Enfermedad venosa aguda

  1. Lozano Sánchez, F.S. 1
  2. Salvador Calvo, R. 1
  3. Velasco Hernández, P. 1
  4. Peña Cortés, R. 1
  1. 1 Servicio de Angiología y Cirugía Vascular, Hospital Universitario de Salamanca, España Salamanca, Departamento de Cirugía, Universidad de Salamanca, Salamanca, España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2021

Issue Title: Enfermedades cardiovasculares (V)

Series: 13

Issue: 39

Pages: 2258-2269

Type: Article

DOI: 10.1016/J.MED.2021.08.002 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Acute venous disease includes deep vein thrombosis, superficial vein thrombosis and venous trauma. We will deal only with the first, which is interesting due to its frequency, severity (pulmonary embolism), recurrence, sequelae (post-thrombotic syndrome) and social and economic implications. It is a multifactorial disease. Virchow's triad: parietal (trauma), haemodynamic (stasis) and blood (hypercoagulability) factors. Clinical symptoms (pain and oedema) are not helpful for diagnosis. An algorithm including a clinical predictive test, D-dimer, and echo-Doppler (test of choice) is an effective and efficient diagnostic strategy. Phlebography and/or computerised angiotomography are reserved for borderline cases. Anticoagulation is the method of choice in the acute and secondary prevention phase. In these phases, direct oral anticoagulants compete with low molecular weight heparins. The duration of anticoagulation, timing of discontinuation and decision to extend treatment must be considered to avoid relapses and complications. Outpatient treatment is an aspect of great clinical, social, and economic relevance, where patient selection is very important. Other treatments (catheter fibrinolysis, interruption of the inferior vena cava etc.) have very specific indications.

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Data source: Dialnet