The accuracy of the diagnosis of deep vein thrombosis in patients with prior venous thromboembolic disease or severe varicose veins

It has been suggested that smoking protects against the development of deep vein thrombosis following myocardial infarction, although large studies on the effects of smoking have generally failed to show any association with venous thromboembolic disease.In a preliminary survey of patients attending an anticoagulant clinic, fewer male smokers, and more female smokers than expected, were attending after a deep vein thrombosis. Further analysis of these results, suggested that they were due, at least in part, to factors other than smoking, and a larger study was undertaken to compare the incidence of smoking in patients who had had a deep vein thrombosis, with that in the hospital outpatient population as a whole. No differences in smoking habits were found “between these groups, but small differences were observed between various groups of patients with venous thromboembolism, e.g. myocardial infarction was listed as a predisposing cause, more often than expected in male non-smokers.Thus, while smoking may effect the development of deep vein thrombosis in particular situations, e.g. after myocardial infarction, this study has failed to show any significant influence on venous thrombosis in general.

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Description of selected diagnostic tools in assessing the risk of venous thromboembolic disease

Pielegniarstwo XXI wieku / Nursing in the 21st Century ◽

10.1515/pielxxiw-2016-0001 ◽

2016 ◽

Vol 15 (1) ◽

pp. 5-8

Author(s):

Renata Piotrkowska ◽

Piotr Jarzynkowski ◽

Janina Książek

Keyword(s):

Pulmonary Embolism ◽

World Literature ◽

Common Factor ◽

Medical Problem ◽

Thromboembolic Disease ◽

Diagnostic Tools ◽

Venous Thromboembolic Disease ◽

Vein Thrombosis ◽

Venous Thromboembolic ◽

Deep Vein

AbstractIntroduction. Deep vein thrombosis (DVT) and its most severe complication, pulmonary embolism (PE) is an interdisciplinary medical problem. Despite a wealth of knowledge, pulmonary embolism is the cause of about 10% of deaths among hospitalized patients and the most common factor which can be prevented. Therefore correct, rapid diagnosis of the patient’s assessment of the risk of sudden death and the quick implementation of treatment are essential to reduce mortality in this disease and prevent its distant complications.Aim of the study. The aim of this paper is to discuss on the basis of Polish and world literature the selected diagnostic tools in assessing the risk of venous thromboembolic disease.

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Predictive factors for concurrent deep-vein thrombosis and symptomatic venous thromboembolic recurrence in case of superficial venous thrombosis

Thrombosis and Haemostasis ◽

10.1160/th10-06-0406 ◽

2011 ◽

Vol 105 (01) ◽

pp. 31-39 ◽

Cited By ~ 50

Author(s):

Celine Genty ◽

Marie-Antoinette Sevestre ◽

Dominique Brisot ◽

Michel Lausecker ◽

Jean-Luc Gillet ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Venous Thrombosis ◽

Predictive Factors ◽

Adverse Outcome ◽

Varicose Veins ◽

Vein Thrombosis ◽

Increased Risk ◽

Venous Thromboembolic ◽

Deep Vein

SummarySuperficial venous thrombosis (SVT) prognosis is debated and its management is highly variable. It was the objective of this study to assess predictive risk factors for concurrent deep-vein thrombosis (DVT) at presentation and for three-month adverse outcome. Using data from the prospective multicentre OPTIMEV study, we analysed SVT predictive factors associated with concurrent DVT and three-month adverse outcome. Out of 788 SVT included, 227 (28.8%) exhibited a concurrent DVT at presentation. Age >75years (odds ratio [OR]=2.9 [1.5–5.9]), active cancer (OR=2.6 [1.3–5.2]), inpatient status (OR=2.3 [1.2–4.4]) and SVT on non-varicose veins (OR=1.8 [1.1–2.7]) were significantly and independently associated with an increased risk of concurrent DVT. 39.4% of SVT on non-varicose veins presented a concurrent DVT. However, varicose vein status did not influence the three-month prognosis as rates of death, symptomatic venous thromboembolic (VTE) recurrence and major bleeding were equivalent in both non-varicose and varicose SVTs (1.4% vs. 1.1%; 3.4% vs. 2.8%; 0.7% vs. 0.3%). Only male gender (OR=3.5 [1.1–11.3]) and inpatient status (OR=4.5 [1.3–15.3]) were independent predictive factors for symptomatic VTE recurrence but the number of events was low (n=15, 3.0%). Three-month numbers of deaths (n=6, 1.2%) and of major bleedings (n=2, 0.4%) were even lower, precluding any relevant interpretation. In conclusion, SVT on non-varicose veins and some classical risk factors for DVT were predictive factors for concurrent DVT at presentation. As SVT remains mostly a clinical diagnosis, these data may help selecting patients deserving an ultrasound examination or needing anticoagulation while waiting for diagnostic tests. Larger studies are needed to evaluate predictive factors for adverse outcome.

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Recurrence of Upper Extremity Deep Vein Thrombosis Secondary to COVID-19

Viruses ◽

10.3390/v13050878 ◽

2021 ◽

Vol 13 (5) ◽

pp. 878

Author(s):

Yesha H. Parekh ◽

Nicole J. Altomare ◽

Erin P. McDonnell ◽

Martin J. Blaser ◽

Payal D. Parikh

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Upper Extremity ◽

Thromboembolic Events ◽

Vein Thrombosis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Deep Vein

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.

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Dextran and postoperative thromboembolism

Drug and Therapeutics Bulletin ◽

10.1136/dtb.13.11.41 ◽

1975 ◽

Vol 13 (11) ◽

pp. 41-43

Keyword(s):

Platelet Aggregation ◽

Coagulation Factors ◽

Venous Thromboembolic Disease ◽

Vein Thrombosis ◽

Dextran 70 ◽

Lower Blood ◽

Venous Thromboembolic ◽

Reduce Platelet Aggregation ◽

Increase Platelet Aggregation ◽

Deep Vein

Two preparations of dextran have been tried for prevention of venous thromboembolic disease, dextran-40 (average m. w. 40,000) and dextran-70 (average m.w. 70,000). Dextrans reduce platelet aggregation and lower blood viscosity.1 Dextran may also reduce the peri-operative rise in the coagulation factors V and VIII.2 However, in some tests dextrans increase platelet aggregation3 and accelerate fibrin formation,4 so that only clinical trial can show whether dextran reduces the incidence of either deep-vein thrombosis or of pulmonary embolism.

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Varicose veins, deep vein thrombosis and haemorrhoids

Refined Carbohydrate Foods and Disease ◽

10.1016/b978-0-12-144750-2.50018-8 ◽

1975 ◽

pp. 143-160 ◽

Cited By ~ 1

Author(s):

DENIS BURKITT

Keyword(s):

Deep Vein Thrombosis ◽

Varicose Veins ◽

Vein Thrombosis ◽

Deep Vein

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Safety of a strategy combining D-dimer testing and whole-leg ultrasonography to rule out deep vein thrombosis

Blood Advances ◽

10.1182/bloodadvances.2020002173 ◽

2020 ◽

Vol 4 (20) ◽

pp. 5002-5010

Author(s):

Synne G. Fronas ◽

Camilla T. Jørgensen ◽

Anders E. A. Dahm ◽

Hilde S. Wik ◽

Jostein Gleditsch ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Pretest Probability ◽

Vein Thrombosis ◽

Venous Thromboembolic ◽

Deep Vein ◽

D Dimer ◽

Rule Out ◽

Compression Ultrasonography ◽

High Pretest Probability

Abstract Guidelines for the diagnostic workup of deep vein thrombosis (DVT) recommend assessing the clinical pretest probability before proceeding to D-dimer testing and/or compression ultrasonography (CUS) if the patient has high pretest probability or positive D-dimer. Referring only patients with positive D-dimer for whole-leg CUS irrespective of pretest probability may simplify the workup of DVT. In this prospective management outcome study, we assessed the safety of such a strategy. We included consecutive outpatients referred to the Emergency Department at Østfold Hospital, Norway, with suspected DVT between February 2015 and November 2018. STA-Liatest D-Di Plus D-dimer was analyzed for all patients, and only patients with levels ≥0.5 µg/mL were referred for CUS. All patients with negative D-dimer or negative CUS were followed for 3 months to assess the venous thromboembolic rate. One thousand three hundred ninety-seven patients were included. Median age was 64 years (interquartile range, 52-73 years), and 770 patients (55%) were female. D-dimer was negative in 415 patients (29.7%) and positive in 982 patients (70.3%). DVT was diagnosed in 277 patients (19.8%). Six patients in whom DVT was ruled out at baseline were diagnosed with DVT within 3 months of follow-up for a thromboembolic rate of 0.5% (95% confidence interval, 0.2-1.2). A simple diagnostic approach with initial stand-alone D-dimer followed by a single whole-leg CUS in patients with positive D-dimer safely ruled out DVT. We consider this strategy to be a valuable alternative to the conventional workup of DVT in outpatients. This trial was registered at www.clinicaltrials.gov as #NCT02486445.

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Predicting Venous Thromboembolic Events in Patients with Coronavirus Disease 2019 Requiring Hospitalization: an Observational Retrospective Study by the COVIDIC Initiative in a Swiss University Hospital

BioMed Research International ◽

10.1155/2020/9126148 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Eleftheria Kampouri ◽

Paraskevas Filippidis ◽

Benjamin Viala ◽

Marie Méan ◽

Olivier Pantet ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Retrospective Study ◽

University Hospital ◽

Thromboembolic Events ◽

Vein Thrombosis ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic ◽

Wells Score ◽

Deep Vein ◽

D Dimer

Background. Coronavirus disease 2019 (COVID-19) can result in profound changes in blood coagulation. The aim of the study was to determine the incidence and predictors of venous thromboembolic events (VTE) among patients with COVID-19 requiring hospital admission. Subjects and Methods. We performed a retrospective study at the Lausanne University Hospital with patients admitted because of COVID-19 from February 28 to April 30, 2020. Results. Among 443 patients with COVID-19, VTE was diagnosed in 41 patients (9.3%; 27 pulmonary embolisms, 12 deep vein thrombosis, one pulmonary embolism and deep vein thrombosis, one portal vein thrombosis). VTE was diagnosed already upon admission in 14 (34.1%) patients and 27 (65.9%) during hospital stay (18 in ICU and nine in wards outside the ICU). Multivariate analysis revealed D-dimer value > 3,120 ng / ml ( P < 0.001 ; OR 15.8, 95% CI 4.7-52.9) and duration of 8 days or more from COVID-19 symptoms onset to presentation ( P 0.020; OR 4.8, 95% CI 1.3-18.3) to be independently associated with VTE upon admission. D-dimer value ≥ 3,000 ng / l combined with a Wells score for PE ≥ 2 was highly specific (sensitivity 57.1%, specificity 91.6%) in detecting VTE upon admission. Development of VTE during hospitalization was independently associated with D-dimer value > 5,611 ng / ml ( P < 0.001 ; OR 6.3, 95% CI 2.4-16.2) and mechanical ventilation ( P < 0.001 ; OR 5.9, 95% CI 2.3-15.1). Conclusions. VTE seems to be a common COVID-19 complication upon admission and during hospitalization, especially in ICU. The combination of Wells ≥ 2 score and D − dimer ≥ 3,000 ng / l is a good predictor of VTE at admission.

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