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In 1846, Virchow recognized the association between venous thrombosis in the legs and PE.DVT is the presence of coagulated blood, a thrombus, in one of the deep venous conduits that return blood to the heart.Primary collecting veins of the lower extremity are passive, thin-walled reservoirs that are tremendously distensible.Most are suprafascial, surrounded by loosely bound alveolar and fatty tissue that is easily displaced.Conclusive diagnosis has historically required invasive and expensive venography, which is still considered the criterion standard.The diagnosis may also be obtained noninvasively by means of ultrasonographic examination.The clinical conundrum is that symptoms (pain and swelling) are often nonspecific or absent.
Each year in the United States, more than 200,000 people develop venous thrombosis; of those, 50,000 cases are complicated by PE.The primary agents include anticoagulants and thrombolytics.(See Medication.) For patient education resources, see the Lung Disease & Respiratory Health Center, as well as the patient education articles Deep Vein Thrombosis (Blood Clot in the Leg, DVT), Phlebitis, and Pulmonary Embolism.These suprafascial collecting veins can dilate to accommodate large volumes of blood with little increase in back pressure so that the volume of blood sequestered within the venous system at any moment can vary by a factor of 2 or more without interfering with the normal function of the veins.Suprafascial collecting veins belong to the superficial venous system.
The earliest known reference to peripheral venous disease is found on the Eber papyrus, which dates from 1550 BC and documents the potentially fatal hemorrhage that may ensue from surgery on varicose veins.