How I treat venous thrombosis in children

Abstract

The prevalence and pathologic significance of central and proximal venous thrombi affecting the atrium and vena cava, as well as the subclavian, jugular, iliac, and femoral veins, was not appreciated widely until the ability to detect these clots in infants and children was enhanced by the development of noninvasive imaging techniques using color-flow and pulsed Doppler in addition to gray scale ultrasound (US), echocardiography, and computerized tomography and magnetic resonance with or without angiography (CT, CTA, MR, and MRA). In addition, it is clear that advances in intensive support of critically ill children have involved widespread use of indwelling central venous catheters and invasive procedures that have increased the incidence of deep venous thrombosis (DVT) in children.¹¹ The development of national and international registries helped to increase awareness of thrombosis in children and focus attention on the serious need for objective data regarding epidemiology, etiology, diagnosis, treatment, and outcome.^5,11-13