Start Submission Become a Reviewer

Reading: Deep Venous Thrombosis: Prevention and Treatment

Download

A- A+
Alt. Display

Review Articles

Deep Venous Thrombosis: Prevention and Treatment

Author:

Mark G. Davies

Methodist DeBakey Heart & Vascular Center, Houston, Texas, US
About Mark G.
M.D., Ph.D., M.B.A.
X close

Abstract

Introduction

Venous thromboembolic diseases comprise the spectrum from deep vein thrombosis (DVT) to pulmonary embolism (PE) and have an incidence of approximately 1 per 1,000 annually in adult populations.1 Rates are slightly higher in men than women. About two-thirds of episodes manifest as DVT and one-third as PE with or without DVT. The major outcomes of venous thrombosis are death, recurrence, post-thrombotic syndrome, and major bleeding due to anticoagulation. Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops.2 Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE.3 The mortality rate for PE is estimated to be as high as 30% in studies that included autopsy-based PE diagnosis.4 Mortality rates are lower among patients with idiopathic venous thrombosis and highest among those whose thrombosis occurs in the setting of cancer. Venous thrombosis increases in incidence with age, with a low rate of about 1 per 10,000 annually before the fourth decade of life, rising rapidly after age 45 years and approaching5-6 per 1000 annually by age 80.5, 6 Aging is associated with a steeper rise in incidence of PE as compared to DVT. Morbidity from venous thromboembolic disease appears to be greater in the elderly.5

Lower limb: There are more than a quarter-million hospital admissions each year in the United States for acute lower-extremity DVT and PE.7-9 In hospital patients without prophylaxis, it is estimated that the incidence of isolated calf DVT and proximal DVT is 25% and 7%, respectively.9, 10 When thrombosis is proximal to the calf, there is a 50% likelihood of pulmonary embolism. There are geographical differences in reports on DVT, with up to twice the reported incidence of calf DVT coming from Europe compared to North America.10

Upper limb: Upper-extremity venous thrombosis represents 0.5 to 1.5% of all venous thromboses. The primary form of the disease also is known as “effort thrombosis” or Paget-Schroetter disease. The secondary form of the disease is most commonly a result of central venous catheterization for central venous or cardiac access. Iatrogenic causes of secondary venous thrombosis account for up to 30% of symptomatic subclavian venous thromboses.11 In addition, studies have shown that clinically silent thrombosis may occur in 20-30% of patients after central venous catheter insertion.12, 13

How to Cite: 1. Davies MG. Deep Venous Thrombosis: Prevention and Treatment. Methodist DeBakey Cardiovascular Journal. 2009;5(4):25-31. DOI: http://doi.org/10.14797/mdcvj.179
Published on 01 Jan 2009.
Peer Reviewed

Downloads

  • PDF (EN)