Deep vein thrombosis (overview) I80.28

Sudden or gradual, partial or complete occlusion of at least one segment of the deep vena cava and muscle veins of the pelvis and/or leg or arm by a thrombus with a tendency to grow and the risk of embolization into the lungs. DVT and pulmonary embolism are one of the main causes of morbidity and mortality during hospitalisation.

These are classified according to the location of the deep thrombosis:

• deep vein thrombosis of the lower extremity
• Deep vein thrombosis of the upper extremity

The risk of DVT depends on age and risk factors (see also Man.) Risk of developing the disease at age < 60 years = 1:10,000 per year; at age > 60 years = 1:1,000 per year. The proportion of TV-OEs(deep vein thrombosis of the upper extremity) is 4-10% of the total collective of TVs (Encke A et al. 2016)

Slowing of the blood flow, endothelial injuries (see endothelium below), changes in the vein wall, increased readiness of the blood to clot (= Virchow's triad).

Further risk factors:

• Age, previous thrombosis, pregnancy, pelvic vein spur, varicose veins, cardiac insufficiency, overweight, ovulation inhibitors; previous or still existing superficial thrombophlebitis; in DVT-OE ZVK, pacemaker.
• Coagulation disorders: deficiency of antithrombin III, protein C, protein S; congenital resistance to activated protein C (APC resistance); factor V (Leiden) defect; elevated levels of von Willebrand factor or factor VIII; mutation in factor II gene (polymorphism of prothrombin).
• Acquired disorders: antiphospholipid-antibody syndrome and lupus anticoagulant, which may occur primarily or as part of an underlying disease (autoimmune disease).

Phlebitis (syn.: superficial venous thrombosis) is a thrombotic change in the superficial venous system.

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