The Diagnostic Management of Recurrent Deep Vein Thrombosis and Pulmonary Embolism

Tan, Melanie; Mol, Gerben C.; Rooden, Jan Kees van; Huisman, Menno V.

doi:10.1055/s-0032-1311798

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…We defined recurrent ipsilateral deep venous thrombosis as a new non-compressible venous segment compared with the original compression ultrasound images of the index deep venous thrombosis or a pronounced increase in vein diameter on compression. 21 22 23 …”

Section: Methodsmentioning

confidence: 99%

One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial

Mol

Ree

Klok

et al. 2016

BMJ

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Objective To study whether stopping elastic compression stockings (ECS) after 12 months is non-inferior to continuing them for 24 months after proximal deep venous thrombosis.Design Multicentre single blind non-inferiority randomised controlled trial.Setting Outpatient clinics in eight teaching hospitals in the Netherlands, including one university medical centre.Participants Patients compliant with compression therapy for 12 months after symptomatic, ultrasound proven proximal deep venous thrombosis of the leg.Interventions Continuation or cessation of ECS 12 months after deep venous thrombosis.Main outcome measures The primary outcome was the incidence of post-thrombotic syndrome 24 months after diagnosis of deep venous thrombosis, as assessed by the standardised Villalta scale in an intention to treat analysis. The predefined non-inferiority margin was 10%. The main secondary outcome was quality of life (VEINES-QOL/Sym).Results 518 patients compliant with ECS and free of post-thrombotic syndrome were randomised one year after diagnosis of deep venous thrombosis to stop or continue ECS therapy for another year. In the stop-ECS group, 51 of 256 patients developed post-thrombotic syndrome, with an incidence of 19.9% (95% confidence interval 16% to 24%). In the continue-ECS group, 34 of 262 patients developed post-thrombotic syndrome (incidence 13.0%, 9.9% to 17%), of whom 85% used ECS six or seven days a week during the study period, for an absolute difference of 6.9% (95% confidence interval upper limit 12.3%). Because the upper limit of the 95% confidence interval exceeds the predefined margin of 10%, non-inferiority was not reached. The number needed to treat to prevent one case of post-thrombotic syndrome by continuing ECS was 14 (95% confidence interval lower limit 8). Quality of life did not differ between the two groups.Conclusion Stopping ECS after one year in compliant patients with proximal deep venous thrombosis seemed not to be non-inferior to continuing ECS therapy for two years in this non-inferiority trial.Trial registration Netherlands Trial Register NTR1442.

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Section: Methodsmentioning

confidence: 99%

One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCTAVIA study): randomised controlled trial

Mol

Ree

Klok

et al. 2016

BMJ

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“…La forma clínica de la TVP puede variar, desde ser asintomática hasta presentarse con dolor, pesadez o calambres en la extremidad afectada 12 . La inflamación local o la decoloración de la extremidad afectada pueden acompañarse de múltiples signos y pruebas (signo de Michaelli, signo de Mahler, prueba de Homan, prueba de Loewenberg) 13 .…”

Section: Presentación Clínicaunclassified

Diagnóstico y tratamiento de la trombosis venosa profunda

Chama-Naranjo¹,

Becerra-Bello²,

Sánchez³

et al. 2021

RMA

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El diagnóstico de la trombosis venosa profunda (TVP) se basa de manera exclusiva en su clínica y la exploración física es poco sensible y específica. Puede emplearse la adecuada integración de ambas partes con los factores de riesgo y un posible diagnóstico alternativo para clasificar a los pacientes de acuerdo con el modelo de la escala de Wells. La determinación del dímero D (DD) indica la necesidad de realizar una ecografía Doppler. La flebografía es todavía la norma de referencia, aunque se reserva para casos específicos. Los anticoagulantes a dosis terapéuticas durante al menos tres meses constituyen la piedra angular terapéutica. Las heparinas de bajo peso molecular han desplazado a las no fraccionadas en el tratamiento de la enfermedad debido a sus menores complicaciones. Se espera que la aparición de nuevos anticoagulantes orales optimice el tratamiento ambulatorio de la TVP.

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“…However, the negative predictive values are nearly 100% accurate, with negative D‐dimer test results of indication of a lack of DVT or PE. Hence, the main clinical application of D‐dimer assay is to safely rule out DVT, PE, or disseminated intravascular coagulation .…”

Section: Introductionmentioning

confidence: 99%