Venous thromboembolism
Description
- One disease, two presentations: DVT and PE
- Classification by provoking factor determines duration of anticoagulation - this is the whole point of the classification
| Category | Definition | Recurrence at 5 yrs off anticoagulation |
|---|---|---|
| Provoked - major transient | Surgery >30 min under GA, caesarean, hospitalisation >=3 days with immobility, trauma with fracture, in the preceding 3 months | ~3% |
| Provoked - minor transient | Long-haul travel, minor surgery, oestrogen therapy, pregnancy/puerperium, leg injury with reduced mobility >3 days | ~15% |
| Provoked - persistent | Active cancer, IBD, antiphospholipid syndrome, chronic immobility | High, ongoing |
| Unprovoked | No identifiable factor | ~30% |
- Other patterns: superficial vein thrombosis (extends to DVT in ~10% - treat if >5 cm or within 3 cm of the saphenofemoral junction), distal (calf) DVT, upper limb DVT (usually catheter-related), splanchnic and cerebral venous thrombosis
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