Advertisement

Venous Thromboembolism

  • Hyun-Yoon Ko
Chapter

Abstract

Deep vein thrombosis and pulmonary embolism are serious health problems and cause serious mortality and morbidity. Patients with spinal cord injuries have a particularly high risk of developing deep vein thrombosis. In patients with spinal cord injuries, the loss of active calf muscle pump in the paralyzed limbs significantly reduces blood flow. As a result, sluggishness of venous return is further exacerbated by the hypercoagulability associated with spinal cord injury. In combination with the pressure that the bed exerts on the calf muscles, this sluggishness causes the bedridden spinal cord injured patient to be at high risk of developing deep vein thrombosis.

References

  1. Baumgartner HR, Muggli R, Tschopp TB, et al. Platelet adhesion, release and aggregation in flowing blood: effects of surface properties and platelet function. Thromb Haemost. 1976;35(1):124–38.CrossRefGoogle Scholar
  2. Bounameaux H, Cirafici P, de Moerloose P, et al. Measurement of D-dimer in plasma as diagnostic aid in suspected pulmonary embolism. Lancet. 1991;337:196–200.CrossRefGoogle Scholar
  3. Christie S, Thibault-Halman G, Casha S. Acute pharmacological DVT prophylaxis after spinal cord injury. J Neurotrauma. 2011;28:1509–14.CrossRefGoogle Scholar
  4. Consortium fore Spinal Cord Medicine. Prevention of venous thromboembolism in individuals with spinal cord injury. 3rd ed. Washington, DC: Paralyzed Veterans of America; 2016.Google Scholar
  5. Deitelzweig S, Jaff MR. Medical management of venous thromboembolic disease. Tech Vasc Interv Radiol. 2004;7:63–7.CrossRefGoogle Scholar
  6. Furlan JC, Fehlings MG. Role of screening tests for deep venous thrombosis in asymptomatic adults with acute spinal cord injury: an evidence-based analysis. Spine (Phila Pa 1976). 2007;32(17):1908–16.CrossRefGoogle Scholar
  7. Green D. Venous thromboembolism. In: Green D, Olson DA, editors. Medical management of long-term disability. Boston, MA: Butterworth-Heinemann; 1996. p. 199–216.Google Scholar
  8. Hadley MN, Walters BC, Aarabi B, et al. Clinical assessment following acute cervical spinal cord injury. Neurosurgery. 2013;72(Suppl 2):40–53.CrossRefGoogle Scholar
  9. Hull RD, Raskob GE. Venous thromboembolic disease. Curr Opin Cardiol. 1991;6(5):750–6.CrossRefGoogle Scholar
  10. Hull RD, Raskob GE, Hirsh J, et al. Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. N Engl J Med. 1986;315(18):1109–14.CrossRefGoogle Scholar
  11. Koopman MM, Bossuyt PM. Low molecular weight heparin for outpatient treatment of venous thromboembolism: safe, effective, and cost reducing? Am J Med. 2003;115:324–5.CrossRefGoogle Scholar
  12. Masuda M, Ueta T, Shiba K, et al. D-dimer screening for deep venous thrombosis in traumatic cervical spinal injuries. Spine J. 2015;15:2338–44.CrossRefGoogle Scholar
  13. Messier MH. Lower extremity venous anatomy. Semin Intervent Radiol. 2005;22:147–56.CrossRefGoogle Scholar
  14. Morris TA. Heparin and low molecular weight heparin: background and pharmacology. Clin Chest Med. 2003;24:39–47.CrossRefGoogle Scholar
  15. Moser KM, LeMoine JR. Is embolic risk conditioned by location of deep venous thrombosis? Ann Intern Med. 1981;94(4 Pt 1):439–44.CrossRefGoogle Scholar
  16. Muriel K, Green RM, Greenberg RK, et al. The anatomy of deep venous thrombosis of the lower extremity. J Vasc Surg. 2003;31:895–900.Google Scholar
  17. Murphy KD. Mechanical thrombectomy for DVT. Tech Vasc Interv Radiol. 2004;7:79–85.CrossRefGoogle Scholar
  18. Peterson CW. Venous thrombosis: an overview. Pharmacotherapy. 1986;6(4 Pt 2):12S–7S.CrossRefGoogle Scholar
  19. Rossi EC, Green D, Rosen JS, et al. Sequential changes in factor VIII and platelets preceding deep vein thrombosis in patients with spinal cord injury. Br J Haematol. 1980;45(1):143–51.CrossRefGoogle Scholar
  20. Rozzelle CJ, Aarabi B, Dhall SS, et al. Management of pediatric cervical spine and spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):205–26.CrossRefGoogle Scholar
  21. Ryken TC, Hurlbert RJ, Hadley MN, et al. The acute cardiopulmonary management of patients with cervical spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):84–92.CrossRefGoogle Scholar
  22. Sprague S, Cook DJ, Anderson D, et al. A systematic review of economic analyses of low-molecular-weight heparin for the treatment of venous thromboembolism. Thromb Res. 2003;112:193–201.CrossRefGoogle Scholar
  23. Stavropoulos SW. Inferior vena cava filters. Tech Vasc Interv Radiol. 2004;7:91–5.CrossRefGoogle Scholar
  24. Stein PD, Hull RD, Patel KC, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140(8):589–602.CrossRefGoogle Scholar
  25. Teasell RW, Hsieh JT, Aubut JA, et al. Venous thromboembolism after spinal cord injury. Arch Phys Med Rehabil. 2009;90:232–45.CrossRefGoogle Scholar
  26. Vogel LC, Anderson CJ. Spinal cord injuries in children and adolescents: a review. J Spinal Cord Med. 2003;26:193–203.CrossRefGoogle Scholar
  27. Watson N. Venous thrombosis and pulmonary embolism in spinal cord injury. Paraplegia. 1968;6(3):13–21.Google Scholar

Suggested Reading

  1. Byrne TN, Benzel EC, Waxman SG. Diseases of the spine and spinal cord. Oxford: Oxford University Press; 2000.Google Scholar
  2. Cardenas DD, Hooton TM, editors. Medical complications in physical medicine and rehabilitation. New York: Demos Medical Publishing, LLC; 2015.Google Scholar
  3. Chhabra HS, editor. ISCoS textbook on comprehensive management of spinal cord injuries. New Delhi: Wolters Kluwer; 2015.Google Scholar
  4. Crossman A, Neary D. Neuroanatomy: an illustrated colour test. 5th ed. Philadelphia, PA: Elsevier; 2015.Google Scholar
  5. Eltorai IM, Schmit JK, editors. Emergencies in chronic spinal cord injury patients. New York: Eastern Paralyzed Veterans Association; 2001.Google Scholar
  6. Green D, Olson DA, editors. Medical management of long-term disability. 2nd ed. Boston, MA: Butterworth-Heinemann; 1996.Google Scholar
  7. Guttmann L. Spinal cord injuries. Comprehensive management and research. Oxford: Blackwell Scientific Publications; 1976.Google Scholar
  8. Holtz A, Levi R. Spinal cord injury. Oxford: Oxford University Press; 2010.Google Scholar
  9. Illis LS, editor. Spinal cord dysfunction: assessment. Oxford: Oxford University Press; 1988.Google Scholar
  10. Kirshblum S, Campagnolo DI, editors. Spinal cord medicine. 2nd ed. Philadelphia, PA: Wolters Kluwer, Lippincott, Williams & Wilkins; 2011.Google Scholar
  11. Lee BY, Ostrander LE, editors. The spinal cord injured patient. 2nd ed. New York: Demos; 2002.Google Scholar
  12. Lin VW, editor. Spinal cord medicine. Principles and practice. 2nd ed. New York: Demos Medical; 2010.Google Scholar
  13. Preston RA. Acid-base, fluids and electrolytes: made ridiculously simple. 2nd ed. Miami, FL: MedMaster, Inc.; 2011.Google Scholar
  14. Verhaagen J, McDonald JW III. Spinal cord injury. In: Aminoff MJ, Boller F, Swaab DF, editors. Handbook of clinical neurology, third series, vol. 109. London: Elsevier; 2012.Google Scholar
  15. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part I. Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976.Google Scholar
  16. Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part II. Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976.Google Scholar
  17. Weaver LC, Polosa C, editors. Autonomic dysfunction after spinal cord injury, Progress in brain research, vol. 152. New York: Elsevier; 2006.Google Scholar
  18. Weidner N, Rupp R, Taney KE, editors. Neurological aspects of spinal cord injury. Cham: Springer; 2017.Google Scholar
  19. Young RR, Woolsey RM, editors. Diagnosis and management of disorders of the spinal cord. Philadelphia, PA: W. B. Saunders; 1995.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Hyun-Yoon Ko
    • 1
  1. 1.Department of Rehabilitation MedicineRehabilitation Hospital, Pusan National University Yangsan Hospital, Pusan National University School of MedicineYangsanSouth Korea

Personalised recommendations