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Semin intervent Radiol 2017; 34(01): 35-49
DOI: 10.1055/s-0036-1597762
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

How We Manage Pediatric Deep Venous Thrombosis

Marisol Betensky
1   Pediatric Thrombosis Program, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
2   Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Mark A. Bittles
3   Department of Radiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
,
Paul Colombani
4   Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
5   Department of Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
,
Neil A. Goldenberg
1   Pediatric Thrombosis Program, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
2   Division of Hematology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
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Publication History

Publication Date:
02 March 2017 (online)

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Abstract

Over the past two decades, the incidence and recognition of venous thromboembolism (VTE) in children has significantly increased, likely as a result of improvements in the medical care of critically ill patients and increased awareness of thrombotic complications among medical providers. Current recommendations for the management of VTE in children are largely based on data from pediatric registries and observational studies, or extrapolated from adult data. The scarcity of high-quality evidence-based recommendations has resulted in marked variations in the management of pediatric VTE among providers. The purpose of this article is to summarize our institutional approach for the management of VTE in children based on available evidence, guidelines, and clinical practice considerations. Therapeutic strategies reviewed in this article include the use of conventional anticoagulants, parenteral targeted anticoagulants, new direct oral anticoagulants, thrombolysis, and mechanical approaches for the management of pediatric VTE.

Keywords

venous thromboembolism - anticoagulants - thrombolytic therapy - pediatric
 

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