Michiels JJ, Michiels JM, Moossdorff W, Lao M, Maasland H, Palareti G. Diagnosis of deep vein thrombosis, and prevention of deep vein thrombosis recurrence and the post-thrombotic syndrome in the primary care medicine setting anno 2014. World J Crit Care Med 2015; 4(1): 29-39 [PMID: 25685720 DOI: 10.5492/wjccm.v4.i1.29]
Corresponding Author of This Article
Jan Jacques Michiels, MD, PhD, Professor, Multidisciplinary Internist and Primary Care Medicine Physician, Goodheart Institute, Bloodcoagulation and Vascular Medicine Research Center, Erasmus Tower, Veenmos 13, 3069 AT Rotterdam, The Netherlands. goodheartcenter@upcmail.nl
Research Domain of This Article
Biology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Feb 4, 2015; 4(1): 29-39 Published online Feb 4, 2015. doi: 10.5492/wjccm.v4.i1.29
Diagnosis of deep vein thrombosis, and prevention of deep vein thrombosis recurrence and the post-thrombotic syndrome in the primary care medicine setting anno 2014
Jan Jacques Michiels, Janneke Maria Michiels, Wim Moossdorff, Mildred Lao, Hanny Maasland, Gualtiero Palareti
Jan Jacques Michiels, Wim Moossdorff, Mildred Lao, Hanny Maasland, Primary Care Medicine Medical Diagnostic Center, Vlambloem 21, 3068 JE Rotterdam, The Netherlands
Jan Jacques Michiels, Janneke Maria Michiels, Multidisciplinary Internist and Primary Care Medicine Physician, Goodheart Institute, Bloodcoagulation and Vascular Medicine Science Center Rotterdam, 3069 AT Rotterdam, The Netherlands
Jan Jacques Michiels, Gualtiero Palareti, Central European Vascular Forum, 11000 Prague, Czech Republic
Janneke Maria Michiels, Primary Care Medicine, Leiden University Medical Center, Leiden, 2333 ZA Leiden, The Netherlands
Gualtiero Palareti, Department of Angiology and Blood Coagulation University Hospital, Policlinico S, Orsola-Malpighi, 40016 Bologna, Italy
Author contributions: Michiels JJ, Moossdorff W and Palareti G designed the study; Michiels JJ wrote the manuscript; Moossdorff W, Lao M and Maasland H performed the ultrasound studies; Michiels JM interpreted the results for use by family doctors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jan Jacques Michiels, MD, PhD, Professor, Multidisciplinary Internist and Primary Care Medicine Physician, Goodheart Institute, Bloodcoagulation and Vascular Medicine Research Center, Erasmus Tower, Veenmos 13, 3069 AT Rotterdam, The Netherlands. goodheartcenter@upcmail.nl
Telephone: +31-62-6970534
Received: March 11, 2014 Peer-review started: October 10, 2014 First decision: October 11, 2014 Revised: October 11, 2014 Accepted: November 7, 2014 Article in press: November 10, 2014 Published online: February 4, 2015 Processing time: 123 Days and 1 Hours
Core Tip
Core tip: A novel clinical concept for the assessment of acute deep vein thrombosis (DVT) and the post-thrombotic syndrome (PTS) by DUS in routine clinical practice at 1, 3 to 6 mo and at one year post-DVT will separates post-DVT patients in 4 groups: Group 1: rapid complete recanalization within 3 mo, no reflux at 6 mo post-DVT, and no PTS for which anticoagulation and medical elastic compression stockings (MECS) can be discontinued at 6 mo post-DVT. Group 2, no PTS with reflux of the deep venous system and no PTS at 6 months post-DVT when when wearing MECS for which anticoagulation should be continued until re-evaluation at 1 year post DVT. Group 3 and 4 PTS with reflux and incomplete recanalization or obstruction at 6-12 mo post-DVT are candidates for long-term anticoagulation and MECS for at least 2 years or even longer to prevent DVT recurrence to prevent progression of PTS. A large scale prospective study is warranted to fine-tune and prove this concept.
