Prevention and management of venous thromboembolism
Nicola Curry
Oxford University Hospitals NHS Foundation Trust, Oxford University, Oxford, UK
Search for more papers by this authorSusan Shapiro
Oxford University Hospitals NHS Foundation Trust, Oxford University, Oxford, UK
Search for more papers by this authorNicola Curry
Oxford University Hospitals NHS Foundation Trust, Oxford University, Oxford, UK
Search for more papers by this authorSusan Shapiro
Oxford University Hospitals NHS Foundation Trust, Oxford University, Oxford, UK
Search for more papers by this authorAdam J Mead PhD, FRCP, FRCPath, FMedSci
Haematopoietic Stem Cell Biology Laboratory, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
Search for more papers by this authorMichael A Laffan DM, MRCP, FRCPath
Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
Search for more papers by this authorGraham P Collins DPhil, FRCP, FRCPath
Department of Haematology, Oxford Cancer and Haematology Centre, Oxford, UK
Search for more papers by this authorDeborah Hay DPhil, MRCP, FRCPath
Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
Search for more papers by this authorA Victor Hoffbrand MA, DM, FRCP, FRCPath, FRCP (Edin), DSc, FMedSci
Emeritus Professor of Haematology Honorary Consultant Haematologist
University College London, London, UK
Royal Free Hospital, London, UK
Search for more papers by this authorSummary
Venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE), has an incidence of about 1 per 1000 per annum, with two-thirds presenting as DVT and one-third as PE. Approximately half of VTEs are associated with hospital admissions, and hospital VTE prevention programmes are important to help reduce this risk. The case fatality of VTE is approximately 5%, but there is also major morbidity caused by post-thrombotic syndrome (PTS) of the leg and chronic thromboembolic pulmonary hypertension (CTPH). Anticoagulants are highly effective in secondary prevention, but leave the patient at risk of bleeding. The risk of recurrence is considerable and patients need to be assessed to identify those who require long-term anticoagulation as secondary prevention. This chapter covers primary VTE prevention (risk assessment and thromboprophylaxis), VTE diagnosis and acute treatment and secondary VTE prevention.
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