AAA.Logo.2014.v4.10-DVT Keygen
In cases of traumatic injury to the IVC, an iatrogenic or post-surgical cause of DVT is likely. Although warfarin is recommended for prophylaxis, even in these situations, DVT with resolution may occur. [ 38 ]
It is equally common for extensive fibrosis to occur in and around the IVC. This fibrosis may cause a pear shaped infrarenal IVC with a dilated, aberrant left renal vein. Both of these conditions are associated with DVT.
Therefore, it is reasonable to examine the reported incidence of DVT and PE in patients with different IVCTs to identify which IVCT is associated with the greatest risk of VTE, a better understanding of which may allow us to accurately estimate the risk of VTE in patients with an IVCT. A single article, cited by Burbelo et al, [ 29 ] reports such data.
A large study by Creutz et al, as summarized by Landeweerd et al, [ 31 ] investigated the etiology of DVT in a retrospective multicenter clinical trial involving 1388 patients who were hospitalized at six medical centers in the United States. Pulmonary embolism occurred in only 15.6% of patients. However, 23.7% of patients had thrombosis of deep veins of the lower extremities. The risk of thrombosis of the IVC was seven times higher in patients with an IVC thrombus compared to those without such a thrombus. Thirty percent of the DVTs in the entire study group occurred in patients with a thrombophilic condition. If the thrombophilic patient had multiple risk factors for thrombosis, there was a higher occurrence of DVT, regardless of whether the IVC was thrombosed or not. This study, designed to exclude PE, showed a much higher incidence of IVCT than was previously believed. Subsequently, Landeweerd concluded that the IVCT, in itself, is not necessarily a thromboembolic risk factor. There is a clear association between the thrombotic risk factors in patients with an IVCT, however, most thromboses of the IVC occur in the presence of these risk factors. So, the IVCT, although a classic risk factor for PE, is also potentially a risk factor for VTE.
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