Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim

Gurlu, Ege; Konstantinides, Stavros

doi:10.5578/llm.20229801

Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim

Ege GÜRLÜ, (Yeditepe Üniversitesi, Tıp Fakültesi, Tıp Fakültesi, İstanbul, Türkiye)

Stavros V. KONSTANTINIDES (Johannes Gutenberg Üniversitesi, Tromboz ve Hemostaz Merkezi, Mainz, Almanya)

Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları

6 2

Yıl: 2023 Cilt: 7 Sayı: 2 Sayfa Aralığı: 43 - 50 Metin Dili: Türkçe DOI: 10.5578/llm.20229801 İndeks Tarihi: 02-11-2023

Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim

Öz:

Venöz tromboembolizm (VTE), toplumda sık görülen bir durumdur ve kendini derin ven trombozu (DVT), pulmoner emboli (PE), üst ekstremite ven trombozu, splanknik ven trombozu (SVT), serebral venöz tromboz (SVT) veya atipik bölgelerde tromboz olarak gösterebilir. Önemli morbidite ve mortalite ile ilişkili olabilmektedir. Kanserli hastalarda VTE insidansının arttığı ve bu durumdan farklı mekanizmaların sorumlu olduğu gösterilmiştir ancak bazı noktalar hala belirsizdir. Bu nedenle, endike olduğunda profilaksi uygulayarak bu tür olayları önlemek ve VTE oluşumu durumunda etkili yönetim stratejileri uygulamak çok önemlidir. Profilaksi, ayaktan hasta için birincil profilaksi gibi bazı noktalarda kısmen tartışmalı bir konu olmaya devam etmektedir. Geçmiş yıllarda direkt oral antikoagülan (DOAC)’lar piyasaya sürüldü ancak kanser hastalarında kullanımları ile ilgili etkinlik ve güvenlik açısından cevaplanmamış sorular vardı. Ana güvenlik sorunu, majör kanama riskiydi ve etkinliği göstermenin ana amacı, semptomatik VTE veya ölümcül PE’nin tekrarının önlenmesi olarak tanımlandı. Bu sorulara doğru cevaplar bulmak için birçok klinik çalışma yapılmıştır. Bu makale, kanserle ilişkili venöz tromboembolizm ve pulmoner embolilerin patofizyolojisi ve klinik yönetimi ile ilgili önemli noktaları gözden geçirmeyi amaçlamaktadır.

Anahtar Kelime: Kanser venöz tromboemboli pulmoner emboli

Cancer Associated Venous Thromboembolism and Pulmonary Embolism: Pathophysiological Considerations and Clinical Management

Öz:

Venous thromboembolism (VTE) is a common entity in the population and its prevalence is even higher in patients with cancer. Venous thromboembolism may manifest itself as deep venous thrombosis (DVT) or pulmonary embolism (PE), or as thrombosis at atypical sites such as upper extremity vein thrombosis, splanchnic vein thrombosis (SVT), cerebral venous thrombosis (CVT) or other locations. It may be associated with significant morbidity and mortality. Many different mechanisms have been shown to be responsible for increased incidence of VTE among patients with cancer, but some points are still unclear. Therefore, preventing these events by administering prophylaxis when it is indicated and tailoring effective management strategies in case of VTE occurrence are crucial. Prophylaxis remains a partly controversial topic, and this especially true as far as primary prophylaxis for ambulatory patient is concerned. In the past years, direct oral anticoagulants (DOACs) were released into market but there were unanswered questions regarding their use in patients with cancer in terms of efficacy and safety. The main safety issue was the risk of major bleeding and the main goal for demonstrating efficacy defined as the prevention of recurrence of symptomatic VTE or fatal PE. Many clinical trials have been conducted to find accurate answers to these questions. This article aims to review important points about the pathophysiology and clinical management of cancer associated venous thromboembolism and pulmonary embolism.

Anahtar Kelime: Cancer venous thromboembolism pulmonary embolism

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	Gurlu E, Konstantinides S (2023). Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. , 43 - 50. 10.5578/llm.20229801
Chicago	Gurlu Ege,Konstantinides Stavros Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. (2023): 43 - 50. 10.5578/llm.20229801
MLA	Gurlu Ege,Konstantinides Stavros Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. , 2023, ss.43 - 50. 10.5578/llm.20229801
AMA	Gurlu E,Konstantinides S Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. . 2023; 43 - 50. 10.5578/llm.20229801
Vancouver	Gurlu E,Konstantinides S Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. . 2023; 43 - 50. 10.5578/llm.20229801
IEEE	Gurlu E,Konstantinides S "Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim." , ss.43 - 50, 2023. 10.5578/llm.20229801
ISNAD	Gurlu, Ege - Konstantinides, Stavros. "Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim". (2023), 43-50. https://doi.org/10.5578/llm.20229801

APA	Gurlu E, Konstantinides S (2023). Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları, 7(2), 43 - 50. 10.5578/llm.20229801
Chicago	Gurlu Ege,Konstantinides Stavros Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları 7, no.2 (2023): 43 - 50. 10.5578/llm.20229801
MLA	Gurlu Ege,Konstantinides Stavros Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları, vol.7, no.2, 2023, ss.43 - 50. 10.5578/llm.20229801
AMA	Gurlu E,Konstantinides S Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları. 2023; 7(2): 43 - 50. 10.5578/llm.20229801
Vancouver	Gurlu E,Konstantinides S Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim. Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları. 2023; 7(2): 43 - 50. 10.5578/llm.20229801
IEEE	Gurlu E,Konstantinides S "Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim." Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları, 7, ss.43 - 50, 2023. 10.5578/llm.20229801
ISNAD	Gurlu, Ege - Konstantinides, Stavros. "Kanserle İlişkili Venöz Tromboemboli ve Pulmoner Emboli: Patofizyolojik Hususlar ve Klinik Yönetim". Türkiye'de Lösemi Lenfoma Miyelom Araştırmaları 7/2 (2023), 43-50. https://doi.org/10.5578/llm.20229801