Revisión de los métodos diagnósticos de la Trombosis Venosa Profunda y Embolismo Pulmonar. Rol del Fragmento D de fibrina
Review of topic on the Diagnosis of Venous Thrombosis and Pulmonary Embolism in Patients with Neoplasms. Role of fibrin Fragment D
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Revisión de los métodos diagnósticos de la Trombosis Venosa Profunda y Embolismo Pulmonar. Rol del Fragmento D de fibrina.
rev. colomb. neumol. [Internet]. 2024 Nov. 26 [cited 2024 Dec. 21];36(2):41-50. Disponible en: https://doi.org/10.30789/rcneumologia.v36.n2.2024.728
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Introducción. La enfermedad tromboembólica venosa, representada por la trombosis venosa profunda y el embolismo pulmonar, constituye una patología de alta prevalencia tanto en pacientes intra como extra hospitalarios, con un número cada vez más amplio de factores de riesgo asociados, algunos de ellos no representados en las escalas de riesgo y pronóstico implementadas en la actualidad. Es el caso de las patologías neoplásicas de órgano sólido y hematológicas, las cuales se han asociado con falsos positivos en el resultado de pruebas como el dímero D y eventos trombóticos recurrentes, lo cual dificulta establecer un algoritmo de diagnóstico y un tiempo de anticoagulación, luego de la resolución del evento trombótico inicial.
Objetivo. Documentar el uso de ecografía doppler de compresión de miembros inferiores, la angioresonancia pulmonar (ARP) y la angiotomografía de tórax con mapa de yodo (ATMY) en pacientes con cáncer y sospecha de eventos trombóticos, tienen un valor predictivo negativo comparable al dímero D en ausencia del cáncer, por ende, se requiere mayor implementación de dichas estrategias diagnósticas en los algoritmos de estos pacientes.
Materiales y métodos. Se realizó una búsqueda de la literatura publicada en las bases de datos Medline (PubMed), OncoWeb y CancerLit (HealthGate), con los siguientes términos MeSH en inglés: pulmonary embolism (embolismo pulmonar), venous thrombosis (trombosis venosa), neoplasms (neoplasia), diagnosis (diagnóstico), D-dimer or fibrin fragment D (dímero D o fragmento D de fibrina), y epidemiology (epidemiología).
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