B. Todd Sitzman, M.D., M.P.H. B. Todd Sitzman, M.D., M.P.H. is with the Department of Anesthesiology and Pain Management, Mayo Clinic Jacksonville. Jacksonville Medicine / December, 1998

Deep vein thrombosis (throm-BO-sis) is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh. They also can occur in other parts of the body. January 2006

Thromb Haemost. 2000 Feb;83(2):191-8. Comment in: Thromb Haemost. 2000 Dec;84(6):1134-5. Thromb Haemost. 2000 Feb;83(2):180-1.

Blood, 1 January 2006, Vol. 107, No. 1, pp. 21-29.

Mark H. Meissner, MD, and E. Eugene Strandness, Jr., MD

The objectives of treatment for patients with venous thromboembolism (VTE) (deep venous thrombosis and/or pulmonary embolism) are 1) to prevent death from pulmonary embolism, 2) to relieve symptoms and prevent extension of deep venous thrombosis, 3) to prevent recurrent VTE, and 4) to prevent the post thrombotic syndrome. The anticoagulant drugs heparin, low molecular weight heparin (LMWH) and warfarin constitute the mainstay of treatment of VTE. In selected cases the use of thrombolytic agents and/or the insertion of an inferior vena cava filter may be indicated. The use of graduated compression stockings following an episode of deep venous thrombosis has been shown to decrease the incidence of the post thrombotic syndrome. For further information on the use of heparin and warfarin, please refer to the guidelines located elsewhere on the TIG web site.

Gregory YH Lip, MD, FRCPE, FESC, FACC The University of Birmingham Graham F Pineo, MD Foothills Hospital Kenneth A Bauer, MD Harvard Medical School

Last Updated: March 2, 2005

Another article by Craig Freied, MD from emedicine site

Hospitals are failing to properly diagnose patients with potentially fatal deep vein thrombosis, according to a public service watchdog. Published: 2006/05/31 18:28:41 GMT © BBC MMVI

Here is a list of terms useful to the new DVT patient

(posted 7/1/01)

Update Date: 10/28/2003 Updated by: Ezra E. W. Cohen, M.D., Section of Hematology/Oncology, Department of Medicine, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

Smeeth L, Cook C, Thomas S, Hall AJ, Hubbard R, Vallance P. Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. Lancet. APRIL1–7 2006;367:1075-1079. Answer: Yes. Acute urinary or respiratory tract infection is linked to a substantial but reversible increase in the risk of venous thromboembolism. The risk increased significantly in the first 2 weeks after acute infection and gradually returned to baseline over 12 months.

Ann Fam Med. 2007;5(1):74-80. ©2007 Annals of Family Medicine, Inc.

DVT occurs when a blood clot forms in a deep vein, usually in the lower limbs. A complication of DVT, pulmonary embolism, can occur when a fragment of a blood clot breaks loose from the wall of the vein and migrates to the lungs, where it blocks a pulmonary artery or one of its branches.

Mayo Clinic January 31, 2005

Vedantham et al. 17 (3) 417

Victims of deep vein thrombosis have lost their appeal for the right to claim compensation from airlines. Last Updated: Thursday, 8 December 2005, 13:02 GMT

BMJ, doi:10.1136/bmj.39098.583356.55 (published 8 February 2007) Conclusion: For patients in the UK with deep vein thrombosis or pulmonary embolism and no known risk factors for recurrence, there seems to be little, if any, advantage in increasing the duration of anticoagulation from three to six months. Any possible advantage would be small and would need to be judged against the increased risk of haemorrhage associated with the longer duration of treatment with warfarin.

Another article from emedicine site, radiological perspective

(Circulation. 2004;109:I-4 – I-8.) © 2004 American Heart Association, Inc.

CMAJ • October 24, 2006; 175 (9). doi:10.1503/cmaj.060366. © 2006 CMA Media Inc. or its licensors. Deep-vein thrombosis (DVT) is a common condition that can lead to complications such as postphlebitic syndrome, pulmonary embolism and death. The approach to the diagnosis of DVT has evolved over the years. Currently an algorithm strategy combining pretest probability, D-dimer testing and compression ultrasound imaging allows for safe and convenient investigation of suspected lower-extremity thrombosis. Patients with low pretest probability and a negative D-dimer test result can have proximal DVT excluded without the need for diagnostic imaging. The mainstay of treatment of DVT is anticoagulation therapy, whereas interventions such as thrombolysis and placement of inferior vena cava filters are reserved for special situations. The use of low-molecular-weight heparin allows for outpatient management of most patients with DVT. The duration of anticoagulation therapy depends on whether the primary event was idiopathic or secondary to a transient risk factor. More research is required to optimally define the factors that predict an increased risk of recurrent DVT to determine which patients can benefit from extended anticoagulant therapy.

Am Fam Physician 2004;69:2829-36. Copyright© 2004 American Academy of Family Physicians. DINO W. RAMZI, M.D., C.M., and KENNETH V. LEEPER, M.D., Emory University School of Medicine, Atlanta, Georgia