Akutna stanja u venskim oboljenjima

Abstract

Emergency conditions in vein disease are deep vein thrombosis or phlebothrombosis and superficial vein thrombosis or thrombophlebitis. They occur globaly in general population and are a significant cause of morbidity and mortality. Since deep vein thrombosis and pulmonary embolism very often come together, they are both reffered to as venous thromboembolism. Early recognition of deep or superficial vein thrombosis is extremely important and therapy with anticoagulants should immediately be innitiated in order to prevent potentially life-threatening thromboembolic complications. Thrombophlebitis is usually diagnosed through physical examination, but patients should be refered to dopler ultrasound of lower extremity veins to rule out the existence of deep vein thrombosis. Venous thromboembolism is initially diagnosed using a clinical scoring system to point out patients with high risk, and also the level of D-dimer in the blood. High risk patients with high probability of venous thromboembolism and high levels of D-dimer are then referred to further diagnostic procedures. Direct oral anticoagulants are the first line of treatment in venous thromboembolism therapy, since they carry a lower risk of haemorrhagic complications that vitamin K antagonists, as well as easier implementation without the need for monitoring. Anticoagulant therapy is used for at least three months in order to prevent early recidives, while patients with high risk of suffering from venous thromboembolism again should be taking prolonged anticoagulant therapy. Anticoagulant therapy, most commonly low-molecular heparin, together with the symptomatic therapy of non-steroid antiinflammatory drugs, is the base for treating thrombophlebitis.