As part of World Thrombosis Day 2019, Arjo has joined the global campaign to spread awareness about venous thromboembolism (VTE) — the most common cause of hospital-related deaths — with informative articles that examine its causes, treatment and prevention methodologies.
VTE is a complex vascular disease that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). A DVT develops most commonly in the deep veins of the calf, thigh and pelvis, and becomes symptomatic when the clot limits blood flow. Pulmonary embolism (PE) is a more serious condition, in which part of or all of the thrombus in the limb breaks off and enters the pulmonary arterial circulation, occluding blood flow to the lungs. If the embolism is large, it can be fatal. Most commonly, VTE develops as a result of illness or surgery associated with immobility. VTE formation, although complex, consists of three primary risk factors collectively referred to as Virchow’s Triad: namely venous stasis, hypercoagulation and vessel injury.1
Situations that lead to the slowing of blood flow (stasis) can make VTE more likely to occur. Immobility is a clear risk factor in relation to venous stasis. When one or more risk factors are present, anyone with reduced mobility is at risk for venous stasis from a new mother to a frail older adult2.
Surgery itself can be challenging as practitioners balance the need for muscle relaxants with the prevention of venous stasis3.
Excessive blood clotting, or hypercoagulation, is a recognized risk factor when it comes to VTE.2 There are both acquired and genetic reasons for excessive blood clotting. Being a smoker, overweight or obese all increase the level of risk. The use of birth control pills or hormone replacement therapy can also increase the risk of developing the condition.2
A person experiencing vascular trauma is at heightened risk of developing VTE. Vessel injury can occur because of a physical accident or injury. It may also be connected to a surgical procedure or central venous catheterization. Those with varicose veins have an elevated risk of developing the condition, as do people who have previously been diagnosed with DVT.5
VTE causes, prevention and noninvasive treatments
Surgical inpatients are at an increased risk for VTE4, with surgery itself posing the greatest risk; and anesthetics, muscle relaxants and vessel damage during surgical intervention heightening the risk3. It is now clear that non-surgical patients are also at high risk for VTE. In recent years, there has been a steady increase in awareness of the need for prophylaxis in high-risk groups such as critical care, cancer, obstetrics, bariatrics, stroke and older pediatric patients.
VTE has recognized causes. There are also effective interventions that help to minimize risk.
- International consensus document (2013) Prevention and Treatment of Venous Thromboembolism.
- Reitsma PH, Versteeg HH, Middeldorp S. Mechanistic view of risk factors for venous thromboembolism. Arteriosclerosis, thrombosis and vascular biology. 2012; 32(3): 563-8.
- Geerts WH, Pineo GF, Heit JA et al. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. 2004; 126(suppl 3): 338-400S.
- Nicolaides A, Fareed J, Kakkar A et al. Prevention and treatment of venous thromboembolism - International Consensus Statement. International Angiology. 2013; 32(2): 111-260.
- Beckman MG, Hooper WC, Critchley SE et al. Venous thromboembolism: a public health concern. Am J Prev Med. 2010; 38(4): S495-501.