![]() Pre-test probability assessment is the first step in the diagnostic algorithm of DVT suspicion ( Figure 2). Probability assessment and d-dimer testing Symptoms include pain, swelling, increased skin veins visibility, erythema, and cyanosis accompanied by unexplained fever. 11ĭiagnosis Deep vein thrombosis without pulmonary embolism symptomsĬlinical signs and symptoms are highly variable and unspecific but remain the cornerstone of diagnostic strategy. Villalta score is used for PTS diagnosis and treatment evaluation ( Table 1). Obesity and poor INR control during the first 3-months treatment are additional independent risk factors. 9 Previous ipsilateral DVT, proximal location (ilio-femoral > popliteal), and residual veins obstruction are most significant PTS risk factors. It represents the most frequent chronic DVT complication, occurring in 30–50% of patients within 2 years after proximal DVT. Long-term complications include post-thrombotic syndrome (PTS), defined as chronic venous symptoms and/or signs secondary to DVT. 8Įarly- and mid-term complications include thrombosis extension, and PE and DVT recurrence (see Supplementary material online, only section). 7 Recurrence risk is high, especially within first 6 months. In patients with DVT without PE, short-term mortality rates of 2–5% were reported, more frequent in proximal than distal DVT. ![]() 7 In 25–50% of first DVT episodes, no predisposing factor is identified. ![]() 6 Distal (below knee) DVTs are more frequently related to transient situations while proximal ones to chronic conditions. 5ĭeep vein thrombosis are mostly secondary to predisposing factors common with pulmonary embolism (PE) ( webtable 1). Recent European population studies reported DVT incidence of 70–140 cases/100,000 person-year. Venous thromboembolism incidence according to age group. ![]()
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