title: Deep vein thrombosis of the lower limbs in intravenous drug users.
abstract: BACKGROUND
  Addiction to intravenously administered drugs has been a serious epidemiological problem for years. Among the related health complications, deep vein thrombosis (DVT) is one of the most important. This paper provides an illustrative presentation of DVT in intravenous drug users (IDUs), HIV-positive subjects among them.
  
  
  METHODS
  We searched PubMed, Ovid Journals, Scopus, ScienceDirect, Cochrane Library, Google Scholar and references from articles obtained. The main terms used to identify appropriate studies of DVT in IDUs were 'intravenous drug users', 'substance-related disorders' and 'deep vein thrombosis'.
  
  
  RESULTS
  No guidelines exist for DVT in intravenous drug users. As many as 47.6% of IDUs report having suffered from DVT. IDUs may constitute approx. 50% of patients under 40 years of age with DVT, this being promoted by multiple vein punctures, groin injections, lack of sterility, insoluble microparticles and other factors. The clinical appearance is more complex than in the general population, which also makes prognosis more difficult. HIV infection can worsen DVT. It often appears as proximal iliofemoral thrombosis, accompanied by local and general complications. Ultrasound with a compression test is an objective method of choice, but must often be complemented with computed tomography. Antithrombotic therapy in IDUs needs to be applied individually. The optimal method is supervised therapy at addiction treatment services.
  
  
  CONCLUSIONS
  Individual and public preventive measures, among them locally prepared guidelines for DVT in IDUs, may be the most important processes capable of effectively reducing the morbidity of septic and non-septic DVT.
authors.affiliation: Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wrocław; Department of Angiology, Regional Specialist Hospital in Wrocław, Research and Development Center in Wrocław, Poland.
authors.forename: Wiesława
authors.initials: W
authors.lastname: Kwiatkowska
authors.affiliation: Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wrocław; Department of Infectious Diseases, Wrocław Medical University, Wrocław, Poland.
authors.forename: Brygida
authors.initials: B
authors.lastname: Knysz
authors.affiliation: Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wrocław; Department of Infectious Diseases, Wrocław Medical University, Wrocław, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Gąsiorowski
authors.affiliation: Wrovasc - Integrated Cardiovascular Centre, Regional Specialist Hospital, Research and Development Center in Wrocław, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Witkiewicz
mesh_terms: D000328:Adult; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000209:etiology*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*