Deep vein thrombosis has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Article milestones Date Process Result May 4, 2012 Peer review Reviewed June 26, 2012 Good article nominee Listed August 4, 2012 Peer review Reviewed November 20, 2012 Peer review Reviewed Current status: Good article

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I think the merge should have been done the other way. The term "deep vein thrombosis" is more common than "deep venous thrombosis"

google results:
633,000 for deep vein thrombosis
358,000 for deep venous thrombosis
Nephron 01:08, 21 July 2005 (UTC)[reply]

The term in medical literature appears to be venous. JFW | T@lk 08:18, 21 July 2005 (UTC)[reply]

Based on what?

Pubmed results:

deep vein thrombosis: 31302

deep

Since an important audience is the less-technical, the common usage is more helpful. Technical readers, if they wish to consult Wikipedia, will be familiar with the more common term. —Preceding unsigned comment added by 67.101.66.55 (talk) 04:22, 30 November 2007 (UTC)[reply]

"A careful history has to be taken considering risk factors (see below), " There's no subsection entitled 'Risk factors'. Could this be clarified or corrected?

Of thrombophlebitis and deep vein thrombosis, the latter is the more serious and clinically relevant ones. Perhaps thrombophlebitis could be mentioned within deep vein thrombosis. Furthermore the content on thrombophlebitis is quite similar to the DVT article. Andrew73 12:33, 15 March 2006 (UTC)[reply]

I would say that they're distinct enough to justify separate articles (DVT is a spontaneous clot usually of the deep leg veins without inflammation, whereas thrombophlebitis is an inflamed clot usually of the superficial arm veins and usually after an IV). Under pressure, I suppose you could merge them into a general "Venous thrombotic conditions" page, but I don't think it makes sense to lump thrombophlebitis under DVT. I do, however, agree with your other comments, and certainly cleaning up the content of thrombophlebitis might clear up some of the confusion.  — JVinocur (talk • contribs) 00:35, 10 May 2006 (UTC)[reply]

Fair enough, but agree that the content of thrombophlebitis needs to be more focused on the superficial variety as that's the context that it's generally used. Andrew73 14:53, 10 May 2006 (UTC)[reply]

Prophylaxis? Pathogenesis? This article is hard to follow for the average lay person such as myself. Can someone rewrite with sections named "Causes" and "Treatment"? -- Barrylb 19:51, 6 May 2006 (UTC)[reply]

A complications section could be useful.

"In up to 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically inapparent." This presumably refers to all patients hospitalized for whatever reason, not all patients hospitalized for suspected DVT - the sentence logic suggests it must be the the former, but it's such a large statistic that it took me a couple of rereads to understand. Moonlander69 23:17, 1 June 2007 (UTC)[reply]

Can someone please explain the risks of using the prescibed medications for DVT and pregnancy. And if I have DVT due to an previous pregnancy what should I do when pregnant again whilst having DVT.

I think the article is way too complex and written in the lingo that doctors use, probably BY a doctor or someone with a lot of medical training. That's OK if they have that training, but the thing is that most of us regular every-day people can't understand it because we don't have that training.

Which parts do you find confusing? I agree that we need to make this content accessible. JFW | T@lk 22:06, 22 November 2007 (UTC)[reply]

Besides the grammar being incorrect in the following sentence, it also seems to reference research that claims the opposite of what it says here.

Other risk factors include advanced age, obesity, infection, immobilization, female sex, use of combined (estrogen-containing) forms of hormonal contraception, tobacco usage and air travel ("economy class syndrome", a combination of immobility and relative dehydration) are some of the better-known causes.and references Tsai A et a (2002). "Cardiovascular risk factors and venous thromboembolism incidence etc." [1].

In the abstract states: RESULTS: Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE.

So although these are the "better-known" causes, that particular research found that it was not associated? Deadstar 13:30, 20 September 2007 (UTC)[reply]

--The "physical inactivity" relates to, e.g., how much exercise a person does per week. But "immobilization" refers to a person on a plane, etc. I suppose the two would overlap in the case of a sickly, bed-bound person. Kenmcl2 (talk) 05:44, 12 February 2009 (UTC)[reply]

This is again supported by a systematic review: doi:10.1111/j.1538-7836.2007.02847.x JFW | T@lk 22:07, 22 November 2007 (UTC)[reply]

Tim Russert from MSNBC Meet The Press just passed because of DVT. He collapsed on his job just after returning from Italy. AugustinMa (talk) 21:35, 13 June 2008 (UTC)[reply]

Apparently, DVT is common after long flights (see Tim Russert above). Can the article add a section about prevention measure before, during and just after a long flight. Thanks AugustinMa (talk) 21:35, 13 June 2008 (UTC)[reply]

The article says: "DVTs occur in about 1 per 1000 persons per year. About 1-5% will die from the complications".

Yet this link http://ap.google.com/article/ALeqM5jLUJgboI9vrUtwrpyeOXkWNLOFOQD937BUI80 gives much higher death number: "the new surgeon general's campaign estimates that every year, between 350,000 and 600,000 Americans get one of these clots — and at least 100,000 of them die". It implies 15-30% death rate. —Preceding unsigned comment added by 97.116.53.139 (talk) 03:14, 16 September 2008 (UTC)[reply]

The number in the hundreds of thousands is for venous thromboembolism, which means DVT + PE. DVT alone doesn't kill. Biosthmors (talk) 19:40, 19 April 2012 (UTC)[reply]

This is going to get interesting: LMWH therapy instead of warfarin was well tolerated but improved outcomes for postthrombotic syndrome and leg ulcers. doi:10.1016/j.amjmed.2008.12.023 JFW | T@lk 20:39, 28 July 2009 (UTC)[reply]

Br J Haem doi:10.1111/j.1365-2141.2009.07732.x JFW | T@lk 21:03, 28 July 2009 (UTC)[reply]

I'm not medical or nursing, so I have not corrected the wording at Wells criterion 8, which currently reads as "major surgery requiring regional or general anesthetic in past 4 weeks". Surely that is a typo for "12 weeks". Patrick Hamilton (talk)

Yep. Just read this comment and I happened to fix that yesterday as I was going through the diagnosis section. Biosthmors (talk) 19:38, 19 April 2012 (UTC)[reply]

The last sentence is a fragment and it is unclear to me what exactly is not being disputed: "Despite the fact that no one disputes this, based on a meta analysis done by the Cochrane Collaboration where they found only one randomized trial of anti coagulation vs placebo in the treatment of VTE in which there was no significant difference between the two." —Preceding unsigned comment added by 64.149.52.154 (talk) 21:29, 18 May 2010 (UTC)[reply]

Rewritten. Biosthmors (talk) 19:41, 19 April 2012 (UTC)[reply]

Traveller's thrombosis should be merged her as it is basically a DVT due to flight. It is the same disease just has some social significance. Doc James (talk · contribs · email) 00:59, 29 May 2011 (UTC)[reply]

I think the image used in the info box is confusing, mostly because of the arrow which appears to point to the thrombus on the leg rather than in it. Is there a similar image without the arrow, under which it could be written something along the lines of "DVTs typically present with a swollen painful calf, and comparing the calf diameters is an integral part of the diagnosing of the syndrome (see right calf)."--Mofs (talk) 21:15, 30 July 2011 (UTC)[reply]

Changed to in. I do have a copy of the image without the arrow but hopefully the text change clears things up.--Doc James (talk · contribs · email) 21:49, 30 July 2011 (UTC)[reply]

Please, please, please, someone knowledgeable on the mainstream medical approaches find references to my paragraph about raising legs. Raising legs does work and is often advised by medical practitioners. Anonywiki (talk) 21:54, 1 August 2011 (UTC)[reply]

I have never seen evidence for this. Would be happy to look at any you come across though. Review articles are best. Cheers Doc James (talk · contribs · email) 15:19, 8 October 2011 (UTC)[reply]

I removed them,[2] as medical conditions which may lead to DVT because they aren't mentioned/sourced in the article. Instead, I added things that were sourced. Biosthmors (talk) 20:28, 27 February 2012 (UTC)[reply]

Nephrotic syndrome is now sourced and in the body of the article as a risk factor. Biosthmors (talk) 16:38, 20 March 2012 (UTC)[reply]

Phlegmasia alba dolens and phlegmasia cerulea dolens are currently discussed in the signs and symptoms section. May-Thurner syndrome and Paget-Schrötter disease are just mentioned in the pathophysiology section. And perhaps we're omitting another worthy manifestation. But I'm wondering if we should discuss all these four entities together, perhaps in the classification section. I'm thinking phlegmasia might be too infrequently mentioned/experienced to justify the word count it is currently given in the signs and symptoms section, although it does give characteristic signs. Biosthmors (talk) 17:43, 5 May 2012 (UTC)[reply]

I removed reference to alba per this discussion. Biosthmors (talk) 21:01, 4 September 2012 (UTC)[reply]

This review is transcluded from Talk:Deep vein thrombosis/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Cwmhiraeth (talk · contribs) 09:48, 6 June 2012 (UTC) I have taken on the GA review of this article. On first inspection it looks impressive and I will be studying it in much greater detail shortly. Cwmhiraeth (talk) 09:48, 6 June 2012 (UTC)[reply]

First thought

"Deep vein thrombosis" is a noun phrase so the abbreviation DVT should be used grammatically in the same way as the phrase. This means that such a sentence as "... most of those suspected of DVT do not have it after evaluation" is unsatisfactory. If you used "blood clot" instead of DVT in the sentence you would get "... most of those suspected of blood clot do not have it after evaluation." So I would prefer "... most of those suspected of having a DVT do not have it after evaluation". This point is rather fundamental to the article. Maybe DVT is widely used in the way you have used it and I am being pedantic. I would welcome some input from others on this point. Cwmhiraeth (talk) 10:25, 6 June 2012 (UTC)[reply]

I would agree but am no expert on grammar and usually count on others to fix mine :-) Doc James (talk · contribs · email) 20:56, 6 June 2012 (UTC)[reply]

I'm not sure but this may help. Here's some text from Lijfering et al.: "many people have several of these risk factors but never develop thrombosis; others suffer from thrombosis but have none." I was thinking one could substitute DVT in for thrombosis without creating an issue. It appears the term venous thrombosis is used: "... carriers have a 5-7 fold increased risk of venous thrombosis". Biosthmors (talk) 21:40, 6 June 2012 (UTC)[reply]

Here's some text from a free source[3] (page 19S under 5.2): "In pregnant patients with suspected DVT in whom initial proximal CUS is negative..." I'll tweak the example to follow this. Biosthmors (talk) 21:54, 6 June 2012 (UTC)[reply]

I thought this might be a problem throughout the article, but it was not. Cwmhiraeth (talk) 14:06, 7 June 2012 (UTC)[reply]

First read through

I have read through the article carefully. In general the prose, grammar, spelling etc. are fine. Here are the small number of points that struck me when considering criterion 1a. I shall consider the other criteria later. There is no rush - I understand that Biosthmors is away for the time being and the review can continue on his return. Cwmhiraeth (talk) 14:06, 7 June 2012 (UTC)[reply]

Classification

1. Bilateral DVT refers to its presence in both legs while unilateral specifies one leg. - What does "it" refer to?

Causes

1. Venous thrombi are recognized to be caused mainly by a combination of venous stasis and hypercoagulability—but to a lesser extent endothelial damage and activation. The three factors of stasis, hypercoaguability, and alterations in the blood vessel wall represent Virchow's triad, and changes to the vessel wall are the least understood. - The second of these sentences seems largely to repeat the information in the first. Rephrase.
2. Acquired risk factors include older age, which is the strongest risk factor; after aging, blood composition favors clotting. - Rephrase this.
3. Relative risks estimates for the three go up to ten or twenty. - Ten or twenty what?

Pathophysiology

1. In contrast to the understanding for how arterial thromboses occur, as with heart attacks, - Should be understanding "of" but whole sentence is awkward.
2. As a whole, platelets constitute less of venous thrombi when compared to arterial ones - Awkward.
3. ... by tissue factor effected thrombin production, which leads to fibrin deposition. - I think this should be "affected".

Surgery patients

1. ... is estimated to be about four percent. - Why not 4% as in the previous paragraph?

Pregnancy

1. Homozygous carriers of factor V Leiden or prothrombin G20210A with a family history of VTE were recommended to ... - Recommended by whom?

Prognosis

1. After the one to two year period after the initial development of symptoms of DVT ... - This sentence is awkward. Could you also explain what "post-thrombotic syndrome" is.

History

1. Although, the historicity of the medical literature is somewhat questioned as the interpretations of Virchow's work differ. - Awkward.

Status?

No one seems to have made any comments here for about two weeks. Do you need help? WhatamIdoing (talk) 20:26, 23 June 2012 (UTC)[reply]

The nominator was due to be away from home for some time but should be back now. I will remind him about this review. Cwmhiraeth (talk) 05:27, 24 June 2012 (UTC)[reply]

I think I've addressed, clarified or reworded the text in relation to all raised concerns. In regards to 1a concerns below, I've made sure each paragraph with recommendations clarify that they were generated by the ACCP.[4] Biosthmors (talk) 23:52, 25 June 2012 (UTC)[reply]

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	The chief problem that I see is the repeated use of the words "suggested" and "recommended" without an indication of who is making these suggestions/recommendations. I suspect that this is referring to the position in the US and the ACCP guidelines but this should be clarified as other organisations, in other parts of the world, may provide different guidance. This has now been done. Cwmhiraeth (talk) 05:47, 26 June 2012 (UTC)[reply]
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	No problem here.
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	Article is well referenced.
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).	Article is well referenced.
	2c. it contains no original research.	As far as I can tell.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	Topic is comprehensively covered.
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.	This does not seem to be a problem.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.	All images are appropriately licensed.
	6b. media are relevant to the topic, and have suitable captions.	Images and captions are appropriate and helpful.
	7. Overall assessment.	A good, well-written article that fulfils the GA criteria. Cwmhiraeth (talk) 05:47, 26 June 2012 (UTC)[reply]

I would like to suggest some modifications.

1. On the one hand: "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." But on the other, by the end of the paragraph: "Warfarin, a common VKA, is known to have teratogenic effects on the fetus if administered in early pregnancy[55][56] and is not advised in pregnant women."

I think the problem is the tail end of the second sentence. It is generally true that warfarin is contraindicated (to varying degrees traditionally) throughout pregnancy. However, after week 13 (if that can be determined with reasonable assurance) it is a relative issue (in distinction to the high level contraindication earlier, especially between weeks 4 and 12 traditionally, acknowledging that we now substitute with e.g. LMWH prior to conception when possible), but warfarin may still (optionally) be used (with care) in e.g. high-risk mechanical valve situations etc.

2. On a second minor point, "Only pregnant women with strong risk factors for VTE are suggested to receive targeted (INR of 2.0 to 3.0) preventative measures." would be better phrased as "Only pregnant women with strong risk factors for VTE should receive preventative measures such as warfarin therapy with a target INR of 2.0 to 3.0." The present wording is unduly inexact.

3. Lastly, for several reasons a citation for this corrected sentence would be a reasonable expectation. FeatherPluma (talk) 03:40, 29 July 2012 (UTC)[reply]

Thanks for the feedback. I think the sourcing for the warfarin sentence is probably the weakest in the entire article, so I will work on this tomorrow. If you have any other ideas you can mention them here or at Wikipedia:Peer review/Deep vein thrombosis/archive2, which is currently open. Biosthmors (talk) 15:57, 29 July 2012 (UTC)[reply]

The current statement is false and potentially harmful. The reference describes the use of warfarin in the postpartum period, not in pregnant women. Warfarin is teratogenic during the first trimester, and can cause dangerous antepartum haemorrhage during the third trimester. Therefore warfarin is contra-indicated during pregnancy. Axl ¤ [Talk] 17:55, 29 July 2012 (UTC)[reply]

Glad you caught that. This fixes the error, right? Biosthmors (talk) 21:13, 30 July 2012 (UTC)[reply]

Recent secondary sources are now cited and I think things are corrected. Biosthmors (talk) 21:57, 30 July 2012 (UTC)[reply]

Yes, thank you. Axl ¤ [Talk] 22:46, 30 July 2012 (UTC)[reply]

I find it interesting that the article does not list smoking as a causal factor. It seems to be the conventional wisdom that smoking increases the risk of DVT, but the only medical studies I've been able to find online (which are quite old, dating from the late 1970s) concluded that smoking had a PROTECTIVE effect against the formation of DVTs. It would be nice if knowledgeable medical professionals could supplement the article with peer-reviewed evidence about the effects of smoking. I emphasize 'peer-reviewed,' because most websites that list smoking as a causal factor do not cite any evidence in support of the statement. They make logical conclusions about the harmful effects of vasoconstriction and platelet aggregation, but do not validate the conclusions through empirical testing. — Preceding unsigned comment added by 202.130.114.242 (talk) 09:34, 10 August 2012 (UTC)[reply]

Smoking as a risk factor is cited by some while some cite it as not well established. The mechanism is elusive. I'm not sure whether or not to cite it. "Smoking is a risk factor for VTE, although the effect is much less for arterial thrombosis and the evidence less consistent.16 There are no mechanistic studies on the relationship between VTE and smoking, but it may be safe to postulate an inflammatory state of the endothelim, also involving components of innate immunity." says doi:10.1161/ATVBAHA.111.242818. The 2008 study they cite is here. Lijfering cites this study and puts it into their table under "Not well established" with a confidence interval of 0.8 to 1.5. van Langevelde says the confidence interval is 1.3 to 1.7 for a risk of DVT in smokers after citing the same 2008 study. Biosthmors (talk) 22:11, 10 August 2012 (UTC)[reply]

doi:10.1055/s-0031-1297367 has a nice section devoted to this topic. Biosthmors (talk) 19:13, 5 September 2012 (UTC)[reply]

doi:10.1056/NEJMoa1114238 is the study and doi:10.1016/j.beha.2012.06.003 might be an appropriate secondary source. Biosthmors (talk) 05:24, 25 August 2012 (UTC)[reply]

This might be useful:

• de Jong PG, Coppens M, Middeldorp S (2012). "Duration of anticoagulant therapy for venous thromboembolism: balancing benefits and harms on the long term". British Journal of Haematology. 158 (4): 433–41. doi:10.1111/j.1365-2141.2012.09196.x. PMID 22734929. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

It says under Risk of recurrence after unprovoked VTE, that men have a higher risk of recurrent VTE than women, and it's gives generally good coverage of the other risk factors. Graham Colm (talk) 14:43, 10 September 2012 (UTC)[reply]

Thanks for pointing this article out. Biosthmors (talk) 21:27, 10 September 2012 (UTC)[reply]

Please be careful not to conflate VTE with DVT. Axl ¤ [Talk] 22:51, 10 September 2012 (UTC)[reply]

Surely, thanks. Biosthmors (talk) 17:22, 11 September 2012 (UTC)[reply]

I don't understand the value behind this edit because the version before already said that, and now (after removing the sources that appear to have no value) it appears the source that is left understates what is unnecessary, which appears to contradict the article. So I'm going to remove it. Biosthmors (talk) 02:49, 27 September 2012 (UTC)[reply]

• For comprehensiveness, the epidemiology section should include a paragraph on provoked DVT, and provoked DVT should probably be defined in classification. Biosthmors (talk) 19:52, 25 October 2012 (UTC)[reply]

• Duration of anticoagulation in those with cancer could be mentioned, as could more detail on preventative treatments after surgeries. Biosthmors (talk) 19:53, 25 October 2012 (UTC)[reply]

• Guideline for chronic cases. Biosthmors (talk) 19:23, 14 November 2012 (UTC)[reply]

• New drugs, such as rivaroxaban, in the research directions section. Biosthmors (talk) 17:11, 16 November 2012 (UTC)[reply]

Thrombus or thrombosis? Biosthmors (talk) 04:19, 6 November 2012 (UTC)[reply]

Imo, both: thrombosis for the condition, thrombus / thrombi for the actual clot/s. —MistyMorn (talk) 08:50, 7 November 2012 (UTC)[reply]

Hmmmm... OK thanks I'll look at this further. Biosthmors (talk) 19:53, 7 November 2012 (UTC)[reply]

Etymologically: thrombosis, clot formation; thrombus, the clot formed. At least, that's according to Wikipedia... [5] [6] ;) —MistyMorn (talk) 20:42, 7 November 2012 (UTC)[reply]

High probability or high-probability? Biosthmors (talk) 22:19, 10 November 2012 (UTC)[reply]

You mean "A Wells score can be divided into two (likely vs. unlikely) or three (low, moderate, or high probability) groups"? If so,looking good as is. More generally, to hyphen or not to hyphen in adjectival phrases that qualify a noun, like "high-throughput PCR", depends on house style. Wikipedia seems to like them [7], BMJ doesn't [8], and some, like Malleus, have, on occasion, been known to get hot-under-the-collar (ouch, no!) hot under the collar. —MistyMorn (talk) 22:55, 10 November 2012 (UTC)[reply]

Thanks I'll remove. Biosthmors (talk) 23:19, 10 November 2012 (UTC)[reply]

Hmmm.... "at-risk", "bed-rest", "oxygen-deprived"... I need to find a rule to draw the line and make things consistent... Biosthmors (talk) 23:34, 10 November 2012 (UTC)[reply]

Looks like Malleus might handle that for you. :) —MistyMorn (talk) 00:33, 11 November 2012 (UTC)[reply]

I'm a hyphen black belt, no worries on that score. As a general rule Biosthmors you only need need hyphens with compound adjectives, to avoid ambiguity. For example, "Wayne Rooney is a well-known footballer", as opposed to "Wayne Rooney is well known". Malleus Fatuorum 03:57, 11 November 2012 (UTC)[reply]

Excellent (Rooney apart)! Presumably where the convention originally came from. —MistyMorn (talk) 10:32, 11 November 2012 (UTC)[reply]

Thanks Malleus for your help. I wonder if "at-risk long-haul travelers" should be "at-risk-long-haul travelers". This document helped clarify most issues. Biosthmors (talk) 21:02, 14 November 2012 (UTC)[reply]

In the United States (U.S.) population, about 5 to 8% of people have thrombophilia of some form.<ref name="CDC"/> Among people who develop VTE, 30 to 50% have thrombophilia. Prevalence estimates are as follows: 0.5 to 9% for antithrombin deficiency, 3 to 9% for protein C deficiency, 1 to 3% for protein S deficiency, 12 to 20% for heterozygous factor V Leiden, 6 to 8% for heterozygous prothrombin G20210A, 0.2 to 4% for the homozygous case, and 2 to 4.5% for individuals doubly heterozygous for factor V Leiden and prothrombin G20210A.<ref name="Varga"/>

Prevalence among whom? Among people who develop VTE in the U.S.? (Sorry, I don't have access to the paper.) —MistyMorn (talk) 00:51, 7 November 2012 (UTC)[reply]

I'll replace the U.S. centric reference with Varga completely to generalize, thanks. Biosthmors (talk) 02:08, 7 November 2012 (UTC)[reply]

Great. —MistyMorn (talk) 08:36, 7 November 2012 (UTC)[reply]

UEDVT should perhaps be split off into its own article. Biosthmors (talk) 19:51, 7 November 2012 (UTC)[reply]

A section of the 2012 NICE guideline, Venous thromboembolic diseases: the management of venous thromboembolic diseases and the role of thrombophilia testing: worth citing here (and, perhaps, elsewhere)? Also, Righini et al, 2006 may be helpful, although as a primary study it doesn't technically meet WP:MEDRS. —MistyMorn (talk) 09:46, 12 November 2012 (UTC)[reply]

Thanks for the tip. I plan to work that guideline in to avoid systemic bias per JFW's comments here. Biosthmors (talk) 16:34, 12 November 2012 (UTC)[reply]

Thanks, I'd missed that. Fwiw, I also feel there are more acronyms/abbreviations than necessary. Although they generally seem to be standard ones which could normally be included in a review article, I feel a more conservative approach is preferable on Wikipedia (though I don't see much on the subject in WP:MEDMOS). —MistyMorn (talk) 20:08, 12 November 2012 (UTC)[reply]

Thanks again. There's another comment like that in the peer review, so I'll plan on moving that way with GCS, IPC, and PTS. Currently, I think VTE is repeated enough/central enough to keep. Biosthmors (talk) 20:20, 12 November 2012 (UTC)[reply]

FYI, I'm leaning towards keeping VKA and LMWH. Biosthmors (talk) 19:03, 15 November 2012 (UTC)[reply]

Someone has written a history of DVT. Citeable: doi:10.1111/jth.12127 JFW | T@lk 21:38, 15 January 2013 (UTC)[reply]

Great, thanks! Biosthmors (talk) 22:14, 15 January 2013 (UTC)[reply]

The article has yet to be incorporated into the article's history section but I do plan on doing so. Biosthmors (talk) 18:23, 18 December 2019 (UTC)[reply]

The imaging images might be better presented horizontally in that section with one of these: Template:Multiple_image#See_also. Biosthmors (talk) 22:25, 3 March 2013 (UTC)[reply]

Done. Biosthmors (talk) 17:20, 4 April 2013 (UTC)[reply]

Epidemiology of provoked DVT might be a topic to include. Biosthmors (talk) 01:58, 12 March 2013 (UTC)[reply]

All the recent reviews I remember seeing only list genetically determined blood states as inherited risk factors. So I don't think listing May–Thurner syndrome/Cockett syndrome/Iliac vein compression syndrome is best as was done with this edit. This source, on page 15S, says "Knowledge of the underlying cause of iliac vein compression syndrome...", which to me suggests we shouldn't assume it's a purely genetic/inherited trait. Biosthmors (talk) 17:17, 4 April 2013 (UTC)[reply]

doi:10.1111/jth.12447 - the hypothesis that thrombophilia leads to an increased risk of post-thrombotic syndrome can be rejected. Systematic review & meta-analysis. JFW | T@lk 13:26, 13 November 2013 (UTC)[reply]

doi:10.1001/jama.2014.65 JAMA JFW | T@lk 11:06, 20 February 2014 (UTC)[reply]

Mainly about NOACs - Br J Haem doi:10.1111/bjh.13431 JFW | T@lk 12:03, 23 April 2015 (UTC)[reply]

http://www.nejm.org/doi/full/10.1056/NEJMcp1407434 mentions laterality in pregnancy at the beginning of the article, which seems worthy of a mention, at least in a footnote. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 12:18, 16 September 2015 (UTC)[reply]

... are not much good doi:10.1016/j.amjmed.2015.11.031 JFW | T@lk 11:59, 11 March 2016 (UTC)[reply]

I believe that the article reflects this knowledge now. Biosthmors (talk) 17:52, 2 January 2020 (UTC)[reply]

doi:10.1016/S0140-6736(16)30514-1 JFW | T@lk 08:25, 2 September 2016 (UTC)[reply]

Have removed the merge tag. For one venous thrombosis includes a wide variety of conditions (DVT, PE, cerebral venous thrombosis, etc). DVT is one specific type of venous thrombosis. Doc James (talk · contribs · email) 05:55, 31 December 2016 (UTC)[reply]

Prevention/research directions looks like it could use updating perhaps. doi:10.1056/NEJMoa1700518 Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 13:11, 4 April 2017 (UTC)[reply]

In general, http://journal.publications.chestnet.org/SS/Antithrombotic_Guideline.aspx could be used to update the article. Biosthmors (talk) pls notify me (i.e. {{U}}) while signing a reply, thx 22:01, 21 June 2017 (UTC) (dead link)[reply]

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This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Peer reviewers: Williann1. As part of a student assignment, feedback on DVT was posted on a user's talk page: [9]. I believe I have already addressed their concerns with regard to compression stockings, but I'll double check. Biosthmors (talk) 17:13, 30 December 2019 (UTC)[reply]

I think that "deep bone thrombosis" (dbt) is the same thing as deep vein thrombosis. I'm not sure, but here is some corroborating text:

About 297 results (0.27 seconds) 
Search Results
Featured snippet from the web
Deep bone thrombosis, which is clotting in the veins that can cause a range of leg pain – this can become a life threatening illness if not addressed.
...
Other symptoms of PAD include:

    numbness/tingling in the lower legs and feet.
    coldness in the lower legs and feet.
    ulcers or sores on the legs or feet that do not heal.

Leg Pain
https://www.viralegs.com › leg-pain

Web results
Causes of Deep Bone Thrombosis - Graphic Online
https://www.graphic.com.gh › Ghana news Headlines › Health
May 2, 2014 - Dear mirror doctor I am a very active 46-year-old man who drives to and from work with no problems. I noticed a gradual increase in the size of ...

Assessment 2 (1) | Thrombosis | Vein - Scribd
https://www.scribd.com › document › Assessment-2-1
Nov 20, 2017 - Deep vein thrombosis deep bone thrombosis (DVT) is a blood clot thrombosis in a major vein that usually develops in the legs and/or pelvis. 2.

Deep Vein Thrombosis - Its a real issue if you drive too much ...
https://uberpeople.net › Geographical › Australia › Sydney
Feb 21, 2016 - 20 posts - ‎18 authors
... abuse prescription drugs and are actually obese telling us all we have to live healthier. On the Deep bone Thrombosis thing just make sure if ...

Leg Pain
https://www.viralegs.com › leg-pain
Deep bone thrombosis, which is clotting in the veins that can cause a range of leg pain – this can become a life threatening illness if not addressed.

Myumaimah : http://myumaimah.com/
https://myumaimah.com.cutestat.com
... wear compression stockings, compression socks for sale, deep bone thrombosis, varicose vein clinic, jobst compression socks, vertical veins in legs, where to ...

The House That Hugh Laurie Built: An Unauthorized Biography ...
https://books.google.com › books
Paul Challen - 2010 - ‎Biography & Autobiography
Within a minute in their first diagnostic session, House has ruled out the schizophrenia as a cause of the deep bone thrombosis (dbt). Unlike his other patients, ...

Deep Bone Thrombosis is Sexy | Torn Flesh Records
https://tornfleshrecords.bandcamp.com › track › deep-bone-thrombosis-is-...
Deep Bone Thrombosis is Sexy by Torn Flesh Records, released 18 November 2013.

Cafe on the Edge of Outer Space - Page 1 - Google Books Result
https://books.google.com › books
Robert Appleton - 2008 - ‎Interstellar travel
It's a deep-bone thrombosis of stars and gravitational attraction. Body to body, orbit to orbit, me to her. We're cosmic trespassers, and I feel just as transparent as ...

The Complete Testament - Page 1011 - Google Books Result
https://books.google.com › books
BLA BLA BLA, WE COULD NOT STOP GIVING HIM HIS MEDICATION EVEN HE IS SHOWING SIGNS OF DEEP BONE THROMBOSIS, BUT BECAUSE WE ...

Dr. Sunder Narasimhan - General Surgeon - Book ... - Practo
https://www.practo.com › bangalore › doctor › sunder-narasimhan-vascula...
Rating: 88% - ‎154 votes - ‎Price range: ₹700 consultation fee
Filter placement for deep bone thrombosis. ○. Cerucial rib. ○. Thoracic Outlet Syndrome. ○. Arterial Duroubosis. ○. Arterial Occlusion. ○. Mesentric Ischemia.

From https://www.google.com/search?client=firefox-b-1-d&q=%22Deep+bone+thrombosis%22 --User123o987name (talk) 16:21, 31 December 2019 (UTC)[reply]

It seems to be a misunderstanding/misspelling by people who really mean deep venous thrombosis. Tellingly, there are only 216 Google hits on your search. Most of the hits are not written by healthcare professionals. I did not find the phrase at all in PubMed. Axl ¤ [Talk] 12:18, 2 January 2020 (UTC)[reply]

Greetings User:Graham Beards. After a long hiatus, I am back to working on this article, which you previously reviewed. Thank you. Because of your comment towards the bottom of Wikipedia:Peer review/Deep vein thrombosis/archive3, I did recently incorporate mention of stroke [10] and I have been researching the potential impact of heart failure. Regarding heart failure as a risk factor for DVT, I am not yet sure. My current opinion is limited by general internet access. A 2016 systematic review and meta-analysis (doi:10.1016/S2352-3026(15)00228-8), for example, states in the abstract "Many studies have investigated the association between venous thromboembolism and heart failure, but have yielded inconsistent findings" but then concludes "Heart failure is a common independent risk factor for venous thromboembolism". Yet it seems odd to cite this article to support the claim that heart failure is a risk factor for DVT because this study is limited to hospitalized patients, and hospitalization itself is already cited on the article as a DVT risk factor. Also, it could be the case that statistical significance for VTE is demonstrated by pooling DVT and PE data while the statistical significance for DVT might not yet be independently established. Similarly, I saw a 2019 study [11] where heart failure appears more correlated with isolated PE than DVT with or without PE, called DVT/PE in this study. While the 2016 meta-analysis suggested that their findings could be considered in future prophylaxis regimens, for what it's worth, the most recent 2018 clinical practice guidelines [12] (that the CDC prominently features on their website[13]) don't have any separate guidance on heart failure patients. I feel a bit lost in the weeds here, but at this point it doesn't seem like a firm fact to call heart failure a risk factor for DVT (unless we operate under the assumption that VTE risk factors are always DVT risk factors). So, should VTE risk factors be cited on the DVT article as DVT risk factors? Biosthmors (talk) 17:07, 2 January 2020 (UTC)[reply]

Perhaps we should just specify that the risk factors in this article are VTE risk factors and then that fixes this issue. Biosthmors (talk) 17:36, 2 January 2020 (UTC)[reply]

The prose of the "Causes" section more or less does this already, I'd say. Also, I did find a more recent open-access study that looked at this issue. It said that "Most, although not all, studies have identified HF as an important risk factor for VTE".[14] It looks like the answer is yes, but it appears to be still in the process of being sorted out by current research. Biosthmors (talk) 13:52, 4 January 2020 (UTC)[reply]

This study provides some related and interesting reading: "Atrial Fibrillation and Cause-Specific Risks of Pulmonary Embolism and Ischemic Stroke" J Am Heart Assoc. 2018 Jan 29;7(3). doi:10.1161/JAHA.117.006502 (freely available source) Biosthmors (talk) 18:15, 8 January 2020 (UTC)[reply]

• economics: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706477/
• diagnosis Wells PS, Ihaddadene R, Reilly A, Forgie MA (January 2018). "Diagnosis of Venous Thromboembolism: 20 Years of Progress" (PDF). Annals of Internal Medicine. 168 (2): 131–140. doi:10.7326/M17-0291. PMID 29310137.
• pathophysiology/causes/risk factors: Salvagno GL, Pavan C, Lippi G (September 2018). "Rare thrombophilic conditions". Annals of Translational Medicine. 6 (17): 342. doi:10.21037/atm.2018.08.12. PMC 6174195. PMID 30306081.{{cite journal}}: CS1 maint: unflagged free DOI (link) however (Annals of Translational Medicine redirects to AME Publishing Company which currently says "It was included on Beall's list of predatory publishers, prior to the list being taken offline in January 2017")
• nonadministration of in-hospital doses (also covered in a 2015 Wall Street Journal article I believe) Kreutzer L, Yang AD, Sansone C, Minami C, Saadat L, Bilimoria KY, Johnson JK (November 2019). "Barriers to Providing VTE Chemoprophylaxis to Hospitalized Patients: A Nursing-Focused Qualitative Evaluation". Journal of Hospital Medicine. 14 (10): 668–672. doi:10.12788/jhm.3290. PMID 31433769. and Owodunni OP, Lau BD, Streiff MB, Kraus PS, Hobson DB, Shaffer DL, Webster KLW, Kia MV, Holzmueller CG, Haut ER (February 2019). "What the 2018 ASH venous thromboembolism guidelines omitted: nonadministration of pharmacologic prophylaxis in hospitalized patients". Blood Advances. 3 (4): 596–598. doi:10.1182/bloodadvances.2018030510. PMC 6391662. PMID 30792188.
• management: Bartholomew JR (December 2017). "Update on the management of venous thromboembolism". Cleveland Clinic Journal of Medicine. 84 (12 Suppl 3): 39–46. doi:10.3949/ccjm.84.s3.04. PMID 29257737.
• FVL paradox: https://ashpublications.org/bloodadvances/article/3/21/3375/422724/Thrombus-stability-explains-the-factor-V-Leiden Biosthmors (talk) 02:24, 18 February 2020 (UTC)[reply]
• long-term / extended / indefinite anticoagulation Kearon C, Kahn SR (January 2020). "Long-term treatment of venous thromboembolism". Blood. 135 (5): 317–325. doi:10.1182/blood.2019002364. PMID 31917402. Biosthmors (talk) 17:57, 4 February 2020 (UTC)[reply]

I am currently not sure if all authors are consistent with their definition for iliofemoral DVT. It appears it might either mean proximal DVT,(I previously cited doi:10.1016/S0140-6736(11)61875-8 to support this use but I'm now paywalled), a certain kind of bad proximal DVT that requires involvement of an iliac vein,[15], or something to be distingished from both femoropopliteal and distal DVT.[16] To be determined. Biosthmors (talk) 19:54, 20 January 2020 (UTC)[reply]

I've decided to go with the explicit definition provided in 2019 guidelines from Australia and New Zealand as this seems to be the most reliable source to cite so far (particularly since it defines iliofemoral DVT in the context of using catheter-directed thrombolysis). The article has been updated accordingly. Biosthmors (talk) 16:55, 22 January 2020 (UTC)[reply]

(Relevant diff, which I reverted.) I massively reworked the newly dubbed "Causes and risk factors" section yesterday by subsuming a risk factor subsection into the prose of the causes section. So I renamed the new mega-section "Causes and risk factors." I think this title works better than just picking one (Causes or Risk factors) because the first paragraph is all about causes and a lot of the prose talks about the interplay between specific risk factors and why they contribute to those causes. So in my mind the dual titles work well for this section. That being said, the article is in flux, and there's conceptual overlap with the aforementioned section and the Pathophysiology section. So maybe we'll ultimately find a new and improved re-organization of the text that makes this thread obsolete. Also, maybe I'm missing some collective wisdom. For what it's worth, it does seem like a sentence should be added that explains how DVT risk is conceptualized as multifactorial and begins once a threshold is reached. I recall seeing that in a review article, but I'm not sure if it is cited or not. Biosthmors (talk) 15:46, 28 January 2020 (UTC)[reply]

I've re-thought this, and I've changed it to just "Causes" since that seems to be the most common thing to do per Wikipedia:Manual_of_Style/Medicine-related_articles#Diseases_or_disorders_or_syndromes. I don't see a loss in quality by not having the word "risk factor" in the section title. Biosthmors (talk) 15:17, 30 January 2020 (UTC)[reply]

• These images of venograms are interesting. But I don't know what they are showing, so I find it confusing. It should be explained if it is going to be used in the article, in my opinion. In other words, I have long found these images distracting and confusing. I moved them here for the time being, and I will ask the author if they will please assist. Biosthmors (talk) 01:18, 29 January 2020 (UTC)[reply]
  • After injecting contrast medium into a vein on the foot, the various vein groups on the lower leg and knee become visible in fluoroscopy. Dilatations of the veins are limited by valves. It can be seen in large sections that the contrast medium does not fill the entire vein, but rather flows around long-stretched thrombi.--Hellerhoff (talk) 19:37, 30 January 2020 (UTC)[reply]
    • Thank you Hellerhoff! Biosthmors (talk) 16:46, 31 January 2020 (UTC)[reply]

• The image currently illustrating post-thrombotic syndrome is complicated by a large area of bruising. It is not ideal. I have searched using some methods at WP:Pictures for medical articles but no luck yet. If anyone has access to an image for post-thrombotic syndrome, that would be great, especially if it shows a healthy leg next to an affected one. Biosthmors (talk) 18:54, 30 January 2020 (UTC)[reply]
  • I did find one on flikr showing PTS with a prominent ulcer. It was from the UK VTE prevention program but it's copyrighted (2013) and it looks like that organization / initiative is quasi-defunct as their former website is no longer active. Biosthmors (talk) 17:59, 4 February 2020 (UTC)[reply]

Bed rest appears to be confined to the history books: "The second half of the [20th] century was characterized by the simplification of anticoagulant treatment, which allowed ambulatory treatment of the disease and the end of the bed‐rest dogma".[17] This explains why I trimmed[18] that content out of the treatment section, which was based on 10+ year old medical sources anyhow. The article already establishes that bed rest is a risk factor (causes section) and that walking helps (prevention section). There's plenty of room to discuss bed rest as a historical treatment in the historical section, as the above quoted source does. But there's no need for us to carp to a few hold-out physicians of the 1990s, as it appears the former text was trying to do. Biosthmors (talk) 18:36, 4 February 2020 (UTC)[reply]

I cited a recent secondary source for content regarding aspirin. The following studies were previously cited in the DVT article, but I commented them out a while back, and I'm not sure we need to cite them. Perhaps listing them here will help make sure the article is comprehensive:

• Stewart DW, Freshour JE (January 2013). "Aspirin for the prophylaxis of venous thromboembolic events in orthopedic surgery patients: a comparison of the AAOS and ACCP guidelines with review of the evidence". The Annals of Pharmacotherapy. 47 (1): 63–74. doi:10.1345/aph.1R331. PMID 23324504.
• Warkentin TE (November 2012). "Aspirin for dual prevention of venous and arterial thrombosis". The New England Journal of Medicine. 367 (21): 2039–41. doi:10.1056/NEJMe1211480. PMID 23121404.
• Simes J, Becattini C, Agnelli G, Eikelboom JW, Kirby AC, Mister R, et al. (INSPIRE Study Investigators (International Collaboration of Aspirin Trials for Recurrent Venous Thromboembolism)) (September 2014). "Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration". Circulation. 130 (13): 1062–71. doi:10.1161/circulationaha.114.008828. PMID 25156992. article states recurrent VTE after unprovoked VTE and discontinuation of VKA is about 10% in the first year and about 5% per year thereafter

Biosthmors (talk) 15:50, 18 February 2020 (UTC)[reply]

Is still commonly used especially in regions that do not have access to newer / more expensive agents. It is still an appropriate treatment and thus IMO should remain mention as such in the lead. Doc James (talk · contribs · email) 20:34, 26 February 2020 (UTC)[reply]

Warfarin is the most commonly prescribed anticoagulant in the UK [19].Graham Beards (talk) 20:53, 26 February 2020 (UTC)[reply]

That's fine by me. For what it's worth, I do wonder what the new NICE guidelines (with their planned release on 31 March 2020[20]) will say. Biosthmors (talk) 22:29, 26 February 2020 (UTC)[reply]

Much of the wealthy world is switching to the newer agents (because the easier). It will be a long time before this will occur for other regions were cost is a more significant factor.

Happy for us to mention that warfarin is generally started with heparin. Just shortened a bit. Doc James (talk · contribs · email) 18:23, 27 February 2020 (UTC)[reply]

Great. And I further clarified things according to my understanding. Biosthmors (talk) 12:12, 28 February 2020 (UTC)[reply]

That NICE guideline was published and it replaces and updates the currently cited NICE guideline the article uses, so that's something to update. Biosthmors (talk) 01:34, 5 May 2020 (UTC)[reply]

Guideline updated here. Need to review references to CG144 and replace. JFW | T@lk 09:57, 5 May 2020 (UTC)[reply]

Agreed! That's on my to-do list. Thanks for posting. Biosthmors (talk) 00:55, 7 May 2020 (UTC)[reply]

A discussion is taking place to address the redirect Deep vein thrombosis in lower limb (NOS). The discussion will occur at Wikipedia:Redirects for discussion/Log/2020 July 13#Deep vein thrombosis in lower limb (NOS) until a consensus is reached, and readers of this page are welcome to contribute to the discussion. Tom (LT) (talk) 06:58, 13 July 2020 (UTC)[reply]

Here we can list sources that might be useful for an updated pathophysiology section:

• Nicklas JM, Gordon AE, Henke PK (March 2020). "Resolution of Deep Venous Thrombosis: Proposed Immune Paradigms". International Journal of Molecular Sciences. 21 (6). doi:10.3390/ijms21062080. PMC 7139924. PMID 32197363.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  • Ignore highlighting. Henke PK publishes widely in respected journals in this topic area [21]
• Branchford BR, Carpenter SL (2018). "The Role of Inflammation in Venous Thromboembolism". Frontiers in Pediatrics. 6: 142. doi:10.3389/fped.2018.00142. PMC 5974100. PMID 29876337.{{cite journal}}: CS1 maint: unflagged free DOI (link) cited & ignore highlighting: cited 72 times in Web of Science as of ~April 1, 2021
• Thålin C, Hisada Y, Lundström S, Mackman N, Wallén H (September 2019). "Neutrophil Extracellular Traps: Villains and Targets in Arterial, Venous, and Cancer-Associated Thrombosis". Arteriosclerosis, Thrombosis, and Vascular Biology. 39 (9): 1724–1738. doi:10.1161/ATVBAHA.119.312463. PMID 31315434. cited
• Laridan E, Martinod K, De Meyer SF (February 2019). "Neutrophil Extracellular Traps in Arterial and Venous Thrombosis". Seminars in Thrombosis and Hemostasis. 45 (1): 86–93. doi:10.1055/s-0038-1677040. PMID 30634198. cited
• Najem MY, Couturaud F, Lemarié CA (May 2020). "Cytokine and chemokine regulation of venous thromboembolism". Journal of Thrombosis and Haemostasis : JTH. 18 (5): 1009–1019. doi:10.1111/jth.14759. PMID 32020753. cited
• Fernandes CJ, Morinaga LTK, Alves JL, Castro MA, Calderaro D, Jardim CVP, et al. (March 2019). "Cancer-associated thrombosis: the when, how and why". European Respiratory Review. 28 (151). doi:10.1183/16000617.0119-2018. PMID 30918022.
• Swystun LL, Liaw PC (August 2016). "The role of leukocytes in thrombosis". Blood. 128 (6): 753–62. doi:10.1182/blood-2016-05-718114. PMID 27354721. cited
• Turetz M, Sideris AT, Friedman OA, Triphathi N, Horowitz JM (June 2018). "Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism". Seminars in Interventional Radiology. 35 (2): 92–98. doi:10.1055/s-0038-1642036. PMC 5986574. PMID 29872243. cited
• Tzoran I, Hoffman R, Monreal M (October 2018). "Hemostasis and Thrombosis in the Oldest Old". Seminars in Thrombosis and Hemostasis. 44 (7): 624–631. doi:10.1055/s-0038-1657779. PMID 29920621.
• Borgel D, Bianchini E, Lasne D, Pascreau T, Saller F (December 2019). "Inflammation in deep vein thrombosis: a therapeutic target?". Hematology. 24 (1): 742–750. doi:10.1080/16078454.2019.1687144. PMID 31736432. cited
• Metz AK, Diaz JA, Obi AT, Wakefield TW, Myers DD, Henke PK (2018). "Venous Thrombosis and Post-Thrombotic Syndrome: From Novel Biomarkers to Biology". Methodist DeBakey Cardiovascular Journal. 14 (3): 173–181. doi:10.14797/mdcj-14-3-173. PMC 6217569. PMID 30410646.
• Diaz JA, Saha P, Cooley B, Palmer OR, Grover SP, Mackman N, et al. (March 2019). "Choosing a Mouse Model of Venous Thrombosis". Arteriosclerosis, Thrombosis, and Vascular Biology. 39 (3): 311–318. doi:10.1161/ATVBAHA.118.311818. PMID 30786739. not needed
• Li WD, Li XQ (August 2016). "Endothelial progenitor cells accelerate the resolution of deep vein thrombosis". Vascular Pharmacology. 83: 10–6. doi:10.1016/j.vph.2015.07.007. PMID 26187355.
• Other topic: Jones T, Horner D (May 2017). "BET 2: Striking the right balance: anticoagulation and isolated distal deep vein thrombosis". Emergency Medicine Journal : EMJ. 34 (5): 334–336. doi:10.1136/emermed-2017-206732.2. PMID 28428437.
• Recent reviews on mechanisms of cancer associated thrombosis also exist
• Nasser NJ, Fox J, Agbarya A (February 2020). "Potential Mechanisms of Cancer-Related Hypercoagulability". Cancers. 12 (3). doi:10.3390/cancers12030566. PMC 7139427. PMID 32121387.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  • per https://www.scopus.com/sources.uri this journal is rated as 181/331 in oncology. a quick google search shows it has already been cited 17 times. Biosthmors (talk) 11:40, 23 April 2021 (UTC)[reply]

Biosthmors (talk) 21:36, 14 August 2020 (UTC)[reply]

Epidemiology:

• Wendelboe AM, Raskob GE (April 2016). "Global Burden of Thrombosis: Epidemiologic Aspects". Circ Res. 118 (9): 1340–7. doi:10.1161/CIRCRESAHA.115.306841. PMID 27126645. cited
• Raskob GE, Angchaisuksiri P, Blanco AN, Buller H, Gallus A, Hunt BJ, et al. (November 2014). "Thrombosis: a major contributor to global disease burden". Arterioscler Thromb Vasc Biol. 34 (11): 2363–71. doi:10.1161/ATVBAHA.114.304488. PMID 25304324. cited

Series of articles in Blood:

• Kearon C, Kahn SR (January 2020). "Long-term treatment of venous thromboembolism". Blood. 135 (5): 317–325. doi:10.1182/blood.2019002364. PMID 31917402. cited
• Abbattista M, Capecchi M, Martinelli I (January 2020). "Treatment of unusual thrombotic manifestations". Blood. 135 (5): 326–334. doi:10.1182/blood.2019000918. PMID 31917405. cited
• Moran J, Bauer KA (January 2020). "Managing thromboembolic risk in patients with hereditary and acquired thrombophilias". Blood. 135 (5): 344–350. doi:10.1182/blood.2019000917. PMID 31917425.
• Weitz JI, Chan NC (January 2020). "Novel antithrombotic strategies for treatment of venous thromboembolism". Blood. 135 (5): 351–359. doi:10.1182/blood.2019000919. PMID 31917385.
• Becattini C, Agnelli G (January 2020). "Acute treatment of venous thromboembolism". Blood. 135 (5): 305–316. doi:10.1182/blood.2019001881. PMID 31917399.

Random:

• Zöller B, Svensson PJ, Dahlbäck B, Lind-Hallden C, Hallden C, Elf J (September 2020). "Genetic risk factors for venous thromboembolism". Expert Review of Hematology. 13 (9): 971–981. doi:10.1080/17474086.2020.1804354. PMID 32731838. cited
• Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. (January 2020). "2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)". European Heart Journal. 41 (4): 543–603. doi:10.1093/eurheartj/ehz405. PMID 31504429. cited
• Chopard R, Albertsen IE, Piazza G (November 2020). "Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review". JAMA. 324 (17): 1765–1776. doi:10.1001/jama.2020.17272. PMID 33141212.
• Wong E, Chaudhry S. "Venous thromboembolism (VTE)". McMaster Pathophysiology Review. Retrieved April 4, 2021.{{cite web}}: CS1 maint: url-status (link)
• Henke PK, Kahn SR, Pannucci CJ, Secemksy EA, Evans NS, Khorana AA, et al. (June 2020). "Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients: A Policy Statement From the American Heart Association". Circulation. 141 (24): e914–e931. doi:10.1161/CIR.0000000000000769. PMID 32375490.

Diagnosis:

• Moore AJE, Wachsmann J, Chamarthy MR, Panjikaran L, Tanabe Y, Rajiah P (June 2018). "Imaging of acute pulmonary embolism: an update". Cardiovascular Diagnosis and Therapy. 8 (3): 225–243. doi:10.21037/cdt.2017.12.01. PMC 6039809. PMID 30057872.{{cite journal}}: CS1 maint: unflagged free DOI (link)

Signs and symptoms:

• Andreou ER, Koru-Sengul T, Linkins L, Bates SM, Ginsberg JS, Kearon C (October 2008). "Differences in clinical presentation of deep vein thrombosis in men and women". Journal of Thrombosis and Haemostasis. 6 (10): 1713–9. doi:10.1111/j.1538-7836.2008.03110.x. PMID 18665920.
• Stubbs MJ, Mouyis M, Thomas M (March 2018). "Deep vein thrombosis". BMJ. 360: k1335. doi:10.1136/bmj.k1335. PMID 29563086. mentions character of pain, exacerbating factors; also check BMJ citations there seems to be a problem with accurate volume numbers?

Lines of Zahn:

• Grimes Z, Bryce C, Sordillo EM, Gordon RE, Reidy J, Paniz Mondolfi AE, et al. (2020). "Fatal pulmonary thromboembolism in SARS-CoV-2-infection". Cardiovascular Pathology. 48: 107227. doi:10.1016/j.carpath.2020.107227. PMC 7214296. PMID 32718733.

Biosthmors (talk) 19:26, 17 March 2021 (UTC)[reply]

A recent edit[22] added the following text, which I just removed as I have concerns over too-close paraphrasing and duplicative content. Some of it however might be worth adding back "Venous blood clots are structures consisting of successive layers of fibrin, platelets, red bloods cells, and leukocytes. Compared to arterial clots, the number of platelets is relatively low, but platelets do seem to play an important role. It's also worth noting that the use of aspirin may decrease the risk of first and recurrent VTE." Biosthmors (talk) 17:20, 2 April 2021 (UTC)[reply]

This edit might have removed the answer but I haven't seen it discussed yet in more recent reviews. Biosthmors (talk) 18:39, 9 April 2021 (UTC)[reply]

In reply to this edit, I've seen a couple reviews mention soleal veins[23] / the soleal vein[24]. The second source discusses the soleal vein in depth. I thought mention of this vein / venous system and a WP:REDlink to it were appropriate. I was thinking since secondary sources mention it, we'd be fine to mention it as well (and that it deserved an article) User:Jfdwolff. Thanks. Biosthmors (talk) 14:42, 11 April 2021 (UTC)[reply]

Thanks for the clarification. The soleal veins are definitely not the only calf veins where DVTs can originate. From the second reference: "The deep veins of lower limbs are divided into the thigh and calf veins. The calf veins comprise three crural veins (posterior tibial, anterior tibial, and peroneal veins) that receive blood flow from the foot sole and the intramuscular veins (soleal and gastrocnemius veins) and their joint vein (popliteal vein). The thigh veins (iliac and femoral veins) run from the calf veins toward the center. The calf and thigh veins have different anatomical features." Therefore, we should either mention all the veins or none of them. JFW | T@lk 08:15, 12 April 2021 (UTC)[reply]

I agree with you that "the soleal veins are definitely not the only calf veins where DVTs can originate". But the source has an entire section on "Growth of a Soleal Vein Thrombus", for example. It doesn't do this with any other vein. The first source cites the second (and another) for its sentence that in "most of the lower extremity DVT cases, thrombus formation starts in the soleal veins of the calf and then propagates to other veins". I'm not sure a majority of LEDVT starts in the soleal vein, but saying they often start there appears to be an accurate and appropriately weighted claim. I'm not wedded to this mention of soleal vein(s), however. Biosthmors (talk) 01:17, 13 April 2021 (UTC)[reply]

I excised the following text: Anticoagulation, which increases the risk of bleeding, is sometimes used indefinitely (lifelong treatment) in those with a high-risk for recurrence. The risk of major bleeding with long-term anticoagulation is about 3% per year,<ref name="Varga"/> and the point where annual VTE risk is thought to warrant long-term anticoagulation is estimated to be between 3 and 9%.<ref name="Keeling"/> Usually, only when individuals exceed a 9% annual VTE risk is long-term anticoagulation a common consideration.<ref name="Keeling">{{cite journal | vauthors = Keeling D, Baglin T, Tait C, Watson H, Perry D, Baglin C, Kitchen S, Makris M | display-authors = 6 | title = Guidelines on oral anticoagulation with warfarin – fourth edition | journal = British Journal of Haematology | volume = 154 | issue = 3 | pages = 311–24 | date = August 2011 | pmid = 21671894 | doi = 10.1111/j.1365-2141.2011.08753.x | doi-access=free}}</ref> For example, antithrombin deficiency, a strong or moderately strong risk factor, carries an annual risk of VTE of only 0.8–1.5%;<ref name="Varga"/> as such, asymptomatic individuals with thrombophilia do not warrant long-term anticoagulation.<ref>[[#CITEREFGuyattAklCrowtherGutterman2012|Guyatt et al. 2012]], p. 11S: 7.1.</ref> The logic of this text is predominantly based upon the use of warfarin. However, anticoagulation now, warfarin or DOACs, has more complicated and differing risk profiles. For example: "... the consequences of a major bleed are generally worse than the consequences of a recurrent VTE: about 12% of major bleeds (probably lower with direct oral anticoagulants [DOACs] than with warfarin10 ), as opposed to 4% of recurrent VTE, are fatal (∼3:1 ratio).3,9,11-13" From [25]. Biosthmors (talk) 06:33, 16 April 2021 (UTC)[reply]

I removed the following: Signs and symptoms alone are not sufficiently [[Sensitivity and specificity|sensitive or specific]] to make a diagnosis, but when considered in conjunction with [[#Diagnosis|pre-test probability]], can help determine the likelihood of DVT.<ref name=2019Tran/> and simplified the content for the signs and symptoms section. I'm currently thinking the diagnosis section should mention and link pre-test probability at the beginning. Biosthmors (talk) 15:38, 22 April 2021 (UTC)[reply]

The page refers to VTE that can relate to either DVT or PE which is backed up by ref used, but other refs and the entry page for VTE says that VTE is the combination of DVT and PE. This needs to be addressed maybe by adding 'some sources...' etc. --Iztwoz (talk) 09:50, 25 April 2021 (UTC)[reply]

Thank you for your edits Iztwoz. I see sources say that DVT and PE comprise VTE. But this just means (as I understand it) that VTE = either DVT, PE, or DVT + PE. I'm unaware of sources that say VTE is only DVT + PE. Even if we found one, I think the preponderance of sources are clear on this. With regards to this diff, the supporting sentence is "Thrombosis at unusual sites accounts for ∼10% of all cases of venous thrombosis, affecting any venous region other than the deep or superficial veins of the lower limbs or those involved in pulmonary circulation."[26] (And just to compare the incidence of superficial vein thrombosis with VTE I found this and they are comparable [both are around 1 to 2 per thousand person years].) I also made a clarifying edit at venous thrombosis. In an ideal world, perhaps there would be a parent article at venous thromboembolism for DVT, DVT + PE, and PE. The article at venous thrombosis should really be a parent article to all forms of venous thrombosis. I don't like the current venous thrombosis page because focuses too heavily on VTE, but I believe that's also (perhaps mainly) my fault. Biosthmors (talk) 11:37, 25 April 2021 (UTC)[reply]

Thanks Biosthmors I admit to a bias for defining venous thromboembolism as comprising both DVT and PE - as per Harrison's for one. A clot in a vein - DVT - is a clot in a vein....it is only a thromboembolism when it or part of it detaches and travels in the bloodstream or what am I misunderstanding? That aside I feel that there is too much coverage of VTE and PE when the entry page is DVT.? These days I can only fit in a few edits mostly when am very tired. --Iztwoz (talk) 19:38, 25 April 2021 (UTC)[reply]

This is copied from Venous thrombosis page - "When a blood clot breaks loose and travels in the blood, this is called a venous thromboembolism (VTE). The abbreviation DVT/PE refers to a VTE where a deep vein thrombosis (DVT) has moved to the lungs (PE or pulmonary embolism).--Iztwoz (talk) 19:54, 25 April 2021 (UTC)[reply]

I understand the concern. In my mind it makes sense that Wikipedia might contradict itself, because sources appear to contradict one another as well. I found this public-facing website of an organization that hosts medical journals, and it says VTE = DVT + PE. (But would they agree if you pressed them that they really mean and/or?) I went to a new guideline-based journal article to see what they say and the first sentence says "Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is an important cause of morbidity and mortality among patients with cancer.": from Key NS, Khorana AA, Kuderer NM, Bohlke K, Lee AYY, Arcelus JI, et al. (February 2020). "Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update". Journal of Clinical Oncology. 38 (5): 496–520. doi:10.1200/JCO.19.01461. PMID 31381464.. I've asked a couple Wikipedian physicians (one is already participating) to take a look at the ongoing peer review for DVT. Maybe they'll chime in. For what it's worth, NICE opts for the term venous thromboembolic diseases in reference to DVT and PE.[27] Thanks for your efforts! A lot of the data generated for DVT is under the rubric of VTE so yes, sometimes this article is more generalist than specific at times. Biosthmors (talk) 20:16, 25 April 2021 (UTC)[reply]

I looked up Harrison's (the same one?) and it said "Venous thromboembolism (VTE) encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE)..."[28] I interpret that to mean DVT, PE, or DVT + PE. Hope this all helps. I hope you get some rest! Biosthmors (talk) 20:22, 25 April 2021 (UTC)[reply]

I read it as it says - VTE comprises DVT and PE, as other surces also say and this does not need anybody's interpretation. A pulmonary embolism on its own cannot be considered to be specifically a venous thromboembolism since it may also be caused by an air bubble or a part of an atherosclerotic plaque.see [29]--Iztwoz (talk) 12:17, 28 April 2021 (UTC)[reply]

Robbins makes the distinction of Pulmonary thromboembolism. Another way of looking at the definition is the description of a pulmonary embolism caused by a deep vein thrombosis.--Iztwoz (talk) 15:23, 28 April 2021 (UTC)[reply]

Changed wording a bit and added refs - I shall leave the rest now for JFW's review. Best--Iztwoz (talk) 17:06, 28 April 2021 (UTC)[reply]

I was looking for a journal article to replace the book/website references and the first journal article I opened prompted me to instead excise one of the contributions FYI. The rationale is in the edit summary. Best. Biosthmors (talk) 23:21, 2 May 2021 (UTC)[reply]

Prompted by Wikipedia:Peer review/Deep vein thrombosis/archive4, I removed the following text from the Classification section because I think it wouldn't be useful for readers. These distinctions are either hardly drawn or absent in the article: DVT that has no symptoms, but is found only by screening, is labeled asymptomatic or incidental.<ref name=airline/><ref name=2020Mulder>{{cite journal | vauthors = Mulder FI, Di Nisio M, Ay C, Carrier M, ((Bosch FTM)), Segers A, Kraaijpoel N, Grosso MA, Zhang G, Verhamme P, Wang TF, Weitz JI, Middeldorp S, Raskob G, ((Beenen LFM)), Büller HR, van Es N | display-authors = 6 | title = Clinical implications of incidental venous thromboembolism in cancer patients | journal = The European Respiratory Journal | volume = 55 | issue = 2 | pages = | date = February 2020 | pmid = 31727694 | doi = 10.1183/13993003.01697-2019 }}</ref>