Complications in Untreated Deep Venous Thrombosis

Abstract

Deep venous thrombosis (DVT) is the formation of a thrombus within the deep venous system, most commonly affecting the lower extremities but potentially occurring in other locations such as the pelvis or upper limbs. It constitutes a primary manifestation of venous thromboembolism (VTE) alongside pulmonary embolism (PE), which arises from thrombus migration to the pulmonary arteries. Clinical presentation ranges from limb swelling, pain, erythema, and warmth to asymptomatic cases, making diagnosis reliant on a combination of pretest probability assessment, D-dimer measurement, and confirmatory imaging, typically compression ultrasonography. Major risk factors include surgery, trauma, immobility, malignancy, and thrombophilia. Management is centered on anticoagulation, with direct oral anticoagulants favored for most patients, and advanced interventions reserved for select severe cases. Untreated DVT carries high morbidity and mortality due to complications such as PE, postthrombotic syndrome (PTS), recurrent VTE, sepsis, and, rarely, chronic thromboembolic pulmonary hypertension (CTEPH). Long-term consequences include chronic venous insufficiency, disability, impaired quality of life, and increased mortality risk. Early recognition and timely intervention are critical to reducing complications and improving outcomes.