Martinelli Ida, Franchini Massimo, Mannucci Pier Mannuccio
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Medicine and Medical Specialties, University of Milan, Milan, Italy.
Blood. 2008 Dec 15;112(13):4818-23. doi: 10.1182/blood-2008-07-165969. Epub 2008 Sep 19.
Venous thromboembolism may involve venous sites other than the lower limbs, such as cerebral, splanchnic, and upper limb veins. Although uncommon, these thromboses may be clinically severe and challenging for caregivers. In this review, the main pathogenic, clinical, and therapeutic features of thromboses in rare venous sites are discussed. Even though there was a lot of recent progress in understanding the mechanistic role of inherited and acquired thrombophilia and of the interactions between different risk factors, the optimal management of these patients is still unsettled, being currently based on the consensus of experts due to the lack of randomized trials. The implementation of large interdisciplinary registries is a necessary weapon to optimize the treatment of rare venous diseases.
静脉血栓栓塞可能累及下肢以外的其他静脉部位,如脑静脉、内脏静脉和上肢静脉。尽管不常见,但这些血栓形成在临床上可能很严重,给护理人员带来挑战。在本综述中,我们讨论了罕见静脉部位血栓形成的主要致病、临床和治疗特征。尽管最近在理解遗传性和获得性血栓形成倾向的机制作用以及不同风险因素之间的相互作用方面取得了很大进展,但这些患者的最佳管理仍未确定,由于缺乏随机试验,目前基于专家共识。实施大型跨学科登记是优化罕见静脉疾病治疗的必要手段。