Venous

Thromboembolism
What is Venous Thromboembolism?

 Blood clot
 Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often
underdiagnosed and serious, but preventable medical conditions.
 Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot
forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis,
but they can also occur in the arm.
 It is important to know about DVT because it can happen to anybody and can
cause serious illness, disability, and in some cases, death. The good news is that
DVT is preventable and treatable if discovered early.
Risk factors for arterial thrombosis may include:

 Smoking.
 Diabetes.
 High blood pressure.
 High cholesterol.
 Lack of activity and obesity.
 Poor diet.
 Family history of arterial thrombosis.
 Lack of movement, such as after surgery or on a long trip.
Symptoms of VTE can include:

 Swollen and tender legs that are painful to the touch, if you have blood clots that
block blood flow to your leg veins (deep vein thrombosis or DVT)
 Shortness of breath and pain when breathing, if you have a blood clot that travels
to the lungs (pulmonary embolism)
 The symptoms of VTE are not the same for everyone. Sometimes VTE does not
cause symptoms until serious complications develop. Because the symptoms of
DVT and pulmonary embolism are different, it’s important to know the warning
signs if you are at risk of VTE.
How is it diagnosed?

 Blood work may be done initially, including a test called D-dimer, which detects
clotting activity.
 For DVT: ultrasound of the leg is most often used
 For PE: Computed tomography, or CT scan, or CAT scan is most often used.
Sometimes ventilation-perfusion lung scan is used. Both tests are able to see
intravenous dyes in the arteries of the lung, looking for blockages by clots.
How is it treated?

 Anticoagulants, including injectables such as heparin or low molecular weight

heparin, or tablets such as apixaban, dabigatran, rivaroxaban, edoxaban and
warfarin (also called direct-acting oral anticoagulants or DOACs). These
medications are used for a number of months. If the VTE occurred after a
provoking factor like surgery, trauma, pregnancy, hospital stay, or with use of
hormone treatments, this is usually given for a fixed number of months. For
patients without these provoking factors treatment can be recommended for
longer durations.
 Thrombolytic therapy, which includes drugs such as a tissue plasminogen
activator (tPA), — a clot-dissolving enzyme. This can be given through an arm
vein, and also by inserting catheters directly into the blood clot in the vein or lung.