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Semin intervent Radiol 2001; 18(2): 083-098
DOI: 10.1055/s-2001-15170
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

The Natural History of Acute Deep Venous Thrombosis

Mark H. Meissner
  • Department of Surgery, University of Washington School of Medicine, Seattle, Washington
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

An understanding of the pathophysiology and natural history of deep venous thrombosis (DVT) is important in optimizing acute therapy and minimizing long-term complications. It is clear that DVT usually arises from the simultaneous convergence of multiple risk factors, both congenital and acquired, and that activated coagulation underlies many of these episodes. The role of venous injury is becoming understood at the endothelial level, and the importance of stasis has been redefined with respect to its role in localizing activated coagulation products. The early natural history of DVT is a balance between processes tending to restore the venous lumen and recurrent thrombotic events. Long-term outcome is directly influenced by these early events. Although few presenting features of DVT reliably predict long-term outcome, factors related to the natural history, including the rate of recanalization, recurrent thrombotic events, the extent and distribution of valvular incompetence, and residual popliteal obstruction, are important. The natural history of DVT potentially can be modified by careful attention to the intensity and duration of anticoagulation and the use of adjunctive measures such as compression stockings and catheter-directed thrombolytic therapy.

KEYWORD

Deep vein thrombosis - post-thrombotic syndrome - pulmonary embolism

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