Deep vein thrombosis (overview)I80.28
Synonym(s)
DefinitionThis section has been translated automatically.
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.
ClassificationThis section has been translated automatically.
These are classified according to the location of the deep thrombosis:
Occurrence/EpidemiologyThis section has been translated automatically.
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)
EtiopathogenesisThis section has been translated automatically.
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).
Note(s)This section has been translated automatically.
Phlebitis (syn.: superficial venous thrombosis) is a thrombotic change in the superficial venous system.
LiteratureThis section has been translated automatically.
- Avila ML et al (2016) Pediatric post-thrombotic syndrome in children: Toward the development of a new diagnostic and evaluative measurement tool. Thromb Res 144:184-191.
- Encke A et al. (2016) The prophylaxis of venous thromboembolism. Dtsch Ärztebl. Int 113: 532-538
- EINSTEIN Investigators (2011) Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 363: 2499-2510
- Heil J et al (2017) Deep vein thrombosis of the upper extremity. Dtsch Ärztebl 114: 244-249
- Lewis BE et al (2007) Direct thrombin inhibition during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia. Expert Rev Cardiovasc Ther 5: 57-68
- Qi X et al (2016) Splenectomy Causes 10-Fold Increased Risk of Portal Venous System Thrombosis in Liver Cirrhosis Patients. Med Sci Monit 22:2528-2550.
- Ridker PM et al (2003) Long-term, low-intensity warfarin therapy for the prevention of recurrent venous thromboembolism. N Engl J Med 348: 1425-1434
- Sajid MS et al (2007) Upper limb deep vein thrombosis: a literature review to streamline the protocol for management. Acta Haematol.118:10-18.
- Scurr JH et al (2001) Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial. Lancet. 357: 1485-1489
- Spencer FA et al (2007) Upper extremity deep vein thrombosis: a community-based perspective. On J med 120:678-684.
- Turpie AG et al (2002) Venous thromboembolism: pathophysiology, clinical features, and prevention. BMJ 325: 887-890