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

Publicado 2024-07-16

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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 Jul. 16 [cited 2024 Nov. 21];. Disponible en: https://doi.org/10.30789/rcneumologia.v36.n2.2024.728
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Manuel Garay-Fernández
Universidad El Bosque image/svg+xml
    https://orcid.org/0000-0002-3249-6501
    David Esteban Arias Mira
    Universidad El Bosque image/svg+xml
      https://orcid.org/0000-0001-7263-5572
      Mostrar biografía de los autores

      Manuel Garay-Fernández,

      Médico Internista Intensivista Neumólogo. Universidad El Bosque, Hospital Santa Clara. Bogotá, Colombia. ORCID: https://orcid.org/0000-0002-3249-6501

      David Esteban Arias Mira,

      Médico Residente de Medicina Interna. Universidad El Bosque, Hospital Santa Clara. Bogotá, Colombia. 

      La enfermedad trombo embólica venosa, representada por la Trombosis Venosa 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, tales como 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. En nuestra revisión se documentó que el uso de ecografía doppler de compresión de miembros inferiores, la ARP y la 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.  

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