Clinical Practice on the Management of Deep Venous Thrombosis and Evaluation of Performance Diagnostic in Moroccan Center

Abstract

1. Abstract <span style=font-size:10.0pt;font-family: times= new= roman,serif;mso-fareast-font-family:times= roman;mso-ansi-language:= en-us=>1.1. Background: Venous Thrombo Embolism (VTE) is a major public health problem in Morocco. The increase in life expectancy, changes of the epidemiological profile of VTE counteracts the constant efforts made in terms of prevention and disease remains ever. <span style=font-size:10.0pt;font-family: times= new= roman,serif;mso-fareast-font-family:times= roman;mso-ansi-language:= en-us=>1.2. MaterialsMfont-family: times= new= roman,serif;mso-ansi-language:= en-us=>Prospective study to host emergency department over a period of 10 months including all Deep Vein Thrombosis (DVT) admitted to the University Hospital of Casablanca. DVT was suspected clinically and retained on the presence of a thrombus in the lower-extremity on venous Doppler. We excluded patients with superficial thrombophlebitis and patients already diagnosed with VTE. <span style=font-size:10.0pt;font-family: times= new= roman,serif;mso-fareast-font-family:times= roman;mso-ansi-language:= en-us=>1.3. Findings: The mean age of our patients was 49 years, with female predominance. A thromboembolic risk factor was found in 88% of patients. The main etiology: immobilization, surgery, heart disease and cancer pathology. Pain and the increase in calf circumference were the signs giving rise to the emergency department visit. The Doppler ultrasound has objectified a proximal localization in 38 patients (47%), distal in 12 patients (15%) and extended to the whole limb in 30 patients (38%). An association to pulmonary embolism was found in 10 patients (12%) and the association with arterial impairment was found in 4 patients (5%). The Wells score was calculated on only 12 patients (15%) and the results of thrombophilia requested in 8 patients (10%). 54 patients (67%) were treated in ambulatory and 26 patients were hospitalized. All patients were started on heparin and 92% have Vitamin K Antagonists (VKA). The causes of non-prescription VKA were: pregnancy in two patients, breakthrough bleeding on cervical cancer, active duodenal ulcer, immune thrombocytopenic purpura and erosive gastritis scalable. <span style=font-size:10.0pt;font-family: times= new= roman,serif;mso-fareast-font-family:times= roman;mso-ansi-language:= en-us=>1.4. Conclusion: DVT remains a topical issue especially with the advent of new anticoagulants. In our current practice, a prospective study in more moroccan university hospital -including large population- is desirable for a better management. 2. Keywords : D-Dimers; Deep Vein Thrombosis; <span lang=FR style=font-size:10.0pt; font-family: times= new= roman,serif;mso-fareast-font-family:times= roman=>Doppler Ultrasound Venous Mapping ; <span style=font-size:10.0pt; font-family: times= new= roman,serif;mso-ansi-language:en-us=>Venous Thromboembolism; Wells Score