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This article has been cited by other articles in PMC. 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.
To present an update on the causes and management of DVT. A review of publications obtained from Medline search, medical libraries, and Google. 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.
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. When this process occurs within the deep veins, it is referred to as deep vein thrombosis DVT. An accurate diagnosis of DVT is extremely important to prevent potentially fatal acute complication of pulmonary embolism PE and long-term complications of postphlebitis syndrome and pulmonary hypertension.
It is also important to avoid unjustified therapy with anticoagulants with associated high risk of bleeding in patients misdiagnosed with the condition.
We aim to critically review the current state of knowledge on this subject, with a view to updating clinicians on the prophylaxis and treatment of DVT. Methods A literature review of DVT was done from to date using a manual library search, journal publications on the subject, and Medline.
Full texts of the materials, including those of relevant references were collected and studied. Information relating to the epidemiology, pathology, clinical presentation, investigations, prophylaxis, treatment, and complications was extracted from the materials.
Results Epidemiology DVT is a major and a common preventable cause of death worldwide. It affects approximately 0. The overall average age- and sex-adjusted annual incidence of venous thromboembolism VTE is perDVT, 48 per ,; PE, 69 per, with higher age-adjusted rates among males than females vs per , respectively.
The risk of recurrence in Caucasians is lower than that of African-Americans and Hispanics. Annual incidences of 0. The highest incidence in childhood is during the neonatal period, followed by another peak in adolescence.
This is especially true for those that occur following surgery. Lending its support to the origin of thrombus in valve pockets is a recent hypothesis of an increased expression of endothelial protein C receptor EPCR and thrombomodulin TM and a decreased expression of Von Willebrand factor vWF noted in valve sinus endothelium compared with vein luminal endothelium.
Venous thrombus must be differentiated from postmortem clot at autopsy. Postmortem clots are gelatinous and have a dark red dependent portion formed by red cells that have settled by gravity and a yellow chicken fat supernatant resembling melted and clotted chicken fat.
They are usually not attached to the underlying wall. This is in contrast to the venous thrombi which are firmer.
They almost always have a point of attachment to the wall and transection reveals vague strands of pale gray fibrin.
Clinically, proximal vein thrombosis is of greater importance and is associated with serious chronic diseases such as active cancer, congestive cardiac failure, respiratory insufficiency, or age above 75 years, whereas distal thrombosis is more often associated with risk factors such as recent surgery and immobilization.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. Homepage Epidemiology Biostatistics Genetic Epidemiology Glossary. BIAS & CONFOUNDING.
vetconnexx.com DORAK. Bias and Confounding Lecture (PPT) Introduction. In epidemiologic research, it is essential to avoid bias, to control confounding and to undertake accurate replication.
Deep venous thrombosis Deep venous thrombosis is a blood clot that forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh. Causes When a clot breaks off and moves through the bloodstream, this is called an embolism.
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Peripheral artery disease (PAD) is a common circulatory disorder that reduces blood flow to the legs and feet. Symptoms are often mistaken as normal signs of aging, when in reality more serious. Apr 29, · 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.