Novel aspects in the diagnostic management of deep vein thrombosis and pulmonary embolism
EHA Library. Huisman M. 06/14/17; 185044
Topic: 6Ca Diagnosis and treatment of venous thromboembolism
Prof. Dr. Menno Huisman
Contributions
Contributions
Learning Objectives
Walter Ageno - Chair Introduction
Inflammation is a protective tissue response to injuries, which involves blood vessels and leukocytes, together with several mediators. Inflammatory processes have a role in the initiation and evolution of atherosclerosis and in the progression to acute thrombotic complications. There is also growing evidence on the association between inflammation and venous thromboembolism (VTE). Inflammatory processes influence initiation and propagation of coagulation activation, downregulation of anticoagulant pathways and inhibition of fibrin removal.
The diagnostic approach to patients with clinically suspected VTE has evolved over time. Initially, diagnosis was only made on clinical grounds, but because signs and symptoms of VTE are nonspecific, objective diagnostic methods were required for a correct diagnosis. However, only a minority of patients referred for imaging tests is actually confirmed to have VTE, thus questioning the cost-effectiveness of their routine use in clinical practice. To improve the diagnostic approach to patients with suspected VTE, algorithms integrating clinical data, laboratory, and imaging tests have been developed and implemented.
The improved diagnostic yield of imaging tests has contributed to an increased detection of small clots with uncertain clinical impact. This is in particular the case of isolated distal deep vein thrombosis and subsegmental pulmonary embolism. Whether these patients require routine anticoagulant treatment remains a matter of debate.
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- To understand the role of coagulation in inflammation and the impact of inflammation on thromboembolic disorders.
- To select the most appropriate diagnostic approach for patients with clinically suspected deep vein thrombosis or pulmonary embolism, with the aim to safely reduce the need for imaging tests.
- To decide the correct therapeutic strategies for patients with small clots such as isolated distal deep vein thrombosis and patients with subsegmental pulmonary embolism.
Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Describe current and emerging diagnostic algorithms for patients with clinically suspected venous thromboembolism.
- Select appropriate diagnostic algorithms for selected populations including older patients, pregnant patients, and patients with suspected recurrent venous thromboembolism.
Inflammation is a protective tissue response to injuries, which involves blood vessels and leukocytes, together with several mediators. Inflammatory processes have a role in the initiation and evolution of atherosclerosis and in the progression to acute thrombotic complications. There is also growing evidence on the association between inflammation and venous thromboembolism (VTE). Inflammatory processes influence initiation and propagation of coagulation activation, downregulation of anticoagulant pathways and inhibition of fibrin removal.
The diagnostic approach to patients with clinically suspected VTE has evolved over time. Initially, diagnosis was only made on clinical grounds, but because signs and symptoms of VTE are nonspecific, objective diagnostic methods were required for a correct diagnosis. However, only a minority of patients referred for imaging tests is actually confirmed to have VTE, thus questioning the cost-effectiveness of their routine use in clinical practice. To improve the diagnostic approach to patients with suspected VTE, algorithms integrating clinical data, laboratory, and imaging tests have been developed and implemented.
The improved diagnostic yield of imaging tests has contributed to an increased detection of small clots with uncertain clinical impact. This is in particular the case of isolated distal deep vein thrombosis and subsegmental pulmonary embolism. Whether these patients require routine anticoagulant treatment remains a matter of debate.
Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- To understand the role of coagulation in inflammation and the impact of inflammation on thromboembolic disorders.
- To select the most appropriate diagnostic approach for patients with clinically suspected deep vein thrombosis or pulmonary embolism, with the aim to safely reduce the need for imaging tests.
- To decide the correct therapeutic strategies for patients with small clots such as isolated distal deep vein thrombosis and patients with subsegmental pulmonary embolism.
Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- Describe current and emerging diagnostic algorithms for patients with clinically suspected venous thromboembolism.
- Select appropriate diagnostic algorithms for selected populations including older patients, pregnant patients, and patients with suspected recurrent venous thromboembolism.
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