-
Clinics in Chest Medicine Sep 2018Overdiagnosis of venous thromboembolism is associated with increasing numbers of patient complications and health care burden. Multiple clinical tools exist to estimate... (Review)
Review
Overdiagnosis of venous thromboembolism is associated with increasing numbers of patient complications and health care burden. Multiple clinical tools exist to estimate the probability of pulmonary embolism and deep venous thrombosis. When used with d-dimer testing, these can further stratify venous thromboembolism risk to help inform the use of additional diagnostic testing. Although there are similar tools to estimate bleeding risk, these are not as well-validated and lack reliability.
Topics: Hemorrhage; Humans; Probability; Pulmonary Embolism; Venous Thromboembolism; Venous Thrombosis
PubMed: 30122172
DOI: 10.1016/j.ccm.2018.04.001 -
The American Journal of Medicine May 2011Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with... (Review)
Review
Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.
Topics: Anticoagulants; Humans; Incidence; Lower Extremity; Prognosis; Pulmonary Embolism; Recurrence; Risk Factors; Upper Extremity Deep Vein Thrombosis; Venous Thrombosis
PubMed: 21531227
DOI: 10.1016/j.amjmed.2010.11.022 -
Forensic Science, Medicine, and... Mar 2019Deep vein thrombosis resulting in lethal pulmonary thromboembolism is not-infrequently encountered in forensic cases. Predisposing factors include immobility, recent...
Deep vein thrombosis resulting in lethal pulmonary thromboembolism is not-infrequently encountered in forensic cases. Predisposing factors include immobility, recent surgery, previous deep venous thromboses/pulmonary thromboembolism, indwelling central venous lines, major trauma, the oral contraceptive pill, pregnancy, congenital cardiac disease, sepsis, malignancy, systemic lupus erythematosus, renal failure and certain inherited thrombophilias. Venous thrombosis associated with air travel was reported in the early 1950's and called the "economy class syndrome", although it is now recognized that reduced movement on long distance flights is more significant than seating class. Long-distance flights of eight hours or more are associated with a two to fourfold increase in the risk of deep venous thrombosis, but only in those individuals who have underlying risk factors. With increasing numbers of flights of more than 16 h duration forensic pathologists are well placed to monitor the potential impact of extended flying on the incidence of lethal pulmonary thromboembolism.
Topics: Air Travel; Forensic Medicine; Humans; Pulmonary Embolism; Risk Factors; Venous Thrombosis
PubMed: 29948593
DOI: 10.1007/s12024-018-9991-9 -
European Journal of Preventive... May 2022
Topics: Aorta; Consensus; Humans; Neoplasms; Peripheral Vascular Diseases; Pulmonary Circulation; Vascular Diseases; Venous Thrombosis; Ventricular Function, Right
PubMed: 34463767
DOI: 10.1093/eurjpc/zwab117 -
Annals of Internal Medicine May 2015This issue provides a clinical overview of deep venous thrombosis, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is... (Review)
Review
This issue provides a clinical overview of deep venous thrombosis, focusing on prevention, diagnosis, treatment, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic.
Topics: Female; Humans; Patient Care; Patient Education as Topic; Pregnancy; Quality of Health Care; Risk Factors; Venous Thrombosis
PubMed: 25939012
DOI: 10.7326/AITC201505050 -
Seminars in Thrombosis and Hemostasis Oct 2006About 10% of all episodes of venous thrombosis are due to upper extremity deep vein thrombosis (UEDVT). Associated risk factors are indwelling central venous catheters,... (Review)
Review
About 10% of all episodes of venous thrombosis are due to upper extremity deep vein thrombosis (UEDVT). Associated risk factors are indwelling central venous catheters, cancer, and coagulation defects; 20% of the episodes are unexplained. The onset of UEDVT is usually heralded by complaints such as arm swelling and pain, but may also be completely asymptomatic, especially in carriers of central venous lines. Objective confirmation is mandatory prior to instituting anticoagulation because the clinical diagnosis is unreliable; ultrasound-based methods represent the preferred diagnostic approach. Prophylaxis with low-dose heparin or low-dose warfarin may be used, especially in carriers of central venous catheters, although its efficacy is still uncertain. Unfractionated or low molecular weight heparins followed by oral anticoagulants should be regarded as the treatment of choice, whereas thrombolysis and surgery may be indicated in selected cases. Up to one third of the patients develop pulmonary embolism that may be fatal; postthrombotic syndrome and recurrent thromboembolism are also frequent complications. UEDVT should no longer be regarded as a rare and benign disease, as reported previously.
Topics: Arm; Blood Coagulation Disorders; Catheterization, Central Venous; Humans; Neoplasms; Risk Factors; Venous Thrombosis
PubMed: 17024601
DOI: 10.1055/s-2006-951458 -
The Orthopedic Clinics of North America Jul 2020When the guidelines of the North American Spine Society concerning deep venous thrombosis (DVT) prophylaxis were followed, only 2 (0.63%) of 315 patients with minimally... (Review)
Review
When the guidelines of the North American Spine Society concerning deep venous thrombosis (DVT) prophylaxis were followed, only 2 (0.63%) of 315 patients with minimally invasive transforaminal lumbar interbody fusions developed DVT complications over a 9-year period. Based on these findings, mechanical DVT prophylaxis appears to be adequate in patients undergoing elective spinal surgery, with no current support for pharmacologic prophylaxis.
Topics: Aged; Humans; Lumbar Vertebrae; Male; Minimally Invasive Surgical Procedures; Pulmonary Embolism; Risk Factors; Spinal Fusion; Spinal Stenosis; Spondylolisthesis; Venous Thrombosis
PubMed: 32498960
DOI: 10.1016/j.ocl.2020.02.006 -
Deutsche Medizinische Wochenschrift... Mar 2001
Comparative Study Review
Topics: Anticoagulants; Follow-Up Studies; Humans; Incidence; Leg; Meta-Analysis as Topic; Muscle, Skeletal; Phlebography; Popliteal Vein; Prevalence; Sensitivity and Specificity; Time Factors; Ultrasonography, Doppler, Duplex; Venous Thrombosis
PubMed: 11332232
DOI: 10.1055/s-2001-12388 -
The British Journal of General Practice... Feb 2011
Topics: Fibrin Fibrinogen Degradation Products; General Practice; Humans; Point-of-Care Systems; Venous Thrombosis
PubMed: 21276343
DOI: 10.3399/bjgp11X556308 -
Seminars in Thrombosis and Hemostasis Feb 2002Upper extremity deep venous thrombosis (UEDVT) makes up approximately 1-4% of all episodes of deep venous thrombosis (DVT). Risk factors for UEDVT include central venous... (Review)
Review
Upper extremity deep venous thrombosis (UEDVT) makes up approximately 1-4% of all episodes of deep venous thrombosis (DVT). Risk factors for UEDVT include central venous catheterization, strenuous upper extremity exercise or anatomic abnormalities causing venous compression, inherited thrombophilia, and acquired hypercoagulable states including pregnancy, oral contraceptive use, and cancer. Unexplained or recurrent UEDVT should prompt a search for inherited hypercoagulable states or underlying malignancy. Clinical presentations include arm, neck, and shoulder pain; edema; skin discoloration; tenderness; and venous distension. Because UEDVT is frequently asymptomatic until complications ensue, a high index of suspicion is required for patients with one or more risk factors for thrombosis. Pulmonary embolism and post-thrombotic syndrome are the most common sequelae of UEDVT. Early detection and treatment of UEDVT decrease complications, morbidity, and mortality. Compressive ultrasonography is an effective and economical means of confirming the clinical diagnosis in most patients. Traditional anticoagulant therapy of UEDVT is giving way to a multimodal approach involving transcatheter thrombolytic therapy followed by a minimum of 3 months of warfarin sodium anticoagulant therapy, venous decompression as needed, and balloon angioplasty with stenting for treatment of residual stricture. Low-dose anticoagulant therapy can safely and effectively mitigate the increased risk of UEDVT associated with the use of central venous catheters.
Topics: Arm; Catheterization; Humans; Risk Factors; Thoracic Outlet Syndrome; Thrombophilia; Venous Thrombosis
PubMed: 11885029
DOI: 10.1055/s-2002-20567