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Deep vein thrombosis (DVT) is a common condition affecting one in 1000 patients in the Western world. Patients normally present acutely with symptoms of a hot, painful, swollen leg. Fortunately, many DVTs remain restricted to the calf veins, with low risk of acute pulmonary embolism. Patients usually respond quickly to anticoagulation and compression, often with full recovery and no long term sequelae.

However, in one‐third of patients, the DVT is located more proximal, involving the femoral and/or iliac veins. In patients with a large proximal DVT, symptoms may improve initially, but up to half of patients will report chronic symptoms. These chronic symptoms, termed post‐thrombotic syndrome (PTS) include leg swelling, difficulty wearing tight shoes or leg coverings, and difficulty walking due to aching and heaviness. In severe cases, this leads to skin changes and venous leg ulceration can occur. As proximal DVT can occur in relatively young and otherwise healthy people, the long term impact of PTS is significant, with reduction in quality of life and significant health care costs.

This MJA perspective shares more.

Learning Outcomes

1. Explain key components of the perspective
2. List main findings
3. Assess the treatment of an acute proximal DVT to resolve symptoms.

Details

Author: Jana‐Lee Moss, Frederikus A Klok, Uyen G Vo and Toby Richards

Article Type: Perspective