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clinical practice on the management of deep venous thrombosis and evaluation of performance diagnostic in moroccan center
2017
1. Abstract 1.1. Background: Venous Thrombo Embolism (VTE) is a major public health problem in
Morocco. The increase in life expectancy, changes of the epidemiological
profile of VTE counteracts the constant efforts made in terms of prevention and
disease remains ever. 1.2. MaterialsMfont-family:" times="" new="" roman","serif";mso-ansi-language:="" en-us"="">Prospective study to host emergency department over a period of 10
months including all Deep Vein Thrombosis (DVT) admitted to the University
Hospital of Casablanca. DVT was suspected clinically and retained on the
presence of a thrombus in the lower-extremity on venous Doppler. We excluded
patients with superficial thrombophlebitis and patients already diagnosed with
VTE. 1.3. Findings: The mean age of our patients was 49 years, with female predominance. A
thromboembolic risk factor was found in 88% of patients. The main etiology:
immobilization, surgery, heart disease and cancer pathology. Pain and the
increase in calf circumference were the signs giving rise to the emergency
department visit. The Doppler ultrasound has objectified a proximal
localization in 38 patients (47%), distal in 12 patients (15%) and extended to
the whole limb in 30 patients (38%). An association to pulmonary embolism was
found in 10 patients (12%) and the association with arterial impairment was
found in 4 patients (5%). The Wells score was calculated on only 12 patients
(15%) and the results of thrombophilia requested in 8 patients (10%). 54
patients (67%) were treated in ambulatory and 26 patients were hospitalized.
All patients were started on heparin and 92% have Vitamin K Antagonists (VKA).
The causes of non-prescription VKA were: pregnancy in two patients,
breakthrough bleeding on cervical cancer, active duodenal ulcer, immune
thrombocytopenic purpura and erosive gastritis scalable. 1.4. Conclusion: DVT remains a topical issue especially with the advent of new
anticoagulants. In our current practice, a prospective study in more moroccan
university hospital -including large population- is desirable for a better
management. 2. Keywords : D-Dimers; Deep Vein Thrombosis; Doppler
Ultrasound Venous Mapping ; Venous
Thromboembolism; Wells Score
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