
Insights
Deep vein thrombosis (DVT) involves blood clots in deep veins, often in the legs or pelvis. Early diagnosis and treatment, including anticoagulants, are crucial for preventing serious complications like pulmonary embolism.
Area of Science:
- Vascular Medicine
- Hematology
Background:
- Deep vein thrombosis (DVT) is the formation of blood clots in deep veins, commonly affecting leg and pelvic veins.
- It is a significant cause of preventable morbidity and mortality.
Purpose of the Study:
- To provide an updated overview of the causes and management strategies for DVT.
Main Methods:
- Literature review utilizing Medline, medical libraries, and Google search.
Main Results:
- DVT affects 0.1% of the population annually, primarily impacting the elderly with a slight male predominance.
- Diagnostic algorithms combine pretest probability, D-dimer testing, and ultrasonography.
- Prophylaxis includes mechanical and pharmacological methods; treatment aims to prevent clot extension, pulmonary embolism, and recurrence.
Conclusions:
- DVT presents numerous risk factors, making prophylaxis essential.
- Anticoagulant therapy, including traditional options and newer direct oral anticoagulants (DOACs) like dabigatran, rivaroxaban, and apixaban, forms the cornerstone of DVT management.
- Thrombolytics and vena caval filters are reserved for rare, specific circumstances.
Background:
Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein) or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.
Aim:
To present an update on the causes and management of DVT.
Methods:
A review of publications obtained from Medline search, medical libraries, and Google.
Results:
DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.
Conclusion:
DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran) and selective factor Xa inhibitors (rivaroxaban and apixaban). Others are currently undergoing trials. Thrombolytics and vena caval filters are very rarely indicated in special circumstances.
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