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Issues and
controversies
in venous thromboembolism
Teresa L. Carman, MD
Bernardo B. Fernandez, Jr., MD, FACP
Abstract
This paper gives specific recommendations on a
number of issues in venous thromboembolism: how to evaluate idiopathic deep vein
thrombosis (DVT); how to treat calf vein thrombosis and upper-extremity DVT; how to use
low-molecular-weight heparin, vena cava filters, catheter-directed thrombolytic therapy,
and compression stockings; how long to continue anticoagulation therapy; and how to manage
recurrent DVT.
Key Points
- In younger patients, hypercoagulable disorders are found in 48% of cases of idiopathic
venous thrombosis.
- Recent evidence indicates that calf vein thrombosis is more dangerous than previously
thought and merits more aggressive management.
- Low-molecular-weight heparin has a role in both treating and preventing DVT.
- Thrombolytic therapy has been documented to reduce the postthrombotic complications of
upper-extremity DVT.
- Patients with recurrent disease may need prolonged anticoagulation therapy.
Author(s)
Teresa L. Carman, MD...Department of Internal Medicine, Cleveland
Clinic Florida, Fort Lauderdale
Bernardo B. Fernandez, Jr, MD, FACP...Department of Vascular Medicine,
Cleveland Clinic Florida, Fort Lauderdale
Address: Bernardo B. Fernandez, Jr., MD, Department of Vascular Medicine,
Cleveland Clinic Florida, 3000 West Cypress Creek Road, Ft. Lauderdale, FL 33309-1743.
John D. Clough, M.D., editor-in-chief
Linda K. Hengstler, editor and publisher
Phillip E. Canuto, executive editor
Ray Borazanian, managing editor |
