Thromboembolic disease refers to pulmonary embolism and deep vein thrombosis, which are often related. Pulmonary embolism occurs when a blood clot breaks off and travels to the lungs, while deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. The risks of thromboembolic disease include immobility, hypercoagulability, trauma, cancer, and central line placement. Prevention focuses on ambulation, compression stockings or devices, and anticoagulation medications, while diagnosis involves tests like ultrasound, CT, and D-dimer. Treatment is primarily long-term anticoagulation to prevent further clots.

1. Thromboembolic Disease
Steven Podnos MD

2. Pulmonary Emboli
• Prevalence unclear
• Risk of Death or severe Cardiopulmonary
compromise
• Thought almost always related to DVT of
lower extremities (can be UE)

3. DVT
• Virchows Triad:
• Immobility
• Hypercoagulability
• Venous Damage

4. Who is at Risk?
• Bedridden (Immobility)
• Trauma (surgical or otherwise) , especially to
lower extremity
• Cancer (hypercoagulable)
• Central lines

5. Prevention
• Ambulation
• TED Hose?
• SCD hose
• Anticoagulation
• Filter?

6. Anticoagulation
• Unfractionated Heparin
• Low Molecular Weight Heparin
• Fondaparinux
• Dabigatran and other Thrombin inhibitors

7. Diagnosis
• DVT-ultrasound, venography
• PE-V/Q scan, CTA, Angiogram
• Role of D Dimer, screen

8. Strategy for suspected TE disease
• D Dimer screen
• If positive, ultrasound lower extremities
• If negative, CTA if possible

9. Treatment of TE disease
• Anticoagulation
• Filter-when anticoagulation not possible or
fails