Acute venous disease: Venous thrombosis and venous trauma

Mark H. Meissner, Thomas W. Wakefield, Enrico Ascher, Joseph A. Caprini, Anthony J. Comerota, Bo Eklof, David L. Gillespie, Lazar J. Greenfield, Aiwu Ruth He, Peter K. Henke, Anil Hingorani, Russell D. Hull, Craig M. Kessler, Robert D. McBane, Robert Mclafferty

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Acute venous disorders include deep venous thrombosis, superficial venous thrombophlebitis, and venous trauma. Deep venous thrombosis (DVT) most often arises from the convergence of multiple genetic and acquired risk factors, with a variable estimated incidence of 56 to 160 cases per 100,000 population per year. Acute thrombosis is followed by an inflammatory response in the thrombus and vein wall leading to thrombus amplification, organization, and recanalization. Clinically, there is an exponential decrease in thrombus load over the first 6 months, with most recanalization occurring over the first 6 weeks after thrombosis. Pulmonary embolism (PE) and the post-thrombotic syndrome (PTS) are the most important acute and chronic complications of DVT. Despite the effectiveness of thromboembolism prophylaxis, appropriate measures are utilized in as few as one-third of at-risk patients. Once established, the treatment of venous thromboembolism (VTE) has been defined by randomized clinical trials, with appropriate anticoagulation constituting the mainstay of management. Despite its effectiveness in preventing recurrent VTE, anticoagulation alone imperfectly protects against PTS. Although randomized trials are currently lacking, at least some data suggests that catheter-directed thrombolysis or combined pharmaco-mechanical thrombectomy can reduce post-thrombotic symptoms and improve quality of life after acute ileofemoral DVT. Inferior vena caval filters continue to have a role among patients with contra-indications to, complications of, or failure of anticoagulation. However, an expanded role for retrievable filters for relative indications has yet to be clearly established. The incidence of superficial venous thrombophlebitis is likely under-reported, but it occurs in approximately 125,000 patients per year in the United States. Although the appropriate treatment remains controversial, recent investigations suggest that anticoagulation may be more effective than ligation in preventing DVT and PE. Venous injuries are similarly under-reported and the true incidence is unknown. Current recommendations include repair of injuries to the major proximal veins. If repair not safe or possible, ligation should be performed.

Original languageEnglish (US)
JournalJournal of Vascular Surgery
Volume46
Issue number6 SUPPL.
DOIs
StatePublished - Dec 2007
Externally publishedYes

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Acute Disease
Venous Thrombosis
Thrombosis
Wounds and Injuries
Thrombophlebitis
Venous Thromboembolism
Pulmonary Embolism
Ligation
Veins
Incidence
Thrombectomy
Venae Cavae
Thromboembolism
Catheters
Randomized Controlled Trials
Quality of Life
Organizations
Therapeutics
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Meissner, M. H., Wakefield, T. W., Ascher, E., Caprini, J. A., Comerota, A. J., Eklof, B., ... Mclafferty, R. (2007). Acute venous disease: Venous thrombosis and venous trauma. Journal of Vascular Surgery, 46(6 SUPPL.). https://doi.org/10.1016/j.jvs.2007.08.037

Acute venous disease : Venous thrombosis and venous trauma. / Meissner, Mark H.; Wakefield, Thomas W.; Ascher, Enrico; Caprini, Joseph A.; Comerota, Anthony J.; Eklof, Bo; Gillespie, David L.; Greenfield, Lazar J.; He, Aiwu Ruth; Henke, Peter K.; Hingorani, Anil; Hull, Russell D.; Kessler, Craig M.; McBane, Robert D.; Mclafferty, Robert.

In: Journal of Vascular Surgery, Vol. 46, No. 6 SUPPL., 12.2007.

Research output: Contribution to journalArticle

Meissner, MH, Wakefield, TW, Ascher, E, Caprini, JA, Comerota, AJ, Eklof, B, Gillespie, DL, Greenfield, LJ, He, AR, Henke, PK, Hingorani, A, Hull, RD, Kessler, CM, McBane, RD & Mclafferty, R 2007, 'Acute venous disease: Venous thrombosis and venous trauma', Journal of Vascular Surgery, vol. 46, no. 6 SUPPL.. https://doi.org/10.1016/j.jvs.2007.08.037
Meissner MH, Wakefield TW, Ascher E, Caprini JA, Comerota AJ, Eklof B et al. Acute venous disease: Venous thrombosis and venous trauma. Journal of Vascular Surgery. 2007 Dec;46(6 SUPPL.). https://doi.org/10.1016/j.jvs.2007.08.037
Meissner, Mark H. ; Wakefield, Thomas W. ; Ascher, Enrico ; Caprini, Joseph A. ; Comerota, Anthony J. ; Eklof, Bo ; Gillespie, David L. ; Greenfield, Lazar J. ; He, Aiwu Ruth ; Henke, Peter K. ; Hingorani, Anil ; Hull, Russell D. ; Kessler, Craig M. ; McBane, Robert D. ; Mclafferty, Robert. / Acute venous disease : Venous thrombosis and venous trauma. In: Journal of Vascular Surgery. 2007 ; Vol. 46, No. 6 SUPPL.
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