Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function

Extract

Introduction

Venous thromboembolism (VTE) incidence increases sharply with age (Figure1) and appears steady over the last 25 years, despite preventive strategies.¹ Women are more often affected at younger ages; this ratio reverses in the elderly.² Incidence is similar in Blacks but lower in Asians.³ Almost two-thirds of VTE cases are isolated deep vein thromboses (DVTs), and 80% are proximal.⁴

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Recent European population studies reported DVT incidence of 70–140 cases/100,000 person-year.⁵

Deep vein thrombosis are mostly secondary to predisposing factors common with pulmonary embolism (PE) (webtable 1).⁶ Distal (below knee) DVTs are more frequently related to transient situations while proximal ones to chronic conditions.⁷ In 25–50% of first DVT episodes, no predisposing factor is identified.

In patients with DVT without PE, short-term mortality rates of 2–5% were reported, more frequent in proximal than distal DVT.⁷ Recurrence risk is high, especially within first 6 months.⁸

Early- and mid-term complications include thrombosis extension, and PE and DVT recurrence (see Supplementary material online, only section).