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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2009 June;22(3):143-47
Deep vein thrombosis of the lower extremities: a benign disease?
Kreidy R., Irani Hakime N.
1 Division of Vascular Surgery, Department of Surgery Saint George Hospital, University Medical Center University of Balamand, Beirut, Lebanon
2 Department of Laboratory Medicine, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
Aim. The aim of this retrospective study of 112 patients with deep vein thrombosis (DVT) of the lower extremities was to define risk factors, to assess diagnostic and therapeutic methods, to report clinical outcome and to propose recommendations for reducing morbidity and mortality of this disease.
Methods. A total of 112 patients (42 males and 70 females) were diagnosed for DVT of the lower extremities. The mean age was 59 years (range 21 to 92). The most common risk factors for thrombosis were: surgery, obesity, advanced age, estroprogestative treatment, cancer, heart failure. Sixteen patients had thrombophilia (hyper-coagulation state); 12 had one and four had two inherited genetic predisposing factor. Diagnostic procedures included Doppler ultrasound, Duplex scan, D Dimer dosage, computed tomography scan and phlebogram. Patients were mainly treated with low molecular weight heparin followed by oral anticoagulation and graduated compression stockings. Four patients required inferior vena cava filter insertion.
Results. Only one mortality was recorded and was related to a major bleeding secondary to a severe thrombocytosis. No other significant morbidity was observed. Patients were followed between 3 to 120 months (mean: 20 months). Six patients died secondary to their malignant disease. Four patients had recurrences and 20 five had post-thrombotic syndrome (three severe).
Conclusion. DVT of the lower extremities is a relatively benign condition when promptly diagnosed and properly treated. Thrombophilia should be screened in young patients, pregnancy, hormonal therapy, familial history, spontaneous, recurrent or extended forms of DVT. Late morbidity can be reduced with compression stockings and recommended periods of anticoagulants.