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- Title
Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome.
- Authors
Lowe, G. D. O.
- Abstract
The post-thrombotic syndrome (PTS) is the major chronic sequel of deep vein thrombosis (DVT) of the leg, and is a major socioeconomic challenge. In addition to systematic prophylaxis of DVT in hospitalized patients, effective management of DVT is important to reduce the incidence of PTS. Thrombolysis and thrombectomy are not indicated routinely. Optimal anticoagulation, usually with heparins initially and then with oral warfarin, is important to prevent recurrent DVT, which is a major risk factor for PTS. Following a routine three-month period of anticoagulation, patients with proximal idiopathic DVT should be individually assessed for the benefits and risks of continued oral anticoagulation, including patient preferences. Risk factors for recurrent DVT include active cancer, pregnancy, continued use of oral oestrogens, male sex, obesity, recurrent thrombosis, established PTS, permanent inferior vena caval filters, residual DVT, high fibrin D-dimer and other thrombophilias. Early walking, continued high levels of physical activity and wearing compression stockings for up to two years may also reduce the risk of PTS.
- Subjects
PULMONARY embolism prevention; VENOUS thrombosis prevention; VENOUS thrombosis risk factors; VENOUS thrombosis treatment; COMPRESSION stockings; BLOOD coagulation tests; EXERCISE; HEMORRHAGE; HEPARIN; HEALTH outcome assessment; VENOUS thrombosis; THROMBOSIS; VEIN surgery; WARFARIN; DISEASE relapse; TREATMENT effectiveness; COMPRESSION therapy
- Publication
Phlebology, 2010, Vol 25, p9
- ISSN
0268-3555
- Publication type
Article
- DOI
10.1258/phleb.2010.010s02