Introduction to the Study of Deep Venous Thrombosis

Abstract

The frequency and incidence of deep venous thrombosis (DVT) and the major known predisposing factors are summarised, and ‘traveller’s thrombosis’ is briefly discussed. The main pathological consequences of the condition are outlined: pulmonary embolism, the main cause of mortality; and post-thrombotic syndrome (a general label for the morbid sequelae, involving valve incompetence and leukocyte infiltration). What we term the ‘consensus model’ of DVT, which attributes the condition to some combination of hypercoagulability, stasis and endothelial injury, is introduced; some variants of this model are outlined. A brief critique of the consensus model is given, followed by a conjecture about its sustained prominence in the field, and this is followed by a critical discussion of the phrase ‘Virchow’s triad’. An alternative model of DVT is briefly outlined. Because both the consensus model and the alternative viewpoint have deep historical roots, we suggest that historical exegesis is necessary to explain their origins and development and to establish a rational understanding of the aetiology of DVT.