Management of Deep vein Thrombosis and pulmonary embolism.pptx

Management of DVT

1. Management of DVT/PE in High-Risk Patients

2. Deep Vein Thrombosis Incidence of Venous Thrombosis: Approximately 124 per 100,000 in the general population. 1/3 of DVT complicate with a clot in the lungs Recurrence at 5 years - 28% Case-fatality rate(recurrence) 3% - 6% Habson PO et al. Arch Intern Med 2000;160:769 Carrier M et al. Ann Intern Med 2010;152:578

3. Pulmonary Embolism Incidence of PE: Estimated at approximately 60 to 70 per 100,000 in the general population. PE is the third most common cardiovascular disease, after coronary artery disease and stroke. Most clinical PE cases occur between ages 60 to 70. Untreated acute PE has a mortality rate as high as 30%. Belohlavek et al. Exp Clin Cardiol  2013;18(2):129–138.

4. Pathophysiology Virchow Triad Hull et al. J Circulation 2013;128:25

5. AHA Classification ESC Classification Key Criteria Mortality Rate Massive High Risk - Hypotension: systolic BP <90 mm Hg or drop >40 mm Hg for ≥15 minutes - Need for vasopressor support ≈30% (within 1 month) Submassive Intermediate Risk - RV strain without hypotension (AHA) - RV strain OR simplified PESI score ≥1 (ESC) - ESC subdivides into intermediate risk–high and intermediate risk–low based on RV dysfunction/injury 2% to 15% (within 7–90 days) Low Risk Low Risk - No criteria for submassive (AHA) or intermediate risk (ESC) ≈1% (within 1 month) Giri et al. J Circulation 2019;140 (20);774-801

6. Sterling et.al, Circ Cardiovasc Interv . 2024;17:e013448

7. Sterling et.al, Circ Cardiovasc Interv . 2024;17:e013448

8.   Szmyt et. al. Cardiovasc Drugs Ther  (2024). https://doi.org/10.1007/s10557-024-07562-4

9.   Szmyt et. al. Cardiovasc Drugs Ther  (2024). https://doi.org/10.1007/s10557-024-07562-4

10. Makowska et. al, J. Clin. Med. 2024, 13, 2863

11. Planer et.al, CMAJ. 2023 195 (24) E833-E843

12. Giri et al. J Circulation 2019;140:20