Prevalence of Thromboembolic Venous Disease and Current Treatment Options in One of the Largest Patient Populations in the Word: India, A Meta-Analysis of Current Published Literature
Authors: Stibbs Peter 
Published: February 2023

Venous thromboembolic incidence and deep venous thrombosis is known to carry both short term and long term sequelae associated with the disease state such as peripheral limb swelling, pain, skin pigmentation , valvular dysfunction, development of varicosities , and skin breakdown and bleeding ulcerations associated with post thrombotic syndrome The prevalence of diagnosed DVT in relation to the United States is approximately 900,000 individual cases per year based on the current estimates of the CDC in a population of 334,379, 200. India has a current population of approximately 1,399,179,585, to date though there has been little information available surrounding the prevalence of DVT within the Indian sub-continent as well as the current technologies approved for treatment of DVT outside of standard oral anticoagulation. There appears to be a disparity in diagnosis rates based on direct physician survey due to lag in uniformed diagnosis criteria in India, as well as variability in payor model which may prevent patients from seeking care initially for symptoms associated with DVT. Treatment methods for DVT appear to be variable with no single consensus for treatment methodologies, as well as a lag in knowledge by clinical medicine practitioners on the latest interventional treatment options for patients based on a 85% majora opinion of poled physicians who perform interventional procedures to treat DVT symptomology. 90% of the interventional practitioners poled stated that DVT treatment has become a primary focus in their practice, where as , only 68% of those poled felt DVT was a major health crisis in India.

In looking at statistical data based on the cited clinical literature, the overall prevalence of DVT in India is found to be around 12%Based on a meta-analysis, the prevalence of DVT in India would be considered high with almost one in eight individuals affected by deep venous thromboembolic disease. Based on physician polling, the current most prevalent method for interventional management of DVT is utilization of catheter directed thrombolysis with 80% of respondents indicating that CDT is currently their method of choice for performance of interventional thrombectomy. That being stated, 75% of respondents stated that mechanical thrombectomy devices and their availability in India would change their methodology of choice for treatment of deep venous thromboembolism. Conclusion The meta-analysis along with anonymized physician questionnaire suggest that the prevalence of DVT in India is high with almost one in eight individuals affected by this condition which is most likely underdiagnosed due to variable factors such as payor model, physician referral gap, and vacuum in knowledge base on latest interventional treatment options by physicians managing the clinical medicine piece. The findings highlight the need for effective prevention and management strategies for DVT in India, especially in high-risk populations and subgroups. Further research is needed to identify the factors contributing to the high prevalence of DVT in India and to develop targeted interventions to reduce the burden of this disease Citations 1. Stibbs@argonmedical.com The objective of this study is to review available peer reviewed clinical literature, as well as to interview physicians involved in the procedural management and care of patient's diagnosed with DVT within the health care systems in India and to understand the approximate prevalence of diagnosed cases of deep venous thrombosis within India, as well as to understand the current treatment options and articulated needs with regards to treatment options needed for patients diagnosed with deep venous thrombosis. Current perceived difficulties by physician's perceptions with regards to treating the patient population with DVT, and how those needs may be addressed via technologies geared towards treatment of DVT via percutaneous image guided devices. Clinical Literature was reviewed with studies utilized that cited diagnosis rates as well as treatment methodologies looking for consistency in percentage of diagnosis, similarities in diagnosis methodology criteria, current treatment methods, and complication rates. After establishing statistical comparability across studies , a base line was established for estimated prevalence of DVT diagnosed in India. After establishing baseline numbers utilizing peer reviewed literature, individual physician responses were noted and extrapolated to find statistical trends in alignment with similar answers rendered on the questionnaire.