Deep Vein Thrombosis & Malignancy Department of Radiation Oncology Presented by Dr. Muhammad Zubaer Hussain. Incidence. About 600,000 hospitalizations per year occur for DVT in the United States. 100,000 to 300,000 VTE-related deaths occur annually in the United States.
In hospitalized patients, the incidence of venous thrombosis is considerably higher and varies from 20-70%.
The in-hospital case- fatality rate for VTE is 12% rising to 21% in elderly persons.
Venous thrombosis is second leading cause of death in cancer patients.
Upper Limb DVT
Lower limb DVT characteristically starts with
(when clot extends proximally into the inferior vena cava. )
( Bilateral DVT is more commonly seen in patients with underlying malignancy )
VTE can cause
or, among survivors
Pharmacological: (Moderate to High risk of DVT)
the third day; subsequent doses are titrated against the INR.
with history of DVT
Low molecular weight heparin(LMWH):
1mg/kg sc 12 hrly
5000 U iv loading continuous inf20U/kg/hr
Parenteral anticoagulation should be continued for a minimum of 5 days
Warfarin: 10 mg on the first and second days, with 5 mg on the third day; subsequent doses are titrated against the INR.