Evidence Based Practice in Venous Thromboembolism

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (10 May 2022) | Viewed by 14015

Special Issue Editors


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Guest Editor
Faculty of Nursing, Respiratory Disorders Lab, University of Thessaly, Larissa, Greece
Interests: pulmonary embolism; chronic thromboembolic disease; venous thromboembolism; interstitial lung disease; respiratory nursing
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Guest Editor
Department of Vascular Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece
Interests: vascular diseases; thrombosis; endovascular procedures

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Guest Editor
Institute of Obstetric Hematology, Perigenesis, Thessaloniki, Greece
Interests: antiphospholipd syndrome; thrombophilia; preeclampsia; obstetric haematology; haemostasis and thrombosis

Special Issue Information

Dear Colleagues,

Venous thromboembolism (VTE) is a disorder that includes deep vein thrombosis and pulmonary embolism. Currently, VTE is the third most common vascular event and a leading cause of death worldwide. There has been a significant effort in recent years to improve decision-making in VTE patients’ care, but due to its multifactorial and heterogenous nature, different standards apply in everyday clinical practice that frequently incorporate individualized approaches and habitual practices.

The goal of the current Special Issue is to collect information that may provide the appropriate means for establishing effective decision making in VTE patients. We warmly invite you and your colleagues to submit original research articles, reviews, systematic reviews, and meta-analyses that address issues related to VTE risk factors, risk assessment, diagnosis, treatment, prognosis, follow-up, monitoring, and prevention.

Dr. Foteini Malli
Prof. Dr. Miltiadis Matsagkas
Dr. Eleftheria-Elmina Lefkou
Guest Editors

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Keywords

  • venous thromboembolism
  • pulmonary embolism
  • deep vein thrombosis
  • risk factors
  • diagnosis
  • risk assessment
  • treatment
  • follow-up
  • prognosis
  • thrombophilia

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Published Papers (4 papers)

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Review

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14 pages, 858 KiB  
Review
Pathophysiological Aspects of Aging in Venous Thromboembolism: An Update
by Dimitra Akrivou, Garifallia Perlepe, Paraskevi Kirgou, Konstantinos I. Gourgoulianis and Foteini Malli
Medicina 2022, 58(8), 1078; https://doi.org/10.3390/medicina58081078 - 10 Aug 2022
Cited by 9 | Viewed by 3877
Abstract
The aim of this review is to highlight all the factors that associate venous thromboembolism (VTE) with aging. Elderly people are characterized by a higher incidence of thrombosis taking into account the co-existing comorbidities, complications and fatality that arise. Based on the Virchow [...] Read more.
The aim of this review is to highlight all the factors that associate venous thromboembolism (VTE) with aging. Elderly people are characterized by a higher incidence of thrombosis taking into account the co-existing comorbidities, complications and fatality that arise. Based on the Virchow triad, pathophysiological aspects of venous stasis, endothelium injury and hypercoagulability in elderly people (≥65 years) are described in detail. More precisely, venous wall structure, nitric oxide (NO) and endothelin-1 expression are impaired in this age group. Furthermore, an increase in high-molecular-weight kininogen (HMWK), prekallikrein, factors V, VII, VIII, IX and XI, clot lysis time (CLT) and von Willebrand factor (vWF) is observed. Age-dependent platelet dysfunction and changes in anticoagulant factors are also illustrated. A “low-grade inflammation stage” is delineated as a possible risk factor for thrombosis in the elderly. Consequently, clinical implications for frail elderly people related to diagnosis, treatment, bleeding danger and VTE recurrence emerge. We conclude that aging is an acquired thrombotic factor closely related to pathophysiological changes. Full article
(This article belongs to the Special Issue Evidence Based Practice in Venous Thromboembolism)
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9 pages, 299 KiB  
Review
The Role of Direct Oral Anticoagulants in Cancer-Associated Thrombosis According to the Current Literature
by Petroula Nana, Konstantinos Dakis, Michail Peroulis, Nikos Rousas, Konstantinos Spanos, George Kouvelos, Eleni Arnaoutoglou and Miltos Matsagkas
Medicina 2021, 57(9), 960; https://doi.org/10.3390/medicina57090960 - 12 Sep 2021
Cited by 1 | Viewed by 2846
Abstract
Venous thromboembolism (VTE) is a common complication among patients suffering from malignancies, leading to an increased mortality rate. Novel randomized trials have added valuable information regarding cancer-associated thrombosis (CAT) management using direct oral anticoagulants (DOACs). The aim of this study is to present [...] Read more.
Venous thromboembolism (VTE) is a common complication among patients suffering from malignancies, leading to an increased mortality rate. Novel randomized trials have added valuable information regarding cancer-associated thrombosis (CAT) management using direct oral anticoagulants (DOACs). The aim of this study is to present an overview of the current literature and recommendations in CAT treatment. A few randomized control trials (RCTs) have been integrated suggesting that DOACs may be effectively applied in CAT patients compared to low molecular weight heparins (LMWHs) with a decreased mortality and VTE recurrence rate. However, the risk of bleeding is higher, especially in patients with gastrointestinal malignancies. Real-world data are in accordance with these RCT findings, while in the currently available recommendations, DOACs are suggested as a reliable alternative to LMWH during the initial, long-term, and extended phase of treatment. Data retrieved from the current literature, including RCTs and “real-world” studies, aim to clarify the role of DOACs in CAT management, by highlighting their benefits and remarking upon the potential adverse outcomes. Current recommendations suggest the use of DOACs in well-selected patients with an increasing level of evidence through years. Full article
(This article belongs to the Special Issue Evidence Based Practice in Venous Thromboembolism)

Other

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14 pages, 657 KiB  
Systematic Review
Obesity as a Risk Factor for Venous Thromboembolism Recurrence: A Systematic Review
by Pinelopi Ntinopoulou, Erato Ntinopoulou, Ioanna V. Papathanasiou, Evangelos C. Fradelos, Ourania Kotsiou, Nikolaos Roussas, Dimitrios G. Raptis, Konstantinos I. Gourgoulianis and Foteini Malli
Medicina 2022, 58(9), 1290; https://doi.org/10.3390/medicina58091290 - 16 Sep 2022
Cited by 8 | Viewed by 3082
Abstract
Background and Objectives: Venous thromboembolism (VTE) encompasses Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE). The duration of anticoagulant therapy following a VTE event partly relies on the risk of recurrent VTE which depends on the clinical setting where VTE occurred and the [...] Read more.
Background and Objectives: Venous thromboembolism (VTE) encompasses Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE). The duration of anticoagulant therapy following a VTE event partly relies on the risk of recurrent VTE which depends on the clinical setting where VTE occurred and the VTE risk factors present. Obesity is considered a minor risk factor and studies in the literature have provided conflicting results on whether obesity influences the development of recurrences. The aim of the present study is to assess the effect of obesity on VTE recurrence in patients that suffered from a previous VTE event. Materials and Methods: We conducted systematic research for English language studies in Medline, Scopus and ProQuest databases in order to identify publications that assess the risk of VTE recurrence in obesity. Inclusion criteria were: 1. Diagnosis of VTE, 2. Definition of obesity as a body mass index ≥30 kg/m2, 3. Report of the risk of obesity on VTE recurrence, 4. Adult human population. We did not include case reports, review studies or studies that assessed other forms of thrombosis and/or used other definitions of obesity. We used the Newcastle-Ottawa scale to address the quality of the studies. Results: Twenty studies were included in the analysis, of which 11 where prospective cohort studies, 6 were retrospective cohort studies, 1 was a cross-sectional study, and 2 were post-hoc analysis of randomized clinical trials. Obesity was significantly associated with recurrences in 9 studies and in 3 of them the association was significant only in females. Conclusions: There is heterogeneity between the studies both in their design and results, therefore the effect of obesity on VTE recurrence cannot be adequately estimated. Future randomized clinical studies with appropriately selected population are needed in order to streamline the effect of obesity on VTE recurrence. Full article
(This article belongs to the Special Issue Evidence Based Practice in Venous Thromboembolism)
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4 pages, 2170 KiB  
Case Report
Bilateral Deep Vein Thrombosis and Pulmonary Embolism Due to Right Common Iliac Artery Aneurysm with a Contained Rupture
by Foteini Malli, Ilias E. Dimeas, Sotirios I. Sinis, Eleni Karetsi, Petroula Nana, George Kouvelos and Konstantinos I. Gourgoulianis
Medicina 2022, 58(3), 421; https://doi.org/10.3390/medicina58030421 - 13 Mar 2022
Cited by 1 | Viewed by 2829
Abstract
Venous thromboembolism (comprising deep venous thrombosis and/or pulmonary embolism) is a common disease, often of multifactorial cause. Focal iliac artery aneurysms are relatively rare, and only a few reports exist in the literature describing patients with venous thromboembolism resulting from venous floe disruption [...] Read more.
Venous thromboembolism (comprising deep venous thrombosis and/or pulmonary embolism) is a common disease, often of multifactorial cause. Focal iliac artery aneurysms are relatively rare, and only a few reports exist in the literature describing patients with venous thromboembolism resulting from venous floe disruption due to iliac artery aneurysm. Thus, we report a case of a 65-year-old male presenting with pulmonary embolism and bilateral deep vein thrombosis associated with a contained rupture of the right common iliac artery aneurysm. Full article
(This article belongs to the Special Issue Evidence Based Practice in Venous Thromboembolism)
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