Document Detail


Isolated Distal DVT: what we Know and What we are Doing.
MedLine Citation:
PMID:  22082302     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Thromboses limited to the infra-popliteal deep veins of the lower limbs (Isolated distal deep vein thrombosis, IDDVT) are frequently diagnosed in subjects with suspected pulmonary embolism (PE; 7%-10%) or DVT (4%-15%), accounting for 31%-56% of all diagnosed leg DVTs. Despite their frequency IDDVTs still remain one of the most debated issues in the field of venous thromboembolism (VTE). Conflicting clinical results have prompted differing opinions on the need to test for IDDVTs and to treat them. Due to discordant results the real risk of IDDVT-associated PE is not well established. IDDVTs are associated with lower risk of recurrence versus other VTEs and less late sequelae than proximal DVT. Diagnosis is based on ultrasound examination of all calf veins, which is more operator-dependent and less sensitive than proximal vein examination. A series of studies has shown, however, that a single complete ultrasound strategy in symptomatic patients has comparable clinical results as serial proximal ultrasound, allowing approximately 15% better DVT diagnosis. Optimal treatment of IDDVT is still controversial. Guidelines recommend anticoagulation for 12 weeks, though 6 weeks may be sufficient. There is however no sufficient proof that all IDDVTs need to be diagnosed and anticoagulated, and criteria to identify subjects at higher risk of complication are lacking. It also seems likely that different approaches may be better for unprovoked or secondary events and for deep or muscle veins. Specifically designed and adequately powered clinical studies addressing the issue of IDDVT need to be urgently undertaken.
Authors:
G Palareti; S Schellong
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-14
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 International Society on Thrombosis and Haemostasis.
Affiliation:
Dept of Angiology & Blood Coagulation, University Hospital of Bologna, Italy Medical Department 2, Municipal Hospital Dresden-Friedrichstadt, Dresden, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effect of an intervention combining self-efficacy theory and pedometers on promoting physical ac...
Next Document:  Alkalinized Lidocaine and Heparin Provide Immediate Relief of Pain and Urgency in Patients with Inte...