Skip to main content

Risk Factors and Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism

  • 887 Accesses

Abstract

Deep venous thrombosis (DVT) is the formation of an intraluminal thrombus that occludes wholly or partially deep veins’ lumen. There is no single cause for DVT, but there are medical conditions that increase the likelihood of developing thrombi. Therefore, the incidence of this condition is associated with the number of risk factors present. Although, there are several risk factor assessment and protocols available for DVT prevention in daily medical practice.

The DVT’s prevention decreases the risk of pulmonary embolism. An estimated one-third of cases of pulmonary embolism progress to death if the condition remains untreated. Survivors are subject to chronic complications: about 4 % develop pulmonary hypertension, and 25–50 % have post-thrombotic syndrome in the lower limb.

Keywords

  • Risk factors
  • Prophylaxis
  • Deep venous thrombosis
  • Pulmonary embolism
  • Venous thromboembolism
  • Caprini score
  • Thromboprophylaxis
  • Low-molecular-weight heparin
  • Low-dose unfractionated heparin
  • Anticoagulant medications

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-46059-8_11
  • Chapter length: 9 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   109.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-46059-8
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   139.99
Price excludes VAT (USA)
Hardcover Book
USD   139.99
Price excludes VAT (USA)

Abbreviations

BMI:

Body mass index

DVT:

Deep venous thrombosis

References

  1. Guyatt GH, Akl EA, Crowther M, Schünemann HJ, Gutterman DD, Zelman Lewis S, et al. Introduction to the ninth edition: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):48S–52.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  2. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):381S–453.

    CAS  CrossRef  PubMed  Google Scholar 

  3. Arcelus JI, Caprini JA. Acute deep venous thrombosis: prevention and medical treatment. In: Rutherford RB, editor. Vascular surgery. Philadelphia; 2014. p. 776.

    Google Scholar 

  4. Prandoni P, Cogo A, Bernardi E, Villalta S, Polistena P, Simioni P, et al. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis. Circulation. 1993;88(4 Pt 1):1730–5.

    CAS  CrossRef  PubMed  Google Scholar 

  5. Nicolaides AN, Fareed J, Kakkar AK, Comerota AJ, Goldhaber SZ, Hull R, et al. Prevention and treatment of venous thromboembolism—International Consensus Statement. Int Angiol. 2013;32(2):111–260.

    CAS  PubMed  Google Scholar 

  6. Caprini JA, Tapson VF, Hyers TM, Waldo AL, Wittkowsky AK, Friedman R, et al. Treatment of venous thromboembolism: adherence to guidelines and impact of physician knowledge, attitudes, and beliefs. J Vasc Surg. 2005;42(4):726–33.

    CrossRef  PubMed  Google Scholar 

  7. Caprini JA. Risk assessment as a guide to thrombosis prophylaxis. Curr Opin Pulm Med. 2010;16(5):448–52.

    CrossRef  PubMed  Google Scholar 

  8. Stinnett JM, Pendleton R, Skordos L, Wheeler M, Rodgers GM. Venous thromboembolism prophylaxis in medically ill patients and the development of strategies to improve prophylaxis rates. Am J Hematol. 2005;78(3):167–72.

    CrossRef  PubMed  Google Scholar 

  9. Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e227S–77.

    CAS  CrossRef  PubMed  PubMed Central  Google Scholar 

  10. Kahn SR, Hirsch A, Shrier I. Effect of postthrombotic syndrome on health-related quality of life after deep venous thrombosis. Arch Intern Med. 2002;162(10):1144–8.

    CrossRef  PubMed  Google Scholar 

  11. Sadaghianloo N, Dardik A. The efficacy of intermittent pneumatic compression in the prevention of lower extremity deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2016;4(2):248–56.

    CrossRef  PubMed  Google Scholar 

  12. Kakkos SK, Szendro G, Griffin M, Daskalopoulou SS, Nicolaides AN. The efficacy of the new SCD response compression system in the prevention of venous stasis. J Vasc Surg. 2000;32(5):932–40.

    CAS  CrossRef  PubMed  Google Scholar 

  13. Wells PS, Lensing AW, Hirsh J. Graduated compression stockings in the prevention of postoperative venous thromboembolism. A meta-analysis. Arch Intern Med. 1994;154(1):67–72.

    CAS  CrossRef  PubMed  Google Scholar 

  14. Turpie AG, Eriksson BI, Lassen MR, Bauer KA. A meta-analysis of fondaparinux versus enoxaparin in the prevention of venous thromboembolism after major orthopaedic surgery. J South Orthop Assoc. 2002;11(4):182–8.

    PubMed  Google Scholar 

  15. Burness CB, Perry CM. Rivaroxaban: a review of its use in the treatment of deep vein thrombosis or pulmonary embolism and the prevention of recurrent venous thromboembolism. Drugs. 2014;74(2):243–62.

    CAS  CrossRef  PubMed  Google Scholar 

  16. Cohen AT, Spiro TE, Buller HR, Haskell L, Hu D, Hull R, et al. Rivaroxaban for thromboprophylaxis in acutely ill medical patients. N Engl J Med. 2013;368(6):513–23.

    CAS  CrossRef  PubMed  Google Scholar 

  17. Mandernach MW, Beyth RJ, Rajasekhar A. Apixaban for the prophylaxis and treatment of deep vein thrombosis and pulmonary embolism: an evidence-based review. Ther Clin Risk Manag. 2015;11:1273–82.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  18. Eriksson BI, Dahl OE, Buller HR, Hettiarachchi R, Rosencher N, Bravo ML, et al. A new oral direct thrombin inhibitor, dabigatran etexilate, compared with enoxaparin for prevention of thromboembolic events following total hip or knee replacement: the BISTRO II randomized trial. J Thromb Haemost. 2005;3(1):103–11.

    CAS  CrossRef  PubMed  Google Scholar 

  19. Sadaghianloo N, Jean-Baptiste E, Declemy S, Hassen-Khodja R, Dardik A. Use of aspirin for the prevention of lower extremity deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2014;2(2):230–9.

    CrossRef  PubMed  Google Scholar 

  20. Junqueira DR, Perini E, Penholati RR, Carvalho MG. Unfractionated heparin versus low molecular weight heparin for avoiding heparin-induced thrombocytopenia in postoperative patients. Cochrane Database Syst Rev. 2012;9:CD007557.

    Google Scholar 

  21. Junqueira DR, Carvalho M, Perini E. Heparin-induced thrombocytopenia: a review of concepts regarding a dangerous adverse drug reaction. Rev Assoc Med Bras. 2013;59(2):161–6.

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raisa Cristina Teodoro da Silva M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

da Silva, R.C.T., Botelho, L.F., Nogueira, R.F., Botelho, F.E. (2017). Risk Factors and Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism. In: Navarro, T., Dardik, A., Junqueira, D., Cisneros, L. (eds) Vascular Diseases for the Non-Specialist. Springer, Cham. https://doi.org/10.1007/978-3-319-46059-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46059-8_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46057-4

  • Online ISBN: 978-3-319-46059-8

  • eBook Packages: MedicineMedicine (R0)