Deep Vein Thrombosis

Pathophysiology

Deep vein thrombosis, or deep venous thrombosis, (DVT) is the formation of a blood clot (thrombus) within a deep vein, predominantly in the legs. Non-specific signs may include pain, swelling, redness, warmness, and engorged superficial veins. DVT often develops in the calf veins and "grows" in the direction of venous flow, towards the heart. When DVT does not grow; it can be cleared naturally and dissolved into the blood (fibrinolysis).

Disease Statistics

The study conducted with self completing postal questionnaire among a random sample of 692 general practitioners in the Netherlands. The overall response rate was 58%. Eighty-nine percent of the respondents initiated objective evaluation. Less than 3% usually make the diagnosis on clinical grounds only. Ninety-two percent initiated adequate treatment for the last patient with deep vein thrombosis. No more than 4% usually treat patients with acenocoumarol alone. Respondents frequently referred a patient to a specialist, 41% to confirm the diagnosis and 85% for treatment. Already 44% feel that management of deep vein thrombosis is a mandate of the general practitioner.

Treatment

The basic treatments for the disease are Anticoagulation, which prevents further coagulation, home treatment, stockings, walking, and repeat imaging and IVC filters, thrombolysis, and thrombectomy. The aims of the physicians are to prevent clot becoming larger, clot becoming lose and traveling to lungs, new clot formation and Post thrombotic syndrome.

Major Research on Disease

The current major research on the diseases are efficacy of low doses of heparin for the prevention of the DVT after a major surgery, accuracy of the clinical assessment for DVT, Decreased plasma levels of activated factor VII in patients with deep vein thrombosis etc.