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Deep Vein Thrombosis in the Elderly

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Vascular Disease in Older Adults

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Abstract

Aging is one of the strongest and most prevalent risk factors for venous thromboembolic (VTE) disease. There is an 80-fold increased risk for individuals >85 years compared to those 25–35 years old. Sixty percent of all VTE events occur in patients ≥70 years old.

Medical comorbidities such as chronic obstructive pulmonary disease, diabetes, stroke, and congestive heart failure increase the risk of VTE and are present in 80% of patients >80 years old. Patients with malignancy have a sevenfold increased risk of VTE. There is a threefold increased risk of cancer in patients >65 years compared to those younger.

Anticoagulation is the mainstay for the management of acute VTE. One must be aware of the patient’s renal function when using low-molecular-weight heparins (LMWH), although the large molecular weight Tinzaparin may be preferable in elderly patients with compromised renal function if LMWH is desirable.

Direct acting oral anticoagulants (DOACs) have been studied against conventional oral anticoagulation with vitamin K antagonists (VKAs) and found to be effective, but significantly safer, than VKAs.

When using thrombolytic agents to treat major VTE, older patients have higher risks of major and intracranial bleeds with systemic thrombolysis. Catheter-based techniques are safer and are used with increasing frequency for patients with a large thrombus burden, offering the advantage of thrombus removal with decreased procedural risk.

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Acknowledgement

The author wishes to recognize the expert asssistance of medical writer/editor, Shakela Watkins, MA, in the preperation of this chapter.

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Authors and Affiliations

  1. Jobst Vascular Institute, Toledo, OH, USA

    Anthony J. Comerota

  2. University of Michigan, Ann Arbor, MI, USA

    Anthony J. Comerota

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Correspondence to Anthony J. Comerota .

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Editors and Affiliations

  1. Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

    Rabih Chaer

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Comerota, A.J. (2017). Deep Vein Thrombosis in the Elderly. In: Chaer, R. (eds) Vascular Disease in Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-29285-4_4

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  • DOI: https://doi.org/10.1007/978-3-319-29285-4_4

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