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Deep Vein Thrombosis (DVT)
Published in Charles Theisler, Adjuvant Medical Care, 2023
A DVT is a serious condition that is caused by deposits of fibrin, RBCs, platelets, and WBC components in a vein, causing vessel wall inflammation and/or obstructing venous outflow in one or more of the larger deep calf, thigh, or pelvic veins. The clot, or thrombus, prevents the normal flow of blood through the vein, increasing venous pressure. Symptoms are not always present but, typically, the reduced blood flow or blood backing up in the vein can cause swelling, hypoxia, pain, redness, and warmth.
A diabetic patient with a leg ulcer
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
There may be a history of DVT, with or without other symptoms or signs of deep venous insufficiency, and/or varicose veins. Patients with varicosities and venous ulceration should be considered for varicose vein surgery to prevent recurrence once healed; and those with deep venous insufficiency often benefit from compression stockings. The mainstay of treatment is compression bandaging, with elevation of the limb, and local treatment of infection, rather than systemic antibiotics. Any arterial component must be excluded (see ABPI later in this question, p. 78); otherwise compression bandaging may exacerbate the ulceration.
Inherited Thrombophilia
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
The risk of thrombotic events is affected by numerous factors including thrombophilia, personal history of deep vein thrombosis (DVT), family history of DVT, surgery, age over 35 years, high parity, high body mass index, smoking, trauma, and immobilization.
Novel risk prediction models, involving coagulation, thromboelastography, stress response, and immune function indicators, for deep vein thrombosis after radical resection of cervical cancer and ovarian cancer
Published in Journal of Obstetrics and Gynaecology, 2023
Jing Zhang, Jia Chen, Xiuqing Yang, Jing Han, Xiaofeng Chen, Yueping Fan, Hui Zheng
Tumour cell reduction is one of the main approaches in the clinical treatment of ovarian cancer and cervical cancer. However, due to the hypercoagulable state of most patients before surgery, the incidence of postoperative DVT increases under the influence of surgical stress (Deitcher 2003). Studies have demonstrated that among gynecological malignancies, ovarian cancer exhibits the highest probability of postoperative DVT, with rates ranging from 13.6% to 27.0%, and the lesions are predominantly located in the lower extremities (Basaran et al.2021). DVT is a venous disorder caused by abnormal clotting of blood in deep veins. This mechanism may be attributed to surgical trauma leading to a significant release of prothrombin, which can influence blood agglutination (Zhao et al.2022). Moreover, the decrease in antithrombin levels and other anticoagulant substances in patients’ bodies after surgery, and changes in blood cells and plasma proteins, further exacerbate the hypercoagulable state of blood and promote thrombosis (Sone et al.2022). Embolus detachment poses the greatest risk of postoperative DVT, which can lead to fatal pulmonary embolism, impair patient’s quality of life, and even result in death. Even when the embolus does not detach, it can cause sequelae such as venous ulcer, pain, and edoema, which require treatment with an embolus screen that is expensive and significantly increases the economic burden of patients (Peng et al.2021).
Patient-specific hemodynamic analysis of IVCS-induced DVT
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Xudong Jiang, Xueping Gu, Tianze Xu, Xiaoqiang Li, Peng Wu, Lili Sun
Deep venous thrombosis (DVT) is the abnormal coagulation of blood in the veins of the lower extremities caused by various reasons, which can block the corresponding blood vessels and cause the obstruction of venous return. If the treatment is not timely, severe venous diseases of the lower extremities may occur, such as varicose veins, pigmentation, chronic and unhealed ulcers, etc. Pulmonary embolism (PE) caused by thrombosis is a serious complication of DVT, which may endanger the life of patients at any time (Beckman et al. 2010; Prandoni 2012). Iliac vein compression syndrome (IVCS) is a disorder of lower extremity and pelvic venous reflux caused by iliac vein compression or abnormal intracavitary adhesion structures, and it usually occurs in the left iliac vein (Cockett and Thomas 1965). IVCS is considered to be the most common secondary risk factor for DVT, the anatomical basis for the occurrence of DVT (Kim et al. 2004), and an important factor for thrombosis recurrence (Meng et al. 2013; Vedanthaqm et al. 2014). Therefore, timely intervention of IVCS to prevent the occurrence of DVT will greatly improve the quality of life.
Prevention, treatment, and risk factors of deep vein thrombosis in critically ill patients in Zhejiang province, China: a multicenter, prospective, observational study
Published in Annals of Medicine, 2021
Li Li, Jia Zhou, Liquan Huang, Junhai Zhen, Lina Yao, Lingen Xu, Weimin Zhang, Gensheng Zhang, Qijiang Chen, Bihuan Cheng, Shijin Gong, Guolong Cai, Ronglin Jiang, Jing Yan
The risk factors for DVT include transient or persistent factors that may additively or synergistically increase thrombotic risk by causing vascular wall damage or dysfunction, stasis, or blood hypercoagulability (Virchow’s triad) [2,3]. Patients in the ICU carry multiple risk factors for DVT, including long-term immobilisation, sedative and analgesic use, deep vein catheterisation, tracheotomy, surgery or invasive procedures, and possibly cancer, among others. All these factors will increase the risk of DVT in a population of patients already at high risk of morbidity and mortality [21–23]. Therefore, the prevention of DVT is crucial for ICU patients. Nevertheless, most studies about the epidemiology, prevention, and treatment of DVT in ICUs are from Western countries, and data on developing countries, such as China, are lacking. Among 80 ICU patients over 9 months at a hospital in Hong Kong, the incidence of DVT in the ICU was 15 patients with an incidence rate of 18.8% [24].