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Controversies in venous thromboembolism: the unique case of isolated distal deep vein thrombosis

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Abstract

Venous thromboembolism (VTE) represents the third leading cause of cardiovascular mortality, and it is the main cause of preventable mortality in hospitalized patients. Among VTE, there is the unique case of isolated distal deep vein thrombosis (IDDVT), which still lacks an agreement in terms of optimal therapeutic strategy. Although most IDDVTs are self-limiting and associated with a very low risk of embolic complications, still not all IDDVTs can be safely identified as stable. Lack of strong scientific evidence, fear of thromboembolic complications, and risk of bleeding upon initiation of anticoagulant treatment result in very heterogeneous therapeutic strategies among physicians. Here, we provide a comprehensive review of the literature, highlight the many controversial issues regarding IDDVTs, and call for a consensus of experts aimed to shed new light on the gray areas of IDDVT management and therapy.

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Abbreviations

VTE:

Venous thromboembolism

IDDVT:

Isolated distal deep vein thrombosis

US:

Ultrasounds

DVT:

Deep vein thrombosis

PE:

Pulmonary embolism

CUS:

Compression ultrasound

ACCP:

American College of Chest Physicians

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Authors and Affiliations

  1. Division of Internal Medicine and Vascular Diseases, Department of Medicine, A. Gemelli University Hospital, Catholic University School of Medicine, Largo Agostino Gemelli 8, 00168, Rome, Italy

    Angelo Porfidia, Annamaria Carnicelli, Nicola Bonadia, Roberto Pola & Raffaele Landolfi

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  1. Angelo Porfidia
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  2. Annamaria Carnicelli
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  3. Nicola Bonadia
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  4. Roberto Pola
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  5. Raffaele Landolfi
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Correspondence to Raffaele Landolfi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments.

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Porfidia, A., Carnicelli, A., Bonadia, N. et al. Controversies in venous thromboembolism: the unique case of isolated distal deep vein thrombosis. Intern Emerg Med 11, 775–779 (2016). https://doi.org/10.1007/s11739-016-1453-3

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  • DOI: https://doi.org/10.1007/s11739-016-1453-3

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