Venske tromboembolije

master's thesis

• Title (english): Venous thromboembolism
• Author: Marijan Pušeljić
• Mentor: Dražen Pulanić (mentor)
• Committee member: Silva Zupančić-Šalek (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Dražen Pulanić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Venske tromboembolije ( VTE ) su potencijalno fatalna stanja koja se javljaju u
gotovo svim kliničkim granama medicine. Uključuje dva odvojena klinička entiteta, a
to su venska tromboza i plućna embolija ( PE ). Duboka venska tromboza ( DVT )
donjih ekstremiteta je najčešće ishodište PE. Godišnja incidencija VTE se razlikuje
između pojedinih istraživanja i iznosi oko 75 do 279 na 100,000 stanovnika. Dob i
etnicitet imaju utjecaj na incidenciju, dok spol u radovima nema konzistentan utjecaj.
Etiologija VTE je multifaktorska, a prema Virchowljevom trijasu se dijeli u tri elementa
( hiperkoagulabilnost, oštećenje endotela i venska staza ). Rizični čimbenici mogu biti
nasljedni i stečeni, a najčešće se direktno ili indirektno povezuju s dva ili sva tri
elementa iz trijasa. Klinička slika VTE je nespecifična i zahtijeva svrstavanje
pacijenata u rizične skupine prema kliničkoj vjerojatnosti za VTE. Dijagnostička
metoda izbora za DVT je kompresijski ultrazvuk s obojenim doplerom, a za PE je CT
pulmonalna angiografija. Određivanje D-dimera je visoko osjetljiva, ali slabo
specifična pretraga kod sumnje na VTE. Liječenje VTE uključuje primjenu
antikoagulantne terapije. Moguće je korištenje i trombolize, kirurške ili
endovaskularne trombektomije i venskih filtera. Najčešće kasne komplikacije VTE su
posttrombotski sindrom i kronična plućna hipertenzija.

Abstract (english)

Venous thromboembolisms ( VTE ) are potentially fatal conditions that occur in
almost all clinical fields of medicine. It consists of two separate clinical entities,
venous thrombosis and pulmonary embolism (PE). Deep vein thrombosis (DVT) of
the lower extremities is the most common source of PE. The annual incidence of VTE
varies between individual studies and is around 75 to 279 per 100,000 population.
Age and ethnicity have an influence on the incidence, but gender influence is nonconsistent.
The etiology of VTE is multifactorial and is divided into three elements
called the Virchow´s triad ( hypercoagulability, endothelial damage and venous
stasis). Risk factors can be inherited or acquired and are often directly or indirectly
associated with two or all elements from the triad. The clinical presentation of VTE is
nonspecific and requires patients classification into risk categories based on the
clinical probability of VTE. The diagnostic method of choice for DVT is compression
ultrasound with color Doppler, and for PE is CT pulmonary angiography. The D-dimer
test is highly sensitive, but poorly specific. Treatment of VTE includes use of
anticoagulant therapy. It is also possible to use thrombolysis, surgical or
endovascular thrombectomy and venous filters. Postthrombotic syndrome and
chronic pulmonary hypertension are the most common late VTE complications.

• Keywords: venska tromboza; plućna embolija; antikoagulansi; trombofilija
• Keywords (english): venous thrombosis; pulmonary embolism; anticoagulants; thrombophilia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:441981
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-04 13:37:15