ABSTRACT
Deep vein thrombosis (DVT) is a serious and potentially lifethreatening disorder. The magnitude of the problem is suggested by the fact that an estimated 180,000-250,000 patients per year are diagnosed clinically as having deep vein thrombosis, while twice this number may suffer from venous stasis ulcers and as many as 7 million may have lower extremity stasis changes and edema on a chronic basis. In addition to the disability associated with the postthrombotic syndrome, the mortality from the most serious complication of deep vein thrombosis, pulmonary thromboembolism, has been estimated to be in the range of 200,000 deaths per year in which it is either the sole cause or a major contributing factor.[1,2]
The frequency of deep vein thrombosis itself is difficult to determine since it may remain clinically silent or may be misdiagnosed when nonspecific lower extremity signs and symptoms are present. Using the very sensitive 125I-labeled fibrinogen scanning test in a series of unselected general surgical patients, Kakkar et al.[3] found that 30% of them developed positive scans in the calf in the postoperative period. The diagnosis was confirmed by venography, and in 35% of them the abnormality disappeared within 72 h. In 23% there was propagation of the thrombus into more proximal veins, and in half of these patients pulmonary thromboembolism occurred. The consequences of untreated deep vein thrombosis, then, are sufficiently serious to warrant aggressive diagnosis and management.
