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Deep vein thrombosis: a clinical review.
MedLine Citation:
PMID:  22287864     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Emeka Kesieme; Chinenye Kesieme; Nze Jebbin; Eshiobo Irekpita; Andrew Dongo
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Publication Detail:
Type:  Journal Article     Date:  2011-04-29
Journal Detail:
Title:  Journal of blood medicine     Volume:  2     ISSN:  1179-2736     ISO Abbreviation:  J Blood Med     Publication Date:  2011  
Date Detail:
Created Date:  2012-01-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101550884     Medline TA:  J Blood Med     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  59-69     Citation Subset:  -    
Affiliation:
Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria;
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