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Annals of Internal Medicine Sep 2022Venous thromboembolism (VTE) is the third most common cardiovascular disorder, affecting up to 5% of the population. VTE commonly manifests as lower-extremity deep... (Review)
Review
Venous thromboembolism (VTE) is the third most common cardiovascular disorder, affecting up to 5% of the population. VTE commonly manifests as lower-extremity deep venous thrombosis (DVT) or pulmonary embolism. Half of these events are associated with a transient risk factor and may be preventable with prophylaxis. Direct oral anticoagulants are effective and safe and carry a lower risk for bleeding than vitamin K antagonists. Many patients with VTE will have a chronic disease requiring long-term anticoagulation. Postthrombotic syndrome affects 25% to 40% of patients with DVT and significantly impacts function and quality of life.
Topics: Anticoagulants; Humans; Quality of Life; Venous Thromboembolism; Venous Thrombosis; Vitamin K
PubMed: 36095313
DOI: 10.7326/AITC202209200 -
Clinical and Experimental Medicine Jul 2023Deep venous thrombosis is a frequent, multifactorial disease and a leading cause of morbidity and mortality. Most of the time deep venous thrombosis is triggered by the... (Review)
Review
Deep venous thrombosis is a frequent, multifactorial disease and a leading cause of morbidity and mortality. Most of the time deep venous thrombosis is triggered by the interaction between acquired risk factors, such as hip fracture, pregnancy, and immobility, and hereditary risk factors such as thrombophilias. The mechanisms underlying deep venous thrombosis are not fully elucidated; however, in recent years, important advances have shed light on the role of venous flow, endothelium, platelets, leukocytes, and the interaction between inflammation and hemostasis. It has been described that the alteration of venous blood flow produces endothelial activation, favoring the adhesion of platelets and leukocytes, which, through tissue factor expression and neutrophil extracellular traps formation, contribute to the activation of coagulation, trapping more cells, such as red blood cells. Thus, the concerted interaction of these phenomena allows the formation and growth of the thrombus. In this work, the main mechanisms involved in the pathophysiology of deep vein thrombosis will be described.
Topics: Humans; Venous Thrombosis; Blood Platelets; Blood Coagulation; Leukocytes; Inflammation
PubMed: 35471714
DOI: 10.1007/s10238-022-00829-w -
International Journal of Molecular... Apr 2021Venous thromboembolism, a complex disease combining deep vein thrombosis (DVT) and its most dangerous complication, pulmonary embolism (PE), strikes millions of people...
Venous thromboembolism, a complex disease combining deep vein thrombosis (DVT) and its most dangerous complication, pulmonary embolism (PE), strikes millions of people worldwide [...].
Topics: Biomarkers; Disease Management; Disease Susceptibility; Humans; Venous Thrombosis
PubMed: 33917767
DOI: 10.3390/ijms22083853 -
VASA. Zeitschrift Fur Gefasskrankheiten Sep 2021Post-thrombotic syndrome (PTS) is a chronic venous insufficiency manifestation following an episode of deep-vein thrombosis (DVT). It is an important and frequent...
Post-thrombotic syndrome (PTS) is a chronic venous insufficiency manifestation following an episode of deep-vein thrombosis (DVT). It is an important and frequent long-term adverse event of proximal DVT affecting 20-50% of patients. This position paper integrates data guiding clinicians in deciding PTS diagnosis, treatment and follow-up.
Topics: Humans; Postthrombotic Syndrome; Venous Insufficiency; Venous Thrombosis
PubMed: 33720757
DOI: 10.1024/0301-1526/a000946 -
Minerva Medica Dec 2021Cerebral venous thrombosis (CVT) is a rare form of deep venous thrombosis (DVT), yet a leading cause of stroke in young adults, with an incidence that seems to be... (Review)
Review
Cerebral venous thrombosis (CVT) is a rare form of deep venous thrombosis (DVT), yet a leading cause of stroke in young adults, with an incidence that seems to be increasing in recent years. Risk factors for CVT overlap with those of DVT in other locations, with the addition of local risk factors, such as infections, head trauma and neurosurgery. The clinical presentation is highly variable, hence the diagnosis of CVT may be delayed or overlooked. Early recognition and timely initiation of anticoagulant treatment are of essence, while decompressive surgery can be lifesaving for patients with impending trans-tentorial herniation. Concomitant intracranial hemorrhage is not a contraindication to anticoagulant treatment. Endovascular treatment may be suggested for selected patients who deteriorate despite anticoagulant treatment. In this review we will provide an extensive and contemporary discussion of the incidence, pathophysiology, risk factors, clinical presentation, neuroimaging and management of CVT, in accordance with recent guidelines. Additionally, we will summarize the latest data with regards to direct oral anticoagulants (DOACs) treatment in CVT.
Topics: Anticoagulants; Humans; Intracranial Thrombosis; Venous Thrombosis
PubMed: 33555165
DOI: 10.23736/S0026-4806.21.07353-5 -
The Journal of Cardiovascular Surgery Oct 2021Compression of the left common iliac vein by the overlying right common iliac artery is a benign anatomic abnormality in most individuals. However, in patients with... (Review)
Review
Compression of the left common iliac vein by the overlying right common iliac artery is a benign anatomic abnormality in most individuals. However, in patients with significant vein compression, outflow obstruction and chronic intraluminal venous damage may lead to May-Thurner Syndrome. This syndrome commonly manifests as unilateral left leg swelling or acute iliofemoral deep venous thrombosis. In addition to clinical findings, diagnosis is made with ultrasound, computed tomography venography, or magnetic resonance venography. The extent of compression of the iliac vein is best determined by venography with intravascular ultrasound. Symptoms and hemodynamic significance of the compression guides the ideal treatment approach. Iliocaval stenting has become the standard treatment for this condition and has promising patency rates and clinical outcomes. This review paper provided an overview of pathophysiology, and utility and limitations of the existing diagnostic modalities and treatment options in the management of May-Thurner Syndrome.
Topics: Angioplasty, Balloon; Humans; Iliac Vein; May-Thurner Syndrome; Recurrence; Stents; Thrombolytic Therapy; Treatment Outcome; Venous Thrombosis
PubMed: 33870678
DOI: 10.23736/S0021-9509.21.11889-0 -
JAAPA : Official Journal of the... Mar 2022
Topics: Humans; Risk Factors; Venous Thrombosis
PubMed: 35192556
DOI: 10.1097/01.JAA.0000819540.23572.34 -
The Surgical Clinics of North America Dec 2021There have been significant advances in vascular surgery in recent years. These advances include procedural techniques, choice of procedure, and application of... (Review)
Review
There have been significant advances in vascular surgery in recent years. These advances include procedural techniques, choice of procedure, and application of nonoperative management. Endovascular techniques have expanded greatly over the past decade. As a result, for many clinical scenarios there is more than 1 option for management, which has given rise to controversies in the choice of best management. This article reviews current controversies in the management of carotid artery disease, abdominal aortic aneurysms, acute deep venous thrombosis, and inferior vena cava filter placement.
Topics: Acute Disease; Anticoagulants; Aortic Aneurysm; Blood Vessel Prosthesis Implantation; Carotid Artery Diseases; Endovascular Procedures; Humans; Thrombolytic Therapy; Vascular Surgical Procedures; Vena Cava Filters; Venous Thrombosis
PubMed: 34774271
DOI: 10.1016/j.suc.2021.06.007 -
Frontiers in Immunology 2023Deep venous thrombosis (DVT) is a part of venous thromboembolism (VTE) that clinically manifests as swelling and pain in the lower limbs. The most serious clinical... (Review)
Review
Deep venous thrombosis (DVT) is a part of venous thromboembolism (VTE) that clinically manifests as swelling and pain in the lower limbs. The most serious clinical complication of DVT is pulmonary embolism (PE), which has a high mortality rate. To date, its underlying mechanisms are not fully understood, and patients usually present with clinical symptoms only after the formation of the thrombus. Thus, it is essential to understand the underlying mechanisms of deep vein thrombosis for an early diagnosis and treatment of DVT. In recent years, many studies have concluded that Neutrophil Extracellular Traps (NETs) are closely associated with DVT. These are released by neutrophils and, in addition to trapping pathogens, can mediate the formation of deep vein thrombi, thereby blocking blood vessels and leading to the development of disease. Therefore, this paper describes the occurrence and development of NETs and discusses the mechanism of action of NETs on deep vein thrombosis. It aims to provide a direction for improved diagnosis and treatment of deep vein thrombosis in the near future.
Topics: Humans; Extracellular Traps; Neutrophils; Lower Extremity; Pain; Venous Thrombosis
PubMed: 37680629
DOI: 10.3389/fimmu.2023.1198952 -
Vascular Medicine (London, England) Dec 2023The spectrum of venous thromboembolic (VTE) disease encompasses both acute deep venous thrombosis (DVT) and chronic postthrombotic changes (CPC). A large percentage of... (Review)
Review
The spectrum of venous thromboembolic (VTE) disease encompasses both acute deep venous thrombosis (DVT) and chronic postthrombotic changes (CPC). A large percentage of acute DVT patients experience recurrent VTE despite adequate anticoagulation, and may progress to CPC. Further, the role of iliocaval venous obstruction (ICVO) in lower-extremity VTE has been increasingly recognized in recent years. Imaging continues to play an important role in both acute and chronic venous disease. Venous duplex ultrasound remains the gold standard for diagnosing acute VTE. However, imaging of CPC is more complex and may involve computed tomography, magnetic resonance, contrast-enhanced ultrasound, or intravascular ultrasound. In this narrative review, we aim to discuss the full spectrum of venous disease imaging for both acute and chronic venous thrombotic disease.
Topics: Humans; Venous Thromboembolism; Veins; Venous Thrombosis; Lower Extremity; Chronic Disease; Acute Disease; Postthrombotic Syndrome
PubMed: 37792749
DOI: 10.1177/1358863X231198069