Contemporary management of acute and chronic deep venous thrombosis.

Prakash Saha, Stephen Black, Karen Breen, Ashish Patel, Bijan Modarai, Alberto Smith

Journal: British medical bulletin 2017;117(1):107-20

PMID: 26893407

Abstract

INTRODUCTION

This review aims to provide an update on the management of deep vein thrombosis (DVT).

SOURCES OF DATA

A systematic search of PubMed, Google Scholar and Cochrane databases was carried out.

AREAS OF AGREEMENT

Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT. Compression bandaging can help heal a venous ulcer.

AREAS OF CONTROVERSY

Compression hosiery to prevent post thrombotic syndrome. Long-term evidence to show clinical benefit of using endovenous therapies to restore deep vein patency.

GROWING POINTS

Developing imaging methods to identify patients who would benefit from venous thrombolysis. The evolution of dedicated venous stents.

AREAS TIMELY FOR DEVELOPING RESEARCH

Understanding the mechanisms that lead to stent occlusion and investigation into the appropriate treatments that could prevent in-stent thrombosis is required.

© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Address: Academic Department of Vascular Surgery, King's College London, St. Thomas' Hospital, London SE1 7EH, UK.; Department of Thrombosis and Haemostasis, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, London SE1 7EH, UK.; Academic Department of Vascular Surgery, King's College London, St. Thomas' Hospital, London SE1 7EH, UK [email protected].
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