Abstract
The term “venous thromboembolism” (VTE) describes a spectrum of disease that includes both deep venous thrombosis (DVT) and pulmonary embolism (PE), and more precisely reflects a sequential disease process. It has been estimated that more than 5 million cases of DVT occur annually in the United States, which lead to approximately 500,000 episodes of PE and perhaps 50,000 deaths each year (1–3). VTE therefore constitutes a major health risk worldwide that deserves the attention of all clinicians. It is important for the intensivist to remember that PE is not a specific disease but merely a complication of deep venous thrombosis (DVT), which, in and of itself, is preventable (1).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Moser KM. Venous thromboembolism. Am Rev Respir Dis 1990; 141: 235–49.
Carter CJ. The natural history and epidemiology of venous thrombosis of venous thrombosis. Prog Cardiovasc Dis 1994; 36: 423–38.
Alpert JS, Dalen JE. Epidemiology and natural history of venous thromboembolism. Prog Cardiovasc Dis 1994; 36: 417–22.
Havig O. Deep vein thrombosis and pulmonary embolism. An autopsy study with multiple regression analysis of possible risk factors. Acta Chir Scand Suppl 1977; 478: 1–120.
Moser KM, LeMoine JR. Is embolic risk conditioned by location of deep venous thrombosis? Ann Intern Med 1981; 94: 439–44.
Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study. Chest 1991; 99: 280–3.
Hingorani A, Ascher E, Hanson J, Scheinman M, Yorkovich W, Lorenson E, DePippo P, Salles-Cunha S. Upper extremity versus lower extremity deep venous thrombosis. Am J Surg 1997; 174: 214–7.
Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975; 17: 257–70.
Alpert JS, Smith R, Carlson J, Ockene IS, Dexter L, Dalen JE. Mortality in patients treated for pulmonary embolism. JAMA 1976; 236: 1477–80.
Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, Johnsson H, Jorfeldt L. Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate. Am Heart J 1997; 134: 479–87.
Uhland H, Goldberg LM. Pulmonary embolism: a commonly missed clinical entity. Dis Chest 1964; 45: 533–6.
Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, Forcier A, Dalen JE. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT study. Arch Intern Med 1991; 151: 933–8.
Nordstrom M, Lindblad B, Bergqvist D, Kjellstrom T. A prospective study of the incidence of deep-vein thrombosis within a defined urban population. J Intern Med 1992; 232: 155–60.
Goldberg RJ, Seneff M, Gore JM, Anderson FA Jr, Greene HL, Wheeler HB, Dalen JE. Occult malignant neoplasm in patients with deep venous thrombosis. Arch Intern Med 1987; 147: 251–3.
Prandoni P, Lensing AW, Buller HR, Cogo A, Prins MH, Cattelan AM, Cuppini S, Noventa F, tenCate JW. Deep-vein thrombosis and the incidence of subsequent symptomatic cancer. N Engl J Med 1992; 327: 1128–33.
Monreal M, Fernandez-Llamazares J, Perandreu J, Urrutia A, Sahuquillo JC, Contel E. Occult cancer in patients with venous thromboembolism: which patients, which cancers. Thromb Haemost 1997; 78: 1316–8.
Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet 1995; 346: 1575–82.
Spitzer WO, Lewis MA, Heinemann LA, Thorogood M, MacRae KD. Third generation oral contraceptives and risk of venous thromboembolic disorders: an international case-control study. Transnational Research Group on Oral Contraceptives and the Health of Young Women. BMJ 1996; 312: 83–8.
Grady D, Hulley SB, Furberg C. Venous thromboembolic events associated with hormone replacement therapy. JAMA 1997; 278: 477.
McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty MJ, Greer IA. Risk factors for pregnancy associated venous thromboembolism. Thromb Haemost 1997; 78: 1183–8.
Ginsberg JS, Wells PS, Brill-Edwards P, Donovan D, Moffatt K, Johnston M, Stevens P, Hirsh J. Antiphospholipid antibodies and venous thromboembolism. Blood 1995; 86: 3685–91.
Simioni P, Prandoni P, Zanon E, Saracino MA, Scudeller A, Villalta S, Scarano L, Girolami B, Benedetti L, Girolami A. Deep venous thrombosis and lupus anticoagulant. A caso-control study. Thromb Haemost 1996; 76: 187–9.
Cohen SH, Ehrlich GE, Kauffman MS, Cope C. Thrombophlebitis following knee surgery. J Bone Joint Surg Am 1973; 55: 106–12.
Hull RD, Raskob GE. Prophylaxis of venous thromboembolic disease following hip and knee surgery. J Bone Joint Surg Am 1986; 68: 146–50.
Bergqvist D. Frequency of thromboembolic complications. In: Bergqvist D. Postoperative Thromboembolism: frequency, etiology, prophylaxis. Berlin: Springer-Verlag, 1983: 12–3.
Mayo ME, Halil T, Browse NL. The incidence of deep vein thrombosis after prostatectomy. Br J Urol 1971; 43: 738–42.
Walsh JJ, Bonnar J, Wright FW. A study of pulmonary embolism and deep leg vein thrombosis after major gynaecological surgery using labelled fibrinogen-phlebography and lung scanning. J Obstet Gynaecol Br Commonw 1974; 81: 311–6.
Geerts WH, Code KI, Jay RM, Chen E, Szalai W. A prospective study of venous thromboembolism after major trauma. N Engl J Med 1994; 331: 1601–6.
Gibbs NM. Venous thrombosis of the lower limbs with particular reference to bed-rest. Br J Surg 1957; 45: 209–36.
Rosendaal FR. Risk factors for venous thrombotic disease. Thromb Haemost 1999; 82: 610–619.
Black MD, French GJ, Rasuli P, Bouchard AC. Upper extremity deep venous thrombosis. Underdiagnosed and potentially lethal. Chest 1993; 103: 1887–90.
Monreal M, Lafoz E, Ruiz J, Valls R, Alastrue A. Upper-extremity deep venous thrombosis and pulmonary embolism. A prospective study. Chest 1991; 99: 280–3.
Heijboer H, Brandjes DP, Buller HR, Sturk A, tenCate JW. Deficiencies of coagulation- inhibiting and fibrinolytic proteins in outpatients with deep-vein thrombosis. N Engl J Med 1990; 323: 1512–6.
Koster T, Rosendaal FR, Briet E, van der Meer FJ, Colly LP, Trienekens PH, Poort SR, Reitsma PH, Vandenbroucke JR Protein C deficiency in a controlled series of unselected outpatients: an infrequent but clear risk factor for venous thrombosis. Blood 1995; 85: 2756–61.
Faioni EM, Valsecchi C, Palla A, Taioli E, Razzari C, Mannucci PM. Free protein S deficiency is a risk factor for venous thrombosis. Thromb Haemost 1997; 78: 1343–6.
Bertina RM, Koeleman BP, Koster T, Rosendaal FR, Dirven RJ, deRonde H, van der Velden PA, Reitsma PH. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994; 369: 64–7.
Poort SR, Rosendaal FR, Reitsma PH, Bertina RM. A common genetic variation in the 3’- untranslated region of the prothrombin gene is associated with elevated prothrombin levels and an increase in venous thrombosis. Blood 1996; 88: 3698–703.
Rosendaal FR, Koster T, Vandenbroucke JP, Reitsma PH. High risk of thrombosis in patients homozygous for factor V Leiden. Blood 1995; 85: 1504–8.
Ridker PM, Miletich JP, Stampfer MI, Goldhaber SZ, Lindpaintner K, Hennekens CH. Factor V Leiden and risks of recurrent idiopathic venous thromboembolism. Circulation 1995; 92: 2800–2.
Simioni P, Prandoni P, Lensing AW, Scudeller A, Sardella C, Prins MH, Vidalia S, Dazzi F, Girolami A. The risk of recurrent venous thromboembolism in patients with an ARG506(Gln mutation in the gene for factor V (factor V Leiden). N Engl J Med 1997; 336: 399–403.
Eichinger S, Minar E, Hirschl M, Bialonczyk C, Stain M, Mannha ter C, Stumpflen A, Schneider B, Kechner K, Kyrle PA. The risk of early recurrent venous thromboembolism after oral anticoagulant therapy in patients with the G20210A transition in the prothrombin gene. Thromb Haemost 1999; 81: 14–7.
den Heijer M, Koster T, Blom Ill, Bos GM, Briet E, Reitsma PH, Vandenbroucke JP, Rosendaal FR. Hyperhomocysteinemia as a risk factor for deep-vein thrombosis. N Engl J Med 1996; 334: 759–62.
Koster T, Blain) AD, Briet E, Vandenbroucke JP, Rosendaal FR. Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 1995; 345: 152–5.
Leclerc JR, Illescas F, Jarzem P. Diagnosis of deep vein thrombosis. In: Leclerc, JR, ed. Venous Thromboembolic Disorders. Philadelphia: Lea & Febiger, 1991: 176–228.
Tapson VF, Carroll BA, Davidson BL, Elliott CG, Fedullo PF, Hales CA, Hull RD, Hyers TM, Leeper KV Jr, Morris TA, Moser KM, Raskob GE, Shure D, Sostman HD, Taylor Thompson B. The diagnostic approach to acute venous thromboembolism. Clinical practice guideline. American Thoracic Society. Am J Respir Crit Care Med 1999; 160: 1043–66.
Hull R, Taylor DW, Hirsh J, Sackett DL, Powers P, Turpie AG, Walker I. Impedance plethysmography: the relationship between venous filling and sensitivity and specificity for proximal vein thrombosis. Circulation 1978; 58: 898–902.
Ginsberg JS, Caco CC, Brill-Edwards PA, Panju AA, Bona R, Demers CM, Tuters LM, Nugent P, McGinnis J, Grant BM, Van der Lander Vries MA. Venous thrombosis in patients who have undergone major hip or knee surgery: detection with compression US and impedance plethysmography. Radiology 1991; 181: 651–4.
Lensing AW, Prandoni P, Brandjes D, Huisman PM, Vigo M, Tomasella G, Krekt J, Wouter TenCate J, Huisman MV, Buller HR. Detection of deep-vein thrombosis by real-time B-mode ultrasonography. N Engl J Med 1989; 320: 343–5.
Cronan JJ, Dorfman GS, Scola FH, Schepps B, Alexander J. Deep venous thrombosis: US assessment using vein compression. Radiology 1987; 162: 191–4.
Appelman PT, DeJong TE, Lampmann LE. Deep venous thrombosis of the leg: US findings. Radiology 1987; 163: 743–6.
Monreal M, Montserrat E, Salvador R, Bechini J, Donoso L, MaCallejas J, Foz M. Real-time ultrasound for diagnosis of symptomatic venous thrombosis and for screening of patients at risk: correlation with ascending conventional venography. Angiology 1989; 40: 527–33.
Pedersen OM, Aslaksen A, Vik-Mo H, Bassoe AM. Compression ultrasonography in hospitalized patients with suspected deep venous thrombosis. Arch Intern Med 1991; 151: 2217–20.
Spritzer CE, Sostman HD, Wilkes DC, Coleman RE. Deep venous thrombosis: experience with gradient-echo MR imaging in 66 patients. Radiology 1990; 177: 235–241.
Vukov LF, Berquist TH, King BF. Magnetic resonance imaging for calf deep venous thrombosis. Ann Emerg Med 1991; 20: 497–9.
Erdman WA, Jayson HT, Redman HC, Miller GL, Parkey RW, Peshock RW. Deep venous thrombosis of extremities: role of MR imaging in the diagnosis. Radiology 1990; 174: 425–31.
Laissy JP, Cinqualbre A, Loshkajian A, Henry-Feugens MC, Crestani B, Riquelme C, SchoumanClaeys E. Assessment of deep venous thrombosis in the lower limbs and pelvis: MR venography versus duplex Doppler sonography. AJR Am J Roentgenol 1996; 167: 971–5.
Evans AJ, Sostman HD, Knelson MH, Spritzer CE, Newman GE, Paine SS, Beam CA. 1992 ARRS Executive Council Award. Detection of deep venous thrombosis: prospective comparison of MR imaging with contrast venography. AJR Am J Roentgenol 1993; 161: 131–9.
Dupas B, elKouri D, Curtet C, Peltier P, deFaucal P, Planchon B, Lejeune JJ. Angiomagnetic resonance imaging of iliofemorcaval venous thrombosis. Lancet 1995; 346: 17–9.
Carpenter JP, Holland GA, Baum RA, Owen RS, Carpenter JT, Cope C. Magnetic resonance venography for the detection of deep venous thrombosis: comparison with contrast venography and duplex Doppler ultrasonography. J Vasc Surg 1993; 18: 734–41.
Lindblad B, Eriksson A, Bergqvist D. Autopsy-verified pulmonary embolism in a surgical department: analysis of the period from 1951 to 1988. Br J Surg 1991; 78: 849–52.
Goldhaber SZ, Hennekens CH, Evans DA, Newton EC, Godleski JJ. Factors associated with correct antemortem diagnosis of major pulmonary embolism. Am J Med 1982; 73: 822–6.
Morgenthaler TI, Ryu JH. Clinical characteristics of fatal pulmonary embolism in a referral hospital. Mayo Clin Proc 1995; 70: 417–24.
The urokinase pulmonary embolism trial. A national cooperative study. Circulation 1973; 47: II 1108.
Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED Investigators. JAMA 1990; 263: 2753–9.
Green RM, Meyer TJ, Dunn M, Glassroth J. Pulmonary embolism in younger adults. Chest 1992; 101: 1507–11.
Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, Weg JG. Clinical laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 1991; 100: 598–603.
Becker DM, Philbrick JT, Bachhuber TL, Humphries JE. D-dimer testing and acute venous thromboembolism. A shortcut to accurate diagnosis? Arch Intern Med 1996; 156: 939–46.
Moser KM. Diagnosing pulmonary embolism. BMJ 1994; 309: 1525–6.
Perrier A, Desmarais S, Goehring C, deMoerlouse P, Morabia A, Unger PF, Slosman D, Junod A, Bounameaux H. D-dimer testing for suspected pulmonary embolism in outpatients. Am J Respir Crit Care Med 1997; 156: 492–6.
Worsley DF, Palevsky HI, Alavi A. A detailed evaluation of patients with acute pulmonary embolism and low-or very-low probability lung scan interpretations. Arch Intern Med 1994; 154: 2737–41.
Stein PD, Terrin ML, Gottschalk A, Alavi A, Henry JW. Value of ventilation/perfusion scans versus perfusion scans alone in acute pulmonary embolism. Am J Cardiol 1992; 69: 1239–41.
Henry JW, Stein PD, Gottschalk A, Relyea B, Leeper KV Jr. Scintigraphic lung scans and clinical assessment in critically ill patients with suspected acute pulmonary embolism. Chest 1996; 109: 462–6.
Stein PD, Athanasoulis C, Alavi A, Greenspan RH, Hales CA, Saltzman HA, Vreim CE, Terrin ML, Weg JG. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 1992; 85: 462–8.
Henschke Cl, Mateescu 1, Yankelevitz DF. Changing practice patterns in the workup of pulmonary embolism. Chest 1995; 107: 940–5.
Remy-Jardin M, Remy J, Deschildre F, Artaud D, Beregi JP, Hossein-Foucher C, Marchandise X, Duhamel A. Diagnosis of pulmonary embolism with spial CT: comparison with pulmonary angiography and scintigraphy. Radiology 1996; 200: 699–706.
van Rossum AB, Treurniet FE, Kieft GJ, Smith SJ, Schepers-Bok R. Role of spiral volumetric computed tomographic scanning in the assessment of patients with clinical suspicion of pulmonary embolism and an abnormal ventilation/perfusion lung scan. Thorax 1996; 51: 23–8.
van Rossum AB, Pattynama PM, Ton ER, Treurniet FE, Arndt JW, vanEck B, Kieft GJ. Pulmonary embolism: validation of spiral CT angiography in 149 patients. Radiology 1996; 201: 467–70.
Mayo JR, Remy-Jardin M, Muller NL, Remy J, Worsley DF, Hossein-Foucher C, Kwong JS, Brown MJ. Pulmonary embolism: prospective comparison of spiral CT with ventilation-perfusion scintigraphy. Radiology 1997; 205: 447–52.
Remy-Jardin M, Remy J, Deschildre F, Artaud D, Beregi JP, Hossein-Foucher C, Marchandise X, Duhamel A. Diagnosis of pulmonary embolism with spiral CT: comparison with pulmonary angiography and scintigraphy. Radiology 1996; 200: 699–706.
Ferretti GR, Bosson JL, Buffaz PD, Ayanian D, Pison C, Blanc F, Carpentier F, Carpentier P, Coulomb M. Acute pulmonary embolism: role of helical CT in 164 patients with intermediate probability at ventilation-perfusion scintigraphy and normal results at duplex US of the legs. Radiology 1997; 205: 453–8.
Cross JJ, Kemp PM, Walsh CG, Flower CD, Dixon AK. A randomized trial of spiral CT and ventilation perfusion scintigraphy for the diagnosis of pulmonary embolism. Clin Radiol 1998; 53: 177–82.
Meaney JF, Weg JG, Chenevert TL, Stafford-Johnson D, Hamilton BH, Prince MR. Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med 1997; 336: 1422–7.
Come PC. Echocardiographic evaluation of pulmonary embolism and its response to therapeutic interventions. Chest 1992; 101: 151S - 162S.
Gabrielsen F, Schmidt A, Eggeling T, Hoeher M, Kochs M, Honnbach V. Massive main pulmonary artery embolism diagnosed with two-dimensional Doppler echocardiography. Clin Cardiol 1992; 15: 545–6.
Nixdorf U, Erbel R, Drexler M, Meyer J. Detection of thromboembolus of the right pulmonary artery by transesophageal two-dimensional echocardiography. Am J Cardiol 1988; 61: 488–9.
Galemt MD, Mogtader A, Hahn RT. Transesophageal echocardiography to diagnose and demonstrate resolution of an acute massive pulmonary embolus. Chest 1992; 102: 297–9.
Popovic AD, Milanovic B, Neskovic AN, Pavlovski K, Putnikovic B, Hadzagic I. Detection of massive pulmonary embolism by transesophageal echocardiography. Cardiology 1992; 80: 94–9.
Hull RD, Hirsh J, Carter CJ, Jay RM, Dodd PE, Ockelford PA, Coates G, Gill GJ, Turpie AG, Doyle DJ, Buller HR, Raskob GE. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 1983; 98: 891–9.
Hull RD, Hirsh J, Carter CJ, Raskob GE, Gill GJ, Jay RM, Leclerc JR, David M, Coates G. Diagnostic value of ventilation-perfusion lung scanning in patients with suspected pulmonary embolism. Chest 1985; 88: 819–28.
Hull RD, Raskob GE, Hirsh J, Jay RM, Leclerc JR, Geerts WH, Rosenbloom D, Sackett DL, Anderson C, Harrison L, Gent M. Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. N Engl J Med 1986; 315: 1109–14.
Basu D, Gallus A, Hirsh J, Cade J. A prospective study of the value of monitoring heparin treatment with the activated partial thromboplastin time. N Engl J Med 1972; 287: 324–7.
Hull RD, Raskob GE, Rosenbloom D, Lemaire J, Pineo GF, Baylis B, Ginsberg JS, Panju AA, Brill-Edwards P, Brant R. Optimal therapeutic level of heparin therapy in patients with venous thrombosis. Arch Intern Med 1992; 152: 1589–95.
Wheeler AP, Jaquiss RD, Newman JH. Physician practices in the treatment of pulmonary embolism and deep venous thrombosis. Arch Inter Med 1988; 148: 1321–5.
Cruickshank MK, Levine MN, Hirsh J, Roberts R, Siguenza M. A standard heparin nomogram for the management of heparin therapy. Arch Intern Med 1991; 151: 333–7.
Raschke RA, Reilly BM, Guidry JR, Fontana JR, Srinivas S. The weight-based heparin dosing nomogram compared with a “standard care” nomogram. A randomized controlled trial. Ann Inter Med 1993; 119: 874–81.
Weitz JI. Low-molecular-weight heparins. N Engl J Med 1997; 337: 688–98.
Lensing AW, Prins MB, Davidson BL, Hirsh J. Treatment of deep venous thrombosis with lowmolecular-weight heparins. A meta-analysis. Arch Intern Med 1995; 155: 601–7.
Meyer G, Brenot F, Pacouret G, Simonneau G, Gillet Juvin K, Charbonnier B, Sors H. Subcutaneous low-molecular-weight heparin fragmin versus intravenous unfractionated heparin in the treatment of acute non massive pulmonary embolism: an open randomized pilot study. Thromb Haemost 1995; 74: 1432–5.
Low-molecular-weight heparin in the treatment of patients with venous thromboembolism. The Columbus Investigators. N Engl J Med 1997; 337: 657–62.
Simonneau G, Sors H, Charbonnier B, Page Y, Laaban JP, Azarian R, Laurent M, Hirsch JL, Ferrari E, Bosson JL, Mottier D, Beau B. A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. The THESEE Study Group. Tinzaparine ou Heparine Standard: Evaluations dans l’Embolie Pulmonarie. N Engl J Med 1997; 337: 663–9.
Koopman MM, Prandoni P, Piovella F, Ockelford PA, Brandjes DP, van der Meer J, Gallus AS, Simonneau G, Chesterman CH, Prins MH. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous lowmolecular-weight heparin administered at home. The Tasman Study Group. N Engl J Med 1996; 334: 682–7.
Levine M, Gen M Hirsh J, Leclerc J, Anderson D, Weitz Ginsberg J, Turpie AG, Demers C, Kovacs M. A comparison of low-molecular-weight heparin administered primarily at home with unfractionated heparin administered in the hospital for proximal deep-vein thrombosis. N Engl J Med 1996; 334: 677–81.
Hull RD, Raskob GE, Rosenbloom D, Panju AA, Brill-Edwards P, Ginsberg JS, Hirsch J, Martin GJ, Green D. Heparin for 5 days as compared with 10 days in the initial treatment of proximal venous thrombosis. N Engl J Med 1990; 322: 1260–4.
Schulman S, Rhedin AS, Lindmarker P, Carlsson A, Larfars G, Nicol P, Loogna E, Svensson E, Ljungberg B, Walter H. A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. Duration of Anticoagulation Trial Study Group. New Engl J Med 1995; 332: 1661–5.
Optimum duration of anticoagulation for deep-vein thrombosis and pulmonary embolism. Research Committee of the British Thoracic Society. Lancet 1992; 340: 873–6.
Carson JL, Kelley MA, Duff A, Weg JG, Fulkerson WJ, Palevsky HI, Schwartz JS, Thompson BT, Popovich J Jr, Hobbins TE, Spera MA, Alavi A, Terrin ML. The clinical course of pulmonary embolism. N Engl J Med 1992; 326: 1240–5.
Tibbutt DA, Davies JA, Anderson JA, Fletcher EW, Hamill J, Holt JM, Thomas ML, Lee G, Miller GA, Sharp AA, Sutton GC. Comparison by controlled clinical trail of streptokinase and heparin in treatment of life-threatening pulmonary embolism. Br Med J 1974; 1 343–7.
Ly B, Amesen H, Eie H, Hol R. A controlled clinical trial of streptokinase and heparin in the treatment of major pulmonary embolism. Acta Med Scand 1978; 203: 465–70.
Levine M, Hirsh J, Weitz J, Cruickshank M, Neemeh J, Turpie AG, Gent M. A randomized trial of a single bolus dosage regimen of recombinant tissue plasminogen activator in patients with pulmonary embolism. Chest 1990; 98: 1473–9.
Dalla-Volta S, Palla A, Santolicandro A, Giuntini C, Pengo V, Visioli O, Zonzin P, Zanuttini D, Barbaresi F, Agnelli G, Morpurgo M, Marini MG, Visani L. PALMS 2: alteplase combined with heparin versus heparin in the treatment of acute pulmonary embolism. Plasminogen activator Italian multicenter study 2. J Am Coll Cardiol 1992; 20: 520–526.
Goldhaber SZ, Haire WD, Feldstein ML, Miller M, Toltzis R, Smith JL, Taveira da Silva AM, Come PC, Lee RT, Parker JA, Mogtader A, McDonough TJ, Braunwald E. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet 1993; 341: 507–11.
Decousus H, Leizorovica A, Parent F, Page Y, Tardy B, Girard P, Laporte S, Faivre R, Charbonnier B, Barral FG, Huet Y, Simonneau G. A clinical trial of vena cavai filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prevention du Risque d’Embolie Pulmonaire par Interruption Cave Study Group. Engl J Med 1998; 338: 409–15.
Clarke DB, Abrams LD. Pulmonary embolectomy: a 25 year experience. J Thorac Cardiovasc Surg 1986; 92: 442–5.
Gray HH, Morgan IM, Paneth M, Miller GA. Pulmonary embolectomy for acute massive pulmonary embolism: an analysis of 71 cases. Br Heart J 1988; 60: 196–200.
Doerge HC, Schoendube FA, Loeser H, Walter M, Messmer BJ. Pulmonary embolectomy: review of a 15-year experience and role in the age of thrombolytic therapy. Eur J Cardiothorac Surg 1996; 10: 952–7.
Greenfield LJ, Proctor MC, Williams DM, Wakefield TW. Long-term experience with transvenous catheter pulmonary embolectomy. J Vasc Surg 1993; 18: 450–7.
Tai NR, Atwal AS, Hamilton G. Modern management of pulmonary embolism. Br J Surg 1999; 86: 853–68.
Proceedings of the American College of Chest Physicians 5th Consensus on Antithrombotic Therapy. 1998. Chest 1998; 114: 439S - 769S.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer Science+Business Media New York
About this chapter
Cite this chapter
Villanueva, A.G. (2001). Venous Thromboembolism. In: O’Donnell, J.M., Nácul, F.E. (eds) Surgical Intensive Care Medicine. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6645-5_22
Download citation
DOI: https://doi.org/10.1007/978-1-4757-6645-5_22
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4757-6647-9
Online ISBN: 978-1-4757-6645-5
eBook Packages: Springer Book Archive