Expedited Management of Deep Vein Thrombosis and Acute Pulmonary Embolism

Abstract

Deep vein thrombosis and pulmonary embolism are common diseases with significant morbidity and mortality. Clinical probability assessment reliably identifies low-risk patients, and when paired with a negative D-dimer test, safely excludes venous thromboembolism. Compression ultrasonography confirms the diagnosis of deep vein thrombosis, whereas computed tomography pulmonary angiography is typically used to confirm pulmonary embolism. Risk assessment of acute pulmonary embolism stratifies low-risk patients for outpatient treatment, and high-risk patients for consideration of thrombolytic therapy. The recent approval of rivaroxaban, a novel oral anticoagulant, can simplify and expedite treatment in select patients. Ongoing clinical trials may uncover methods to prevent postthrombotic syndrome and chronic thromboembolic pulmonary hypertension. In this report, we review current diagnostic and management methods for deep vein thrombosis and pulmonary embolism.