deep vein thrombosis (DVT)
Jump to navigation
Jump to search
[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91]
Introduction
Deep vein thrombosis (DVT) is the clotting of blood in the deep veins of the leg or arm, generally accompanied by inflammation (thrombophlebitis). Also see venous thromboembolism.
Etiology
risk factors <odds ratio in parenthesis>
- immobilization (8.0), hospitalization
- long-distance travel (prolonged sitting)[13][28]
- major surgery (21.7)
- orthopedic surgery
- knee or hip surgery
- 50% incidence of postoperative DVT without prophylaxis
- mean times to DVT post-surgery[18]
- knee replacement: 2 weeks
- hip fracture: 3 weeks
- total hip replacement: 4 weeks
- knee replacement: 2 weeks
- abdominal or pelvic surgery
- thoracic surgery
- orthopedic surgery
- neoplasms, esp. adenocarcinoma (5,6,24)
- pregnancy
- pharmaceutical agents
- hypercoagulable states
- factor V Leiden associated with 5-fold risk for 1st DVT but only 1.5-fold increased risk for recurrent DVT[5]
- previous DVT
- venulitis
- chemical
- chemotherapy
- radiocontrast
- vasopressors
- infectious
- thromboangiitis obliterans (Buerger's disease)
- Behcet syndrome
- chemical
- varicose veins (RR=5.3)[79]
- polycythemia
- nephrotic syndrome
- congestive heart failure
- inflammatory bowel disease
- advanced age
- trauma (12.7)
- fractures of the spine, pelvis, femur, tibia
- injuries of the spinal cord, head & chest
- obesity (3.9)
- infection
- QThrombosis (DVT/VTE risk calculator)
Epidemiology
Pathology
- calf DVT affecting the tibial, peroneal, gastrocnemius & soleal veins occurs more frequently than proximal DVT
- 20% of calf DVTs propagate to proximal DVT affecting the popliteal, femoral & iliac veins
- intrinsic pathway may play a role
- FXI-ASO, siRNA reducing level of factor XI, prevents DVT after total knee arthroplasty better than enoxaparin (see FXI-ASO)
- proximal DVTs involve superficial collateral veins
Clinical manifestations
- Symptoms:
- acute onset of unilateral leg swelling
- exacerbation of pain with weight-bearing or ambulation
- pain described as tight, aching, deep or vice-like
- (see thrombophlebitis)
- Signs:
- asymmetry
- swelling
- unilateral edema
- begins in the foot & ankle
- progresses upward depending upon extent of thrombosis
- edema is pitting
- an 'orange peel' consistency develops when venous return is severely inhibited
- compare extremity circumference by measurement above & below the knee
- calf circumference > 3 cm difference between lower legs
- tenderness
- extremity may be warm
- extremity may be red, cyanotic or discolored
- Homan's sign (unreliable)
- venous collaterals
- palpable cord
- fever
- asymmetry
- pain, edema, cyanosis, & arterial compromise suggest proximal DVT
- massive proximal DVTs involve both deep veins & collateral veins
- increased venous stasis, extravasation of venous fluid into the interstitium, painful swelling & violaceous changes
- extremity may be cool & tender to palpation
- also see complications
- see phlegmasia cerulea dolens
Laboratory
- D-dimer by ELISA or Liatest
- may be useful for assessment of DVT with low-moderate pretest probability[2][5]
- patients with normal plasma D-dimer & low probability Well's rule or primary care rule do not need imaging studies[5][60] even if there are no alternative diagnoses[5]
- cutoff level 400 ng/mL
- 500 ng/mL moderate risk patients; 1000 ng/mL low risk patients (risk from Wells prediction score)[45]
- 95% sensitive for proximal DVT
- a negative test with low pre-test probability effectively rules out DVT
- 35% specificity
- a positive test requires confirmation
- in combination with ultrasound[15]
- first test of choice in low risk patients[5]
- probably unnecessary for high-risk patients
- proceed directly to ultrasound[45]
- may be useful for assessing risk of recurrent DVT after anticoagulation is stopped[5][19]
- may be useful for assessment of DVT with low-moderate pretest probability[2][5]
- fecal occult blood
- complete blood count
- serum chemistries
- prostate-specific antigen (PSA) for unprovoked DVT
- serum Ca+2 & serum albumin
- Pap Smear for unprovoked DVT in women[62]
- hypercoagulability workup
- not routinely indicated[5][75]
- target testing of high-risk patients
- indications:
- idiopathic DVT
- recurrent DVT
- family history of venous thromboembolism
- setting of thrombotic event, provoked vs unprovoked, provides greater prognostic information than does hypercoagulability workup[5]
- results of hypercoagulability workup generally do not influence treatment or duration of treatment[5]
- see criteria for hypercoagulability workup
- not routinely indicated[5][75]
- monitor platelet count along with INR in patients treated with warfarin[61]
- see ARUP consult[42]
Radiology
- obtain imaging if Wells score (DVT) > 1[5]
- non-invasive tests
- ultrasound*[15][17]
- Well's rule or primary care rule to predict need for ultrasound[32]
- Well's rule not useful in inpatient setting[63]
- criteria is failure of venous lumen to fully collapse under gentle pressure from ultrasound transducer/probe
- non-compressibility of popliteal vein is consistent with upper leg DVT
- 90% predictive value above knee
- sensitivity 50-80% below knee, specificity 95%
- pelvic veins not well visualized[7]
- 82% sensitivity & specificity vs venography[7] for upper extremity DVT
- negative results on whole-leg compression ultrasound in patients with low to intermediate risk of DVT (including post-partum women) is adequate to exclude a DVT[37][39]
- negative results on proximal-leg compression ultrasound requires a repeated study[37]
- operator-dependent
- 2-point compression study inadequate to rule out DVT[57]
- a patient with a positive d-dimer test & a negative 2-point compression study should undergo full lower extremity ultrasound within 1 week[57]
- Well's rule or primary care rule to predict need for ultrasound[32]
- impedance plethysmography (IPG)
- 90% predictive value above knee
- unreliable below knee
- I-fibrinogen scanning
- 90% predictive for calf DVT
- ultrasound*[15][17]
- ascending contrast venography
- gold standard
- complications
- DVT in 2-3%
- hypersensitivity
- uncomfortable for patient
- renal insufficiency
- congestive heart failure
- expensive
- magnetic resonance* venography or direct thrombus imaging for pelvic & subclavian venous thrombosis[7]
- chest X-ray (rule out lung carcinoma)
- mammography for unprovoked DVT in women[62]
- CT of abdomen not helpful for detection of cancer in unprovoked DVT[62]
* negative ultrasound is sufficient to exclude clinically significant DVT & withhold anticoagulation[17]
* see Follow-up in Management: section for ultrasound after completion of anticoagulation
* resolution may be limited in patients who have had hip surgery[7]
Complications
- pulmonary embolus (PE)
- 5-20% with calf DVT
- 30-50% with untreated proximal DVT
- superficial saphenous vein thrombosis rarely causes pulmonary embolism unless the thrombus propagates into the deep venous system at the greater saphenous- femoral vein junction
- postphlebitic syndrome
- compression stockings reduce incidence
- below knee stockings as effective as thigh length after proximal DVT[38]
- postphlebitic syndrome still develops in 1/3 of patients
- heparin-induced thrombocytopenia
- compartment syndrome
- compresses arteries as well as veins
- extension of isolated calf DVT to proximal DVT or PE occurs in 9% of patients not anticoagulated vs 3% anticoagulated patients, median time to proximal DVT 13 days,median time to PE 15 days[71]
- risk higher when thrombus involves vein branches within the gastrocnemius or soleus muscle vs tibial veins or peroneal vein[71]
Differential diagnosis
- cellulitis with or without lymphangitis
- compartment syndrome
- muscle strain or rupture
- lymphedema
- rupture of Baker's (popliteal) cyst
- postphlebitic syndrome (chronic)
- Well's rule or primary care rule used to assess likelihood of DVT prior to ultrasound[32]
Management
- general
- most important goal is prevention of pulmonary embolus
- negative ultrasound is sufficient to exclude clinically significant DVT & withhold anticoagulation[17]
- most patients can be managed at home without hospitalization
- supportive
- bedrest
- elevation of extremity above heart
- graduated compression stocking
- only if postphlebitic syndrome[69] (not for prophylaxis)
- compression after DVT reduces residual vein obstruction & thus postphlebitic syndrome[81]
- 6-24 months after 6 month treatment of proximal DVT[77]$
- one year of therapy non-inferior to 2 years[89]
anticoagulation
- anticoagulation for all patients with proximal DVT unless contraindication (see inferior vena cava (IVC) filter below)
- initiate therapy with LMW heparin, apixaban or rivaroxaban[5][25]
- LMW heparin preferable to unfractionated heparin[5]
- fondaparinux (Arixtra) is an alternative
- continue LMW heparin for at least 5 days & until the INR is therapeutic (2.0-3.0)[5] (2 INR measurements at least 24 hours apart)
- outpatient therapy is safe & effective in selected patients[5]
- enoxaparin 1.5 mg/kg SQ QD or 1 mg/kg SQ BID[6]
- efficacy similar to heparin
- may be used as an outpatient
- no need to monitor coagulation tests
- dalteparin 200 units/kg SQ QD
- tinzaparin 175 units/kg SQ QD
- fondaparinux
- thrombin inhibitor or danaparoid if thrombocytopenia that may be due to heparin-induced thrombocytopenia[5]
- recent hospitalization, surgery, or known heparin exposure
- initial management with LMW heparin can be done safely in the home[52]
- use unfractionated heparin if emergent surgery or thrombolytic therapy is likely[5]
- avoid if high risk of bleeding until bleeding risk resolves
- see inferior vena cava (IVC) filter below
- see special case of antiphospholipid antibody syndrome
- American College of Chest Physicians recommends use of newer anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban) vs warfarin in patients with or without cancer[5][69]
- no difference in outcomes (recurrent DVT or all-cause mortality) in use of newer anticoagulants vs warfarin[43]
- bleeding risk similar[76]
- see special case of antiphospholipid antibody syndrome
- duration of anticoagulation (same as warfarin)
- apixaban & rivaroxaban may be used as monotherapy
- initial LMW heparin unnecessary [5]
- treatment with apixaban for 1 year reduces recurrence of DVT[44]
- rivaroxaban alone[31]
- 15 mg PO BID for 3 weeks, followed by 20 mg PO QD
- no need for bridging LMW heparin[74]
- as good as SQ enoxaparin with conversion to warfarin
- low risk of recurrent DVT or bleeding while treated with rivaroxaban[64] (low = 0 in study)
- rivaroxaban with less major bleeding than LMW heparin/warfarin[67]
- rivaroxaban & apixaban probably confer the lowest risks for major bleeding[54]
- dabigatran requires initial LMW heparin[5][46]
- non-inferior to warfarin
- associated with higher risk of acute coronary syndrome than warfarin (risk 0.9% vs 0.2%)[46]
- edoxaban requires initial LMW heparin[5]
- no difference in outcomes (recurrent DVT or all-cause mortality) in use of newer anticoagulants vs warfarin[43]
- in cancer patients, initial anticoagulation with apixaban, rivaroxaban or LMW heparin[5]
- if warfarin is used, begin concurrently with heparin or LMW heparin
- bolus, 10 mg QD for 1-2 days
- begin at 2.5 mg QD
- adjust dose to achieve INR of 2.0-3.0
- >= 5 days overlap with heparin/LMW heparin & until INR > 2 for 24 hours[5]
- duration of warfarin (anticoagulation) therapy:
- 3-6 months for 1st occurrence with transient reversible risk factor[5][22][35] includes patients heterozygous for factor V Leiden mutation[5] - 6 weeks of therapy if provoked DVT in patient < 21 years[86]
- 6-12 months for 1st occurrence with thrombophilia or other chronic risk factor(s)
- indefinite therapy for idiopathic DVT & low risk of bleeding[5]; recurrent proximal DVT
- continue anticoagulation until catheter removed if catheter- associated DVT[5]
- repeat ultrasound prior to discontinuing anticoagulation to assess residual thrombosis
- long-term low-intensity anticoagulation for patients with idiopathic deep vein thrombosis: INR 1.5-2.0 (after 3 months of standard therapy)[10][11][25]
- risk of fatal pulmonary embolism after 6 month course of warfarin is low (< 1%)[23], especially if DVT was provoked
- results of thrombophilia testing generally do not influence duration of therapy, especially for patients with a single DVT resulting from major transient risk factor[5]
- use LMW heparin rather than warfarin in patients with underlying malignancy based mostly on single trial[65]
- LMW heparin & warfarin equivalent[65]
- rivaroxaban associated with low recurrence of VTE but higher rate of hemorrhage compared with dalteparin[80]
- avoid LMW heparin in patients with obesity or renal insufficiency
- special considerations for women of child-bearing age
- if INR becomes subtherapeutic in the 1st month following pulmonary embolism, add LMW heparin until INR is stable in the therapeutic range[5]
- falling platelet count & rapidly rising INR after the switch from heparin to warfarin is consistent with cancer-associated disseminated intravascular coagulation[61]
- after excluding heparin-induced thrombocytopenia, discontinue warfarin, initiate a thrombin inhibitor & vitamin K, & search for an occult malignancy[61]
- American College of Chest Physicians recommends use aspirin after stopping anticoagulation[69]
- benefit of anticoagulation not supported by randomized clinical trials (see anticoagulation)[59]
- initiate therapy with LMW heparin, apixaban or rivaroxaban[5][25]
procedures
- inferior vena cava (IVC) filter (i.e. Greenfield filter)
- proximal DVT in patient with contraindication to anticoagulation
- major bleeding from arteriovenous malformation or other cause
- anticoagulation once bleeding risk resolves
- recurrent thromboembolism despite adequate anticoagulation
- presence of a large, free-floating inferior vena cava thrombus
- recurrent embolism with pulmonary hypertension
- proximal DVT in patient with contraindication to anticoagulation
- thrombolytic therapy
- controversial
- IV or catheter-directed thrombolysis for large iliofemoral DVT[5][36]
- impaired venous drainage, severe edema, acute limb ischemia[5]
- catheter-directed thrombolysis associated with more complications than anticoagulation alone[53][78]
- MKSAP18[5] downplays complications
- surgical treatment (thrombectomy): threatened viable limb
isolated calf venous thrombosis
- isolated calf venous thrombosis
- anticoagulation for 3 months if symptomatic[5]
- if anticoagulation not given, serial noninvasive studies of the lower extremity should be done for 2 weeks to assess proximal extension of thrombus
- LMW heparin no better than placebo in reducing DVT extension to proximal veins, contralateral proximal DVT, or symptomatic pulmonary embolism in low-risk patients with isolated calf DVT, but does result in increased bleeding[72]
- anticoagulation prevents recurrent venous thromboembolism[85]
- better outcomes with anticoagulation than serial ultrasound surveillance[85]
Prophylaxis, Duration of Anticoagulation, Activity, Follow-up
- Prophylaxis
- early ambulation
- stop offending agent
- pneumatic compression device (pcd)
- subcutaneous heparin
- warfarin
- B-vitamins to lower homocysteine of no benefit[20]
- vitamin E may be useful for primary prevention in women
- low dose aspirin
- 100 mg QOD ineffective in preventing DVT in women > 45 years[21]
- 100 mg QD reduces recurrent DVT in patients with unprovoked DVT who have received 6-18 months of warfarin[41]
- rivaroxaban 10 or 20 mg QD more effective in preventing recurrent thromboembolism than aspirin with no difference in bleeding (RR= 1.5%, 1.2%, & 4.4%, respectively)[73]
- fondaparinux (Arixtra) is more effective than LMW heparin following orthopedic surgery[5]
- LMW heparin for at least 3-6 months for cancer patients with subsequent transition to warfarin if necessary[5]
- duration of anticoagulation
- 3-6 months for provoked DVT
- extended anticoagulation for unprovoked proximal DVT
- life-long anticoagulation for:
- 2 or more spontaneous episodes of DVT
- 1 spontaneous, life-threatening venous thromoembolism
- 1 spontaneous venous thromboembolism in a patient with hypercoagulability
- HERDOO2 score may be useful in women to assess need for long-term anticoagulation after unprovoked DVT
- activity:
- hospitalization
- elevate extremity
- ambulate as tolerated
- discharge
- gradually resume normal activities
- avoid prolonged sitting or standing
- patients with low-risk PE may be treated at home or discharged early[69]
- avoid contact sports that exposes patient to risk of injury
- hospitalization
- follow-up:
- serial INR to monitor warfarin therapy
- follow-up ultrasound is not routinely performed after an acute DVT[27]
- if follow-up ultrasound demonstrates non-obstructive residual thrombus 3-6 months after surgery or trauma, discontinue anticoagulation[88]
- if post-phlebitic syndrome is suspected, impedance plethysmography (ipg) or ultrasound can document the location & degree of venous insufficiency
- graduated compression stocking if postphlebitic syndrome[69] thus postphlebitic syndrome[81]
- 6-24 months after 6 month treatment of proximal DVT[77]$
- one year of compression non-inferior to 2 years[89]
- routine screening for potentially treatable carcinomas
Prognosis & Risk
- prognosis:
- distal & proximal deep venous thrombosis associated with similar outcomes in patients with cancer[90]
- risk factors for recurrent DVT[9][16]
- residual thrombosis (2.4)*
- idiopathic DVT (2,5)
- hypercoagulable state (3.1)
- heterozygousity for factor V Leiden mutation only confers 1.5 fold risk of recurrent DVT[5]
- plasma d-dimer > 750 ng/mL (3.1)#[12][19][26]
- male sex (3.6)[14] <31% vs 9%>
- risk or recurrence is lowest if 1st episode is provoked by surgery[30]
- 1/3 of patients with initial unprovoked venous thromboembolism who discontinue anticoagulation may experience recurrence within 10 years[84]
- good prognosis = age < 80 years, no significant comorbidity, stable vital signs - can be managed as outpatient[5]
- risk for DVT is increased in relatives of index cases of unprovoked DVT (RR=2.4)[55]
- risk increases with younger age of index case
- for each younger year, risk increases by 3%
- risk increase if more than one family member affected (RR=2.71)
- risk increases if index case has factor V Leiden mutation or prothrombin G20210A gene variant (RR=4.42)[55]
- risk increases with younger age of index case
* relative risk in parenthesis
# 3 weeks after cessation of anticoagulation
$ knee-high compression stockings after proximal DVT?[77]
More general terms
More specific terms
- cerebral venous thrombosis; dural sinus thrombosis
- splanchnic vein thrombosis (SVT)
- upper extremity deep vein thrombosis (UEDVT)
Additional terms
- HERDOO2 Score
- hypercoagulability
- postphlebitic syndrome; post-thrombotic syndrome
- primary care rule for deep vein thrombosis
- prophylaxis for venous thromboembolism (VTE)
- pulmonary embolism (PE)
- QThrombosis (VTE/DVT risk calculator)
- venous thromboembolism (VTE)
- venous thromboembolism associated with pregnancy
- Wells clinical prediction rules for DVT
References
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998
- ↑ 2.0 2.1 Escoffre-Barbe M et al Evaluation of a new rapid D-dimer assay for clinically suspected deep venous thrombosis (Liatest D-dimer). Am J Clin Pathol. 1998 Jun;109(6):748-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/9620034
- ↑ Weinmann EE, Salzman EW. Deep-vein thrombosis. N Engl J Med. 1994 Dec 15;331(24):1630-41. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/7772110
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 283-285
- ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 5.36 5.37 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ 6.0 6.1 Merli G et al Subcutaneous enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment of venous thromboembolic disease. Ann Intern Med 134:191, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11177331
- ↑ 7.0 7.1 7.2 7.3 7.4 Fraser DG et al, Diagnosis of lowe-limb deep vein thrombosis: a prospective blinded study of magnetic resonance direct thrombus imaging. Ann Intern Med 136:89, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11790060
- ↑ Baarslag HJ, van Beek EJ, Koopman MM, Reekers JA. Prospective study of color duplex ultrasonography compared with contrast venography in patients suspected of having deep venous thrombosis of the upper extremities. Ann Intern Med. 2002 Jun 18;136(12):865-72. Erratum in: Ann Intern Med. 2003 Mar 4;138(5):438. Summary for patients in: Ann Intern Med. 2002 Jun 18;136(12):I-30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12069560
- ↑ 9.0 9.1 Prandoni P et al Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med. 2002 Dec 17;137(12):955-60. Summary for patients in: Ann Intern Med. 2002 Dec 17;137(12):I32. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12484710
- ↑ 10.0 10.1 Prescriber's Letter 10(3):13 2003
- ↑ 11.0 11.1 Ridker PM et al and the PREVENT Investigators. Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med. 2003 Apr 10;348(15):1425-34. Epub 2003 Feb 24. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12601075 <Internet> http://content.nejm.org/cgi/reprint/NEJMoa035029v1.pdf
Schafer AI. Warfarin for venous thromboembolism - walking the dosing tightrope. N Engl J Med. 2003 Apr 10;348(15):1478-80. Epub 2003 Feb 24. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12601074 <Internet> http://content.nejm.org/cgi/reprint/NEJMe030018v1.pdf - ↑ 12.0 12.1 Journal Watch 23(19):149, 2003 Eichinger S et al D-dimer levels and risk of recurrent venous thromboembolism. JAMA. 2003 Aug 27;290(8):1071-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12941680
- ↑ 13.0 13.1 Kelman CW et al Deep vein thrombosis and air travel: record linkage study. BMJ. 2003 Nov 8;327(7423):1072. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/14604926 <Internet> http://bmj.bmjjournals.com/cgi/content/full/327/7423/1072
Schwarz T et al Venous thrombosis after long-haul flights. Arch Intern Med. 2003 Dec 8-22;163(22):2759-64. PMID: https://www.ncbi.nlm.nih.gov/pubmed/14662630
Martinelli I et al Risk of venous thromboembolism after air travel: interaction with thrombophilia and oral contraceptives. Arch Intern Med. 2003 Dec 8-22;163(22):2771-4. PMID: https://www.ncbi.nlm.nih.gov/pubmed/14662632
Hughes RJ et al Frequency of venous thromboembolism in low to moderate risk long distance air travellers: the New Zealand Air Traveller's Thrombosis (NZATT) study. Lancet. 2003 Dec 20;362(9401):2039-44. PMID: https://www.ncbi.nlm.nih.gov/pubmed/14697802 - ↑ 14.0 14.1 Journal Watch 24(14):111, 2004 Kyrle PA, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Eichinger S. The risk of recurrent venous thromboembolism in men and women. N Engl J Med. 2004 Jun 17;350(25):2558-63. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15201412
- ↑ 15.0 15.1 15.2 Journal Watch 25(11):89, 2005 Kearon C, Ginsberg JS, Douketis J, Crowther MA, Turpie AG, Bates SM, Lee A, Brill-Edwards P, Finch T, Gent M. A randomized trial of diagnostic strategies after normal proximal vein ultrasonography for suspected deep venous thrombosis: D-dimer testing compared with repeated ultrasonography. Ann Intern Med. 2005 Apr 5;142(7):490-6. Summary for patients in: Ann Intern Med. 2005 Apr 5;142(7):I48. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15809460
Hull RD. Revisiting the past strengthens the present: an evidence-based medicine approach for the diagnosis of deep venous thrombosis. Ann Intern Med. 2005 Apr 5;142(7):583-5. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15809468 - ↑ 16.0 16.1 Journal Watch 25(12):98, 2005 Christiansen SC, Cannegieter SC, Koster T, Vandenbroucke JP, Rosendaal FR. Thrombophilia, clinical factors, and recurrent venous thrombotic events. JAMA. 2005 May 18;293(19):2352-61. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15900005
- ↑ 17.0 17.1 17.2 17.3 Subramaniam RM, Heath R, Chou T, Cox K, Davis G, Swarbrick M. Deep venous thrombosis: withholding anticoagulation therapy after negative complete lower limb US findings. Radiology. 2005 Oct;237(1):348-52. Epub 2005 Aug 26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16126924
- ↑ 18.0 18.1 Bjornara BT et al, Frequency and timing of clinical venous thromboembolism after major joint surgery. J Bone Joint Surg Br 2006; 88:386 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16498018
- ↑ 19.0 19.1 19.2 Palareti G et al for the PROLONG investigators. D-dimer testing to determine the duration of anticoagulation therapy. N Engl J Med 2006, 355:1780 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17065639
- ↑ 20.0 20.1 den Heijer M et al, Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomised, placebo-controlled, double-blind trial. Blood 2007, 109:139 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16960155
Ray JG et al, Homocysteine-lowering therapy and risk for venous thromboembolism: A randomized trial. Ann Intern Med 2007, 246:761 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17470822 - ↑ 21.0 21.1 Glynn RJ et al, Effect of low-dose aspirin on the occurrence of venous thromboembolism: A randomized trial. Ann Intern Med 2007, 147:525 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17938390
- ↑ 22.0 22.1 Campbell IA et al, Anticoagulation for three vs six months in patients with deep vein thrombosis or pulmonary embolism, or both: randomised trial. BMJ 2007, 334:674 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17289685
- ↑ 23.0 23.1 Douketis JD et al, The risk for fatal pulmonary embolism after discontinuing anticoagulation therapy for venous thromboembolism. Ann Intern Med 2007, 147:766 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18056660
- ↑ Trujillo-Santos J et al, Clinical outcome in patients with venous thromboembolism and hidden cancer. Findings from the RIETE Registry. J Thromb Haemost 2008, 6:251 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18021305
- ↑ 25.0 25.1 25.2 Prescriber's letter 15(9): 2008 Chart: venous thromboembolism (vte) treatment -- chest update Guidelines: accp antithrombotic and thrombolytic guidelines, 8th edition. executive summary detail-document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241009&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 26.0 26.1 Verhovsek M et al. Systematic review: D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolism. Ann Intern Med 2008 Oct 7; 149:481. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18838728
- ↑ 27.0 27.1 Prandoni P et al Residual thrombosis on ultrasonography to guide the duration of anticoagulation in patients with deep venous thrombosis: A randomized trial. Ann Intern Med 2009 May 5; 150:577 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19414836
Goldhaber SZ Optimal duration of anticoagulation after venous thromboembolism: Fixed and evidence-based, or flexible and personalized? Ann Intern Med 2009 May 5; 150:644. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19414845 - ↑ 28.0 28.1 Chandra D et al Travel and risk for venous thromboembolism. Ann Intern Med 2009 Aug 4; 151:180. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19581633
- ↑ 29.0 29.1 Stein PD et al. Silent pulmonary embolism in patients with deep venous thrombosis: A systematic review. Am J Med 2010 May; 123:426. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20399319
- ↑ 30.0 30.1 Iorio A et al. Risk of recurrence after a first episode of symptomatic venous thromboembolism provoked by a transient risk factor: A systematic review. Arch Intern Med 2010 Oct 25; 170:1710 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20975016
- ↑ 31.0 31.1 The EINSTEIN Investigators Oral Rivaroxaban for Symptomatic Venous Thromboembolism N Engl J Med December 4, 2010 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21128814 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1007903
- ↑ 32.0 32.1 32.2 van der Velde EF, Toll DB, ten Cate-Hoek AJ et al Comparing the Diagnostic Performance of 2 Clinical Decision Rules to Rule Out Deep Vein Thrombosis in Primary Care Patients Annals of Family Medicine 9:31-36 (2011) <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21242558 <Internet> http://www.annfammed.org/cgi/content/full/9/1/31
- ↑ 33.0 33.1 Douketis J et al. Risk of recurrence after venous thromboembolism in men and women: Patient level meta-analysis. BMJ 2011 Feb 24; 342:d813. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21349898
- ↑ Jaff MR et al Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Association. Circulation March 21, 2011 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21422387
Prescriber's Letter 18(4): 2011 COMMENTARY: Duration of Anticoagulation After Venous Thromboembolism GUIDELINES: Antithrombotic Therapy for Venous Thromboembolic Disease (June 2008) GUIDELINES: Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension (March 2011) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270409&pb=PRL (subscription needed) http://www.prescribersletter.com - ↑ 35.0 35.1 Boutitie F et al. Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: Analysis of individual participants' data from seven trials. BMJ 2011 May 24; 342:d3036. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21610040
Middeldorp S. Duration of anticoagulation for venous thromboembolism: Treatment for more than three months is not necessary if lifelong treatment is not intended. BMJ 2011 May 24; 342:d2758 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21610039 - ↑ 36.0 36.1 Enden T et al Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial Lancet. 2012 Jan 7;379(9810):31-8. Epub 2011 Dec 13 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22172244 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961753-4/abstract
Hofmann LV and Kuo WT Catheter-directed thrombolysis for acute DVT The Lancet, Early Online Publication, 13 December 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22172245 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961875-8/fulltext - ↑ 37.0 37.1 37.2 Johnson SA, Stevens SM, Woller SC, et al. Risk of a deep vein thrombosis following a single negative whole-leg compression ultrasound: a systematic review and meta-analysis. JAMA 2010; 303(5):438-445. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20124539
- ↑ 38.0 38.1 Prandoni P et al. Thigh-length versus below-knee compression elastic stockings for prevention of the post-thrombotic syndrome in patients with proximal-venous thrombosis: A randomized trial. Blood 2011 Dec 16 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22180438 <Internet> http://bloodjournal.hematologylibrary.org/content/early/2011/12/16/blood-2011-11-391961
- ↑ 39.0 39.1 Le Gal G et al Diagnostic value of single complete compression ultrasonography in pregnant and postpartum women with suspected deep vein thrombosis: prospective study BMJ 2012;344:e2635 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22531869 <Internet> http://www.bmj.com/content/344/bmj.e2635
- ↑ 40.0 40.1 40.2 40.3 Rogers MAM et al. Triggers of hospitalization for venous thromboembolism. Circulation 2012 May 1; 125:2092 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22474264
White RH. Identifying risk factors for venous thromboembolism. Circulation 2012 May 1; 125:2051. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22474263 - ↑ 41.0 41.1 Becattini C et al Aspirin for Preventing the Recurrence of Venous Thromboembolism N Engl J Med 2012; 366:1959-1967 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22621626 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1114238
- ↑ 42.0 42.1 ARUP Consult: Venous Thromboembolism The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/venous-thromboembolism
- ↑ 43.0 43.1 Fox BD et al Efficacy and safety of novel oral anticoagulants for treatment of acute venous thromboembolism: direct and adjusted indirect meta-analysis of randomised controlled trials BMJ 2012;345:e7498 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23150473 <Internet> http://www.bmj.com/content/345/bmj.e7498
- ↑ 44.0 44.1 Agnelli G et al Apixaban for Extended Treatment of Venous Thromboembolism. N Engl J Med. December 8, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23216615 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1207541
- ↑ 45.0 45.1 45.2 Linkins L-A et al. Selective D-dimer testing for diagnosis of a first suspected episode of deep venous thrombosis: A randomized trial. Ann Intern Med 2013 Jan 15; 158:93 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23318311
- ↑ 46.0 46.1 46.2 Schulman S et al Extended Use of Dabigatran, Warfarin, or Placebo in Venous Thromboembolism. N Engl J Med 2013; 368:709-718February 21, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23425163 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1113697
Connors JM Extended Treatment of Venous Thromboembolism. N Engl J Med 2013; 368:767-769February 21, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23425170 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1215678 - ↑ Kearon C. Long-term anticoagulation for venous thromboembolism: duration of treatment and management of warfarin therapy. Clin Chest Med. 2010 Dec;31(4):719-30. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21047578
- ↑ Kearon C, Akl EA, Comerota AJ, Prandoni P et al Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e419S-94S. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22315268
corresponding NGC guideline updated Sept 2016
Kearon C et al Antithrombotic Therapy for VTE Disease: CHEST Guideline. Chest. January 2016 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26867832 - ↑ Bates SM, Jaeschke R, Stevens SM et al Diagnosis of DVT: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e351S-418S PMID: https://www.ncbi.nlm.nih.gov/pubmed/22315267 (corresponding NGC guideline withdrawn Dec 2017)
- ↑ 50.0 50.1 Agnelli G et al Oral Apixaban for the Treatment of Acute Venous Thromboembolism. N Engl J Med. July 1, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23808982 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1302507
Cushman M Treating Acute Venous Thromboembolism: Shift with Care. N Engl J Med. July 1, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23808983 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1307413 - ↑ 51.0 51.1 Chee CE et al. Predictors of venous thromboembolism recurrence and bleeding among active cancer patients: A population-based cohort study. Blood 2014 Apr 2 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24782507 <Internet> http://bloodjournal.hematologylibrary.org/content/early/2014/04/29/blood-2014-01-549733
- ↑ 52.0 52.1 Lozano F et al. Home versus in-hospital treatment of outpatients with acute deep venous thrombosis of the lower limbs. J Vasc Surg 2014 May; 59:1362. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24439322 <Internet> http://www.jvascsurg.org/article/S0741-5214%2813%2902218-0/abstract
- ↑ 53.0 53.1 Bashir R et al Comparative Outcomes of Catheter-Directed Thrombolysis Plus Anticoagulation vs Anticoagulation Alone to Treat Lower- Extremity Proximal Deep Vein Thrombosis. JAMA Intern Med. Published online July 21, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25047081 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1889011
- ↑ 54.0 54.1 Castellucci LA et al. Clinical and safety outcomes associated with treatment of acute venous thromboembolism: A systematic review and meta-analysis. JAMA. 2014 Sep 17;312(11):1122-35 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25226478
- ↑ 55.0 55.1 55.2 Couturaud F et al. Factors that predict thrombosis in relatives of patients with venous thromboembolism. Blood 2014 Sep 25; 124:2124 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25049279 <Internet> http://www.bloodjournal.org/content/124/13/2124?ijkey=3e220be10d5b84cec6334f534b6fa2e492378e79&keytype2=tf_ipsecsha
- ↑ 56.0 56.1 Kearon C et al. d-dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: A cohort study. Ann Intern Med 2015 Jan 6; 162:27 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25560712 <Internet> http://annals.org/article.aspx?articleid=2088546
- ↑ 57.0 57.1 57.2 Adhikari S et al. Isolated deep venous thrombosis: Implications for 2-point compression ultrasonography of the lower extremity. Ann Emerg Med 2014 Nov 20 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25465473 <Internet> http://www.annemergmed.com/article/S0196-0644%2814%2901419-X/abstract
- ↑ Vedovati MC et al. Direct oral anticoagulants in patients with VTE and cancer: A systematic review and meta-analysis. Chest 2015 Feb; 147:475. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25211264
Raskob GE, van Es N, Verhamme P et al Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism. N Engl J Med. Dec 12, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29231094 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1711948 - ↑ 59.0 59.1 The NNT: Anticoagulation Given for Acute Venous Thromboembolism (Deep Venous Thrombosis and Pulmonary Embolism). http://www.thennt.com/nnt/anticoagulation-for-venous-thromboembolism/
Cundiff DK et al. Anticoagulants vs non-steroidal anti-inflammatories or placebo for treatment of venous thromboembolism. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003746. PMID: https://www.ncbi.nlm.nih.gov/pubmed/1643746 - ↑ 60.0 60.1 The NNT: Deep Venous Thrombosis (DVT) Diagnostics and Likelihood Ratios, Explained http://www.thennt.com/lr/deep-venous-thrombosis-dvt/
Wells PS, Owen C, Doucette S, Fergusson D, Tran H. Does this patient have deep vein thrombosis? JAMA. 2006 Jan 11;295(2):199-207. http://www.ncbi.nlm.nih.gov/pubmed/16403932 - ↑ 61.0 61.1 61.2 61.3 Green D Limb Gangrene in Cancer Patients Receiving Warfarin. NEJM Journal Watch. June 4, 2015 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
Warkentin TE et al. Warfarin-induced venous limb ischemia/gangrene complicating cancer: A novel and clinically distinct syndrome. Blood 2015 May 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25979950 - ↑ 62.0 62.1 62.2 62.3 Carrier M et al Screening for Occult Cancer in Unprovoked Venous Thromboembolism. N Engl J Med. June 22, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26095467 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1506623
- ↑ 63.0 63.1 Silveira PC et al. Performance of Wells score for deep vein thrombosis in the inpatient setting. JAMA Intern Med 2015 Jul 1; 175:1112 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25985219
- ↑ 64.0 64.1 Beam DM et al. Immediate discharge and home treatment with rivaroxaban of low-risk venous thromboembolism diagnosed in two U.S. emergency departments: A one-year preplanned analysis. Acad Emerg Med 2015 Jul; 22:788 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26113241
- ↑ 65.0 65.1 65.2 Lee AYY et al. Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: A randomized clinical trial. JAMA 2015 Aug 18; 314:677. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26284719
- ↑ Liu D, Peterson E, Dooner J et al Diagnosis and management of iliofemoral deep vein thrombosis: clinical practice guideline. CMAJ. 2015 Sep 28. pii: cmaj.141614 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26416989
- ↑ 67.0 67.1 Eerenberg ES et al. Clinical impact and course of major bleeding with rivaroxaban and vitamin K antagonists. J Thromb Haemost 2015 Sep; 13:1590 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26179293
- ↑ Weitz JI, Eikelboom JW, Samama MM et al New antithrombotic drugs: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e120S-51S PMID: https://www.ncbi.nlm.nih.gov/pubmed/22315258
- ↑ 69.0 69.1 69.2 69.3 69.4 69.5 Kearon C et al Antithrombotic Therapy for VTE Disease: CHEST Guideline. Chest. January 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26867832 <Internet> http://journal.publications.chestnet.org/article.aspx?articleid=2479255
- ↑ 70.0 70.1 Mol GC et al. One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): Randomised controlled trial. BMJ 2016 May 31; 353:i2691 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27245485 Free PMC Article
- ↑ 71.0 71.1 71.2 Utter GH et al. Therapeutic anticoagulation for isolated calf deep vein thrombosis. JAMA Surg 2016 Jul 20; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27437827
- ↑ 72.0 72.1 Righini M, Galanaud JP, Guenneguez H et al Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a randomised, double-blind, placebo-controlled trial. Lancet Haematology. Nov 7, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27836513 <Internet> http://thelancet.com/journals/lanhae/article/PIIS2352-3026(16)30131-4/fulltext
Schellong SM Low risk is not enough: the dilemma of calf vein thrombosis. Lancet Haematology. Nov 7, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27839799 <Internet> http://thelancet.com/journals/lanhae/article/PIIS2352-3026(16)30164-8/fulltext - ↑ 73.0 73.1 Weitz JI, Lensing AW, Prins MH, et al. Rivaroxaban or aspirin for extended treatment of venous thromboembolism. N Engl J Med 2017 Mar 18; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28316279 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMoa1700518
Crowther MA, Cuker A. Reduced-intensity rivaroxaban for the prevention of recurrent venous thromboembolism. N Engl J Med 2017 Mar 18; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28316277 Free Article <Internet> http://www.nejm.org/doi/10.1056/NEJMe1701628 - ↑ 74.0 74.1 Johnson SA, Eleazer GP, Rondina MT. Pathogenesis, diagnosis, and treatment of venous thromboembolism in older adults. J Am Geriatr Soc. 2016;64(9):1869-1878 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27556937
- ↑ 75.0 75.1 Connors JM Thrombophilia Testing and Venous Thrombosis. N Engl J Med 2017; 377:1177-1187. September 21, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28930509 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMra1700365
- ↑ 76.0 76.1 Jun M, Lix LM, Durand M et al Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study. BMJ. 2017 Oct 17;359:j4323 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29042362, Free full text <Internet> http://www.bmj.com/content/359/bmj.j4323
- ↑ 77.0 77.1 77.2 77.3 77.4 ten Cate-Hoek AJ, Amin EE, Bouman AC et al Individualised versus standard duration of elastic compression therapy for prevention of post-thrombotic syndrome (IDEAL DVT): a multicentre, randomised, single-blind, allocation-concealed, non-inferiority trial. The Lancet Haematology. Dec 4, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29217387 <Internet> http://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(17)30227-2/fulltext
- ↑ 78.0 78.1 Vedantham S, Goldhaber SZ, Julian JA et al Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis. N Engl J Med 2017; 377:2240-2252. Dec 7, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29211671 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1615066
- ↑ 79.0 79.1 Chang SL, Huang YL, Lee MC et al Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease. JAMA. 2018;319(8):807-817. February 27, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29486040 https://jamanetwork.com/journals/jama/article-abstract/2673551
- ↑ 80.0 80.1 Young AM, Marshall A, Thirlwall J et al. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: Results of a randomized trial (SELECT-D). J Clin Oncol 2018 Jul 10; 36:2017 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29746227
- ↑ 81.0 81.1 81.2 Amin EE, Bistervels IM, Meijer K et al. Residual vein occlusion in relation to immediate compression and postthrombotic syndrome in deep vein thrombosis. Blood 2018 Sep 20 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30237155 <Internet> http://www.bloodjournal.org/content/early/2018/09/24/blood-2018-03-836783
- ↑ Watson L, Broderick C, Armon MP. Thrombolysis for acute deep vein thrombosis. Cochrane Database Syst Rev. 2014 Jan 23;(1):CD002783. Review. Update in: Cochrane Database Syst Rev. 2016 Nov 10;11:CD002783. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24452314
- ↑ 83.0 83.1 Kearon C, Parpia S, Spencer FA et al. Long-term risk of recurrence in patients with a first unprovoked venous thromboembolism managed according to D-dimer results: A cohort study. J Thromb Haemost 2019 Apr 29; PMID: https://www.ncbi.nlm.nih.gov/pubmed/31033194 https://onlinelibrary.wiley.com/doi/abs/10.1111/jth.14458
- ↑ 84.0 84.1 Khan F, Rahman A, Carrier M et al Long term risk of symptomatic recurrent venous thromboembolism after discontinuation of anticoagulant treatment for first unprovoked venous thromboembolism event: systematic review and meta-analysis. BMJ 2019;366:l4363 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31340984 https://www.bmj.com/content/366/bmj.l4363
Bikdeli B et al Minimizing recurrent venous thromboembolism. BMJ 2019;366:l4686 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31345836 https://www.bmj.com/content/366/bmj.l4686 - ↑ 85.0 85.1 85.2 Kirkilesis G et al. Treatment of distal deep vein thrombosis. Cochrane Database Free PMC article https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013422.pub2/full
Kuczmik W et al. Calf vein thrombosis outcomes comparing anticoagulation and serial ultrasound imaging management strategies. Mayo Clin Proc 2021 May; 96:1184. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33840522 https://www.mayoclinicproceedings.org/article/S0025-6196(21)00090-2/fulltext - ↑ 86.0 86.1 86.2 Goldenberg NA et al. Effect of anticoagulant therapy for 6 weeks vs 3 months on recurrence and bleeding events in patients younger than 21 years of age with provoked venous thromboembolism: The Kids-DOTT randomized clinical trial. JAMA 2022 Jan 11; 327:129 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35015038 PMCID: PMC8753509 (available on 2022-07-11) https://jamanetwork.com/journals/jama/fullarticle/2787908
- ↑ 87.0 87.1 Ageno W et al. Rivaroxaban treatment for six weeks versus three months in patients with symptomatic isolated distal deep vein thrombosis: Randomised controlled trial. BMJ 2022 Nov 23; 379:e072623. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36520715 Free article https://www.bmj.com/content/379/bmj-2022-072623
- ↑ 88.0 88.1 NEJM Knowledge+ Hematology
- ↑ 89.0 89.1 89.2 Meng J et al. Is it necessary to wear compression stockings and how long should they be worn for preventing post thrombotic syndrome? A meta-analysis of randomized controlled trials. Thromb Res 2023 May; 225:79 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37030189 Free article https://www.thrombosisresearch.com/article/S0049-3848(23)00090-7/fulltext
- ↑ 90.0 90.1 Galanaud JP et al. Clinical presentation and outcomes of patients with cancer-associated isolated distal deep vein thrombosis. J Clin Oncol 2024 Feb 10; 42:529. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37471683 https://ascopubs.org/doi/10.1200/JCO.23.00429
- ↑ What is deep vein thrombosis? http://www.nhlbi.nih.gov/health/dci/diseases/dvt/dvt_whatis.html