Deep vein thrombosis

The term deep vein thrombosis (DVT) is practically a synonym for those that occur in the lower limbs. However, it can also be used for those that occur in the upper limbs and neck veins. Other types of venous thrombosis, such as intra-abdominal and intracranial, are discussed in specific sections.

Epidemiology

  • 1.6 new cases per 1000 per year
  • 2.5-5% of population is affected
  • >50% have long terms symptoms of post thrombotic syndrome
  • 6% of DVT patients report eventual venous ulcers (0.1% general population)
Risk factors
  • Age (relative risk increase ~2 per 10 year increase)
  • Surgery (orthopaedic patients at highest risk: hip 48%, knee 61%)
  • Trauma
  • History of venous thromboembolism (2-9% increase)
  • Primary hypercoagulable states
    • Protein A, C, and S deficiency 10x increased risk
    • Factor V Leiden (heterozygous 8x increased risk, homozygous 80x)
  • Oestrogen replacement (2-4x increased risk)
  • Immobilisation (2x increased risk)
  • Pregnancy (0.075% of pregnancies)

Radiographic features

Ultrasound

The majority of deep venous thromboses occur in the lower extremities and begin in the soleal veins of the calf. Doppler compression sonography is the imaging modality of choice. Features include:

  • non-compressible venous segment
  • increased venous diameter: acute thrombus
  • decreased venous diameter: chronic thrombus
  • loss of phasic flow on Valsalva manoeuvre
  • absent colour flow: if completely occlusive
  • increased flow in superficial veins
  • lack of flow augmentation of calf squeeze
  • anechoic thrombus: acute thrombus
  • echogenic thrombus: chronic thrombus

Complications

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Article information

rID: 1204
Tags: vascular, refs
Synonyms or Alternate Spellings:
  • Deep vein thrombosis (DVT)
  • DVT
  • Deep venous thrombosis
  • Deep vein thromboses
  • DVT's
  • DVTs
  • Deep vein thrombi
  • Deep venous thrombi
  • Deep venous thromboses
  • Deep vein thrombus
  • Deep venous thrombus

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Cases and figures

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    DVT Left Poplitea...
    Case 2: in left popliteal vein
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    Case 3
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    Case 4: on left
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    Longitudinal popl...
    Case 5
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    Doppler color-flo...
    Case 6
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    Common femoral ve...
    Case 7
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    Case 8
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    Case 9: subclavian and internal jugular
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