Venous Thromboembolic Disease in Children and Adolescents

Abstract

The VTE is mainly a disease of the older adult, though its incidence has increased significantly in the pediatric population over the past several years. This trend is likely due to enhanced awareness and recognition of VTE, as well as increased prevalence of thromboembolic associated risk factors, such as increases in the proportion of children with predisposing medical conditions. The evaluation and management of a child with VTE is similar to that of adults, however pediatric patients have their own distinct aspects of care, stemming from particularities of the hemostatic system, age-related risk factors and differences in response to anticoagulant and antithrombotic therapy. This review addresses the risk factors and the evaluation and management of children with VTE.

Factors Associated with Contralateral Deep Venous Thrombosis after Iliocaval Venous Stenting

“…Documented thrombophilia is one of the important factors that may be associated with high risk of ipsilateral, contralateral or recurrent DVT especially in young patients. 12,13 In this study, one patient at CHU, Nord, had positive homozygous factor V Leiden mutation and a history of old left IFDVT, and developed extensive right IFDVT. Extended or lifelong anticoagulation is critical in the prophylaxis and management of this high risk group.…”

Venous Thromboembolism in Children: From Diagnosis to Management

“…Venous thromboembolism (VTE) in children is a severe issue with high mortality rates and can cause acute and chronic related complications, such as pulmonary embolism, cerebro-vascular events, and post-thrombotic syndrome (PTS) [ 1 , 2 ]. In recent years, the occurrence of VTE in the pediatric population has increased, due to both greater exposure to risk factors, and improved diagnostic techniques [ 3 , 4 ]. The majority of thrombotic events are observed in neonates and adolescents, in relation to the wide range of underlying diseases and interventions.…”

“…The majority of thrombotic events are observed in neonates and adolescents, in relation to the wide range of underlying diseases and interventions. The majority of pediatric subjects with VTE present inherited or acquired risk factors, such as the use of a central venous catheter (CVC), which accounts for more than 90% of neonatal VTE and more than 50% of paediatric VTE [ 4 ]. Spontaneous thrombosis in healthy children is rare and represents the biggest challenge regarding treatment, especially in terms of duration.…”

Novel Coagulation Analyzers in Development: A Glimpse toward the Future of Microfluidics

“…3,4 Patients presenting with symptoms of thrombosis or bleeding respectively undergo screening with hypercoagulability or bleeding panel testing to identify specific coagulation defects that may predispose a patient to hemostatic disorders. [5][6][7] In addition, patients undergoing specific cardiovascular or surgical procedures may require testing to risk stratify and determine the most appropriate strategy for thrombosis or bleeding prophylaxis. 8 Finally, coagulation testing may be necessary to assess the effect of anticoagulant or procoagulant medications and allow titration of effect.…”