समीपस्थ गहरी शिरा घनास्त्रता — पोप्लिटियल, ऊरु, या इलियाक शिराओं में थ्रोम्बस — के साथ प्रस्तुत वृक्क शिरा घनास्त्रता एक नैदानिक रूप से महत्वपूर्ण शिरापरक थ्रोम्बोएम्बोलिक स्थिति का प्रतिनिधित्व करती है जिसके लिए शीघ्र, संरचित प्रबंधन की आवश्यकता है।
DOI: 10.3949/ccjm.91a.22090
Proximal DVT is defined as thrombus in the popliteal, femoral, or iliac veins.
The 2021 CHEST guidelines recommend treating proximal DVT with anticoagulation for at least 3 months.
Proximal DVT confers up to a 50% risk of pulmonary embolism if left untreated, so treatment with anticoagulation is recommended even in the absence of symptoms ("incidental DVT").
The 2021 CHEST guidelines recommend the use of DOACs over warfarin whenever possible, based on data showing a lower risk of major bleeding (especially intracranial hemorrhage) with DOACs vs warfarin (strong recommendation with moderate-certainty evidence).
Use of an inferior vena cava filter should be considered only in patients deemed to have an unacceptably high bleeding risk.
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