Management of venous thromboembolisms: Part i. the consensus for deep vein thrombosis

Kang Ling Wang, Pao Hsien Chu, Cheng Han Lee, Pei Ying Pai, Pao Yen Lin, Kou Gi Shyu, Wei Tien Chang, Kuan Ming Chiu, Chien Lung Huang, Chung Yi Lee, Yen Hung Lin, Chun Chieh Wang, Hsueh Wei Yen, Wei Hsian Yin, Hung I. Yeh, Chern En Chiang, Shing Jong Lin, San Jou Yeh

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

Deep vein thrombosis (DVT) is a potentially catastrophic condition because thrombosis, left untreated, can result in detrimental pulmonary embolism. Yet in the absence of thrombosis, anticoagulation increases the risk of bleeding. In the existing literature, knowledge about the epidemiology of DVT is primarily based on investigations among Caucasian populations. There has been little information available about the epidemiology of DVT in Taiwan, and it is generally believed that DVT is less common in Asian patients than in Caucasian patients. However, DVT is a multifactorial disease that represents the interaction between genetic and environmental factors, and the majority of patients with incident DVT have either inherited thrombophilia or acquired risk factors. Furthermore, DVT is often overlooked. Although symptomatic DVT commonly presents with lower extremity pain, swelling and tenderness, diagnosing DVT is a clinical challenge for physicians. Such a diagnosis of DVT requires a timely systematic assessment, including the use of the Wells score and a D-dimer test to exclude low-risk patients, and imaging modalities to confirm DVT. Compression ultrasound with high sensitivity and specificity is the front-line imaging modality in the diagnostic process for patients with suspected DVT in addition to conventional invasive contrast venography.Most patients require anticoagulation therapy, which typically consists of parenteral heparin bridged to a Vitamin K antagonist, with variable duration. The development of non-Vitamin K oral anticoagulants has revolutionized the landscape of venous thromboembolism treatment, with 4 agents available,including rivaroxaban, dabigatran, apixaban, and edoxaban. Presently, all 4 drugs have finished their large phase III clinical trial programs and come to the clinical uses in North America and Europe. It is encouraging to note that the published data to date regarding Asian patients indicates that such new therapies are safe and efficacious. Ultimately, our efforts to improve outcomes in patients with DVT rely on the awareness in the scientific and medical community regarding the importance of DVT.

Original languageEnglish
Pages (from-to)1-22
Number of pages22
JournalActa Cardiologica Sinica
Volume32
Issue number1
DOIs
Publication statusPublished - 2016 Jan

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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