Embolism, Deep vein thrombosis and Brain aneurysm (Paperback) | Released: 30 Aug 2019

Globally, about 234 million major surgical interventions are performed each year and postoperative complications cause a significant morbidity, mortality and economic burden to surgical patients as well as healthcare systems . Pulmonary embolism (PE), a life-threatening complication of venous thromboembolism (VTE), represents a major postoperative complication. Undeniably, surgery increases the risk of PE by fivefold.The pathogenesis involves the interplay of an acute inflammatory reaction triggered by vascular endothelial lesions due to surgical dissections, hypercoagulability induced by surgical stress and anaesthetic drugs, and venous stasis due to perioperative immobilisation and delayed rehabilitation, all described by Virchow more than a century ago . Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can lead to death. Acute PE is linked with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Moreover, individuals who survive PE can develop post-PE syndrome, which is characterised by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and chronic functional limitations. Several important improvements have been made in the diagnostic and therapeutic management of acute PE in present times, such as the introduction of a simplified diagnostic algorithm for suspected PE as well as phase III trials demonstrating the value of direct oral anticoagulants in acute and extended treatment of venous thromboembolism. Future research should aim to address new treatment options (for example, fibrinolysis enhancers) and improved methods for predicting long-term complications and defining optimal anticoagulant therapy parameters in individual patients, and to gain a greater understanding of post-PE syndrome. Thrombosis is a common pathology underlying ischemic heart disease, ischemic stroke, and venous thromboembolism (VTE). The Global Burden of Diseases(GBD), Injuries, and Risk Factors (GBD) Study 2014 documented by Journal of Thrombosis and Haemostasis (Haemost 2014), that ischemic heart disease and stroke collectively caused one in four deaths worldwide. According to current research the global disease burden caused by venous thromboembolism (VTE) in low income, middle-income and high-income countries. Studies from western Europe, North America, Australia and southern Latin America (Argentina) yielded consistent results, with annual incidence rates ranging from 0.75 to 2.69 per 1000 individuals in the population. The incidence increased to between 2 and 7 per 1000 among those aged >= 70 years. Although the incidence is lower in individuals of Chinese and Korean ethnicity, their disease burden is not low, because of population aging Estimates of the global burden of disease were obtained from Global Burden of Disease Project reports, recent systematic reviews, and published literature for recent studies reporting measures of incidence, burden, and disability-adjusted life-years. Estimates per 100 000 of the global incidence rate (IR) for each condition are ischemic heart disease, IR=1518.7; myocardial infarction, IR=139.3; ischemic stroke, IR=114.3; atrial fibrillation, IR=77.5 in males and 59.5 in females; and venous thromboembolism, IR=115 to 269. Mortality rates (MRs) for each condition are ischemic heart disease, MR=105.5; ischemic stroke, MR=42.3; atrial fibrillation, MR=1.7; and venous thromboembolism, MR=9.4 to 32.3. Global public awareness is substantially lower for pulmonary embolism (54%) and deep-vein thrombosis (44%) than heart attack (88%) and stroke (85%). Over time, the incidence and MRs of these conditions have improved in developed countries, but are increasing in developing countries. More research is needed to prevent aneurysm