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Sample records for acute deep venous

  1. Pregnancy after catheter-directed thrombolysis for acute iliofemoral deep venous thrombosis

    DEFF Research Database (Denmark)

    Jørgensen, M; Broholm, R; Bækgaard, N

    2013-01-01

    To assess the safety and efficacy of low-molecular-weight heparin (LMWH) in pregnancy and puerperium in women with previous acute iliofemoral deep venous thrombosis (DVT) treated with catheter-directed thrombolysis (CDT).......To assess the safety and efficacy of low-molecular-weight heparin (LMWH) in pregnancy and puerperium in women with previous acute iliofemoral deep venous thrombosis (DVT) treated with catheter-directed thrombolysis (CDT)....

  2. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

    Science.gov (United States)

    Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

    2015-07-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

  3. Tissue factor pathway inhibitor relates to fibrin degradation in patients with acute deep venous thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes J; Bladbjerg, Else-Marie; Gram, Jørgen

    2008-01-01

    Reduced concentration of tissue factor pathway inhibitor is a risk factor for development of deep venous thrombosis, whereas elevated concentrations of tissue factor pathway inhibitor are observed in patients with acute myocardial infarction and disseminated intravascular coagulation. Presently, we...... studied the association between inflammation, endothelial cell perturbation, fibrin degradation and the concentration of tissue factor pathway inhibitor in patients suspected for acute deep venous thrombosis. We determined the tissue factor pathway inhibitor -33T/C polymorphism, free and total tissue...... factor pathway inhibitor, C-reactive protein, von Willebrand factor and D-Dimer in 160 consecutive patients admitted to hospital with a tentative diagnosis of acute deep venous thrombosis. Deep venous thrombosis was identified in 57 patients (18 distal and 39 proximal). The distribution of the tissue...

  4. Advanced management of acute iliofemoral deep venous thrombosis: emergency department and beyond.

    Science.gov (United States)

    Pollack, Charles V

    2011-06-01

    Recent attention to the increasing incidence of venous thromboembolism has included a call to action from the surgeon general and new guidelines from various specialty organizations. The standard of care for treatment of deep venous thrombosis in the emergency department (ED), supported by the 2008 American College of Chest Physicians (ACCP) guidelines, involves initiation of anticoagulation with low-molecular-weight heparin, pentasaccharide, or unfractionated heparin. For selected appropriate patients with extensive acute proximal deep venous thrombosis, the ACCP guidelines now recommend thrombolysis in addition to anticoagulation to reduce not only the risk of pulmonary embolism but also the risk of subsequent postthrombotic syndrome and recurrent deep venous thrombosis. Postthrombotic syndrome is a potentially debilitating chronic cluster of lower-extremity symptoms occurring in 20% to 50% of deep venous thrombosis patients subsequent to the acute insult, sometimes not until years later. A strategy of early thrombus burden reduction or frank removal might reduce the incidence of postthrombotic syndrome, as per natural history studies, venous thrombectomy data, observations after systemic and catheter-directed thrombolysis, and the still-limited number of randomized trials of catheter-directed thrombolysis (with anticoagulation) versus anticoagulation alone. Contemporary invasive (endovascular) treatments mitigate the drawbacks historically associated with thrombolytic approaches by means of intrathrombus delivery of drugs with greater fibrin specificity and lower allergenicity, followed by mechanical dispersion to accelerate lysis and then aspiration of remaining drug and clot debris. With a 2016 target completion date, the National Heart, Lung, and Blood Institute--sponsored Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis trial is comparing the safety and efficacy, in terms of both deep venous thrombosis and

  5. Catheter-directed thrombolysis in the treatment of acute deep venous thrombosis: a meta-analysis.

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    Zheng, J J; Zhang, Z H; Shan, Z; Wang, W J; Li, X X; Wang, S M; Li, Y-X; Cheng, G-S

    2014-07-24

    We performed a meta-analysis for systematic evaluation of the status quo of catheter thrombolysis for the treatment of acute lower limb deep vein thrombosis in China. We searched the China Biomedical bibliographic database (CBM), China National Knowledge Infrastructure (CNKI), Weipu full-text electronic journals, Wanfang full-text database, and Medline (1990 through June 2011) for clinical randomized controlled trials of catheter-directed thrombolysis and superficial venous thrombolysis to compare their efficacies for the treatment of acute deep vein thrombosis. The results were analyzed by using the Cochrane-recommended RevMan 4.2 software package, and the odds ratio (OR) was used as the combined measure of efficacy. The search retrieved 8 randomized controlled trials, and meta-analysis using the total rate of effective treatment as the clinical observation index found that the combined OR for the catheter thrombolysis group versus the superficial venous thrombolysis group was significant (P venous thrombolysis for the treatment of acute deep vein thrombosis in the lower limb in Chinese individuals. However, the included trials were only of medium quality, so more rational and scientific clinical trials are needed to validate this conclusion.

  6. A vascular laboratory protocol for improving and managing after-hours suspected acute deep venous thrombosis.

    Science.gov (United States)

    Martin, Angela H; Eckert, George; Lemmon, Gary W; Sawchuk, Alan; Dalsing, Michael C

    2014-04-01

    This study reviews the clinical and workforce impact of a suggested protocol designed for the management of suspected acute deep venous thrombosis (DVT) in patients seen after standard vascular laboratory business hours. The protocol included the use of Wells score, D-dimer and a single dose of therapeutic anticoagulant to defer venous duplex ultrasound (VDU) testing until routine business hours unless contraindicated. Information was collected on medical history, physical exam and the timing of any diagnostic studies and treatment provided. Over 15% of studies done after-hours were deemed unnecessary by our protocol and in every individual the results were negative for an acute DVT. There were no adverse events from a one-time dose of anticoagulant. Limiting emergency VDU coverage to evaluate for acute DVT based on a management protocol can eliminate unnecessary after-hours VDU testing without having a negative impact on patient care.

  7. Catheter-Directed Thrombolysis via Small Saphenous Veins for Treating Acute Deep Venous Thrombosis.

    Science.gov (United States)

    Yang, Bin; Xu, Xiao-Dong; Gao, Peng; Yu, Ji-Xiang; Li, Yu; Zhu, Ai-Dong; Meng, Ran-Ran

    2016-08-23

    BACKGROUND There is little data comparing catheter-directed thrombolysis (CDT) via small saphenous veins vs. systematic thrombolysis on complications and efficacy in acute deep venous thrombosis patients. The aim of our study was to compare the efficacy and safety of CDT via the small saphenous veins with systematic thrombolysis for patients with acute deep venous thrombosis (DVT). MATERIAL AND METHODS Sixty-six patients with acute DVT admitted from June 2012 to December 2013 were divided into 2 groups: 27 patients received systemic thrombolysis (ST group) and 39 patients received CDT via the small saphenous veins (CDT group). The thrombolysis efficiency, limb circumference differences, and complications such as post-thrombotic syndrome (PTS) in the 2 groups were recorded. RESULTS The angiograms demonstrated that all or part of the fresh thrombus was dissolved. There was a significant difference regarding thrombolysis efficiency between the CDT group and ST group (71.26% vs. 48.26%, P=0.001). In both groups the postoperative limb circumference changes were higher compared to the preoperative values. The differences between postoperative limb circumferences on postoperative days 7 and 14 were significantly higher in the CDT group than in the ST group (all Pdeep venous thrombosis.

  8. Prevalence of deep venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    DUAN Sheng-chen; YANG Yuan-hua; LI Xu-yan; LIANG Xiao-ning; GUO Rui-jun; XIE Wan-mu; KUANG Tu-guang; DAI Hua-ping; WANG Chen

    2010-01-01

    Background Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P=0.01), and the mechanical ventilation requirement increased (P <0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P <0.001); pneumonia as concomitance (P=0.01); respiratory failure type Ⅱ (P=0.013); current smoking (P=0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P=0.01 ).Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.

  9. Association of deep venous thrombosis with calf vein diameter in acute hemorrhagic stroke.

    Science.gov (United States)

    Ogata, Toshiyasu; Yasaka, Masahiro; Wakugawa, Yoshiyuki; Kitazono, Takanari; Okada, Yasushi

    2013-10-01

    We investigated the association between the development of deep venous thrombosis (DVT) and calf vein diameter in patients with acute hemorrhagic stroke. We measured the maximum diameter of paralytic side posttibial veins (PTVs) and peroneal veins (PVs) in 49 patients with intracerebral hemorrhage on admission and at 2 weeks after stroke onset by ultrasonography. We also examined for the presence or absence of DVT, and then analyzed the association of DVT with the maximum vein diameter. At 2 weeks after stroke, DVTs were detected in PTVs in 7 patients and in PVs in 6 patients. The maximum calf vein diameters at 2 weeks were significantly greater in patients with DVT compared with those without DVT (PTV, P = .033; PV, P = .015). Although calf vein diameter at admission did not influence the future incidence of DVT in patients with intracerebral hemorrhage, the presence of DVT was associated with calf vein dilatation.

  10. Acute deep venous thrombosis of the upper extremity as demonstrated by scintigraphy with {sup 99m}Tc-apcitide

    Energy Technology Data Exchange (ETDEWEB)

    Dunzinger, A.; Piswanger-Soelkner, J.; Lipp, R. [Medical Univ. Graz (Austria). Div. of Nuclear Medicine; Hafner, F.; Brodmann, M. [Medical Univ. Graz (Austria). Div. of Angiology

    2008-07-01

    With an incidence of 0.7% inhabitants per year, acute deep venous thrombosis (DVT) is a common occurrence (20). Its incidence in the upper extremities, however, is not as precisely known; the literature reports that 1% to 10% of all DVT cases involve the upper limbs. Acute DVT of upper limb is mainly iatro-genic following interventions like implantation of pacemakers or central venous catheters, and is more likely to occur in obese patients or those with malignant diseases. Life-threatening pulmonary embolism (PE) may occur if acute DVT remains undetected. The presented case report demonstrates the feasibility of {sup 9}9mTc-apcitide scintigraphy for diagnosis of acute DVT of the upper limb and exclusion of PE in a single examination.

  11. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

    Meyer-Olesen, Christine L; Nielsen, Sune F; Nordestgaard, Børge G

    2015-01-01

    BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease...... venous thrombosis. CONCLUSIONS: Increased rheumatoid factor in the general population was associated with up to 3-fold increased long-term risk and up to 9-fold increased 1-year risk of deep venous thrombosis....... was incident deep venous thrombosis. There were no losses to follow-up. RESULTS: During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs venous thrombosis, with multivariable adjusted hazard...

  12. 中央型急性期下肢DVT置管溶栓与外周溶栓的比较%Outcomes of anticoagulation and thrombolysis for acute deep venous thrombosis via central venous catheter and peripheral venous injection

    Institute of Scientific and Technical Information of China (English)

    朱少问; 郑小兵; 冯翔

    2013-01-01

    目的:比较中央型急性期DVT经外周静脉溶栓与局部置管溶栓治疗的效果,以指导临床治疗.方法:通过回顾性分析我院及江苏南通大学附属医院2010年9月~2012年7月期间收治的共42例下肢深静脉血栓形成患者的临床资料,按照治疗方法分为置管溶栓组(A组)、外周溶栓组(B组).其中外周溶栓组共20例,左侧13例,右侧6例,双侧1例.置管溶栓组共22例,左侧15例,右侧6例,双侧1例.通过监测患者临床症状,测量下肢周径变化比较两组治疗效果.结果:置管溶栓治疗方法具有平均起效时间快、总溶栓疗程短、溶栓药物总剂量低、并发症发生率及PTS发生率低等优点,而远期复发率与外周溶栓组无明显差异.结论:置管溶栓治疗方法优于外周溶栓治疗.%Objective :To compare the curative efficacy of anticoagulation and thrombolysis for acute deep venous thrombosis( DVT ) via central venous catheter management or peripheral venous management for summary of the clinical experience. Methods :The clinical data were reviewed in 42 patients with DVT undergone treatment respectively in our institution and the Affiliated Hospital of Nantong University between Sept. 2010 and Jul. 2012. The patients were randomized into either group A( n=22; 15 were symptoms of left lower extremity,6 of right and 1 of both extremities ) by thrombolytic therapy via central venous catheter or group B( n =20; 13 were acute episode of left lower limb, 6 of right and 1 of both lower limbs. ) managed with peripheral venous anticoagulation and thrombolysis. Two groups of patients were assessed for the curative efficacy by observing the relief of clinical symptoms and measuring the changes of the limb circumference. Results:Thrombolytic therapy for acute DVT via central venous catheter demonstrated advantages by earlier effects, shortened therapy duration, requirement of lower drug dosage, fewer incidence of complications and risk of developing the

  13. Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Salvolini, Luca [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)], E-mail: lucasalvolini@alice.it; Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Giuseppetti, Gian Marco; Giovagnoni, Andrea [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)

    2008-03-15

    Both pulmonary arterial and peripheral venous sides of venous thromboembolism (VTE) can now be efficiently and safely investigated by multi-detector CT (MDCT) at the same time by a combined CT angiography/CT venography protocol. In the emergency setting, the use of such a single test for patients suspected of suffering from VTE on a clinical grounds may considerably shorten and simplify diagnostic algorithms. The selection of patients to be submitted to MDCT must follow well-established clinical prediction rules in order to avoid generalized referral to CT on a generic clinical suspicion basis and excessive population exposure to increased ionizing radiation dose, especially in young patients. Clinical and anatomical wide-panoramic capabilities of MDCT allow identification of underlying disease that may explain patients' symptoms in a large number of cases in which VTE is not manifest. The analysis of MDCT additional findings on cardiopulmonary status and total thrombus burden can lead to better prognostic stratification of patients and influence therapeutic options. Some controversial points such as optimal examination parameters, clinical significance of subsegmentary emboli, CT pitfalls and/or possible falsely positive diagnoses, and outcome of untreated patients in which VTE has been excluded by MDCT without additional testing, must of course be taken into careful consideration before the definite role of comprehensive MDCT VTE 'one-stop-shop' diagnosis in everyday clinical practice can be ascertained.

  14. Deep venous thrombosis and postthrombotic syndrome: invasive management.

    Science.gov (United States)

    Comerota, A J

    2015-03-01

    Invasive management of postthrombotic syndrome encompasses the two ends of the deep vein thrombosis spectrum, patients with acute iliofemoral deep vein thrombosis and those with chronic postthrombotic iliofemoral venous obstruction. Of all patients with acute deep vein thrombosis, those with involvement of the iliofemoral segments have the most severe chronic postthrombotic morbidity. Catheter-based techniques now permit percutaneous treatment to eliminate thrombus, restore patency, potentially maintain valvular function, and improve quality of life. Randomized trial data support an initial treatment strategy of thrombus removal. Failure to eliminate acute thrombus from the iliofemoral system leads to chronic postthrombotic obstruction of venous outflow. Debilitating chronic postthrombotic symptoms of the long-standing obstruction of venous outflow can be reduced by restoring unobstructed venous drainage from the profunda femoris vein to the vena cava.

  15. [Sequence of venous blood flow alterations in patients after recently endured acute thrombosis of lower-limb deep veins based on the findings of ultrasonographic duplex scanning].

    Science.gov (United States)

    Tarkovskiĭ, A A; Zudin, A M; Aleksandrova, E S

    2009-01-01

    This study was undertaken to investigate the sequence of alterations in the venous blood flow to have occurred within the time frame of one year after sustained acute thrombosis of the lower-limb deep veins, which was carried out using the standard technique of ultrasonographic duplex scanning. A total of thirty-two 24-to-62-year-old patients presenting with newly onset acute phlebothrombosis were followed up. All the patients were sequentially examined at 2 days, 3 weeks, 3 months, 6 months and 12 months after the manifestation of the initial clinical signs of the disease. Amongst the parameters to determine were the patency of the deep veins and the condition of the valvular apparatus of the deep, superficial and communicant veins. According to the obtained findings, it was as early as at the first stage of the phlebohaemodynamic alterations after the endured thrombosis, i. e., during the acute period of the disease, that seven (21.9%) patients were found to have developed valvular insufficiency of the communicant veins of the cms, manifesting itself in the formation of a horizontal veno-venous reflux, and 6 months later, these events were observed to have occurred in all the patients examined (100%). Afterwards, the second stage of the phlebohaemodynamic alterations was, simultaneously with the process of recanalization of the thrombotic masses in the deep veins, specifically characterized by the formation of valvular insufficiency of the latter, manifesting itself in the form of the development of a deep vertical veno-venous reflux, which was revealed at month six after the onset of the disease in 56.3% of the examined subjects, to be then observed after 12 months in 93.8% of the patients involved. Recanalization of thrombotic masses was noted to commence 3 months after the onset of thrombosis in twelve (37.5%) patients, and after 12 months it was seen to ensue in all the patients (100%), eventually ending in complete restoration of the patency of the affected

  16. Catheter-Directed Thrombolysis with a Continuous Infusion of Low-Dose Urokinase for Non-Acute Deep Venous Thrombosis of the Lower Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Gao, Binbin; Zhang, Jingyong; Wu, Xuejun; Han, Zonglin; Zhou, Hua; Dong, Dianning; Jin, Xing [Shandong Provincial Hospital, Shandong University, Ji' nan (China)

    2011-02-15

    We wanted to evaluate the feasibility of catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for treating non-acute (less than 14 days) deep venous thrombosis of the lower extremity. The clinical data of 110 patients who were treated by catheter-directed thrombolysis with a continuous infusion of low-dose urokinase for lower extremity deep venous thrombosis was analysed. Adjunctive angioplasty or/and stenting was performed for the residual stenosis. Venous recanalization was graded by pre- and posttreatment venography. Follow-up was performed by clinical evaluation and Doppler ultrasound. A total of 112 limbs with deep venous thrombosis with a mean symptom duration of 22.7 days (range: 15-38 days) were treated with a urokinase infusion (mean: 3.5 million IU) for a mean of 196 hours. After thrombolysis, stent placement was performed in 25 iliac vein lesions and percutaneous angioplasty (PTA) alone was done in fi ve iliac veins. Clinically significant recanalization was achieved in 81% (90 of 112) of the treated limbs: complete recanalization was achieved in 28% (31 of 112) and partial recanalization was achieved in 53% (59 of 112). Minor bleeding occurred in 14 (13%) patients, but none of the patients suffered from major bleeding or symptomatic pulmonary embolism. During followup (mean: 15.2 months, range: 3-24 months), the veins were patent in 74 (67%) limbs. Thirty seven limbs (32%) showed progression of the stenosis with luminal narrowing more than 50%, including three with rethrombosis, while one revealed an asymptomatic iliac vein occlusion: 25 limbs (22%) developed mild post-thrombotic syndrome, and none had severe post-thrombotic syndrome. Valvular reflux occurred in 24 (21%) limbs. Catheter-directed thrombolysis with a continuous infusion of low-dose urokinase combined with adjunctive iliac vein stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower

  17. [Recanalization of lower-limb deep veins as an index of efficacy of treatment for acute venous thrombosis].

    Science.gov (United States)

    Kuznetsov, M R; Sapelkin, S V; Boldin, B V; Leont'ev, S G; Neskhodimov, L A

    2016-01-01

    The authors analysed the results of examination and treatment of a total of 102 patients presenting with iliofemoral venous thrombosis. During treatment, ultrasonographic duplex scanning was used to determine the localization of the proximal margin of thrombotic masses, the time of appearing of the first signs of recanalization, its degree at various levels of the deep venous system, as well as alteration in velocity of the venous blood flow in the deep veins of the lower limbs. The dynamics of clinical symptoms was assessed by the visual analogue scale. Clinical and instrumental examination was performed on day 10, and then 1, 3, 6 and 12 months after the beginning of treatment. The patients were subdivided into three groups. Group One comprised 38 patients receiving therapy with low-molecular-weight heparin (enoxaprin) followed by switching to indirect anticoagulants (warfarin) combined with venotonics (original highly-purified diosmin 600 mg once daily). Group Two was composed of 33 patients receiving rivaroxaban at a dose of 15 mg twice daily for 3 weeks, followed by 20 mg once daily. Group Tree patients (n=31) were also given rivaroxaban according to the above-described standard regimen but in combination with venotonics (original highly-purified diosmin 600 mg once daily). The obtained findings showed that prescribing rivaroxaban to patients from the first day of the disease made it possible to considerably improve and accelerate the processes of restoration of patency of deep veins of lower extremities as compared with the patients taking vitamin K antagonists (warfarin). In patients receiving rivaroxaban, there were no cases of residual thrombotic occlusions of the major veins, and recanalization in three fourths of patients was assessed as good and in the remaining third as moderate. In the warfarin group, occlusion in the iliac veins was noted to persist persisted in 13% of patients, with good recanalization observed only in half of the patients. Addition

  18. Atypical presentation of priapism in a patient with acute iliocaval deep venous thrombosis secondary to May-Thurner syndrome.

    Science.gov (United States)

    Alhalbouni, Saadi; Deem, Samuel; Abu-Halimah, Shadi; Sadek, Betro T; Mousa, Albeir

    2013-08-01

    We report on a 42-year-old male who presented with priapism, severe scrotal swelling, and left lower extremity pain and swelling. Initial management of priapism failed, and he was noted to have both cavernosal and glandular venous obstruction. Computed tomography (CT) was performed and identified extensive acute thrombosis involving the distal inferior vena cava and the left iliac veins. Pharmacomechanical thrombolysis (PMT) was started over the course of two days. At completion of thrombolysis, the culprit lesion in the left common iliac vein was treated with angioplasty and stenting. His postoperative course was uneventful, and his priapism as well as the scrotal and leg swelling improved. He was discharged home on full anticoagulation. To our knowledge, this is the first available description of this rare presentation along with a literature review of the underlying vascular etiology for priapism.

  19. Effect of cause of iliac vein stenosis and extent of thrombus in the lower extremity on patency of iliac venous stent placed after catheter-directed thrombolysis of acute deep venous thrombosis in the lower extremity

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    Jung, Sung Il; Choi, Young Ho; Yoon, Chang Jin; Lee, Min Woo; Chung, Jin Wook; Park, Jae Hyung [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-10-01

    To assess the CT findings of acute deep venous thrombosis (DVT) in a lower extremity prior to catheter-directed thrombolysis, and to evaluate their relevance to the patency of an iliac venous stent placed with the help of CT after catheter-directed thrombolysis of DVT. Fourteen patients [M:F=3:11; age, 33-68 (mean, 50.1) years] with acute symptomatic DVD of a lower extremity underwent CT before and after catheter-directed thrombolysis using an iliac venous stent. The mean duration of clinical symptoms was 5.0 (range, 1-14 days. The CT findings prior to thrombolysis were evaluated in terms of their anatomic cause and the extent of the thrombus, and in all patients, the patency of the iliac venous stent was assessed at CT performed during a follow-up period lasting 6-31 (mean, 18.9) months. All patients were assigned to the patent stent group (n=9) or the occluded stent group (n=5). In the former, the anatomic cause of patency included typical iliac vein compression (May-Thurner syndrome) (n=9), and a relatively short segmental thrombus occurring between the common iliac and the popliteal vein (n=8). Thrombi occurred in the iliac vein (n=3), between the common iliac and the femoral vein (n=3), and between the common iliac and the popliteal vein (n=2). In one case, a relatively long segmental thrombus occurred between the common iliac vein and the calf vein. In the occluded stent group, anatomic causes included atypical iliac vein compression (n=3) and a relatively long segmental thrombus between the common iliac and the calf vein (n=4). Typical iliac vein compression (May-Thurner syndrome) occurred in two cases, and a relatively short segmental thrombus between the external iliac and the common femoral vein in one. Factors which can affect the patency of an iliac venous stent positioned after catheter-directed thrombolysis are the anatomic cause of the stenosis, and the extent of a thrombus revealed at CT of acute DVT and occurring in a lower extremity prior to

  20. Retrograde Tempofilter II{sup TM} Placement within the Superior Vena Cava in a Patient with Acute Upper Extremity Deep Venous Thrombosis: the Filter Stands on Its Head

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    Yim, Nam Yeol [The Armed Forces Yangju Hospital, Yangju (Korea, Republic of); Chang, Nam Kyu; Lim, Jae Hoon; Kim, Jae Kyu [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-02-15

    The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofi lter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis

  1. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: martin.kocher@seznam.cz; Krcova, Vera [Department of Hematooncology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Cerna, Marie [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Prochazka, Martin [Department of Obstetrics and Gynaecology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)

    2009-04-15

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  2. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  3. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post......Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... will focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  4. Diagnosing deep venous thrombosis in primary care

    NARCIS (Netherlands)

    Oudega, Rudolphus

    2005-01-01

    In patients suspected of deep venous thrombosis (DVT) in primary care, it is a challenge to discriminate the patients with DVT from those without DVT. The risk of missing the diagnosis and the risk of unnecessary referral and treatment with a potential harmful therapy has to be balanced by the prima

  5. Nursing for patients with acute or chronic pulmonary deep venous thrombosis%急、慢性肺血栓栓塞症患者的护理

    Institute of Scientific and Technical Information of China (English)

    张平; 姜波; 季颖群; 赵广东; 张中和

    2007-01-01

    @@ 静脉血栓栓塞症(venous thromboembolism,VTE)是把深静脉血栓栓塞症(deep venous thrombosis,DVT)和肺栓塞(pulmonary embolism,PE)作为整体理解,肺栓塞是来自全身静脉系统或右心的栓子游离后阻塞肺动脉或其分支引起的肺循环和呼吸功能障碍的临床综合征.

  6. The clinical value of color Doppler ultrasound diagnosis of acute lower extremity deep venous thrombosis%彩色多普勒超声诊断下肢深静脉急性血栓的临床价值

    Institute of Scientific and Technical Information of China (English)

    雷声鸣; 童燕燕; 林继平

    2011-01-01

    Objective To evaluate the clinical value of color Doppler ultrasound in acute deep vein thrombosis diagnosis. Methods 38 patients acute deep venous thrombosis were treatment with color Doppler ultrasound then observed the, imaging features and the flow characteristics. Results The data in the diagnosis of acute thrombosis in 38 cases, 1 case of misdiagnosis, diagnosis rate of 97.44%, In which 37 patients with unilateral thrombosis, I case of thrombosis of both lower extremities; left lower extremity venous thrombosis in 27 cases, 10 cases of right lower limb thrombosis. Conclusion Color Doppler ultrasound examination for acute lower extremity deep venous thrombosis diagnosis has important clinical value, the preferred and reliable disease- based inspection methods.%目的 探讨彩色多普勒超声在下肢深静脉急性血栓诊断的价值.方法 应用彩色多普勒超声诊断39例下肢深静脉急性血栓,观察声像图特征及血流特点.结果 本组资料中诊断急性血栓38例,误诊1例,诊断符合率97.44%,其中单侧血栓37例,双下肢血栓1例;左下肢静脉血栓27例,右下肢血栓10例.结论 彩色多普勒超声检查对下肢深静脉急性血栓的诊断有重要的临床价值,为本病的首选和可靠的检查方法.

  7. The aetiology of deep venous thrombosis.

    Science.gov (United States)

    Malone, P C; Agutter, P S

    2006-09-01

    Most ideas about the pathogenesis of deep venous thrombosis (DVT) are dominated by a 'consensus model' first articulated around 1962. This model invokes 'Virchow's triad' and attributes thrombogenesis in veins to some combination of 'hypercoagulability', 'stasis' and 'intimal injury'. This arose as a by-product of studies on the mechanisms of haemostasis and bleeding diatheses that were at best only indirectly relevant to thrombosis, and there are reasons for doubting the causal significance of 'hypercoagulability' and 'stasis' in the aetiology of DVT. Proponents of the consensus model make little reference to a substantial literature, mostly historical, that: (a) emphasizes the significance of the venous valve pockets (VVP) and blood rheology in DVT pathogenesis; and (b) describes morphological features specific to venous thrombi that a valid aetiological model must explain. This literature provides the basis for an alternative hypothesis of DVT aetiology, published some 30 years ago, which has been experimentally corroborated and is compatible with recent cell and molecular biological studies of the venous endothelium. We review this alternative hypothesis, considering its potential value for future research on DVT and embolism, and its significance for clinical practice.

  8. Novel Biomarkers Associated with Deep Venous Thrombosis: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Dawn M Barnes

    2007-01-01

    Full Text Available Primary and recurrent venous thromboembolic disease (VTE, deep venous thrombosis and pulmonary embolism remain a significant source of morbidity and mortality in the hospitalized patient. Non-specific subjective complaints and lack of specific objective findings related to acute deep venous thrombosis (DVT and pulmonary embolism (PE complicate the diagnosis. There remains no single serum marker available to exclusively confirm the diagnosis of VTE. While D-dimer is highly sensitive and useful for diagnostic exclusion, it lacks the specificity necessary for diagnostic confirmation resulting in the need for a variety of additional studies (i.e.: duplex ultrasound, venography, V/Q scanning, helical thoracic and pelvic CT scans and pulmoary angiography. There is evolving research supporting the utility of various plasma markers as novel “biomarkers” for VTE including selectins, microparticles, interleukin-10 and other cytokines. This review attempts to examine recent literature assessing the utility of P-selectin, microparticles, D-dimer, E-selectin, thrombin, interleukins and fibrin monomers in the diagnosis and guidance of therapy for VTE.

  9. Pharmacomechanical thrombectomy and catheter-directed thrombolysis of acute lower extremity deep venous thrombosis in a 9-year-old boy with inferior vena cava atresia.

    Science.gov (United States)

    Hamidian Jahromi, Alireza; Coulter, Amy H; Bass, Patrick; Zhang, Wayne W; Tan, Tze-Woei

    2015-04-01

    Lower extremity deep venous thrombosis (DVT) is uncommon in the pediatric population, but it can be associated with severe symptoms and potential long-term morbidity secondary to post-thrombotic syndrome. Inferior vena cava (IVC) atresia can predispose a patient to the development of extremity DVT. There is no clear consensus on optimal management of extensive extremity DVT in pediatric patients, especially in patients with IVC anomalies. We report a case of iliofemoral DVT in a 9-year-old boy with IVC atresia and presumed protein S deficiency that was treated successfully using pharmacomechanical thrombectomy and catheter-directed thrombolysis. He was maintained on long-term anticoagulation and remained symptom free at 6 months' follow-up.

  10. 急性下肢深静脉血栓形成的微创治疗%Minimally Invasive Therapy in Acute Deep Venous Thrombosis of Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    张希全; 王义平; 潘晶晶; 朱伟; 李长海; 郭锋; 董戈; 张清

    2012-01-01

    Objective To discuss the clinical effect and value of minimally invasive therapy on lower extremity deep venous thrombosis (DVT). Methods The clinical data of 911 patients with acute lower extremity DVT from April 1998 to December 2011 were analyzed retrospectively. There were 489 males, 422 females; the age ranged from 23-86 years old with (58. 72±11. 95) years old. Five hundred and sixty-eight patients occurred on the left leg, 343 patients on the right leg. There were 487 cases of central type, 166 cases of peripheral type,258 cases of mixed type. All the patients were implanted inferior vena cava filter under local anesthesia, then inserted an 8-14 F catheter via the femoral vein of the affected limbs to suck mechanically thrombus. Five hundred and twenty-seven cases of iliofemoral vein thrombus were inserted into sheathing canal with the help of technique of guide wire griped. The guide wire could be plugged into femoral vein, even more far, with the help of sheathing canal. Following the guide wire, a diameter-10 mm balloon catheter was used to pull the thrombus to iliac vein, with the watching of DSA, so it could be sucked from iliac vein. Before sucking thrombus, a diameter-12 mm balloon was put into the confluence of inferior vena cava and iliac vein, in case of thrombus fall off with blood flow to block inferior vena cava. Results Among 911 patients, 423 cases were only treated by sucking thrombus, 275 cases sucking thrombus plus endovascular thrombolysis, 91 cases sucking thrombus plus endovascular thrombolysis plus percutaneous transluminal angioplasty (PTA) , 122 cases sucking thrombus plus endovascular thrombolysis plus PTA plus stenting.the average hospital stay was 7. 5 d.①Discharge success rate: 907 (99. 56%) cases were successful by interventional therapy, 4 (0. 44%) cases were failed. Nine hundred and eleven patients were performed mechanical thrombus suction, which was 556 cases of grade Ⅲ, 142 cases of grade Ⅱ , 213 cases of grade

  11. Deep venous thrombosis and pulmonary embolism following physical restraint

    DEFF Research Database (Denmark)

    Laursen, S B; Jensen, T N; Bolwig, T

    2005-01-01

    physical restraint may occur in spite of no pre-existing risk factors. Medical guidelines for the prevention of thrombosis following physical restraint are presented. Despite the absence of controlled trials of treatment effectiveness, the catastrophic outcome of DVT and PE warrants early and vigorous......OBJECTIVE: We describe a case of deep venous thrombosis (DVT) and pulmonary embolism (PE) following the use of physical restraint in a patient with a diagnosis of acute delusional psychotic disorder. METHOD: A new case report of DVT and PE associated with prolonged physical restraint is presented....... The literature on physical restraint, DVT, and PE was reviewed using a search of Medline and Psychinfo from 1966 to the present. RESULTS: Four other reported cases of DVT and PE were found in association with physically restrained patients. CONCLUSION: Risk of DVT and PE in association with immobilization during...

  12. Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology

    Energy Technology Data Exchange (ETDEWEB)

    Parellada, Antoni J.; Reiter, Sean B.; Glickman, Peter L.; Kloss, Linda A. [Frankford Hospitals, DII - Diagnostic Imaging, Inc., Department of Radiology, Philadelphia, PA (United States); Morrison, William B. [Thomas Jefferson University, Philadelphia, PA (United States); Carrino, John A. [Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Patel, Pinecca [Frankford Hospitals, Jefferson Health System, Philadelphia, PA (United States)

    2006-09-15

    The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis. The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality. All patients showed marked reactive edema in the surrounding soft tissues or muscles. Three patients showed MR evidence of branching rim-enhancing structures within intramuscular plexuses characteristic of venous thrombosis (gastrocnemius, n=1; sural, n=2); one patient showed a distended popliteal vein. Ultrasound was able to duplicate the MRI findings in three patients: one patient showed above-the-knee extension on ultrasound; neither of the two patients with intramuscular thrombosis demonstrated on ultrasound showed extension to the deep venous trunks. Intramuscular venous thrombosis can present as marked edema-like muscle changes on MRI, simulating primary musculoskeletal conditions. In the absence of clinical suspicion for deep venous thrombosis, only the identification of rim-enhancing branching intramuscular tubular structures will allow the correct diagnosis to be made. (orig.)

  13. Acute leukemia complicating deep venous thrombosis:5 cases report and literature review%急性白血病合并深静脉血栓5例报道并文献复习

    Institute of Scientific and Technical Information of China (English)

    胡成琳; 曾翰庆; 罗云; 娄世锋

    2015-01-01

    Objective To analyze the clinical characteristics ,diagnosis and treatment of acute leukemia complicating deep ve‐nous thrombosis(DVT) to deepen the cognition on this complication .Methods The clinical data of consecutive patients with acute leukemia were performed the retrospective analysis .The occurrence situation of deep venous thrombosis was investigated and the a‐broad related literatures were reviewed .Results A total of 116 cases of acute leukemia in our department from July 2011 to March 2014 were treated ,in which 85 cases were acute myeloid leukemia and 31 cases were acute lymphoblastic leukemia;5 cases devel‐oped DVT with the proportion of 4 .31% (5/116) .Of these cases ,3 cases were acute promyelocytic leukemia and 2 cases were acute lymphoblastic leukemia .Conclusion The occurrence rate of DVT in the patients with acute promyelocytic leukemia is relatively higher ,if the patients have the corresponding symptom ,timely diagnosis and treatment should be conducted .%目的:分析急性白血病合并深静脉血栓患者的临床特点,加深对此合并症的认识。方法回顾分析重庆医科大学附属第二医院血液科连续收治急性白血病患者的临床资料,调查深静脉血栓发生情况,并复习国外相关文献。结果该科于2011年7月至2014年3月间共收治急性白血病患者116例,其中急性髓细胞白血病85例,急性淋巴细胞白血病31例;共有5例患者发生深静脉血栓,占4.31%(5/116)。5例患者中急性早幼粒细胞白血病3例,急性淋巴细胞白血病2例。结论急性早幼粒细胞白血病患者深静脉血栓发生率相对较高,如有相应症状应及时诊治。

  14. Endovascular management of deep venous thrombotic diseases of the lower extremity

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

    2004-07-01

    Pulmonary embolism and venous ischemia are acute complications of deep vein thrombosis (DVT) of the lower extremities. Delayed complications include a spectrum of debilitating symptoms referred to as postthrombotic syndrome (PST). Because the early symptoms and patient signs are nonspecific for DVT, careful history taking and radiological evaluation of the extent and migration of thrombus should be used to establish an objective diagnosis and the need for treatment. Anticoagulation therapy is recognized as the mainstay treatment in acute DVT. However, there are few data to suggest any major beneficial effect of the early clearing of massive DVT and PTS. Endovascular, catheter-directed, thrombolysis techniques, used alone or in combination with mechanical thrombectomy devices, have been proven to be highly effective in clearing acute DVT, which may allow the preservation of venous valve function and the prevention of subsequent venous occlusive disease. Definitive management of the underlying anatomic occlusive abnormalities should also be undertaken.

  15. Genetic risk factors in patients with deep venous thrombosis, a retrospective case control study on Iranian population

    OpenAIRE

    Hosseini, Soudabeh; Kalantar, Ebrahim; Hosseini, Maryam Sadat; Tabibian, Shadi; Shamsizadeh, Morteza; Dorgalaleh, Akbar

    2015-01-01

    Background Venous thromboembolism (VTE) could be manifested as deep venous thrombosis (DVT) or pulmonary embolism (PE). DVT is usually the more common manifestation and is usually formation of a thrombus in the deep veins of lower extremities. DVT could occur without known underlying cause (idiopathic thrombosis) which could be a consequence of an inherited underlying risk factor or could be a consequence of provoking events, such as trauma, surgery or acute illness (provoked thrombosis). Our...

  16. Deep venous thrombosis and pulmonary embolism in psychiatric settings

    Directory of Open Access Journals (Sweden)

    Els G. Van Neste

    2009-03-01

    Full Text Available Background and objectives: Deep venous thrombosis and pulmonary embolism are serious, possibly life-threatening events which are often ignored in psychiatric settings. This article investigates which psychiatric patients are at increased risk of developing a venous thromboembolism. To our knowledge we are the first to perform a literature review of clinical studies relating venous thrombosis and pulmonary embolism to psychotropic drugs and mental disorders. Methods: A Medline search for English studies using the appropriate search terms was performed. In addition, cross references of the relevant articles` literature references were considered. We withheld 12 observational studies, 29 case-reports and one review-article. Results: We found evidence that low potency antipsychotic drugs like chlorpromazine and thioridazine, and clozapine for treatment of resistant schizophrenia have an increased risk of venous thromboembolism. There is no evidence that antidepressants, benzodiazepines or mood stabilizers have a similar effect. Also psychiatric conditions like physical restraint, catatonia and neuroleptic malignant syndrome are related to a higher incidence of deep venous thrombosis. Conclusions: Limitations of the studies and hypotheses about underlying biological mechanisms are reviewed. The rationale for prophylactic measures is discussed and recommendations to prevent deep venous thrombosis and pulmonary embolism are given.

  17. Interventional Treatment by Popliteal Vein Puncture and Transcatheter Aspiration for Acute Lower Extremity Deep Venous Thrombosis%经腘静脉穿刺导管抽吸介入治疗急性下肢深静脉血栓

    Institute of Scientific and Technical Information of China (English)

    申刚; 陈德基; 何明基; 练辉

    2012-01-01

    目的 探讨经腘静脉穿刺导管抽吸治疗急性下肢深静脉血栓(lower extremity deep venous thrombosis,LEDVT)的临床应用价值.方法 对32例LEDVT患者行经腘静脉穿刺导管抽取栓术为主的综合介入治疗,其中行导管血栓抽吸术32例,导管接触溶栓术32例,球囊扩张术18例,支架植入术12例.结果 32例介入治疗有效率100%,患者平均住院时间为8.4d.患肢肿胀、疼痛均于介入治疗后1~2d内开始消退.术后下肢静脉造影复查,静脉通畅率100%.出院时健、患肢膝关节上、下15 cm处周径差及患肢膝关节上、下15 cm处周径与入院时比较,差异有统计学意义(P<0.01).治疗过程中无严重并发症发生.结论 经腘静脉穿刺导管抽吸治疗LEDVT是一种快捷、有效的方法,值得临床推广使用.%Objective To discuss the clinical value of popliteal vein puncture and transcatheter aspiration in the interventional treatment for acute lower extremity deep venous thrombosis(LEDVT). Methods Popliteal vein puncture and synthetic interventional treatment were performed in 32 cases,including catheter-directed thrombolysis in 32 cases,transcatheter aspiration in 32 cases,angioplasty 18 cases,and stenting in 12 cases. Results Total achievement ratio by interventional therapy was 100% ,the average days in hospital was ?.4 days. Swelling and pain in affected limb disappeared or relieved after interventional therapy for 1 ~2 days. Vein patency rate was 100% when 32 patients received lower venography after treatment. Knee joint upper and down IS cm perimeter of uninjured and injured side had statistical difference. Knee joint upper and down 15cm perimeter o f before and after therapy had statistical difference. The cause of treatment does not appear serious complications. Conclusion Popliteal vein puncture and transcatheter aspiration for acute deep venous thrombosis of lower limb is a quick and effective method, with better prognosis, which is worthy to be

  18. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Haage, Patrick; Schmitz-Rode, Thomas [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krings, Timo [Department of Neuroradiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2002-11-01

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  19. Unicompartmental muscle edema: an early sign of deep venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Patrick T. [Mayo Clinic Scottsdale, Department of Diagnostic Radiology, 13400 E. Shea Boulevard, Scottsdale, AZ 85259 (United States); Ilaslan, Hakan [Mayo Clinic Rochester, Department of Diagnostic Radiology, Rochester, Minnesota (United States)

    2003-01-01

    The finding of muscle edema restricted to a single muscle compartment on MRI usually indicates a diagnosis of traumatic injury, myositis, denervation or neoplasm. This case demonstrates that deep venous thrombosis can also be the cause of isolated deep posterior compartment muscle edema in the calf and should be considered in the differential diagnosis even in the absence of diffuse soft tissue or subcutaneous edema. (orig.)

  20. A novel approach for assessing the progression of deep venous thrombosis by area of venous thrombus in ultrasonic elastography.

    Science.gov (United States)

    Wang, Chao; Wang, Lei; Zhang, Yuhui; Chen, Ming

    2014-04-01

    Exact age determination of deep venous thrombosis (DVT) is important for an appropriate treatment. The purpose of this present study is to assess the age of acute DVT with the area of venous thrombi in elasticity imaging during the thrombosis procession. The thrombus area is obtained from a specially designed program. It was applied to clot specimens induced in human great saphenous (n = 15) at selected time points following the initiation of thrombosis. The relative mean proportion of blood clots was 50.01% ± 12.44% at day 1; 69.94% ± 8.19% at day 3; 81.93% ± 6.15% at day 6; and 92.37% ± 4.06% at day 9. The results indicated that the thrombus area increased significantly over time, while the normalized strain values inside the thrombus changed only a little. The pathological analyses also showed the same results. Therefore, we conclude that the area of venous thrombi in elasticity imaging may be a novel function for acute DVT staging.

  1. To what extent might deep venous thrombosis and chronic venous insufficiency share a common etiology?

    Science.gov (United States)

    Malone, P Colm; Agutter, P S

    2009-08-01

    According to the valve cusp hypoxia hypothesis (VCHH), deep venous thrombosis is caused by sustained non-pulsatile (streamline) venous blood flow. This leads to hypoxemia in the valve pockets; hypoxic injury to the inner (parietalis) endothelium of the cusp leaflets activates the elk-1/egr-1 pathway, leading to leukocyte and platelet swarming at the site of injury and, potentially, blood coagulation. Here, we propose an extension of the VCHH to account for chronic venous insufficiency. First, should the foregoing events not proceed to frank thrombogenesis, the valves may nevertheless be chronically injured and become incompetent. Serial incompetence in lower limb valves may then generate ''passive'' venous hypertension. Second, should ostial valve thrombosis obstruct venous return from muscles via tributaries draining into the femoral vein, as Virchow illustrated, ''active'' venous hypertension may supervene: muscle contraction would force the blood in the vessels behind the blocked ostial valves to re-route. Passive or active venous hypertension opposes return flow, leading to luminal hypoxemia and vein wall distension, which in turn may impair vasa venarum perfusion; the resulting mural endothelial hypoxia would lead to leukocyte invasion of the wall and remodelling of the media. We propose that varicose veins result if gross active hypertension stretches the valve ''rings'', rendering attached valves incompetent caudad to obstructed sites, replacing normal centripetal flow in perforating veins with centrifugal flow and over-distending those vessels. We also discuss how hypoxemia-related venous/capillary wall lesions may lead to accumulation of leukocytes, progressive blockage of capillary blood flow, lipodermosclerosis and skin ulceration.

  2. Primary leiomyosarcoma of saphenous vein presenting as deep venous thrombosis.

    Science.gov (United States)

    Fremed, Daniel I; Faries, Peter L; Schanzer, Harry R; Marin, Michael L; Ting, Windsor

    2014-12-01

    Only a small number of venous leiomyosarcomas have been previously reported. Of these tumors, those of saphenous origin comprise a minority of cases. A 59-year-old man presented with symptoms of deep vein thrombosis and was eventually diagnosed with primary leiomyosarcoma of great saphenous vein origin. The tumor was treated with primary resection and femoral vein reconstruction with autologous patch. Although extremely rare, saphenous leiomyosarcoma can present as deep vein thrombosis. Vascular tumors should be included in the differential diagnosis of atypical extremity swelling refractory to conventional deep vein thrombosis management.

  3. Venous Return and Clinical Hemodynamics: How the Body Works during Acute Hemorrhage

    Science.gov (United States)

    Shen, Tao; Baker, Keith

    2015-01-01

    Venous return is a major determinant of cardiac output. Adjustments within the venous system are critical for maintaining venous pressure during loss in circulating volume. This article reviews two factors that are thought to enable the venous system to compensate during acute hemorrhage: 1) changes in venous elastance and 2) mobilization of…

  4. Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: a Rare Association

    Directory of Open Access Journals (Sweden)

    Gökhan Çelik

    2011-11-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disorder of unknown etiology and it may rarely be associated with a second disorder. Celiac disease is an immune-mediated enteropathy characterized with malabsorption caused by gluten intolerance, and several reports indicate an association between celiac disease and sarcoidosis. In addition, although celiac disease is associated with several extraintestinal pathologies, venous thrombosis has been rarely reported. Herein we present a rare case report of a patient with a diagnosis of sarcoidosis, celiac disease and deep venous thrombosis because of the rare association of these disorders. The patient was admitted with abdominal pain, weight loss, chronic diarrhea and a 5-day history of swelling in her right leg. A diagnosis of deep venous thrombosis was achieved by doppler ultrasonographic examination. The diagnosis of celiac disease was made by biopsy of duodenal mucosa and supported with elevated serum level of anti-gliadin IgA and IgG, and a diagnosis of sarcoidosis was achieved by transbronchial needle aspiration from the subcarinal lymph node during flexible bronchoscopy.

  5. Association of varicosities and concomitant deep venous thrombosis in patients with superficial venous thrombosis, a systematic review

    NARCIS (Netherlands)

    Baggen, Vivan J M; Chung, Kaman; Koole, Koos; Sarneel, Michelle H J; Rutten, Frans H; Hajer, Gideon R

    2015-01-01

    BACKGROUND: In patients with superficial venous thrombosis (SVT) co-existence of deep venous thrombosis (DVT) can be present. Varicosities are considered as a risk factor for both SVT and DVT separately. However, current evidence is contradictory whether varicosities are associated with an increased

  6. Interventional therapy of integrating traditional Chinese and western medicine in the treatment of acute lower extremity deep venous thrombosis%中西医结合介入治疗急性下肢深静脉血栓形成

    Institute of Scientific and Technical Information of China (English)

    张新刚

    2012-01-01

    目的 探讨中西医结合介入治疗急性下肢深静脉血栓形成的应用价值.方法 68例急性下肢深静脉血栓患者均经血管超声及造影证实,所有急性下肢深静脉血栓患者均在置入下腔静脉滤器后,经插管溶栓治疗和采用活血化瘀、益气活血中药和溶栓抗凝等中西药治疗,采用自行设计的治疗效果量化测量表进行量化判定.结果 治疗后1个月复查,临床治愈30例(44.12%),显效36例(52.94%),有效2例(2.94%).总有效率为100%,未出现严重并发症.结论 中西医结合介入治疗方法对急性下肢深静脉血栓形成有良效的效果,结合中医辨证论治综合治疗,可以提高疗效.%Objective To explore the value of interventional therapy of integrating traditional Chinese and western medicine in the treatment of acute lower extremity deep venous thrombosis (ALEDVT). Methods A total of 68 ALEDVT patients whose diagnoses were confirmed by sonography and angiography were enrolled in the study. All the ALEDVT patients underwent catheter- directed thrombolysis and the integrated treatment of traditional Chinese and western medicine after insertion of inferior vena cava filter. The therapeutic efficacy was measured by a self -designed form. Results The results of the re- examination conducted one month later were as follows: totally recovered in 30 patients (44.12%), obviously effective in 36 (52.94%), and effective in 2 patients (2.94%). The overall cure rate was 100% with no serious complications. Conclusion Interventional therapy of integrating traditional Chinese and western medicine has good effect on ALEDVT. It can greatly improve the efficacy.

  7. Graduated compression stockings in the prevention of deep vein thrombosis in patients with acute myocardial infarction.

    Science.gov (United States)

    Kierkegaard, A; Norgren, L

    1993-10-01

    Venous volume (venous capacity) of the calf is low in patients with acute myocardial infarction, who also have a high risk of deep vein thrombosis (DVT). The effect of graduated compression stockings on the venous volume and on the incidence of DVT was therefore studied in 80 patients aged 70 years and above with acute myocardial infarction. Graduated compression stockings were randomly fitted to one leg, the other serving as a control, after which the venous volume was measured by strain gauge plethysmography. The incidence of DVT was measured by the 125I fibrinogen uptake test. Venous volume was significantly higher in legs treated with graduated compression stockings compared to control legs. DVT developed in eight control legs but not in any leg treated with graduated compression stockings (P = 0.003). DVT was also significantly more frequent in women compared to men and the majority of DVT developed in legs with very low venous volume values.

  8. The Role of Apolipoprotein (A In Pathogenesis and Clinical Course of Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Chrapko Marek

    2015-02-01

    Full Text Available Deep venous thrombosis is widespread disease, which complications, like: pulmonary embolism and postphlebitis syndrome areimportant social problem. There are many well-known and accurately described risk factors, though in many cases etiology remains unexplained. Further research into causes of deep venous thrombosis seem to be fully justified.

  9. Deep venous thrombosis in a young woman with hypoplastic inferior vena cava.

    Science.gov (United States)

    Lavens, Matthias; Moors, Boudewijn; Thomis, Sarah

    2014-05-01

    We present a 33-year-old woman with deep venous thrombosis of the left iliac vein and the left lower limb. A computed tomography scan of her abdomen revealed a hypoplastic inferior vena cava and agenesis of the right kidney. Congenital anomalies of the inferior vena cava are uncommon and are sometimes an unrecognized cause of deep venous thrombosis.

  10. A clinical prediction score for upper extremity deep venous thrombosis.

    Science.gov (United States)

    Constans, Joel; Salmi, Louis-Rachid; Sevestre-Pietri, Marie-Antoinette; Perusat, Sophie; Nguon, Monika; Degeilh, Maryse; Labarere, Jose; Gattolliat, Olivier; Boulon, Carine; Laroche, Jean-Pierre; Le Roux, Philippe; Pichot, Olivier; Quéré, Isabelle; Conri, Claude; Bosson, Jean-Luc

    2008-01-01

    It was the objective of this study to design a clinical prediction score for the diagnosis of upper extremity deep venous thrombosis (UEDVT). A score was built by multivariate logistic regression in a sample of patients hospitalized for suspicion of UEDVT (derivation sample). It was validated in a second sample in the same university hospital, then in a sample from the multicenter OPTIMEV study that included both outpatients and inpatients. In these three samples, UEDVT diagnosis was objectively confirmed by ultrasound. The derivation sample included 140 patients among whom 50 had confirmed UEDVT, the validation sample included 103 patients among whom 46 had UEDVT, and the OPTIMEV sample included 214 patients among whom 65 had UEDVT. The clinical score identified a combination of four items (venous material, localized pain, unilateral pitting edema and other diagnosis as plausible). One point was attributed to each item (positive for the first 3 and negative for the other diagnosis). A score of -1 or 0 characterized low probability patients, a score of 1 identified intermediate probability patients, and a score of 2 or 3 identified patients with high probability. Low probability score identified a prevalence of UEDVT of 12, 9 and 13%, respectively, in the derivation, validation and OPTIMEV samples. High probability score identified a prevalence of UEDVT of 70, 64 and 69% respectively. In conclusion we propose a simple score to calculate clinical probability of UEDVT. This score might be a useful test in clinical trials as well as in clinical practice.

  11. [Epidemiology and management of isolated distal deep venous thrombosis].

    Science.gov (United States)

    Galanaud, J-P; Kahn, S R; Khau Van Kien, A; Laroche, J-P; Quéré, I

    2012-12-01

    Isolated distal deep-vein thromboses (DVT) are infra-popliteal DVT without involvement of proximal veins or pulmonary embolism (PE). They can affect deep calf (tibial anterior, tibial posterior, or peroneal) or muscular (gastrocnemius or soleal) veins. They represent half of all lower limbs DVT. Proximal and distal DVTs differ in terms of risk factor profile, proximal DVT being more frequently associated with chronic risk factors and distal DVT with transient ones. Their natural history (rate of spontaneous proximal extension) is debated leading to uncertainties on the need to diagnose and treat them with anticoagulant drugs. In the long term, the risk of venous thromboembolic recurrence is lower than that of proximal DVT and their absolute risk of post-thrombotic syndrome is unknown. French national guidelines suggest treating with anticoagulants for 6 weeks a first episode of isolated distal DVT provoked by a transient risk factor and treating for at least 3 months unprovoked or recurrent or active cancer-related distal DVT. The use of compression stockings use is suggested in case of deep calf vein thrombosis. Ongoing therapeutic trials should provide important data necessary to establish an evidence-based mode of care, especially about the need to treat distal DVT at low risk of extension with anticoagulants.

  12. The incidence of venous thromboembolism and practice of deep venous thrombosis prophylaxis in hospitalized cirrhotic patients

    Directory of Open Access Journals (Sweden)

    Alqahtani Saad

    2011-01-01

    Full Text Available Abstract Background Cirrhotic patients are characterized by a decreased synthesis of coagulation and anticoagulation factors. The coagulopathy of cirrhotic patients is considered to be auto-anticoagulation. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE and examine the practice of deep venous thrombosis (DVT prophylaxis among hospitalized cirrhotic patients. Methods A retrospective cohort study was performed in a tertiary teaching hospital. We included all adult patients admitted to the hospital with a diagnosis of liver cirrhosis from January 1, 2009 to December 31, 2009. We grouped our cohort patients in two groups, cirrhotic patients without VTE and cirrhotic with VTE. Results Over one year, we included 226 cirrhotic patients, and the characteristics of both groups were similar regarding their clinical and laboratory parameters and their outcomes. Six patients (2.7% developed VTE, and all of the VTEs were DVT. Hepatitis C was the most common (51% underlying cause of liver cirrhosis, followed by hepatitis B (22%; 76% of the cirrhotic patients received neither pharmacological nor mechanical DVT prophylaxis. Conclusion Cirrhotic patients are at risk for developing VTE. The utilization of DVT prophylaxis was suboptimal.

  13. Deep venous thrombosis after office vasectomy: a case report

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    Zazove Philip

    2010-08-01

    Full Text Available Abstract Introduction Postoperative pulmonary embolism is considered a complication of major surgery. However, thromboembolism can also occur following minor procedures. We report a case of a major embolic event following a straightforward office vasectomy. Case presentation A healthy 35-year-old Asian man underwent an uncomplicated office vasectomy. Soon after, he noticed vague chest pain and dyspnea. Lower extremity Doppler ultrasound revealed acute venous thrombosis. A computer-assisted tomography angiogram revealed extensive bilateral pulmonary emboli. Extensive laboratory work-up failed to identify thrombophilia. He has not had any recurrences in the eight years since the initial presentation. Conclusion This case highlights that major embolic events can follow minor office procedures. Patients with suggestive findings should be investigated aggressively.

  14. Simultaneous acute deep vein thrombosis and acute brucellosis. A case report

    Science.gov (United States)

    Andaç, Şeyda; Kalender, Mehmet; Yıldırım, Onur; İmre, Ayfer

    2016-01-01

    Brucellosis is a zoonotic disease common in developing countries. Vascular complications, including arterial and venous, associated with Brucella infection have rarely been reported. A case of deep venous thrombosis (DVT) developing after a diagnosis of acute brucellosis in a young milkman is presented. A 26-year-old man presented with pain in the right leg. The patient's medical history included a diagnosis of brucellosis in our hospital where he had presented with complaints of weakness and fever. Peripheral venous Doppler ultrasound showed DVT, and the patient was treated with anticoagulants. The patient was discharged with warfarin therapy and anti-brucellosis treatment. Although rare, some infectious agents may cause vascular pathologies. Patients presenting with symptoms of DVT or similar vascular pathologies should be assessed for infectious agents, particularly in those coming from Brucella-endemic areas. PMID:27516795

  15. Iliofemoral venous thrombosis following fascial excision of a deep burn of the lower extremity: case report.

    Science.gov (United States)

    Gibran, N S; Heimbach, D M; Nicholls, S C

    1992-12-01

    Burned patients with deep venous thrombosis present a particularly perplexing challenge. They frequently require central venous catheters. Their altered skin integrity does not permit correlation with the typical changes described by the classic terminology for thrombophlebitis or its most severe forms, phlegmasia cerulea dolens or phlegmasia alba dolens. They are at risk of exsanguination or massive graft loss with lytic therapy or anticoagulation. Venous thrombectomy may be a necessary limb-saving surgical option.

  16. Risk factors for cerebral venous thrombosis and deep venous thrombosis in patients aged between 15 and 50 years

    NARCIS (Netherlands)

    Koopman, Karen; Uyttenboogaart, Maarten; Vroomen, Patrick C A J; van der Meer, Jannes; De Keyser, Jacques; Luijckx, Gert-Jan

    2009-01-01

    Cerebral venous thrombosis (CVT) and deep vein thrombosis or pulmonary embolism (DVT/PE) are associated with many risk factors. It is unclear why CVT occurs less often than DVT/PE. Age dependent risk factors may play a role. The aim of our study was to compare risk factors in a uniform age group of

  17. Patients with deep venous thrombosis and thrombophilia risk factors have a specific prolongation of the lag time in a chromogenic thrombin generation assay

    NARCIS (Netherlands)

    Haas, F.J.L.M.; Kluft, C.; Biesma, D.H.; Schutgens, R.E.G.

    2011-01-01

    The objective of the present study was to evaluate the influence of thrombophilia risk factors on variables of a chromogenic thrombin generation assay (ETP) in a setting with acute deep venous thrombosis (DVT) and non-DVT patients. In 152 outpatients suspected for DVT, the results of thrombophilia i

  18. The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

    LENUS (Irish Health Repository)

    O'Sullivan, Gerard J

    2011-06-01

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer "single-session" techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  19. Chronic Stress Facilitates the Development of Deep Venous Thrombosis

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    Tao Dong

    2015-01-01

    Full Text Available The increasing pressure of modern social life intensifies the impact of stress on the development of cardiovascular diseases, which include deep venous thrombosis (DVT. Renal sympathetic denervation has been applied as one of the clinical approaches for the treatment of drug-resistant hypertension. In addition, the close relationship between oxidative stress and cardiovascular diseases has been well documented. The present study is designed to explore the mechanism by which the renal sympathetic nerve system and the oxidative stress affect the blood coagulation system in the development of DVT. Chronic foot shock model in rats was applied to mimic a state of physiological stress similar to humans. Our results showed that chronic foot shock procedure could promote DVT which may be through the activation of platelets aggregation. The aggravation of DVT and activation of platelets were alleviated by renal sympathetic denervation or antioxidant (Tempol treatment. Concurrently, the denervation treatment could also reduce the levels of circulating oxidation factors in rats. These results demonstrate that both the renal sympathetic nerve system and the oxidative stress contribute to the development of DVT in response to chronic stress, which may provide novel strategy for treatment of clinic DVT patients.

  20. Obesity as a causal risk factor for deep venous thrombosis

    DEFF Research Database (Denmark)

    Klovaite, Jolanta; Benn, M; Nordestgaard, B G

    2015-01-01

    OBJECTIVE: To test the hypothesis that obesity is causally associated with deep venous thrombosis (DVT). DESIGN: A Mendelian randomization design. SETTING: The Copenhagen General Population Study and the Copenhagen City Heart Study combined. SUBJECTS: Body mass index (BMI) measurements were.......95-1.25) for DVT and 1.54 (1.12-2.10) for DVT complicated by PE. In instrumental variable analysis, the causal odds ratio (95% CI) for an increase in BMI of 1 kg m(-2) was 1.13 (0.92-1.39) for DVT alone and 1.86 (1.14-3.02) for DVT complicated by PE. The absolute 10-year risk of DVT in a high-risk group (i.......e. those aged >60 years and homozygous for Factor V Leiden) was 35% in obese individuals and 18% in normal-weight individuals. CONCLUSION: A strong observational association between obesity and DVT with or without PE, supported by a direct genetic association between the obesity-specific locus FTO and DVT...

  1. Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

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    Nelson Oliveira

    2011-01-01

    Full Text Available Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  2. Primary iliac venous leiomyosarcoma: a rare cause of deep vein thrombosis in a young patient.

    Science.gov (United States)

    Oliveira, Nelson; Dias, Emanuel; Lima, Ricardo; Oliveira, Fernando; Cássio, Isabel

    2011-01-01

    Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging. Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation. Phlegmasia alba dolens installed progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy. Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

  3. Acute cytomegalovirus infection complicated by venous thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Parola Philippe

    2005-08-01

    Full Text Available Abstract Background CMV-induced vasculopathy and thrombosis have been reported, but they are rare conditions usually encountered in immunocompromised patients. However more and more complications of CMV infections are recognized in immunocompetent patients. Case presentation We present a case report of a previously healthy adult with cytomegalovirus infection that was complicated by tibiopopliteal deep venous thrombosis and in whom Factor V Leiden heterozygous mutation was found. Conclusion This new case report emphasizes the involvement of cytomegalovirus in induction of vascular thrombosis in patients with predisposing risk factors for thrombosis. It is necessary to screen for CMV infection in patients with spontaneous thrombosis and an history of fever.

  4. [Tactics of the patients management in continuing acute thrombosis of deep veins].

    Science.gov (United States)

    Prasol, V A; Mishenina, E V; Okley, D V

    2015-03-01

    Experience of active tactics of treatment application in 18 patients, suffering an acute thrombosis in system of lower vena cava, is presented. Possibilities were estimated and efficacy of active surgical tactics proved in continuing deep vein thrombosis on early stage were estimated. Active tactics, using catheter--governed thrombolysis, permits to escape pulmonary thromboembolism and to reduce a severity of further chronic venous insufficiency.

  5. 急性下肢深静脉血栓形成后肺栓塞严重程度的危险因素分析%Risk factors associated with the severity of pulmonary embolism in patients with acute deep venous thrombosis of lower extremities

    Institute of Scientific and Technical Information of China (English)

    罗小云; 张福先; 张昌明; 胡路; 冯亚平; 梁刚柱; 牛鹿原; 张欢; 成龙

    2015-01-01

    目的 探讨急性下肢深静脉血栓形成患者肺栓塞严重程度的危险因素.方法 本研究为前瞻性研究.2010年7月至2012年7月收集首都医科大学附属北京世纪坛医院血管外科诊断的急性下肢深静脉血栓形成的患者资料,其中符合纳入、排除标准的208例患者纳入本研究.其中男性101例,女性107例,平均年龄(59±16)岁.利用肺动脉CT血管造影、肺动脉磁共振血管造影或肺动脉数字减影血管造影筛查肺栓塞,并评估其肺栓塞程度.采用x2检验和Logistic回归对深静脉血栓形成患者发生肺栓塞程度的危险因素进行单因素和多因素分析.结果 208例下肢深静脉血栓形成患者中70例发生肺栓塞,总体发生率为33.7%.单因素分析结果显示,下肢深静脉血栓范围(x2=17.286,P=0.004)、下肢深静脉血栓部位(x2=15 602,P=0.008)对肺栓塞的严重程度有影响.年龄(x2=7.099,P=0.260)、性别(x2=7.014,P=0.067)、明显血栓危险因素(x2=3.335,P=0.345)对肺栓塞的严重程度无影响.多因素有序Logistic回归分析显示肺栓塞的程度随着下肢深静脉血栓范围的扩大和部位的增加而加重,髂股静脉血栓(OR =6.172,95% CI:1.590 ~ 23.975,P=0.009)、双下肢深静脉血栓(OR=7.140,95% CI:2.406 ~ 24.730,P=0.001)是肺栓塞严重程度的独立危险因素.结论 髂股静脉血栓形成、双侧下肢深静脉血栓形成是发生严重肺栓塞的独立危险因素,对这些高危患者应更加注重肺栓塞的防治.%Objective To identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities.Methods This prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital.There were 101 male and 107 female patients,with a mean age of (59 ± 16) years.Gender,age,extension,side of lower extremities of deep

  6. Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

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    Michael Blaivas

    2012-01-01

    Full Text Available Background-Aim. Upper extremity deep vein thrombosis (UEDVT is an increasingly recognized problem in the critically ill. We sought to identify the prevalence of and risk factors for UEDVT, and to characterize sonographically detected thrombi in the critical care setting. Patients and Methods. Three hundred and twenty patients receiving a subclavian or internal jugular central venous catheter (CVC were included. When an UEDVT was detected, therapeutic anticoagulation was started. Additionally, a standardized ultrasound scan was performed to detect the extent of the thrombus. Images were interpreted offline by two independent readers. Results. Thirty-six (11.25% patients had UEDVT and a complete scan was performed. One (2.7% of these patients died, and 2 had pulmonary embolism (5.5%. Risk factors associated with UEDVT were presence of CVC [(odds ratio (OR 2.716, P=0.007], malignancy (OR 1.483, P=0.036, total parenteral nutrition (OR 1.399, P=0.035, hypercoagulable state (OR 1.284, P=0.045, and obesity (OR 1.191, P=0.049. Eight thrombi were chronic, and 28 were acute. We describe a new sonographic sign which characterized acute thrombosis: a double hyperechoic line at the interface between the thrombus and the venous wall; but its clinical significance remains to be defined. Conclusion. Presence of CVC was a strong predictor for the development of UEDVT in a cohort of critical care patients; however, the rate of subsequent PE and related mortality was low.

  7. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

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    Shalini Koppisetty

    2015-01-01

    Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

  8. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Science.gov (United States)

    Moualla, Maan

    2016-01-01

    Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism. PMID:28050169

  9. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Peter V. Bui

    2016-01-01

    Full Text Available Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism.

  10. Venous thromboembolism and subsequent hospitalisation due to acute arterial cardiovascular events: a 20-year cohort study

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Horvath-Puho, Erzsebet; Pedersen, Lars

    2007-01-01

    of myocardial infarction and stroke in 25,199 patients with deep venous thrombosis, 16,925 patients with pulmonary embolism, and 163,566 population controls. FINDINGS: For patients with deep venous thrombosis, the relative risks varied from 1.60 for myocardial infarction (95% CI 1.35-1.91) to 2.19 (1......-up, with 20-40% increases in risk for arterial cardiovascular events. Relative risks were similar for those with provoked and unprovoked deep venous thrombosis and pulmonary embolism. INTERPRETATION: Patients with venous thromboembolism have a substantially increased long-term risk of subsequent arterial......BACKGROUND: In some studies, venous thromboembolism has been associated with atherosclerosis and with the risk of arterial cardiovascular events such as myocardial infarction and stroke. Other studies, however, do not show this association. To help clarify these discrepant findings, we aimed...

  11. 导管溶栓治疗对急性深静脉血栓形成转归的影响%Outcome comparisons of anticoagulation, systematic thrombolysis and catheter-directed thrombolysis in the treatment of lower extremity acute deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    张智辉; 单臻; 王文见; 李晓曦; 王深明

    2013-01-01

    目的 探讨抗凝、系统溶栓与导管溶栓治疗下肢急性深静脉血栓形成(DVT)的远期疗效及对深静脉血栓后综合征(PTS)的影响.方法 随访2005年1月至2009年12月在中山大学附属第一医院及广州医学院第二附属医院血管外科收治的下肢急性DVT患者(152例)的临床资料,根据治疗方法分为单纯抗凝组(A组)、系统溶栓联合抗凝组(B组)和导管溶栓联合抗凝组(C组).随访时行静脉彩超或下肢顺行静脉造影了解患肢静脉通畅情况,用Villalta评分法调查各组患者PTS的发生率,用CIVIQ-2调查表研究各组患者的生活质量,分析各组患者出院后抗凝时间及弹力袜使用情况.结果 (1)A、B、C3组患者静脉通畅率分别为69.1%、70.8%、85.1%,C组与A组差异有统计学意义(P<0.05),C组虽然高于B组,但差异尚无统计学意义(P>0.05),A、B两组间差异无统计学意义(P>0.05).(2)A、B、C3组PTS的发生率分别为56.8%、54.2%、38.3%,C组与A、B两组间差异有统计学意义(P<0.05),A、B两组间的差异无统计学意义(P>0.05).(3)A、B、C3组CIVIQ-2评分为20±14、20±12、17±11,C组较A、B两组分数低,但差异尚无统计学意义(P>0.05).(4)A、B、C3组出院后平均抗凝及弹力袜时间差异无统计学意义(P>0.05).结论 与单纯抗凝及系统溶栓相比较,导管溶栓联合抗凝能降低急性下肢DVT转归为PTS的发生率,改善临床症状,提高生活质量.%Objective To explore the outcomes of anticoagulation,systematic thrombolysis and catheter-directed thrombolysis (CDT) in the treatment of lower extremity acute deep venous thrombosis (DVT).Methods The clinical data of 152 patients with lower extremity acute DVT from January 2005 to December 2009 were analyzed retrospectively.They were divided into single anticoagulation group (A),systematic thrombolysis plus anticoagulation group (B) and CDT plus anticoagulation group (C).Follow-up studies were performed

  12. Congenital agenesis of inferior vena cava: a rare cause of unprovoked deep venous thrombosis.

    Science.gov (United States)

    Parsa, Pouria; Lane, John S; Barleben, Andrew R; Owens, Erik L; Bandyk, Dennis

    2015-07-01

    Congenital anomalies of the inferior vena cava (IVC), although rare, are a risk factor for lower limb deep venous thrombosis (DVT). A 19-year-old male presented with a left flank and groin pain caused by iliofemoral venous thrombosis. Vascular imaging by computed tomography (CT) scanning and venography demonstrated agenesis of the IVC. Catheter-directed thrombolysis via a popliteal vein was attempted but did not alter the patency of the common femoral vein outflow collaterals into the retroperitoneal azygous venous system. The patient was anticoagulated using systemic heparin infusion and clinical symptoms resolved within 5 days. He was transitioned to oral Coumadin anticoagulation, and follow-up venous duplex testing demonstrated no infrainguinal DVT and phasic venous flow with respiration in the femoral vein indicating patent collateral veins. Anomalies of the IVC are present in 0.3-0.5% of otherwise healthy individuals. Agenesis of the IVC has an incidence of 0.0005-1% in the general population but is found in almost 5% of patients venous collaterals on noncontrast CT imaging. In young adults presenting with unprovoked lower limb DVT, the presence of an IVC anomaly should be considered and evaluated for by venous duplex testing and if necessary CT venography.

  13. Endovascular treatment options in the management of lower limb deep venous thrombosis.

    Science.gov (United States)

    Nazir, Sarfraz Ahmed; Ganeshan, Arul; Nazir, Sheraz; Uberoi, Raman

    2009-09-01

    Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.

  14. Acquired and Heritable Thrombophilia in Indian Patients With Pediatric Deep Venous Thrombosis (DVT).

    Science.gov (United States)

    Pai, Navin; Ghosh, Kanjaksha; Shetty, Shrimati

    2014-09-01

    Deep venous thrombosis (DVT) in children is more often associated with underlying pathological conditions than with hereditary thrombophilia. The present study is a retrospective analysis of thrombophilia in 285 pediatric patients with venous thrombosis at different sites. Four common thrombophilia markers, that is protein C, protein S, antithrombin III, and factor V Leiden (FVL) mutation, were analyzed. Thrombosis in hepatic and portal veins was more common in pediatric patients (73%) when compared to other sites (27%). Overall, hereditary thrombophilia accounted for 15.5% of the patients with venous thrombosis. The FVL mutation, which was the major causative factor in Budd-Chiari syndrome and portal vein thrombosis cases in the adult group, was not a major contributing factor in pediatric group, that is, 1.8% of the patients. In conclusion, the risk factors for venous thrombosis vary in different age groups.

  15. Incidence of deep venous thrombosis and stratification of risk groups in a university hospital vascular surgery unit

    Directory of Open Access Journals (Sweden)

    Alberto Okuhara

    2015-06-01

    Full Text Available BACKGROUND: There is a knowledge gap with relation to the true incidence of deep vein thrombosis among patients undergoing vascular surgery procedures in Brazil. This study is designed to support the implementation of a surveillance system to control the quality of venous thromboembolism prophylaxis in our country. Investigations in specific institutions have determined the true incidence of deep vein thrombosis and identified risk groups, to enable measures to be taken to ensure adequate prophylaxis and treatment to prevent the condition.OBJECTIVE: To study the incidence of deep venous thrombosis in patients admitted to hospital for non-venous vascular surgery procedures and stratify them into risk groups.METHOD: This was a cross-sectional observational study that evaluated 202 patients from a university hospital vascular surgery clinic between March 2011 and July 2012. The incidence of deep venous thrombosis was determined using vascular ultrasound examinations and the Caprini scale.RESULTS: The mean incidence of deep venous thrombosis in vascular surgery patients was 8.5%. The frequency distribution of patients by venous thromboembolism risk groups was as follows: 8.4% were considered low risk, 17.3% moderate risk, 29.7% high risk and 44.6% were classified as very high risk.CONCLUSION: The incidence of deep venous thrombosis in vascular surgery patients was 8.5%, which is similar to figures reported in the international literature. Most vascular surgery patients were stratified into the high and very high risk for deep venous thrombosis groups.

  16. Use of bisphosphonates and raloxifene and risk of deep venous thromboembolism and pulmonary embolism

    DEFF Research Database (Denmark)

    Vestergaard, P; Schwartz, K; Pinholt, E M;

    2010-01-01

    Prior studies have associated raloxifene and strontium ranelate with deep venous thromboembolism and pulmonary embolism. In a cohort study, we observed an increased risk also with the bisphosphonates. However, the increase was present already before the start of bisphosphonates pointing at an eff...

  17. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombos

    NARCIS (Netherlands)

    Tick, L.W.; Kramer, M.H.H.; Rosendaal, F.R.; Faber, W.R.; Doggen, C.J.M.

    2008-01-01

    Background: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). Objectives: To determine the risk of PTS after DVT and to assess risk factors for PTS. Methods: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk fa

  18. Lupus anticoagulants and the risk of a first episode of deep venous thrombosis

    NARCIS (Netherlands)

    De Groot, PG; Lutters, B; Derksen, RHWM; Lisman, T; Meijers, JCM; Rosendaal, FR

    2005-01-01

    We have determined lupus anticoagulants, anti-beta(2) glycoprotem I (beta(2)GPI) and antiprothrombin antibodies in the Leiden Thrombophilia Study, a population-based case-control study designed to determine risk factors for deep venous thrombosis (DVT). Lupus anticoagulant (LAC) was measured in 473

  19. Role of Color Flow Ultrasound in Detection of Deep Venous Thrombosis

    Science.gov (United States)

    Mohammed, Shelan Hakeem; AL-Najjar, Salwa A.

    2016-01-01

    Background: Deep vein thrombosis (DVT) of lower limbs is one of the most causes for the majority of death caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. Most venous thrombi are clinically silent. B-mode and color Doppler imaging is needed for early diagnosis of DVT to prevent complications and squeal of…

  20. Arterial complications, venous thromboembolism and deep venous thrombosis prophylaxis after anterior cruciate ligament reconstruction: A systematic review

    Science.gov (United States)

    Janssen, Rob Paulus Augustinus; Reijman, Max; Janssen, Daan Martijn; van Mourik, Jan Bernardus Antonius

    2016-01-01

    AIM To summarize the current knowledge on vascular complications and deep venous thrombosis (DVT) prophylaxis after anterior cruciate ligament (ACL) reconstruction. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. MEDLINE, EMBASE, Cochrane, Web of Science, CINAHL, PubMed publisher, and Google scholar medical literature databases were searched up to November 10, 2015. Any arthroscopic surgical method of primary or revision intra-articular ACL reconstruction of all graft types in humans was included. A risk of bias assessment was determined. RESULTS Fourty-seven studies were included in the review. Pseudaneurysms were the most frequently reported arterial complication after ACL reconstruction, irrespective of graft type or method of graft fixation with an incidence of 0.3%. The time to diagnosis of arterial complications after ACL reconstruction varied from days to mostly weeks but even years. After ACL reconstruction without thromboprophylaxis, the incidence of DVT was 9.7%, of which 2.1% was symptomatic. The incidence of pulmonary embolism was 0.1%. Tourniquet time > 2 h was related to venous thromboembolism. Thromboprophylaxis is indicated in patients with risk factors for venous thromboembolism. CONCLUSION After ACL reconstruction, the incidence of arterial complications, symptomatic DVT and pulmonary embolism was 0.3%, 2.1% and 0.1% respectively. Arterial complications may occur with all types of arthroscopic ACL reconstruction, methods of graft fixation as well as any type of graft. Patients considered to be at moderate or high risk of venous thromboembolism should routinely receive thromboprophylaxis after ACL reconstruction. PMID:27672574

  1. Optimal timing by contrast media of deep venous thrombosis. Study of whole body contrast media by helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Taniyama, Hidemi; Seto, Kazuto [Kagoshima City Hospital (Japan)

    2002-11-01

    The contrast media of deep veins in the lower extremities reaches there more slowly and is more variable than the arrival time in an artery. Therefore, it was worried about the contrast media by CT of deep venous thrombosis (suspect) due to the injection speed and the setup of delay time. On this occasion, before examining deep venous thrombosis, I refer to the data of CT volume of each department place and the arrival time contrast media by whole body CT and has applied to delay time examination of deep venous thrombosis (suspect). (author)

  2. Deep Venous Thrombosis in Teen With Crouzon Syndrome Post-Le Fort III Osteotomy With Rigid External Distraction.

    Science.gov (United States)

    Roussel, Lauren O; Myers, Rene P; Girotto, John A

    2015-11-01

    Venous thromboembolic events are rare in pediatric patients. Risk factors associated with the development of venous thromboembolic events in pediatric patients include the use of central venous catheters, hospitalization, cancer, sepsis, trauma, surgery, and congenital prothrombotic disorders.The authors present the case of a 14-year-old man with Crouzon syndrome who required Le Fort III osteotomy with rigid external distraction for significant midface hypoplasia who presented postoperatively with an extensive deep venous thrombosis. This is the first reported case of symptomatic venous thrombosis post-Le Fort III osteotomy and rigid external distraction. Although rare, surgeons should be aware of this potential complication.

  3. [A lost Seldinger technique guide wire as the cause of deep venous thrombosis].

    Science.gov (United States)

    Flessenkämper, I; Marcus, M

    2001-09-01

    Five months after the initial abdominal surgery, a female patient presented with a deep venous thrombosis of the right leg. A guide wire, lost during perisurgical insertion of a central venous catheter using Seldinger's technique, was identified and surgically removed. The guide wire had previously remained undetected despite regular radiological controls. The article presents details of the case together with a review of the literature regarding potential complications of Seldinger's technique. Common reasons and possible options for preventive and therapeutic strategies will be discussed.

  4. Unmasking a young adult migratory deep venous thrombosis--case report.

    Science.gov (United States)

    Haliga, Raluca; Drug, V L; Negru, D; Ambarus, V; Neghina, Ionela; Sorodoc, L

    2013-01-01

    Venous thromboembolism is a known complication of cancer which impacts on patient mortality and quality of life. The primary site of cancer is an important risk factor, with highest rates observed in patients with brain, pancreas, gastric, kidney, ovary and lung cancers. The extent of metastatic spread further adds to the risk. In this article, we present the case of a young patient who was diagnosed with an aggressive form of pancreatic neoplasm with secondary determinations, without any previous digestive symptoms, with the occasion of a recurrent and migratory deep venous thrombosis (DVT).

  5. Perioperative treatment of femoral neck fracture with deep venous thrombosis: A case report

    Institute of Scientific and Technical Information of China (English)

    Ming Liu; Lei Liu; Fuguo Huang; Yue Fang; Gang Zhong; Zhou Xiang

    2015-01-01

    Deep venous thrombosis (DVT) is an important cause of disability and mortality after major orthopedic surgery.The roles of perioperative treatment and prevention of DVT in patients with femoral neck fractures who require major surgery have not yet been well explored in Chinese clinical practice.Here we report a case of calf muscular venous thrombosis in a 55-year-old woman with femoral neck fracture before surgery.Preventive and treatment measures including the administration of heparin sodium, application of venous foot pump and placement of inferior vena cava filter were taken.The condition of the patient was stable during the perioperative period and the surgery was successful.Besides, postoperative examination showed that the femur healed well and the functional recovery was satisfactory.Our results suggest that femoral neck fracture patients combined with DVT can receive surgery after accurate preoperative assessment and proper preoperative treatment.

  6. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  7. A follow-up study of the fate of small asymptomatic deep venous thromboses

    Directory of Open Access Journals (Sweden)

    Persson Lena M

    2010-02-01

    Full Text Available Abstract Background Postoperative asymptomatic deep venous thromboses (ADVT can give rise to posttthrombotic syndrome (PTS, but there are still many unresolved issues in this context. For example, there is a lack of knowledge regarding the fate of small ADVT following minor orthopedic surgery. This follow-up study evaluates postthrombotic changes and clinical manifestations of PTS in a group of patients with asymptomatic calf vein DVT after surgery for Achilles tendon rupture. Methods Forty-six consecutive patients with distal ADVT were contacted and enrolled in a follow-up consisting of a single visit at the hospital at a mean time of 5 years postoperatively, including clinical examination and scoring, ultrasonography and venous plethysmography. All patients had participated in DVT-screening with colour duplex ultrasound (CDU 3 and 6 weeks postoperatively and 80% of them were treated with anticoagulation. Results With CDU postthrombotic changes and deep venous reflux were detected at follow-up in more than 50% of the patients, more commonly in somewhat larger calf DVT:s initially affecting more than one vessel. However, only about 10% of the patients had significant venous reflux according to venous plethysmography. No patient had plethysmographic evidence of remaining outflow obstruction, but presence of postthrombotic changes shown with CDU negatively influenced venous outflow capacity measured with plethysmography. A clinical entity of PTS was rarely found and occurred only in two patients (4% and then classified by Villalta scoring as of mild degree with few clinical signs of disease. Distal ADVT:s detected in the early postoperative period (3 weeks showed DVT-progression in 75% of the limbs that were still immobilized and without anticoagulation. Conclusions Asymptomatic postoperative distal DVT:s following surgery for Achilles tendon rupture have a good prognosis and a favourable clinical outcome. In our material of 46 patients the

  8. Acute Portomesenteric Venous Thrombosis following Laparoscopic Small Bowel Resection and Ventral Hernia Repair

    Directory of Open Access Journals (Sweden)

    Bhradeev Sivasambu

    2015-01-01

    Full Text Available Acute portomesenteric venous thrombosis is a rare but life-threatening complication of laparoscopic surgery that has been described in literature. Prompt diagnosis and early initiation of treatment are vital to prevent life-threatening complications such as mesenteric ischemia and infarction. A 51-year-old lady had laparoscopic small bowel resection and primary anastomosis with ventral hernia repair 4 weeks earlier for partial small bowel obstruction. Her postoperative period was uneventful and she was discharged home. Four weeks after surgery she developed watery diarrhea and generalized abdominal pain for four-day duration. A computed tomography of the abdomen revealed portomesenteric venous thrombosis although a computed tomography of abdomen before surgery 4 weeks back did not show any portomesenteric venous thrombosis. We are reporting a case of acute portomesenteric venous thrombosis as a complication of laparoscopic surgery.

  9. Catheter-directed thrombolysis of below-knee deep venous thrombosis of the lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk; Sohn, Young Jun; Heo, Eun A; Cho, Hyun Sun; Park, Seong Hoon; Lee, Young Hwan [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2008-02-15

    To evaluate the technical feasibility and clinical efficacy of the use of local thrombolysis for below-knee deep vein thrombosis (DVT). From a population of 41 patients with a lower extremity DVT, the prospective clinical trial included 11 patients (7 female, 4 male, average age 61.4 years) treated with catheter-directed thrombolysis with urokinase for below-knee DVT. After removal of the proximal ilofemoral DVT, additional interventional procedures to remove the residual thrombosis and restore the venous flow from the below-knee vein were performed in cases of continuous occlusion of venous flow from the popliteal and tibial veins. Under ultrasound (US) guidance, catheter-directed thrombolysis with urokinase was performed through the ipsilateral popliteal vein. After administration of oral anticoagulation therapy, CT and venography were performed to identify patency and the presence of a recurrent thrombosis. Successful removal of the thrombus and restoration of venous flow were achieved in all of the patients (100%). Restoration of flow with a residual thrombus occurred in one case. Focal venous stenosis was discovered in four cases. The duration of urokinase infusion was 1-4 days (average 2.36 days), which was considered long. For 15.2 months, the venous lumen of all cases was preserved without a recurrent thrombosis. Catheter-directed thrombolysis is an effective procedure for recanalization of below-knee DVT in patients with a lower extremity DVT.

  10. Iliofemoral and iliocaval interventions in deep venous thrombosis; Iliofemorale und iliocavale Interventionen bei tiefer Venenthrombose

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    2005-05-01

    Significant spontaneous thrombus disintegration in deep venous thrombosis (DVT) occurs very infrequently. On the contrary, these thrombi are prone to appositional growth and migration into the pulmonary arteries. The development of chronic venous insufficiency due to postthrombotic syndrome is a frequent consequence of DVT. Therapeutic options in DVT include anticoagulation and recanalising procedures such as thrombolysis and thrombectomy. After appropriate indication assessment, the interventional radiologist can offer an efficacy-proven minimally-invasive vessel restitution approach by performing locoregional thrombolysis, pharmacomechanical therapy or, particularly in iliocaval thrombosis, mechanical thrombectomy. These methods not only serve to restitute of vessel patency, but also allow preserving venous valve function. In DVT with recurrent pulmonary embolism, retrievable filters with extended implantation duration can be deployed. In chronic proximal venous flow obstruction or in case of significant residual stenosis after thrombolysis, balloon angioplasty with stent implantation is the treatment modality of choice. Consequently, the radiologist can adopt an important role in the treatment of extensive venous disease. In this article, the treatment modalities concerning iliofemoral and iliocaval thrombosis are demonstrated and illustrated. (orig.)

  11. Catheter-directed thrombolysis for double inferior vena cava with deep venous thrombosis: A case report and literature review.

    Science.gov (United States)

    Wang, Xiaodong; Chen, Zhengxin; Cai, Qianrong

    2014-08-01

    Double inferior vena cava (DIVC) with deep venous thrombosis (DVT) is rare, and there is only one reported case of DIVC with DVT treated by catheter-directed thrombolysis. We report a case of a 32-year-old man with an extensive venous clot involving the infrarenal segment of a double IVC who received filter implantation and catheter-directed thrombolysis.

  12. Neonatal deep white matter venous infarction and liquefaction: a pseudo-abscess lesion

    Energy Technology Data Exchange (ETDEWEB)

    Ruess, Lynne; Rusin, Jerome A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States); The Ohio State University College of Medicine and Public Health, Columbus, OH (United States); Dent, Carly M.; Tiarks, Hailey J.; Yoshida, Michelle A. [Nationwide Children' s Hospital, Department of Radiology, Columbus, OH (United States)

    2014-11-15

    Deep white matter hemorrhagic venous infarction with subsequent cavitation due to necrosis and liquefaction has been described in neonates and may be associated with infection and meningitis. In our experience, the MRI pattern of these lesions is confused with the pattern seen with cerebral abscesses. The purpose of our study was to characterize the MRI findings of post infarction necrosis and liquefaction after hemorrhagic deep white matter venous infarction in infants and to distinguish these lesions from cerebral abscesses. An institutional review board approved a retrospective review of imaging records to identify all patients with cerebral venous infarction at a children's hospital during a 10-year period. Nine infants had deep white matter hemorrhagic venous infarction with white matter fluid signal cavitary lesions. A diagnosis of cerebral abscess was considered in all. The imaging and laboratory findings in these patients are reviewed and compared to descriptions of abscesses found in the literature. There were six female and three male infants. The mean age at presentation was 20 days (range: 0-90 days), while the corrected age at presentation was less than 30 days for all patients. Seven patients presented with seizures and signs of infection; one infant presented with lethargy and later proved to have protein C deficiency. MRI was performed 0-12 days from presentation in these eight patients. Another patient with known protein C deficiency underwent MRI at 30 days for follow-up of screening US abnormalities. There were a total of 38 deep cerebral white matter fluid signal cavitary lesions: 25 frontal, 9 parietal, 2 temporal, 2 occipital. Larger lesions had dependent debris. All lesions had associated hemorrhage and many lesions had evidence of adjacent small vessel venous thrombosis. Lesions imaged after gadolinium showed peripheral enhancement. Three lesions increased in size on follow-up imaging. Three patients, two with meningitis confirmed via

  13. Deep venous thrombosis due to massive compression by uterine myoma

    Directory of Open Access Journals (Sweden)

    Aleksandra Brucka

    2010-10-01

    Full Text Available A 42-year-old woman, gravida 3, para 3 was admitted to hospital because of painful oedema of her right lower extremity. Initial physical examination revealed a gross, firm tumour filling the entire peritoneal cavity. Doppler ultrasound scan revealed a thrombus in the right common iliac vein, extending to the right femur and popliteal veins, and partially into the calf deep vein. Computed tomography confirmed the existence of an abdominal tumour probably deriving from the genital organs and the presence of a thrombus in the said veins.The patient underwent hysterectomy where a myomatous uterine was removed. She was put on subcutaneous enoxaparine and compressive therapy of the lower extremities. Such symptoms as pain and oedema receded. Control Doppler scan showed fibrinolysis, partial organization of the thrombus and final vein recanalisation. After exclusion of other risk factors of deep vein thrombosis apart from stasis, we conclude that the described pathology was the effect of compression of regional pelvic structures by a uterine myoma.

  14. Risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease combined with deep venous thrombosis%慢性阻塞性肺疾病急性加重期合并深静脉血栓形成危险因素及抗凝因子检测

    Institute of Scientific and Technical Information of China (English)

    孙建英; 刘飒; 王红阳; 刘晨; 刘新茹; 贾红光

    2010-01-01

    Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P 3 d、吸烟、机械通气的例数增多及住院时间延长(P<0.01),动脉血二氧化碳分压(PaCO2)增高(P<0.05);抗凝血酶Ⅲ活性、蛋白S含量下降(P<0.05)及血D-二聚体含量增加(P<0.05).结论 造成AECOPD患者制动的因素如长期卧床及吸烟、机械通气是发生DVT的高危因素;且Ⅱ型呼吸衰竭的患者更容易合并DVT;AECOPD合并DVT患者存在纤溶功能失衡状态,应监测纤溶指标变化.

  15. Elevated Fibrinogen Levels Associate with Risk of Pulmonary Embolism, but not with Deep Venous Thrombosis

    DEFF Research Database (Denmark)

    Klovaite, Jolanta; Nordestgaard, Børge G; Tybjærg-Hansen, Anne;

    2013-01-01

    RATIONALE: It is unclear whether elevated plasma fibrinogen associates with both deep venous thrombosis(DVT) and its complication pulmonary embolism(PE), and whether elevated fibrinogen is a direct cause of these disorders. OBJECTIVES: We tested the hypotheses that elevated plasma fibrinogen...... relationship using a Mendelian randomization approach, we genotyped for FGB(rs1800790; rs4220) encoding fibrinogen beta chain. MEASUREMENTS AND MAIN RESULTS: Increasing plasma fibrinogen quintiles associated with increased risk of PE in combination with DVT(P-trend...

  16. Thrombus Size is Associated with Etiology of Deep Venous Thrombosis – A Cross-Sectional Study

    OpenAIRE

    2005-01-01

    The aim of this study was to evaluate the impact of risk factors for deep vein thrombosis (DVT) on thrombus sizes in lower extremities. The size and extent of thrombus was scored according to International Consensus Committee for venous disease classification. After the diagnosis of DVT was established and its size scored, predominant risk factors for DVT in each patient were identified (malignant disease, thrombophilia, postoperative state, hormonal therapy, heredity, limb trauma, immobiliza...

  17. Bilateral catheter-directed thrombolysis in a patient with deep venous thrombosis caused by a hypoplastic inferior vena cava

    NARCIS (Netherlands)

    Sloot, S.; Van Nierop, J.; Kootstra, J. J.; Wittens, C.; Fritschy, W. M.

    2015-01-01

    Introduction Deep venous thrombosis treatment using catheter-directed thrombolysis is advocated over systemic thrombolysis because it reduces bleeding complications. With the development of a catheter that combines ultrasound vibrations and the local delivering of thrombolytics, new and safer treatm

  18. Comparison of four clinical scores for the predicting lower limb deep venous thrombosis in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Li Zhua; Min Liu; Xiaojuan Guo; Jianguo Wang; Youmin Guo; Chen Wang; Hongxia Ma; Yulin Guo

    2008-01-01

    To evaluate Wells, Kahn, St.Andr é and Constans scores for the prediction of deep venous thrombosis in Chinese patients.Methods:One hundred and seventy-two patients, prospectively, blinded referred for evaluation with four clinical-score systems for suspected deep venous thrombosis, were examined by ultrasonography.Sensitivity, specificity, positive predictive value, nega- tive predictive value and receiver operation curves were calculated for four clinical scores.The difference between areas of the ROC curve for each of the scores was compared with others and reference line.Results:Forty-six of 172 patients had deep venous throm- bosis proven by sonography.The sensitivity, specificity, positive predictive value and negative predictive value for Wells score was 91.3%, 27.4% and 74.2% respectively, for Constans score; 95.7%, 34.9%, 34.9% and 95.7% respectively.Area under ROV curve of Constans with the reference line.Conclusion:Based on the results of our study, the sensitivity, negative prediction value and area under ROC Considering the aim of the clinical assessment, Constans score and Wells score are more efficient for Chinese hospitalized patients.

  19. Continuous veno venous hemofiltration in treatment of acute necrotizing pancreatitis

    Institute of Scientific and Technical Information of China (English)

    谢红浪; 季大玺; 龚德华; 刘芸; 徐斌; 周红; 刘志红; 黎磊石; 李维勤; 全竹富; 黎介寿

    2003-01-01

    Objective To investigate the effectiveness of using continuous veno venous hemofiltration (CVVH) in the treatment of acute necrotizing pancreatitis (ANP). Methods Thirteen ANP patients were involved in this study, including 4 females and 9 males, averaging 50.6±10.8 years old. CT scans upon admission revealed 33% necrosis involving the body of the pancreas in 2 patients, 67% necrosis in 3 patients and 100% necrosis in the other 8; the CT severity score was 8.9±2.1. CVVH was maintained for at least 72 hours and the AN69 hemofilter (1.2 m2) was changed every 24 hours. The ultrafiltration rate during CVVH was 2993.9±983.0 ml/h, the blood flow rate was 250-300 ml/min, and the substitute fluid was infused in a pre-diluted manner. Low molecular weight heparin was used as anticoagulant. Results CVVH was well tolerated in all the patients. Bloody abdominal cavity drainage fluid was observed in 2 patients, but no other side-effects related with CVVH were observed. Two patients died of systemic fungal infections and another died of intracranial fungi infection, resulting in an ICU mortality of 23.1%. Ten of the patients survived in the ICU, but one of them died for other reasons unrelated to the SAP before discharge. The APACHE Ⅱ score before CVVH was 15.2±6.5, but decreased significantly to 8.1±5.3, 7.5±4.9 and 8.0±5.2 at the 24th, 48th and 72nd hour after CVVH, respectively (P<0.01). Serum concentration of IL-1β and TNFα decreased to the trough at the 6th hour after a new hemofilter was used and increased slowly to pre-CVVH levels 12 hours later. After CVVH had ceased, the serum levels of two cytokines increased to their peaks at the 120th hour and decreased eventually at the 144th hour. The sieving coefficient (SC) of IL-1β and TNFα was 0.33±0.11 and 0.16±0.08. Conclusion CVVH offered therapeutic options for ANP and was well tolerated resulting in clearance of IL-1β and TNFα; CVVH at early stages of SAP may contribute to the improvement of outcome.

  20. Arteriovenous Fistula Complicated by Popliteal Venous Access for Endovascular Thrombolytic Therapy of Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Sung Su; Kim, Jeong Ho; Park, Chul Hi; Hwang, Hee Young; Kim, Hyung SiK [Gacheon University Gil Medical Center, Gacheon (Korea, Republic of); Jeon, Young Sun; Kim, Won Hong [Inha University College of Medicine, Incheon (Korea, Republic of)

    2008-10-15

    We report a case of an iatrogenic arteriovenous fistula complicated by catheter- directed thrombolytic therapy in a patient with acute deep vein thrombosis of a lower extremity. To the best of our knowledge, this is the first report of an arteriovenous fistula between the sural artery and popliteal vein in that situation. As the vessels have a close anatomical relationship, the arteriovenous fistula seems to be a potential complication after endovascular thrombolytic therapy of acute deep vein thrombosis.

  1. Early diagnosis of lower extremity deep venous thrombosis and therapeutic effect of anticoagulation therapy with Roberts' age adjusted warfarin loading protocol in patients with acute ischemic stroke%急性脑梗死患者下肢深静脉血栓的诊断及华法林抗凝治疗的疗效和安全性

    Institute of Scientific and Technical Information of China (English)

    罗伟良; 刘武; 邱金华; 许南燕; 李才明; 温红

    2009-01-01

    Objective To explore the early diagnosis of lower extremity deep venous thrombosis (LDVT)and evaluate the therapeutic effect of anticoagulant therapy in hospitalized patients with acute ischemic stroke. Methods According to Wells model for suspecting lower extremity deep venous thrombosis,patients with suspected LDVT were confirmed by compression ultrasonography. If the patients diagnosed with LDVT had no contraindications to anticoagulant therapy,they were treated with low molecular weight heparin(LMWH)subcutaneous injection and oral warfarin at the same time.The dosage of oral warfarin was determined by Roberts'age adjusted warfarin loading protocol.LMWH was stopped when the patients'international normalized ratio(INR)was 2.0~3.0 for two consecutive days. Results From January 2003 to August 2007,2067 cases with acute ischemic stroke were admitted to the department of neurology in Huizhou Municipal Central Hospital including 18 cases with LDVT and the incidence was 0.9%.The patients with LDVT all had paralytic extremities including 13 left legs and 5 right legs with deep vein thrombosis.All the 18 cases were treated by anticoagulant including 17 cases with oral warfarin treatment for 3 months.Symptoms in all LDVT patients were eliminated.12 cases had been observed for one year and 5 cases for three months after they stopped taking warfatin.There were no patients with pulmonary thromboembolism and LDVT recurrence. Conclusions By using Wells model for suspecting LDVT,patients with acute ischemic stroke-complicated LDVT can be timely diagnosed.The goal of prompt and enough anticoagulant can be achieved according to Roberts'age adjusted warfarin loading protocol.Because of racial difference,population difference and other unknown factors,the incidence of acute ischemic stroke patients with complicated LDVT is much lower in Huizhou.It suggests that it should be unnecessary to use LMWH in patients with acute ischemic stroke to prevent LDVT in Huizhou.%目的 探

  2. Deep venous thrombosis: The valve cusp hypoxia thesis and its incompatibility with modern orthodoxy.

    Science.gov (United States)

    Malone, P Colm; Agutter, Paul S

    2016-01-01

    The valve cusp hypoxia thesis (VCHT) of the aetiology of deep venous thrombosis (DVT) was adumbrated in this journal in 1977 and fully articulated in 2008, the original hypothesis having been strongly corroborated by experiments published in 1981 and 1984. It presents a unitary account of the pathogenesis of venous thrombosis and embolism that is rooted in the pathophysiological tradition of Hunter, Virchow, Lister, Welch and Aschoff, a tradition traceable back to Harvey. In this paper we summarise the thesis in its mature form, consider its compatibility with recent advances in the DVT field, and ask why it has not yet been assimilated into the mainstream literature, which during the past half century has been dominated by a haematology-orientated 'consensus model'. We identify and discuss seven ways in which the VCHT is incompatible with these mainstream beliefs about the aetiology of venous thrombosis, drawing attention to: (1) the spurious nature of 'Virchow's triad'; (2) the crucial differences between 'venous thrombus' and 'clot'; the facts that (3) venous thrombi form in the valve pockets (VVPs), (4) DVT is not a primarily haematological condition, (5) the so-called 'thrombophilias' are not thrombogenic per se; (6) the conflict between the single unitary aetiology of DVT and the tacit assumption that the condition is 'multicausal'; (7) the inability of anticoagulants to prevent the initiation of venous thrombogenesis, though they do prevent the growth of thrombi to clinically significant size. In discussing point (7), we show that the VCHT indicates new approaches to mechanical prophylaxis against DVT. These approaches are then formulated as experimentally testable hypotheses, and we suggest methods for testing them preclinically using animal trials.

  3. Acute on Chronic Venous Thromboembolism on Therapeutic Anticoagulation

    Directory of Open Access Journals (Sweden)

    Byron Bassi

    2013-01-01

    Full Text Available A case of proximal venous thromboembolism in a patient who presented to the ED with lower extremity pain is presented. Making this diagnosis is very important as fifty percent of patients with symptomatic proximal DVTs will go on to develop PE without treatment. This report underscores the utility of bedside ultrasonography in the emergency department.

  4. Acute venous thrombosis as complication and clue to diagnose a SAPHO syndrome case. A case report.

    Science.gov (United States)

    Rosero, A; Ruano, R; Martin, M; Hidalgo, C; Garcia-Talavera, J

    2013-01-01

    This report concerns a male adult admitted for sternal and left arm pain, who was diagnosed and treated for acute deep venous thrombosis in the left subclavian and axillary veins. X-ray and a hybrid single photon emission tomography and computed tomography (SPECT-CT) scintigraphy scan revealed high intensity uptake in both sternoclavicular joints, which corresponded to hyperostosis, thereby suggesting a SAPHO syndrome. Upon reviewing the patient's medical history, we found dermatological pustulosis disease and an intermittent sternal chest pain untreated since 10 years ago. In the biochemical study we found erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevation, hyperglobulinemia, and mild anaemia. Initial treatment included nonsteroidal anti-inflammatory drugs (NSAIDs) with low response, which then changed to methotrexate, sulfasalazine, and prednisone. The patient's pain was controlled almost completely in 10 months. A control bone scan revealed a marked decrease in intensity of bone deposits according to clinical response. To our knowledge, there are only a few cases of SAPHO and thrombosis and none are followed up with a bone SPECT-CT scan.

  5. Extensive Deep Venous Thrombosis in a Patient with Neurolept Malignant Syndrome despite Being on Prophylaxis

    Directory of Open Access Journals (Sweden)

    Jerrin C. Mathew

    2011-01-01

    Full Text Available The risk of venous thromboembolism (VTE in patients with Neuroleptic malignant syndrome (NMS and those on antipsychotic medications is well established. We present here a case whereby the patient had NMS and developed extensive deep venous thrombosis (DVT despite being on standard DVT Prophylaxis. Our case illustrates that empiric intravenous heparin for the initial few days after the onset of NMS may be considered in those with high risk of VTE, as in such patients standard DVT prophylaxis may not be sufficient. To standardize as to which patients with NMS would be at the highest risk of VTE while on standard DVT prophylaxis, the role of a standardized scoring system and a double-blind randomized trial in the future would probably be beneficial.

  6. Novel treatment techniques for recanalization of femoral-popliteal deep venous occlusion from chronic thrombosis.

    Science.gov (United States)

    Spencer, Elizabeth Brooke; Stratil, Peter; Mizones, Heidi

    2014-06-01

    Patients with postthrombotic syndrome due to previous femoral-popliteal deep venous thrombosis often experience lifestyle-limiting lower-extremity pain and swelling. Conservative treatment options include compression stockings and lymphedema massage, but in many cases these treatments only temporarily and partially improve symptoms. Ultrasound and venography in patients with postthrombotic syndrome often show only partial recanalization of the femoral vein with significant collateral vein formation. These abnormal veins are insufficient for adequate venous drainage from the lower extremity as evidenced by the patient's continued symptoms. Recanalization of the occluded or partially occluded femoral vein using prolonged venoplasty, with or without chemical thrombolysis, combined with optimizing anticoagulation and conservative treatment measures, results in lasting improvement in symptoms for a high percentage of patients.

  7. Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

    Directory of Open Access Journals (Sweden)

    Duicu Carmen

    2016-06-01

    Full Text Available Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

  8. Venous thromboembolism in adults treated for acute lymphoblastic leukaemia: Effect of fresh frozen plasma supplementation

    NARCIS (Netherlands)

    I. Lauw (Ivoune); B. van der Holt (Bronno); S. Middeldorp (Saskia); J.C.M. Meijers; J.J. Cornelissen (Jan); B.J. Biemond (Bart)

    2013-01-01

    textabstractTreatment of acute lymphoblastic leukaemia (ALL) is frequently complicated by venous thromboembolism (VTE). The efficacy and optimal approach of VTE prevention are unclear, particularly in adult patients. We assessed the effect of thromboprophylaxis on symptomatic VTE incidence in cycle

  9. Placing of tunneled central venous catheters prior to induction chemotherapy in children with acute lymphoblastic leukemia

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Frydenberg, Morten

    2010-01-01

    BACKGROUND: Tunneled central venous catheters (CVCs) are inevitable in children with acute lymphoid leukemia (ALL). The aim of this study was to evaluate the risk of CVC-related complications in children with ALL in relation to timing of catheter placement and type of catheter. PROCEDURE: All chi...

  10. Acutely altered hemodynamics following venous obstruction in the early chick embryo.

    Science.gov (United States)

    Stekelenburg-de Vos, Sandra; Ursem, Nicolette T C; Hop, Wim C J; Wladimiroff, Juriy W; Gittenberger-de Groot, Adriana C; Poelmann, Robert E

    2003-03-01

    In the venous clip model specific cardiac malformations are induced in the chick embryo by obstructing the right lateral vitelline vein with a microclip. Clipping alters venous return and intracardiac laminar blood flow patterns, with secondary effects on the mechanical load of the embryonic myocardium. We investigated the instantaneous effects of clipping the right lateral vitelline vein on hemodynamics in the stage-17 chick embryo. 32 chick embryos HH 17 were subdivided into venous clipped (N=16) and matched control embryos (N=16). Dorsal aortic blood flow velocity was measured with a 20 MHz pulsed Doppler meter. A time series of eight successive measurements per embryo was made starting just before clipping and ending 5h after clipping. Heart rate, peak systolic velocity, time-averaged velocity, peak blood flow, mean blood flow, peak acceleration and stroke volume were determined. All hemodynamic parameters decreased acutely after venous clipping and only three out of seven parameters (heart rate, time-averaged velocity and mean blood flow) showed a recovery to baseline values during the 5h study period. We conclude that the experimental alteration of venous return has major acute effects on hemodynamics in the chick embryo. These effects may be responsible for the observed cardiac malformations after clipping.

  11. Ultrasound Screening for Deep Venous Thrombosis Detection: A Prospective Evaluation of 200 Plastic Surgery Outpatients

    Directory of Open Access Journals (Sweden)

    Eric Swanson, MD

    2015-03-01

    Conclusions: The natural history of thromboembolism in plastic surgery outpatients differs from orthopedic patients. The risk of a deep venous thrombosis in a patient treated with Spontaneous breathing, Avoid gas, Face up, Extremities mobile anesthesia is approximately 0.5%. Thromboses are unlikely to develop intraoperatively. In the single affected patient, the thrombosis was located distally, in a location that is less prone to embolism and highly susceptible to anticoagulation. Ultrasound screening is an effective and highly feasible method to identify affected patients for treatment.

  12. Double-edged sword in the heart: trapped deep venous thrombus in a patent foramen ovale.

    Science.gov (United States)

    Acikel, Sadik; Ertem, Ahmet G; Kiziltepe, Ugursay; Dogan, Mehmet; Kilic, Harun; Yeter, Ekrem

    2012-10-01

    Trapped thrombus in a patent foramen ovale is a rare condition. Echocardiography is the main tool for diagnosis and for determination of the treatment to choose. There are a number of treatment options for trapped deep venous thrombus in a patent foramen ovale, including surgical thrombectomy, thrombolytics, and anticoagulant therapy. All patients should be evaluated individually, because the systemic and pulmonary thromboembolism risk of all treatment options is like a 'double-edged sword'. Here, we report a case of a patient with trapped thrombus in the patent foramen ovale detected by echocardiography, and successfully treated with surgical thrombectomy under extracorporeal circulation.

  13. Diagnosis of deep venous thrombosis. A review of radiologic, radionuclide, and non-imaging methods

    Energy Technology Data Exchange (ETDEWEB)

    Jacobson, A. F. [University of Washington, Puget Sound Health Care System, Nuclear Medicine Section, Washington (United States)

    2001-12-01

    Accurate diagnosis of deep venous thrombosis (DVT) can be achieved through appropriate use of the various imaging and non-imaging techniques currently available in clinical practice. This paper summarizes the roles of imaging techniques such as duplex ultrasound, contrast and radionuclide venography, and magnetic resonance imaging, as well as clinical prediction models and D-dimer testing, in the evaluation of patients with suspected DVT. Recent data examining the prognostic value of several of these tests, alone and in combination, are also reviewed. The associations of testing for DVT and pulmonary embolism, and the controversies which sometimes surround them, are also briefly examined.

  14. Deep venous thrombosis and pulmonary embolism detected by FDG PET/CT in a patient with bacteremia

    DEFF Research Database (Denmark)

    Nielsen, Anne Lerberg; Thomassen, Anders; Hess, Søren;

    2013-01-01

    We report incidental FDG PET/CT findings of deep venous thrombosis and pulmonary embolism in a patient with bacteremia. In this patient, diagnosis of thromboembolism was not considered until FDG PET/CT imaging was performed, and the findings prompted immediate anticoagulant therapy. The role of FDG...... PET/CT in venous thromboembolism is not yet well established, but the potential benefit must be kept in mind when interpreting FDG PET/CT images regardless of the underlying disease....

  15. Deep vein thrombosis after spine operation in prone position with subclavian venous catheterization: a case report.

    Science.gov (United States)

    Cho, Jae Kyung; Han, Jin Hee; Park, Sung Wook; Kim, Keon Sik

    2014-07-01

    We experienced a case of deep vein thrombosis after spine surgery in the prone position with a central venous catheter (CVC). Posterior lumbar interbody fusion was performed on a 73-year-old female patient who was diagnosed with spinal stenosis. Accordingly, in the operation room under general anesthesia, two-lumen CVC were inserted into the left subclavian vein. The surgery was performed in the prone position with a Wilson frame. On the next day, there was a sudden occurrence of severe edema in the patient's left arm. By ultrasonography and computed tomography scanning, extensive deep vein thrombosis was observed in the left subclavian vein. The existence of a factor affecting blood flow such as the prone position may increase the risk of thrombus formation. Therefore, careful perioperative evaluation should be implemented.

  16. The use of micro-/milli-fluidics to better understand the mechanisms behind deep venous thrombosis

    Science.gov (United States)

    Schofield, Zoe; Alexiadis, Alessio; Brill, Alexander; Nash, Gerard; Vigolo, Daniele

    2016-11-01

    Deep venous thrombosis (DVT) is a dangerous and painful condition in which blood clots form in deep veins (e.g., femoral vein). If these clots become unstable and detach from the thrombus they can be delivered to the lungs resulting in a life threatening complication called pulmonary embolism (PE). Mechanisms of clot development in veins remain unclear but researchers suspect that the specific flow patterns in veins, especially around the valve flaps, play a fundamental role. Here we show how it is now possible to mimic the current murine model by developing micro-/milli-fluidic experiments. We exploited a novel detection technique, ghost particle velocimetry (GPV), to analyse the velocity profiles for various geometries. These vary from regular microfluidics with a rectangular cross section with a range of geometries (mimicking the presence of side and back branches in veins, closed side branch and flexible valves) to a more accurate venous representation with a 3D cylindrical geometry obtained by 3D printing. In addition to the GPV experiments, we analysed the flow field developing in these geometries by using computational fluid dynamic simulations to develop a better understanding of the mechanisms behind DVT. ZS gratefully acknowledges financial support from the EPSRC through a studentship from the Sci-Phy-4-Health Centre for Doctoral Training (EP/L016346/1).

  17. Anatomical description of the deep venous channel from the anterior vestibular wall of the right atrium.

    Science.gov (United States)

    Filipoiu, F M; Bălgrădean, Mihaela; Brezean, I; Jinga, V

    2013-01-01

    The deep venous channels in the walls of the right atrium are not routinely described in medical treatises although their existence has been remarked from some time. Our study demonstrates that the right atrium is opened for some of the anterior veins of the heart through a venous channel located deep in the myocardium of the vestibule of the right atrium. We suggest that no Thebesian veins drain into this channel. We achieved anatomical dissection in 14 adult human cadaveric hearts, which had been fixed in formalin solution, and we found the channel in 75% of cases. These channels were measured, photographed and presented in detail. We highlighted the importance of the proximity with the tricuspid annulus in order to avoid incidents during tricuspid annuloplasty. The authors intend that through a qualitative study to draw attention to such a structure often ignored. This vascular structure and its role in cardiac physiology and pathology have not been investigated yet. Although not constant, specialists in cardiology and cardiac surgery should be informed about this basic detail on the endocardium morphology.

  18. Central Venous Line and Acute Neurological Deficit: A Case Series

    Directory of Open Access Journals (Sweden)

    SeyedHossein Ahmadi

    2015-10-01

    Full Text Available Central venous catheter (CVC insertion is a practical way to assess patients hemodynamic specially in cardiovascular surgery but this relatively simple junior level procedure is not risk free and its common reported complications include; pneumothorax, hydrothorax, hemothorax, local hematoma, cardiac tamponade, vascular injury, thrombosis, embolism, and catheter disruption. Here in this article we are going to present 6 patients with very unusual presentation of CVC complication which was neurological deficit presented by agitation , unconsciousness, disorientation to time and place and  hemiparesis. All patients undergone neurologic consult and brain computed tomography. Final diagnosis was brain ischemic damage and finally we kept them on conservative management; fortunately we did not have any permanent damage.

  19. Inflammatory factors as markers for early development and prognosis of acute deep venous thrombosis in critically ill patients%炎症因子在危重病人急性深静脉血栓形成和转归中的作用分析

    Institute of Scientific and Technical Information of China (English)

    朱晓琼; 王强; 薛冰

    2016-01-01

    目的 探讨炎症因子在危重病人急性深静脉血栓(DVT)病程中的动态变化及与DVT的相关性.方法 收集2013年10月至2015年7月在ICU住院期间发生急性DVT患者26例为病例组,分别于发病第1、4、14 d检测血清白介素-6(IL-6)、白介素-10(IL-10)、C反应蛋白(CRP)、PCT、ESR水平,同期健康体检者30例为对照组.结果 ①病例组发病第1、4d血清IL-6、IL-10、CRP水平均高于发病第14 d和对照组,差异有统计学意义(P<0.05);发病第14 d血清IL-6、IL-10、CRP水平与对照组比较差异无统计学意义(P>0.05);②病例组三个时间段的PCT、ESR水平均高于对照组,差异有统计学意义(P<0.05),三个时间段之间PCT、ESR比较差异无统计学意义(P>0.05).结论 血清IL-6、IL-10、CRP参与危重病人急性DVT的发生与发展.%Objective To evaluate the dynamic changes of inflammatory factors in blood during the development of acute deep venous thrombosis (DVT) and the association between these indices and DVT in critically ill patients.Methods 26 hospitalized patients with acute DVT from ICU from December 2013 to July 2015 were selected as case group.Tested inflammatory factors including IL-6,IL-10,CRP,PCT,ESR on the 1st,4th,14th day after confirmed diagnosis.30 healthy examined people were selected as control group.Results ①The levels of IL-6,IL-10,and CRP on the 1st,4th day after confirmed diagnosis in case group were higher than those on the 14th day and those in control group;there were no statistically significant differences in the levels of IL-6,IL-10,and CRP on the 14th day between two groups (P>0.05).② The levels of PCT,ESR in case group at three time points were significantly higher than those in control group;there were no statistically significant differences in the levels of PCT,ESR among three time points (P>0.05).Conclusion Inflammatory factors such as IL-6,IL-10,CPRjointly participate the onset and development of DVT in critically ill

  20. Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Cakir, Volkan, E-mail: drvolkancakir@gmail.com [Katip Celebi University, Ataturk Training and Research Hospital, Department of Radiology, Division of İnterventional Radiology (Turkey); Gulcu, Aytac, E-mail: aytac.gulcu@deu.edu.tr [Dokuz Eylul University Hospital, Department of Radiology (Turkey); Akay, Emrah, E-mail: emrahakay@hotmail.com [Sakarya University Hospital, Department of Radiology (Turkey); Capar, Ahmet E., E-mail: ahmetergina@gmail.com [Dokuz Eylul University Hospital, Department of Radiology (Turkey); Gencpinar, Tugra, E-mail: tugra01@hotmail.com [Dokuz Eylul University Hospital, Department of Cardiovascular Surgery (Turkey); Kucuk, Banu, E-mail: banu.kucuk@deu.edu.tr [Dokuz Eylul University Hospital, Department of Radiology (Turkey); Karabay, Ozalp, E-mail: ozalp.karabay@deu.edu.tr [Dokuz Eylul University Hospital, Department of Cardiovascular Surgery (Turkey); Goktay, A. Yigit, E-mail: yigit.goktay@deu.edu.tr [Dokuz Eylul University Hospital, Department of Radiology (Turkey)

    2014-08-15

    PurposeThe purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis.MethodsIn this randomised, prospective study, 42 patients with acute proximal iliofemoral deep vein thrombosis documented via Doppler ultrasound examination, were separated into an interventional treatment group (16 males, 5 females, average age 51 years) and a medical treatment group (13 males, 8 females, average age 59 years). In the interventional group, PAT with large-lumen 9-F diameter catheterisation was applied, after initiation of standard anticoagulant therapy. Balloon angioplasty (n 19) and stent implementation (n: 14) were used to treat patients with residual stenosis (>50 %) after PAT. Prophylactic IVC filters were placed in two patients. The thrombus clearance status of the venous system was evaluated by venography. In both the medical and interventional groups, venous patency rates and clinical symptom scores were evaluated at months 1, 3, and 12 after treatment.ResultsDeep venous systems became totally cleared of thrombi in 12 patients treated with PAT. The venous patency rates in month 12 were 57.1 and 4.76 % in the interventional and medical treatment groups, respectively. A statistically significant improvement was observed in clinical symptom scores of the interventional group (PAT) with or without stenting (4.23 ± 0.51 before treatment; 0.81 ± 0.92 at month 12) compared with the medical treatment group (4.00 ± 0.63 before treatment; 2.43 ± 0.67 at month 12). During follow-up, four patients in the medical treatment and one in the interventional group developed pulmonary embolisms.ConclusionsFor treatment of acute deep vein thrombosis, PAT with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical

  1. Non-traumatic thoracic emergencies: CT venography in an integrated diagnostic strategy of acute pulmonary embolism and venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Ghaye, Benoit; Dondelinger, Robert F. [Department of Medical Imaging, University Hospital Sart Tilman, Domaine Universitaire du Sart Tilman B35, 4000 Liege (Belgium)

    2002-08-01

    Deep venous thrombosis and pulmonary embolism are the two aspects of venous thrombo-embolism. Investigation of lower limb veins has been part of various diagnostic algorithms in the past 15 years. Recently, the combination of CT venography (CTV) of lower limbs and abdominal veins together with CT angiography of the pulmonary arteries has allowed a complete examination of venous thrombo-embolism in one session. The technical aspects, imaging findings, venous anatomy on CT, interpretative pitfalls, results and advantages of CT venography are reviewed. (orig.)

  2. {sup 99m}Tc-apcitide scintigraphy in patients with clinically suspected deep venous thrombosis and pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Dunzinger, Andreas; Piswanger-Soelkner, Jutta-Claudia; Lipp, Rainer W. [Medical University of Graz, Division of Nuclear Medicine, Department of Internal Medicine, Graz (Austria); Hafner, Franz; Brodmann, Marianne [Medical University of Graz, Divison of Angiology, Department of Internal Medicine, Graz (Austria); Schaffler, Gottfried [Medical University of Graz, Department of Radiology, Graz (Austria)

    2008-11-15

    Detection of acute deep venous thrombosis (DVT) in patients presenting with clinical symptoms suggesting DVT and pulmonary embolism (PE) with {sup 99m}Tc-apcitide, a synthetic polypeptide, binding to glycoprotein IIb/IIIa receptors expressed on activated platelets is the objective of the study. Nineteen patients (11 males, eight females) received within 24h after admission to the hospital a mean of 841MBq (range 667 to 1,080) {sup 99m}Tc-apcitide i.v. followed by planar recordings 10, 60, and 120min after injection. Images were compared to the results of compression ultrasonography and/or phlebography. Patients with clinically suspected PE underwent spiral computed tomography or lung perfusion scans. {sup 99m}Tc-apcitide scintigraphy showed acute clot formation in 14 out of 16 patients where the other imaging modalities suggested DVT. Positive scintigraphic results were seen up to 17days after the onset of clinical symptoms. In three out of three patients without any proof of DVT, {sup 99m}Tc-apcitide scintigraphy was truly negative. Glycoprotein receptor imaging showed only one segmental PE in six patients with imaging-proven subsegmental (N = 3) or segmental PE (N = 3). {sup 99m}Tc-apcitide scintigraphy may be an easy and promising tool for the detection of acute clot formation in patients with DVT up to 17days after the onset of clinical symptoms with a sensitivity of 87% and a specificity of 100%. However, it failed to demonstrate PE in 83% of examined patients with proven PE. (orig.)

  3. Catheter-directed Thrombolysis in Acute Superior Vena Cava Syndrome Caused by Central Venous Catheters.

    Science.gov (United States)

    Cui, Jie; Kawai, Tasuo; Irani, Zubin

    2015-01-01

    Indwelling central venous catheters have been reported to increase the risk of superior venous cava (SVC) syndrome. This case report describes the development of acute SVC syndrome in a 28-year-old woman with end-stage renal disease implanted with a left-side hemodialysis reliable outflow graft and a right-side double lumen hemodialysis catheter via internal jugular veins. Her symptoms were not alleviated after catheter removal and systemic anticoagulation therapy. She was eventually treated with catheter-directed thrombolysis and a predischarge computer tomographic venogram on postthrombolytic procedure day 7 showed patent central veins and patient remained asymptomatic. This case demonstrates that catheter-directed thrombolysis can be safely employed to treat refractory catheter-induced acute SVC syndrome in end-stage renal disease patients.

  4. Lower extremity deep venous thrombosis with fatal pulmonary thromboembolism caused by benign pelvic space-occupying lesions--an overview.

    Science.gov (United States)

    Rosenfeld, Hannah; Byard, Roger W

    2012-05-01

    Venous stasis predisposes to thrombosis. One hundred and sixty cases of fatal pulmonary thromboembolism were reviewed to determine how many cases had deep venous thromboses associated with venous blood flow reduction caused by external pressure from benign pelvic masses. Three cases were identified, representing 2% of cases overall (3/160): a 44-year-old woman with a large uterine leiomyoma (1048 g); a 74-year-old man with prostatomegaly and bladder distension (containing 1 L of urine); and a 70-year-old man with prostatomegaly and bladder distension (containing 3 L of urine). Although a rare cause of fatal deep venous thrombosis and pulmonary thromboembolism, space-occupying pelvic lesions can lead to extrinsic pressure on adjacent veins reducing blood flow and causing stasis and thrombosis. Individuals with large pelvic masses may, therefore, be at increased risk of pulmonary thromboembolism from deep venous thrombosis, particularly in the presence of concurrent risk factors such as immobility, thrombophilias, malignancy, and significant cardiopulmonary disease.

  5. Optimized image reconstruction for detection of deep venous thrombosis at multidetector-row CT venography

    Energy Technology Data Exchange (ETDEWEB)

    Das, Marco; Muehlenbruch, Georg; Mahnken, Andreas Horst; Guenther, Rolf W.; Wildberger, Joachim Ernst [University Hospital, University of Technology (RWTH), Department of Diagnostic Radiology, Aachen (Germany); Weiss, Claudia [RWTH Aachen, Institute of Medical Statistics, Aachen (Germany); Schoepf, U. Joseph [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Leidecker, Christianne [Institute of Medical Physics, University of Erlangen, Erlangen (Germany)

    2006-02-01

    The aims of this study were to optimize image quality for indirect CT venography (sequential versus spiral), and to evaluate different image reconstruction parameters for patients with suspected deep venous thrombosis (DVT). Fifty-one patients (26/25 with/without DVT) were prospectively evaluated for pulmonary embolism (PE) with standard multidetector-row computed tomography (MDCT) protocols. Retrospective image reconstruction was done with different slice thicknesses and reconstruction increments in sequential and spiral modes. All reconstructions were read for depiction of DVT and to evaluate best reconstruction parameters in comparison with the thinnest reconstruction (''gold standard''). Image noise and venous enhancement were measured as objective criteria for image quality. Subjective image quality was rated on a four-point scale. Effective dose was estimated for all reconstructions. In sequential 10/50 reconstruction DVT was completely detected in 13/26 cases, partially in 10/26 cases and was not detected at all in 3/26 cases, and 15/26, 9/26 and 2/26 cases for the 10/20 reconstruction, respectively. DVT was completely detected in all spiral reconstructions. Image noise ranged between 14.8-29.1 HU. Median image quality was 2. Estimated effective dose ranged between 2.3 mSv and 11.8 mSv. Gaps in sequential protocols may lead to false negative results. Therefore, spiral scanning protocols for complete depiction of DVT are mandatory. (orig.)

  6. Effects of walking in deep venous thrombosis: a new integrated solid and fluid mechanics model.

    Science.gov (United States)

    López, Josep M; Fortuny, Gerard; Puigjaner, Dolors; Herrero, Joan; Marimon, Francesc; Garcia-Bennett, Josep

    2016-08-09

    Deep venous thrombosis (DVT) is a common disease. Large thrombi in venous vessels cause bad blood circulation and pain; and when a blood clot detaches from a vein wall, it causes an embolism whose consequences range from mild to fatal. Walking is recommended to DVT patients as a therapeutical complement. In this study the mechanical effects of walking on a specific patient of DVT were simulated by means of an unprecedented integration of 3 elements: a real geometry, a biomechanical model of body tissues, and a computational fluid dynamics study. A set of computed tomography images of a patient's leg with a thrombus in the popliteal vein was employed to reconstruct a geometry model. Then a biomechanical model was used to compute the new deformed geometry of the vein as a function of the fiber stretch level of the semimembranosus muscle. Finally, a computational fluid dynamics study was performed to compute the blood flow and the wall shear stress (WSS) at the vein and thrombus walls. Calculations showed that either a lengthening or shortening of the semimembranosus muscle led to a decrease of WSS levels up to 10%. Notwithstanding, changes in blood viscosity properties or blood flow rate may easily have a greater impact in WSS.

  7. Diagnosis of deep venous thrombosis by phlebography and /sup 99/Tcsup (m)-Plasmin

    Energy Technology Data Exchange (ETDEWEB)

    Edenbrandt, C.M.; Nilsson, J.; Ohlin, P. (County Hospital, Helsingborg (Sweden). Dept. of Medicine, Diagnostic Radiology and Clinical Physology)

    1982-01-01

    One hundred and thirty-four patients admitted to the medical emergency ward due to suspected deep venous thrombosis (DVT) were examined. The uptake of intravenously injected porcine /sup 99/Tcsup (m)-plasmin was estimated in both legs. Thereafter, phlebography was performed using a high osmolar contrast medium. All phlebographies were evaluated independently. All patients with negative phlebography were examined after 3-5 days. The plasmin test and phlebography were repeated when called for. The sensivity of the plasmin test was 100% and the specificity 51% when compared to phlebography. The extension of the DVT as demonstrated by the plasmin test was similar to that determined by phlebography. Post-phlebographic trombosis was very rare. It is concluded that /sup 99/Tcsup (m)-plasmin test is a rapid method, convenient to the patient and well suitable as a screening test. The results indicate that a negative plasmin test excludes DVT while a positive test necessitates additional examination by phlebography.

  8. Experimental Validation of Methods for Prophylaxis against Deep Venous Thrombosis: A Review and Proposal.

    Science.gov (United States)

    Agutter, Paul S; Malone, P Colm; Silver, Ian A

    2012-01-01

    The experimental procedure by which the valve cusp hypoxia (VCH) hypothesis of the etiology of deep venous thrombosis (DVT) was confirmed lends itself to testing of methods of prophylaxis. Similar animal experiments could end the present exclusive reliance on statistical analysis of data from large patient cohorts to evaluate prophylactic regimes. The reduction of need for such (usually retrospective) analyses could enable rationally-based clinical trials of prophylactic methods to be conducted more rapidly, and the success of such trials would lead to decreased incidences of DVT-related mortality and morbidity. This paper reviews the VCH hypothesis ("VCH thesis", following its corroboration) and its implications for understanding DVT and its sequelae, and outlines the experimental protocol for testing prophylactic methods. The advantages and limitations of the protocol are briefly discussed.

  9. Experimental Validation of Methods for Prophylaxis against Deep Venous Thrombosis: A Review and Proposal

    Directory of Open Access Journals (Sweden)

    Paul S. Agutter

    2012-01-01

    Full Text Available The experimental procedure by which the valve cusp hypoxia (VCH hypothesis of the etiology of deep venous thrombosis (DVT was confirmed lends itself to testing of methods of prophylaxis. Similar animal experiments could end the present exclusive reliance on statistical analysis of data from large patient cohorts to evaluate prophylactic regimes. The reduction of need for such (usually retrospective analyses could enable rationally-based clinical trials of prophylactic methods to be conducted more rapidly, and the success of such trials would lead to decreased incidences of DVT-related mortality and morbidity. This paper reviews the VCH hypothesis (“VCH thesis”, following its corroboration and its implications for understanding DVT and its sequelae, and outlines the experimental protocol for testing prophylactic methods. The advantages and limitations of the protocol are briefly discussed.

  10. Quantitative ultrasound venous valve movement: early diagnosis of deep vein thrombosis

    Science.gov (United States)

    Muhd Suberi, Anis Azwani; Wan Zakaria, Wan Nurshazwani; Tomari, Razali; Ibrahim, Nabilah

    2016-07-01

    The purpose of this paper is to provide an in-depth analysis of computer aided system for the early diagnosis of Deep Vein Thrombosis (DVT). Normally, patients are diagnosed with DVT through ultrasound examination after they have a serious complication. Thus, this study proposes a new approach to reduce the risk of recurrent DVT by tracking the venous valve movement behaviour. Inspired by image processing technology, several image processing methods namely, image enhancement, segmentation and morphological have been implemented to improve the image quality for further tracking procedure. In segmentation, Otsu thresholding provides a significant result in segmenting valve structure. Subsequently, morphological dilation method is able to enhance the region shape of the valve distinctly and precisely. Lastly, image subtraction method is presented and evaluated to track the valve movement. Based on the experimental results the normal range of valve velocity lies within the range of blood flow velocity (Vb) and occasionally may result in higher values.

  11. Patient compliance and satisfaction with mechanical devices for preventing deep venous thrombosis after joint replacement.

    Science.gov (United States)

    Robertson, K A; Bertot, A J; Wolfe, M W; Barrack, R L

    2000-01-01

    A consecutive series of patients having total joint arthroplasty at a single university hospital were sequentially treated with two mechanical devices for prevention of deep venous thrombosis (DVT). The first 104 patients (group 1) wore thigh-high sequential compression device (SCD). The next 120 patients (group 2) wore a foot pump. Daily documentation of hourly compliance with each respective device was recorded until discharge. A patient satisfaction questionnaire was also obtained. Patient understanding about the devices' function aided compliance (73% compliance in group 1, and 77% in group 2). The satisfaction questionnaire revealed significantly greater satisfaction in group 2 (73%) versus group 1 (55%). Of a subgroup of 35 patients who had used both devices, 24 preferred the foot pump, 7 the SCD, and 4 had no preference. This study showed a higher degree of compliance and satisfaction for foot pumps as prophylaxis against DVT.

  12. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm

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    Levi Kitchen

    2016-06-01

    Full Text Available Introduction: Unilateral leg swelling with suspicion of deep venous thrombosis (DVT is a common emergency department (ED presentation. Proximal DVT (thrombus in the popliteal or femoral veins can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS, a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1 propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS is unavailable; and (2 summarize the controversy surrounding IC-DVT treatment. Discussion: The Figure combines D-dimer testing with serial CUS or a single deferred FLUS for the diagnosis of IC-DVT. Such an algorithm has the potential to safely direct the management of suspected IC-DVT when definitive testing is unavailable. Whether or not to treat diagnosed IC-DVT remains widely debated and awaiting further evidence. Conclusion: When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient’s risk factors for both thrombus propagation and complications of anticoagulation. [West J Emerg Med. 2016;17(4384-390.

  13. Prevalence, Pattern of Presentation, Risk Factors and Outcome of Acute Mesenteric Venous Thrombosis in Taif Province,

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    Mohamed Al Saeed*, Mohamed Hatem*Aseel Abu Duruk*Hala A Mohamed**,

    2013-07-01

    Full Text Available Background and aim of the study: Mesenteric venous thrombosis has a global incidence of 10-15% of all cases of mesenteric ischemia; however reports from high altitude provinces of Saudi Arabia as Taif and Aseer recorded an incidence above 60%. The aim of this study is to record the incidence, pattern of presentation, risk factors; diagnostic tools and outcome of treatment in a single center (King Abdul Aziz Specialist Hospital Taif, Saudi Arabia.Material and method: In this retrospective chart review study, we reviewed the records and data of all patients presented to King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2009 to January 2013 and their final diagnosis were proved to be acute mesenteric venous thrombosis. Traumatic, postoperative and non occlusive cases were excluded from the study.Results:Sixteen patients with final diagnosis of acute mesenteric venous thrombosis were included in this study, out of 26 patients (61.5% presented and diagnosed as acute occlusive mesenteric ischemia. Males were more affected than females. The mean age of the patients was 55±13.4 years. The mean duration of symptoms was 4.9±1.4 days.The most common presenting symptoms were; abdominal pain followed by nausea, vomiting, anorexia, bloody diarrhea and fever. The most prevalent physical findings was tachycardia followed by ileus, 5 patients presented by marked peritoneal signs 3 of them were shocked. Multiple risk factors were detected in all patients. Laboratory findings were not conclusive and diagnosis was established by CT angiography in most of the patients. During operation, all patients were found to have a segment of infarction of the small intestine and in one of them the cecum was involved. Resection of the gangrenous parts was done for all patients. Second look operation was performed in 25% of patients. The total mortality was 18.75%. Conclusion: Acute mesenteric venous thrombosis is the most common cause of acute occlusive

  14. Real-time magnetic resonance imaging of deep venous flow during muscular exercise—preliminary experience

    Science.gov (United States)

    Merboldt, Klaus-Dietmar; Voit, Dirk; Dahm, Johannes; Frahm, Jens

    2016-01-01

    Background The accurate assessment of peripheral venous flow is important for the early diagnosis and treatment of disorders such as deep-vein thrombosis (DVT) which is a major cause of post-thrombotic syndrome or even death due to pulmonary embolism. The aim of this work is to quantitatively determine blood flow in deep veins during rest and muscular exercise using a novel real-time magnetic resonance imaging (MRI) method for velocity-encoded phase-contrast (PC) MRI at high spatiotemporal resolution. Methods Real-time PC MRI of eight healthy volunteers and one patient was performed at 3 Tesla (Prisma fit, Siemens, Erlangen, Germany) using a flexible 16-channel receive coil (Variety, NORAS, Hoechberg, Germany). Acquisitions were based on a highly undersampled radial FLASH sequence with image reconstruction by regularized nonlinear inversion at 0.5×0.5×6 mm3 spatial resolution and 100 ms temporal resolution. Flow was assessed in two cross-sections of the lower leg at the level of the calf muscle and knee using a protocol of 10 s rest, 20 s flexion and extension of the foot, and 10 s rest. Quantitative analyses included through-plane flow in the right posterior tibial, right peroneal and popliteal vein (PC maps) as well as signal intensity changes due to flow and muscle movements (corresponding magnitude images). Results Real-time PC MRI successfully monitored the dynamics of venous flow at high spatiotemporal resolution and clearly demonstrated increased flow in deep veins in response to flexion and extension of the foot. In normal subjects, the maximum velocity (averaged across vessel lumen) during exercise was 9.4±5.7 cm·s−1 for the right peroneal vein, 8.5±4.6 cm·s−1 for the right posterior tibial vein and 17.8±5.8 cm·s−1 for the popliteal vein. The integrated flow volume per exercise (20 s) was 1.9, 1.6 and 50 mL (mean across subjects) for right peroneal, right posterior tibial and popliteal vein, respectively. A patient with DVT presented with

  15. Cost-effectiveness analysis of early veno-venous hemofiltration for severe acute pancreatitis in China

    Institute of Scientific and Technical Information of China (English)

    Kun Jiang; Xin-Zu Chen; Qing Xia; Wen-Fu Tang; Lei Wang

    2008-01-01

    AIM: To determine the most cost-effective hemofiltration modality for early management of severe acute pancreatitis (SAP) in China.METHODS: We carried out a search of Pub-Medline and Chinese Biomedical Disk database. Controlled clinical trials on Chinese population were included in the analysis. The four decision branches that were analyzed were: continuous or long-term veno-venous hemofiltration (CWH/LWH), short-term veno-venous hemofiltration (SWH), SWH plus peritoneal dialysis (PD), and non-hemofiltration control group. The effectiveness of the technique was determined by survival rate, complications prevention and surgery preservation. The total cost of hospitalization was also assessed.RESULTS: The SWH only technique was the least costly modality, $5809 (44449 RMB), and was selected as the baseline treatment modality. SWH only arm achieved the lowest C/E ratio in terms of overall survival, complications prevention and surgery preservation. In incremental cost-effectiveness analysis, the CWH/ LVVH only and the control arms were inferior to other techniques. Sensitivity analysis showed SWH only and SWH plus PD arms overlapped in C/survival ratio.CONCLUSION: The role of early veno-venous hemofiltration as an alternative therapy for SAP remains controversial. However, we propose that early use of short-term high-volume veno-venous hemofiltration would have a beneficial impact on the management of SAP.

  16. Deep venous thrombosis and pulmonary embolism caused by an intravascular synovial sarcoma of the common femoral vein.

    Science.gov (United States)

    Schoneveld, J M; Debing, E; Verfaillie, G; Geers, C; Van den Brande, P

    2012-11-01

    Malignant tumors arising in deep veins of the lower extremities are very uncommon. To our best knowledge, this is the seventh case of a primary venous intravascular synovial sarcoma (SS) reported in literature. A 32-year-old woman was admitted with a second episode of deep venous thrombosis of the right lower limb and pulmonary embolism. Physical and radiological examinations showed besides the thrombosis a tumor arising from the right common femoral vein involving the bifurcation of the common femoral artery. At surgery, en block resection of the tumor including the deep femoral vein and arterial bifurcation was done with an arterial reconstruction using a synthetic graft. Histopathological examination revealed an intravascular SS of the common femoral vein. The mainstay of curative therapy is complete surgical resection of all tumor manifestations with negative histological margins.

  17. The Nursing of Deep Venous Thrombosis%深静脉血栓形成的护理

    Institute of Scientific and Technical Information of China (English)

    张立红

    2015-01-01

    Objective The operating nursing and its efficiency of deep venous thrombosis are to be investigated. Methods Analyze the nursing data selected from 22 cases of deep venous thrombosis. Results Of al 22 cases of deep venous thrombosis,12 patients are cured and 10 patients have improved their health,and there is no complication incidence. Conclusion Proper nursing is conducive to venous circulation return,lessening treatment time and complication incidence,improving the treatment efficiency.%目的:探讨深静脉血栓形成的手术护理方法效果。方法对22例深静脉血栓形成的护理方法进行分析。结果本组收治的22例深静脉血栓形成中,治愈12例,好转10例。无并发症的发生。结论正确的护理,以利于静脉回流,缩短疗程,减少并发症发生,提高疗效。

  18. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

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    Novović Miloš

    2012-01-01

    Full Text Available Introduction. Arterial blood gas (ABG analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD. Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG values of pH, partial pressure of carbon dioxide (PCO2, partial oxygen pressure (PO2, bicarbonate (HCO3, and venous and arterial blood oxygen saturation (SO2 can reliably predict ABG levels in patients with acute exacerbation of COPD. Methods. Forty-seven patients with a prior diagnosis of COPD were included in this prospective study. The patients with acute exacerbation of this disease were examined at the General Hospital EMS Department in Prijepolje. ABG samples were taken immediately after venous sampling, and both were analyzed. Results. The Pearson correlation coefficients between arterial and venous parameters were 0.828, 0.877, 0.599, 0.896 and 0.312 for pH, PCO2, PO2, HCO3 and SO2, respectively. The statistically significant correlation between arterial and venous pH, PCO2 and HCO3, values was found in patients with acute exacerbation of COPD (p<0.001. Conclusion. When we cannot provide arterial blood for analysis, venous values of the pH, Pv,CO2 and HCO3 parameters can be an alternative to their arterial equivalents in the interpretation of the metabolic status in patients with acute exacerbation of COPD, while the values of venous Pv,O2 and Sv,O2 cannot be used as predictors in the assessment of oxygen status of such patients.

  19. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

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    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  20. Congestive kidney failure in cardiac surgery: the relationship between central venous pressure and acute kidney injury.

    Science.gov (United States)

    Gambardella, Ivancarmine; Gaudino, Mario; Ronco, Claudio; Lau, Christopher; Ivascu, Natalia; Girardi, Leonard N

    2016-11-01

    Acute kidney injury (AKI) in cardiac surgery has traditionally been linked to reduced arterial perfusion. There is ongoing evidence that central venous pressure (CVP) has a pivotal role in precipitating acute renal dysfunction in cardiac medical and surgical settings. We can regard this AKI driven by systemic venous hypertension as 'kidney congestive failure'. In the cardiac surgery population as a whole, when the CVP value reaches the threshold of 14 mmHg in postoperative period, the risk of AKI increases 2-fold with an odds ratio (OR) of 1.99, 95% confidence interval (95% CI) of 1.16-3.40. In cardiac surgery subsets where venous hypertension is a hallmark feature, the incidence of AKI is higher (tricuspid disease 30%, carcinoid valve disease 22%). Even in the non-chronically congested coronary artery bypass population, CVP measured 6 h postoperatively showed significant association to renal failure: risk-adjusted OR for AKI was 5.5 (95% CI 1.93-15.5; P = 0.001) with every 5 mmHg rise in CVP for patients with CVP <9 mmHg; for CVP increments of 5 mmHg above the threshold of 9 mmHg, the risk-adjusted OR for AKI was 1.3 (95% CI 1.01-1.65; P = 0.045). This and other clinical evidence are discussed along with the underlying pathophysiological mechanisms, involving the supremacy of volume receptors in regulating the autonomic output in hypervolaemia, and the regional effect of venous congestion on the nephron. The effect of CVP on renal function was found to be modulated by ventricular function class, aetiology and acuity of venous congestion. Evidence suggests that acute increases of CVP should be actively treated to avoid a deterioration of the renal function, particularly in patients with poor ventricular fraction. Besides, the practice of treating right heart failure with fluid loading should be avoided in favour of other ways to optimize haemodynamics in this setting, because of the detrimental effects on the kidney function.

  1. Radiolabeled tirofiban – a potential radiopharmaceutical for detection of deep venous thrombosis

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    Darkovska-Serafimovska M

    2016-09-01

    Full Text Available Marija Darkovska-Serafimovska,1,2 Emilija Janevik-Ivanovska,1 Icko Djorgoski,2 Zorica Arsova-Sarafinovska,1,3 Milka Zdravkovska,1 Trajan Balkanov,4 Nenad Ugresic5 1Department of Pharmacy, Faculty of Medical Sciences, Goce Delcev University, Stip, 2Department of Physiology, Faculty of Natural Sciences and Mathematics, Ss Cyril and Methodius University in Skopje, 3Department of Quality Control of Medicines, Institute for Public Health of the Republic of Macedonia, 4Department of Pharmacology and Toxicology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, Skopje, Republic of Macedonia; 5Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia Aim: The aim of this study was to investigate the possibility of using 99mtechnetium (99mTc-labeled tirofiban (a reversible antagonist of glycoprotein IIb/IIIa for detection of deep venous thrombosis (DVT in rats without causing an antiplatelet effect.Methods: The ability of in vitro tirofiban to inhibit adenosine 5'-diphosphate (ADP-induced platelet aggregation was evaluated using optical aggregometer. Binding of 99mTc-tirofiban to platelets was evaluated. Serum levels of unlabeled (a validated high performance liquid chromatography method and 99mTc-tirofiban after single intravenous injection were evaluated in male Wistar rats with or without induced DVT (femoral vein ligation model, and the rats were also subjected to whole body scintigraphy.Results: Tirofiban in vitro inhibits ADP-induced aggregation of human platelets in a dose- and concentration-dependent manner (10 nM to 2 µM, but only if it is added before ADP and not after ADP. 99mTc labeling did not affect the ability of tirofiban to bind to either human or rat platelets, nor did it affect tirofiban pharmacokinetics in intact rats or in animals with induced DVT. When 99mTc-tirofiban was injected to rats after induction of DVT, at a molar dose lower than the one showing only a weak antiaggregatory

  2. An instrument for measuring health-related quality of life in patients with Deep Venous Thrombosis (DVT: development and validation of Deep Venous Thrombosis Quality of Life (DVTQOL questionnaire

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    Stigendal Lennart

    2004-06-01

    Full Text Available Abstract Background Few studies have evaluated patient-reported outcomes in connection with a primary event of deep venous thrombosis, partly due to a lack of disease-specific measures. The aim here was to develop a disease-specific health-related quality of life (HRQL measure, the deep venous thrombosis quality of life questionnaire (DVTQOL, for patients with recent exposition and treatment of proximal deep venous thrombosis. Methods A total of 121 consecutive outpatients (50 % males; mean age 61.2 ± 14 years treated with warfarin (Waran® for symptomatic proximal deep venous thrombosis were included in the study. Patients completed the SF-36, EQ-5D and the pilot version of the DVTQOL. Results Items having: high ceiling and floor effect, items with lower factor loadings than 0.50 and items loading in several factors were removed from the pilot version of DVTQOL. In addition, overlapping and redundant items identified by the Rasch analysis were excluded. The final DVTQOL questionnaire consists of 29 items composing six dimensions depicting problems with: emotional distress; symptoms (e.g. pain, swollen ankles, cramp, bruising; limitation in physical activity; hassle with coagulation monitoring; sleep disturbance; and dietary problems. The internal consistency reliability was high (alpha value ranged from 0.79 to 0.93. The relevant domains of the SF-36 and EQ-5D significantly correlated with DVTQOL, thereby confirming its construct validity. Conclusions The DVTQOL is a short and user-friendly instrument with good reliability and validity. Its test-retest reliability and responsiveness to change in clinical trials, however, must be explored.

  3. Retrospective study on clinical features and interventional therapy of acute deep venous thrombosis of lower extremity combined with type Ⅱ heparin-induced thrombocytopenia%急性下肢深静脉血栓形成合并Ⅱ型肝素诱导血小板减少症的临床特征及介入综合治疗效果

    Institute of Scientific and Technical Information of China (English)

    苏浩波; 赵伯翔; 黄昊; 楼文胜; 顾建平; 何旭; 陈亮; 陈国平; 宋进华; 施万印; 汪涛

    2015-01-01

    此类患者深静脉血栓介入治疗效果。%Objective To explore the clinical features, diagnosis and interventional management of acute deep venous thrombosis of lower extremity (LEDVT)combined with type Ⅱ heparin-induced thrombocytopenia (HITⅡ) and to improve the knowledge of this disease. Methods A retrospective review and analysis of the clinical data of the patients with acute LEDVT combined with HIT Ⅱ enrolled from January 2010 to June 2014. All of them underwent anticoagulation with low molecular weight heparin (LMWH) and the comprehensive interventional therapy at the beginning of treatment.When HIT Ⅱ was identified, all forms of heparin and LMWH were avoided . Alternative anticoagulation was commenced with argatrobam. Adjustments in interventional therapy were taken while the short-term low-dose glucocorticoid treatment were used.The clinical manifestations, changes of PLT, 4Ts score (Warkentin 4T scoring system, 4Ts) , HIT antibody assay (ELISA) and response to therapy of the patients were analyzed and the treatment effect was observed . The efficacy of interventional therapy was evaluated according to the improvement clinical symptoms and venography. Results The incidence of acute LEDVT combined with HIT Ⅱ was 1.9%(8/416). There were 4 males and 4 females with a median age of 24 years in this study. The median time between their initiation exposure to heparin and onset of thrombocytopenia was 5 days (range,3 to 8 days). The median platelet counts prior to HIT Ⅱ was 218 × 109/L( range,122 × 109/L to 254 × 109/L ). Platelet counts decreased to the lowest level range from 20 × 109/L to 51 × 109/L(median 32 × 109/L). After alternative anticoagulation, the interval period which PLT recovered to the basic level was range from 3 to 7 days (median 3.5 days) . According to the score of 4Ts , there were 2 cases score 6 and 6 cases score 8. HIT antibody assay (ELISA) was detected in 6 patients which the results were positive. During heparin

  4. Artery and deep Venous Catheter Thrombolysis for deep Venous Thrombosis Synchroni-zation%动脉加深静脉置管同步溶栓治疗深静脉血栓

    Institute of Scientific and Technical Information of China (English)

    黄永东; 毛健; 梁枫; 张振岳

    2015-01-01

    目的:评价经动脉加深静脉置管同步溶栓治疗下肢深静脉血栓( DVT)的疗效。方法回顾性分析27例下肢深静脉血栓溶栓治疗患者,在行下腔静脉滤器置入术后,其中15例患者行动脉加深静脉置管同步溶栓治疗下肢深静脉血栓及抗凝治疗。另12例患者行单纯患肢深静脉置入溶栓导管溶栓治疗加抗凝治疗。结果随访27例患者均未出现大出血和致死性肺动脉栓塞等严重并发症,22例患者下肢DVT完全或大部分溶解,下肢肿胀恢复正常。5例达到部分溶解,但深静脉主干有血流通过,并有较多侧枝循环。肿胀明显缓解。其中经动脉加深静脉置管同步溶栓治疗的患者中,完全或大部分溶解15例,单纯静脉溶栓完全或大部分溶解的有5例。结论动脉加深静脉置管同步溶栓下肢深静脉血栓一种安全可行、疗效好、起效快的方法,较单纯静脉溶栓时间缩短,而且静脉血栓完全溶解率较高。%Objective To evaluate the artery and deep venous catheter synchronous thrombolysis for lower extremity deep venous thrombosis( DVT) effect. Methods A retrospective analysis of 27 cases of lower extremity deep venous thrombolytic therapy for patients,in inferior vena cava filter placement,including 15 ca-ses of patients with deep vein tube indwelling arterial and synchronous thrombolysis for lower extremity deep venous thrombosis and anticoagulation therapy. The other 12 patients were treated with simple limb vein insert-ed catheter thrombolysis therapy and anticoagulation thrombolysis. Results The serious complications of bleeding and fatal pulmonary embolism were not found in follow-up of 27 patients,22 cases of patients with lower extremity DVT completely or mostly dissolved,lower limb swelling back to normal. 5 patients achieved a partial dissolution,but deep vein blood flow through,and there is more collateral circulation. Swelling signifi-cantly ease. The arterial and deep venous

  5. Deep venous thrombosis in the antenatal period in a large cohort of pregnancies from western India

    Directory of Open Access Journals (Sweden)

    Salvi Vinita

    2007-07-01

    Full Text Available Abstract Background Deep venous thrombosis (DVT is an important complication in the peripartal and postpartal period. Methods We followed up prospectively the prevalence of DVT in 34720 prenatal mothers between June 2002 and July 2006 attending the antenatal clinics of two major hospitals in Mumbai, India. Thirty two women (0.1% presented for the first time with symptomatic DVT i.e. 17 in the first trimester, 6 in the second and 9 in the third trimester of pregnancy. Nine had history of fetal loss while in the remaining twenty three there was no history of fetal loss. Results The evaluation of both acquired and heritable thrombophilia showed a conglomeration of thrombophilia in this group when compared to 100 normal pregnant women who have given birth to at least one healthy baby with no history of fetal death, DVT or other obstetrical complications. The relative risks for all the antiphospholipid antibodies (APA studied i.e lupus anticoagulant (LA, IgG/IgM antibodies for cardiolipin (ACA, β2 glycoprotein 1 (β2 GP 1 and annexin V were significantly higher in women with pregnancy associated DVT (RR 7.4 95% CI 4.3–11.3 P Conclusion We conclude that the prevalence of DVT in India is more or less similar to other reports published and both acquired and heritable thrombophilia show strong association with DVT associated with pregnancy.

  6. Incidence of cannula associated deep vein thrombosis after veno-venous ECMO.

    Science.gov (United States)

    Menaker, Jay; Tabatabai, Ali; Rector, Raymond; Dolly, Katelyn; Kufera, Joseph; Lee, Eugenia; Kon, Zachary; Sanchez, Pablo; Pham, Si; Herr, Daniel L; Mazzeffi, Michael; Rabinowitz, Ronald P; OʼConnor, James V; Stein, Deborah M; Scalea, Thomas M

    2017-02-13

    Limited literature regarding the incidence of cannula associated deep vein thrombosis (CaDVT) following veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty eight patients were admitted between August 2014 and January 2016 to the Lung Rescue Unit were included in the study. Protocolized anticoagulation levels (partial thromboplastin time 45-55 second) and routine post decannulation DVT screening were in place during the study period. Forty-one (85.4%) patients had CaDVT. Of those with CaDVT, 31 (76%) patients were treated with full anti-coagulation therapy. 34 (76%) patients with right internal jugular cannulation had CaDVT at cannula site. Twenty-five (61%) patients had CaDVT in the lower extremity. (18 associated right femoral vein cannulation; 7 left femoral vein cannulation) 18 (44%) patients had both upper and lower extremity CaDVT. Overall, patients with CaDVT tended to be older, have a higher body mass index (BMI) and on ECMO longer (p=NS). Mean PTT during time on ECMO between patients that did and did not have CaDVT did not differ. No clinical evidence of pulmonary embolism was seen.

  7. Current prescribing patterns of elastic compression stockings post-deep venous thrombosis.

    LENUS (Irish Health Repository)

    Roche-Nagle, G

    2012-02-01

    OBJECTIVES: Post-thrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT) characterized by chronic pain, swelling and heaviness, and may result in ulceration. Elastic compression stockings (ECS) worn daily after DVT appear to reduce the incidence and severity of PTS. The aims of our study were to investigate practices and perceptions of DVT patients and physicians regarding the use of ECS after DVT. METHODS: Two surveys were conducted. The first was sent to 225 staff and trainee clinicians and the second was administered to 150 DVT patients. RESULTS: The results demonstrated that the majority of senior staff (75%) believed that ECS were effective in preventing PTS and in managing venous symptoms. However, this was in contrast with junior trainees (21%) (P < 0.05). This resulted in only 63% of patients being prescribed ECS post-DVT. There was a lack of consensus as regards the optimal timing of initiation of ECS, duration of therapy and compression strength. Nearly all DVT patients who were prescribed ECS purchased them, 74% wore them daily, and most (61%) reported that ECS relieved swelling and symptoms. Physicians correctly predicted the main reasons for non-compliance, but misjudged the scale of patient compliance with ECS. CONCLUSIONS: Our findings suggest that there is a lack of consensus among doctors regarding ECS use after DVT and widespread education regarding the latest evidence of the benefit of ECS after DVT.

  8. Endovascular Management of Deep venous Thrombosis of Lower Extremity in Patients with Malignant Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Su Jin; Kim, Jae Kyu; Jang, Nam Kyu; Han, Seung Min; Kang, Heoung Keun; Choi, Soo Jin Nah [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2009-07-15

    To evaluate the efficacy of endovascular management of lower extremity deep vein thrombosis (DVT) in patients with malignant disease. Between January 2002 and January 2008, six consecutive patients (5 male and 1 female, mean age-65 years) with lower extremity DVT and malignant disease underwent endovascular management. The duration of symptoms lasted 4-120 days (mean-31 days; 20 days or less in four patients and more than 20 days in two). A catheter-directed thrombolysis was performed via the ipsilateral popliteal vein or common femoral vein, used alone or combined with a percutaneous mechanical thrombectomy. Angioplasty or stent placement was performed in residual stenosis or occlusion of the vein. The follow-up period lasted 1-14 months (mean 7.6 months) and was performed via a color Doppler ultrasonography or computed tomographic venography. Technical success and relief from symptoms was achieved within two days was achieved in five patients. Minor hemorrhagic complications occurred in two cases: hematuria and a hematoma at the puncture site. Upon follow-up, a recurrent DVT occurred in three patients as well as a patent venous flow in two. One patient died within 1 month due to a metastatic mediastinal lymphadenopathy. Endovascular management of the lower extremity DVT is effective for quickly eliminating a thrombus, relieving symptoms, and decreasing hemorrhagic complications in patients with malignant disease.

  9. Prophylactic IVC Filter Placement during Endovascular Treatment of Deep Venous Thrombosis of the Lower Extremities

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk; Cho, Han Il; Lee, Yeum Sik; Bang, Dong Ho; Park, Seong Hoon; Lee, Young Hwan [Wonkwang University Hospital, Iksan (Korea, Republic of)

    2009-09-15

    To evaluate the efficacy of an IVC filter implantation in the prevent of a pulmonary embolism (PE) during endovascular treatment for a deep venous thrombosis (DVT) of the lower extremities. We implanted IVC filters in 43 patients (22 females, 21 males, average age: 63 years) with DVT and who had undergone treatments including thrombolysis, aspiration and mechanical thrombectomy, as well as stent placement. We evaluated the incidence of PE by capturing the thrombus within the IVC filters, as well as the amount of captured thrombus. New developing PE or aggravating of PE in patients with existing PE was avoided in all patients. No thrombus was evident in the IVC filter of 19 (44%) of the patients, whereas any thrombus was captured in 24 (56%) of the patients. Small amounts of thrombus were captured in 10 patients, whereas large amounts of thrombus were captured in 14 patents within the IVC filter. We performed a retrieval of the IVC filters in 17 patients within an average period of 15.3 days (range 6-45 days). The captured incidence of migrated thrombus in the IVC filters was high in 56% of cases. As a result, PE was effectively prevented by IVC filters during the interventional treatment of DVT in the lower extremities.

  10. Acute posttraumatic pediatric cerebral venous thrombosis: Case report and review of literature

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    Al-Wala Awad

    2014-01-01

    Full Text Available Background : Pediatric cerebral venous thrombosis (CVT is a common sequelae of infection, coagulopathies, and dehydration in the pediatric population. Acute posttraumatic CVT is an uncommon etiology of pediatric CVT that presents a unique management challenge. There are no established guidelines outlining the treatment of this small subset of patients. Case Description: We present a case of a 12-year-old boy with posttraumatic CVT who was safely treated with anticoagulation therapy, and had resolution of his symptoms and radiographic improvement within 3 days of therapy. The relevant literature is reviewed. Conclusion : Anticoagulation therapy may be safely used in the treatment of acute posttraumatic CVT in pediatric patients, and may reduce the incidence of clot propagation, hospitalization time, and cost of treatment.

  11. Acute Brachial Artery Thrombosis in a Neonate Caused by a Peripheral Venous Catheter

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    Simon Berzel

    2014-01-01

    Full Text Available This case describes the diagnostic testing and management of an acute thrombosis of the brachial artery in a female neonate. On day seven of life, clinical signs of acutely decreased peripheral perfusion indicated an occlusion of the brachial artery, which was confirmed by high-resolution Doppler ultrasound. Imaging also showed early stages of collateralization so that surgical treatment options could be avoided. Unfractionated heparin was used initially and then replaced by low-molecular-weight heparin while coagulation parameters were monitored closely. Within several days, brachial artery perfusion was completely restored. Acetylsalicylic acid was given for additional six weeks to minimize the risk of recurring thrombosis. If inadequately fixated in a high-risk location, a peripheral venous catheter can damage adjacent structures and thus ultimately cause arterial complications.

  12. Assessment of coagulation function and ultrasound features after reteplase and recombinant streptokinase thrombolysis of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Wei Xiong

    2016-01-01

    Objective: To assess coagulation function and ultrasound features after reteplase and recombinant streptokinase thrombolysis of lower extremity deep venous thrombosis. Methods:A total of 78 cases of patients with lower extremity deep venous thrombosis who were treated in our hospital were selected as research subjects and divided into observation group 39 cases and control group 39 cases according to different treatment regimens. Control group received recombinant streptokinase thrombolysis, observation group received reteplase thrombolysis, and then the effect of the two thrombolytic ways was evaluated by color Doppler ultrasonography and circulating blood test. Results:Ultrasound showed that complete recanalization rate of thrombus of observation group after treatment was higher than that of control group;plasma PT, APTT and TT values of observation group after thrombolysis were higher than those of control group, FIB, D-D, NO, ET, E-selectin, P-selectin, Hcy, CRP, IL-6, IL-8 and TNF-αvalues were lower than those of control group, and WBC, Nc and Mc cell number were less than those of control group. Conclusion:Reteplase for thrombolysis of lower extremity deep venous thrombosis has more distinguished effect on dissolving thrombus as well as optimizing body’s coagulation, inflammatory system state and other aspects, and is a more ideal thrombolytic drug.

  13. Deep venous thrombosis and pulmonary embolism. Part 1. Initial treatment: usually a low-molecular-weight heparin.

    Science.gov (United States)

    2013-04-01

    Patients with deep venous thrombosis are at a short-term risk of symptomatic or even life-threatening pulmonary embolism, and a long-term risk of post-thrombotic syndrome, characterised by lower-limb pain, varicose veins, oedema, and sometimes skin ulcers. What is the best choice of initial antithrombotic therapy following deep venous thrombosis or pulmonary embolism, in terms of mortality and short-term and long-term complications? How do the harm-benefit balances of the different options compare? To answer these questions, we reviewed the available literature using the standard Prescrire methodology. Unfractionated heparin has documented efficacy in reducing mortality and recurrent thromboembolic events in patients with pulmonary embolism or symptomatic proximal (above-knee) deep venous thrombosis. The authors of a systematic review selected 23 trials of low-molecular-weight heparin (LMWH) versus adjusted-dose unfractionated heparin in a total of 9587 patients. Deaths, recurrences and major bleeds were less frequent with LMWH than with unfractionated heparin. The results of other meta-analyses are similar, but all are undermined by a probable publication bias and methodological flaws. Compared to unfractionated heparin, LMWHs have the advantage of fixed-dose administration, once or twice daily, by subcutaneous injection. All available LMWHs seem to have similar efficacy. Those with the longest experience of use are enoxaparin, dalteparin and nadroparin. The harm-benefit balances of fondaparinux and rivaroxaban do not appear more favourable than that of an LMWH followed by an adjusted-dose vitamin K antagonist. A meta-analysis included 12 trials comparing thrombolysis with anticoagulation alone in 700 patients with deep venous thrombosis. Adding a thrombolytic drug did not reduce mortality or the incidence of pulmonary embolism, whereas it increased the incidence of bleeding. A meta-analysis of 13 trials failed to show that adding a thrombolytic drug to initial

  14. Comparison of skin and muscle biopsies before and after pentoxifylline treatment in patients with leg ulcers due to deep venous incompetence.

    Science.gov (United States)

    Angelides, N S; von der Ahe, C W; Themistocleus, P

    1991-01-01

    The aim of this study was to understand the possible mechanisms by which deep venous insufficiency and venous hypertension are associated with trophic skin changes and ulceration and to explain the therapeutic effect of Pentoxifylline in patients with leg ulcers due to deep venous incompetence. Twenty patients were included in this pilot study. They were graded into two groups: group 1, included 10 patients (5 F and 5 M) with deep venous incompetence and normal arteries; group 2, included 10 patients (1 F and 9 M) with deep venous incompetence and moderate arterial disease. Skin and muscle biopsies were carried out before and after the oral administration of 1,200 mg of Pentoxifylline daily (400 mg t.d.s). The following parameters were investigated by means of light microscopy and immunofluorescence tests: engorgement of venous stroma; decrease of intimal elastica; hyaline degeneration; floccular degeneration; pericapillary fibrin deposits and fibrin degradation products; inflammation and fat necrosis; myofibril degeneration; fibrous scar; regeneration and reconstitution of muscle fibres. The results indicated that local inflammation at the ulcer's area cause accumulation of white blood cells in the capillaries and the interstitial fluid, where there is also accumulation of fibrinogen. These changes may lead to chronic tissue ischaemia and ulceration. The known favourable effect of Pentoxifylline on red cells and leucocyte function as well as its lowering effect on plasma fibrinogen level, may be responsible for the observed therapeutic effect of Pentoxifylline on venous leg ulcers.

  15. Gestational related changes in the deep venous system of the lower limb on light reflection rheography in pregnancy and the puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Calderwood, C.J. [St John' s Hospital, Livingston and Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh (United Kingdom)], E-mail: catherine.calderwood@luht.scot.nhs.uk; Jamieson, R. [Princess Royal Maternity Unit, Glasgow Royal Infirmary, Glasgow (United Kingdom); Greer, I.A. [Hull York Medical School, University of York, York (United Kingdom)

    2007-12-15

    Objective: To assess whether light reflection rheography testing is affected by the changes that occur in the deep venous system of the lower limb in pregnancy and the puerperium. Methods: Twenty five women with a singleton pregnancy were recruited to undergo duplex Doppler ultrasound examinations of the common femoral vein to measure the vessel diameter and the blood flow velocity. Light reflection rheography testing was subsequently performed and the rate of venous emptying in the lower limb calculated. Serial measurements using both techniques were made at 15, 28, 36 weeks, and term gestation and at 2 days and 6 weeks postpartum. Results: Duplex Doppler ultrasound confirmed that there is progressive dilatation of the deep venous system in pregnancy, which reaches a maximum at term and reverses after delivery. There is an accompanying reduction in blood flow velocity, which reaches a nadir at term and increases after delivery. The rate of venous emptying as measured by light reflection rheography decreases with increasing gestation, but did not fall to a level consistent with venous occlusion by a deep venous thrombosis. Conclusions: Light reflection rheography has been shown to provide reliable results in pregnancy and the puerperium. Therefore, it is a potential tool for screening for deep venous thrombosis in this population.

  16. Incidence and prevention of venous thromboembolism in acutely ill hospitalized elderly Chinese

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-ying; FAN Jin; CHENG You-qin; WANG Yan; YAO Chen; ZHONG Nan-shan

    2011-01-01

    Background As the third most frequent cardiovascular disease, venous thromboembolism (VTE) remains a major cause of morbidity and mortality in hospitalized patients. The aim of this study was to determine the incidence of VTE and steps for its prevention in acutely ill hospitalized elderly Chinese patients.Methods A prospective multi-center study was conducted from June 2006 to November 2007. A total of 607 patientsfrom 40 research centers in China were enrolled. Data of the patients' baseline characteristics, VTE events and prophylaxis/therapy methods were collected.Results Fifty-nine patients (9.7%) had an objectively confirmed VTE during the 90-day follow-up, of which, 59.3%occurred during the first week and 75% within 14 days. Forty-one patients died (6.6%) during the follow-up, 36.6% died within three weeks. We also found that medical disorders including respiratory failure (16.4%), acute brain infarction (15.6%), acute infectious diseases (14.3%), acute coronary artery syndrome (8.7%) and heart failure (7.6%) play a role in provoking VTE. Only 13.0% of the elderly patients with high risk of VTE used low dose unfractionated heparin, 7.1% used low molecular weight heparin, 5.4% used warfarin,0.3% used graduated compression stockings and none of them used intermittent pneumatic compression.Conclusions Our study showed similar results between our study and western countries in the VTE incidence by day 90 in elderly hospitalized patients with acute medical illness. Great caution must be applied in the care of acutely ill elderly hospitalized patients to deal with the complications of VTE. Application of safe and effective prophylaxes against embolism remains a critical challenge.

  17. Relationship between deep venous thrombosis and inflammatory cytokines in postoperative patients with malignant abdominal tumors

    Directory of Open Access Journals (Sweden)

    T. Du

    2014-11-01

    Full Text Available Deep venous thrombosis (DVT is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP, interleukins (IL-6 and IL-10, nuclear transcription factor-κB (NF-κB and E-selectin (E-Sel were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05. The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively, whereas IL-10 had a protective effect (OR=0.94, P=0.011. Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000. Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.

  18. Radiolabeled tirofiban – a potential radiopharmaceutical for detection of deep venous thrombosis

    Science.gov (United States)

    Darkovska-Serafimovska, Marija; Janevik-Ivanovska, Emilija; Djorgoski, Icko; Arsova-Sarafinovska, Zorica; Zdravkovska, Milka; Balkanov, Trajan; Ugresic, Nenad

    2016-01-01

    Aim The aim of this study was to investigate the possibility of using 99mtechnetium (99mTc)-labeled tirofiban (a reversible antagonist of glycoprotein IIb/IIIa) for detection of deep venous thrombosis (DVT) in rats without causing an antiplatelet effect. Methods The ability of in vitro tirofiban to inhibit adenosine 5′-diphosphate (ADP)-induced platelet aggregation was evaluated using optical aggregometer. Binding of 99mTc-tirofiban to platelets was evaluated. Serum levels of unlabeled (a validated high performance liquid chromatography method) and 99mTc-tirofiban after single intravenous injection were evaluated in male Wistar rats with or without induced DVT (femoral vein ligation model), and the rats were also subjected to whole body scintigraphy. Results Tirofiban in vitro inhibits ADP-induced aggregation of human platelets in a dose- and concentration-dependent manner (10 nM to 2 μM), but only if it is added before ADP and not after ADP. 99mTc labeling did not affect the ability of tirofiban to bind to either human or rat platelets, nor did it affect tirofiban pharmacokinetics in intact rats or in animals with induced DVT. When 99mTc-tirofiban was injected to rats after induction of DVT, at a molar dose lower than the one showing only a weak antiaggregatory effect in vitro, whole body scintigraphy indicated localization of 99mTc-tirofiban around the place of the induced DVT. Conclusion 99mTc labeling of tirofiban does not affect its ability to bind to glycoprotein IIb/IIIa or its in vivo pharmacokinetics in rats, either intact or with DVT. A low, nonantiaggregatory dose of 99mTc-tirofiban may be used to visualize DVT at an early stage. PMID:27713618

  19. Relationship between deep venous thrombosis and inflammatory cytokines in postoperative patients with malignant abdominal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Du, T.; Tan, Z. [National Wuhan University, Zhongnan Hospital, School of Medicine, Department of General Surgery, Wuhan, Hubei Province (China)

    2014-08-22

    Deep venous thrombosis (DVT) is a common surgical complication in cancer patients and evidence that inflammation plays a role in the occurrence of DVT is increasing. We studied a population of cancer patients with abdominal malignancies with the aim of investigating whether the levels of circulating inflammatory cytokines were associated with postoperative DVT, and to determine the levels in DVT diagnoses. The serum levels of C-reactive protein (CRP), interleukins (IL)-6 and IL-10, nuclear transcription factor-κB (NF-κB) and E-selectin (E-Sel) were determined in 120 individuals, who were divided into 3 groups: healthy controls, patients with and patients without DVT after surgery for an abdominal malignancy. Data were analyzed by ANOVA, Dunnet's T3 test, chi-square test, and univariate and multivariate logistic regression as needed. The CRP, IL-6, NF-κB, and E-Sel levels in patients with DVT were significantly higher than those in the other groups (P<0.05). The IL-10 level was higher in patients with DVT than in controls but lower than in patients without DVT. Univariate analysis revealed that CRP, IL-6, NF-κB, and E-Sel were statistically associated with the risk of DVT (OR=1.98, P=0.002; OR=1.17, P=0.000; OR=1.03, P=0.042; and OR=1.38, P=0.003; respectively), whereas IL-10 had a protective effect (OR=0.94, P=0.011). Multivariate analysis showed that E-Sel was an independent risk factor (OR=1.41, P=0.000). Thus, this study indicated that an increased serum level of E-Sel was associated with increased DVT risk in postoperative patients with abdominal malignancy, indicating that E-Sel may be a useful predictor of diagnosis of DVT.

  20. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  1. Effect of the time of diagnosis on outcome in patients with acute venous thromboembolism. Findings from the RIETE Registry.

    Science.gov (United States)

    Lecumberri, Ramón; Soler, Silvia; Del Toro, Jorge; Barba, Raquel; Rosa, Vladimir; Ciammaichella, Maurizio M; Monreal, Manuel

    2011-01-01

    The influence of the day of diagnosis (weekends vs. weekdays) on outcome in patients with acute venous thromboembolism (VTE) has not been thoroughly studied. We used the RIETE database to compare the clinical characteristics, treatment details, and mortality rate at 7 and 30 days, of all patients diagnosed with acute VTE on weekends versus those diagnosed on weekdays. Up to January 2010, 30,394 patients were included in RIETE, of whom 5,479 (18%) were diagnosed on weekends. Most clinical characteristics were similar in both groups, but patients diagnosed on weekends had less often cancer (20% vs. 22%; p=0.004), and presented more likely with pulmonary embolism (PE) than those diagnosed on weekdays (52% vs. 47%; p <0.001). Most patients in both groups received initial therapy with low-molecular-weight heparin (90% and 91%, respectively; p=0.01), then switched to vitamin K antagonists (72% and 71%, respectively; p=0.007). The 7-day mortality rate in patients presenting with PE was 2.75% in those diagnosed on weekends versus 3.00% in those diagnosed on weekdays (p=0.49). At 30 days, the mortality rate was 6.51% versus 6.06%, respectively (p=0.38). In patients presenting with deep vein thrombosis alone, the 7-day mortality rate in those diagnosed on weekends was 1.04% versuss 0.66% in those diagnosed on weekdays (p=0.053). The mortality rate at 30 days was of 3.41% versus 2.88% (p=0.14), respectively. In RIETE, the clinical characteristics, treatment strategies, and 7- and 30-day mortality rates of patients diagnosed on weekends were similar to those in patients diagnosed on weekdays.

  2. Clinical Value of Color Doppler Ultrasound in Diagnosis of Lower Extremity Deep Venous Thrombosis%彩色多普勒超声诊断下肢深静脉血栓的临床价值

    Institute of Scientific and Technical Information of China (English)

    段林; 谢军

    2015-01-01

    Objective To study the color Doppler flow imaging (CDFI) Detection of deep venous thrombosis of the application. Methods 46 patients with lower extremity deep venous thrombosis (DVT) in patients using color Doppler ultrasonic diagnostic apparatus of the lower extremity deep venous acute and chronic thrombosis in patients with inspection, observation of its two-dimensional images, color flow characteristics and spectral characteristics. Results 46 patients with vascular lesions in the two-dimensional ultrasound image, color Doppler flow imaging and spectral Doppler area showed a significant specificity and sensitivity. Conclusion Color Doppler ultrasound accurate, sensitive, non-invasive diagnosis of deep venous thrombosis is one ef ective method worthy of clinical application.%目的:探讨彩色多普勒血流显像(CDFI)检测下肢深静脉血栓的应用价值。方法对46例下肢深静脉血栓(DVT)患者,采用彩色多普勒超声诊断仪对下肢深静脉急、慢性血栓患者进行检查,观察其二维图像、彩色血流特点及频谱特征。结果46例患者的病变血管在二维超声图像、彩色多普勒血流显像以及频谱多普勒方面均有显著的特异性和敏感性。结论彩色多普勒超声检查准确、敏感、无创,是诊断下肢深静脉血栓的有效方法之一,值得临床推广应用。

  3. [A mathematical analysis of strain-gauge curves in the diagnosis of deep venous thrombosis].

    Science.gov (United States)

    Vega Gómez, M E; Ley Pozo, J; Aldama Figueroa, A; Alvarez Sánchez, J A; Charles-Edouard Otrante, D; Fernández Boloña, A; Gutierrez Jiménez, O

    1991-01-01

    The plethysmographic strain gauge venous outflow curves were studied by means of an exponential function. The parameters analyzed made possible the establishment of differences between patients with and without DVT.

  4. Leukocytic Response and Peripheral Venous Blood Lymphocyte Apoptosis as a Marker of Tissue Ischemia in Acute Massive Blood Loss

    Directory of Open Access Journals (Sweden)

    N. V. Borovkova

    2013-01-01

    Full Text Available Objective: to estimate the level of peripheral venous blood lymphocyte apoptosis and intraoperative hypoxia in victims with acute massive blood loss. Subjects and methods. Twenty-two patients with open and close chest and abdominal traumas complicated by acute massive blood loss were examined. All the patients were emergently operated on to stop bleeding. Tissue metabolism was evaluated from gases, acid-base parameters, and plasma lactate, glucose, potassium, and sodium levels. Apoptosis of mononuclear cells was studied and dead leukocytes were counted using flow cytometry. Results. Preoperatively, the victims were found to have venous hypoxemia, hyperlactatemia, hyperglycemia, moderate leukocytosis, and higher dead leukocyte counts. There were also raised counts of lymphocytes coming into the process of apoptosis. A significant relationship was found between monocyte counts and hypoxia values. At the end of surgery, oxygen balance values became stable and exerted an effect on the count of leukocytes, the relative level of granulocytes, the relative and absolute counts of dead and damaged leukocytes, and the concentration of lymphocytes in the victims’ venous blood during the early stages of apoptosis, as evidenced by nonlinear regression models. Conclusion. The indicators of immunocompetent cell apoptosis and the count of venous blood dead leukocytes along with lactate levels and venous hypoxemia parameters reflect the degree of tissue hypoxia and may be used as specific markers.

  5. Analysis of clinical characteristics of 96 patients with acute superior mesenteric venous thrombosis

    Directory of Open Access Journals (Sweden)

    Wen-hui LIU

    2015-06-01

    Full Text Available Objective To investigate the clinical characteristics of patients suffering from acute superior mesenteric venous thrombosis (ASMVT. Methods Clinical data of 96 ASMVT patients admitted to the PLA General Hospital from January 2000 to December 2013 were retrospectively analyzed. Clinical characteristics and death-associated risk factors were studied, and the influence of treatment strategy and thrombosis location on patients' outcome were analyzed. Results The patients were divided into survival group (n=83 and death group (n=13 according to the outcome. The mean age was 46.9 years old, and the ratio of male/female was 3:1. Thirty-nine patients presented isolated superior mesenteric venous thrombosis (SMVT and fiftyseven patients presented combined SMVT. In the death group, higher incidence of severe acute pancreatitis and isolated SMVT were found than the survival group (P<0.01, P=0.004. The patients were again divided into laparotomy group, interventional thrombolysis group, and conservative treatment group according to treatment modality. The interval between symptom onset and treatment was shorter, the incidence of isolated SMVT and mortality rate were higher in the laparotomy group compared with those in interventional thrombolysis group and conservative treatment group. There was no death in the conservative treatment group. In comparison with the combined SMVT group, more patients in the isolated SMVT group presented peritoneal signs and less with history of splenectomy (P<0.001, P=0.002. The proportion of patients with laparotomy and bowel necrosis in the isolated SMVT group was higher than those in the combined SMVT group (P=0.023, P=0.012. Conclusions Patients with isolated SMVT are more likely to have peritoneal signs and bowel necrosis, surgical treatment is mandatory. Patients with combined SMVT often have a history of splenectomy. ASMVT patients with severe pancreatitis may present higher mortality rate. DOI: 10.11855/j

  6. Role of IVC Filters in Endovenous Therapy for Deep Venous Thrombosis: The FILTER-PEVI (Filter Implantation to Lower Thromboembolic Risk in Percutaneous Endovenous Intervention) Trial

    Energy Technology Data Exchange (ETDEWEB)

    Sharifi, Mohsen, E-mail: seyedmohsensharifi@yahoo.com [Arizona Cardiovascular Consultants (United States); Bay, Curt [A.T. Still University, Arizona School of Health Sciences (United States); Skrocki, Laura; Lawson, David; Mazdeh, Shahnaz [Arizona Cardiovascular Consultants (United States)

    2012-12-15

    Objectives: The purpose of this study was to evaluate the necessity of and recommend indications for inferior vena cava (IVC) filter implantation during percutaneous endovenous intervention (PEVI) for deep venous thrombosis (DVT).BackgroundPEVI has emerged as a powerful tool in the management of acute proximal DVT. Instrumentation of extensive fresh thrombus is potentially associated with iatrogenic pulmonary embolism (PE). The true frequency of this complication has not been studied in a randomized fashion. We evaluated IVC filter implantation during PEVI for DVT. Methods: A total of 141 patients with symptomatic proximal DVT undergoing PEVI for symptomatic DVT were randomized to receive an IVC filter (70 patients) or no filter (71 patients; control group). The anticoagulation and PEVI regimen were similar between the two groups. Patients with development of symptoms suggestive of PE underwent objective testing for PE. Results: PE developed in 1 of the 14 symptomatic patients in the filter group and 8 of the 22 patients in the control group (P = 0.048). There was no mortality in any group. Three patients (4.2%) in the control group had transient hemodynamic instability necessitating resuscitory efforts. Predictors of iatrogenic PE were found to be PE at admission; involvement of two or more adjacent venous segments with acute thrombus; inflammatory form of DVT (severe erythema, edema, pain, and induration); and vein diameter of {>=}7 mm with preserved architecture. Conclusions: IVC filter implantation during PEVI reduces the risk of iatrogenic PE by eightfold without a mortality benefit. A selective approach may be exercised in filter implantation during PEVI.

  7. Accuracy of complete compression ultrasound in ruling out suspected deep venous thrombosis in the ambulatory setting. A prospective cohort study.

    Science.gov (United States)

    Sevestre, Marie-Antoinette; Labarère, José; Casez, Pierre; Bressollette, Luc; Taiar, Mébarka; Pernod, Gilles; Quéré, Isabelle; Bosson, Jean-Luc

    2009-07-01

    Evidence on the safety of complete compression ultrasound for ruling out deep venous thrombosis (DVT) is derived from studies conducted in tertiary care centers, although most patients with suspected DVT are managed in the ambulatory office setting. It was the objective of this study to estimate the rate of venous thromboembolism when anticoagulant therapy is withheld from ambulatory patients with normal findings on a single complete compression ultrasound. As part of a prospective cohort study, 3,871 ambulatory patients with clinically suspected DVT were enrolled by 255 board-certified vascular medicine physicians practicing in private offices in France. Compression ultrasound of the entire lower extremities was performed using a standardised examination protocol. Anticoagulant therapy was withheld from patients with negative findings on compression ultrasound, and 1,254 of them were randomly selected for follow-up. The main outcome measure was the three-month incidence of symptomatic venous thromboembolic events confirmed by objective testing. DVT was detected in 1,023 patients (26.4%), including 454 (11.7%) and 569 (14.7%) cases of proximal and isolated distal DVT, respectively. Of the 1,254 patients with negative results sampled for follow-up, six received anticoagulant therapy during follow-up and five were lost to follow-up. Five of 1,243 patients (0.4%, 95% confidence interval [CI], 0.1-0.9) experienced non-fatal symptomatic venous thromboembolic events (pulmonary embolism in two patients and DVT in three patients) and eight of 1,254 patients (0.6%, 95% CI, 0.3-1.2) died during the three-month follow-up. In conclusion, anticoagulant therapy can be safely withheld after negative complete compression ultrasound without further testing in the ambulatory office setting.

  8. Deep Venous Thrombosis with Pulmonary Embolism Related to IVIg Treatment: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Michael T. Flannery

    2015-01-01

    Full Text Available IVIg therapy has potentially been related to arterial and venous therapy. We performed an Ovid review focusing on IVIg and thrombotic events. While a few case reports were reviewed case series and case control studies were particularly reviewed in relation to thrombotic events. Outcomes demonstrate a correlation between underlying cardiovascular risk factors with predominately arterial events which typically occurred within 4–24 hours of infusion. While venous events occurred less commonly they were associated with traditional risk factors and occurred later, typically, 1–7 days following infusion of IVIg. Potential causation of thrombotic events was discussed.

  9. Venous thromboembolism risk and prophylaxis in the acute hospital care setting: the Irish results of the ENDORSE study.

    LENUS (Irish Health Repository)

    Murphy, O

    2012-05-01

    ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting), is a multinational, cross-sectional survey of venous thromboembolism (VTE) risk prevalence and effective prophylaxis in the acute hospital care setting. Three Irish hospitals enrolled in the study. The American College of Chest Physicians (ACCP) guidelines were employed to evaluate VTE risk and prophylaxis. Of 552 patients, 297 (53.8%) and 255 (46.2%) were categorised as surgical or medical, respectively, with 175 (59%) surgical and 109 (43%) medical patients deemed to be at risk for VTE. Of these, only 112 (64%) and 51 (47%) received recommended VTE prophylaxis, respectively. The results are consistent with those observed in other countries and demonstrate a high prevalence of risk for VTE and a low rate of prophylaxis use, particularly in medical patients. Awareness of VTE guidelines should be an integral component of health policy.

  10. Management of venous thromboembolism in patients with acute leukemia at high bleeding risk: a multi-center study.

    Science.gov (United States)

    Napolitano, Mariasanta; Valore, Luca; Malato, Alessandra; Saccullo, Giorgia; Vetro, Calogero; Mitra, Maria Enza; Fabbiano, Francesco; Mannina, Donato; Casuccio, Alessandra; Lucchesi, Alessandro; Del Principe, Maria Ilaria; Candoni, Anna; Di Raimondo, Francesco; Siragusa, Sergio

    2016-01-01

    In the last decades, evaluation of clinically relevant thrombotic complications in patients with acute leukemia (AL) has been poorly investigated. The authors performed a multi-center study to evaluate the management of symptomatic venous thromboembolism (VTE) in adult patients with AL. The intention was to find as clinically relevant the following: symptomatic Venous Thrombosis (VT) occurred in typical (lower limbs) and atypical (cerebral, upper limbs, abdominal, etc) sites with or without pulmonary embolism (PE). Over a population of 1461 patients with AL, 22 cases of symptomatic VTE were recorded in hospitalized patients with a mean age of 54.6 years. The absolute incidence of VTE was 1.5%. VTE occurred during chemotherapy in 17/22 (77.2%) cases, mainly (14/17, 82.3%) during the induction phase. Treatment of acute VTE was based on Low Molecular Weight Heparin (LMWH) at full dosage for the first month from diagnosis and reduced dosage (75%) for the following months.

  11. [Surgical treatment of acute deep leg and pelvic vein trombosis].

    Science.gov (United States)

    Gall, F; Husfeldt, K J

    1977-08-25

    In the last 3 years 93 cases of iliofermoral trombosis were treated by surgery. We prefer the method used by Brunner, but under general anaesthesia and using a Bentley-Autotransfusion-System (ATS). The average age of our patients was 55 years (age ranged between 17 and 87 years). No lethal pulmonary embolism was observed. 2, 1 percent of the patients died following apoplex or acute heart failure. Of 67 patients who were operated on 6 months ago or more 70 percent have no further complaints, 28 percent still have some residual edema and only 2 patients have a severe postthrombotic syndrome. 50 percent of 40 control-phlebograms demonstrated patency of all veins. 20 percent had short segmentary occlusions with definite signs of recanalisation, while in 27 percent of the cases occlusions of the lower leg and thigh were found, the iliac veins being free. Only 2 postoperative phlebograms showed a complete iliofemoral venous occlusion. Our results prove, that the operative thrombectomy is a successful method, with which the main complications of the iliofemoral thrombosis-pulmonary embolisation and postthrombotic syndrome-can difinitely be reduced. Also because of better long term results, the operative therapy of acute ilofemoral thrombosis should be generally prefered instead of conservative treatment.

  12. Contact thermography, 99mTc-plasmin scintimetry and 99mTc-plasmin scintigraphy as screening methods for deep venous thrombosis following major hip surgery

    DEFF Research Database (Denmark)

    Christensen, S W; Wille-Jørgensen, P; Kjaer, L

    1987-01-01

    Fifty-six patients scheduled for total hip alloplasty were screened for deep venous thrombosis by means of 99mTc-plasmin scintimetry, 99mTc-plasmin scintigraphy and contact thermography. Investigations were performed on the seventh postoperative day, and a total of 112 legs were examined. Bilateral....... The nosographic sensitivity/specificity was 33%/75% for scintimetry, 50%/91% for scintigraphy and 33%/87% for contact thermography, respectively. It is concluded that all three tests are of no value as screening methods for deep venous thrombosis following major elective hip surgery....

  13. Postural abnormality as a risk marker for leg deep venous thrombosis in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Kazushi Yamane

    Full Text Available BACKGROUND: Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abnormalities as assessed by photographic measurements. METHODS: This cross-sectional study assessed the presence of deep vein thrombosis using bilateral leg Doppler ultrasonography in 114 asymptomatic outpatients with Parkinson's disease. RESULTS: Deep vein thrombosis was detected in 23 patients (20% with Parkinson's disease. Deep vein thrombosis was located in the distal portion in 18 patients and in the proximal portion in 5 patients. No significant differences in age, sex, body mass index, disease duration, Hoehn-Yahr stage, anti-Parkinson's drugs, or daily levodopa-equivalent dose were seen between deep vein thrombosis-positive and -negative groups. Univariate analysis for developing deep vein thrombosis in patients with Parkinson's disease identified the following markers: long-term wheelchair use, bent knee, bent spine, and D-dimer elevation. Bending angles were significantly greater in the deep vein thrombosis-positive group at the knee and spine than in the deep vein thrombosis-negative group. Half of Parkinson's disease patients with camptocormia had deep vein thrombosis. Among diabetes mellitus cases, long-term wheelchair use, bent knee over 15°, camptocormia, D-dimer elevation, the more risk markers were associated with a higher incidence of DVT. The presence of risk markers contributed to the development of deep vein thrombosis. On multivariate logistic regression analysis, a bent knee posture was strongly associated with an increased risk of deep vein thrombosis. CONCLUSION: Presence of leg deep vein thrombosis correlated with postural abnormalities in Parkinson's disease. We recommend non-invasive ultrasonographic screening for leg

  14. 产后下肢深静脉血栓的病因及预防%Cause and Prevention of Postpartum Deep Venous Thrombosis of Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    钱芳; 赵小魁; 吴萍; 黄文英; 线小英

    2012-01-01

    目的:探讨产后下肢深静脉血栓形成的原因及预防.方法:对我院2006年1月至2010年12月发生的8例产后下肢深静脉血栓形成的病例资料进行回顾性分析.结果:所有病例经治疗后症状改善,复查超声提示血栓消失.无一例发生肺栓塞.结论:产后下肢深静脉血栓形成与血液高凝状态、血流缓慢以及静脉壁损伤等因素有关.严格掌握剖宫产手术指征,降低剖宫产率,产后早下床活动以促进静脉回流可预防深静脉血栓形成.%Objective: To investigate the causes and prevention methods of postpartum deep venous thrombosis of lower extremities. Methods: Clinical data of 8 patients with postpartum deep vein thrombosis of lower extremities were analyzed and summarized in our department from January, 2006 to December, 2010. Result: After the treatment, the symptoms and signs of all the cases were relieved. Ultrasound showed that deep venous thrombosis was disappeared. No one pulmonary embolism occurred. Conclusion: Factors which induced postpartum deep venous thrombosis of lower extremities are related to blood hypercoagulability, slow blood flow and venous endothelium injury, and so on. The indications of cesarean section should be controlled to reduce the rate of cesarean section. Early postpartum activities are taken to accelerate the venous refluence, which can prevent deep venous thrombosis of lower extremities.

  15. 彩色多普勒超声对下肢深静脉血栓形成的诊断价值%Application value of color Doppler ultrasound in diagnosing lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    靳静

    2016-01-01

    目的 探讨彩色多普勒超声对下肢深静脉血栓形成的诊断价值.方法 选取2011年3月至2015年11月河北省廊坊市人民医院行彩色多普勒超声检查的下肢深静脉血栓形成患者63例,结合患者临床表现,分析彩色多普勒超声检查结果.结果 63例下肢深静脉血栓形成患者经彩色多普勒超声检查,左下肢40例(63.5%),右下肢20例(31.7%),双下肢2例(3.2%),漏诊1例(1.6%),诊断率为98.4%(62/63).62例确诊患者中急性栓塞14例(22.2%),亚急性栓塞40例(63.5%),慢性栓塞8例(12.7%).结论 应用彩色多普勒超声对下肢深静脉血栓高危患者进行检查,无创安全、及时准确、可重复操作且经济便捷,为临床提供可靠的诊断依据,是诊断下肢深静脉血栓形成的首选辅助检查方法.%Objective To explore the value of color Doppler ultrasound in diagnosing lower extremity deep venous thrombosis.Methods Sixty-three cases with lower extremity deep venous thrombosis who underwent color Doppler ultrasound from March 2011 to November 2015 were enrolled.The results of color Doppler ultrasound were analyzed based on clinical data.Results Totally 40 cases (63.5%) of left lower limb,20 cases (31.7%) of right lower limb and 2 cases (3.2%) of bilateral lower limb deep venous thrombosis were diagnosed by color Doppler ultrasound,1 case (1.6%) was missed,with diagnostic rate of 98.4% (62/63);among the 62 patients,14 cases (22.2%) were confirmed as acute lower extremity deep venous thrombosis,40 cases (63.5%) were confirmed as subacute lower extremity deep venous thrombosis and 8 cases (12.7%) were confirmed as chronic lower extremity deep venous thrombosis.Conclusion Color doppler ultrasound is non-invasive,safe,timely,accurate,repeatable,inexpensive and convenient,and is a preferred method for diagnosing lower extremity deep venous thrombosis.

  16. Postural Abnormality as a Risk Marker for Leg Deep Venous Thrombosis in Parkinson’s Disease

    OpenAIRE

    Kazushi Yamane; Fumiharu Kimura; Kiichi Unoda; Takafumi Hosokawa; Takahiko Hirose; Hiroki Tani; Yoshimitsu Doi; Simon Ishida; Hideto Nakajima; Toshiaki Hanafusa

    2013-01-01

    BACKGROUND: Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abnormalities as assessed by photographic measurements. METHODS: This cross-sectional study assessed the presence of deep vein thrombosis using bilateral leg Doppler ultrasonography in 114 asymp...

  17. Presentación de un caso: trombosis venosa profunda bilateral de etiología infrecuente Case report: rare bilateral deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Mónica Fernández del Castillo Ascanio

    2012-03-01

    Full Text Available La agenesia de vena cava inferior (VCI es una patología poco frecuente que suele diagnosticarse a raíz de una trombosis venosa secundaria sintomática de las venas ilíacas. Presentamos el caso de un varón de 28 años que acude al centro de salud por dolor en miembros inferiores y datos de insuficiencia venosa. Se visualiza mediante ecografía trombosis venosa profunda (TVP bilateral.Agenesis of the inferior vena cava (IVC is a rare condition usually diagnosed as secondary to symptomatic deep venous thrombosis of iliac veins. We report a 28-year-old male that was admitted in the medical center due to pain in both legs and history of venous insufficiency. Ultrasound reveáis bilateral deep venous thrombosis.

  18. The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity

    Directory of Open Access Journals (Sweden)

    Fahad Al-Hameed

    2015-01-01

    Full Text Available The diagnosis of deep venous thrombosis (DVT may be challenging due to the inaccuracy of clinical assessment and diversity of diagnostic tests. On one hand, missed diagnosis may result in life-threatening conditions. On the other hand, unnecessary treatment may lead to serious complications. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia (KSA, an expert panel led by the Saudi Association for Venous Thrombo-Embolism (SAVTE; a subsidiary of the Saudi Thoracic Society with the methodological support of the McMaster University Working Group, produced this clinical practice guideline to assist healthcare providers in evidence-based clinical decision-making for the diagnosis of a suspected first DVT of the lower extremity. Twenty-four questions were identified and corresponding recommendations were made following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE approach. These recommendations included assessing the clinical probability of DVT using Wells criteria before requesting any test and undergoing a sequential diagnostic evaluation, mainly using highly sensitive D-dimer by enzyme-linked immunosorbent assay (ELISA and compression ultrasound. Although venography is the reference standard test for the diagnosis of DVT, its use was not recommended.

  19. Evaluation of molecular genetic variation associated with deep venous thrombosis in lower limb fractures in traumatic patients

    Directory of Open Access Journals (Sweden)

    Ali Tabrizi

    2012-01-01

    Full Text Available Background: Genetic variation in multiple genes associated with hemostasis and thrombosis is well documented to impact the rates of future venous thromboembolism; in addition, trauma and orthopedic surgery in lower limb and immobilization are important factors in increasing the incidence of thrombosis. Gene mutation can be predisposing factor for thrombosis in traumatic patients under anti-coagulant agent prophylaxis. The aim of this study is to evaluate the different gene mutations in these patients. Materials and Methods: In this cross-sectional descriptive study, the sample consisted of 53 patients with deep venous thrombosis (DVT and 32 traumatic patients without thrombosis as the control group. Two groups matched together according to sex, age, weight, and medications. DNA analysis for mutation of multivariate of genes in thrombosis was studied. Results: Regarding gene variations, there was statistically significant difference only in Prothrombin (Factor II, G20210A between the patients with thrombosis and control group (P = 0.01. But, there was no difference between two groups considering other gene mutations. Mutation of Prothrombin gene (G20210A was a predictive factor for thrombosis with odds ratio of 1.1 (CI 0.3-1.9. Conclusion: According to the outcomes resulted from this study, genetic mutation in Prothrombin (Factor II [G20210A] is one of the most important genetic variations involved in traumatic patients with DVT despite prophylaxis. Genetic mutation in Prothrombin appears to be predisposing factor for thrombosis associated with trauma.

  20. Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

    Science.gov (United States)

    Wang, Chun-xi; Han, Li-na; Gu, Ying; Liang, Fa-qi; Zhang, Li; Liu, Hong-yi; Zhao, Wen-guang; Wang, Qi; Wang, Xiao-ling

    2007-11-01

    The purpose of this article is to report long-term follow-up of improved external vulvuloplasty, intravenous laser photocoagulation and local sclerotherapy treatment of primary deep venous valvular insufficiency in eight hundred and seventy-two patients from Nov. 2000 to May 2006. Patients were evaluated clinically and with duplex ultrasound at 1, 3, and 12 months, and yearly thereafter until the fifth year to assess treatment efficacy and adverse reactions. Successful occlusion of the great saphenous vein and absence of deep vein reflux on color Doppler imaging, were noted in 956 limbs of 852 cases( 1 month follow-up), 946 limbs of 842 cases (6 month to 1 year follow-up), 717 of 626 (1~2 year follow-up), 501 of 417 (2~3 year follow-up), 352 of 296 (3~5year follow-up), 142 of 106 (5 year follow-up) after initial treatment. The cumulative total number of recurrence of reflux was fifteen cases. The respective competence rate was 95.18%, 96.23%, 94.23%, 95.25%, 94.23% and 94.12%. Of note, all recurrence occurred before 9 months, with the majority noted before 3 months. Bruising was noted in 0.7% of patients, tightness along the course of treated vein in 1.0% of limbs. There have been no paresthesia of cases, skin burns and deep vein thrombosis.

  1. High risk of pulmonary embolism and deep venous thrombosis but not of stroke in granulomatosis with polyangiitis (Wegener's)

    DEFF Research Database (Denmark)

    Faurschou, Mikkel; Obel, Niels; Baslund, Bo

    2014-01-01

    OBJECTIVE: To assess the incidence of stroke, pulmonary embolism (PE), and deep venous thrombosis (DVT) in granulomatosis with polyangiitis (Wegener's) (GPA). METHODS: Patients diagnosed with GPA at a Danish tertiary care center during 1993-2011 were identified (n = 180). Each patient was matched...... with 19 population controls (n = 3,420). Information on hospitalizations for stroke, PE, and DVT was obtained from the Danish National Hospital Register. The occurrence of vascular events in the GPA cohort was compared with that in the control group by calculation of incidence rate ratios (IRRs). RESULTS......: The median duration of followup was 7.2 years (interquartile range 3.1-11.7 years) in the GPA cohort. Within the first 2 years following the diagnosis of vasculitis, the incidences of PE and DVT were substantially increased among the patients (IRR 25.7 [95% confidence interval (95% CI) 6.9-96] for PE and IRR...

  2. Acutely altered hemodynamics following venous obstruction in the early chick embryo

    NARCIS (Netherlands)

    S. Stekelenburg-de Vos (Sandra); N.T.C. Ursem (Nicolette); W.C.J. Hop (Wim); J.W. Wladimiroff (Juriy); A.C. Gittenberger-de Groot (Adriana); R.E. Poelmann (Robert)

    2003-01-01

    textabstractIn the venous clip model specific cardiac malformations are induced in the chick embryo by obstructing the right lateral vitelline vein with a microclip. Clipping alters venous return and intracardiac laminar blood flow patterns, with secondary effects on the mechanical

  3. Combined use of clinical pre-test probability and D-dimer test in the diagnosis of preoperative deep venous thrombosis in colorectal cancer patients

    DEFF Research Database (Denmark)

    Stender, Mogens; Frøkjaer, Jens Brøndum; Hagedorn Nielsen, Tina Sandie

    2008-01-01

    The preoperative prevalence of deep venous thrombosis (DVT) in patients with colorectal cancer may be as high as 8%. In order to minimize the risk of pulmonary embolism, it is important to rule out preoperative DVT. A large study has confirmed that a negative D-dimer test in combination with a low...

  4. Cost-Effectiveness of Dabigatran Compared to Vitamin-K Antagonists for the Treatment of Deep Venous Thrombosis in the Netherlands Using Real-World Data

    NARCIS (Netherlands)

    van Leent, Merlijn W. J.; Stevanovic, Jelena; Jansman, Frank G.; Beinema, Maarten J.; Brouwers, Jacobus R. B. J.; Postma, Maarten J.

    2015-01-01

    Background Vitamin-K antagonists (VKAs) present an effective anticoagulant treatment in deep venous thrombosis (DVT). However, the use of VKAs is limited because of the risk of bleeding and the necessity of frequent and long-term laboratory monitoring. Therefore, new oral anticoagulant drugs (NOACs)

  5. 深静脉穿刺置管在急诊中的应用%Application of Deep Venous Puncture in Emergency Department

    Institute of Scientific and Technical Information of China (English)

    熊伟

    2015-01-01

    目的分析探讨深静脉穿刺置管术在急诊临床工作中的应用价值。方法回顾性分析我院2012年10月~2014年10月52例行深静脉穿刺置管的患者进行分析。结果深静脉穿刺置管术成功率高,能迅速的帮助休克患者补液,抢救效果良好,且并发症少。结论深静脉穿刺置管术是一项效果明显的急救技术,在急诊抢救工作中有重要作用。%Objective To explore the application value of deep venous puncture and catheterization in emergency treatment.Methods Retrospective analysis of 52 patients with deep venous catheterization from October 2012 to October 2014 in our hospital.Results The success rate of deep venous catheterization was high,and it can help the patients with shock in a rapid rate of fluid infusion,the rescue ef ect is good,and the complications are few.Conclusion Deep venous catheterization is an ef ective emergency treatment technology,which plays an important role in the emergency rescue work.

  6. A Unique Case of Pulmonary Hyalinizing Granuloma Associated With FDG-avid PET Scan and Deep Venous Thrombosis.

    Science.gov (United States)

    Khalid, Imran; Stone, Chad; Kvale, Paul

    2009-04-01

    An 83-year-old obese woman with a 60-pack-year smoking history was referred for evaluation of an abnormal chest radiograph [chest x-ray (CXR)]. Her past medical history was significant for recurrent deep venous thrombosis without any predisposing factors. CXR showed a large mass in the right mid lung and another nodule at the right apex, highly suspicious for a neoplastic process. These were not present on a CXR from 2 years earlier. An fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scan revealed that all lesions were strongly FDG-avid. Six CT-guided core-needle lung biopsy specimens were obtained from the lung mass and all contained dense, lamellar, or "ropy" keloid-like collagen bundles arranged in a haphazard pattern. The biopsy specimens lacked significant necrosis and granulomas. Congo red stain with polarization was also negative for amyloid. The diagnosis of pulmonary hyalinizing granuloma (PHG) was made. A complete hypercoagulable workup was performed but no underlying abnormalities were found, including a negative lupus anticoagulant and malignancy workup. The patient was maintained on warfarin and followed with serial CT scans for 1 year, with spontaneous regression in the lung mass. The case is unique as it is the first case that reports an association of PHG with recurrent deep venous thrombosis in the absence of autoimmune or procoagulant factors and emphasizes the need for life-long anticoagulation in such scenarios. Also, we report the FDG-avid PET scan findings here that are novel for this disease in adults and add PHG to the list of diseases causing false-positive PET scans when malignancy is suspected.

  7. Predictors for the development of post-thrombotic syndrome in patients with primary lower limb deep venous thrombosis: A case-control study.

    Science.gov (United States)

    Siddiqui, Nadeem A; Sophie, Ziad; Zafar, Farhan; Soares, Delvene; Naz, Iram

    2017-02-01

    Introduction Post-thrombotic syndrome is a common and debilitating sequelae of lower limb deep venous thrombosis. Very little awareness is present about the risk factors and about the diagnosis, prevention, and treatment of this condition. Objective The objective of this study is to identify the predictors of post-thrombotic syndrome after lower limb deep venous thrombosis. Materials and methods A case-control study was conducted on all adult patients who were admitted with lower limb deep venous thrombosis at our institution from January 2005 to June 2012. These patients were scheduled for a research clinic visit, which included informed consent, data collection, and physical examination. Patients found to have post-thrombotic syndrome served as cases and those without post-thrombotic syndrome served as controls. Villalta scoring system was used to diagnose the post-thrombotic syndrome and then to assess the severity of the condition in both the groups. Cox regression risk factor analysis was performed to identify the predictors of post-thrombotic syndrome. Results Out of the 125 patients examined, 49 were found to have post-thrombotic syndrome. Risk factors found to be significant were body mass index of more than 35 kg/m(2) ( n = 13, p = 0.003), history of immobilization ( n = 19, p = 0.003), one or more hypercoagable disorders ( n = 32, p = 0.02), iliofemoral deep venous thrombosis ( n = 18, p = 0.001), complete obstruction on ultrasound ( n = 26, p = 0.016), unstable range of international normalized ratio ( n = 23, p = 0.041) and non-compliance for the use of compressions stockings ( n = 14, p = 0.001). On multivariate analysis, one or more hypercoagable disorder, iliofemoral deep venous thrombosis, and non-compliance to the use of compression stockings were found to be independent risk factors for the development of post-thrombotic syndrome. Conclusion One or more hypercoagable disorders, iliofemoral

  8. Percutaneous aspiration thrombectomy for the treatment of acute lower extremity deep vein thrombosis: is thrombolysis needed?

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, S.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of); Oh, J.H. [Department of Radiology, Kyung Hee University Medical Center, Seoul (Korea, Republic of)], E-mail: radkwon@dreamwiz.com; Seo, T.-S. [Department of Radiology, Korea University Guro Hospital, Seoul (Korea, Republic of); Ahn, H.J.; Park, H.C. [Department of Surgery, Kyung Hee University Medical Center, Seoul (Korea, Republic of)

    2009-05-15

    Aim: To assess the technical feasibility and initial success of aspiration thrombectomy as a potential alternative to lytic therapy in initial endovascular management of acute lower extremity deep vein thrombosis (DVT). Materials and Methods: From July 2004 to October 2007, a retrospective analysis of 27 patients (male:female 5:22; mean age 59 years) with acute iliofemoral or femoropopliteal DVT of less than 2 weeks was performed. All patients underwent sonography of the lower extremities, and 13 patients underwent computed tomography (CT) venography. All patients received an inferior vena cava (IVC) filter and were initially treated with aspiration thrombectomy using the pullback technique with or without basket thrombus fragmentation. If persistent stenotic portions (>50% luminal narrowing) were noted, balloon angioplasty or stent placement was performed. Successful recanalization was defined as successful restoration of antegrade flow in the treated vein with elimination of any underlying obstructive lesion. Results: The mean procedure time was 65 min (range 40-100 min). Successful initial recanalization was achieved in 24 patients (88.9%) without complications. Urokinase was required for three patients (11.1%) due to a hard thrombus remaining in the iliac vein. Of the 27 patients, 23 had residual venous stenosis in the common iliac vein or external iliac vein. Therefore, balloon angioplasty (n = 23) and stent placement (n = 22) was performed. The remaining four patients were treated using only aspiration thrombectomy without angioplasty or stent placement. Conclusion: Aspiration thrombectomy without catheter-directed thrombolysis is a safe and effective treatment for acute DVT of the lower extremities, and minimizes the risk of haemorrhagic complications.

  9. Study on the significance of color Doppler ultrasound in diagnosis of deep venous thrombosis%彩色多普勒超声诊断下肢深静脉血栓的应用价值研究

    Institute of Scientific and Technical Information of China (English)

    邱爽

    2013-01-01

    Objective To explore the significance of color Doppler ultrasound in diagnosis of deep venous thrombosis. Methods Ninety patients with deep vein thrombosis were examined by color Doppler ultrasound using GE LOGIQ E9 color Doppler ultrasonographic instrument for checking bilateral iliac vein, external iliac vein, femoral vein, popliteal vein, posterior tibial vein, anterior tibial vein and its branches, in order to observe the distribution of deep vein thrombosis and various thrombotic ultrasonographic characteristics. Results 1. Deep venous thrombosis had been found in 103 limbs of 90 patients including unilateral venous thrombosis in 77 cases, bilateral thrombosis in 13 cases, venous thrombosis located in left side of 74 (71. 84% ) limbs, and in right side of 29 (28. 16% ) limbs. Femoral vein thrombosis occupied highest proportion, and it reached 32.04% , followed by iliac vein and femoral vein reached 21.36% , the lowest percentage in iliac vein reached 4. 85%. 2. The ultrasound image of acute thrombosis manifested as uniform hypoechoic venous lumen occlusion or partial blockage of lumen with widened smooth wall. The ultrasound image in chronic thrombus manifested as irregular hyperechoic shape in occluded or partial occluded venous lumen, and the lumen became smaller with localized or diffuse thickening and rough inner wall. Conclusion Color Doppler ultrasound has high significance in diagnosis of deep venous thrombosis.%目的 探讨彩色多普勒超声诊断下肢深静脉血栓的应用价值.方法 90例下肢深静脉血栓患者均接受彩色多普勒超声检查,采用GE LOGIQ E9彩色多普勒超声诊断仪,依次检查双侧髂总静脉、髂外静脉、股静脉、胭静脉、胫后静脉、胫前静脉及其分支,观察下肢深静脉血栓分布情况及各种血栓声像图特征.结果 ①90例患者中,共显示103条患肢存在下肢深静脉血栓,其中单侧77例,双侧13例,左侧74条(71.84%),右侧29条(28.16%).股

  10. [Diagnostic validity of radionuclide phlebography in the detection of clinically occult deep venous thrombosis in patients with thromboembolism].

    Science.gov (United States)

    Markovic, S; Baskot, B; Ajdinovic, B; Pervulov, S; Gligic, B; Perovanovic, M

    2001-01-01

    Diagnostic reliability of radionuclide phlebography (RNP) compared to contrast phlebography in the detection of deep veins' thrombosis (DVT) in patients with confirmed thromboembolism of the lungs (TEL) was evaluated. RNP. These findings were compared to contrast phlebography (CP), performed in the group of 25 patients in whom TEL was confirmed clinically, radiologically, scintigraphically and biochemically, but without clinical signs and symptoms of DVT. In 15 patients where RNP revealed unilateral DVT, CP finding was confirmed in all: in 6 (40%) on the left, and in 9 (60%) on the right side. In 10 patients with bilateral signs of DVT observed by scintigraphy, DVT finding was confirmed in 7 (70%), while in 3 (30%) patients, scintigraphic signs of DVT were falsely positive. In the segments of deep venous system, specificity of RNP in the detection of DVT in the lower leg was 60%, sensitivity was 100%, accuracy was 64% with 62% falsely positive findings. In the upper legs specificity was 79%, sensitivity was 100%, and accuracy was 86% with 24% falsely positive findings, while in the pelvis specificity was 87%, sensitivity was 100%, accuracy was 83% with 14% falsely positive findings.

  11. Experience in clinical nursing of patients undergoing deep venous catheterization%心血管疾病护理中不安全因素分析

    Institute of Scientific and Technical Information of China (English)

    刘传芬; 吴漫

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. ConclusionEnhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%本文将2010年6月-2012年6月来我院进行治疗的心血管患者198例作为研究对象,分析护理过程中存在的不安全因素,进而提出相关的改进措施。采取问卷调查的方式,本文对其中的不安全因素进行了归纳总结,得出心血管科的护理人员应该对护理过程中所存在的这些不安全因素给予足够的重视,通过自身护理水平的不断提高来减少医患之间的纠纷,进而提高医院的整体服务质量。

  12. Acute deep vein thrombosis and endovascular techniques: It is time for a new aggiornamento!

    Science.gov (United States)

    Pernès, J-M; Auguste, M; Kovarski, S; Borie, H; Renaudin, J-M; Coppe, G

    2012-10-01

    The stated aims of treating acute deep vein thrombosis (DVT) are to prevent a pulmonary embolism, stop the clot from spreading, reduce the risk of a recurrence; they are less concerned with the late morbidity associated with post-thrombotic syndrome (PTS). In accordance with the French (Afssaps, 2009) and North American (ACCP, 2008) recommendations, anticoagulants (LMWH, heparin, AVK) form the cornerstone for treating DVT. These treatments appear to be far less effective in preventing post-thrombotic syndrome (PTS), associated with venous hypertension, residual occlusion, and with reflux caused by valve incompetence. Given that, the new aim is to optimise the prevention of PTS, the ACCP guidelines, unlike those of Afssaps, "suggest" for selected patients suffering from acute iliofemoral DVT, the use of both classic anticoagulants, and in situ percutaneous administration of thrombolytic drugs (recommendation grade 2B) and simultaneous correction of any underlying anatomical anomalies using angioplasty and stenting (recommendation 2C). Contemporary endovascular methods, referred to collectively as "facilitated" thrombolysis, combine low doses of rtPa or Urokinase administered locally, and the removal of the clot using various mechanical, rotating, rheolytic systems, or using ultrasound. The results of non-randomised, heterogeneous studies objectivised a lysis rate of 80%, a 50% lower risk of haemorrhage complications compared with systemic thrombolysis (<4%), and a clear reduction in treatment time (one-shot methods possible for procedures lasting less than 2 hours). This data ties in with the modern "open vein" concept which underpins the hope of an improvement in the late prognosis of acute DVT, through the removal of a clot, thereby improving permeability and valve integrity; this hypothesis is supported by the results at 24 months of a randomised CaVent objectifying absolute risk reduction of 15% in the thrombolysis in situ. The current randomised study (ATTRACT

  13. Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Sh, Hongjian [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)], E-mail: shihongjian@sina.com; Huang Youhua; Shen Tao; Xu Qiang [Department of Radiology, Affiliated Wujin Hospital of Jiangsu University, 2 North Yongning Road, Changzhou 213002 (China)

    2009-08-15

    Purpose: To evaluate the efficacy of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in the treatment of massive symptomatic lower limb deep venous thrombosis (DVT). Materials and methods: One hundred and three clinically confirmed DVT patients were discharged from our institution. Sixteen patients with massive lower limb DVT were included in this retrospective study. After prophylactic placement of inferior vena cava filters (IVCFs), percutaneous mechanical thrombectomy (ATD, n = 10; Straub, n = 6) and catheter-directed thrombolysis were performed in all patients. Complementary therapy included percutaneous transluminal venous angioplasty (PTA, n = 3) and stent placement (n = 1). The doses of thrombolytic agents, length of hospital stay, peri-procedure complications and discharge status were reviewed. Oral anticoagulation was continued for at least 6 months during follow-up. Results: The average hospital stay was 7 days. The technical success rate (complete and partial lysis of clot) was 89%, the other 11% patients only achieved less than 50% clot lysis. The mean dose of urokinase was 3.3 million IU. There were no significant differences of clinical outcome between the ATD and Straub catheter group. The only major complication was an elderly male who experienced a fatal intracranial hemorrhage while still in the hospital (0.97%, 1/103). Minor complications consisted of three instances of subcutaneous bleeding. No transfusions were required. Vascular patency was achieved in 12 limbs during follow-up. No pulmonary emboli occurred. There is one recurrent DVT 4.5 months after the treatment. Conclusions: Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis is an effective and safe method for the treatment of symptomatic DVT. A randomized prospective study is warranted.

  14. Venous pCO(2) and pH can be used to screen for significant hypercarbia in emergency patients with acute respiratory disease.

    Science.gov (United States)

    Kelly, Anne-Maree; Kyle, Elizabeth; McAlpine, Ross

    2002-01-01

    This prospective study of patients with acute respiratory illness or potential ventilatory compromise compared pCO(2) and pH on an arterial and a venous blood sample with the aims of determining whether venous pH and pCO(2) can replace arterial values in the management of patients with acute respiratory disease and to determine whether there is a cut-off level of venous pCO(2) that can accurately screen for significant hypercarbia (pCO(2) > 50 mm Hg). Data were analyzed using bias plot and receiver operator characteristic (ROC) curve methods. There were 196 sample-pairs analyzed; 56 (29%) had significant hypercarbia. For pH, there was very good agreement with venous samples being an average of 0.034 pH units lower than arterial samples. With respect to pCO(2), there was only fair agreement, with the pCO(2) on average 5.8 mm Hg higher in venous samples and 95% limits of agreement -8.8 to +20.5 mm Hg. The ROC curve analysis showed that a venous pCO(2) level of 45 mm Hg was a potential screening cutoff (sensitivity for the detection of hypercarbia of 100%, specificity 57%). This study shows that venous pH is an acceptable substitute for arterial measurement but there is not sufficient agreement for venous pCO(2) to be able to replace arterial pCO(2) in the clinical evaluation of ventilatory function. Venous pCO(2) may be able to be used as a screening test for hypercarbia using a screening cut-off of 45 mm Hg.

  15. Veno-venous extracorporeal membrane oxygenation in a patient with severe acute respiratory failure – case report

    Science.gov (United States)

    Dec, Paweł Łukasz; Lesińska, Anna Justyna; Bocheńska, Anna; Wasilewski, Piotr; Feldyk, Grzegorz; Kubisa, Anna; Pieróg, Jarosław; Bielewicz, Michał; Grodzki, Tomasz

    2015-01-01

    Acute respiratory failure resistant to conventional pulmonary therapy often requires intensive medical care. In rare cases, ventilator therapy proves insufficient, and only the option of employing veno-venous extracorporeal membrane oxygenation (ECMO V-V) remains. The present article describes the case of a 23-year-old patient who experienced severe acute respiratory distress syndrome with associated multiple organ failure. The patient was admitted to the pulmonary ward of the Alfred Sokołowski Regional Pulmonary Hospital in Szczecin-Zdunowo with suspected pneumonia of unknown etiology. After the initial 5 days of diagnostics at the pulmonary ward, the patient required a further 97 days of hospital treatment and spent 63 days at the Intensive Care Unit. There, he underwent ECMO V-V therapy lasting 22 days, which resulted in the improvement of his arterial blood gas parameters and clinical condition. PMID:26336483

  16. Venous Sampling

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Venous sampling Venous sampling is a diagnostic procedure that uses ... the limitations of venous sampling? What is venous sampling? Venous sampling is a diagnostic procedure that involves ...

  17. Research progress in the application of inferior vena cava filter on acute venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Ioannis Stefanidis; George Galyfos; Stavros Kerasidis; Ioannis Stamatatos; Georgios Geropapas; Sotirios Giannakakis; Georgios Kastrisios; Gerasimos Papacharalampous; Chrisostomos Maltezos

    2015-01-01

    Anticoagulant therapy using heparins or per os vitamin K antagonists has been the treatment of choice in patients with venous thromboembolic disease for decades. However, the introduction of inferior vena cava (IVC) filters recently has provided new therapeutic choices appropriate for specific groups of patients with venous thromboembolic disease. This review aims to present all current evidence on the indications and precautions for the proper IVC filters utilization. There is still a great challenge in identifying the proper populations that would benefit from an IVC filter implantation or extraction. New randomized trials are needed to produce safe and clear guidelines of proper use.

  18. Anatomic variation of the deep venous system and its relationship with deep vein thrombosis found on the lower extremity venograms that were obtained after artificial joint replacements

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Sun; Lee, Jee Eun; Hwang, Ji Young; Shim, Sung Shine; Yoo, Jeong Hyun; Suh, Jeong Soo; Park, Jae Young [College of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2006-11-15

    artificial joint replacements. The total number of asymptomatic DVT cases was 43 (23.1%) and DVT was found in the calf in 39 of these cases. Post-operative venograms of the lower extremity showed 7 types of anatomic variation in the deep venous system. The incidence of silent post-operative DVT was not influenced by anatomic variations of the deep vein system, whether there were a small or large number of valves and the operation sites for artificial joint replacement. The most frequent site of DVT after artificial joint replacement was the calf.

  19. Safety and Efficacy of Low Dosage of Urokinase for Catheter-directed Thrombolysis of Deep Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    Xiao-Long Du; Ling-Shang Kong; Qing-You Meng; Aimin Qian; Wen-Dong Li; Hong Chen; Xiao-Qiang Li

    2015-01-01

    Background:Catheter-directed thrombolysis (CDT) has been a mainstay in treating deep venous thrombosis (DVT).However,the optimal dosage of a thrombolytic agent is still controversial.The goal of this study was to evaluate the safety and efficacy of low dosage urokinase with CDT for DVT.Methods:A retrospective analysis was performed using data from a total of 427 patients with DVT treated with CDT in our single center between July 2009 and December 2012.Early efficacy of thrombolysis was assessed with a thrombus score based on daily venography.The therapeutic safety was evaluated by adverse events.A venography or duplex ultrasound was performed to assess the outcome at 6 months,1 year and 2 years postoperatively.Results:The mean total dose of 3.34 (standard deviation [SD] 1.38) million units of urokinase was administered during a mean of 5.18 (SD 2.28) days.Prior to discharge,Grade Ⅲ (complete lysis) was achieved in 154 (36%) patients;Grade Ⅱ (50-99% lysis) in 222 (52%);and Grade Ⅰ (50% lysis) in 51 (12%).The major complications included one intracranial hemorrhage,one hematochezia,five gross hematuria,and one pulmonary embolism.Moreover,no death occurred in the study.Conclusions:Treatment of low-dose catheter-directed thrombosis is an efficacious and safe therapeutic approach in patients with DVT offering good long-term outcomes and minimal complications.

  20. Testosterone therapy, thrombophilia, and hospitalization for deep venous thrombosis-pulmonary embolus, an exploratory, hypothesis-generating study.

    Science.gov (United States)

    Glueck, Charles J; Friedman, Joel; Hafeez, Ahsan; Hassan, Atif; Wang, Ping

    2015-04-01

    Our hypothesis was that testosterone therapy (TT) interacts with previously undiagnosed thrombophilia-hypofibrinolysis, leading to hospitalization for deep venous thrombosis (DVT)-pulmonary emboli (PE). We determined the prevalence of DVT-PE associated with TT 147 men hospitalized in the last 12 months for DVT-PE. Of the 147 men, 2 (1.4%) had TT before and at the time of their DVT-PE. Neither had risk factors for thrombosis. Neither smoked. Case #1 (intramuscular T 50mg/week) had 2 PE, 6 and 24 months after starting TT. DVT-PE in case #2 (T gel 100mg/day) occurred 24 months after starting T. Both men were found to have previously undiagnosed familial thrombophilia (protein S deficiency, homocysteinemia, high Factor VIII). In case #2, on 100mg T gel/day, serum estradiol was high, 51 pg/ml (upper normal limit 42.6 pg/ml). At least 1.4% of men hospitalized for DVT-PE were on TT and had previously undiagnosed thrombophilia, suggesting a thrombotic interaction between exogenous T and thrombophilia-hypofibrinolysis. Given the increasing use of TT, our preliminary findings should facilitate design of a much-needed, multi-center, prospective study of pro-thrombotic interactions between T therapy and thrombophilia for subsequent thrombotic events including DVT-PE.

  1. 骨科术后下肢深静脉血栓的防治%Prevention and treatment of deep venous thrombosis in lower extremity after orthopedic operation

    Institute of Scientific and Technical Information of China (English)

    赵小魁; 陈茁; 杨敬; 杨万石

    2012-01-01

    目的 探讨骨科术后下肢深静脉血栓的防治措施.方法 回顾性分析15例下肢深静脉血栓,对患者采用卧床休息、抬高患肢,溶栓、抗凝等治疗.结果 所有病例经治疗后症状缓解,复查超声提示血栓消失或缩小,无严重并发症.结论 下肢深静脉血栓可继发肺栓塞导致死亡,医护人员在临床工作中要引起足够重视,对骨科技术有血栓形成高危因素的患者要早期预防,做到及时发现、积极治疗.%Objective To explore the treatment and prevention of deep venous thrombosis ( DVT ) in lower extremity after orthopedic operation. Methods 15 cases of deep venous thrombosis were analyzed retrospectively, from January 2005 to December 2010. All the cases stayed in bed and rest, raised the affected limb, treated by thrombolysis, anticoagulant and dispersion drugs. Results After the treatment, Symptom remission in all cases. No serious complications occurred. The deep venous thrombosis were disappeared or reduced reviewing by ultrasound. Conclusion Deep venous thrombosis may cause pulmonary embolism and death. Doctors and nurses should think highly of it. Early preventions should be given to the patients with high risks. The effective treatment should be taken timely and carefully.

  2. 医用弹力袜在下肢深静脉血栓形成患者护理中的应用%Application of medical elastic stockings in nursing of patients with deep venous thrombosis form-tion

    Institute of Scientific and Technical Information of China (English)

    梁玉婷; 蒋学军

    2009-01-01

    目的 探讨医用弹力袜在急性下肢深静脉血栓形成患者护理中的应用效果.方法 将2005年1月-2008年1月在我院确诊为急性下肢深静脉血栓形成的62例患者随机分为实验组和对照组各31例,对照组采取一般护理措施,实验组在一般护理措施基础上加用医用弹力袜,并对2组随访观察血栓后综合征的发病情况,进行χ2检验.结果 随访1~4年,实验组复发2例,出现血栓后综合征3例;对照组复发8例,出现血栓后综合征10例,对照组复发率和血栓后综合征发病率均显著高于实验组.结论 医用弹力袜能有效预防急性下肢深静脉血栓形成,并且能减轻血栓后综合征的症状,值得推广.%Objective To discuss the application of medical elastic stockings in nursing of patients with deep venous thrombosis formation. Methods 62 patients diagnosed as acute lower limbs deep ve-nous thrombosis from January, 2005 to January, 2008 were randomly divided into the experimental group and the control groups with 31 patients in each group, the control group took general nursing measures, the experimental group used the medical elastic stockings based on the general care measures, The inci-dence of post- thrombosis syndrome was observed in two groups and underwent χ2 test. Results After two years follow- up, 2 patients relapsed and 3 patients appeared post- thrombosis syndrome in the experimental group, 8 patients relapsed and 10 patients had post-thrombosis syndrome in the control group. The relapse rate and incidence rate of peat-thrombosis syndrome in the control group were higher than those of the experimental group. Conclusions The use of medical elastic stockings can prevent acute lower limbs deep venous throm-bosis, and can reduce the symptoms of post-thrombosis syndrome, which deserves to be spread widely.

  3. Risk factors analysis and nursing of deep venous thrombosis%深静脉血栓形成的危险因素分析及护理

    Institute of Scientific and Technical Information of China (English)

    孔焱; 李秀媚; 袁奕英

    2013-01-01

    Objective:To investigate the risk factors for deep vein thrombosis and nursing measures,and to provide basis for clinical treatment.Methods:A retrospective analysis of July 2010 to July 2012,the 215 patients in our hospital by Doppler ultrasonography in vascular diagnosis of deep vein thrombosis,analyzed the patient age,primary disease,the occurrence of thrombosis site,summarized and analysed the risk factors for deep vein thrombosis and primary site.For deep venous thrombosis in patients at high risk for specific nursing interventions,prevention of pulmonary thromboembolism occurrence.Results:It was found that elderly patients,fractures and severe trauma patients,diabetes,hypertension and other diseases and tumors in patients with deep venous thrombosis incidence was higher,left side primary deep venous thrombosis than right side.Conclusion:Elderly,multiple trauma,severe trauma,diabetes,hypertension,cancer is a risk factor for deep vein thrombosis,given a reasonable nursing measures contribute to deep venous thrombosis in the early detection and treatment.%目的:探讨深静脉血栓形成的危险因素及其护理措施,为临床治疗提供依据.方法:回顾性分析2010年7月~2012年7月我院住院经多普勒血管超声确诊深静脉血栓患者215例,分析患者年龄构成、原发疾病及发生血栓部位,总结分析深静脉血栓形成的危险因素及好发部位.对深静脉血栓高危患者给予特定护理措施,预防肺血栓栓塞症的发生.结果:老年、骨折及严重创伤患者,合并糖尿病、高血压等疾病及肿瘤患者其深静脉血栓发病率较高,左侧较右侧好发深静脉血栓.结论:老年、多发伤、严重创伤、糖尿病、高血压、肿瘤是深静脉血栓的危险因素,给予合理的护理措施有助于深静脉血栓的早期发现和治疗.

  4. Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Hong-Li Jiang; Wu-Jun Xue; Da-Qing Li; Ai-Ping Yin; Xia Xin; Chun-Mei Li; Ju-Lin Gao

    2005-01-01

    AIM: To investigate whether continuous veno-venous hemofiltration (CWH) in different filtration rate to eliminate cytokines would result in different efficiency in acute pancreatitis, whether the saturation time of filter membrane was related to different filtration rate, and whether the onset time of CWH could influence the survival of acute pancreatitis.METHODS: Thirty-seven patients were classified into four groups randomly. Group 1 underwent low-volume CVVH within 48 h of the onset of abdominal pain (early CVVH,n = 9). Group 2 received low-volume CVVH after 96 h of the onset of abdominal pain (late CVVH, n = 10). Group 3underwent high-volume CWH within 48 h of the onset of abdominal pain (early CWH, n = 9). Group 4 received high-volume CWH after 96 h of theonset of abdominal pain (late CVVH, n = 9). CVVH was sustained for at least 72 h. Blood was taken before hemofiltration, and ultrafiltrate was collected at the start of CWH and every 12 h during CVVH period for the purpose of measuring the concentrations of TNF-α, IL-1β and IL-6. The concentrations of TNF-α, IL-1β and IL-6 were measured by swine-specific El ISA. The Solartron 1 255 B frequency response analyzer (British) was used to observe the resistance of filter membrane.RESULTS: The survival rate had a significant difference (94.44% vs68.42%, P<0.01) high-volume and low-volume CVVH patients. The survival rate had also a significant difference (88.89% vs 73.68%, P<0.05) between early and late CWH patients. The hemodynamic deterioration (MAP, HR, CVP) was less severe in groups 4 and 1 than that in group 2, and in group 3 than in group 4. The adsorptive saturation time of filters membranes was 120-180 min if the filtration rate was 1 000-4 000 mL/h. After the first, second and third new hemofilters were changed,serum TNF-α concentrations had a negative correlation with resistance (r: -0.91, -0.89, and -0.86, respectively in group 1; -0.89, -0.85, and -0.76, respectively in group 2;-0.88, -0.92, and

  5. Prevention of venous thromboembolism in hospitalized acutely ill medical patients: focus on the clinical utility of (low-dose fondaparinux

    Directory of Open Access Journals (Sweden)

    Di Nisio M

    2013-09-01

    Full Text Available Marcello Di Nisio,1,2 Ettore Porreca3 1Department of Medical, Oral and Biotechnological Sciences, University G D'Annunzio of Chieti-Pescara, Chieti, Italy; 2Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; 3Department of Medicine and Aging, Centre for Aging Sciences, Internal Medicine Unit, University G D'Annunzio Foundation, Chieti, Italy Abstract: Venous thromboembolism (VTE is a frequent complication among acutely ill medical patients hospitalized for congestive heart failure, acute respiratory insufficiency, rheumatologic disorders, and acute infectious and/or inflammatory diseases. Based on robust data from randomized controlled studies and meta-analyses showing a reduced incidence of VTE by 40% to about 60% with pharmacologic thromboprophylaxis, prevention of VTE with low molecular weight heparin (LMWH, unfractionated heparin (UFH, or fondaparinux is currently recommended in all at-risk hospitalized acutely ill medical patients. In patients who are bleeding or are at high risk for major bleeding, mechanical prophylaxis with graduated compression stockings or intermittent pneumatic compression may be suggested. Thromboprophylaxis is generally continued for 6 to 14 days or for the duration of hospitalization. Selected cases could benefit from extended thromboprophylaxis beyond this period, although the risk of major bleeding remains a concern, and additional studies are needed to identify patients who may benefit from prolonged prophylaxis. For hospitalized acutely ill medical patients with renal insufficiency, a low dose (1.5 mg once daily of fondaparinux or prophylactic LMWH subcutaneously appears to have a safe profile, although proper evaluation in randomized studies is lacking. The evidence on the use of prophylaxis for VTE in this latter group of patients, as well as in those at higher risk of bleeding complications, such as patients with thrombocytopenia, remains scarce. For critically ill patients

  6. CT Venography for Deep Vein Thrombosis Using a Low Tube Voltage (100 kVp) Setting Could Increase Venous Enhancement and Reduce the Amount of Administered Iodine

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eun-Suk; Chung, Jae-Joon; Kim, Sungjun; Kim, Joo Hee; Yu, Jeong-Sik; Yoon, Choon-Sik [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720 (Korea, Republic of)

    2013-07-01

    To investigate the validity of the 100 kVp setting in CT venography (CTV) in the diagnosis of deep vein thrombosis (DVT), and to evaluate the feasibility of reducing the amount of administered iodine in this setting. After receiving the contrast medium (CM) of 2.0 mL/kg, 88 patients underwent CTV of the pelvis and lower extremities by using one of four protocols: Group A, 120 kVp setting and 370 mgI/mL CM; group B, 120 kVp and 300 mgI/mL; group C, 100 kVp and 370 mgI/mL; group D, 100 kVp and 300 mgI/mL. The groups were evaluated for venous attenuation, vein-to-muscle contrast-to-noise ratio (CNR{sub VEIN}), DVT-to-vein contrast-to-noise ratio (CNR{sub DVT}), and subjective degree of venous enhancement and image quality. Venous attenuation and CNR{sub VEIN} were significantly higher in group C (144.3 Hounsfield unit [HU] and 11.9), but there was no significant difference between group A (118.0 HU and 8.2) and D (122.4 HU and 7.9). The attenuation value of DVT was not significantly different among the four groups, and group C had a higher absolute CNR{sub DVT} than the other groups. The overall diagnostic image quality and venous enhancement were significantly higher in group C, but there was no difference between groups A and D. The 100 kVp setting in CTV substantially help improve venous enhancement and CNR{sub VEIN}. Furthermore, it enables to reduce the amount of administered iodine while maintaining venous attenuation, as compared with the 120 kVp setting.

  7. Compartment syndrome as a complication of ileofemoral deep venous thrombosis:a case presentation.

    Science.gov (United States)

    Lamborn, David R; Schranz, Craig

    2014-02-01

    A 22-year-old morbidly obese, nonpregnant woman presented with left ileofemoral deep vein thrombosis (DVT) presenting as low back pain and bilateral, left greater than right, leg swelling and pain for 2 days. While on heparin, she developed compartment syndrome in her left leg and had evidence of dead muscle tissue at the time of fasciotomy. Three options exist for treatment of ileofemoral DVT: catheter-directed thrombolysis (CDT), CDT plus pharmacomechanical thrombolysis or percutaneous mechanical thrombectomy, and surgical thrombectomy. Catheter-directed thrombolysis alone or in conjunction with pharmacomechanical thrombolysis in patients with low risk of bleeding has shown significant lysis of occlusion in 79% of patients with ileofemoral DVT with relatively low complication rates. Surgical thrombectomy and fasciotomy have not proven to be as effective but are appropriate alternatives if CDT is not available. Standard anticoagulation alone is likely not a sufficient treatment for ileofemoral DVT. Other therapies including CDT, CDT plus pharmacomechanical thrombolysis or percutaneous mechanical thrombectomy, or surgical thrombectomy to address lysis of the clot should be attempted first or in conjunction with anticoagulation for appropriate patients. Catheter-directed thrombolysis with or without pharmacomechanical thrombolysis is the preferred initial treatment.

  8. 彩色多普勒超声对下肢深静脉血栓的诊断价值%Diagnosis Value of Color Doppler Ultrasonography of Deep Venous Thrombosis of the Lower Limbs

    Institute of Scientific and Technical Information of China (English)

    陈淑臻

    2013-01-01

    Objective Discusses color doppler ultrasonography in the diagnosis of deep venous thrombosis of the lower limbs value. Methods Will our deep vein thrombosis of the lower limbs were in patients with the clinical data of 100 patients were retrospectively analyzed. Results 100 cases of lower limb deep vein thrombosis case detection of acute deep vein thrombosis of the lower limbs (45 cases) and detection chronic lower limb deep vein thrombosis in 55 cases. Conclusion Color doppler ultrasound help clinical to make the right diagnosis,deep vein thrombosis of the lower limbs can be used as the first choice for the method, it is worth clinical application.%  目的探讨彩色多普勒超声对下肢深静脉血栓的诊断价值。方法将我院收治的下肢深静脉血栓患者100例的临床资料进行回顾性分析。结果100例下肢深静脉血栓形成病例检出急性下肢深静脉血栓45例,检出慢性下肢深静脉血栓55例。结论彩色多普勒超声有助于临床做出正确诊断,可作为下肢深静脉血栓的首选检查方法,值得临床推广应用。

  9. 下肢手术后有症状的下肢深静脉血栓形成%Symptomatic Deep Venous Thrombosis after Lower Extremity Operation

    Institute of Scientific and Technical Information of China (English)

    袁加斌; 刘仲前; 庞健; 张耀明; 魏丹; 尹立雪; 吴志红

    2001-01-01

    Objective: To discuss clinical manifestation,early diagnosis and preventive measure of symptomatic deep venous thrombosis after lower extremity operation.Methods: Five cases of symptomatic deep venous thrombosis after lower extremity operation were reviewed,of which clinical manifestation and results of Doppler Ultrasonography were analyzed.Results: Pain of lower leg was the first and a high valuable symptom of deep venous thrombosis in lower extremity.Compressive dressing after operation was a possible factor associated with deep venous thrombosis in lower extremity.Conclusions: Possible appearence of deep venous thrombosis in lower extremity must be considered after lower extremity operation if pain of lower leg is presented.Doppler Ultrasonograhy can confirm the diagnosis.Combined preventive measures should be carried out for high-risk patients after operation.%目的:探讨下肢手术后有症状的下肢深静脉血栓形成的临床特点、早期诊断方法和预防措施。方法:对5例下肢手术后发生有症状的下肢深静脉血栓形成患者的临床表现和彩色多普勒结果进行分析。结果:下肢手术后小腿出现疼痛是下肢深静脉血栓形成最早出现并具有很高诊断价值的临床特点。手术后肢体加压包扎是一促进下肢深静脉血栓形成的可能因素。结论:下肢手术后出现小腿后侧疼痛时应考虑下肢深静脉血栓形成的可能,彩色多普勒检查可明确诊断。对高危患者围手术期应采取综合预防措施。

  10. Pycnogenol® in chronic venous insufficiency and related venous disorders.

    Science.gov (United States)

    Gulati, Om P

    2014-03-01

    The present review provides an update of the biological profile of Pycnogenol in the light of its use in the treatment of chronic venous insufficiency (CVI) and related venous disorders such as deep vein thrombosis (DVT), post-thrombotic syndrome, long haul air-travel-related leg oedema, venous ulcers and acute haemorrhoids. Pycnogenol is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. subsp. atlantica. Its strong antioxidant, anti-inflammatory and vasodilator activities, antithrombotic effects and collagen stabilizing properties make it uniquely able to target the multi facet pathophysiology of CVI and related venous disorders. Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long haul flights and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration. This review highlights clinical research findings on the safety, compliance and efficacy of Pycnogenol, including its use in combination products.

  11. Increased Levels of NF-kB-Dependent Markers in Cancer-Associated Deep Venous Thrombosis.

    Directory of Open Access Journals (Sweden)

    Grazia Malaponte

    Full Text Available Several studies highlight the role of inflammatory markers in thrombosis as well as in cancer. However, their combined role in cancer-associated deep vein thrombosis (DVT and the molecular mechanisms, involved in its pathophysiology, needs further investigations. In the present study, C-reactive protein, interleukin-6 (IL-6, tumor necrosis factor-α (TNF-α, interleukin-1 (IL-1β, matrix metalloproteases-9 (MMP-9, vascular endothelial growth factor (VEGF, tissue factor (TF, fibrinogen and soluble P-selectin, were analyzed in plasma and in monocyte samples from 385 cancer patients, of whom 64 were concomitantly affected by DVT (+. All these markers were higher in cancer patients DVT+ than in those DVT-. Accordingly, significantly higher NF-kB activity was observed in cancer patients DVT+ than DVT-. Significant correlation between data obtained in plasma and monocyte samples was observed. NF-kB inhibition was associated with decreased levels of all molecules in both cancer DVT+ and DVT-. To further demonstrate the involvement of NF-kB activation by the above mentioned molecules, we treated monocyte derived from healthy donors with a pool of sera from cancer patients with and without DVT. These set of experiments further suggest the significant role played by some molecules, regulated by NF-kB, and detected in cancer patients with DVT. Our data support the notion that NF-kB may be considered as a therapeutic target for cancer patients, especially those complicated by DVT. Treatment with NF-kB inhibitors may represent a possible strategy to prevent or reduce the risk of DVT in cancer patients.

  12. Cerebral sinus venous thromboses in children with acute lymphoblastic leukaemia - a multicentre study from the Nordic Society of Paediatric Haematology and Oncology

    DEFF Research Database (Denmark)

    Ranta, Susanna; Tuckuviene, Ruta; Mäkipernaa, Anne

    2014-01-01

    We present a prospective multicentre cohort of 20 children with acute lymphoblastic leukaemia (ALL) and cerebral sinus venous thrombosis (CSVT). The study covers a period of 5 years and comprises 1038 children treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO...

  13. Characteristics and risk factors of major and clinically relevant non-major bleeding in cancer patients receiving anticoagulant treatment for acute venous thromboembolism-the CATCH study

    NARCIS (Netherlands)

    Kamphuisen, P.W.; Lee, A.Y.Y.; Meyer, Guy; Bauersachs, R.; Janas, M.S.; Jarner, M.F.; Khorana, A.A.

    2015-01-01

    Background: Cancer patients with acute venous thromboembolism (VTE) receiving anticoagulant treatment have a substantial risk of bleeding complications. Aims: To assess the rate, site and risk factors of clinically relevant bleeding (CRB; major or clinically relevant non-major bleeding) in cancer pa

  14. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven;

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  15. Short-Term Catheter-Directed Thrombolysis with Low-Dose Urokinase Followed by Aspiration Thrombectomy for Treatment of Symptomatic Lower Extremity Deep Venous Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Se Hee; Lim, Nam Yeul; Song, Jang Hyeon [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kim, Jae Kyu; Lim, Jae Hoon [Dept. of Radiology, Hospital, Ulsan University School of Medicine, Gweangju (Korea, Republic of); Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of); Choi, Soo Jin Na; Chung, Sang Young [Dept. of Radiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju (Korea, Republic of)

    2011-10-15

    To evaluate the venous patency in patients treated by catheter-directed thrombolysis with low-dose urokinase (UK) for symptomatic lower extremity deep venous thrombosis (DVT). Eighty-nine consecutive patients (46 women and 43 men; mean age, 58.1 years), treated by catheter-directed thrombolysis with low-dose UK were included in this study. Immediate venous patency was evaluated in terms of technical success (successful restoration of antegrade in-line flow in the treated vein with residual stenosis rate of less than 30%) and clinical success (significant reduction of clinical symptoms before hospital discharge). Late venous patency was evaluated in terms of primary patency rate and clinical success. Immediate technical success was achieved in all patients and immediate clinical success in 80 (90%) patients. There was no major systemic bleeding complication. The primary patency rate at 6 months and 12 months was 84% and 79%, respectively. Fifty-six (63%) patients were asymptomatic after a median clinical follow-up of 18 months, eleven (12%) patients improved moderately, seven (8%) patients remained unchanged, and fifteen (17%) patients had no clinical follow-up. Short-term catheter-directed thrombolysis with low-dose UK can be an effective, safe method to manage DVT of the lower extremities.

  16. Incidence and Risk Factors of Deep Venous Thrombosis in Asymptomatic Iliac Vein Compression: A Prospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Min-Kai Wu; Xiao-Yun Luo; Fu-Xian Zhang

    2016-01-01

    Background:Deep vein thrombosis (DVT) may be associated with iliac vein compression.Up to now,the majority of data has come from a retrospective study about the correlation between DVT and iliac vein compression.This prospective study was to determine the incidence of DVT in individuals with iliac vein compression and identify risk factors predictive of DVT.Methods:A total of 500 volunteers without symptoms of venous diseases of lower extremities and overt risk factors of deep venous thrombosis between October 2011 and September 2012 in Shijitan Hospital were enrolled in this cohort study.All the participants underwent contrast-enhanced abdominal computed tomography (CT) to evaluate iliac vein compression.Baseline demographic information and degree of iliac vein compression were collected.They were categorized into ≥50% or <50% iliac vein compression group.Ultrasound examination was performed to screen DVT at the time of CT examination and 3,6,9,and 12 months after the examination.Primary event was DVT of ipsilateral lower extremity.Correlation between DVT and iliac vein compression was estimated by multivariate Logistic regression after adjusting for age,gender,malignancy,surgery/immobilization,chemotherapy/hormonal therapy,and pregnancy.Results:In 500 volunteers,8.8% (44) had ≥50% iliac vein compression and 91.2% (456) had <50% iliac vein compression.Ipsilateral DVT occurred in six volunteers including two in iliofemoral vein,two in popliteal vein,and two in calf vein within l year.Univariate analysis showed that the incidence of DVT was 6.8% in ≥50% compression group,significantly higher than that in <50% compression group (0.7%) (x2 =12.84,P =0.01).Patients with malignancy had significantly higher incidence of DVT than those without malignancy (x2 =69.60,P < 0.01).Multivariate Logistic regression indicated that iliac vein compression and malignancy were independent risk factors of DVT.After adjustment for malignancy

  17. Genetic variation in the fibrinogen gamma gene increases the risk for deep venous thrombosis by reducing plasma fibrinogen gamma' levels.

    Science.gov (United States)

    Uitte de Willige, Shirley; de Visser, Marieke C H; Houwing-Duistermaat, Jeanine J; Rosendaal, Frits R; Vos, Hans L; Bertina, Rogier M

    2005-12-15

    We investigated the association between haplotypes of fibrinogen alpha (FGA), beta (FGB), and gamma (FGG), total fibrinogen levels, fibrinogen gamma' (gammaA/gamma' plus gamma'/gamma') levels, and risk for deep venous thrombosis. In a population-based case-control study, the Leiden Thrombophilia Study, we typed 15 haplotype-tagging single nucleotide polymorphisms (htSNPs) in this gene cluster. None of these haplotypes was associated with total fibrinogen levels. In each gene, one haplotype increased the thrombosis risk approximately 2-fold. After adjustment for linkage disequilibrium between the genes, only FGG-H2 homozygosity remained associated with risk (odds ratio [OR], 2.4; 95% confidence interval [95% CI], 1.5-3.9). FGG-H2 was also associated with reduced fibrinogen gamma' levels and reduced ratios of fibrinogen gamma' to total fibrinogen. Multivariate analysis showed that reduced fibrinogen gamma' levels and elevated total fibrinogen levels were both associated with an increased risk for thrombosis, even after adjustment for FGG-H2. A reduced fibrinogen gamma' to total fibrinogen ratio (less than 0.69) also increased the risk (OR, 2.4; 95% CI, 1.7-3.5). We propose that FGG-H2 influences thrombosis risk through htSNP 10034C/T [rs2066865] by strengthening the consensus of a CstF site and thus favoring the formation of gammaA chain above that of gamma' chain. Fibrinogen gamma' contains a unique high-affinity, nonsubstrate binding site for thrombin, which seems critical for the expression of the antithrombin activity that develops during fibrin formation (antithrombin 1).

  18. Real clinical practice of catheter therapy for deep venous thrombosis: periprocedural and 6-month outcomes from the EDO registry.

    Science.gov (United States)

    Mizuno, Atsushi; Anzai, Hitoshi; Utsunomiya, Makoto; Yajima, Junji; Ohta, Hiroshi; Ando, Hiroshi; Umemoto, Tomoyuki; Higashitani, Michiaki; Ozaki, Shunsuke; Sakamoto, Hiroshi; Nakao, Masashi; Yuzawa, Yasufumi; Kaneko, Hidehiro; Nakamura, Masato

    2015-07-01

    A recent national study in Japan indicated that 5.8 % of deep venous thrombosis (DVT) patients were treated using endovascular procedures, 83 % of which included catheter-directed thrombolysis (CDT). However, the details of these endovascular procedures and their outcomes have not yet been fully evaluated. Using DVT data from the EDO registry (EnDOvascular treatment registry) database, a total of 35 symptomatic iliac or femoral DVT patients who received endovascular treatment (54.3 % male, age 64.7 ± 15.1) were analyzed. The dominant patient risks were being bedridden (22.9 %) and May-Thurner syndrome (25.7 %). Approximately 77.1 % of patients were treated using an antegrade approach, and CDT and other endovascular procedures were performed in 82.9 and 57.1 % of patients, respectively. A periprocedural inferior vena cava (IVC) filter was used in 94.1 % of patients, which remained implanted in 37.1 and 20.0 % of patients after discharge and 6 months after hospitalization, respectively. After 6 months of treatment, 2.9 % of patients experienced a recurrence of DVT and 5.7 % suffered revascularization, but no patient had a recurrence of pulmonary embolism. Subjective symptoms improved in 80.0 % of patients, while 2.9 % of patients felt worse at 6 months after treatment. Postthrombotic syndrome-related symptoms were observed in seven patients (19.4 %), and edema was most frequently observed (71.4 %). The details of CDT procedures, such as approach site and the removal of the IVC filter, varied among hospitals. Despite improved symptoms, further procedural standardization and data collection should be conducted to reduce complications and improve outcomes.

  19. The incidence of deep venous thrombosis in high-risk Indian neurosurgical patients: Need for early chemoprophylaxis?

    Directory of Open Access Journals (Sweden)

    Ajith John George

    2016-01-01

    Full Text Available Introduction: Deep venous thrombosis (DVT is thought to be less common in Asians than in Caucasian population. The incidence of DVT in high-risk groups, especially the neurosurgical (NS patients, has not been well studied. This leaves no firm basis for the start of early prophylactic anticoagulation within first 5 postoperative days in Indian NS patients. This is a prospective observational study to determine the early occurrence of DVT in the NS patients. Patients and Methods: We screened 137 consecutive high-risk NS patients based on inclusion and exclusion criteria. The femoral veins were screened using Doppler ultrasound on day 1, 3, and 5 of admission into the NS Intensive Care Unit (ICU at tertiary center from South India. Results: Among 2887 admissions to NICU 147 patients met inclusion criteria. One hundred thirty seven were screened for DVT. There was a 4.3% (6/137 incidence of DVT with none of the six patients having signs or symptoms of pulmonary embolism. Among the risk factors studied, there was a significant association with femoral catheterization and a probable association with weakness/paraparesis/paraplegia. The mortality in the study group was 10.8% with none attributable to DVT or pulmonary embolism. Conclusion: There is a low incidence of DVT among the high risk neurosurgical population evaluated within the first 5 days of admission to NICU, limiting the need for early chemical thrombo-prophylaxis in these patients. With strict protocols for mechanical prophylaxis with passive leg exercise, early mobilization and serial femoral Doppler screening, heparin anticoagulation can be restricted within the first 5 days of ICU admission in high risk patients.

  20. Effect of low molecular weight heparin in combined with Shuxuetong in preventing the post-traumatic deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Li-Mian Xu

    2016-01-01

    Objective:To observe the effect of low molecular weight heparin in combined with Shuxuetong in preventing the post-traumatic deep venous thrombosis (DVT).Methods:A total of 120 patients with post-traumatic DVT who were admitted in our hospital from February, 2014 to February, 2015 were included in the study and divided into the treatment group and the control group with 60 cases in each group according to different treatment protocols. The patients in the treatment group were given subcutaneous injection of low molecular weight heparin calcium and intravenous drip of Shuxuetong, while the patients in the control group were only given subcutaneous injection of low molecular weight heparin calcium. The changes of swelling degrees and coagulation indicators of the affected limb before and after treatment, and the clinical efficacy in the two groups were compared.Results:The total effective rate in the treatment group was significantly higher than that in the control group. The mean range of the perimeter 15cm above and below the bilateral knee joints after treatment in the treatment group was significantly lower than that in the control group. The shrinking rate of the mean range of the perimeter of the bilateral limbs in the treatment group was significantly higher than that in the control group. The comparison of PT, APTT, FIB, and INR before treatment between the two groups was not statistically significant. PT, APTT, and INR after treatment in the treatment group were significantly higher than those in the control group, while FIB was significantly lower than that in the control group.Conclusions:The low molecular weight heparin in combined with Shuxuetong can effectively prevent the post-traumatic DVT, with no requirement of monitoring of the bleeding tendency and safety.

  1. 深静脉置管临床护理体会%Experience in clinical nursing of patients undergoing deep venous catheterization

    Institute of Scientific and Technical Information of China (English)

    廖道荣

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. Conclusion Enhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%目的探讨在临床中精心护理有效预防深静脉置管的并发症。方法选取我院内科2010年2月~2013年3月进行深静脉置管治疗的50例患者进行护理观察。结果严格无菌操作,穿刺部位的护理,密切观察,良好的心理护理,保持导管通畅等对中心静脉导管进行有效维护,可以降低各种并发症的发生率,取得了良好的护理效果。结论加强对患者深静脉置管的护理,可以确保患者的生命安全,为重病患者的治疗和护理带来方便,有效提高患者的身体恢复水平,精心护理有效预防深静脉置管并发症发生。

  2. 糖尿病合并冠心病的临床护理分析%Experience in clinical nursing of patients undergoing deep venous catheterization

    Institute of Scientific and Technical Information of China (English)

    施文清

    2013-01-01

    Objective To investigate the role of careful clinical nursing in preventing the complications of deep venous catheterization. Methods Fifty patients who underwent deep venous catheterization in the Internal Medicine Department of our hospital from February 2010 to March 2013 were selected for nursing evaluation. Results Standard aseptic operation, nursing for the site of puncture, close observation, good psychological nursing, and effective maintenance of central venous catheter like keeping the catheter unobstructed could reduce the rates of various complications and achieve good nursing effect. ConclusionEnhancing the nursing of patients undergoing deep venous catheterization can ensure the life and safety of patients, bring convenience to the treatment and nursing of severe cases, and effectively promote the recovery of patients, and careful nursing can effectively prevent the complications of deep venous catheterization.%目的:探讨糖尿病合并冠心病患者的临床护理措施。方法将我院收治的84例糖尿病合并冠心病患者随机分为两组,各42例,对照组采取常规护理干预,实验组给予全面护理。观察分析两组并发症发生情况与患者护理满意率。结果实验组并发症发生率明显低于对照组(P约0.05),实验组患者护理满意率明显高于对照组患者(P约0.05)。结论对糖尿病合并冠心病患者采取全面护理干预,能够有效降低并发症发生率,提高患者护理满意率,值得临床推广使用。

  3. Impact of Initial Central Venous Pressure on Outcomes of Conservative versus Liberal Fluid Management in Acute Respiratory Distress Syndrome

    Science.gov (United States)

    Semler, Matthew W.; Wheeler, Arthur P.; Thompson, B. Taylor; Bernard, Gordon R.; Wiedemann, Herbert P.; Rice, Todd W.

    2016-01-01

    Objective In acute respiratory distress syndrome (ARDS), conservative fluid management increases ventilator-free days without affecting mortality. Response to fluid management may differ based on patients’ initial central venous pressure (CVP). We hypothesized initial CVP would modify the effect of fluid management on outcomes. Design Retrospective analysis of the Fluid and Catheter Treatment Trial, a multicenter randomized trial comparing conservative to liberal fluid management in ARDS. We examined the relationship between initial CVP, fluid strategy, and 60-day mortality in univariate and multivariable analysis. Setting Twenty acute care hospitals. Patients Nine hundred and thirty-four ventilated ARDS patients with a CVP available at enrollment, 609 without baseline shock (for whom fluid balance was managed by study protocol). Interventions None. Measurements and Main Results Among patients without baseline shock, those with initial CVP > 8 mmHg experienced similar mortality with conservative and liberal fluid management (18% versus 18%, p=0.928), whereas those with CVP ≤8 mmHg experienced lower mortality with a conservative strategy (17% versus 36%, p=0.005). Multivariable analysis demonstrated an interaction between initial CVP and the effect of fluid strategy on mortality (p=0.031). At higher initial CVPs, the difference in treatment between arms was predominantly furosemide administration, which was not associated with mortality (p=0.122). At lower initial CVPs, the difference between arms was predominantly fluid administration, with additional fluid associated with increased mortality (p=0.013). Conclusions Conservative fluid management decreases mortality for ARDS patients with a low initial central venous pressure. In this population, the administration of intravenous fluids appears to increase mortality. PMID:26741580

  4. 骨科术后下肢深静脉血栓形成的危险因素%Risk Factors of Deep Venous Thrombosis after Orthopaedic Surgery

    Institute of Scientific and Technical Information of China (English)

    何汉良

    2014-01-01

    目的:调查骨科术后下肢深静脉血栓形成的危险因素。方法:选择骨科择期手术患者4170例,进行下肢深静脉血栓形成的危险因素调查和分析。结果:4170例中,发生深静脉血栓203例(4.87%),年龄>60岁、BMI>25 kg/m2、高血压、高脂血症、D-二聚体≥500μg/L、全身麻醉、手术时间>3 h和术后5 d内没有下床活动等是其发生的危险因素(OR>1,P<0.05)。结论:导致骨科术后深静脉血栓发生的危险因素较多,早期干预可以减少并发症的发生率。%Objective To investigate the risk factors of deep venous thrombosis after orthopaedic surgery. Methods A number of 4170 cases undergoing elective orthopaedic surgery were selected to investigate and ana⁃lyze the risk factors of deep venous thrombosis Results The occurrence of deep vein thrombosis was 203 (4.87%) in 4170 cases. The risk factors for its occurrence included age>60 years, BMI>25kg/m2, hyperten⁃sion, hyperlipidemia, D-dimer≥500μg/L, general anesthesia, and surgical time>3 h and 5 d of no activity after surgery(OR>1, P<0.05). Conclusion Many factors can lead to deep venous thrombosis after orthopaedic sur⁃gery. Early intervention can reduce the incidence of complications.

  5. 下肢深静脉血栓切除术的评价%The Evaluation of Deep Venous Thrombectomy of Lower Extremity

    Institute of Scientific and Technical Information of China (English)

    邵明哲; 叶建荣

    2004-01-01

    1938年Lawen首先报道髂股静脉血栓切除术(iliofemoral venous thrombectomy),其后15年,很多医师选择静脉血栓切除术(thrombectomy,TX)治疗急性DVT(deep venous thrombosis,DVT),但由于难以接受的再栓塞率(rethrombosis)、瓣膜闭锁功能不全(valvular incompetence)以及普遍较差的远期疗效该手术被多数美国、欧洲外科医师放弃,随着外科技术的进一步发展和暂时

  6. The HAS-BLED Score Identifies Patients with Acute Venous Thromboembolism at High Risk of Major Bleeding Complications during the First Six Months of Anticoagulant Treatment.

    Directory of Open Access Journals (Sweden)

    Judith Kooiman

    Full Text Available The HAS-BLED score enables a risk estimate of major bleeds in patients with atrial fibrillation on vitamin K-antagonists (VKA treatment, but has not been validated for patients with venous thromboembolism (VTE. We analyzed whether the HAS-BLED score accurately identifies patients at high risk of major bleeds during VKA treatment for acute VTE.Medical records of 537 patients with acute VTE (primary diagnosis pulmonary embolism in 223, deep vein thrombosis in 314 starting VKA treatment between 2006-2007 were searched for items on the HAS-BLED score and the occurrence of major bleeds during the first 180 days of follow-up. The hazard ratio (HR for the occurrence of major bleeds comparing non-high with high-risk patients as defined by a HAS-BLED score ≥ 3 points was calculated using Cox-regression analysis.Major bleeds occurred in 11/537 patients (2.0%, 5.2/100 person years, 95% CI 2.8-9.2. Cumulative incidences of major bleeds were 1.3% (95% CI 0.1-2.5 in the non-high (HAS-BLED < 3 and 9.6% (95%CI 2.2-17.0 in the high-risk group (HAS-BLED ≥ 3, (p <0.0001 by Log-Rank test, with a HR of 8.7 (95% CI 2.7-28.4. Of the items in the HAS-BLED score, abnormal renal function (HR 10.8, 95% CI 1.9-61.7 and a history of bleeding events (HR 10.4, 95% CI 2.5-42.5 were independent predictors of major bleeds during follow-up.Acute VTE patients with a HAS-BLED score ≥ 3 points are at increased risk of major bleeding. These results warrant for correction of the potentially reversible risk factors for major bleeding and careful International Normalized Ratio monitoring in acute VTE patients with a high HAS-BLED score.

  7. Implanted central venous catheter-related acute superior vena cava syndrome: management by metallic stent and endovascular repositioning of the catheter tip

    Energy Technology Data Exchange (ETDEWEB)

    Qanadli, S.D.; Mesurolle, B.; Sissakian, J.F.; Chagnon, S.; Lacombe, P. [Service de Radiologie, Hopital Ambroise Pare, 92 - Boulogne (France)

    2000-08-01

    We describe a case of a 49-year-old woman with stage-IIIB lung adenocarcinoma who experienced an acute superior vena cava syndrome related to an implanted central venous catheter without associated venous thrombosis. The catheter was surgically implanted for chemotherapy. Superior vena cava syndrome appeared after the procedure and was due to insertion of the catheter through a subclinical stenosis of the superior vena cava. Complete resolution of the patient's symptoms was obtained using stent placement and endovascular repositioning of the catheter tip. (orig.)

  8. Discrepant ratios of arterial versus venous thrombosis in hemophilia A as compared with hemophilia B.

    Science.gov (United States)

    Girolami, Antonio; Bertozzi, Irene; de Marinis, Giulia Berti; Tasinato, Valentina; Sambado, Luisa

    2014-04-01

    The occurrence of thrombosis in patients with congenital bleeding disorders represents an exceptional event. Hemophilia A and hemophilia B patients have been showed to present both arterial and venous thrombosis (85 cases of arterial thrombosis and 34 cases of venous thrombosis). The great majority of arterial thrombosis are myocardial infarction or other acute coronary syndromes, whereas the majority of venous thrombosis are deep vein thrombosis and/or pulmonary embolisms. However there are discrepancies in the proportion of arterial and venous thrombosis seen in hemophilia A versus hemophilia B. The ratio of arterial versus venous thrombosis in hemophilia A is 3.72 whereas that for hemophilia B is 1.12. This indicates that arterial thrombosis is more frequent in hemophilia A as compared to hemophilia B and the opposite is true for venous thrombosis. The potential significance of this discrepancy is discussed.

  9. Recanalization of Acute and Subacute Venous and Synthetic Bypass-Graft Occlusions With a Mechanical Rotational Catheter

    Energy Technology Data Exchange (ETDEWEB)

    Wissgott, Christian, E-mail: cwissgott@wkk-hei.de; Kamusella, Peter; Andresen, Reimer [Westkuestenklinikum Heide-Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Institute of Diagnostic and Interventional Radiology/Neuroradiology (Germany)

    2013-08-01

    PurposePercutaneous mechanical thrombectomy (PMT) is now established as an alternative treatment of acute arterial occlusions in addition to fibrinolysis and surgical thrombectomy. The objective of this retrospective study was the investigation of a rotational atherothrombectomy catheter in terms of safety and efficacy in the treatment of acute and subacute femoropopliteal bypass occlusions.Materials and MethodsForty-two patients (average age 65.8 {+-} 9.1 years) with acute (<14 days [n = 31]) and subacute (14-42 days [n = 11]) femoropopliteal bypass occlusions were treated consecutively with a rotational debulking and removal catheter (Straub Rotarex). The average occlusion length was 28.4 {+-} 2.9 (24-34) cm. Thirty-four (81 %) patients underwent venous bypass, and 8 (19 %) patients underwent polytetrafluoroethylene bypass.ResultsThe technical success rate was 97.6 % (41 of 42). In 1 patient, blood flow could not be restored despite the use of the atherothrombectomy system. The average catheter intervention time was 6.9 {+-} 2.1 (4-9) min. Ankle-brachial index increased from 0.39 {+-} 0.13 to 0.83 {+-} 0.11 at discharge and to 0.82 {+-} 0.17 after 1 month (p < 0.05). There were a total of 2 (4.8 %) peri-interventional complications: One patient developed a distal embolism, which was successfully treated with local lysis, and another patient had a small perforation at the distal anastomosis, which was successfully treated with a stent.ConclusionPMT with the Rotarex atherothrombectomy catheter represents a safe and effective option in the treatment of acute and subacute femoropopliteal bypass occlusions because it can quickly restore blood flow.

  10. Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Jian Kang

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT is a common complication of arthroplasty in old patients. We analyzed risk factors for lower-limb DVT after arthroplasty in patients aged over 70 years to determine controllable risk factors. Methods: This was a retrospective study of 1,025 patients aged >70 years treated with knee arthroplasty at our hospital between January 2009 and December 2013. Of 1,025 patients, 175 had postoperative lower-limb DVT. We compared medical history, body mass index (BMI, ambulatory blood pressure, preoperative and postoperative fasting blood glucose (FBG, preoperative blood total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, and preoperative homocysteine (Hcy between thrombus and non-thrombus groups. B-mode ultrasonography was used to detect lower-limb DVT before the operation and 7 days after the operation in all patients. Logistic regression analysis was used to determine risk factors for DVT. Results: Incidence of diabetes (P = 0.014, BMI (P = 0.003, preoperative FBG (P = 0.004, postoperative FBG (P = 0.012, and preoperative Hcy (P < 0.001 were significantly higher in the thrombus group. A significantly greater proportion of patients in the non-thrombus group had early postoperative activity (P < 0.001 and used a foot pump (P < 0.001. Operative duration was significantly longer in the thrombus group (P = 0.012. Within the thrombus group, significantly more patients had bilateral than unilateral knee arthroplasty (P < 0.01. Multivariate logistic analysis revealed BMI, preoperative Hcy, postoperative FBG, long operative duration, bilateral knee arthroplasty, and time to the activity after the operation to be predictive factors of DVT. At 6-month follow-up of the thrombus group, 4.7% of patients had pulmonary embolism and 18.8% had recurrent DVT; there were no deaths. Conclusions: Obesity, inactivity after operation, elevated preoperative Hcy and postoperative FBG, long operative duration, and

  11. Relationship between endothelial cell protein C receptor gene 6936A/G polymorphisms and deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-dong; TIAN Lu; LI Ming; JIN Wei; ZHANG Hong-kun; ZHENG Cheng-fei

    2011-01-01

    Background Deep venous thrombosis (DVT) can result in pulmonary embolism, a fatal complication that is due to the dislodgement and movement of a blood clot (thrombus) from a limb into the lungs. Genetic risk factors related to DVT development include mutations in coagulation proteins, especially the endothelial protein C receptor (EPCR), a component of the anticoaguiation protein C (PC) pathway. The objective of the present study was to analyze the relationship between the 6936A/G polymorphism in the EPCR gene and the occurrence of DVT.Methods This study involved 65 patients with DVT and 71 age- and gender-matched healthy controls. Peripheral blood samples were collected from all subjects. Plasma levels of soluble EPCR (sEPCR) were measured by enzyme-linked immunosorbent assay. Genomic DNA was extracted and EPCR gene product was amplified by a standard PCR reaction.Gene product bands were sequenced to identify EPCR gene polymorphisms.Results In the control group, the level of sEPCR in subjects with 6936AG genotype was significantly higher than that in subjects with 6936AA genotype ((0.97±0.32) pg/ml vs. (0.61±0.24) pg/ml, P <0.01). Similarly in the DVT group, the level of sEPCR in subjects with the 6936AG were greater than that in subjects with the 6936AA genotype ((0.87±0.21) pg/ml vs. (0.50±0.18) pg/ml, P <0.01). The sEPCR level in DVT patients was significantly higher than that in healthy controls ((0.68±0.32) pg/ml vs. (0.54±0.22) pg/ml, P <0.05). The 6936AG genotype frequency in DVT patients was significantly higher than that in healthy controls (P <0.05). In contrast, the 6936AA genotype frequency in DVT patients was lower than that in healthy controls (P <0.05). Subjects carrying 6936AG had an increased risk of thrombosis (OR=2.75, 95% CI:1.04-7.30, P <0.05).Conclusions EPCR gene 6936A/G polymorphism is associated with increased plasma levels of sEPCR. Subjects carrying 6936AG likely have an increased risk of thrombosis.

  12. Analysis of Risk Factors for Lower-limb Deep Venous Thrombosis in Old Patients after Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Jian Kang; Xu Jiang; Bo Wu

    2015-01-01

    Background:Deep venous thrombosis (DVT) is a common complication of arthroplasty in old patients.We analyzed risk factors for lower-limb DVT after arthroplasty in patients aged over 70 years to determine controllable risk factors.Methods:This was a retrospective study of 1,025 patients aged >70 years treated with knee arthroplasty at our hospital between January 2009 and December 2013.Of 1,025 patients,175 had postoperative lower-limb DVT.We compared medical history,body mass index (BMI),ambulatory blood pressure,preoperative and postoperative fasting blood glucose (FBG),preoperative blood total cholesterol,triglyceride,high-and low-density lipoprotein cholesterol,and preoperative homocysteine (Hcy) between thrombus and non-thrombus groups.B-mode ultrasonography was used to detect lower-limb DVT before the operation and 7 days after the operation in all patients.Logistic regression analysis was used to determine risk factors for DVT.Results:Incidence of diabetes (P =0.014),BMI (P =0.003),preoperative FBG (P =0.004),postoperative FBG (P =0.012),and preoperative Hcy (P < 0.001) were significantly higher in the thrombus group.A significantly greater proportion of patients in the non-thrombus group had early postoperative activity (P < 0.001) and used a foot pump (P < 0.001).Operative duration was significantly longer in the thrombus group (P =0.012).Within the thrombus group,significantly more patients had bilateral than unilateral knee arthroplasty (P < 0.01).Multivariate logistic analysis revealed BMI,preoperative Hcy,postoperative FBG,long operative duration,bilateral knee arthroplasty,and time to the activity after the operation to be predictive factors of DVT.At 6-month follow-up of the thrombus group,4.7% of patients had pulmonary embolism and 18.8% had recurrent DVT;there were no deaths.Conclusions:Obesity,inactivity after operation,elevated preoperative Hey and postoperative FBG,long operative duration,and bilateral knee arthroplasty were risk

  13. Factor VII-activating protease in patients with acute deep venous thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes J; Vitzthum, Frank; Funding, Eva;

    2008-01-01

    Factor VII-activating protease (FSAP) is involved in haemostasis and inflammation. FSAP cleaves single chain urokinase-type plasminogen activator (scu-PA). The 1601GA genotype of the 1601G/A polymorphism in the FSAP gene leads to the expression of a FSAP variant with reduced ability to activate scu...

  14. 产后下肢深静脉血栓中西医防治及护理干预的效果分析%Analysis on the effect of Western medicine treatment and nursing intervention in the treatment of deep venous thrombosis of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    何秋红

    2015-01-01

    目的:探讨产后下肢深静脉血栓中西医防治及护理干预的康复效果。方法:选择产后并发DVT的患者82例,随机分为治疗组42例和对照组40例,对比分析其差异。结果:治疗组经医护干预后,治愈率62.50%,取得总有效率93.75%;对照组经医护干预后,治愈率48.94%,取得总有效率76.60%,两组对比有显著性差异。结论:通过对产后下肢深静脉血栓中西医防治及护理干预,可提高患者的康复效果。%Objective:To investigate the rehabilitation effect of Western medicine and nursing intervention in the treatment of deep venous thrombosis of lower extremity deep venous thrombosis.Methods: 82 patients with postpartum DVT were randomly divided into treatment group and control group with 40 cases and control group with 42 cases.Results: the treatment group by medical intervention, the cure rate was 62.50%, the total effective rate was 93.75%; control group by medical intervention and 48.94% cure rate and obtains the total efficiency 76.60%. There exists remarkable difference between the two groups. Conclusion: through the treatment of Western medicine in the prevention and treatment of deep venous thrombosis in lower extremity deep venous thrombosis, it can improve the rehabilitation effect of patients.

  15. 产后下肢深静脉血栓形成原因及护理对策%Causes of Postpartum Deep Venous Thrombosis and the Nursing Strategy

    Institute of Scientific and Technical Information of China (English)

    徐庆

    2014-01-01

    目的探讨产后出现下肢深静脉血栓形成原因及预防护理对策。方法回顾性分析我院出现产后下肢深静脉血栓患者所采取的护理措施。结果经过改进护理措施后,术后并发下肢深静脉血栓几率明显减少。结论针对下肢深静脉血栓形成的原因,采取积极的预防护理措施,可降低患者下肢深静脉血栓形成的发生率。%Objective To explore the causes, prevention and nursing strategy of postpartum deep venous thrombosis. Methods The nursing strategies of postpartum deep venous thrombosis in our hospital were analyzed retrospectively. Results The rate of postpartum deep venous thrombosis occurrence was significantly decreased after improving of nursing strategy. Conclusion For dealing with the causes of deep venous thrombosis, a positive prevention and nursing strategy decrease the occurrence rate of deep venous thrombosis.

  16. Prevalence of JAK2V617F mutation in deep venous thrombosis patients and its clinical significance as a thrombophilic risk factor: Indian perspective.

    Science.gov (United States)

    Singh, Neha; Sharma, Amit; Sazawal, Sudha; Ahuja, Ankur; Upadhyay, Ashish; Mahapatra, Manoranjan; Saxena, Renu

    2015-09-01

    Venous thromboembolism is known to be a complex interaction of genetic and acquired factors leading to thrombosis. JAK2V617F mutation is believed to contribute to a thrombophilic phenotype, possibly through enhanced leukocyte-platelet interactions in myeloproliferative neoplasms (MPNs). Several studies have focused on the importance of screening for JAK2V617F mutation in patients with splanchnic venous thrombosis (VT) for the detection of nonovert MPNs. The role of JAK2V617F mutation in VT outside the splanchnic region is still widely unsettled. The primary aim of this study was to find out the prevalence of JAK2V617F mutation in patients with deep venous thrombosis (DVT), its clinical significance as a prothrombotic risk factor, and its possible interactions with other genetic thrombophilic risk factors. A total of 148 patients with idiopathic, symptomatic DVT were evaluated. Median age of presentation was 32 years (range 15-71 years) with a sex ratio of 1.3:1. Overall, the most common genetic prothrombotic factor was factor V Leiden mutation, found in 10.8% (16 of 148) of patients who also showed strong association with increased risk of thrombosis (odds ratio 5.94, confidence interval 1.33-26.4, P = .019). Deficiencies in protein C, protein S, and antithrombin were seen in 8 (5.4%), 10 (6.7%), and 8 (5.4%) patients, respectively. It was observed that the frequency of JAK2V617F mutation was lower in Indian patients, and it also showed weaker association with risk of thrombosis, at least in cases of venous thrombosis outside the splanchnic region.

  17. Retrospective analysis of deep venous thrombosis caused by central venous catheter in hemodialysis patients%血透患者中心静脉置管导致深静脉血栓368例分析

    Institute of Scientific and Technical Information of China (English)

    张林; 廖丹; 李红

    2011-01-01

    Objective To analyze the etiology of deep vein thrombosis caused by central venous catheter in hemodi-alysis patients and explore the methods of prevention and treatment. Methods A retrospective study was performed to a-nalysis the relationship between deep vein thrombosis (DVT) with central venous catheter and other patient characteristics (age, complications, catheter lien time and degree of activity) in 421 patient accepted hemodialysis by central venous catheter in blood purification center of our hospital. Resnlts 8 cases occurred deep vein thrombosis complication. Among them, 7 (87. 6%) happened in hemodialysis through femoral vein indwelling catheter, and significantly higher than through Subclavian vein indwelling catheter (12. 5%). In the 8 patients. 4 cases (50%) is diabetic nephropathy, 2 patients (25%) chronic glomerulonephritis, 1 case (12. 5%) hypertension nephropathy, 1 case (12. 5%) multiple myeloma correlation nephritis. The incidence in diabetic nephropathy group was significant higher compared with other diseases group (P<0. 01). Catheter lien time was 8 hours~9 months, average 6. 3 months. But in the eight patients was average 7. 6 months, and significantly higher compared with other patients (P<0. 01). Lower limbs deep vein thrombosis incidence in 60 years old and above cases is significantly higher than less than 60 years old (P<0. 01). Conclusion DVT occurrence is directly associated with central venous catheter, but also with the age, complications, catheter lien time.%目的 探讨血液透析患者经中心静脉置管导致深静脉血检的病因、治疗以及预防措施.方法 回顾性分析血液净化中心421例次留置中心静脉导管患者发生深静脉血栓(DVT)情况,并探讨相关因素与发生DVT之间的关系.结果 8例发生相关深静脉血栓并发症,其中股静脉留置导管7例(87.5%),镇骨下静脉留置导管1例(12.5%),两组之间比较有显著性差异(P<0.01); 8例患者中有4倒(50

  18. Artificial neural networks predict the incidence of portosplenomesenteric venous thrombosis in patients with acute pancreatitis.

    Science.gov (United States)

    Fei, Y; Hu, J; Li, W-Q; Wang, W; Zong, G-Q

    2017-03-01

    Essentials Predicting the occurrence of portosplenomesenteric vein thrombosis (PSMVT) is difficult. We studied 72 patients with acute pancreatitis. Artificial neural networks modeling was more accurate than logistic regression in predicting PSMVT. Additional predictive factors may be incorporated into artificial neural networks.

  19. Deep Venous Thrombosis of the Leg, Associated with Agenesis of the Infrarenal Inferior Vena Cava and Hypoplastic Left Kidney (KILT Syndrome in a 14-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Sakshi Bami

    2015-01-01

    Full Text Available Agenesis of the inferior vena cava (IVC is a rare anomaly which can be identified as incidental finding or can be associated with iliofemoral vein thrombosis. IVC agenesis has a known association with renal anomalies which are mainly confined to the right kidney. We describe a case of a 14-year-old male who presented with left leg swelling and pain. Ultrasonography confirmed the presence of left leg deep vein thrombosis (DVT. No underlying hematologic risk factors were identified. A CT scan was obtained which demonstrated absent infrarenal IVC and extensive thrombosis in the left deep venous system and development of collateral venous flow into the azygous/hemiazygous system, with extension of thrombus into paraspinal collaterals. An additional finding in the patient was an atrophic left kidney and stenosis of an accessory left renal artery. Agenesis of the IVC should be considered in a young patient presenting with lower extremity DVT, especially in patients with no risk factors for thrombosis. As agenesis of the IVC cannot be corrected, one should be aware that there is a lifelong risk of lower extremity DVT.

  20. Interventional therapy for deep venous thrombosis of lower extremity%下肢深静脉血栓的介入治疗

    Institute of Scientific and Technical Information of China (English)

    廖宏伟; 杜文彬; 王一; 王会志

    2012-01-01

    Objective: To explore the clinical effects of treating deep venous thrombosis of patients with interventional therapy. Methods: 110 cases of DVT were analyzed, 70 cases received interventional therapy, and 40 cases received thrombolysis therapy. Result: The effective rate of interventional therapy were 100%, and the effective rate of thrombolysis therapy were 70%, no cases died of pulmonary thrombosis. Conclusion; Interventional therapy is excellent and practical for the patients with deep venous thrombosis,%目的:探讨下肢深静脉血栓介入治疗的效果.方法:110例下肢深静脉血栓患者,70例接受介入治疗,40例行单纯局部溶栓治疗.结果:介入治疗有效率100%,局部溶栓治疗有效率70%,两组患者均未发生肺栓塞.结论:经皮介入治疗下肢深静脉血栓是一种新的可行方法.

  1. 脑卒中患者下肢深静脉血栓的预防及护理%Prevention and care of stroke patients with deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    廖慧秀; 邹海; 吴志忠

    2012-01-01

      Deep venous thrombosis accounted for a large proportion of peripheral vascular disease,and showed an increasing trend. Department of neurology in our hospital through the summary of the mechanism of deep venous thrombosis in a timely manner to take effective measures of prevention and care,found that can effectively prevent and reduce the incidence of deep venous thrombosis.%  下肢深静脉血栓在周围血管病中占了很大的比例,并呈逐年上升趋势。笔者总结下肢深静脉血栓形成的机制,及时采取有效的预防与护理措施,有效地预防和减少下肢深静脉血栓的发生。

  2. DEFICIENT PROTEIN C AND PROTEIN S INDUCED ACUTE VENOUS MESENTERIC ISCHEMIA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Darwin Britto

    2016-05-01

    Full Text Available BACKGROUND A 35 year old lady presented with unresolved severe abdominal pain and vomiting. She was diagnosed to have superior mesenteric vein thrombosis with gangrenous small bowel and multiple splenic infarcts secondary to Protein C and Protein S deficiency. She underwent emergency explorative laparotomy and extensive small bowel resection and anastomosis and splenectomy. This is to stress the importance of keeping mesenteric ischemia as an important differential diagnosis in cases of acute abdomen

  3. Acute extensive portal and mesenteric venous thrombosis after splenectomy: Treated by interventional thrombolysis with transjugular approach

    Institute of Scientific and Technical Information of China (English)

    Mao-Qiang Wang; Han-Ying Lin; Li-Ping Guo; Feng-Yong Liu; Feng Duan; Zhi-Jun Wang

    2009-01-01

    AIM: To present a series of cases with symptomatic acute extensive portal vein (PV) and superior mesenteric vein (SMV) thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolysis. METHODS: A total of 6 patients with acute extensive PV-SMV thrombosis after splenectomy were treated by transjugular approach catheter-directed thrombolysis.The mean age of the patients was 41.2 years. After access to the portal system via the transjugular approach, pigtail catheter fragmentation of clots,local urokinase injection, and manual aspiration thrombectomy were used for the initial treatment of PV-SMV thrombosis, followed by continuous thrombolytic therapy via an indwelling infusion catheter in the SMV, which was performed for three to six days. Adequate anticoagulation was given during treatment, throughout hospitalization, and after discharge. RESULTS: Technical success was achieved in all 6 patients. Clinical improvement was seen in these patients within 12-24 h of the procedure. No complications were observed. The 6 patients were discharged 6-14 d (8 ± 2.5 d) after admission. The mean duration of follow-up after hospital discharge was 40 ± 16.5 mo. Ultrasound and contrast-enhanced computed tomography confirmed patency of the PV and SMV, and no recurrent episodes of PV-SMV thrombosis developed during the follow-up period .CONCLUSION: Catheter-directed thrombolysis via transjugular intrahepatic access is a safe and effective therapy for the management of patients with symptomatic acute extensive PV-SMV thrombosis.

  4. Venous thromboembolism risk and prophylaxis in the acute hospital care setting: report from the ENDORSE study in Egypt

    Directory of Open Access Journals (Sweden)

    Goubran Hadi A

    2012-09-01

    Full Text Available Abstract Background Venous thromboembolism (VTE is a leading cause of hospital-related deaths worldwide. However, the proportion of patients at risk of VTE who receive appropriate prophylaxis in Egypt is unknown. The ENDORSE study in Egypt is part of a global initiative to uncover the incidence of high-risk surgical and medical patients and determine what proportion of these patients receive appropriate VTE prophylaxis. Methods Ten Egyptian hospitals participated in this observational study, enrolling all surgical and medical patients that met the study criteria. This resulted in a cohort of 1,008 patients in acute care facilities who underwent a retrospective chart review. Each patient’s VTE risk status and the presence or absence of appropriate prophylactic care was assessed according to the American College of Chest Physicians (ACCP guidelines 2004. Results Of the 1,008 patients enrolled, 395 (39.2% were found to be at high-risk for VTE. Overall, 227 surgical patients were at high-risk, although only 80 (35.2% received ACCP-recommended prophylaxis. Similarly, 55/268 (32.75% of high-risk medical patients received appropriate VTE prophylaxis. Low molecular weight heparin was the most commonly used anticoagulant, while mechanical prophylactic use was quite low (1.5% in high-risk patients. Conclusions In Egypt, more than one-third of all patients hospitalized for surgery or acute medical conditions are at high risk for developing VTE. However, only a small fraction of these patients receive appropriate VTE prophylaxis. Corrective measures are necessary for preventing VTE morbidity and mortality in these high risk patients.

  5. 脑卒中偏瘫患者下肢深静脉血栓的预防和护理%Prevention and nursing of lower extremity deep venous thrombosis in the hemiplegic patients after stroke

    Institute of Scientific and Technical Information of China (English)

    马海萍

    2014-01-01

    The pathogenic factors, clinical manifestation, prevention and nursing of lower extremity deep venous thrombosis in the hemiplegic patients after stroke were reviewed. The suggestions concerned prevention and nursing of the lower extremity deep venous thrombosis were proposed for the clinical nurses.%分析脑卒中偏瘫患者下肢深静脉血栓的形成因素、临床表现、预防及护理要点,为护理人员预防和护理脑卒中偏瘫患者下肢深静脉血栓形成提供参考。

  6. A young man with nonhealing venous ulcers

    NARCIS (Netherlands)

    Vloedbeld, M. G.; Venema, A. W.; Smit, A. J.

    2006-01-01

    A 35-year-old man presented with nonhealing ulcers at an atypical location on his left foot, caused by a combination of venous insufficiency (after deep venous thrombosis) and arterial insufficiency. The underlying cause was Buerger's disease.

  7. Prevention of deep venous thrombosis after hip replacement operation%髋关节置换术后下肢深静脉血栓形成的预防

    Institute of Scientific and Technical Information of China (English)

    张红卫

    2008-01-01

    目的 探讨髋关节置换术后下肢深静脉血栓形成的早期预防方法.方法 分析我院2004年8月至2007年6月行髋关节置换术32例的临床资料,给予低分子肝素等综合方法预防术后DVT发生.结果 32例中术后出现深静脉血栓(DVT)5例,约占15.63%,低于相关报道,且未出现严重的肺栓塞,未见明显不良反应及出血倾向,肝肾功能无明显异常变化.结论 低分子肝素等综合方法预防术后DVT安全有效,能显著改善患者全身状况及心肺功能,改善静脉回流,明显减少DVT发生率.%Objective To search the early prevention of deep venous thrombosis after hip replacement operation. Methods Clinical data of 32 patients with hip replacement operation were analyzed. All patients were given low molecular heparin to prevent the development of deep venous thrombosis after operation. Results 15.63% (5/32) patients became deep venous thrombosis after operation, which were lower than that of reported. No serious lung embolism had appeared. No adverse effect and hemorrhagic tendency were found, and no obvious dysfunction of hepatic function and renal function was also found. Conclusion Integration method including using low molecular heparin is effective and safety for prevention of deep venous thrombosis after operation, and may remarkably improve the eardiorespiratory function and venous return, reduce the incidence of deep venous thrombosis.

  8. 下肢深静脉功能不全与Cockett综合征%Lower extremity deep venous insufficiency and Cockett syndrome.

    Institute of Scientific and Technical Information of China (English)

    董国祥; 李选; 赵军

    2001-01-01

    目的下肢静脉曲张及下肢深静脉功能不全病人的左髂总静脉(LCIV)病变的发病情况及其之间的关系,以指导临床治疗。方法连续为73例(100条患肢)下肢静脉曲张病人行术前患肢深静脉逆行造影及LCIV造影。结果 (1)LCIV总异常率为47.9%。在有左侧下肢静脉曲张的病人中有31例(59.6%),在只有右侧下肢静脉曲张的病人中,仅4例(19.4%),两组间的LCIV异常的比率差异有显著意义(P=0.0017)。LCIV异常包括髂腔静脉交界处压迹、不同程度的狭窄、增宽、充盈缺损和侧支形成。(2)下肢深静脉功能不全67条肢体,占67.0%。在左LCIV造影异常的病例中,左侧下肢深静脉Ⅲ或Ⅳ级逆流者14例,在左LCIV造影正常的病例中,左侧下肢深静脉有Ⅲ或Ⅳ级逆流者仅6例,二者间差异也有显著意义(P=0.0205)。结论 Cockett综合征可能是左下肢静脉曲张的原因之一,同时也是左下肢深静脉功能不全的原因之一。%Objective This study was To investigate the incidence rate of Cockett syndrome and relationship between Cockett syndrome and varicose veins and deep venous incompetence of the left lower extremities.Methods 73 patients(100 legs) with varicose veins of the lower extremities were investigated by descending deep venography and iliography preoperatively.Results There were 35(47.9%) cases with abnormalities of the left common iliac vein (ALCIV)in all the cases.There were 31 cases with this conditions in the patients with varicose veins of the left or both lower extremity.While in the patients with varicose veins of the only right lower extremity,there were only 4 cases with ALCIV.In contrast,there was a significant difference between groups(χ2=9.8641,P=0.0017).In the patients with ALCIV,14 cases with Ⅲ or Ⅳ grade of deep venous incomptence were found, and only 6 cases with deep venous incompetence in the patients without ALCIV.There was a significant difference(χ2

  9. 超声引导下深静脉置管体会%Experience of deep venous catheterization guided by ultrasound

    Institute of Scientific and Technical Information of China (English)

    李俊

    2016-01-01

    Objective:To analyze the characteristics of deep venous catheter guided by ultrasound,and to explore its clinical application value.Methods:102 patients with deep venous puncture were selected,all patients were divided into the two groups on average,the ultrasound guided puncture group(the observation group)and the blind puncture group(the control group).We observed the puncture time,surgical bleeding,the success rate of one time intubation of the two groups,and evaluated its therapeutic effect and safety.Results:The success rate(96.1%) of one time intubation of the observation group was higher than that of the control group(70.6%).The puncture time of observation group was significantly shorter than that in control group,the amount of bleeding in operation was less than that in control group,and the incidence of complications were lower than that in control group,the comparisons were statistically significant(P<0.05).Conclusion:Deep venous catheterization guided by ultrasound can reduce the incidence of surgical complications,shorter puncture time,with a higher success rate of one time intubation and less bleeding.%目的:分析超声引导下深静脉置管的特点,并探讨其临床应用价值.方法:收治行深静脉穿刺术患者 102例,平均分为超声引导下穿刺组(观察组)和盲探穿刺组(对照组),观察两组的穿刺时间、手术出血情况、1次插管成功率,评价其治疗效果和安全性.结果:观察组1次插管成功率(96.1%)高于对照组(70.6%);观察组的穿刺时间明显要短于对照组,手术出血量也要小于对照组,各项手术并发症发生率要低于对照组,差异均有统计学意义(P<0.05).结论:超声引导下深静脉置管可以降低手术并发症发生率,其穿刺时间较短,1次置管成功率高,且手术出血量少.

  10. CT venography for deep venous thrombosis: can it predict catheter-directed thrombolysis prognosis in patients with iliac vein compression syndrome?

    Science.gov (United States)

    Choi, Jin Woo; Jae, Hwan Jun; Kim, Hyo-Cheol; Min, Sang-Il; Min, Seung-Kee; Lee, Whal; Chung, Jin Wook

    2015-02-01

    To evaluate the prognostic value of CT venography for catheter-directed thrombolysis (CDT) in iliac vein compression syndrome (IVCS) patients with deep venous thrombosis (DVT). The institutional review board approved this retrospective study and waived informed consent. Among the 201 consecutive patients treated in our interventional suite for DVT from January 2001 to June 2013, 48 IVCS patients (12 men, 36 women) who underwent pre-procedural CT venography, CDT with stenting, and follow-up imaging were analyzed. To identify possible determinants of 6-month patency, CT venography was evaluated with Fisher's exact test and logistic regression analyses. Based on the analyses, image-based criteria were established and compared to the current symptom duration-based approach by receiver-operating-characteristic curve analyses and the McNemar test. Recoiling of external iliac vein (EIV) diameter (enhancement (HR 20.545, p = .016) were significant risk factors for venous occlusion within 6 months of CDT. The dual-parameter image-based criteria were significantly superior to the current symptom duration-based approach in terms of area under the curve value (p = .010) and predictive accuracy (p = .031). With a 2-point cut-off, the proposed criteria demonstrated a 66.7 % sensitivity, 100.0 % specificity, and 92.9 % predictive accuracy for identifying non-responders of CDT. CT venography may be useful in assessing CDT prognoses in IVCS patients, particularly to identify non-responders who demonstrate recoiling of EIV diameter and rim enhancement on CT venography.

  11. D-dimer is not elevated in asymptomatic high altitude climbers after descent to 5340 m: the Mount Everest Deep Venous Thrombosis Study (Ev-DVT).

    Science.gov (United States)

    Zafren, Ken; Feldman, Joanne; Becker, Robert J; Williams, Sarah R; Weiss, Eric A; Deloughery, Tom

    2011-01-01

    We performed this study to determine the prevalence of elevated D-dimer, a marker for deep venous thrombosis (DVT), in asymptomatic high altitude climbers. On-site personnel enrolled a convenience sample of climbers at Mt. Everest Base Camp (Nepal), elevation 5340 m (17,500 ft), during a single spring climbing season. Subjects were enrolled after descent to base camp from higher elevation. The subjects completed a questionnaire to evaluate their risk factors for DVT. We then performed a D-dimer test in asymptomatic individuals. If the D-dimer test was negative, DVT was considered ruled out. Ultrasound was available to perform lower-extremity compression ultrasounds to evaluate for DVT in case the D-dimer was positive. We enrolled 76 high altitude climbers. None had a positive D-dimer test. The absence of positive D-dimer tests suggests a low prevalence of DVT in asymptomatic high altitude climbers.

  12. ACUTE EFFECTS OF DIFFERENT SELF‐MASSAGE VOLUMES ON THE FMS™ OVERHEAD DEEP SQUAT PERFORMANCE

    Science.gov (United States)

    Škarabot, Jakob; Vigotsky, Andrew D; Brown, Amanda Fernandes; Gomes, Thiago Matassoli; Novaes, Jefferson da Silva

    2017-01-01

    Background The Functional Movement Screen (FMS™) is a battery of tests designed to assess movement competency; the overhead deep squat test, specifically, has been shown to be an accurate predictor of overall FMS™ scores. Self‐massage (SM) is a ubiquitous warm‐up utilized to increase joint range of motion and, therefore, may be effective for improving performance of the overhead deep squat test. Purpose To examine how different doses (30, 60, 90, and 120 seconds) of SM of different areas of the body (plantar fascia, latissimus dorsi, and lateral thigh) affects the score obtained on an overhead deep squat test. Methods Twenty recreationally active females were recruited to be tested on four occasions: sessions one and two consisted of baseline testing, session three consisted of SM applied to the lateral thigh, and session four consisted of SM applied to the lateral torso and plantar fascia. Results In all SM conditions, at least 90 seconds was required for a change in deep squat score from baseline; therefore, it is concluded that SM the lateral torso, plantar fascia, and lateral thigh for 90 seconds or more are effective interventions for acutely improving overhead deep squat scores. Conclusion Self‐massage appears to be an effective modality for inducing acute improvements in the performance of the FMS™ overhead deep squat in all conditions tested. Level of evidence 2b PMID:28217420

  13. Risk factors associated with the occurrence of silent pulmonary embolism in patients with deep venous thrombosis%下肢深静脉血栓发生无症状性肺栓塞的相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    林万里; 丁锐; 万圣云; 王成宏; 童钟

    2014-01-01

    Objective To investigate the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in the lower limbs, and to evaluate the associated risk factors .Methods A total of 203 patients with acute deep venous thrombosis was retrieved as subjects .All patients completed computed tomography pulmonary arteriography and were assigned into silent PE group and non silent PE groups.The association between covariates and the prevalence of silent pulmonary embolism in patients with deep venous thrombosis in lower limbs were assessed using chi -square test and multivariable Logistic regression analysis .Results Of 203 patients with deep venous thrombosis in lower limbs 64 patients had silent pulmonary embolism (31.5%).Univariate analysis indicated that position of deep venous thrombosis , DVT limb, previous DVT history , coexisting heart diseases were significantly associated with silent pulmonary embolism(P<0.01).Multivariate Logistic regression analysis showed that the central type of deep venous thrombosis (OR=0.158;95%CI,0.063~0.393;P<0.01), the right leg(OR=3.632;95%CI,1.004~13.138;P=0.045), no previous history of deep ve-nous thrombosis(OR=0.179;95%CI,0.046~0.704;P=0.014), coexisting heart diseases(OR=4.063;95%CI,1.107~14.918;P=0.035)were risk factors for silent pulmonary embolism .Conclusions Silent pulmonary embolism occurs frequently in patients with acute deep venous thrombosis in lower limbs .And central type of deep venous thrombosis , the right leg , no previous history of deep ve-nous thrombosis and coexisting heart diseases increase the risk for the occurrence of silent pulmonary embolism .%目的:探讨下肢深静脉血栓( DVT)患者无症状性肺栓塞( PE)的发生率及相关危险因素。方法收集2009-2013年入住血管外科的急性下肢深静脉血栓患者共203例,所有患者均完成计算机断层扫描肺动脉造影( CTPA)。并根据结果分为发生无症状性PE组和未发生无症状性PE组,

  14. 腹部外科术后下肢深静脉血栓的预防及护理体会%Prevention and nursing experience of lower extremity deep venous thrombosis after abdominal surgery

    Institute of Scientific and Technical Information of China (English)

    黄丽朋

    2014-01-01

    目的:总结预防腹部外科术后患者下肢深静脉血栓的发生及护理经验。方法:2012年3月-2014年6月收治腹部手术患者140例,均给予肝素钠抗凝及右旋糖酐祛聚治疗,在积极治疗的同时,加强心理护理、急性期卧床休息护理、饮食指导、热敷、抗凝及溶栓时的护理。结果:本组140例患者经过治疗和护理,发生下肢静脉血栓3例(2.1%),此3例患者经过35~74 d的治疗和护理,侧支循环建立良好,均痊愈出院。结论:加强对腹部外科术后患者的心理护理和健康指导,鼓励患者早下床、多按摩等,可以有效降低下肢深静脉血栓的形成。%Objective:To summary the prevention and nursing experience of lower extremity deep venous thrombosis of patients after abdominal surgery.Methods:140 patients with abdominal surgery were selected from March 2012 to June 2014.They were all treated with heparin anticoagulation and dextranum remove clustering method.At the same time of active treatment,we strengthened the psychological nursing,the bed rest nursing of acute period,diet guidance,hot compress,anticoagulation and thrombolysis nursing.Results:140 patients in this group after treatment and nursing,3 cases(2.1%) occurred lower limb vein thrombosis.After 35 to 74 days treatment and nursing, their side limb circulation established good,and they were cured and discharged.Conclusion:To strengthen the psychological nursing and health guidance for patients after abdominal surgery,and encourage patients to get out of bed early,multi massage,can effectively reduce the formation of lower extremity deep venous thrombosis.

  15. Low molecular weight heparin for the prevention of deep venous thrombosis: a suitable monitoring in elderly patients?

    Science.gov (United States)

    Mahé, Isabelle; Drouet, Ludovic; Chassany, Oliver; Grenard, Anne-Sophie; Caulin, Charles; Bergmann, Jean-François

    2002-01-01

    Monitoring of anti-Xa activity (aXa) levels is not routinely required in patients receiving enoxaparine at prophylactic dosages, since aXa is supposed to stay below the manufacturer's recommended range in patients treated for venous thrombosis (0.5-1 IU/ml). In order to aXa in elderly subjects receiving prophylactic enoxaparin, 68 consecutive patients (mean age 82.5 +/- 10.7 years) hospitalized in a medical department receiving 4000 IU enoxaparin daily subcutaneously for the prevention of venous thromboembolic disease were studied. After the first injection of enoxaparin, the aXa of 57.4% patients was superior to 0.5 IU/ml while 69.4% had an aXa higher than 0.5 after 8.4 +/- 1.2 days. A negative relationship between aXa and body weight and a trend towards a positive correlation between aXa and age but not with creatinine clearance were noted. Our findings question the opportunity to monitor aXa in elderly patients receiving 4000 IU enoxaparin as antithrombotic prophylaxis.

  16. Correlation factors and nursing measures for deep venous thrombosis of lower extremity%下肢深静脉血栓形成相关因素及护理要点

    Institute of Scientific and Technical Information of China (English)

    王红月

    2014-01-01

    Objective:To collect relevant clinical data and explore the correlated factors of deep venous thrombosis,and to summarize the nursing measures. Methods:One-hundred and twenty-four patients'data were collected and analyzed,and the influence to deep venous thrombosis was studied. Results:Trauma fracture,cerebral vascular bed,heart failure and major surgery( heart,chest,abdomen)were the significant factors about deep venous thrombosis,the differences were significant(P ﹤ 0. 05). Conclusion:We should figure out the factors about deep venous thrombosis and take effective nurs-ing measures in order to decrease the incidence of deep venous thrombosis and complications.%目的:收集相关病例资料,分析下肢深静脉血栓形成的相关因素,并阐明各时期护理要点。方法对124例下肢深静脉血栓形成的相关因素进行分析,研究其对下肢深静脉血栓形成的影响。结果外伤骨折、脑血管病卧床、心功能衰竭和大手术(心、胸、腹)后与下肢深静脉血栓形成密切相关,具有统计学差异(P ﹤0.05)。结论明确下肢深静脉血栓形成的高危因素,并对其进行有针对性的护理干预,以降低下肢深静脉血栓形成发生率及并发症发生。

  17. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Directory of Open Access Journals (Sweden)

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  18. The present condition and prospects of the research into pulmonary embolism -deep venous thrombosis%肺栓塞-深静脉血栓形成的研究现状与展望

    Institute of Scientific and Technical Information of China (English)

    翟振国; 王辰

    2006-01-01

    @@ 肺栓塞(pulmonary embolism,PE)是肺循环领域中一个非常重要的医学课题.肺血栓栓塞症(pulmonary thromboembolism,PTE)为PE的最常见类型,占PE中的绝大多数(约90%以上),通常所称PE即指PTE.近年来,以PTE和深静脉血栓形成(deep venous thrombosis,DVT)为主要临床类型的静脉血栓栓塞性疾病(venous thromboembolism,VTE)的防治研究已有迅猛的发展.

  19. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, /sup 125/I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references.

  20. Venous ulcers - self-care

    Science.gov (United States)

    Risk factors for venous ulcers include: Varicose veins History of blood clots in the legs ( deep vein thrombosis ) Blockage of the lymph vessels , which causes fluid to build up in the legs Older age, ...

  1. 彩色多普勒超声在下肢深静脉血栓的诊断应用%Application of color Doppler ultrasound in diagnosis of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    韩诚

    2014-01-01

    Objective:To evaluate the diagnosis significance of color Doppler ultrasound in deep lower vena thrombsis . Methods:35 cases patients with deep venous thrombosis were treated with color Doppler ultrasound then observed location, shape of thrombosis, diameter of affected vein, blood flow characteristics.Results:The data in the diagnosis of thrombosis in 35 cases,1 case of thrombosis of both lower extremities,34 case of thrombosis of single lower extremities;left lower extremity venous thrombosis in 24 cases,10 cases of right lower extremity venous throm-bosis.Conclusion:Color Doppler ultrasound examination for lower extremity deep venous thrombosis diagnosis has important clinical value,the preferred and reliable methods for lower extremity deep venous thrombosis .%目的:评价彩超对下肢深静脉血栓的诊断意义。方法:应用彩色多普勒超声诊断35例下肢深静脉血栓,观察血栓形成的位置、形态、受累静脉的管径、血流情况特点。结果:该组资料中诊断血栓35例,其中单侧血栓34例,双下肢血栓l例;左下肢静脉血栓24例,右下肢静脉血栓l0例。结论:彩色多普勒超声检查对下肢深静脉血栓的诊断有重要的临床价值,为该病的可靠和首选的检查方法。

  2. Use of Multifrequency Bioimpedance Analysis in Male Patients with Acute Kidney Injury Who Are Undergoing Continuous Veno-Venous Hemodiafiltration.

    Directory of Open Access Journals (Sweden)

    Harin Rhee

    Full Text Available Fluid overload is a well-known predictor of mortality in patients with acute kidney injury (AKI. Multifrequency bioimpedance analysis (MF-BIA is a promising tool for quantifying volume status. However, few studies have analyzed the effect of MF-BIA-defined volume status on the mortality of critically ill patients with AKI. This retrospective medical research study aimed to investigate this issue.We retrospectively reviewed the medical records of patients with AKI who underwent continuous veno-venous hemodiafiltration (CVVHDF from Jan. 2013 to Feb. 2014. Female patients were excluded to control for sex-based differences. Volume status was measured using MF-BIA (Inbody S20, Seoul, Korea at the time of CVVHDF initiation, and volume parameters were adjusted with height squared (H2. Binary logistic regression analyses were performed to test independent factors for prediction of in-hospital mortality.A total of 208 male patients were included in this study. The mean age was 65.19±12.90 years. During the mean ICU stay of 18.29±27.48 days, 40.4% of the patients died. The in-hospital mortality rate increased with increasing total body water (TBW/H2 quartile. In the multivariable analyses, increased TBW/H2 (OR 1.312(1.009-1.705, p=0.043 and having lower serum albumin (OR 0.564(0.346-0.919, p=0.022 were independently associated with higher in-hospital mortality. When the intracellular water (ICW/H2 or extracellular water (ECW/H2 was adjusted instead of the TBW/H2, only excess ICW/H2 was independently associated with increased mortality (OR 1.561(1.012-2.408, p=0.044.MF-BIA-defined excess TBW/H2 and ICW/H2 are independently associated with higher in-hospital mortality in male patients with AKI undergoing CVVHDF.

  3. Endothelial cell protein C receptor gene 6936A/G and 4678G/C polymorphisms as risk factors for deep venous thrombosis.

    Science.gov (United States)

    Zoheir, Naguib; Eldanasouri, Nabiel; Abdel-Aal, Asmaa A; Hosny, Karim Adel; Abdel-Ghany, Wafaa M

    2016-04-01

    Endothelial cell protein C receptor (EPCR) enhances the generation of activated protein C by the thrombin-thrombomodulin complex. A soluble form of EPCR (sEPCR) is present in plasma. Two polymorphisms in the EPCR gene (6936A/G and 4678G/C) have been reported to influence the risk of venous thromboembolism. We aimed to investigate the relation between EPCR gene polymorphisms (6936A/G and 4678C/G) and deep venous thrombosis (DVT) and their relations to sEPCR level. This study involved 90 patients with DVT and 90 age and sex-matched healthy controls. Plasma levels of sEPCR were measured in 45 cases of the primary DVT by ELISA. PCR-restriction fragment length polymorphism (RFLP) was used for detection of EPCR polymorphisms (6936A/G and 4678G/C). Regarding 6936A/G, our results demonstrated that mutant genotypes (AG, GG) were associated with an increased risk for DVT [P factor against DVT (P = 0.014, OR 0.289, 95% CI 0.108-0.776) as well as its mutant allele C (P = 0.02, OR 0.600, 95% CI 0.388-0.927), but it had no effect on sEPCR level. Our data suggest that 6936A/G polymorphism is a risk factor for DVT and is associated with elevated plasma levels of sEPCR, while 4678G/C polymorphism plays a role in protection against DVT.

  4. Prevalence of deep venous thrombosis in the lower limbs and the pelvis and pulmonary embolism in patients with positive antiphospholipid antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Kinuya, Keiko; Kakuda, Kiyoshi; Matano, Sadaya; Sato, Shigehiko; Sugimoto, Tatsuho [Tonami General Hospital, Toyama (Japan); Asakura, Hidesaku; Kinuya, Seigo; Michigishi, Takatoshi; Tonami, Norihisa

    2001-12-01

    Antiphospholipid antibodies (AA) are immunoglobulins that cross-react with phospholipid on cell membrane, and are therefore associated with a hypercoagulable state manifested by arterial/venous thromboses. We aimed to determine the prevalence of deep venous thrombosis in the lower limbs and the pelvic region (DVT) and pulmonary embolism (PE) in patients with positive AA. Sixty-six patients (48 female, 18 male) with positive lupus anticoagulant (LA) and/or positive anticardiolipin antibody (aCL) underwent radionuclide (RN) venography with 370 MBq of {sup 99m}Tc-MAA. Pulmonary perfusion scintigraphy was performed in 58 patients. Fifteen patients had positive LA and positive aCL (LA+/aCL+), 33 patients had positive LA only (LA+/aCL-) and 18 patients had positive aCL only (LA-/aCL+). Forty-three patients were diagnosed with primary antiphospholipid syndrome (APS) and 19 were diagnosed with APS associated with SLE. DVT was detected in 21 of 66 patients (32%). Patients with LA+/aCL+ showed higher prevalence of DVT (53%) as compared to LA+/aCL- (27%) and LA-/aCL+ (22%). PE was found in 13 of 58 patients (22%). The prevalence of PE was higher in patients with positive aCL (33% in LA+/aCL+; 36% in LA-/aCL+) than in patients with negative aCL (10%). Because of the high prevalence of DVT and PE in patients with AA, RN scintigraphy must be recommended in screening for these clinical troubles. These results indicate that the prevalence of DVT and PE may vary in subgroups of AA. (author)

  5. Prognostic significance of residual venous obstruction in patients with treated unprovoked deep vein thrombosis: a patient-level meta-analysis.

    Science.gov (United States)

    Donadini, Marco P; Ageno, Walter; Antonucci, Emilia; Cosmi, Benilde; Kovacs, Michael J; Le Gal, Grégoire; Ockelford, Paul; Poli, Daniela; Prandoni, Paolo; Rodger, Marc; Saccullo, Giorgia; Siragusa, Sergio; Young, Laura; Bonzini, Matteo; Caprioli, Monica; Dentali, Francesco; Iorio, Alfonso; Douketis, James D

    2014-01-01

    Residual venous obstruction (RVO) could improve the stratification of the risk of recurrence after unprovoked deep vein thrombosis (DVT), but results from clinical studies and study-level meta-analyses are conflicting. It was the objective of this analysis to determine if RVO is a valid predictor of recurrent venous thromboembolism (VTE) in patients with a first unprovoked DVT who had received at least three months of anticoagulant therapy. Individual patient data were obtained from the datasets of original studies, after a systematic search of electronic databases (Medline, Embase, Cochrane Library), supplemented by manual reviewing of the reference lists and contacting content experts. A multivariate, shared-frailty Cox model was used to calculate hazard ratios (HRs) for recurrent VTE, including, as covariates: RVO; age; sex; anticoagulation duration before RVO assessment; and anticoagulation continuation after RVO assessment. A total of 2,527 patients from 10 prospective studies were included. RVO was found in 1,380 patients (55.1%) after a median of six months from a first unprovoked DVT. Recurrent VTE occurred in 399 patients (15.8%) during a median follow-up of 23.3 months. After multivariate Cox analysis, RVO was independently associated with recurrent VTE (HR = 1.32, 95% confidence interval [CI]: 1.06-1.65). The association was stronger if RVO was detected early, i.e. at three months after DVT (HR = 2.17; 95% CI: 1.11-4.25), but non-significant if detected later, i.e. >6 months (HR = 1.19; 95% CI: 0.87-1.61). In conclusion, after a first unprovoked DVT, RVO is a weak overall predictor of recurrent VTE. The association is stronger if RVO is detected at an earlier time (3 months) after thrombosis.

  6. Aspiration Thrombectomy Using a Guiding Catheter in Acute Lower Extremity Deep Vein Thrombosis: Usefulness of the Calf-Squeeze Technique

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae A; Kwak, Hyo Sung; Han, Young Min; Yu, Hee Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2011-05-15

    The effectiveness of the calf-squeeze technique during aspiration thrombectomy using guiding catheter in the treatment of an acute lower extremity deep vein thrombosis (DVT) was evaluated by the use of imaging and the clinical follow-up of patients. A prospective analysis of ten patients (seven women, three men; median age, 56.9 years) with common iliac vein (CIV) obstruction and ipsilateral DVT was performed for this study. All patients presented with leg edema or pain and were treated with catheter-directed thrombolysis via an ipsilateral popliteal vein approach after insertion of a temporary inferior vena cava (IVC) filter. Subsequently, the patients were treated with by aspiration thrombectomy using a guiding catheter to remove the residual thrombus. The calf-squeeze technique during aspiration thrombectomy can be used to induce the proximal migration of thrombi in the popliteal, tibial, and muscular veins were used to increase venous flow. The calf-squeeze technique was employed at mean of 1.3 times (range, 1-3 times). All patients showed proximal migration of a popliteal and muscular vein thrombus during the execution of the calf-squeeze technique. Successful recanalization was achieved in all patients (100%) without any complications. On duplex ultrasonography, which was performed immediately after the aspiration thrombectomy, four patients had a residual thrombus in the soleal muscular veins. However, none of the patients had a thrombus in the popliteal and tibial veins; and, during follow-up, no DVT recurred in any patient. The use of the calf-squeeze technique during aspiration thrombectomy after catheter-directed thrombolysis can induce the proximal migration of thrombi in the popliotibial and muscular veins and is an effective method that can remove a thrombus in calf veins.

  7. The impact of an “acute dialysis start” on the mortality attributed to the use of central venous catheters: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Tennankore Karthik K

    2012-07-01

    Full Text Available Abstract Background Central venous catheters (CVCs are associated with early mortality in dialysis patients. However, some patients progress to end stage renal disease after an acute illness, prior to reaching an estimated glomerular filtration rate (eGFR at which one would expect to establish alternative access (fistula/peritoneal dialysis catheter. The purpose of this study was to determine if exclusion of this “acute start” patient group alters the association between CVCs and mortality. Methods We conducted a retrospective cohort study of 406 incident dialysis patients from 1 Jan 2006 to 31 Dec 2009. Patients were classified as acute starts if 1 the eGFR was >25 ml/min/1.73 m2, ≤3 months prior to dialysis initiation and declined after an acute event (n = 45, or 2 in those without prior eGFR measurements, there was no supporting evidence of chronic kidney disease on history or imaging (n = 12. Remaining patients were classified as chronic start (n = 349. Results 98 % and 52 % of acute and chronic starts initiated dialysis with a CVC. There were 148 deaths. The adjusted mortality hazard ratio (HR for acute vs. chronic start patients was 1.84, (95 % CI [1.19-2.85]. The adjusted mortality HR for patients dialyzing with a CVC compared to alternative access was 1.19 (95 % CI [0.80-1.77]. After excluding acute start patients, the adjusted HR fell to 1.03 (95 % CI [0.67-1.57]. Conclusions A significant proportion of early dialysis mortality occurs after an acute start. Exclusion of this population attenuates the mortality risk associated with CVCs.

  8. Venous Thromboembolism in China

    Institute of Scientific and Technical Information of China (English)

    赵永强

    2005-01-01

    @@ Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are two manifesttions of venous thromboembolism (VTE) . Although the controversy remained,it has been widely accepted for many years that Chinese people have lower incidence of VTE than Caucasians with the different etiology and clinical features.

  9. Massive splenic infarction and splenic venous thrombosis observed in a patient with acute splenic syndrome of sickle cell traits on contrast-enhanced thin-slice computed tomography.

    Science.gov (United States)

    Hayashi, Takana Yamakawa; Matsuda, Izuru; Hagiwara, Kazuchika; Takayanagi, Tomoko; Hagiwara, Akifumi

    2016-09-01

    We report a case of splenic infarction in a patient with sickle cell traits (SCT), focusing on the computed tomography (CT) findings. The patient was an African-American man in his twenties with no past medical history who experienced sudden left upper quadrant pain while climbing a mountain (over 3000 m above sea level). Dynamic contrast-enhanced CT revealed massive non-segmental splenic infarction accompanied with nodule-like preserved splenic tissue. The region of splenic infarction did not coincide with the arterial vascular territory and differed from the features of infarction caused by large arterial embolism. In addition, thrombotic occlusion of the distal splenic vein was depicted on plain and contrast-enhanced thin-slice CT images. Early-phase contrast-enhanced images also showed inhomogeneous enhancement of the hepatic parenchyma. The patient's symptoms improved with conservative therapy. A hemoglobin electrophoresis test confirmed the diagnosis of SCT. SCT is usually asymptomatic, but hypoxic environments may induce acute splenic syndrome, which is commonly manifested as splenic infarction. We observed splenic venous thrombosis and inhomogeneous hepatic parenchymal enhancement in addition to a huge splenic infarction in our patient. To the best of our knowledge, this is the first report describing the specific imaging findings, particularly splenic venous thrombosis and inhomogeneous hepatic parenchymal enhancement, of acute splenic syndrome in a patient with previously undiagnosed SCT. These findings demonstrate the pathophysiology of SCT, and may help with the diagnosis of this disease.

  10. Size of the thrombus in acute deep vein thrombosis and the significance of patients' age and sex.

    Science.gov (United States)

    Kierkegaard, A

    1981-01-01

    To determine the significance of patients' age and sex on the size of the thrombus in acute deep vein thrombosis, 420 consecutive phlebograms with acute deep vein thrombosis were studied. A significant correlation between the size of the thrombus and increasing age of the patient as well as the sex of male was noted. It is concluded that older patients and men often are at a high risk of pulmonary embolism at the time of diagnosis.

  11. 围手术期病人下肢深静脉血栓的预防及治疗对策%Perioperative prevention and treatment of low extremity deep venous thrombosis (LDVT)

    Institute of Scientific and Technical Information of China (English)

    艾宇航

    2012-01-01

    下肢深静脉血栓(low extremity deep venous throm bosis,LDVT)形成是围手术期常见的并发症,防止围术期 LDVT形成对病人来说至关重要,一旦发生LDVT危险较大.应重视围手术期LDVT的处理对策,重点在于早期预防、早期诊断、早期积极治疗.%Low extremity deep venous thrombosis (LDVT) is one of the common complications during perioperative period. Perioperative prevention and treatment of LDVT are very important. The author summarized the treatment strategies of LDVT, including early prevention, early diagnosis and early aggressive therapy.

  12. 腹腔镜结直肠癌术后下肢深静脉血栓的Meta分析%Incidence of Postoperative Deep Venous Thrombosis after Open and Laparoscopic Colorectal Cancer Surgery: Meta-analysis

    Institute of Scientific and Technical Information of China (English)

    吴霁晖; 王冠; 王栋; 傅卫

    2011-01-01

    目的 探讨腹腔镜与开腹结直肠癌手术后下肢深静脉血栓(deep venous thrombosis,DVT)发生率的差异.方法 收集1989年1月~2010年5月已公开发表的腹腔镜与开腹结直肠癌手术后DVT发生情况的随机对照研究结果,按照Meta分析的要求对初步检索到的所有研究结果的质量进行评估和筛选,对入选的所有研究结果进行Meta分析,计算腹腔镜手术组相对开腹手术组术后发生DVT的优势比(odds ratio,OR),评价腹腔镜手术和开腹手术后DVT发生率有无统计学差异.结果 符合纳入标准的共9篇文章,总样本量2606例.其中腹腔镜手术组1453例,发生术后DVT 11例;开腹手术组1153例,发生术后DVT 15例.合并OR=0.63,95%可信区间为0.31~1.27.结论 与开腹结直肠癌手术相比,腹腔镜手术不会增加术后DVT发生的风险.%Objective A higher incidence of deep venous thrombosis after laparoscopic or open colorectal cancer surgery is still debatable. A Meta-analysis was conducted to compare the incidence of postcolorectal surgery deep venous thrombosis between laparoscopic and open surgery groups. Methods Published randomized controlled trials were collected and evaluated; the data extracted were then analyzed by using meta-analysis. Odds ratio (OR) of the incidence of deep venous thrombosis between laparoscopic group and open surgery group were calculated to show the benefits of laparoscope or open surgery in terms of deep venous thrombosis occurred during hospital stay. Results A total of 2606 cases from 9 trials were included in our study. 11 cases of deep venous thrombosis out of 1453 cases occurred in the laparoscopic group while 15 out of 1153 incidences of deep venous thrombosis occurred in the open surgery group. The pooled OR was 0.63 (95% confidence interval 0.31 to 1.27). Conclusion Laparoscopic surgery does not increase the risk of deep venous thrombosis.

  13. Reversible diencephalic dysfunction as presentation of deep cerebral venous thrombosis due to hyperhomocysteinemia and protein S deficiency: Documentation of a case

    Directory of Open Access Journals (Sweden)

    Kaukab Maqbool Hassan

    2013-01-01

    Full Text Available A 45-year-old man presented with global headache, vomiting and abnormal behavior after cross-country run at high altitude. There was no seizure, loss of consciousness, fever or head injury. He was conscious, abulic and uncooperative with normal vitals. There was no focal neurological deficit. Non contrast computed tomography scan of head was normal. Magnetic resonance imaging of brain showed venous infarct in bilateral thalami, left basal ganglia and periventricular white matter. Magnetic resonance venography revealed thrombosis involving internal cerebral veins, septal veins, thalamostriate veins, vein of Galen and proximal portion of straight sinus. His condition steadily improved on low molecular weight heparin bridged with oral anticoagulation for one year. At two months, serum homocysteine was 31.51 μmol/l (5.46-16.2 μmol/l and protein S was 49.00% (77-143.00%. He received methylcobalamin, pyridoxine and folic acid. After 16 months, he was asymptomatic with partially recanalized deep cerebral veins and serum homocysteine falling to 16.50 μmol/l (5.46-16.2 μmol/l.

  14. Clinical Study on Effect of Osteoking (恒古骨伤愈合剂) in Preventing Postoperational Deep Venous Thrombosis in Patients with Intertrochanteric Fracture

    Institute of Scientific and Technical Information of China (English)

    ZHAO Hong-bin; HU Min; ZHENG Hong-yu; LIANG Hong-suo; ZHU Xiao-song

    2005-01-01

    Objective: To evaluate the effect of Osteoking (恒古骨伤愈合剂) in preventing postoperational deep venous thrombosis (DVT) in patients with intertrochanteric fracture (ITF). Methods: With prospective and randomized controlled clinical design adopted, 62 patients with ITF after operation were assigned into 2 groups, the tested group and the control group, Osteoking (25 ml every other day) and SanchiDifference of round length of thighs and shanks between two sides were measured on the 10th day and Doppler ultrasonic examination on the fractured leg was carried out. Results: The occurrence rate of DVT in the tested goup was 9.4%, which was lower than that in the control group (30.0%, P<0.05). All the difference of round lengths, either that of the thigh or the shank, was less in the tested group than that in the control group, showing statistical significance ( P<0.05 ). Conclusion: Osteoking has a satisfactory effect in preventing postoperational DVT in patients with ITF.

  15. Detection of acute cerebral ischaemia with Tc-99m apcitide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, S. [Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330 (Thailand)

    2002-10-01

    The established indication for Tc99m apcitide scintigraphy is for detecting deep venous thrombosis. However, due to its mechanism of binding to GP IIb/IIIa receptors on activated platelets, it can be used to image acute cerebral thrombosis. I report a patient with an acute ischaemic stroke, with right leg swelling, referred for Tc99m apcitide scintigraphy to show of deep venous thrombosis. There was no abnormal uptake in the legs but there was in the left parieto-occipital region. This correlated with the clinical and CT data, indicating an acute ischaemic stroke in this area. (orig.)

  16. 32 Cases With Deep Venous Thrombosis in Pregnancy and Puerperium%妊娠期与产褥期下肢深静脉血栓形成32例诊疗分析

    Institute of Scientific and Technical Information of China (English)

    秦靖宜; 郭学利

    2015-01-01

    Objective To explore the factors,diagnosis,treatment and prevention of deep venous thrombosis during pregnancy and puerperium.Methods Thedata of 32 patients with deep venous thrombosis during pregnancy and puerperium were reviewed and analyzed.Results Except 2 cases terminating pregnancy,32 patients recovered after treatment,without stilbirth,abortion,suffocation son,oaf childbirth and died.Conclusion Deep venous thrombosis happens easily on pregnancy and puerperium. These women should be diagnosed and treated early if they have high risk.%目的 探讨妊娠期、产褥期深静脉血栓形成的相关原因、诊断方法、治疗效果及预防措施.方法 对我院2012年~2015年收治的32妊娠期、产褥期DVT患者的临床资料进行回顾性分析.结果 32例妊娠期、产褥期DVT治疗后痊愈,除2例终止妊娠外无死胎、流产,无窒息儿、畸形儿娩出,无死亡患者.结论 妊娠期、产褥期是DVT的高发期,使用抗凝、溶栓等治疗多可痊愈;对临床疑似病例, 应尽早诊治.

  17. 产后住院患者合并深静脉血栓形成的临床分析%Deep venous thrombosis in postpartum inpatients

    Institute of Scientific and Technical Information of China (English)

    孙平; 孔北华

    2011-01-01

    目的 探讨产后住院患者深静脉血栓形成(DVT)的临床特点、诊治及预防.方法 回顾性分析我院2008年1月至12月间收治的2789例产妇,分析产后住院期间并发下肢DVT患者的临床特点及诊治方法 ,并结合文献复习讨论病因及预防措施.结果 我院2008年产后住院患者DVT的发生率为0.72%,均为周围型DVT.高龄、经产妇、剖宫产、肥胖和静脉血栓栓塞性疾病(VTE)病史是产后DVT的主要危险因素.治疗采用以抗凝为主的综合性药物治疗,均取得较好的近期疗效.结论 产妇住院期间合并DVT的类型主要是周围型,低分子肝素是常用的安全有效的抗凝药物.对于存在DVT危险因素的产妇应采取积极预防措施.%Objective To describe clinical characteristics of deep venous thrombosis (DVT) after delivery and to study how to choose methods of diagnosis, treatment and prophylaxis of DVT. Methods Among 2 789 lying-in women in our hospital from January 2008 to December 2008 ,clinical characteristics and methods of diagnosis and treatment of 20 inpatients with DVT were retrospectively analyzed. After reviewing the previous literature, pathogenesis and prophylactic steps were discussed. Results The incidence rate of postpartum DVT was 0.72% in 2 789 lying-in women, and the main type was peripheral DVT. Advanced age, venous thromboembolism, fatness, multipara and caesarean section were the high risk factors for inpatient postpartum DVT. A combination of plasma D-dimmer and Doppler ultrasonography was the best choice to definitely diagnose DVT. Low molecule weight heparin (LMWH) anticoagulation was effective in the treatment of postpartum DVT. Conclusions The main type of DVT in inpatients after delivery is peripheral DVT. Preoperative and postoperative prophylactic treatment for DVT should be considered in a high risk population.LMWH is commonly used and is safe for the treatment of DVT.

  18. [Present and future in the management of venous vascular diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít; Gavorníková, Eva

    2015-02-01

    The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium's deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical support of leg ulcer healing, along with sulodexide and pentoxifylline. Compressive sclerotherapy, liquid or foam, is a safe and effective invasive method to treat telangiectasias, reticular varicose veins and subcutaneous varicose veins. Direct oral anticoagulants (DOAC) represent one of the therapeutic and preventive options of deep venous thrombosis (DVT) and of venous thromboembolism (VTE) with a limitation in patients with malignant conditions and in pregnancy. The most effective is triple simultaneous pharmaco-kinezio-mechano-phlebothromboemboloprophylaxis. Superficial vein thromboses longer than 5 cm are indicated to anticoagulant therapy too.

  19. Extra-abdominal venous thromboses at unusual sites.

    Science.gov (United States)

    Martinelli, Ida; De Stefano, Valerio

    2012-09-01

    Venous thrombosis typically involves the lower extremities. Rarely, it can occur in cerebral, splanchnic, or renal veins, with a frightening clinical impact. Other rare manifestations are upper-extremity deep vein thrombosis, that can complicate with pulmonary embolism and post-thrombotic syndrome, and retinal vein occlusion, significantly affecting the quality of life. This review is focused on venous thromboses at unusual extra-abdominal sites. Local infections or cancer are frequent in cerebral sinus-venous thrombosis. Upper-extremity deep vein thrombosis is mostly due to catheters or effort-related factors. Common risk factors are inherited thrombophilia and oral contraceptive use. Acute treatment is based on heparin; in cerebral sinus-venous thrombosis, local or systemic fibrinolysis should be considered in case of clinical deterioration. Vitamin-K antagonists are recommended for 3-6 months; indefinite anticoagulation is suggested for recurrent thrombosis or unprovoked thrombosis and permanent risk factors. However, such recommendations mainly derive from observational studies; there are no data about long-term treatment of retinal vein occlusion.

  20. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration.

  1. Analysis of deep venous thrombosis after splenectomy from two different diseases.%两种不同原因脾切除术后深静脉血栓形成分析

    Institute of Scientific and Technical Information of China (English)

    壮毅; 徐进; 杨晓峰; 岳茂兴; 李瑛

    2011-01-01

    目的 探讨两种不同原因脾切除(肝硬化伴脾功能亢进,肝硬化组.外伤性脾破裂,外伤组)术后深静脉血栓形成原因及对策.方法 统计分析两种不同原因脾切除患者WBC和PLT计数、Hb变化规律,比较术前凝血功能,并计算两组脾切除术后深静脉血栓形成率.结果 脾切除可使肝硬化组术后短时期内WBC恢复正常;对两组Hb没有影响;两组术后PLT均高于正常,但外伤组更明显;两组术前凝血功能没有差异;肝硬化组深静脉血栓形成率较外伤组更高.结论 深静脉血栓形成与PLT升高有一定关系,但不是主要的,术后需要增强CT和多普勒超声监测,一旦明确深静脉血栓形成应即予积极抗凝等冶疗.%Objective To investigate etiological factors and treatments of deep venous thrombosis after splenectomy because of hepatocirrhosis with hypersplenism, traumatic splenic rupture. Methods WBC, PLT count and HB in two groups patients' peripheral blood, and coagulative funtion of pre-operation, and rate of deep venous thrombosis of two groups were analyzed. Results WBC count in hepatocirrhosis group recovered to normal in short time after operation; no difference of HB between two groups; PLT count of two groups were higher than that of the normal patients, but that in the trauma group was higher than that in the hepatocirrhosis groups; no difference of coagulative funtion pre-operation between two groups; the rate of deep venous thrombosis in the hepatocirrhosis group was higher than that in the trauma. Conclusion There is some relation between deep venous thrombosis and higher PLT count,but not the major cause. Using contrast enhanced CT and color Doppler flow imaging (CDFI) after splenectomy is necessary. Once diagnosis of deep venous thrombosis is confm-ned, adequate anticoagulant therapy should be given.

  2. 创伤致实验动物深静脉血栓形成的研究%Detection of traumatic deep venous thrombosis of laboratory animals

    Institute of Scientific and Technical Information of China (English)

    许琴; 张东辉; 许永华; 李建瑛; 是文辉; 李佳佳; 马娜; 王军文

    2011-01-01

    为观察创伤致实验动物深静脉血栓形成及其组织学变化,分别选用犬、新西兰兔及Wistar大鼠作为实验动物,进行骨科有创手术过程,其中犬24条进行人为股骨颈骨折钢板内固定手术,新西兰兔20只行单侧肢股骨骨折后髋人字石膏固定术,Wistar大鼠30只行单侧肢体(左后肢)骨缺损性骨折后髋人字石膏固定术。以大体解剖,血管彩超,血管组织学,血常规等指标进行检测深静脉血栓的形成。结果受试犬中有10条犬在术后4周内陆续死亡,尸检可见心脏内形成鸡脂样血栓,另有4条犬在术后6周及8周死亡,尸检心脏内见到血栓,其余犬饲养至48周,未见血栓形成,总体血栓形成率为58.3%;新西兰兔手术后饲养至8周,患肢每周进行血管彩超检测,未检测到血栓形成,但术部有大量囊性积液;30只大鼠术后9d内镜检肢体深静脉血栓形成率为77.8%。本试验表明骨科有创手术可致实验动物深静脉血栓形成,不同种属间有差异,犬及大鼠的发生率比兔要高,在用实验动物进行骨科的相关研究课题及临床兽医进行手术时要采取必要的预防措施。%Dogs,rabbits and Wistar rats were used for invasive orthopedic surgery to detect the formulation of traumatic deep venous thrombosis(DVT) and investigate the pathologic changes. 24 dogs received plate fixation of manmade femoral neck fractures; 20 New Zealand rabbits were undertaken plaster immobilization after unilateral limb comminuted fractures;30 Wistar rats received plaster immobilization after unilateral limb ununited fractures. Gross anatomy, vascular ultrasound, vascular pathology and blood parameters were tested to detect deep venous thrombosis of the animals. 10 dogs died within 4 weeks after surgery,autopsy showed chicken fat like thrombus formed in their hearts,and another 4 dogs died at 6 and 8 weeks after surgery,with the thrombus in

  3. Trombose venosa profunda e sua relação com trombofilias e neoplasias: estudo retrospectivo Deep venous thrombosis and its relationship with thrombophilias and malignancies: retrospective study

    Directory of Open Access Journals (Sweden)

    Ana Vieira Baptista

    2012-09-01

    Full Text Available Objectivos: Avaliação dos resultados obtidos através dos protocolos instituídos no Serviço para despiste de trombofilias e/ou neoplasias em doentes internados ao longo de 5 anos com o diagnóstico de trombose venosa profunda (TVP. Material e métodos: Estudo retrospectivo, através da consulta dos processos hospitalares, de todos os doentes com idade igual ou inferior a 50 anos internados no Serviço entre 01 de Janeiro de 2006 e 31 de Dezembro de 2010 com esse diagnóstico, e análise dos resultados obtidos nos protocolos. Resultados: De um total de 89 doentes, 64 (71,9% eram do sexo feminino e 25 (28,1% do masculino, sendo a média de idades de 33,3 ±10,0 anos. 14,6% dos doentes já haviam tido, pelo menos, um episódio prévio de TVP e 78,7% apresentavam, pelo menos, um factor de risco. Em 65 doentes (73,0% foi aplicado o protocolo de despiste de trombofilias e de neoplasias, tendo sido detectadas trombofilias congénitas em 41 doentes (63,1%, dois casos de síndrome dos anticorpos anti-fosfolipídicos (SAF, um caso de gamapatia monoclonal, um de neoplasia do pulmão e um de cordoma do sacro. 49 dos doentes que realizaram os protocolos (75,4% foram orientados para a Consulta de Hematologia, sendo que em 40 deles (81,6% foi sugerido manter a anticoagulação oral por um período superior a 12 meses. Conclusões: Dada a elevada prevalência de polimorfismos genéticos que conferem risco trombótico acrescido e os não raros casos de SAF e de neoplasias ocultas presentes nesta população de doentes, considera-se que, apesar dos elevados custos, se deverá continuar a fazer o despiste deste tipo de patologias.Objectives: Evaluation of the results obtained with the application of specific protocols established in the Department for screening for thrombophilia and malignancy in patients hospitalized during a period of five years with the diagnosis of deep venous thrombosis (DVT. Material and methods: A retrospective study was performed

  4. [Prospective study of the outcome of rheoplethysmographic parameters after deep venous thrombosis of the lower extremities. Role in the decision to discontinue anticoagulants].

    Science.gov (United States)

    Ferrini, M; Blum, I; Tartulier, M; Aupetit, J F

    1987-01-01

    Forty-eight patients (25 M, 23 F) age range 25 to 83 years were admitted for treatment of deep vein thrombosis (DVT) of lower limbs confirmed by phlebocavography. Lesions were sural in 6 cases (Gr. 1), subcrural in 28 (Gr. 2) and supracrural in 13 (Gr. 3). Rheoplethysmography with venous occlusion (ORP) was performed and repeated every four months until (possible) recovery of normal emptying parameters (EI). Mean observation period was 25 +/- 8 months. In group 1, ORP indices were always restored to normal values within 4 months. In groups 2 and 3, normal values of IDV were observed in 23/38 patients within a median period of 10 months. Actuarial analysis of changes in EI values showed normalization in 65% of patients within 12 to 16 months with lack of significant differences between values for groups 2 and 3. Beyond this period of time any recovery of normal emptying indices is more aleatory, the residual obstructive syndrome appearing to be established definitely. Antivitamin K therapy (AVK) was instituted in 44 patients, and discontinuation was a function of normalization of EI. Good long-term results (clinical and ORP) were noted in 26/28 cases: one patient had recurrence of DVT with regional extension of thrombus and another a thrombosis on a Mobin-Uddin filter. Restoration of normal EI values during the 16 months following onset of DVT of lower limbs constitutes a valuable index for cessation of AVK therapy. After this period, recovery from the obstructive syndrome is more aleatory and decision to continue therapy must be based on other criteria.

  5. Risk of postoperative deep venous thrombosis in patients with colorectal cancer treated with open or laparoscopic colorectal surgery: A meta-analysis

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    Y Z Xie

    2014-01-01

    Full Text Available Introduction: Whether the incidence rate of deep venous thrombosis (DVT between laparoscopic and open colorectal cancer surgery the same or not were under the debated without conclusion. The aim of this study was to compare the incidence of DVT after laparoscopic or open colorectal cancer surgery by meta-analysis. Materials and Methods: The open published articles comparing the incidence of DVT after laparoscopic or open colorectal cancer were collected in the data bases of Medline, the Cochrane central register of controlled trials and CNKI. The relative risk (RR was pooled by using random or fixed effect mode to evaluate the incidence of DVT between laparoscopic or open colorectal cancer surgery.Results: After searching the databases, 9 randomized clinical studies with 2606 colorectal cancer cases were included in this meta-analysis. The mean operation time was 201.8 ± 17.28 min with its range of 180.0-224.4 min in the laparoscopic surgery group and 148.1 ± 18.8 min with its range of 135.0-184.0 min in the open surgery group. The operation time for laparoscopic surgery group were significant lower than in the open surgery group (P < 0.05. The RR of DVT between the laparoscopy and open surgery groups was 0.71 with its 95% confidence interval of 0.35-1.45 (P = 0.35. Conclusions: The operation time in laparoscopic colorectal cancer surgery was statistical longer than in the open colorectal cancer surgery, but the DVT risk of the two surgery approach was not different according to this meta-analysis.

  6. Tissue Factor Pathway Inhibitor-1 Is a Valuable Marker for the Prediction of Deep Venous Thrombosis and Tumor Metastasis in Patients with Lung Cancer

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    Xianming Fei

    2017-01-01

    Full Text Available Activation of blood coagulation contributes to cancer progression. Tissue factor pathway inhibitor-1 (TFPI-1 is the main inhibitor of extrinsic coagulation pathway. The aim of this study is to assess the predicting significance of TFPI-1 for thrombotic complication and metastasis in lung cancer patients. Total of 188 non-small cell lung cancer (NSCLC patients were included in this study. Plasma TFPI-1, D-dimer (D-D, antithrombin (AT, Fibrinogen (Fbg, and coagulating factor VIII activity (FVIII:C were measured. In NSCLC patients, significantly decreased TFPI-1 and AT and increased D-D, Fbg, and FVIII:C levels were observed, and there was a significant correlation between TFPI-1 and other hemostatic parameters (P<0.001, resp.. NSCLC patients with deep venous thrombosis (DVT or metastasis had significantly lower TFPI-1 levels than those without DVT or metastasis (P<0.01, resp.. Multivariate regression revealed that TFPI-1 acted as a predictor for DVT or tumor metastasis in NSCLC patients [OR: 4.15 or 3.28, P<0.05, resp.]. The area under ROC curve of TFPI-1 was 0.905 (95% CI, 0.842~0.967 or 0.828 (95% CI, 0.742~0.915 for predicting DVT or metastasis (P<0.001, resp.. The optimal point of TFPI-1 was 57.7 or 54.3 ng/mL for predicting DVT or metastasis, respectively. Combination of TFPI-1 and D-D measurements can improve the predicting power for DVT or metastasis in NSCLC patients. Our findings suggested that TFPI-1 was a valuable predictor of DVT and tumor metastasis in NSCLC patients.

  7. 深静脉血栓中静脉瓣破坏的相关研究进展%Progress in studying of damage of venous valves in deep vein thrombosis

    Institute of Scientific and Technical Information of China (English)

    周瑜; 乔彤

    2013-01-01

    静脉瓣在人体中起重要作用,观察发现当深静脉血栓形成与溶解时,静脉瓣多有损坏.目前关于静脉瓣损伤的机制还没有完全阐述清楚,其中诸多不利因素引起的炎症反应会导致血栓形成,以及血栓形成后引起的炎症反应在深静脉血栓病程中普遍存在.故本文着重在炎症方面回顾近年来深静脉血栓中静脉瓣破坏的研究进展.%Venous valve plays an important role in regulating the venous flow,especially in preventing the blood backflow.It has heen observed that when deep vein thrombosis and dissolved,the valves in the lesions had been destroied or dysfunction.The mechanism of damage of vein valve has not been fully clarified,but as we know,it's common that the inflammatory reaction,due to many unfavorable factors,can cause thrombosis.On the other hand,deep vein thrombosis could bring out the inflammatory reaction as well.So the author will review the development of researching of the destruction of venous valves in recent years.

  8. 全髋关节置换后下肢深静脉血栓形成的4项危险因素%Four risk factors of deep venous thrombosis in lower limbs after total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张晟; 解笑宸; 姚粤峰; 韦良臣

    2015-01-01

    BACKGROUND:Deep venous thrombosis is one of the most common and dangerous complication. There wil be serious consequences for failing to prevent deep venous thrombosis in advance, so we need to evaluate the risk factors of deep venous thrombosis. OBJECTIVE:To evaluate the clinical risk factors for lower limb deep vein thrombosis after total hip arthroplasty. METHODS:Data of 162 patients who were treated from January 2010 to February 2013 in Department of Bone and Joint Surgery, Shenzhen Hospital of Peking University for total hip arthroplasty were analyzed retrospectively. Al patients received ultrasonography on deep veins of lower limb preoperatively and postoperatively 3 and 7 days. Risk factors of deep venous thrombosis were analyzed using Logistic regression analysis in patients undergoing total hip arthroplasty. RESULTS AND CONCLUSION:The selected factors for Logistic regression model contained bone cement prosthesis, age distribution, body mass index, and general anesthesia. Their OR values were 9.215, 11.247, 3.842, 4.825, respectively. They were risk factors for the occurrence of deep venous thrombosis. Above results indicated that use of bone cement prosthesis, age, body mass index>25 kg/m2 and general anesthesia are risk factors for deep venous thrombosis after total hip replacement, so they should cause clinical attention and we should take active measures to prevent them.%背景:下肢深静脉血栓形成是人工全髋关节置换常见的也是危险性较大的并发症,如果不能提前预防,会造成严重后果,故在临床中需要对下肢深静脉血栓形成的危险因素进行评估。目的:评估人工全髋关节置换后下肢深静脉血栓形成的临床危险因素。方法:对2010年1月至2013年2月在北京大学深圳医院骨关节科行人工全髋关节置换的162例患者资料进行回顾性分析,所有患者均在置换前、置换后第3天和第7天进行双下肢深静脉彩超检查。采用Logistic

  9. Late results of catheter-directed recombinant tissue plasminogen activator fibrinolytic therapy of iliofemoral deep venous thrombosis Resultados de longo prazo do tratamento fibrinolítico da trombose venosa iliacofemoral por infusão seletiva do ativador de plasminogênio tissular recombinante em baixas doses

    Directory of Open Access Journals (Sweden)

    Ivan Benaduce Casella

    2007-02-01

    Full Text Available PURPOSE: To evaluate the efficacy of catheter-directed low-dose recombinant tissue-type plasminogen activator infusion in the treatment of iliofemoral deep venous thrombosis and prevention of post-thrombotic syndrome. METHOD: Eighteen patients (out of 260 evaluated with acute iliofemoral deep venous thrombosis and no previous evidence of venous insufficiency were prospectively selected for thrombolytic therapy. Catheter-directed low-dose recombinant tissue-type plasminogen activator (1 mg/h was infused into the thrombotic segments. RESULTS: Effective fibrinolysis was achieved in 14 of 18 cases, with correlation between effective fibrinolysis and major/complete resolution of acute signs and symptoms (P OBJETIVOS: Avaliar a eficácia da infusão seletiva por cateter do ativador de plasminogênio tecidual recombinante em baixas doses no tratamento da trombose venosa iliacofemoral e na prevenção da síndrome pós-trombótica. MÉTODO: Dezoito pacientes (de 260 avaliados portadores de trombose venosa profunda iliacofemoral sem evidência prévia de insuficiência venosa foram selecionados para terapia fibrinolítica e submetidos a infusão seletiva por cateter do ativador de plasminogênio tecidual recombinante na dose de 1mg/dl nos segmentos venosos trombóticos. RESULTADOS: Quatorze pacientes apresentaram fibrinólise efetiva; observamos correlação entre o grau de melhora clínica observado e a redução percentual do volume trombótico (P<.01. Não houve episódios de complicações graves. Quatro pacientes apresentaram retrombose precoce (1 a 8 semanas. Os pacientes foram seguidos por um período de até 131 semanas (média 85.2. A incidência de sinais e sintomas clínicos de insuficiência venosa e os achados ecográficos de refluxo valvular foram significativamente menores nos pacientes em que a terapia fibrinolítica foi efetiva e a perviedade mantida ao longo do período de seguimento, na comparação com os casos de falha aguda ou de

  10. Clinical characteristics and risk factors of symptomatic central venous catheter-related deep vein thrombosis in children%儿童中心静脉置管相关症状型深静脉血栓形成的临床特点和影响因素

    Institute of Scientific and Technical Information of China (English)

    裴亮; 杨雨航; 杨妮; 文广富; 许巍; 刘春峰

    2016-01-01

    Objective To investigate the clinical features and risk factors in children with symptomatic central venous catheter-related deep vein thrombosis,and to provide guidence for clinical therapy.Methods The clinical data of 105 children with central venous catheter were retrospectively analyzed.According to the thrombosis or not,these children were classified into two groups:thrombosis group and non-thrombosis group.The risk factors influencing symptomatic central venous catheter-related deep vein thrombosis forming were identified by Logistic regression analysis.Results Among the 105 cases with central venous catheter,the male to female ratio was 68:37;age ranged from 8.5 months to 13 years old with average age(5.5 ±4.0) years old.There were 98 cases in non-thrombosis group and 7 cases in thrombosis group.Factors such as age[(5.7 ±4.1)years old vs.(2.5 ± 1.8) years old],central venous catheter dwell time[(6.1 ±2.3)d vs.(8.9 ± 2.1) d],more than 7 days parenteral nutrition application (11/98 cases vs.5/7 cases) and more than 7 days intravenous application of mannitol(7/98 cases vs.4/7 cases)were found significantly different between the thrombosis group and non-thrombosis group(P < 0.05).Multivariate Logistic regression analysis showed that more than 7 days parenteral nutrition application and intravenous mannitol were the risk factors of symptomatic central venous catheter-related deep vein thrombosis [OR =50.703 (95 % CI 3.258-789.056),OR =15.590 (95 % CI 1.196-203.146),P < 0.05].Conclusion Symptomatic central venous catheter-related deep vein thrombosis is a common complication of deep venous catheterization.It cause acute pulmonary embolism and some critical diseases,and influence the prognosis and prolong hospital stay.Application of intravenous nutrition more than 7 days and intravenous mannitol more than 7 days are the risk factors of symptomatic central venous catheter-related deep vein thrombosis.%目的 调查儿童中心静脉置管相关症状

  11. Epidemiology of recurrent venous thrombosis

    Directory of Open Access Journals (Sweden)

    D.D. Ribeiro

    2012-01-01

    Full Text Available Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

  12. 下肢深静脉血栓形成介入治疗规范的专家共识%Agreement on the guidelines for the interventional treatment of deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    中华医学会放射学分会介入学组

    2011-01-01

    @@ 下肢深静脉血栓形成(deep venous thrombosis,DVT)是血液在下肢深静脉内不正常凝结引起的疾病,血液回流受阻,出现下肢肿胀、疼痛、功能障碍,血栓脱落可引起肺动脉栓塞(pulmonary embolism,PE).DVT和PE合称为静脉血栓栓塞症(venous thromboembolism,VTE).DVT如在急性期未得到有效治疗,血栓机化,常遗留静脉功能不全,称为血栓后综合征(postthrombosis syndrome,PTS)[1-2].

  13. Focused Sonographic Examination of the Heart, Lungs and Deep Veins in Acute Admitted Patients with Respiratory Symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    of the clinical examination. In addition, most of the diseases, which are commonly seen in patients with acute respiratory symptoms, can be diagnosed using sonography. Sonography could be integrated as a part of the primary evaluation, potentially improving the diagnostic performance. We therefore evaluated...... the use of sonographic examination of the heart, lungs and deep veins, performed within one hour of the primary evaluation, in acute admitted patients with respiratory symptoms. Methods: We performed a prospective cross sectional blinded observational study, conducted in a medical emergency department....... Patients were included if one or more of the following symptoms or clinical findings were present: respiratory rate > 20, saturation heart, lungs and deep veins...

  14. THE SUCCESSFUL TREATMENT OF A PERIPHERAL VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE ACUTE RESPIRATORY FAILURE IN THE EARLY PERIOD AFTER ADULT LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2014-01-01

    Full Text Available Aim: of our clinical study was to present own experience of veno-venous extracorporeal membrane oxygenation (VV ECMO for the treatment of an adult patient (female, 28 yrs, 150 cm, 35 kg with acute respiratory distress syndrome (ARDS in the early period after liver transplantation against satisfactory liver graft function. Materials and methods. Double-lumen cannula 22 F was placed percutaneously in the right internal jugular vein. The ext- racorporeal contour reduced in length and the polymethylpeptene oxygenator (priming volume 175 ml were also. Results. In 1 hour after the beginning of VV ECMO, we registered the noted improvement of arterial blood gas and acid-base balance (regress of respiratory acidosis, improvement of arterial oxygenation which allowed us to use the «protective» mode of mechanical ventilation. Improvement of gas exchange and regress of clinical and radiological manifestations of ARDS allowed for VV ECMO weaning and decannulation on day 7. The patient was discharged from ICU and then from our Centre to a homestay respectively on the 9th and 16th day after VV ECMO weaning with the satisfactory liver graft and lungs function. Conclusion. VV ECMO can be successfully applied to correct the life-threatening acute respiratory failure in the early period after liver transplantation. 

  15. Combined treatment of subacute and acute synthetic and venous bypass-graft occlusions with percutaneous mechanical thrombectomy and thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Hundt, Walter, E-mail: hundt@med.uni-marburg.de [Department of Radiology, Philipps University Marburg (Germany); Kalinowski, Mark; Stamm, Anna C. [Department of Radiology, Philipps University Marburg (Germany); Portig, Irene [Department of Cardiology, Division of Angiology, Philipps University Marburg (Germany); Swaid, Zaher; Dietz, Carsten; Geks, Josef [Department of Surgery, Philipps University Marburg (Germany); Burbelko, Mykhaylo [Department of Radiology, Philipps University Marburg (Germany)

    2013-12-01

    Introduction: Percutaneous mechanical thrombectomy (PMT) is a third choice of treatment for acute arterial occlusions, in addition to thrombolysis and surgical thrombectomy. The aim of this retrospective study was to compare the combined treatment of PMT and local thrombolysis with thrombolysis therapy alone. Materials and methods: Sixty-nine patients with acute (<14 days [n = 35]) or subacute (14–42 days [n = 34]) femoropopliteal bypass occlusions were treated with PMT combined with thrombolysis. Seventy-two patients with acute [n = 40] or subacute [n = 32] femoropopliteal bypass occlusions were treated with thrombolysis alone. The thrombolysis in myocardial infarction (TIMI) classification was used to assess the bypass occlusion. Local thrombolysis time and dosage, reopening time, time in the intensive care unit, necessary surgical re-interventions, and clinical outcome were compared between the 2 groups. Results: The TIMI scores were significantly higher in the PMT plus thrombolysis group than in the thrombolysis group (acute occlusions 1188 versus 935, p < 0.001; subacute occlusions 935 versus 605, p < 0.001). The total urokinase dosage, the total hours of thrombolysis, time in the intensive care unit, and total hospital stay in the acute PMT plus thrombolysis group were significantly lesser than those in the thrombolysis group. After 24 h of treatment, the ankle-brachial index improved in all groups (p < 0.001): in the acute and subacute PMT plus thrombolysis group to 0.63 ± 0.14 and 0.43 ± 0.08, respectively; and in the acute and subacute thrombolysis group to 0.51 ± 0.11 and 0.41 ± 0.04, respectively. Conclusions: PMT combined with thrombolysis is a safe and very effective therapy for acute and subacute femoropopliteal bypass occlusions compared to treatment with thrombolysis alone.

  16. Effective Nursing Measures for the Prevention of Deep Venous Thrombosis of Lower Extremity%有效预防下肢深静脉血栓的护理措施

    Institute of Scientific and Technical Information of China (English)

    孙爱静

    2015-01-01

    目的:了解骨折患者下肢深静脉血栓的有效预防措施,降低其发生率。方法对该院2014年6月—2014年8月收治的115例下肢骨折患者进行病例回顾性分析,分析不同护理方式对下肢静脉血栓发生情况的影响。结果115例病例中发生下肢深静脉血栓6例,发生率5.2%,常规护理加下肢气压泵护理可有效的减少骨折患者发生下肢静脉血栓,与常规护理组比较,差异有统计学意义(P<0.05)。结论下肢骨折长期卧床患者,应采取常规护理加下肢气压泵护理,以有效地降低下肢深静脉血栓形成的概率,减轻病人的痛苦。%Objective To understand the effective nursing measures for the prevention of deep venous thrombosis of lower extremi-ty so as to reduce the incidence of the disease. Methods A retrospective analysis was conducted on 115 patients with fracture of lower limb admitted in our hospital from June 2014 to August 2014. And the effects of different nursing methods on the incidence of venous thrombosis of lower extremity were analyzed. Results Of the 115 cases, 6 cases had deep venous thrombosis of lower extremity, the in-cidence was 5.2%. Conventional nursing and lower limb pneumatic pump nursing could effectively reduce the occurrence of venous thrombosis of lower extremity, compared with the nursing effect of the conventional nursing group, the difference between the groups was statistical significant. Conclusion For long-term bedridden fracture patients, conventional nursing and lower limb pneumatic pump nursing can effectively reduce the probability of deep venous thrombosis of lower extremity and the pain of the patients.

  17. Acute mechanical stretch promotes eNOS activation in venous endothelial cells mainly via PKA and Akt pathways.

    Directory of Open Access Journals (Sweden)

    Zhenqian Hu

    Full Text Available In the vasculature, physiological levels of nitric oxide (NO protect against various stressors, including mechanical stretch. While endothelial NO production in response to various stimuli has been studied extensively, the precise mechanism underlying stretch-induced NO production in venous endothelial cells remains incompletely understood. Using a model of continuous cellular stretch, we found that stretch promoted phosphorylation of endothelial NO synthase (eNOS at Ser¹¹⁷⁷, Ser⁶³³ and Ser⁶¹⁵ and NO production in human umbilical vein endothelial cells. Although stretch activated the kinases AMPKα, PKA, Akt, and ERK1/2, stretch-induced eNOS activation was only inhibited by kinase-specific inhibitors of PKA and PI3K/Akt, but not of AMPKα and Erk1/2. Similar results were obtained with knockdown by shRNAs targeting the PKA and Akt genes. Furthermore, inhibition of PKA preferentially attenuated eNOS activation in the early phase, while inhibition of the PI3K/Akt pathway reduced eNOS activation in the late phase, suggesting that the PKA and PI3K/Akt pathways play distinct roles in a time-dependent manner. Finally, we investigated the role of these pathways in stretch-induced endothelial exocytosis and leukocyte adhesion. Interestingly, we found that inhibition of the PI3K/Akt pathway increased stretch-induced Weibel-Palade body exocytosis and leukocyte adhesion, while inhibition of the PKA pathway had the opposite effects, suggesting that the exocytosis-promoting effect of PKA overwhelms the inhibitory effect of PKA-mediated NO production. Taken together, the results suggest that PKA and Akt are important regulators of eNOS activation in venous endothelial cells under mechanical stretch, while playing different roles in the regulation of stretch-induced endothelial exocytosis and leukocyte adhesion.

  18. Multifaceted Intervention to Prevent Venous Thromboembolism in Patients Hospitalized for Acute Medical Illness: A Multicenter Cluster-Randomized Trial.

    Directory of Open Access Journals (Sweden)

    Pierre-Marie Roy

    Full Text Available Misuse of thromboprophylaxis may increase preventable complications for hospitalized medical patients.To assess the net clinical benefit of a multifaceted intervention in emergency wards (educational lectures, posters, pocket cards, computerized clinical decision support systems and, where feasible, electronic reminders for the prevention of venous thromboembolism.Prospective cluster-randomized trial in 27 hospitals. After a pre-intervention period, centers were randomized as either intervention (n = 13 or control (n = 14. All patients over 40 years old, admitted to the emergency room, and hospitalized in a medical ward were included, totaling 1,402 (712 intervention and 690 control and 15,351 (8,359 intervention and 6,992 control in the pre-intervention and intervention periods, respectively.Symptomatic venous thromboembolism or major bleeding (primary outcome occurred at 3 months in 3.1% and 3.2% of patients in the intervention and control groups, respectively (adjusted odds ratio: 1.02 [95% confidence interval: 0.78-1.34]. The rates of thromboembolism (1.9% vs. 1.9%, major bleedings (1.2% vs. 1.3%, and mortality (11.3% vs. 11.1% did not differ between the groups. Between the pre-intervention and intervention periods, the proportion of patients who received prophylactic anticoagulant treatment more steeply increased in the intervention group (from 35.0% to 48.2%: +13.2% than the control (40.7% to 44.1%: +3.4%, while the rate of adequate thromboprophylaxis remained stable in both groups (52.4% to 50.9%: -1.5%; 49.1% to 48.8%: -0.3%.Our intervention neither improved adequate prophylaxis nor reduced the rates of clinical events. New strategies are required to improve thromboembolism prevention for hospitalized medical patients.ClinicalTrials.gov NCT01212393.

  19. THE RUSSIAN DATA OF INTERNATIONAL ENDORSE REGISTER (EPIDEMIOLOGIC INTERNATIONAL DAY FOR THE EVALUATION OF PATIENTS AT RISK OF VENOUS THROMBOSIS IN ACUTE HOSPITAL CARE SETTING

    Directory of Open Access Journals (Sweden)

    V. A. Sulimov

    2008-01-01

    Full Text Available Aim. To estimate a risk factor frequency of venous thromboembolism (VTE in patients urgently hospitalized in hospitals, and also to estimate of patients part having effective prevention of VTE.Material and methods. ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk of Venous Thrombosis in Acute Hospital Care Setting is the international register. Patients of 40 years and older hospitalised in therapeutic departments as well as patients of 18 years and older hospitalised in surgical departments (358 hospitals in 32 countries were included in the register. The case history analysis of all patients was performed for estimation of risk VTE and evaluation of preventive therapy quality according to American College of Chest Physicians (ACCP Recommendation 2004.Results. Totally 68 183 patients (including 30 827 (45% surgical patients and 37 356 (55% therapeutic patients were enrolled in Global ENDORSE Register. Russian centers enrolled 4 788 patients (including 2 829 (59% surgical patients and 1 959 (41% therapeutic patients. Totally 35 329 (51,8% patients enrolled in Global ENDORSE Register (64,4% of surgical patients (19 842 and 41,5% of therapeutic patients (15 487 had VTE risks. In Russia 2 188 enrolled patients (45,7% had VTE risks (52% of surgical patients (1 470 and 36,7% of therapeutic patients (718. Totally 17 732 (50,2% patients enrolled in Global Register ENDORSE and having VTE risks received VTE preventive therapy according to АССР Recommendations 2004. In Russia 521 (23,8% patients enrolled in Global ENDORSE Register and having VTE risks received VTE preventive therapy according to АССР Recommendations 2004. It is more than 2 times less in comparison with world level (р<0.001.Conclusion. There are a lot of patients with VTE risks in hospitals. It is necessary to improve preventive therapy of VTE due to better hospital management and more active use of АССР Recommendations 2004.

  20. 大隐静脉抽剥对下肢深静脉瓣膜功能的影响%Effect of deep venous valve function after the stripping of saphenous vein

    Institute of Scientific and Technical Information of China (English)

    曾昕明; 王鹏程; 赵军

    2010-01-01

    目的 研究大隐静脉激抽剥术治疗下肢慢性静脉功能不全对改善深静脉瓣膜功能的作用.方法 收集45例(50条肢体)住院治疗的下肢下肢慢性静脉功能不全的患者,行大隐静脉高位结扎剥脱术.所有患者术前均经过双功能彩色多普勒超声检查记录深静脉血流动力学指标,手术后3个月对患者进行随访,比较手术前后深静脉瓣膜功能是否有改善及改善的程度.结果 除6例共7条患肢术后3个月未见明显降低级别外,其余患肢所有患肢术后均出现深静脉功能级别下降1级或1级以上;术前深静脉功能记分为139,术后3个月降到93,差异有显著性(P<0.01).血流动力学指数(股浅静脉第一对瓣膜返流时间与返流最大流速)术后均显著改善(P<0.05).结论 大隐静脉激抽剥术治疗下肢慢性静脉功能不全的有效术式,并且确实可以在一定程度上改善深静脉瓣膜功能.%Objective To evaluate the effect on deep venous valve function after proximal saphenous vein ligation and ablation of varicose veins in treatment of chronic venous insufficiency (CVI) of lower limbs.Methods Forty five(50 limbs)cases with CVI were enrolled to accept surgical management of vein systems.Each patient was detected with Color Doppler Ultra sonography, whose deep venous hemodynamics index was measured and recorded pre-operation and three month after operation. Results Except 6 ( 7 limbs) cases without degradation of deep venous valve function class post operation, the others cases are all decrease one or more. The scoring of deep venous valve function post operation are significantly decrease from 139 (pre-operation)to 93 (P<0. 01 ). The index of deep venous hemodynamics( back flow time and peak flow rate of back flow)has prominent improvement after operation(P< 0 05). Conclusion It is effective way of proximal saphenous vein ligation and ablation of varicose veins in treatment of CVI and it is confirmed that it can

  1. 运用循证护理预防全髋关节置换术后DVT的发生%Application of evidence-based nursing to prevent the incidence of deep venous thrombosis after total hip replacement

    Institute of Scientific and Technical Information of China (English)

    邓顺华; 朱娟

    2009-01-01

    目的 探索循证护理在全髋关节置换术后预防下肢深静脉血栓( Deep venous thrombosis DVT)的干预方法.方法 采用回顾性对照方法,将患者分为对照组和实验组,将循证护理实施前收治的52例患者列为对照组;循证护理实施后收治的52例患者列为实验组.对照组采用常规护理方法,实验组运用循证护理方法,即根据病人情况,提出临床护理问题--下肢深静脉血栓(DVT);查阅相关资料,寻找循证支持;循证的观察与应用.比较两组患者DVT的发生率、对疾病知识的掌握情况及满意度.结果 实验组患者没有一例发生DVT,对疾病相关知识的掌握情况及满意度明显提高,两组患者比较差异有统计学意义,P<0.05.结论 应用循证护理预防全髋关节置换术后DVT是积极有效的,在临床护理领域中实施循证护理具有良好的发展前景.%Objective Explore the evidence-based nursing interventions to prevent the complication of lower extremity deep venous thrombosis after total hip replacement.Methods Using retrospective methods to control,the patients were divided into control group and experimental group , the 52 patients admitted before application of evidence-based nursing were set as the control group,while those 52 patients admitted after application of evidence-based nursing were set as the experimental group. Using conventional methods of nursing in the control group, using the evidence-based nursing in the experimental group, that is based on the patient's situation, raised the proplem of clinical nursing--lower extremity deep venous thrombosis;Access to relevant information, search for evidence-based to support; Observation and application of evidence-based. The incidence of lower extremity deep venous thrombosis,mastering degree of disease-related knowledge and satisfaction degree were compared between two groups.Results No patient occurred with lower extremity deep venous thrombosis in the experimental

  2. Treatment of acute deep burns in lower extremities of the elderly

    Institute of Scientific and Technical Information of China (English)

    Babur M. Shakirov

    2015-01-01

    Objective: To study the different surgical treatments in 154 elderly patients with acute deep burns of lower extremities admitted in Burn Department of RSCUMA.Methods:Skin grafts in extensive burns were performed in 32 patients for the purpose of achieving early closure of the burn area. In 116 patients with burn surface area of 6-25 %, skin grafting was performed on the granulating wound when the wound was ready for accepting skin graft. In these 19 cases, a stamp graft procedure was used in 12 patients and Mowlen-Jackson method of skin grafting in 7 cases.Results:Analysis of the nearest results showed that 28 out of 154 patients came back to the hospital for new surgery due to loss of ability of normal movement of their extremities.Conclusions:Careful patient selection and timing of surgery will help to avoid any adverse effect on patient outcome.

  3. TCM Clinical Research on the Risk Factors of Deep Venous Thrombosis of Lower Extremity%下肢深静脉血栓形成高危因素的中医临床研究

    Institute of Scientific and Technical Information of China (English)

    曹纪委; 杜萌萌

    2016-01-01

    Objective To analyze the reason of deep venous thrombosis of lower extremity .Methods Date of 20 cases of patients with deep venous thrombosis of lower extremity were retrospectively analyzed .Results In 20 patients, the age of onset in 17 cases was more than 40 years old, accounting for 85%.Morbidity after operation were 4 cases, accounting for 20%.2 patients had long-term braking, accounting for 10%, 2 patients had malignant tumor , accounting for 10%, and 6 cases had history of traumatic fractures , accounting for 30%. Conclusion Various postoperative malignant tumors , trauma, fracture, older age, long-term brake bed are risk factors of deep venous thrombosis of lower extremity .%目的:分析下肢深静脉血栓形成( LDVT)的原因。方法回顾性分析20例下肢深静脉血栓形成的患者资料。结果20例患者中,发病年龄≥40岁共17例,占85%;手术后发病4例,占20%;长期制动患者2例,占10%;恶性肿瘤患者2例,占10%;创伤骨折史者6例,占30%。结论高龄、各种术后、长期制动卧床、恶性肿瘤、创伤骨折等都是LDVT的原因。

  4. [Medial venous catheter or midline (MVC)].

    Science.gov (United States)

    Carrero Caballero, Ma Carmen; Montealegre Sanz, María; Cubero Pérez, Ma Antonia

    2014-01-01

    Current clinical practice is characterised for importance of the patient's quality of life and the need to reduce the costs of their treatment. We search intravenous therapy alternatives that meet the needs of the patient, reducing the complications associated with the use of venous catheters. Scientific evidence shows that there are midline venous catheters that offer patients and professionals the possibility of extending the duration of infusion therapy, using more venous compatibility materials, and with less risk of infection. The Midlines are becoming in a safe an efficient device for intravenous therapy, continuous and intermittent infusion, provided the necessary care by expert nurses. Midline catheters are peripheral venous access devices between 3 to 10 inches in length (8 to 25 cm). Midlines are usually placed in an upper arm vein, such as the brachial or cephalic, and the distal extreme ends below the level of the axillary line. Midlines catheters implanted in the cephalic or deep basilica veins get more blood flow. This large blood volume justifies the lower risk of mechanical or chemical phlebitis. Midlines are routinely used for two to six weeks. Due that the extrem of these catheters does not extend beyond the axillary line, there are limitations for its use: type of infused drugs, velocity of infusion, etc. In general, solutions that have pH 5 to 9, or an osmolarity less than 500 mOsm are appropriate for infusion through a Midline. Its use is recommended in case of treatments over 7 days with low irritant capacity fluids. According to the Infusion Nurses Society's standards of practice, Midline catheters are appropriate for all intravenous fluids that would normally be administered through a short peripheral IV Importantly, due that the catheter does not pass through the central veins, Midlines can be placed without a chest X-ray to confirm placement. For certain situations, Midlines are suitable for acute units and even for care home settings

  5. CORRIGENDUM to Four Thrombotic Events Over 5 Years, Two Pulmonary Emboli and Two Deep Venous Thrombosis, When Testosterone-HCG Therapy Was Continued Despite Concurrent Anticoagulation in a 55-Year-Old Man With Lupus Anticoagulant

    Science.gov (United States)

    2017-01-01

    Owing to errors made by the authors, Charles J. Glueck, Kevin Lee, Marloe Prince, Vybhav Jetty, Parth Shah, and Ping Wang, the following article contains errors. Glueck CJ, Lee K, Prince M, et al. Four Thrombotic Events Over 5 Years, Two Pulmonary Emboli and Two Deep Venous Thrombosis, When Testosterone-HCG Therapy Was Continued Despite Concurrent Anticoagulation in a 55-Year-Old Man With Lupus Anticoagulant. J Investig Med High Impact Case Rep. 2016;4(3):1-6. doi: 10.1177/2324709616661833 PMID:28321420

  6. 彩色多普勒超声在下肢深静脉血栓诊断中的应用分析%Analysis on Color Doppler Ultrasound Application in Diagnosis of Deep Venous Thrombosis of Lower Extremity

    Institute of Scientific and Technical Information of China (English)

    高宏

    2015-01-01

    Objective To evaluate the efficacy of color doppler ultrasound application in diagnosis of deep venous thrombosis of lower extremity. Methods We chose 42 patients suffering from deep venous thrombosis of lower extremity who were treated in hospital from December 2013 to December 2014 and separated them into study group and control group at random. Patients in study group were given color doppler ultrasound examination; while patients in control group were diagnosed by DSA(digital subtraction angiography),and then compared diagnosis effect of two groups. Results Diagnosis accuracy and complication incidence in study group were much better than those in control group; there was a diagnosis differential between two groups,and such a differential had statistic value(P<0.05). Conclusion Color doppler ultrasound examination is accurate and efficiency in diagnosis of deep venous thrombosis of lower extremity; it is conducive to increasing diagnosis efficiency and reducing complication incidence,therefore,color doppler ultrasound examination is rather worthwhile to be promoted and applied in diagnosis of deep venous thrombosis.%目的:探讨彩色多普勒超声在下肢深静脉血栓诊断中的应用分析。方法选取2013年12月~2014年12月我院接诊的42例下肢深静脉血栓患者,随机分为实验组和对照组,实验组采用彩色多普勒超声诊断技术,对照组采用数字减影血管造影(DSA)诊断技术,观察两组患者的诊断效果。结果实验组患者的诊断准确率、并发症的发生率好于对照组,差异有统计学意义(P<0.05)。结论彩色多普勒超声在下肢深静脉血栓诊断中的效果显著,诊断率高,并发症的发生率低。

  7. Chinese medicine treatment of deep venous thrombosis of the lower extremity after artificial joint replacement%人工关节置换后中医药治疗下肢深静脉血栓形成

    Institute of Scientific and Technical Information of China (English)

    吴正林

    2012-01-01

    BACKGROUND: The incidence of lower extremity deep venous thrombosis is high after artificial joint replacement and mainly caused by intimal damage, slow blood flow velocity and blood hypercoagulable state.OBJECTIVE: To evaluate the preventive and therapeutic effects of Chinese medicine on the lower extremity deep venous thrombosis after artificial joint replacement.METHODS: A computer-based online search was performed for the articles from January 1989 to October 2011 with the key words of “Chinese medicine, lower extremity deep venous thrombosis, prevention and treatment, artificial joint replacement”. The articles that related with the Chinese medicine for the treatment of lower extremity deep venous thrombosis after artificial joint replacement were included; the repeat studies or Meta-analysis articles were excluded. A total of 26 articles were included to review.RESULTS AND CONCLUSION: For the treatment of lower extremity deep venous thrombosis, the main treatment methods include functional exercise, the pressure gradient therapy, and the thrombolytic and anticoagulant therapy. In recent years, the Chinese medicine shows a good effect in the treatment of lower extremity deep venous thrombosis and the main Chinese medicine include salvia miltiorrhiza, ligustrazine and astragalus mongholicus. Some Chinese herbal compound with the effect of promoting blood circulation also has a role in the prevention of lower extremity deep venous thrombosis. It demonstrates that Chinese medicine shows a good effect both on the prevention and treatment of lower extremity deep venous thrombosis with less adverse reaction. Chinese and Western medicine combined with functional exercise is an effective means for the prevention and treatment of lower extremity deep venous thrombosis.%背景 人工关节置换后下肢深静脉血栓形成的发病率较高,主要原因包括血管内膜受损、血流速度缓慢及血液呈高凝状态3个方面.目的 评价中医药在防

  8. Venous thromboembolism: The intricacies

    Directory of Open Access Journals (Sweden)

    Dutta T

    2009-01-01

    Full Text Available Venous thromboembolism (VTE has been a subject of great interest of late. Since Rudolph Virchow described the famous Virchow′s triad in 1856, there have been rapid strides in the understanding of the pathogenesis and factors responsible for it. Discovery of various thrombophilic factors, both primary and acquired, in the last 40 years has revolutionized prognostication and management of this potentially life-threatening condition due to its associated complication of pulmonary thromboembolism. Detailed genetic mapping and linkage analyses have been underlining the fact that VTE is a multifactorial disorder and a complex one. There are many gene-gene and gene-environment interactions that alter and magnify the clinical picture in this disorder. Point in case is pregnancy, where the risk of VTE is 100-150 times increased in the presence of Factor V Leiden, prothrombin mutation (Prothrombin 20210A and antithrombin deficiency. Risk of VTE associated with long-haul air flight has now been well recognized. Thrombotic events associated with antiphospholipid syndrome (APS are 70% venous and 30% arterial. Deep venous thrombosis and pulmonary embolism are the most common venous events, though unusual cases of catastrophes due to central vein thrombosis like renal vein thrombosis and Budd-Chiari syndrome (catastrophic APS may occur.

  9. Successful treatment of acute hereditary angioedema attacks with self-administered icatibant in patients with venous access problems.

    Science.gov (United States)

    Wiednig, Michaela

    2013-04-25

    Hereditary angioedema is a rare and potentially fatal autosomal dominant disorder characterised by unpredictable skin, gastrointestinal tract or respiratory tract oedema. Plasma-derived C1-esterase inhibitors are effective in the prophylaxis or treatment of hereditary angioedema type I and II attacks, but must be administered intravenously. This may be problematic in patients with venous access difficulties. Icatibant, a bradykinin B2-receptor antagonist, is administered subcutaneously. In July 2008 icatibant received approval for healthcare professional-administered treatment of hereditary angioedema attacks in adults. In 2011 it received European Medicines Agency and US Food and Drug Administration licences for patient-administered treatment of hereditary angioedema attacks. Given these approvals, and with the appropriate training, icatibant could provide the opportunity for patients to self-administer treatment. This is one of the first long-term follow-up reports of patients with hereditary angioedema using self-administered icatibant. During follow-up, icatibant remained effective and patient satisfaction was high.

  10. Venous Ultrasound (Extremities)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Venous (Extremities) Venous ultrasound uses sound waves to ... limitations of Venous Ultrasound Imaging? What is Venous Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  11. 股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全%Treatment of primary deep venous valve insufficiency in lower limb by venous external valvuloplasty on the first valve of superficial femoral vein

    Institute of Scientific and Technical Information of China (English)

    陈寅; 黄惊鸿; 龚景庆

    2001-01-01

    Objective To evaluate the results of treatment of primary deepvenous insufficiency in lower limbs.Methods 55 patients were treated by venous external valvuloplasty on the first valve of superficial femoral vein with PTFE.Results All of the patients were followed up for 4 to 14 months after operation. The results of treatment were very good.Conclusions Primary deep venous valve insufficiency with mild to moderate venous reflux was treated by venous external valvuloplasty on the first valve of superficial femoral vein. It has advantages of few complications and simple operative technique with good results.%目的 评估应用股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全的疗效。方法 对原发性下肢深静脉瓣膜功能不全的55例患者施以股浅静脉第一对瓣膜包窄术,包窄材料选用聚四氟乙烯人造血管。结果 本组病人术后均随访4~14个月,术前临床症状缓解,疗效好。结论 股浅静脉第一对瓣膜包窄术治疗瓣膜轻、中度倒流的原发性下肢深静脉瓣膜功能不全,有坚实的理论基础,并有并发症少,操作简单,疗效好等优点,值得推广。

  12. Physical activity, immobilization and the risk of venous thrombosis

    NARCIS (Netherlands)

    Stralen, Karlijn Janneke van

    2008-01-01

    Deep venous thrombosis is a common disease. Already in 1856 it was suggested that immobilization could cause venous thrombosis. However, so far little research has shown whether exercise or ambulation could decrease the risk of venous thrombosis. We performed a historical review regarding the role o

  13. 神经外科术后下肢深静脉血栓形成的预防和护理%PreventionandNursingcareofLowerExtremityDeepVenousThrombosisAfterDepartmentofNeurosurgerySurgery

    Institute of Scientific and Technical Information of China (English)

    韩亚南

    2013-01-01

    Objective To observe and analyze the methods of prevention and nursing of deep venous thrombosis of lower limb after operation in the Department of neurosurgery. Methods In our hospital from 2011 March to 2012 March were treated in the Department of Neurosurgery, need operation a total of 16 cases. Analysis of patient factors of deep venous thrombosis of lower extremity and related nursing measures. Results 16 cases of patients with deep vein thrombosis were treated and careful nursing after cured, no pulmonary embolism, no deaths. Conclusion To induce formation of lower extremity deep venous thrombosis related factors, for the patients with high risk of operation of the preventive measures, for patients who have deep vein thrombosis, thrombolysis therapy and nursing work well, improve the quality of postoperative prognosis.%  目的观察分析神经外科术后下肢深静脉血栓形成的预防和护理方法。方法选取我院从2011年3月至2012年3月神经外科收治的需要手术的患者共16例。总结分析患者出现下肢深静脉血栓的因素以及相关的护理措施。结果16例发生下肢深静脉血栓的患者均经过治疗和精心的护理后痊愈出院,没有并发肺栓塞,没有出现死亡病例。结论了解诱发下肢深静脉血栓的形成因素,对于高危手术患者做好相关的预防措施,对于已经形成下肢深静脉血栓的患者则做好溶栓等治疗和护理工作,提高患者术后的预后质量。

  14. Research on the prevention and nursing of deep venous thrombosis after operation in department of orthopedics%骨科手术后深静脉血栓形成的预防研究及护理

    Institute of Scientific and Technical Information of China (English)

    倪伟

    2015-01-01

    Objective:After operation in department of orthopedics,to explore how to improve the level of nursing care of deep venous thrombosis of the lower extremity,and how to help patients recover as soon as possible through effective nursing measures. Methods:60 patients with operation in department of orthopedics were selected.They were divided into the observation group and the control group.The observation group was given the basic means of prevention and drug prevention,and the control group was given the conventional means of prevention.In the observation group,patients with deep venous thrombosis were given comprehensive nursing care,and the control group was given routine nursing measures.Results:In the control group,the incidence of deep vein thrombosis was higher than that of the observation group(P<0.05).Conclusion:For patients after the operation in department of orthopedics,improving the prevention for deep vein thrombosis and strengthening the effective nursing for patients with deep venous thrombosis can reduce complication and promote the rehabilitation of patients.%目的:探讨骨科手术后,如何能够提高下肢深静脉血栓的护理水平,以及如何通过有效护理措施来帮助患者尽早康复。方法:收治骨科手术患者60例,分为对照组和观察组,观察组在基本预防手段上配合药物预防,对照组实施常规预防手段。观察组中并发深静脉血栓的患者进行综合护理,对照组则实施常规护理手段。结果:对照组深静脉血栓形成的发生率高于观察组(P<0.05)。结论:患者进行骨科手术以后,提高针对深静脉血栓的预防水平,以及加强对深静脉血栓患者的有效护理能够降低并发率,促进患者早日康复。

  15. 胃肠外科围手术期下肢深静脉血栓形成的临床分析%Clinical characteristics and risk factors of deep venous thrombosis of lower extremities in patients of gastrointestinal surgery

    Institute of Scientific and Technical Information of China (English)

    郜永顺; 黄晶晶; 陈鹏; 张云飞; 闫西忠; 孙建刚

    2016-01-01

    Objective To study the clinical characteristics and risk factors of lower extremity deep venous thrombosis (DVT) during perioperative period of gastrointestinal surgery.Methods Color Doppler ultrasound was used for detecting lower extremity deep venous thrombosis in 120 patients undergoing gastrointestinal surgery from November 2014 to August 2015 in the First Affiliated Hospital of Zhengzhou University.Results There were 49 cases (40.8%) of lower extremity DVT after operation,including 24 cases (49%) of left lower extremity,10 cases (20.4%) of right lower extremity,and 15 cases (30.6%) of both lower extremities.48 cases (98%) were asymptomatic muscular venous thrombosis.73.5% (36 cases) DVT occurred within 2 hours postoperatively.Multiple logistic regression analysis showed that age over 60 years,malignant tumor,overweight (BMI ≥ 24 kg/m2),D-dimer increment > 1 mg/L,postoperative infection were closely related to the occurence of deep venous thrombosis of the lower extremities.Conclusion Asymptomatic muscular venous thrombosis within 2 hours after surgery is the main type of lower limb thrombosis in the perioperative gastrointestinal surgery.Age over 60 years,malignant tumor,postoperative infection,D-dimer increment > 1 mg/L,overweight are independent risk factors for lower extremity DVT after gastrointestinal surgery.%目的 探讨胃肠外科围手术期下肢深静脉血栓(deep venous thrombosis,DVT)形成的临床特点和危险因素.方法 应用彩色多普勒超声动态监测2014年1 1月至2015年8月郑州大学第一附属医院胃肠外科收治的所有符合入组标准的120例胃肠道疾病手术患者围手术期下肢深静脉血栓形成情况,统计所有患者手术前后DVT相关临床指标,并分析其对下肢DVT形成的影响.结果 在120例患者中,术后出现下肢DVT的有49例(40.8%),其中左下肢24例(49.0%),右下肢10例(20.4%),双下肢15例(30.6%),以无症状型肌间静

  16. Establishment of rabbit models of lower limb deep venous thrombosis after hip fracture%髋部骨折后下肢深静脉血栓形成家兔模型的建立

    Institute of Scientific and Technical Information of China (English)

    张英; 贾丙申; 周建强; 谭海涛; 王晟; 付昆; 孟志斌

    2011-01-01

    背景:目前各种方法诱导下肢深静脉血栓的动物模型缺乏统一的标准.目的:建立髋部骨折后下肢深静脉血栓形成兔模型.方法:采用专用击打装置,用位于28 cm高度的击打物击打家兔后下肢左侧大腿根部;建立兔髋部骨折模型,另一侧兔后下肢不击打设为对照侧.4周后选取下肢髂静脉行彩色多普勒超声以及凝血功能的检查血栓形成情况.结果与结论:家兔经打击后经彩色多普勒超声检查存在下肢深静脉血栓,血栓长度(124±37) mm.对照侧无下肢深静脉血栓形成.血栓形成率81.8%,死亡率为9.1%.结果证实,实验成功建立的兔髋部骨折后下肢深静脉血栓形成模型,简单可行.%BACKGROUND: At present, many methods for inducing lower limb venous thrombosis lack of unified standards.OBJECTIVE: To establish rabbit models of lower limb venous thrombosis after hip facture METHODS: Hip fracture was induced in rabbits by impacting the root of left leg by a dropping object from a height of 28 cm. The right leg was not impacted and served as the control side. After 4 weeks, the iliac and femoral veins of the lower limbs were selected for color Doppler ultrasonography and blood coagulation examination. RESULTS AND CONCLUSION: Color Doppler ultrasonography showed that there was a thrombosis area with a length of (124±37) mm in the lower limb deep veins. No lower limb deep venous thrombosis was found in the control side. Thrombosis rate was 81.8% and death rate was 9.1%. These findings suggest that rabbit models of lower limb deep venous thrombosis after hip fracture could be successfully established, and the method is simple and feasible.

  17. Cerebral venous thrombosis in adult patients with acute lymphoblastic leukemia or lymphoblastic lymphoma during induction chemotherapy with l-asparaginase: The GRAALL experience.

    Science.gov (United States)

    Couturier, Marie-Anne; Huguet, Françoise; Chevallier, Patrice; Suarez, Felipe; Thomas, Xavier; Escoffre-Barbe, Martine; Cacheux, Victoria; Pignon, Jean-Michel; Bonmati, Caroline; Sanhes, Laurence; Bories, Pierre; Daguindau, Etienne; Dorvaux, Véronique; Reman, Oumedaly; Frayfer, Jamile; Orvain, Corentin; Lhéritier, Véronique; Ifrah, Norbert; Dombret, Hervé; Hunault-Berger, Mathilde; Tanguy-Schmidt, Aline

    2015-11-01

    Central nervous system (CNS) thrombotic events are a well-known complication of acute lymphoblastic leukemia (ALL) induction therapy, especially with treatments including l-asparaginase (l-ASP). Data on risk factors and clinical evolution is still lacking in adult patients. We report on the clinical evolution of 22 CNS venous thrombosis cases occurring in 708 adults treated for ALL or lymphoblastic lymphoma (LL) with the Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-induction protocol, which included eight L-ASP (6,000 IU/m(2) ) infusions. The prevalence of CNS thrombosis was 3.1%. CNS thrombosis occurred after a median of 18 days (range: 11-31) when patients had received a median of three l-ASP injections (range: 2-7). Patients with CNS thrombosis exhibited a median antithrombin (AT) nadir of 47.5% (range: 36-67%) at Day 17 (range: D3-D28), and 95% of them exhibited AT levels lower than 60%. There were no evident increase in hereditary thrombotic risk factors prevalence, and thrombosis occurred despite heparin prophylaxis which was performed in 90% of patients. Acquired AT deficiency was frequently detected in patients with l-ASP-based therapy, and patients with CNS thrombosis received AT prophylaxis (45%) less frequently than patients without CNS thrombosis (83%), P = 0.0002). CNS thrombosis was lethal in 5% of patients, while 20% had persistent sequelae. One patient received all planned l-ASP infusions without recurrence of CNS thrombotic whereas l-ASP injections were discontinued in 20 patients during the management of thrombosis without a significant impact on overall survival (P = 0.4).

  18. Homocysteine on the clinical significance of deep venous thrombosis%同型半胱氨酸对下肢深静脉血栓的临床意义

    Institute of Scientific and Technical Information of China (English)

    周燕翔

    2012-01-01

      目的探讨HCY与下肢深静脉血栓患者的关系及其临床意义.方法采用循环酶法检测87例下肢深静脉血栓患者及60例健康对照者血清HCY水平,并进行比较.结果下肢深静脉血组患者的HCY明显高于正常对照组,下肢静脉血栓患者HCY水平与健康对照组之间的差异有显著性(P<0.01).结论下肢深静脉血栓患者血清HCY水平的升高可以作为一个独立的危险因素,并对疗效观察有一定的临床意义.%  Objective To explore HCY and lower extremity deep vein thrombosis patients relationship and its clinical significance. Methods Using cycle enzymatic testing 87 patients (limbs deep vein thrombosis patients and 60 cases of healthy controls serum HCY levels), and comparison. Results Lower extremity deep venous blood groups were significantly higher than that of normal control group of HCY, venous thrombosis patients HCY levels and the difference between the healthy controls(P<0.01). Conclusion Lower extremity deep vein thrombosis patients serum HCY leels can serve as an independent risk factors, and the curative effect observation has certain clinical significance.

  19. Application of ringing of superficial femoral vein for deep venous insufficiency%股浅静脉戴戒术在下肢深静脉瓣膜功能不全中的应用评价

    Institute of Scientific and Technical Information of China (English)

    周克堂; 吴成稳; 周志强

    2013-01-01

    目的 探讨股浅静脉戴戒术治疗下肢深静脉瓣膜功能不全的体会及评价.方法 回顾分析2008年1月至2011年9月睢县人民医院收治的80例行股浅静脉戴戒术患者病例资料.结果 80例患者均行股浅静脉戴戒术,通过术后随访和影像学复查,疗效显著.结论 股浅静脉戴戒术在下肢深静脉瓣膜功能不全的治疗中效果满意,适于各基层医院应用.%Objective To evaluate the experience of surgical treatment of deep venous insufficiency by ringing of superficial femoral vein. Methods A retrospectively analysis for the data of 80 patients was treated in our hospital with ringing of superficial femoral vein from Jan. 2008 to Sep. 2011. Results All the patients was treated by the ringing of superficial femoral vein,the symptoms were alleviated through postoperative follow -up and imaging review. Conclusions Use the ringing of superficial femoral vein is a more effective method for the deep venous insufficiency of patients. Suitable for the application of basic-level hospitals.

  20. Application of Workshop Model in Deep Venous Catheter Maintenance Training for Nurses%工作坊模式在护士静脉导管维护培训中的应用

    Institute of Scientific and Technical Information of China (English)

    金瑛; 苏琴; 陈霞君; 吴玉琴

    2016-01-01

    目的探讨以工作坊模式对新护士行深静脉导管维护培训,提高新护士操作规范性和熟练性。方法2014年8月至2015年9月,分别对98名新入职护士应用工作坊模式进行培训,采用深静脉导管维护考核评分表分别在其培训前及培训后一月进行更换肝素帽、冲封管、更换敷贴、用物准备及健康教育评估考核。结果更换肝素帽、冲封管、更换敷贴及宣教较工作坊培训前比较均有统计学意义(Z值分别为-8.55;-8.49;-8.42;-6.50;P<0.001)。通过工作坊的培训模式,新护士深静脉导管维护考核总分较培训前有明显提高,差异具有统计学意义(Z值为-8.60,P<0.001)。结论应用工作坊的培训模式,既能提高新入职护士深静脉导管维护的规范性及操作的熟练性,又能有效地提高新护士学习的主观能动性,提高了培训效果。%Objective To discuss the deep venous catheter maintenance training on new nurses with workshop model to improve their skill normalization and proficiency.Methods From August 2014 to September 2015, 98 new nurses were trained for deep venous catheter maintenance with workshop model. They were evaluated in terms of the replacement of heparin cap, hep-lock cannula and application, stuff preparations and health education with deep venous catheter maintenance assessment sheet before and after one month training.Results Compared with before, the replacement of heparin cap, hep-lock cannula and application and health education after workshop training was of statistical significance (Z=-8.55; -8.49; -8.42 respectively; -6.50; P<0.001 ). Through workshop training model, the scores of deep venous catheter maintenance for new nurses has been significantly improved with statistical difference (Z=-8.60, P<0.001).Conclusion Workshop training model can improve the normalization and proficiency of deep venous catheter maintenance for new nurses. It can effectively improve

  1. Complement C3 and High Risk of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Nørgaard, Ina; Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Complement activation may contribute to venous thromboembolism, including deep venous thrombosis and pulmonary embolism. We tested the hypothesis that high complement C3 concentrations are associated with high risk of venous thromboembolism in the general population. METHODS: We...... similar for deep venous thrombosis and pulmonary embolism separately. The multivariable-adjusted hazard ratio for venous thromboembolism for a 1-g/L increase in complement C3 was 2.43 (1.74-3.40). CONCLUSIONS: High concentrations of complement C3 were associated with high risk of venous thromboembolism...... included 80 517 individuals without venous thromboembolism from the Copenhagen General Population Study recruited in 2003-2012. Plasma complement C3 concentrations were measured at baseline, and venous thromboembolism (n = 1176) was ascertained through April 2013 in nationwide registries. No individuals...

  2. Familial risk of venous thromboembolism: a nationwide cohort study

    DEFF Research Database (Denmark)

    Sørensen, H T; Riis, A H; Diaz, L J

    2011-01-01

    Background: Venous thromboembolism has genetic determinants, but population-based data on familial risks are limited. Objectives: To examine the familial risk of venous thromboembolism. Methods: We undertook a nationwide study of a cohort of patients with deep venous thrombosis or pulmonary...... and expected number of venous thromboembolism cases among siblings, using population-specific, gender-specific and age-specific incidence rates. Results: We identified 30 179 siblings of 19 599 cases of venous thromboembolism. The incidence among siblings was 2.2 cases per 1000 person-years, representing...... with pulmonary embolism. Conclusion: Venous thromboembolism has a strong familial component....

  3. Venous thromboembolic disease. CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, L. R. [Medical College of Wisconsin, Pulmonary Medicine and Intensive Care, Dept. of Diagnostic Radiology, Milwaukee, WI (United States)

    2001-12-01

    Helical and multidetector CT has proven to be a valuable imaging modality for both pulmonary embolism and deep venous thrombosis. This paper will review the sensitivity and specificity of CT and discuss diagnostic algorithms utilizing CT and more established imaging technologies.

  4. SURGICAL TREATMENT OF POSTPARTUM ILIOFEMORAL DEEP VEIN THROMBOSIS--CASE REPORTS.

    Science.gov (United States)

    Cazan, I; Strobescu, Cristina; Baroi, Genoveva; Cazan, Simona; Lefter, G; Popa, R F

    2016-01-01

    The writing committee for Antithrombotic Therapy for Venous Thromboembolic Disease of the 2008 ACCP guidelines made the following recommendations for thrombus removal strategies in patients with deep vein thrombosis (DVT): open surgical thrombectomy is recommended in patients with acute iliofemoral DVT to reduce symptoms and post-thrombotic morbidity; whenever available, catheter-directed thrombolysis is preferred to surgical venous thrombectomy, the risk of hemorrhage being diminished; surgical venous thrombectomy is recognized to be efficient in cases where catheter-directed thrombolysis is unavailable or the patients are not suitable candidates for such a procedure. Randomized studies comparing surgical thrombectomy and anticoagulant therapy in patients with iliofemoral DVT (IFDVT) showed that at 6 months, 5 years, and 10 years the patients in the thrombectomy group presented increased permeability, lower venous pressure, less edema, and fewer postthrombotic symptoms compared to the patients receiving anticoagulant therapy. In this article we present 3 cases of IFDVT in postpartum patients diagnosed by Doppler ultrasound of the deep venous system. The 3 patients received anticoagulant therapy prior to surgery. Surgery consisted in thrombectomy of the common, superficial and deep femoral veins, external and internal iliac veins, and femoral-saphenous arteriovenous fistula. The patients received postoperative antithrombotic therapy and were followed-up at 3, 6 and 9 months by Doppler ultrasound of the deep venous system.

  5. Acute respiratory distress syndrome (ARDS) treated successfully by veno-venous extracorporeal membrane oxygenation (ECMO) in a nearly drowned patient.

    Science.gov (United States)

    Sonoo, Tomohiro; Ohshima, Kazuma; Kobayashi, Hiroaki; Asada, Toshifumi; Hiruma, Takahiro; Doi, Kento; Gunshin, Masataka; Murakawa, Tomohiro; Anraku, Masaki; Nakajima, Susumu; Nakajima, Jun; Yahagi, Naoki

    2014-09-01

    This report highlights about one acute respiratory distress syndrome (ARDS) case after near-drowning resuscitated using extracorporeal membrane oxygenation (ECMO). Few cases have been reported about ECMO use for near-drowning and in most of these cases, ECMO was initiated within the first week. However, in our report, we would like to emphasize that seemingly irreversible secondary worsening of ARDS after nearly drowned patient was successfully treated by ECMO use more than 1 week after near-drowning followed by discharge without home oxygen therapy, social support, or any complication. This is probably due to sufficient lung rest for ventilator-associated lung injury during ECMO use. Based on our case's clinical course, intensive care unit physicians must consider ECMO even in the late phase of worsened ARDS after near-drowning.

  6. Relationship between factor Ⅷ, protein C, protein S and lower deep venous thrombosis%深静脉血栓形成与凝血因子Ⅷ及蛋白C、蛋白S的相关性

    Institute of Scientific and Technical Information of China (English)

    潘以锋; 孙敏莉; 张皓; 张柏根

    2010-01-01

    Objective To detect the activity of plasma factor Ⅷ, protein C, protein S in patients with lower deep venous thrombosis. Methods American IL automatic analyzer was used to detect the activity of factor Ⅷ, protein C and protein S in 40 patients with deep venous thrombosis and 40 normal controls. Results The plasma level of factor Ⅷ was statistically significantly higher in the study group than in the control group ( P < 0. 05 ). Factor Ⅷ was associated with an increased risk of venous thrombosis with the relative risk being 11. 0 (95% CI, 3.3-36. 7). Excluding the patients with reduced protein C and protein S levels, the relative risk was dropped to 5.4 (95% CI, 1.6-18.2). There also were significant differences in the activity of protein C, protein S between the study group and the normal control group ( P < 0. 05 ). Conclusion The activity of factor Ⅷ in patients with deep venous thrombosis is increased significantly, and the activity of protein C, protein S decreased obviously. All of those are risk factors for deep venous thrombosis.%目的 检测下肢深静脉血栓形成的患者血浆中凝血因子Ⅷ(FⅧ)及蛋白C、蛋白S水平的变化,探讨其与深静脉血栓形成的关系.方法 用ACL TOP型全自动血凝分析仪检测40例急件期深静脉血栓形成患者及40例健康体检者血浆中FⅧ及蛋白C、蛋白S的活性.结果 与正常对照组比较,病例组患者体内FⅧ的活性明显增高,是深静脉血栓形成的危险因素,OR值为11.0,95%可信区间为3.3~36.7,排除蛋白C、蛋白S降低的影响,则OR值为5.4,95%可信区间为1.6~18.2.两组比较,病例组中蛋白C和蛋白S的活性明显降低,差异有统计学意义(P<0.05).结论 深静脉血栓形成的患者体内FⅧ活性明显升高,而蛋白C及蛋白S的活性明显降低,凝血及抗凝系统的异常是深静脉血栓形成的高危因素之一.

  7. The deep Venous thrombosis prevention effect of CPM to patients of lower limb fracture%CPM对预防下肢骨折术后患者深静脉血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    陈丹琼; 谭晓珍; 蔡新良

    2008-01-01

    Objective To study the deep veltous thrombosis prevention effect of CPM to patients of lower limb fracture surgery.Methods 268 patients decided into experiment group and control group.134 cases in each group.CPM applied to those of experimental group,no CPM used in those of control group.Functional exercise instruct by specific medical personnel,deep venous thrombosis observed on two groups.Results Experimental group is much better than control group(P<0.05).Conclusion It is useful for those patients of lower limb fracture surgery to prevention the deep venous thrombosis use CPM.%目的 探讨CPM下肢功能训练对预防下肢骨折患者深静脉血栓形成的影响.方法 将268例下肢骨折患者随机分为CPM实验组(134例)和对照组(134例)两组进行对比,CPM实验组应用CPM装置进行训练,对照组不使用CPM,只由专业医务人员指导,鼓励患者主动、被动功能训练,观察两组预防深静脉血栓形成的效果.结果 CPM实验组在预防患者下肢深静脉血栓形成明显优于对着组(P<0.05).结论 下肢骨折术后患者患者应用CPM装置有利于预防深静脉血栓形成.

  8. Study of Deep Venous Puncture Catheter Placement in Rescuing Blood Shock Patients%深静脉穿刺置管术在抢救失血休克患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    曾明昊

    2013-01-01

      目的:对深静脉穿刺置管术在抢救失血休克患者临床进行研究。方法:选自我院自2009年12月~2011年12月期间急诊收治的应用深静脉穿刺置管术救治的失血性休克患者30例,对其采用深静脉穿刺置管术进行救治。结果:30例病人28例恢复有效循环血容量,2例患者因其病情过于严重,失血量过多导致救治无效死亡。结论:对于失血性休克及时救治可以帮助患者提高生存率,且深静脉穿刺置管术在抢救失血休克患者的效果是显著的,值得在临床上推广。%Objective:To study of effect of deep venous puncture catheter placement on rescuing blood shock patients. Methods:We select 30 cases of patients who come to the emergency department of our hospital during December 2009 to Decembe2011, and all of them suffering from blood shock patients and all the patients were recused by deep venous puncture catheter placement .Results:28 patients among the 30 patients returned to the effective circulating blood volume ,and other two patients are death because of their serious disease and their excessive hemorrhage volume. Conclusion:The uncontrolled hemorrhagic shock for timely treatment can help patients to improve survival rates, and the effect of deep vein in rescuing patients with hemorrhagic shock is significant and is worth developing in clinical practice.

  9. MRA for diagnosis of venous thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Sostman, H. D. [Cornell University, Weill Medical College, Chair of Radiology, New York (United States)

    2001-12-01

    Direct imaging of pulmonary embolism (PE) and deep vein thrombosis (DVT) with CT, and potentially with MR, will continue to replace V/Q scintigraphy. Venous imaging with MR far detecting DVT is used in a few centers, and their published accuracy figures are impressive. Recent studies of MR pulmonary angiography for PE reported that sensitivity of MRA was 85-100%, specificity 95-96%, but this data must be confirmed in other centers and patient populations. MR has advantages compared with CT, which make it worthwhile to continue MR development. Ionizing radiation and iodinated contrast material are not used. Imaging the pulmonary arteries and then imaging whichever venous region is of clinical interest is practical in a single examination. Repeated examinations can be performed safely. New contrast materials will facilitate the practically and accuracy of the MR technique and perfusion imaging may increase sensitivity. MR also has disadvantages compared with CT. It does not image effectively the non-vascular compartment of the lungs. It is more expensive, patient monitoring is more cumbersome, and a routine technique, which embodies all of MR's potential advantages, has not been packaged and tested. Accordingly, helical CT is a realistic option in clinical management of patients with suspected PE in most centers, while clinical application of MR is limited to centers with appropriate MR expertise and technology. However, MR has a number of fundamental characteristics that make it potentially ideal modality for evaluating patients with suspected acute venous thromboembolic disease and further clinical research with MRA is warranted.

  10. Thrombin Avtivable Fibrinolysis Inhibitor in Venous and Arterial Thrombosis

    NARCIS (Netherlands)

    E.L.E. de Bruijne

    2011-01-01

    textabstractVenous and arterial thromboses are major causes of morbidity and mortality. Venous thrombosis is the result of pathological occlusive clot formation in the veins. It occurs mainly in the deep veins of the leg (deep vein thrombosis), from which parts of the clot frequently embolize to the

  11. Acute Superior Mesenteric Venous Thrombosis: Transcatheter Thrombolysis and Aspiration Thrombectomy Therapy by Combined Route of Superior Mesenteric Vein and Artery in Eight Patients

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Shuofei, E-mail: yangshuofei@gmail.com; Liu, Baochen, E-mail: 306446264@qq.com; Ding, Weiwei, E-mail: dingwei-nju@hotmail.com; He, Changsheng, E-mail: hechsh@163.com; Wu, Xingjiang, E-mail: wuxingjiang@sohu.com; Li, Jieshou, E-mail: lijieshou2013@sohu.com [Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University (China)

    2015-02-15

    PurposeTo assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT).MethodsThis retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months. The demographics, etiology, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed. Anatomic and imaging classification of location and extent of thrombus at diagnosis and degree of thrombus lysis were described.ResultsTechnical success was achieved with substantial improvement in symptoms and thrombus resolution after thrombolytic therapy in all patients. The local urokinase infusion by SMA and SMV was performed for 5–7 (6.13 ± 0.83) and 7–15 (12 ± 2.51) days. Anticoagulation was performed catheter-directed and then orally throughout hospitalization and after discharge. Four patients required delayed localized bowel resection after thrombolytic therapy with no death. Thrombolytic therapy was not interrupted despite minor bleeding at the puncture site in two patients and sepsis in another two postoperatively. Nearly complete removal of thrombus was demonstrated by contrast-enhanced CT scan and portography before discharge. Patients were discharged in 10–27 (19.25 ± 4.89) days after admission. No recurrence developed during the follow-up of 10–13 (12.13 ± 0.99) months.ConclusionsCatheter-directed thrombolytic and aspiration therapy via SMV+SMA is beneficial for ASMVT in avoiding patient death, efficient resolving thrombus, rapid improving symptoms, reversing extensive intestinal ischemia, averting bowel resection, or localizing infarcted bowel segment and preventing short bowel syndrome.

  12. Assessment of Risk Factors for Deep Venous Thrombosis after Total Joint Arthroplasty%人工关节置换术后并发深静脉血栓的危险因素评估

    Institute of Scientific and Technical Information of China (English)

    吴芳丽; 孟延丰

    2011-01-01

    目的 探讨影响人工关节置换术后下肢深静脉血栓(deep venous thrombosis,DVT)形成的相关危险因素.方法 回顾性分析187例人工髋、膝关节置换术的病例.选择性别、年龄、体重指数、合并症及凝血指标5项与人工关节置换术后DVT形成进行相关统计分析,行二分类Logistic回归分析筛查危险因素.结果 187例患者术后发生DVT 16例.年龄、体重指数、伴高血压或冠心病、凝血5项与DVT有相关性(P<0.05).高纤维蛋白原(fibrinogen,Fbg)血症、肥胖、伴高血压或冠心病是DVT形成的相关危险因素,风险分别为24.318、2.108、4.431及5.506.结论 高Fbg血症、肥胖、伴高血压或冠心病是人工关节置换术后并发DVT的独立危险因素,术前监测血浆Fbg水平对早期预测人工关节置换术后并发DVT具有重要意义.%Objective To explore the risk factors for deep venous thrumbosis after total joint arthroplasty. Methods A total of 187 cases of total hip or knee replacement operation were analyzed retrospectively. The statistical indexes included sex , age, the body mass index( BMI) ,other system disease and coagulable function tests. Regression analysis was performed using Binary Logistic Regression. Results Of 187 cases. 16 had DVT. Age.BMI, with hypertension or coronary heart disease and coagulable function tests were correlated with DVT( P < 0. 05 ) . High levels of fibrinogen , obesity , with hypertension or coronary heart disease were the risk factors for DVT following total joint replacement. Conclusion High Ievels of fibrinogen, obesity, with hypertension or coronary heart disease are independent risk factors for DVT after total joint arthroplasty. Determination of plasma fibrinogen before surgery is very useful for predicting occurence of deep venous thrombosis after total joint arthroplasty.

  13. Deep venous thrombosis with suspected pulmonary embolism: simultaneous evaluation using combined CT venography and pulmonary CT angiography; Trombose venosa profunda e suspeita de tromboembolismo pulmonar: avaliacao simultanea por meio de angiotomografia pulmonar e venotomografia combinadas

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Laura de Moraes [Universidade Federal, Rio de Janeiro (UFRJ), RJ (Brazil)]. E-mail: lauramgomes@terra.com.br; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Rodrigues, Rosana Souza [Hospital Copa D' Or, Rio de Janeiro, RJ (Brazil)

    2006-01-15

    Objective: To evaluate the occurrence and the correlation between pulmonary embolism (PE) and deep venous thrombosis (DVT) using a single CT angiography protocol. Materials and methods: This was a prospective study performed at Hospital Copa D'Or, Rio de Janeiro, Brazil from July 2003 to June 2004. We analyzed 116 CT angiography examinations of patients with clinical suspicion of PE. After an interval of approximately three minutes, venous phase images from the diaphragm to the knees were acquired without additional contrast injection in order to determine the presence of DVT. Results: From the 116 patients studied, 23 (19.8%) had PE, 24 (20.7%) had DVT, 15 (12.9%) had both PE and DVT and 9 (7.8%) had DVT alone. Among the 23 cases of PE, 15 (65.2%) had concomitant DVT whereas 8 (34.8%) had only PE. Among the 24 cases of DVT, 15 (62.5%) had associated PE and 9 (37.5%) had DVT alone. Conclusion: The results showed a strong relationship between PE and DVT, as well as the importance of investigating DVT in cases with suspected PE and the benefits of performing indirect CT venography after pulmonary CT angiography as a single examination alternative method for simultaneous investigation of PE and DVT. (author)

  14. 血液净化患者深静脉导管感染的危险因素研究%Study on Risk Factors of Deep- venous Catheter Infection in Patients Undergoing Blood Purification

    Institute of Scientific and Technical Information of China (English)

    费沛; 肖厚勤; 罗昌霞; 郑璇

    2012-01-01

    目的 分析血液净化患者深静脉导管感染的危险因素,为临床实施有效的预防措施提供参考信息.方法 选择2010年1月- 2011年10月湖北医药学院附属太和医院收治的血液净化患者142例,观察患者是否发生深静脉导管感染,并分析患者性别、年龄、置管部位、置管时间、导管腔数、基础疾病种类是否为感染发生的危险因素.结果 本组142例血液净化患者发生深静脉导管感染17例,发生率为12.0%,其发生不受患者的性别、年龄影响(P>0.05),受患者的置管部位、置管时间、导管腔数、基础疾病种类的影响(P<0.05).结论 血液净化患者的置管部位、置管时间、导管腔数、基础疾病种类均为发生深静脉导管感染的危险因素,应针对以上各项采取有效的预防措施以提高患者的治疗效果.%Objective To analyze the risk factors for deep - venous catheter infection in patients undergoing blood purification, and to provide the reference for applying the preventive measures in clinical practice. Methods One hundred and forty - two patients undergoing blood purification hospitalized in Taihe Hospital Affiliated to Hubei Medical College from January 2010 to October 2011 were enrolled in the study. The occurence of deep - venous catheter infection was observed in the patients, and the gender, age, site of catheter, catheter- retaining time, the number of catheter cavity and the kinds of underlying diseases of the patients were analyzed to identify the risk factors for the infection. Results Among 142 patients undergoing blood purification, 17 suffered with deep-venous catheter infection, and the incidence rate was 12.0%. Its occurrence was unrelated to the patients' gender and age (P>0.05), but related to the site of catheter, catheter-retaining time, the number of catheter cavity and the kinds of underlying diseases of the patients (P<0.05). Conclusions Site of catheter, catheter-retaining time, the

  15. Ultrasonic diagnosis and research progress of primary deep venous valve insufficiency%原发性下肢深静脉瓣膜功能不全的超声诊断进展

    Institute of Scientific and Technical Information of China (English)

    严继萍; 孙欣; 宋秋美; 雷成功; 卢涌洁; 张波

    2005-01-01

    1968年Kistner提出原发性下肢深静脉瓣膜功能不全(Primary Deep Venous Valve Insufficiency,PDVI)的概念,并用瓣膜重建术进行治疗,被视为近代静脉外科的重要进展之一.根据Kistner的观点下肢深静脉瓣膜功能不全有原发性和继发性之分,原发性下肢深静脉瓣膜功能不全是从下肢深静脉血栓形成后遗功能不全区分出来的一个独立的疾病.

  16. 脑出血患者术后早期活动对预防下肢深静脉血栓形成的影响%The effect of the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    李爱文; 谢春雷; 李春霞; 黄维明; 钟丽丽

    2010-01-01

    Objective To explore the clinical results that the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis. Methods A total of 84 cases of the postoperative patients with cerebral hemorrhage were randomly divided into experimental group and control group, the experimental group was implemented the early activities' program; the control group was implemented the current clinical to prevent the conventional care of deep venous thrombosis; the two groups' patients were recorded the change of the blood pressure and heart rate after they were operated in 6 hours; the two groups' patients during hospitalization were observed if the complication with deep venous thrombosis or not Results The comparison of the change in blood prssure and heart rate after they were operated in 6 hours had no significance different (P > 0. 05) , the comparison in the prevention of occuring the deep venous thrombosis (P 0.05);术后发生下肢深静脉血栓的防治上比较,差异有统计学意义(P<0.05).结论 脑出血术后早期活动可促进患者术后早期康复,预防下肢深静脉血栓的发生.

  17. 下肢深静脉瓣膜反流程度与临床表现相关性调查%The correlation between the lower extremity deep venous reflux degree and clinical symptoms

    Institute of Scientific and Technical Information of China (English)

    代雪娜; 周涛

    2013-01-01

    目的:探讨下肢深静脉瓣膜反流程度与临床表现的相关性。方法回顾性收集2006年1月~2012年6月896例原发性慢性下肢静脉功能不全(PCVI)的患者资料,对符合纳入标准的269例患者进行系统抽样调查,根据数字减影血管造影结果及下肢深静脉的反流程度对患者进行Kistener分级,探讨下肢深静脉瓣膜反流程度与临床症状分级(C分级)、临床症状严重程度评分(VCSS)及功能障碍评分(VDS)的相关性。结果下肢深静脉瓣膜反流程度与C分级、VCSS、VDS有相关性(相关系数分别为:0.437、0.505和0.449,P0.05),是否处理伴发疾病对临床症状严重度及劳动力丧失度有相关性(P0.05). Whether to manage the concomitant diseases or not related to VCSS and VDS significantly (P<0.05). Conclusion The severity of PCVI clinical symptoms can be affected by the lower extremity deep venous reflux degree and the function of perforating veins. The repair of deep venous valve plays important roles in long-term efficacy and reducing the recurrence rate of PCVI.

  18. Risk factors of Deep venous thrombosis in hip arthroplasty and nursing intervention%髋关节置换术后下肢静脉血栓形成的危险因素及护理干预

    Institute of Scientific and Technical Information of China (English)

    徐晓莲

    2012-01-01

    目的 探讨髋关节置换术后下肢静脉血栓(DVT)形成的危险因素及护理干预对策.方法 回顾性分析行髋关节置换术的84例患者的临床资料,对有可能造成DVT的危险因素进行分析,并提出相应的护理干预对策.结果 84例患者中有12例发生DVT,发生率为14.3%,年龄、身体质量指数(BMI)、吸烟史、饮酒史、高血压、糖尿病、高血脂、术后制动时间、麻醉方式、术后抗凝药物的使用、骨水泥、肢体延长是下肢静脉血栓形成的相关因素(P<0.05),其中BMI、抗凝药物的使用及肢体延长是独立危险因素(P<0.05).结论 髋关节置换术DVT形成是多因素作用的共同结果,应加强对危险因素的评估,术前积极预防,术后精心护理,以减少下肢静脉血栓的形成.%Objective risk factors of deep venous thrombosis (DVT) in hip arthroplasty and nursing intervention. Methods a retrospective analysis of in 84 cases of hip arthroplasty patients' clinical data from 2008 November to 2011 August in our hospital,potential risk factors that cause DVT were analyzed,and corresponding nursing measures were put forward. Results 12 cases in 84 cases developed DVT,the incidence was 14. 3%,age,smoking history,BMI,drinking history,hypertension,diabetes,high blood lipids,postoperative braking time,anesthesia,postoperative anticoagulant drug use,bone cement,limb lengthening was = s venous thrombosis of lower extremities associated factors (P<0.05),BMI,anticoagulant drug use and limb lengthening is the independent risk factor (P < 0.05). Conclusion surgical venous thrombus formation is the result of many factors,should strengthen the assessment of risk factors,preoperative active prevention,careful postoperative care,in order to reduce venous thrombosis.

  19. 脊柱手术围手术期深静脉血栓高危因素分析%The analysis of the high risk factors of deep venous thrombosis after spinal surgery

    Institute of Scientific and Technical Information of China (English)

    张伟; 阿尔宾; 武永刚; 高飞

    2016-01-01

    背景深静脉血栓是骨科手术后常见并发症之一,然而脊柱手术术后静脉血栓发生率及其高危因素在国内少有报道。目的探究脊柱手术围手术期深静脉血栓发生率并对其高危因素进行分析。方法回顾分析2011年至2013年我院脊柱外科实施脊柱手术且病例资料完整的患者,根据双下肢静脉彩超检查深静脉血栓有无,对患者性别,BMI,年龄,术前日常活动,出血量,手术时间,是否使用内固定等因素进行对比分析。对于血清D-二聚体以术前1μg/ml术后2μg/ml为标准进行分组比较。结果术后双下肢发生深静脉血栓47例(27.8%)分析其危险因素包括:女性(P=0.05),70岁以上(P=0.023),术前日常活动不能步行者(P=0.0006),出血量400ml以上(P=0.005),内固定植入(P=0.047)。血清DD术前值以1.0µg/ml为标准分组(P=0.0004),以术后2µg/ml分组,特别是术后3日(P=0.002),7日(P=0.0004),10日(P=0.012)均有统计学差异。结论对脊柱术后围手术期深静脉血栓发生的高危因素需严密关注并积极给予抗凝药物干预。%Background The deep venous thrombosis is one of most common complications after orthopedic surgery. However, there is rare report about the incidence rate of deep venous thrombosis after spinal surgery and the analysis of the risk factors. Objective To analysis of the incidence of deep venous thrombosis after posterior spinal surgery and high risk factors. Methods A retrospective study was conducted in patients undergoing spinal surgery from Oct, 2011 to 2013. They were assigned to two groups by deep venous thrombosis or not. The gender, BMI, age, Active Daily Life, blood loss, surgery time and instrumentation were measured and analyzed. And they were separated using D-dimer (preoperative 1μg/ml and postoperative 2μg/ml) and compered. Results The incidence of deep venous thrombosis after spinal surgery is

  20. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  1. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    coagulopathy status. Localized intravascular coagulopathy may cause serious thrombohemorrhagic events, including deep venous thrombosis and pulmonary embolism.Keywords: venous malformation, extratruncular lesions, truncal lesions, noninvasive tests, less invasive tests, localized intravascular coagulopathy

  2. Clinical Value of Thrombelastogram on Patients of Deep Venous Thrombosis and Pulmonary Em-bolism%血栓弹力图在下肢深静脉血栓与肺栓塞的应用价值

    Institute of Scientific and Technical Information of China (English)

    周闯; 向华; 孙林; 张智明; 刘觉仕

    2016-01-01

    [Objective]To investigate the clinical value of thrombelastogram on patients of deep venous throm-bosis (DVT)and DVT combined with pulmonary embolism (PE).[Methods]12 cases of DVT and DVT with PE in the hospital from March 2014 to September 2014 were selected,of which 8 cases were newly diagnosed as DVT patients,and 4 cases as DVT combined with PE.12 healthy subjects with no history of DVT nor PE were selected as control group,who underwent venous ultrasonography,CT pulmonary angiography (CTA)and Thrombelasto-gram examination.Thrombelastogram index related with DVT and DVT with PE such as blood coagulation time (R),coagulation time (K),maximum blood clot strength (MA),angle,blood coagulation indicators were com-pared with.[Results]There was no statistical significant difference between the DVT group,the DVT combined with PE group and the control group in age,gender,R,MA,K,Angel and CL (P >0.05).[Conclusion]Deep venous thrombosis and deep venous thrombosis combined with pulmonary embolism had no obvious difference in the Thrombelastogram index ,the application value of Thrombelastogram in VTE needs to be further studied.%[目的]探讨血栓弹力图对下肢深静脉血栓形成(DVT)患者与DVT合并肺栓塞(PE)患者的应用价值.[方法]选择2014年3~9月本院收治的新发DVT及DVT合并PE患者12例,其中新发DVT患者8例,DVT合并PE患者4例,选择同期无DVT或PE病史的12例健康体检者为对照组,均行下肢静脉彩超、肺动脉CT血管成像(CTA)、血栓弹力图等检查.比较DVT患者及DVT合并PE患者在血栓弹力图相关指标如凝血反应时间(R值)、凝固时间(K值)、最大血凝块强度(MA)、凝固角(Angel)、凝血综合指数(CL)的异同点.[结果]DVT组、DVT合并PE组与对照组在年龄、性别、R、MA、K、Angel、CL方面比较,组间比较差异无统计学意义(P>0.05).[结论]下肢深静脉血栓形成与下肢深静脉血栓形成合并肺栓塞在血栓弹力图指标上无明显差异,血

  3. Determinants of Calcium Infusion Rate During Continuous Veno-venous Hemofiltration with Regional Citrate Anticoagulation in Critically Ⅲ Patients with Acute Kidney Injury

    Institute of Scientific and Technical Information of China (English)

    De-Lin Liu; Li-Feng Huang; Wen-Liang Ma; Qi Ding; Yue Han; Yue Zheng; Wen-Xiong Li

    2016-01-01

    Background:It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA).This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI).Methods:A total of 18 patients with AKI requiring CVVH were prospectively analyzed.Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit.The infusion of 4% trisodium citrate was started at a rate of 29.9 mmol/h prefilter and adjusted according to postfilter ionized calcium.The infusion of 10% calcium gluconate was initiated at a rate of 5.5 mmol/h and adjusted according to systemic ionized calcium.The infusion rate oftrisodium citrate and calcium gluconate as well as ultrafiltrate flow rate were recorded at 1,2,4,6,12,and 24 h after starting CVVH,respectively.The calcium loss rate by CVVH was also calculated.Results:Fifty-seven sessions of CVVH were performed in 18 AKI patients.The citrate infusion rate,calcium loss rate by CVVH,and calcium infusion rate were 31.30 (interquartile range:2.70),4.60 ± 0.48,and 5.50 ± 0.35 mmol/h,respectively.The calcium infusion rate was significantly higher than that of calcium loss rate by CVVH (P < 0.01).The correlation coefficient between the calcium and citrate infusion rates,and calcium infusion and calcium loss rates by CVVH was-0.031 (P > 0.05) and 0.932 (P < 0.01),respectively.In addition,calcium infusion rate (mmol/h) =1.77 + 0.8 × (calcium loss rate by CVVH,mmol/h).Conclusions:The calcium infusion rate correlates significantly with the calcium loss rate by CVVH but not with the citrate infusion rate in a fixed blood flow rate during CVVH with RCA.

  4. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii.

  5. Cerebral venous thrombosis presenting with cerebellar ataxia and cortical blindness.

    Science.gov (United States)

    Ben Sassi, Samia; Mizouni, Habiba; Nabli, Fatma; Kallel, Lamia; Kefi, Mounir; Hentati, Fayçal

    2010-01-01

    Venous infarction in the cerebellum has been reported only rarely, probably because of the abundant venous collateral drainage in this region. Bilateral occipital infarction is a rare cause of visual loss in cerebral venous thrombosis. We describe a 50-year-old woman with a history of ulcerative colitis who developed acute cerebellar ataxia and cortical blindness. She had bilateral cerebellar and occipital lesions related to sigmoid venous thrombosis and achieved complete recovery with anticoagulation therapy. Cerebral venous thrombosis should be considered in cases of simultaneous cerebellar and occipital vascular lesions.

  6. Imaging of deep venous thrombosis in patients using a radiolabelled anti-D-dimer Fab' fragment ({sup 99m}Tc-DI-DD3B6/22-80B3): results of a phase I trial

    Energy Technology Data Exchange (ETDEWEB)

    Macfarlane, David [University of Queensland, School of Medicine, Brisbane (Australia); Socrates, Angelides; Larcos, George [University of Sydney, Department of Medicine, Sydney (Australia)]|[Westmead Hospital, Department of Nuclear Medicine and Ultrasound, Westmead (Australia)]|[Westmead Hospital, Centre for Biomedical Imaging and Research, Westmead (Australia); Eisenberg, Paul [Amgen Inc, Thousand Oaks, CA (United States); Roach, Paul [University of Sydney, Department of Medicine, Sydney (Australia)]|[Royal North Shore Hospital, Nuclear Medicine, St. Leonards (Australia); Gerometta, Michael [Agen Biomedical Pty Ltd, Brisbane (Australia); Smart, Richard; Tsui, Wendy [St. George Hospital, Nuclear Medicine Department, Sydney (Australia)]|[University of New South Wales, Department of Medicine, Sydney (Australia); Scott, Andrew M. [Austin Hospital, Centre for PET, Melbourne (Australia)]|[Ludwig Institute, Melbourne (Australia)

    2009-02-15

    {sup 99m}Tc-DI-DD3B6/22-80B3 (ThromboView registered, hereafter abbreviated to {sup 99m}Tc-DI-80B3 Fab') is a radiolabelled humanised monoclonal Fab' fragment with affinity and specificity for D-dimer domains of cross-linked fibrin. Detection of thromboembolic events has been demonstrated in canine models. The study objectives were evaluation of safety and characterisation of biodistribution, immunogenicity and pharmacokinetic profile of increasing doses of {sup 99m}Tc-DI-80B3 Fab' in subjects with acute lower-limb DVT. Twenty-six patients with acute lower limb DVT were enrolled. Of these, 21 received a single intravenous dose of 0.5 mg (n = 6), 1.0 mg (n = 9) or 2 mg (n = 6) {sup 99m}Tc-DI-80B3 Fab'. Blood and urine samples and gamma camera images were collected to 24 h after administration for pharmacokinetic and dosimetry analysis. Vital signs, electrocardiography, hematological and biochemical data and human anti-human antibody (HAHA) levels were monitored for up to 30 days following administration. Patients were assigned to either planar or single photon emission computed tomographic (SPECT) imaging of the thorax at 4 h following injection. Thirty-five adverse events were reported in 15 of the 21 subjects. Those deemed possibly related to administration of {sup 99m}Tc-DI-80B3 Fab' included mild hypertension, mild elevation of LD (lactate dehydrogenase) and moderate elevation of ALT (alanine transaminase). HAHA assays remained negative. Pharmacokinetics and organ dosimetry were comparable to prior normal volunteer data. Localisation of Thromboview registered to sites of known thrombus was evident as early as 30 min post-injection. In subjects with acute DVT, {sup 99m}Tc-DI-80B3 Fab' was well tolerated with favourable characteristics for the detection of acute venous thrombosis. (orig.)

  7. Observation and treatment of deep venous thrombosis after operation in Department of orthopedics%骨科大手术后患者深静脉血栓形成观察及其治疗方法

    Institute of Scientific and Technical Information of China (English)

    梁永革; 李洪钊; 张军

    2015-01-01

    Objective: To investigate the pathogenic cause, the disease type and the related treatment of deep venous throm-bosis in patients after Department of orthopedics operation.Methods:Random retrieval in recent 5 years in our hospital 24 cases of orthopedic surgery clinical data, a comprehensive analysis of the postoperative deep vein thrombosis formation causes, disease manifestations and treatment countermeasures such as.Results: 24 cases were due to pelvic and lumbar fracture disease in 18 cases, age over 60 years old in 11 cases, cardiovascular disease 6 cases, 5 cases of diabetes, including central type, peripheral type and mixed type 4 cases, 17 cases and 3 cases in each. After the standard, early treatment, the patients were cured, no pulmonary embolism or lower limb necrosis and other sequelae.Conclusion:The deep venous thrombosis occurred in the Department of orthopedics operation patients after operation, and the clinical early detection and formulation of the corresponding treatment, for the disease prevention and control is very key.%目的:观察骨科大手术后患者深静脉血栓的致病原因、病型表现及其相关治疗措施。方法随机调取最近5年我院24例骨科大手术病例资料,综合分析其术后深静脉血栓的形成原因、病型表现和治疗对策等。结果24例病例因骨盆及腰椎等骨折致病者18例,年龄≥60岁者11例,心血管病者6例,糖尿病者5例;包括中央型、周围型和混合型各4例、17例和3例。经过规范、及早治疗,患者均痊愈出院,未见肺栓塞或下肢坏死等后遗症。结论导致骨科大手术患者术后出现深静脉血栓与多种因素有关,临床及早发现并制定相应方案治疗,对于本病的防治非常关键。

  8. Current opinion on iliofemoral venous thrombectomy.

    Science.gov (United States)

    Stephens, G L

    1976-02-01

    Iliofemoral venous thrombosis is discussed and a technique of iliofemoral venous thrombectomy is presented. Operative phlebography is recommended. The personal recommendations of leading American vascular surgeons in treating the patient with acute iliofemoral venous thrombosis are presented. I recommend thrombectomy for phlegmasia cerulea dolens, and in previously healthy, young ambulatory patients with phlegmasia alba dolens who are seen within 48 hours following thrombosis and have failed to show clinical improvement after a trial of bed rest, elevation of the lower extremities, and intravenous heparin. The majority of patients seen with phlegmasia alba dolens will best be served with nonoperative treatment.

  9. Developmental Venous Anomaly: Benign or Not Benign

    Science.gov (United States)

    AOKI, Rie; SRIVATANAKUL, Kittipong

    2016-01-01

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes. PMID:27250700

  10. Diagnosis and treatment of venous ulcers.

    Science.gov (United States)

    Collins, Lauren; Seraj, Samina

    2010-04-15

    Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. The primary risk factors for venous ulcer development are older age, obesity, previous leg injuries, deep venous thrombosis, and phlebitis. On physical examination, venous ulcers are generally irregular, shallow, and located over bony prominences. Granulation tissue and fibrin are typically present in the ulcer base. Associated findings include lower extremity varicosities, edema, venous dermatitis, and lipodermatosclerosis. Venous ulcers are usually recurrent, and an open ulcer can persist for weeks to many years. Severe complications include cellulitis, osteomyelitis, and malignant change. Poor prognostic factors include large ulcer size and prolonged duration. Evidence-based treatment options for venous ulcers include leg elevation, compression therapy, dressings, pentoxifylline, and aspirin therapy. Surgical management may be considered for ulcers that are large in size, of prolonged duration, or refractory to conservative measures.

  11. Measuring the Pressure in the Superficial Inferior Epigastric Vein to Monitor for Venous Congestion in Deep Inferior Epigastric Artery Perforator Breast Reconstructions : A Pilot Study

    NARCIS (Netherlands)

    Smit, Jeroen M.; Audolfsson, Thorir; Whitaker, Iain S.; Werker, Paul M. N.; Acosta, Rafael; Liss, Anders G.

    2010-01-01

    During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outf

  12. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates.

  13. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Xin-bin, E-mail: gxb3906080@sina.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Fu, Zhenqiang, E-mail: fuzhenqiang1005@163.com [Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Song, Lai-jun, E-mail: laijunsong@sina.com [Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Guan, Sheng, E-mail: gsradio@126.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China)

    2013-01-15

    Objective: To explore and evaluate the efficacy of intrasinus thrombolysis (IST) in patients with cerebral venous sinus thrombosis (CVST) during postpartum period. Methods: 11 patients during postpartum period with CVST who received IST during July 2007–November 2011 were included. Urokinase was infused into the sinuses via a microcatheter. Magnetic resonance venography (MRV) was performed to assess the recanalization of venous sinuses. Results: Before discharge, the intracranial pressure in 11 patients was under 200 mmH{sub 2}O. MRV confirmed that venous sinus of 9 patients were smooth. The cortex venous and deep venous recovered to normal. Venous sinus of 2 patients recanalized partly, and cortex venous and deep venous had compensation. 9 patients had good outcome and 2 patients had only mild deficits. Conclusion: Intrasinus thrombolysis is safe and effective in patients with severe cerebral venous sinus thrombosis during postpartum period.

  14. Reaserach on the risk factors associated with lower limb deep venous thrombosis in elderly patients with type 2 diabetes mellitus%老年2型糖尿病患者下肢深静脉血栓形成的相关危险因素

    Institute of Scientific and Technical Information of China (English)

    张琳; 杨秋萍; 吴亚楠; 李灿晖; 沈芸

    2011-01-01

    目的 研究老年2型糖尿病(T2DM)下肢深静脉血栓形成的危险因素.方法 对60~86岁的45例T2DM非血栓患者、40例非糖尿病下肢深静脉血栓患者以及35例T2DM伴下肢深静脉血栓形成患者进行病例对照研究.收集患者的血糖、血脂及血小板等22项资料,对上述指标先以单因素分析筛选出有统计学意义的危险因素,再进行Logistic 逐步回归分析.结果 糖尿病血栓组空腹血糖[(7.65±2.05)mmol/L]及餐后2小时血糖[(12.10±3.28) mmol/L]较糖尿病非血栓组和非糖尿病血栓组高(P<0.01);糖尿病血栓组血小板[(192.34±96.38) mmol/L]较非糖尿病血栓组和糖尿病非血栓组高(P<0.01);下肢深静脉血栓形成与餐后2小时血糖及血小板呈正相关(P<0.05);与服用阿司匹林呈负相关(P<0.01).结论 糖尿病是下肢深静脉血栓形成的危险因素之一,抗血小板治疗是防治糖尿病血栓形成的有效方法.%Objective To study the risk factors associated with lower limb deep venous thrombosis in elderly patients with type 2 dialetes mellitus (T2DM).Methods 45 elderly non-venous thrombosis patients with T2DM ,40 elderly non-diabetic patients with lower limb deep venous thrombosis,and 35 elderly lower limb deep venous thrombosis people with T2DM were selected, patients' data including blood glucose ,blood lipids,and platelet etc.Several statistically significant risk factors were screened out with univariate statistic, then independent risk factors were determined with stepwise logistic regression analysis.Results The degree of fasting blood glucose and 2 h-postprandial blood glucose were higher in group of deep venous thrombosis with T2DM than those of control group ( P <0.0l ).The degree of platelet was higher in group of deep venous thrombosis with T2DM than that of control group ( P <0.01 ).Lower limb deep venous thrombosis had positive correlation with 2 h-postprandial blood glucose and platelet ( P < 0.05 ), and negative

  15. Risk Factors for Deep Venous Thrombosis in Lower Extremity Followinging Gynecological Operation%妇科手术后下肢深静脉血栓形成的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李丽军

    2014-01-01

    Objective To explore the risk factors for deep venous thrombosis ( DVT) in the lower extremity following gynecological operation .Methods Eighty-three patients with DVT in the lower extremity following gynecological operation were selected as case group and 83 patients without DVT in the lower extremity undergoing gynecological operation were selected as control group .The related factors including age , occupation , body weight , complications , operative method,operative time,menstrual cycle and cancer were analyzed by univariate unconditional logistic regression analysis and multivariate unconditional logistic regression analysis .Results The univariate unconditional logistic regression analysis suggested that DVT correlated with age ,body weight ,complications ( including hypertension ,diabetes mellitus and hyper-lipemia),cancer,operative method and occupation (P<0.05).The multivariate unconditional logistic regression analysis suggested that complications (including hypertension ,diabetes mellitus and hyperlipemia ),cancer and occupation were independent factors for DVT(P<0.05),the former two were risk factors ,occupation which was physical labor was the protective factor .Conclusion The complications ( including hypertension , diabetes mellitus and hyperlipemia ) and gynecological cancer are the related risk factors for deep venous thrombosis in the lower extremity following gynecological operation.Physical labor is the protective factor for deep venous thrombosis in the lower extremity following gynecological operation.%目的:探讨妇科手术后下肢深静脉血栓形成( DVT )的危险因素。方法选择妇科手术后发生下肢DVT的83例患者为病例组,同期行妇科手术但未发生下肢DVT的83例患者为对照组。对两组年龄、职业性质、体重、合并症、手术方式、手术时间、月经时期、恶性肿瘤等进行单因素及多因素非条件logistic回归分析。结果单因素分析结果显示,DVT发

  16. ICU深静脉导管感染的病原菌分布和耐药性分析%Investigation of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU

    Institute of Scientific and Technical Information of China (English)

    李静; 周利霞; 范秋生

    2012-01-01

    Objective To investigate the characteristics of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU.Methods From January 2006 to August 2010,the culture and drug sensitivity test results of 342 deep venous catheter tip from ICU were analyzed retrospectively. Results Among the results of 342 catheter tip cultures,101 strains( 29. 5% )of pathogenic bacteria were detected. The proportion of G+ bacteria,enterobacteria ceae,non-fermentation G- bacteria and fungi was 29 strains( 28.7% ),25 strains( 24. 8% ),33 strains( 32. 6% )and 14 strains ( 13.9% )respectively. The six most common pathogenic bacteria were pseudomonas aeruginosa 20 strains( 19.8% ), Klebsiella pneumonia 12 strains( 11.9% ),Staphylococcus aureus 10 strains( 9. 9% ), Staphylococcus epidermis 8 strains( 7. 9% ),En-terococcus faecium 7 strains( 6. 9% ) and Saccharomyces albicans 7 strains( 6. 9% ). 8 strains( 80. 0% )of Staphylococcus aureus were MRSA,7 strains( 63. 6% )of coagulase negative Staphylococci were MRCNS and 14 strains( 56. 0% )of Enterobacte-riaceae were ESBLs. Most isolated strains were multiple drug resistant. Conclusion The most common pathogens cultured from the deep venous catheter tip in ICU were highly resistant to antibiotics. The clinical micro-organisms laboratory should report the results of bacterial culture and drug susceptibility quickly and accurately for reasonable use of antibiotic drugs in clinical treatment.%目的 探讨ICU深静脉导管感染的病原菌分布和细菌耐药性特征.方法 对2006年1月-2010年8月ICU送检的342例次深静脉导管标本的细菌培养和药敏试验结果进行分析.结果 342份标本中共检出病原菌101株(29.5%):革兰阳性球菌、肠杆菌科、非发酵革兰阴性杆菌和真菌分别为29株(28.7%)、25株(24.8%)、33株(32.6%)和14株(13.9%).病原菌分离率前6位依次为铜绿假单胞菌20株(19.8%)、肺炎克雷伯菌12株(11.9%)

  17. 改进颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用%Internal jugular vein puncture techniques in interventional therapy of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    张岩; 王秀平; 刘建

    2013-01-01

    Objective To evaluate the internal jugular vein puncture technique for interventional treatment of lower extremity deep venous thrombosis.Methods From February 2009 to November 2012,56 patients with lower extremity deep venous thrombosis required transjugular interventional therapy.Two methods of internal jugular vein puncture using a guide wire marking and fine needle puncture techniques was 100%without complication perforating artery.Results In 18 patients,the fine needle puncture was successful in the first attempt(12),after multiple punctures(3),unsuccessful despite repeated punctures(3)with erroneous carotid artery punctures in 2 patients.No pneumothorax,hemothorax,or cervical hematoma occurred with either technique.Conclusions Both transjugular vein puncture techniques are simple and safe with high success and low complication rates for treatment of lower extremity deep venous thrombosis.%目的:探讨改进的颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用价值。方法2009年2月~2012年11月期间,在下肢深静脉血栓介入治疗中对56例需要经颈静脉入路者,对颈内静脉穿刺进行了导丝标记法和细针穿刺法两种技术改进,观察穿刺技术改进后颈内静脉穿刺的成功率及并发症发生情况。结果38例采用导丝标记法,均一次穿刺成功,其一次穿刺成功率为100%,无1例误穿动脉;18例采用细针穿刺法,其中12例一次穿刺成功,3例多次穿刺成功,3例反复穿刺失败,2例误穿颈动脉。两种穿刺技术均未发生颈部血肿、气胸、血胸等与颈静脉穿刺相关的并发症。结论上述两种改进颈静脉穿刺技术,操作简单,成功率和安全性高,创伤小,在下肢深静脉血栓介入治疗中具有一定的应用价值。

  18. 深静脉留置针在危重病患者CT增强扫描中的应用%Application of Deep Venous Puncture Catheter Placement in CT Enhancement Scanning among Critically Ill Patients

    Institute of Scientific and Technical Information of China (English)

    董金芳; 孙雪东

    2011-01-01

    Objective To discuss the effects of intravenous detailed needle and deep venous puncture catheter placement in CT enhancement scanning among critically ill patients. Methods A total of 506 critically ill patients underwent spiral CT enhancement scanning were randomly divided into the treatment group ( 260 cases ) and the control group ( 246 cases ) . Deep venous puncture catheter was applied in the treatment group while intravenous detailed needle was applied in the control group. Exosmotic ratio, achievement ratio of first CT enhancement scanning, and achievement ratio of first time puncture were compared between the two groups. Results The exosmotic ratios of contrast medium were significantly different between the two groups ( 0.08% vs 11.79% , P < 0.01 ) . Achievement ratios of first CT enhancement scanning were significantly different between the two groups ( 98.08% vs 94.31%, P<0.05 ) . Achievement ratios of first time puncture were not significantly different between the two groups ( 95.00% vs 96.34% , P >0.05 ) . Conclusion Deep venous puncture catheter placement is superior to intravenous detailed needle among critically ill patients undergoes CT enhancement scanning combined with high pressure syringe through decreasing the exosmotic ratios of contrast medium, relieving pain, and ensuring enhancement effects.%目的 探讨深静脉留置针与普通静脉留置针在危重病患者CT增强扫描中的应用效果,为危重病患者CT增强扫描提供最佳穿刺工具及方法.方法 将采用静脉留置针行CT增强扫描的506例患者随机分为试验组(260例)和对照组(246例).试验组患者使用深静脉留置针,对照组患者使用常规静脉留置针,比较两组患者造影剂外渗率、一次穿刺成功率及一次增强成功率.结果 试验组和对照组患者造影剂外渗率(0.08%与11.79%)比较,差异有统计学意义(P<0.01);一次增强成功率(98.08%与94.31%)比较,差异有统计学意义(P<0

  19. Overview of venous thromboembolism.

    Science.gov (United States)

    Abad Rico, José Ignacio; Llau Pitarch, Juan Vicente; Rocha, Eduardo

    2010-12-14

    Thrombosis occurs at sites of injury to the vessel wall, by inflammatory processes leading to activation of platelets, platelet adherence to the vessel wall and the formation of a fibrin network. A thrombus that goes on to occlude a blood vessel is known as a thromboembolism. Venous thromboembolism begins with deep vein thrombosis (DVT), which forms in the deep veins of the leg (calf) or pelvis. In some cases, the DVT becomes detached from the vein and is transported to the right-hand side of the heart, and from there to the pulmonary arteries, giving rise to a pulmonary embolism (PE). Certain factors predispose patients toward the development of venous thromboembolism (VTE), including surgery, trauma, hospitalization, immobilization, cancer, long-haul travel, increased age, obesity, major medical illness and previous VTE; in addition, there may also be a genetic component to VTE. VTE is responsible for a substantial number of deaths per annum in Europe. Anticoagulants are the mainstay of both VTE treatment and VTE prevention, and many professional organizations have published guidelines on the appropriate use of anticoagulant therapies for VTE. Treatment of VTE aims to prevent morbidity and mortality associated with the disease, and any long-term complications such as VTE recurrence or post-thrombotic syndrome. Generally, guidelines recommend the use of low molecular weight heparins (LMWH), unfractionated heparin (UFH) or fondaparinux for the pharmacological prevention and treatment of VTE, with the duration of therapy varying according to the baseline characteristics and risk profile of the individual. Despite evidence showing that the use of anticoagulation prevents VTE, the availability of several convenient, effective anticoagulant therapies and the existence of clear guideline recommendations, thromboprophylaxis is underused, particularly in patients not undergoing surgery. Greater adherence to guideline-recommended therapies, such as LMWH, which can be

  20. [Comparison of the efficacy and tolerance of Kabi 2165 and standard heparin in the prevention of deep venous thrombosis in total hip prosthesis].

    Science.gov (United States)

    Barre, J; Pfister, G; Potron, G; Droulle, C; Baudrillard, J C; Barbier, P; Kher, A

    1987-01-01

    A series of 80 patients operated for total hip prosthesis under epidural anesthesia was randomly allocated to treatment with Kabi 2165 (n = 40): 2,500 U anti-Xa preoperatively and evening of operation and 2,500 U anti-Xa morning and evening daily up to the 9th or 10th day postoperatively, or standard heparin (n = 40): 3,750 U preoperatively and then 8 hourly, at a dose adjusted with thrombin time and cephalin + activator time, daily up to the 9th or 10th day. Phlebography was performed routinely on the 9th or 10th day. Venous thrombosis occurred in 7 patients (17.5%) in the Kabi 2165 group, including two high, potentially emboligenic, localizations (5%), and in 4 patients (10%) in the standard heparin group, including 2 potentially emboligenic clots (5%). The difference is not statistically significant (total number: p = 0.5; potentially emboligenic: p = 0.33). Pulmonary embolism did not occur. Overall tolerance, evaluated from hemoglobin and hematocrit values, intra- and post-operative bleeding and operation wound hematoma and at injection site was comparable in the two groups.

  1. Spontaneous multisystem deep venous thrombosis as an unusual presentation of Behçet's disease in a young Afro-Caribbean patient.

    Science.gov (United States)

    Mitra, Anuja

    2015-07-23

    Behçet's disease is an autoimmune mediated multisystem vasculitis. It is most prevalent in Middle Eastern and Mediterranean patients and considered rare in Afro-Caribbean populations. The disease phenotype in Afro-Caribbean patients is more severe with systemic involvement, in particular lesions affecting the vascular system known as angio-Behçet's. The archetypal triad of disease in Behçet's includes oral stomatitis, genital ulceration and ocular lesions, however, the variety of symptoms patients experience is recognised by the revised International Criteria for Behçet's disease and is reflected in the clinical scoring criteria. The authors report an unusual case of Behçet's disease in a young Afro-Caribbean patient presenting with spontaneous bilateral renal, cerebral and pulmonary venous thrombosis as first presentation. Physicians should be aware of the aggressive and atypical manner in which Behçet's can present in Afro-Caribbean patients in order to avoid diagnostic delay and remain vigilant for thromboembolic lesions in this population.

  2. Predicting deep venous thrombosis using Wells scoring system combined with D-dimer and fibrin degradation product%复合骨折后下肢深静脉血栓形成Wells评分与D-二聚体及纤维蛋白降解产物的预测

    Institute of Scientific and Technical Information of China (English)

    沈明荃; 谢增如

    2014-01-01

    背景:文献报道各种对深静脉血栓形成的诊断方法,但是结合危险度预测评分系统及多种实验室指标对深静脉血栓形成的预测诊断率的提高尚不明确。  目的:使用Wel s评分系统并结合D-二聚体及纤维蛋白降解产物提高诊断创伤后下肢深静脉血栓敏感性。方法:下肢骨折及脊柱骨折患者82例,排除患病前合并深静脉血栓形成高危因素的患者及曾患有深静脉血栓形成的患者。入院后检测患者D-二聚体、纤维蛋白酶原降解产物、纤维蛋白酶原、凝血酶原时间、部分活化凝血酶原时间、血小板计数、C-反应蛋白及血沉相关指标,并做彩色多普勒下肢超声检测。根据下肢深静脉栓塞评分表(Wel s评分表)评分分为低危、中危及高危患者。  结果与结论:彩色多普勒下肢超声检测深静脉血栓形成组30例;非深静脉血栓形成组52例,两组患者 D-二聚体及纤维蛋白降解产物的峰值差异有显著性意义(P OBJECTIVE:To improve the diagnosis sensitivity of traumatic deep venous thrombosis of lower extremity using Wel s scoring system combined D-dimer and fibrin degradation product. METHODA total of 82 patients with low limb fractures and spine fracture were included in this study, those patients with high risk factors of deep venous thrombosis or with the history of deep venous thrombosis were excluded. After admission, the fol owing indicators of deep venous thrombosis were determined, including D-dimer, fibrin degradation product, fibrinogenase, prothrombin time, activated partial thrombokinase time, blood platelets count, C-reaction protein, and erythrocyte sedimentation rate. In addition, Doppler ultrasound detection of double lower limbs deep vein was performed, and the results were recorded. According to scoring system of deep venous thrombosis of lower extremity (Wel s scoring system), the patients were assigned into low-risk, middle

  3. The causes and protective measures of deep venous thrombosis of lower limb fractures in elderly patients%浅析老年患者下肢骨折并发深静脉血栓的原因及防护对策

    Institute of Scientific and Technical Information of China (English)

    黄子珊

    2013-01-01

    Objective To investigate the cause of deep venous thrombosis after lower limb fracture in elderly patients and effective protective measures. Methods 12 cases of lower extremity on analysis of deep venous thrombosis of lower limb fracture standard treatment and nursing of patients with deep vein thrombosis were performed and the test method of related factors, summed up the reasons and put forward effective countermeasures. Results there were no significant differences between different gender of patients with fracture of lower limb deep venous thrombosis (P>0.05), the probability of different age, whether the operation, whether complicated with hypertension, hyperlipidemia, diabetes and abnormal blood coagulation (Gao Ning) was statistically signiifcant and the difference between different parts of the patients with fracture of lower limb deep venous thrombosis (P0.05),不同年龄段、是否手术、是否合并高血压、高血脂、糖尿病和凝血功能异常(高凝)以及不同部位的下肢骨折患者并发深静脉血栓形成概率的差异有统计学意义(P<0.05)。结论年龄、手术、合并高血压、高血脂、糖尿病和高凝血液以及骨折部位是并发深静脉血栓形成的相关因素。针对相关因素,通过积极的治疗和护理措施可以有效防治深静脉血栓的形成。

  4. An unusual cause of hydrocephalus: aqueductal developmental venous anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Yagmurlu, Banu; Fitoz, Suat; Atasoy, Cetin; Erden, ilhan [Ankara University School of Medicine, Department of Radiology, Ankara (Turkey); Deda, Gulhis; Unal, Ozlem [Ankara University School of Medicine, Division of Pediatric Neurology, Ankara (Turkey)

    2005-06-01

    Vascular malformations are infrequent causes of aqueductal stenoses, developmental venous anomaly (DVA) being the rarest among them. DVAs, also known as venous angiomas, are congenital in origin and characterized by dilatation of vessels in the superficial and deep venous system. Although they are usually clinically silent, they can be complicated by hemorrhage, seizures and neurologic deficits. Herein, we report MR imaging findings of a 7-year-old girl whose hydrocephalus was due to an abnormal vein coursing through the aqueduct. (orig.)

  5. Ultrasonographic diagnosis of acute superior mesenteric venous thrombosis%急性肠系膜上静脉血栓形成的超声诊断

    Institute of Scientific and Technical Information of China (English)

    陈顺平; 胡元平; 陈丽霞

    2011-01-01

    目的:探讨急性肠系膜上静脉血栓形成的超声诊断价值。方法回顾性分析17例手术病理、CT及临床随访证实的急性肠系膜上静脉血栓形成患者的临床资料及超声影像特点。结果 17例急性肠系膜上静脉血栓形成的超声影像学表现中,9例肠系膜上静脉内可见低回声及无血流信号或(和)血流信号充盈缺损,4例门静脉或(和)脾静脉内可见低回声及无血流信号和血流信号充盈缺损,2例肠管扩张及肠壁增厚,2例可见腹腔积液。超声对急性肠系膜上静脉血栓形成诊断准确率为65% (11/17)。根据肠系膜上静脉血栓形成时门静脉或(和)脾静脉是否同时受累其被分为大血管型(10例)和小血管型(7例)。超声对大血管型和小血管型急性肠系膜上静脉血栓形成的诊断准确率分别为90%(9/10)和29%(2/7),两者差异有统计学意义(x2=3.41,P<0.05)。结论超声检查对急性肠系膜上静脉血栓形成有较高的诊断价值,对大血管型急性肠系膜上静脉血栓形成的诊断率更高。%Objective To investigate the diagnosis of acute superior mesenteric venous thrombosis(MVT) by ultrasonography. Methods Seventeen patients with MVT were confirmed by operation or CT scanning and followed-up, whose ultrasonographic features were analyzed retrospectively. Results Ultrasonographic features of seventeen patients with MVT were enlarged superior mesenteric vein filled with hypoecho without flow signals( n =9) ,portal vein and(or) splenic vein filled with hypoecho without flow signals (n =4), intestine wall thickening and intestine distension( n =2) and ascites( n =2). The accuracy of ultrasonographic examination for SMV was 65% (11/17). According to MVT with or without splenic or portal vein involvement,MVT were been classified as two type:large vessel type(n =10) and small vessel type(n =7). The accuracy of ultrasonographic examination for large vessel type and small vessel

  6. Clinical aspects of venous thrombophilia.

    Science.gov (United States)

    Girolami, Antonio; Fabris, Fabrizio; Girolami, Bruno

    2002-01-01

    Venous thrombophilia is the result of clotting changes namely of a hypercoagulable state together with blood flow and vessel wall changes. There is no need for all these components to be present in order for thrombosis to occur. As the matter of fact, thrombosis may occur even if only one of these conditions is present. In clinical practice a combination of factors is usualy seen. In comparison with arterial thrombophilia, clotting changes and blood flow seen to play a major role in venous thrombosis. Venous thrombophilia may remain asynptomatic or may result in a series of clinical syndromes. The commonest of these are: 1. Superficial vein thrombosis, 2. Deep vein thrombosis of legs, 3. Deep vein thrombosis of arms, 4. Caval veins thrombosis, 5. Portal vein thrombosis, 6. Hepatic veins thrombosis, 7. Renal vein thrombosis, 8. Cerebral sinuses thrombosis, 9. Right heart thrombosis, 10. Miscellaneous (ovarian, adrenal veins thrombosis, etc.). Since the first two are widely and easily recognized, these is no need for an extensive discussion. Deep vein thromboses of upper limbs are not as frequent as those of lower limbs or of superficial phlebitis but they can still be recognized on clinical grounds and non invasive techniques. The remaining 7 syndromes are less common and therefore less frequently suspected and recognized. Of particular interest, among these less common manifestations of venous thrombophilia are hepatic vein and renal vein thrombosis. Hepatic veins thrombosis, sometimes part of inferior vena cava thrombosis is most frequently due to an isolated occlusion of hepatic veins thereby causing a form of venocclusive disease. Occasionally diagnosis may be difficult because of slow onset of symptoms (hepatomegaly, right flank pain, fever, ascites etc.). The same is true for renal vein thrombosis which may also be of difficult diagnosis since it causes proteinuria and flank pain. The proteinuria is often interpreted as due to a nephrotic syndrome which

  7. Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

    Science.gov (United States)

    Watenpaugh, Donald E.

    1996-01-01

    Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

  8. Clinical Analysis of Catheter Direct Thrombolysis Therapy in 28 Patients with Acute Deep V ein Throm-bosis of Lower Limbs%导管直接溶栓治疗28例急性下肢深静脉血栓临床分析

    Institute of Scientific and Technical Information of China (English)

    宋海龙; 闫笑迎; 李宏

    2015-01-01

    目的:分析研究导管溶栓术( CDT)治疗急性下肢深静脉血栓形成( DVT)的早中期疗效。方法分析2009年1月~2014年9月CDT治疗的28例急性下肢DVT患者的临床资料。全部患者均行患肢静脉造影,以判断疗效。结果28例CDT手术技术成功率100%,全组患者术中、术后均无严重并发症发生。溶栓前后静脉通畅评分比较差异显著(t=13.926,P<0.01)。溶栓后静脉通畅率为(60±19)%。结论 CDT治疗急性下肢DVT早中期疗效较好,并发症少,值得在临床上使用。%Objective To analyze therapeutic effect of early and middle-stage catheter direct thrombolysis therapy in the treatment of acute deep vein thrombosis of lower limbs.Mtehods We retrospectively analyzed the clinical infor-mation among 28patients of acute deep vein thrombosis in lower limbs , who were treated with catheter direct thrombolysis therapy in our hospital from January 2009 to September2014.All patients were detected with the venography at the af -fected limbs,to determine the efficacy.Results The success rate of catheter direct thrombolysis therapy was 100% in 28 patients of acute deep vein thrombosis in lower limbs.No intraoperative and postoperative complications were found. There were significant differences in the venous patency scores before and after thrombolysis therapy ( t=13.926, P<0.01).The venous patency rate was (60 ±19)%after thrombolysis.Conclusions Catheter direct thrombolysis therapy has early and middle-stage efficacy in treatment of acute deep vein thrombosis of lower limbs, and induces few compli-cations, therefore it deserves clinical application.

  9. 妇产科术后并发下肢深静脉血栓的特点分析与防治措施%Characteristic analysis and prevention measures of obstetrics and gynecology postoperative deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    李薛鹏

    2013-01-01

    Objective To analyze the etiology characteristics and prevention of postoperative deep venous thrombosis (DVT) in department of obstetrics and gynecology,in order to summarize the more effective methods and measures.Methods From October 2010 to October 2012,180 patients with DVT were observed about the clinical characteristics as well as the precautionary measures.Results The number of deep venous thrombosis in benign group was 2 cases (2.63 %),which was significantly lower than 11 cases (10.58%) in the malignant group,,there was significant difference (x2 =32.91,P < 0.05).In 13 patients with deep vein thrombosis,11 cases occurred in the left lower limb.The number of people suffering from thrombosis in cesarean section common iliac vein was 16 cases (11.85 %),the number of people suffering from thrombosis in natural childbirth maternal iliac vein total was 4 cases (2.96%),there was significant difference(x2 =11.72,P <0.05).The number of people suffering from thrombosis in cesarean section calf deep vein was 11 cases (8.15%),the number of people suffering from thrombosis in natural childbirth maternal calf deep vein was 3 cases (2.22%),there was significant difference (x2 =3.51,P < 0.05).The number of people suffering from thrombosis and pulmonary embolism in cesarean section was 9 cases (6.67%),the number of people suffering from thrombosis and pulmonary embolism in natural childbirth maternal was 2 cases (1.48%),there was significant difference(x2 =12.31,P < 0.05).The number of cesarean section suffering from thrombosis merger varicose veins was 7 cases (5.19%),natural childbirth women suffering from thrombosis veins merge was 2 cases (1.48%),there was significant difference (x2 =2.28,P < 0.05).Conclusions Postoperative deep venous thrombosis risk factors in department of obstetrics and gynecology was malignant tumor,patients' left lower limb is the prone parts of malignancy.Pay a high degree of attention to tumor after surgery and

  10. Differentiation of parenteral anticoagulants in the prevention and treatment of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Adiguzel Cafer

    2011-03-01

    Full Text Available Abstract Background The prevention of venous thromboembolism has been identified as a leading priority in hospital safety. Recommended parenteral anticoagulant agents with different indications for the prevention and treatment of venous thromboembolism include unfractionated heparin, low-molecular-weight heparins and fondaparinux. Prescribing decisions in venous thromboembolism management may seem complex due to the large range of clinical indications and patient types, and the range of anticoagulants available. Methods MEDLINE and EMBASE databases were searched to identify relevant original articles. Results Low-molecular-weight heparins have nearly replaced unfractionated heparin as the gold standard antithrombotic agent. Low-molecular-weight heparins currently available in the US are enoxaparin, dalteparin, and tinzaparin. Each low-molecular-weight heparin is a distinct pharmacological entity with different licensed indications and available clinical evidence. Enoxaparin is the only low-molecular-weight heparin that is licensed for both venous thromboembolism prophylaxis and treatment. Enoxaparin also has the largest body of clinical evidence supporting its use across the spectrum of venous thromboembolism management and has been used as the reference standard comparator anticoagulant in trials of new anticoagulants. As well as novel oral anticoagulant agents, biosimilar and/or generic low-molecular-weight heparins are now commercially available. Despite similar anticoagulant properties, studies report differences between the branded and biosimilar and/or generic agents and further clinical studies are required to support the use of biosimilar low-molecular-weight heparins. The newer parenteral anticoagulant, fondaparinux, is now also licensed for venous thromboembolism prophylaxis in surgical patients and the treatment of acute deep-vein thrombosis; clinical experience with this anticoagulant is expanding. Conclusions Parenteral

  11. 急性肠系膜上静脉血栓形成35例分析%Acute Superior Mesenteric Venous Thrombosis:An Analysis of 35 Patients

    Institute of Scientific and Technical Information of China (English)

    李保松; 何向辉; 戴向晨; 朱理玮

    2011-01-01

    Objective To discuss the etiology, manifestations, diagnosis and therapy of acute superior mesenteric venous thrombosis. Methods Of all thirty-five patients with acute superior mesenteric venous thrombosis, twenty-six patients were treated medically by anticoagulant and thrombolytic therapy. Nine patients under surgical management were treated by partial resection of the small intestine and after operation thrombolytic therapies were administrated. Results Twenty-two patients in anticoagulant and thrombolytic therapy group were cured. Five patients showed recurrence. Four of them needted surgical intervention and one patient died after surgery. Nine patients received emergency surgical treatment, eight of them survived while one died.Conclusion The main causes of acute superior mesenteric venous thrombosis are abdominal surgery, hypercoagulation disorders and portal hypertension. Appropriate use of abdominal enhanced CT examination, early diagnosis and anticoagulant thrombolytic therapy are crucial for better therapeutic results. An appropriate timed surgery with removal of necrotic bowel adequately and postoperative anticoagulation therapy are keys to reduce morality.%目的:探讨急性肠系膜上静脉血栓形成的病因、临床表现及诊断治疗.方法:35例急性肠系膜上静脉血栓形成患者中26例确诊后给予抗凝溶栓治疗.9例确诊后即行手术治疗,均行小肠部分切除术,术后继续抗凝治疗.结果:抗凝溶栓组26例中22例治愈,5例出院后于两年内复发再次入院治疗,4例中转手术,1例术后死亡.急症手术组9例治愈8例,术后死亡1例.结论:急性肠系膜上静脉血栓形成与腹部手术、高凝状态及门脉高压有关.腹部强化CT检查,早期诊断并抗凝溶栓治疗,可取得较好的疗效.手术时机把握合适,术中正确判断切除坏死肠管范围及术后抗凝治疗,是降低死亡率的关键.

  12. Presentación de un caso: trombosis venosa profunda bilateral de etiología infrecuente Case report: rare bilateral deep venous thrombosis

    OpenAIRE

    Mónica Fernández del Castillo Ascanio; Sonia Pascual Pérez; Carlos Gálvez García

    2012-01-01

    La agenesia de vena cava inferior (VCI) es una patología poco frecuente que suele diagnosticarse a raíz de una trombosis venosa secundaria sintomática de las venas ilíacas. Presentamos el caso de un varón de 28 años que acude al centro de salud por dolor en miembros inferiores y datos de insuficiencia venosa. Se visualiza mediante ecografía trombosis venosa profunda (TVP) bilateral.Agenesis of the inferior vena cava (IVC) is a rare condition usually diagnosed as secondary to symptomatic deep ...

  13. 人工髋关节置换术患者下肢深静脉血栓的预防%The prevention of lower extremity deep venous thrombosis in patients with artificial hip replacement

    Institute of Scientific and Technical Information of China (English)

    张桂霞

    2015-01-01

    Objective:To analyze the reason of developing deep vein thrombus( DVT) after artificial hip replacement and to suggest effective nursing strategies to prevent DVT. Methods:The retrospective analysis of the clinical data of 68 patients undergoing artificial hip replacement was performed, to whom the effective nursing intervention was applied. Results:The artificial hip replacement was completed successfully in all 68 pa-tients,without DVT complicated. Conclusion:The effective accomplishment of admission assessment, psychological nursing, health education, postoperative early exercise of function, accurate use of anticoagulants and reduction of blood vessel injury can significantly prevent DVT in patient with artificial hip replacement.%目的::分析人工髋关节置换术后深静脉血栓( deep venous thrombosis,DVT)形成的原因,选择有效的预防性护理措施。方法:回顾性分析收治的68例人工髋关节置换术患者的临床资料,采取有效护理措施。结果:68例患者人工髋关节置换术均顺利完成,无并发DVT病例。结论:做好入院评估,心理护理及宣教工作,术后早期进行功能锻炼,合理应用抗凝药物,减少血管损伤,可以有效地预防人工髋关节置换术患者DVT的发生。

  14. [Current and future diagnostic strategies in venous thromboembolic disease].

    Science.gov (United States)

    Gabriel Botella, F; Labiós Gómez, M; Brasó Aznar, J V; Llavador Ros, G; Bort Martí, J

    1999-08-01

    Thromboembolic disease (TD), which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is the most common acute cardiovascular condition after ischemic cardiopathy and stroke. It is often difficult to diagnose, as it is well-known that half of PE episodes appear are recognized while the patient is still alive and which appear in 30-40% of symptomatic patients. Nonetheless, there are two well-differentiated phases in the diagnosis of TD: the suspicion, and the diagnosis. The first is very important, and is within the competence of any physician. The second can be ratified when carrying out specific tests. We have developed successive steps in the two phases of diagnosis, we critically review the distinct parts currently implicated in the strategic diagnosis of TD. Finally, we analyze the new diagnostic techniques to substitute, possibly, angiography in many cases, and perhaps to include ventilation/perfusion (V/Q) pulmonary gammagraphy, once become generally available.

  15. 表现为下肢深静脉血栓的盆腔肿瘤四例报告%Pelvic tumors misdiagnosed as lower extremity deep venous thrombosis:4 cases report

    Institute of Scientific and Technical Information of China (English)

    刘铖; 李鼎锋; 郭钧; 崔秋

    2015-01-01

    Objective To explore the reasons for the misdiagnosis of pelvic tumors as lower extremity deep venous thrombosis ( DVT ), as well as the diagnostic and treatment methods for pelvic tumors.Methods Four patients with pelvic tumors were misdiagnosed as lower extremity DVT. The reasons of misdiagnosis and diagnosis and treatment for pelvic tumors were analyzed based on the relevant literatures.Results There were one case of ifbroneuroma, one cases of moderately differentiated squamous-cell carcinoma, one case of myxo-lfuidity liposarcoma and one case of synovial sarcoma. Tumors in the patient with fibroneuroma were completely removed. Malignant tumors in the other 3 patients were resected, when the tumor size was shrinked with a clear boundary and the blood supply was decreased after 3 cycles of intra-arterial chemotherapy via an implanted pump from the femoral artery to the common iliac artery. No recurrence or metastasis was found in the follow-up.Conclusions The clinical manifestations are untypical in the patients with pelvic tumors, which are easily misdiagnosed as DVT. Therefore, great attention should be paid in the diagnosis. Resection is preferred for benign tumors, and intra-arterial intervention chemotherapy should be applied ifrst for malignant tumors, followed by surgery.

  16. Trombose venosa profunda como complicação da escleroterapia química no tratamento de telangiectasias dos membros inferiores Deep venous thrombosis as complication of chemical sclerotherapy in the treatment of leg telangiectasias

    Directory of Open Access Journals (Sweden)

    Adilson Ferraz Paschôa

    2005-01-01

    Full Text Available Os autores relatam dois casos de escleroterapia de telangiectasias, as quais complicaram com trombose venosa profunda. O primeiro caso foi confirmado por flebografia, e o segundo, por duplex scan. Um paciente, 8 anos após, apresentou uma tromboflebite espontânea de veia safena parva, que resultou em pesquisa de trombofilia positiva para o Fator V Leiden. A outra paciente teve pesquisa de trombofilia negativa. Os relatos de tromboembolismo relacionado à escleroterapia são escassos na literatura. O objetivo do trabalho é alertar para essa possibilidade, valorizando as queixas de dor e edema após a escleroterapia. Havendo suspeita clínica, o duplex scan deve ser realizado.The authors report two cases of sclerotherapy for telangiectasias, which complicated with deep venous thrombosis. The first case was confirmed by phlebography and the second one by duplex scan. One patient, 8 years later, had a spontaneous lesser saphenous vein thrombophlebitis, which resulted in positive thrombophilia investigation for factor V Leiden. The other patient had negative investigation for thrombophilia. There are very few reports on thromboembolism after sclerotherapy in the literature. This study aims to warn against this possibility, valuing the complaints of pain and swollen leg after the sclerotherapy. In case of clinical suspicion, a duplex scan should be performed.

  17. Investigation of the effects of naratriptan, rizatriptan, and sumatriptan on jugular venous oxygen saturation in anesthetized pigs: implications for their mechanism of acute antimigraine action.

    Science.gov (United States)

    Létienne, Robert; Verscheure, Yvan; John, Gareth W

    2003-10-01

    The effects of naratriptan, rizatriptan, and sumatriptan on arteriovenous oxygen saturation difference and carotid hemodynamics were compared in the anesthetized pig. Oxygen and carbon dioxide partial pressures in systemic arterial and jugular venous blood as well as hemoglobin oxygen saturation were determined by conventional blood gas analysis. Vehicle (n = 19) or naratriptan, rizatriptan, or sumatriptan (0.63, 2.5, 10, 40, 160, 630, and 2,500 microg/kg i.v.; n = 7/group) were infused cumulatively. In naratriptan-, rizatriptan-, and sumatriptan-treated animals, jugular venous oxygen saturation decreased dose dependently (geometric mean ED50 values of 3.1, 17.9, and 16.0 microg/kg, respectively) concomitantly with increases in carotid vascular resistance. Rizatriptan significantly and dose dependently, from 160 microg/kg, increased PvCO2 (P animals studied. Maximal variations in PvCO2 were found to correlate highly with those in PvO2 (P = 0.002), but maximal variations in carotid resistance failed to correlate with those in PvCO2 (P = 0.76) or PvO2 (P = 0.28). The results demonstrate that the triptans investigated robustly produced carotid vasoconstriction, but elicited less consistent decreases in VOS and increases in jugular PvCO2, possibly suggestive of distinct mechanisms. Collectively, the data suggest that triptan-induced increases in arteriovenous oxygen saturation difference and carbon dioxide partial pressure in venous blood draining the head are class effects.

  18. 神经外科术后患者下肢深静脉血栓形成原因分析及其护理对策探讨%Cause analysis and nursing countermeasures of the deep venous thrombosis forma-tion of lower limbs after neurosurgical operation

    Institute of Scientific and Technical Information of China (English)

    马官英

    2015-01-01

    目的:探讨神经外科术后患者下肢深静脉血栓的形成原因及预防方法,并研究相关护理对策,以促进患者预后。方法对本医院从2011年4月至2013年4月所接收治疗并接受手术治疗的患者658例,其中包括并发下肢深静脉血栓患者102例进行回顾性分析,比较并发下肢静脉血栓与未发生下肢静脉血栓的患者性别、年龄、有无并发症、意识障碍与否、偏瘫与否、体重指数正常与否,总结出神经外科手术患者发生静脉血栓的原因并提出相关护理措施。结果发生下肢静脉血栓患者年龄显著高于未发生静脉血栓的患者( P<0.05);合并有高血压、糖尿病等疾病的患者较易发生下肢静脉血栓( P<0.05);偏瘫、意识障碍、肥胖也是造成神经外科手术患者发生下肢深静脉血栓的原因。结论下肢深静脉血栓是神经外科手术患者常见并发症之一,了解其形成原因并采取有效的护理对策能够降低该并发症的发病概率,提高患者生活质量。%Objective To explore the causes and prevention measures of deep venous thrombosis and study the nursing countermeasures in order to promote the patients' rehabilitation. Methods A total of 658 patients who were giv­ en surgeries in our hospital from April 2012 to April 2013 , including 102 patients of deep venous thrombosis who were selected and carried out a retrospective sampling survey. The gender, age, whether suffered complications or not, wheth­ er had conscious or not, paralyzed or not , whether had the normal weights or not between the patients with and without venous thrombosis of lower limbs were compared. The causes of the venous thrombosis of the neurosurgical patients was summed up and the relevant nursing measures were pointed out. Results The age of the patients of deep venous throm­ bosis was significantly higher than that of the patients without venous thrombosis ( P<0. 05 );patients who had

  19. Imaging of head and neck venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Flis, Christine M.; Connor, Stephen E. [King' s College Hospital, Neuroradiology Department, London (United Kingdom)

    2005-10-01

    Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team. (orig.)

  20. 股浅静脉瓣膜戴戒加曲张浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全的疗效%Indirect loop valvuloplasty of superficial femoral vein plus superficial varicose stripping for primary incompetence of deep venous valve of the lower limbs

    Institute of Scientific and Technical Information of China (English)

    马中; 王岭; 凌瑞; 陈美芬; 边杰芳; 陈江浩

    2005-01-01

    我院血管外科自1997—2003年采用瓣膜戴戒加浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全(primary deep venous insufficiency,PDVI)患者19例(31例患肢),取得较好疗效,现报告如下。

  1. 护理干预对预防骨科手术后深静脉血栓形成的效果评价%Effect evaluation ot nursing intervention on prevention of deep venous thrombosis after orthopaedic surgery of lower extremities

    Institute of Scientific and Technical Information of China (English)

    靳彩霞

    2011-01-01

    Objective To investigate the impact of nursing intervention on the prevention of deep venous thrombosis after orthopaedic surgery of lower extremities.Methods 104 patients were selected from our hospital after orthopaedic surgery of lower extremities were randomly divided into the control group and the observation group with 52 cases in each group,the control group was given normal routine care,the observation group received target-oriented nursing.The incidence of deep venous thrombosis was compared between the two groups.Results The rate of deep venous thrombosis in the observation group was significantly lower than that in the control group.Conclusions Through targeted nursing intervention,we can effectively prevent deep venous thrombosis after orthopaedic surgery of lower extremities,so it deserved promotion and application in clinic.%目的 探讨护理干预对预防骨科手术后深静脉血栓形成的效果.方法 2009年11月至2010年11月从我院选取104例骨科手术后患者,随机分为对照组和观察组各52例,对照组实施普通的常规护理,观察组实施有针对性的护理干预.比较2组深静脉血栓形成情况.结果 观察组下肢深静脉血栓发生率显著低于对照组.结论 通过有针对性的护理干预,可以有效的预防骨科手术后下肢深静脉血栓形成,值得在临床上应用和推广.

  2. Deep venous thrombosis in preterm infants:3 cases report%早产儿下肢静脉血栓3例报告

    Institute of Scientific and Technical Information of China (English)

    胡琦; 范文婷; 邓睿; 廖伟

    2016-01-01

    目的:提高对早产儿静脉血栓诊断及治疗的认识。方法回顾性分析3例早产儿下肢静脉血栓的临床特征、治疗经过及预后,并结合文献进行分析。结果3例早产儿的胎龄29~36周,出现血栓时间为出生1~57 d。1例予外周静脉穿刺植入中心静脉导管(PICC),3例均有感染征象及创伤。予溶栓及抗凝治疗1例,大剂量溶栓治疗1例,此2例均治疗成功且无出血并发症;另1例患儿放弃治疗后病情恶化。结论危重症早产儿是血栓症的高危人群。感染、置管、易栓体质及母亲高危因素均是血栓发生的高危因素。早发现、早诊断并采取合理有效的个体化治疗可改善预后。%Objective To enhance the awareness of diagnose and treatment of venous thrombus in premature infants. MethodsThe clinical features, treatment and prognosis of lower limb vein thrombus in three case of premature infants were retrospectively analyzed.ResultsThree premature infants of gestational age 29-36 weeks were found thrombosis in 1-57 days after birth. One case received peripherally inserted central cathete (PICC). All of three cases had infection signs and trauma. One case received thrombolytic and anticoagulant therapy, one case received high dose thrombolytic therapy, and both of them were treated successfully without bleeding complication. However, another case was deteriorated after giving up treatment.ConclusionsCritically ill premature infants are at high risk of thrombosis. Infection, indwelling tube, thrombophilia constitution, and maternal risk factors were the high risk factors of thrombosis. Early detection, early diagnosis, and effective individualized treatment can improve the prognosis.

  3. Air travel and venous thrombosis : results of the WRIGHT study : Part I: Epidemiology

    NARCIS (Netherlands)

    Kuipers, Saskia

    2009-01-01

    In venous thrombosis, a blood clot develops in a vein, usually a deep vein of the leg, causing obstruction of the blood flow. Venous thrombosis is a multicausal disease, in which genes and environment interact. One of the environmental factors that increases the risk of venous thrombosis is long dis

  4. Treatment of an acute deep hand burn in a lowincome country with no available microsurgery: a case report

    Science.gov (United States)

    Amouzou, K.S.; El Harti, A.; Kouevi-Koko, T.E.; Abalo, A.; Dossim, A.

    2016-01-01

    Summary Deep hand burns usually lead to joint and tendon exposure. A simple skin graft is insufficient to achieve healing. Soft tissue reconstruction represents a surgical challenge that ranges from the simplest to the most complex flaps. In some areas, microsurgery is not technically possible. Choice is then limited to pedicled distant flaps such as the abdominal wall flap-graft. We report a case of an acute burned hand with exposure of metacarpophalangeal joints from the second to the fourth radius as well as proximal inter phalangeal joints from the second to the fifth radius and extensor tendons, treated in the burns and wound care unit of the Sylvanus Olympio Teaching Hospital in Lomé. The dorsum hand and fingers were covered with a pedicled abdominal flap-graft that was severed in two stages at 22 and 29 days. We achieved good results (sensitivity S3+, useful aesthetic hand) at two-year follow up. PMID:28149255

  5. A case of acute postoperative keratitis after deep anterior lamellar keratoplasty by multidrug resistant Klebsiella

    Directory of Open Access Journals (Sweden)

    Leena Bajracharya

    2015-01-01

    Full Text Available A healthy lady of 42 years underwent deep anterior lamellar keratoplasty for granular dystrophy. The very next day, it was complicated by development of infectious keratitis. The organism was identified as multidrug resistant Klebsiella pneumoniae. Donor corneal button may be implicated in the transmission of infection in an otherwise uneventful surgery and follow-up. Nosocomial infections are usually severe, rapidly progressive and difficult to treat. Finally, the lady had to undergo therapeutic penetrating keratoplasty for complete resolution of infection.

  6. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  7. Combined magnetic resonance imaging of deep venous thrombosis and pulmonary arteries after a single injection of a blood pool contrast agent

    Energy Technology Data Exchange (ETDEWEB)

    Hansch, Andreas; Neumann, Steffi; Baltzer, Pascal; Waginger, Matthias; Kaiser, Werner A.; Mentzel, Hans-Joachim [Friedrich-Schiller-University Jena, Institute of Diagnostic and Interventional Radiology, Jena (Germany); Betge, Stefan; Poehlmann, Gunther [Friedrich-Schiller-University Jena, Department of Internal Medicine I, Jena (Germany); Pfeil, Alexander; Wolf, Gunter [Friedrich-Schiller-University Jena, Department of Internal Medicine III, Jena (Germany); Boettcher, Joachim [SRH Klinikum Gera, Institute of Diagnostic and Interventional Radiology, Gera (Germany)

    2011-02-15

    Agreement rate between magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) for the detection of deep vein thrombosis (DVT) in the lower extremities was attempted by using the intravascular MRI contrast agent gadofosveset trisodium. The potential of this method to detect pulmonary embolism (PE) was also evaluated. Forty-three consecutive inpatients with ultrasound-confirmed DVT but no clinical signs of PE were prospectively enrolled in this feasibility study. MRI was performed after a single injection of gadofosveset trisodium. The pulmonary arteries were imaged using a 3D Fast Low Angle Shot (FLASH) gradient recalled echo sequence. Additionally, pulmonary arteries, abdominal veins, pelvic and leg veins were imaged using a fat-suppressed 3D gradient echo Volume Interpolated Breath-hold Examination (VIBE FS). Gadofosveset trisodium-enhanced MRI detected more thrombi in the pelvic region, upper leg and lower leg than the initial DUS. In addition, PE was detected in 16 of the 43 DVT patients (37%). This study shows the feasibility of a combined protocol for the MRI diagnosis of DVT and PE using gadofosveset trisodium. This procedure is not only more sensitive in detecting DVT compared to standard DUS, but is also able to detect PE in asymptomatic patients. (orig.)

  8. Venous ulcers of the lower limb: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Chatterjee S Sasanka

    2012-01-01

    Full Text Available Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  9. Venous ulcers of the lower limb: Where do we stand?

    Science.gov (United States)

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  10. 髋关节置换术后下肢深静脉血栓形成的影响因素分析%The influence factors of lower extremities deep venous thrombosis after hip replacement

    Institute of Scientific and Technical Information of China (English)

    郑桂娟; 郭佳

    2015-01-01

    Objective To analyze the influence factors of lower extremities deep venous thrombosis after hip replacement,and provide guidance for perioperative prevention.Methods 52 cases of patients underwent total hip replacement were selected,who were given color doppler ultrasound examination for lower limb venous thrombosis after hip replacement.And analyzed risk factors of lower extremity deep vein thrombosis from patient's gender,age,blood lipid,D -dimer,complications and surgical index.Results During the 52 cases,16 cases were found with postopera-tive lower limb deep vein thrombosis (30.8%);Single factor analysis showed that patients with age ≥65 years,over-weight or obese (BMI≥25kg/m2 ),high triglycerides (TG ≥ 1.7mmol/L)and high D -dimer level (≥500μg/L), diabetes or high blood pressure,large blood transfusion combined with a greater incidence of postoperative deep vein thrombosis (P <0.05).Further multiple factors regression analysis showed that age ≥65 years,overweight or obesity, high triglycerides,high D -dimer,diabetes,large blood transfusions were independent risk factors of lower extremity deep vein thrombosis (OR =15.693,1.278,9.832,3.053,1.855,1.014,all P <0.05).Conclusion Patients with total hip replacement should be given preoperative vein thrombosis risk assessment,patients with age ≥65,overweight or obese,high triglycerides,D -dimer level,diabetes,large number of blood transfusions have higher risk of deep vein thrombosis,we should focus on perioperative monitoring,application of low molecular heparin,lower limb vein pump, etc.early postoperative lower limb rehabilitation exercise,to reduce the occurrence of deep vein thrombosis.%目的:分析全髋关节置换术后下肢深静脉血栓形成的影响因素,为围术期预防提供指导。方法收集行全髋关节置换手术患者52例,全部患者术后行彩超检查下肢静脉血栓情况,统计术后下肢深静脉血栓发生率,并从患者性别、年龄、血脂、D

  11. Incidence of acute deep vein thrombosis in two districts. A phlebographic study.

    Science.gov (United States)

    Kierkegaard, A

    1980-01-01

    The incidence of deep vein thrombosis (DVT), diagnosed by ascending phlebography, was calculated in two Swedish districts. The average incidence per thousand population and year was 0.85 in males and 0.68 in females. Before the age of 50 the incidence was very low and almost the same in both sexes. After age 50 the incidence in men markedly increased with age. A similar increase was found in women, but not before age 60. DVT occurring after age 50 was significantly more common in men than in women. The study strongly suggests male sex as a risk factor for DVT.

  12. 腰鼓式股静脉环缩术治疗静脉瓣膜功能不全25例分析%Reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    朱洪波; 明亮; 陈兆永; 周晓春; 王勇

    2008-01-01

    目的 评价腰鼓式股静脉瓣环缩术结合术中造影治疗下肢浅静脉曲张的疗效.方法 对原发性下肢深静脉瓣膜功能不全的25例患者(共29条下肢)经大隐静脉残端逆行造影,指导股浅静脉瓣膜腰鼓式环缩手术.结果 股浅静脉瓣环缩术者下肢肿胀均好转,溃疡愈合,无深静脉血栓发生.结论 腰鼓式股浅静脉瓣环缩术是治疗深静脉瓣膜功能不全较好手段,结合术中造影可有效解决如何确定缩窄管径的大小及修复瓣膜的数目的 难题.%Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.

  13. Focused sonographic examination of the heart, lungs and deep veins in an unselected population of acute admitted patients with respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian Borbjerg; Sloth, Erik; Lassen, Annmarie Touborg;

    2012-01-01

    symptoms, can be diagnosed with sonography. The protocol describes a prospective, blinded, randomised controlled trial that aims to assess the diagnostic impact of a pragmatic implementation of focused sonography of the heart, lungs and deep veins as a diagnostic modality in acute admitted patients......INTRODUCTION: Patients admitted to hospital with acute respiratory symptoms remain a diagnostic challenge for the emergency physician. The use of focused sonography may improve the initial diagnostics, as most of the diseases, commonly seen and misdiagnosed in patients with acute respiratory...... diagnostic work up is supplemented by focused sonographic examination of the heart, lungs and deep veins of the legs. In the control group, usual diagnostic work up is performed. The χ(2) test, alternatively the Fischer exact test will be used, to establish whether there is a difference in the distribution...

  14. Cerebral venous thrombosis: Update on clinical manifestations, diagnosis and management

    Directory of Open Access Journals (Sweden)

    Leys Didier

    2008-01-01

    Full Text Available Cerebral venous thrombosis (CVT has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to misdiagnoses. Headache is the most common symptom and may be associated with other symptoms or remain isolated. The other frequent manifestations are focal neurological deficits and diffuse encephalopathies with seizures. The key to the diagnosis is the imaging of the occluded vessel or of the intravascular thrombus, by a combination of magnetic resonance imaging (MRI and magnetic resonance venography (MRV. Causes and risk factors include medical, surgical and obstetrical causes of deep vein thrombosis, genetic and acquired prothrombotic disorders, cancer and hematological disorders, inflammatory systemic disorders, pregnancy and puerperium, infections and local causes such as tumors, arteriovenous malformations, trauma, central nervous system infections and local infections. The breakdown of causes differs in different parts of the world. A meta-analysis of the most recent prospectively collected series showed an overall 15% case-fatality or dependency rate. Heparin therapy is the standard therapy at the acute stage, followed by 3-6 months of oral anticoagulation. Patients with isolated intracranial hypertension may require a lumbar puncture to remove cerebrospinal fluid before starting heparin when they develop a papilloedema that may threaten the visual acuity or decompressive hemicraniectomy. Patients who develop seizures should receive antiepileptic drugs. Cerebral venous thrombosis - even pregnancy-related - should not contraindicate future pregnancies. The efficacy and safety of local thrombolysis and decompressive hemicraniectomy should be tested

  15. Plaur and Plat in vascular tissues induce von Willebrand factor release to promote deep venous thrombosis%血管组织中Plaur和Plat诱导血管性血友病因子释放促血栓形成

    Institute of Scientific and Technical Information of China (English)

    胡继红; 吴雪梅; 李宏昆; 李兴国; 周如丹; 赵学凌; 王兵

    2012-01-01

    BACKGROUND: At present, the core control network, molecular etiology and mechanism of deep vein thrombosis is still not completely clear, furthermore, there is no ideal method for early diagnosis of deep venous thrombosis.OBJECTIVE: To observe the prothrombotic role of Plaur and Plat in the vein endothelial cells in rats with traumatic deep vein thrombosis.METHODS: Clamps plus lower limb immobilization with plaster spica were used to establish rat traumatic deep vein thrombosis models. Based on time points and whether thrombosis occurred, the experiment animals were divided into pre-thrombosis, thrombosis, and non-thrombosis groups, and then femoral vein endothelial cells were harvested at 2.5 and 25 hours after modeling.RESULTS AND CONCLUSION: Gene chip analysis and real-time PCR results showed that after trauma 2.5 hours, mRNA expressions of Plaur, Plau and von Willebrand factor in the femoral vein were raised. In the process of thrombosis, Plaur, Plau and Von Willebrand factor mRNA expressions were significantly increased. Signal path analysis showed that the Plaur and Plau were upstream regulation genes for von Willebrand factor, and von Willebrand factor was the key gene for triggering platelet adhesion, aggregation and thrombosis. These findings imply that Plaur and Plau can be raised by up-regulation of von Willebrand factor expression, further to cause platelet adhesion and aggregation, and to promote traumatic deep vein thrombosis in rats.%背景:目前,深静脉血栓形成的分子病因学机制及其形成的核心调控网络仍未完全阐明,对于深静脉血栓的早期诊断预测也无理想的方法.目的:观察创伤性深静脉血栓形成大鼠静脉内皮细胞中Plaur和Plat的促血栓形成作用.方法:采用股静脉钳夹联合下肢石膏制动构建大鼠创伤性深静脉血栓模型.依据取材时间及是否有血栓形成分为血栓形成前组、血栓形成组和血栓不形成组,分别于造模后2.5,25 h取大鼠股静

  16. A differentiated approach to the diagnosis of pulmonary embolism and deep venous thrombosis using multi-slice CT; Abklaerung von Lungenembolie und venoeser Thromboembolie mittels Mehrschicht-Spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, J.E.; Mahnken, A.H.; Stargardt, A.; Haage, P.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik (Germany); Sinha, A.M. [Medizinische Klinik 1, Universitaetsklinikum der RWTH Aachen (Germany); Schaller, S. [Siemens Medical Solutions, Computertomographie, Forchheim (Germany)

    2002-03-01

    Purpose: To establish a differentiated protocol for multi-slice CT (MSCT) examinations in cases of clinically suspected pulmonary embolism (PE) using pulmonary CT-angiography (CTA) and indirect CT-phlebography (CTP). Materials and Methods: 161 patients with suspected PE were examined using an MSCT (SOMATOM Volume Zoom; Siemens, Forchheim, Germany). After intravenous administration of 120 ml of contrast material, a thin collimation chest-CT scan was performed (120 kV, 100 mAs, collimation: 4 x 1 mm). If PE was present, or previous examinations and clinical signs suggested deep venous thrombosis (DVT), a CTP was subsequently completed. CTPs were performed using a 4 x 5 mm protocol (120 kV, 170 mAs). Venous phase scanning, starting from the pelvic crest, was completed in the popliteal fossa three minutes after contrast material injection. In 73 extremities, CTP were compared to the results of ultrasound, phlebography and autopsy. Scan ranges were documented in all patients. Cumulative doses were calculated for male and female subgroups. Results: 62 patients in our series suffered from PE and in 47 of these patients deep venous thrombosis was seen additionally. Of the 99 patients without PE, 47 also received indirect CTP. CTP confirmed the suspicion and extent of DVT in 8 patients. Only in 2 of 39 patients (5.1%) was previously unknown DVT found, despite the exclusion of PE. Regarding DVT, sensitivity was 94.3% and specificity was 92.1% for indirect CTP. Cumulative chest CT doses averaged 3.3 mSv for males and 4.2 mSv for females, the calculated CTP dosage was 9.3 mSv (according to ICRP 60). Conclusions: the examination protocol presented its suitable for clinical usage in patients with suspected PE. If PE is confirmed, indirect CTP is justified, so that detailed information of the venous system can be obtained. However, the relatively high radiation dosage of an additional CTP requires a strict indication regiment in patients with a negative CTA. (orig.) [German

  17. 血浆D-二聚体测定在深静脉血栓形成中的意义%Measuring of D-dimer in patients with deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐颖; 钱申贤

    2013-01-01

    目的:探讨血浆D-二聚体测定对深静脉血栓形成(DVT)诊断和疗效评估的意义及DVT患者临床危险因素。方法回顾性分析435例DVT患者的血浆D-二聚体水平,同时在体检人群中随机选择150例作为对照组,比较分析DVT患者中135例初诊时的危险因素。进一步监测其中的33例DVT患者治疗后1~3d、7~10d、15d的血浆D-二聚体变化情况。结果 DVT患者血浆D-二聚体水平与对照组相比有统计学差异(P=0.000),抗凝治疗的有效率为78.8%。治疗有效组DVT患者的血浆D-二聚体下降程度与无效组相比有统计学差异(P=0.005)。年龄<40岁的DVT患者中手术和外伤是主要危险因素,而年龄≥40岁患者中肿瘤、内科疾病、中心静脉置管及长期卧床是其主要危险因素。结论血浆D-二聚体是DVT诊断及疗效评估的重要指标,DVT危险因素是其一级预防的依据。%Objective To investigate plasma D- dimer levels in patients with deep venous thrombosis (DVT). Methods Plasma D- dimer levels were measured in 435 patients with DVT, and 150 healthy subjects (controls). The clinical data and plas-ma D- dimer levels were retrospectively analyzed in 135 DVT patients and the D- dimer levels were monitored in 33 DVT patients during the anticoagulation therapy at different time points (at 1~3d, 7~10d and 15d). Results Compared to healthy subjects, plasma D- dimer levels in DVT patients were significantly increased (P=0.000). The overal effective rate of treatment was 78.8%, D- dimer levels in effective patientws was significantly decreased after treatment (P=0.005). For patients aged<40, surgery and trauma were major risk factors of DVT;for those aged≥40, medical diseases, cancer, placement of central venous catheter and long- term bed rest were major risk factors. Conclusion Measurement of plasma D- dimer levels is of value in diagnosis and monotoring of therapeutic effect for patients with deep vein

  18. Risk evaluation and nursing intervention of deep venous thrombosis in ICU patients%ICU患者发生深静脉血栓的风险评估及护理干预

    Institute of Scientific and Technical Information of China (English)

    王彬; 唐晟

    2011-01-01

    目的 对ICU患者实行深静脉血栓形成(DVT)风险评估,探讨预防护理干预的效果.方法 将383例ICU住院患者随机分为两组,对照组147例采用ICU病房常规护理,实验组236例进行DVT风险评估,并给予相应的护理干预措施.观察两组患者发生DVT的情况.结果 对照组DVT发生21例(14.29%),实验组DVT发生9例(3.81%),两组比较差异有统计学意义(x2=13.75,P<0.01).结论 对ICU患者采取DVT风险评估后给予预防护理措施可以显著降低其发生率.%Objective To investigate the effect of risk evaluation of deep venous thrombosis (DVT)and nursing interventions on ICU patients.Methods 383 cases ICU patients were divided into two groups.The control group (147 cases) was treated with conventional measures.The experimental group (236 cases) was treated with risk evaluation of DVT and nursing interventions.Incidence rates of DVT of the two groups were observed.Results There were 9 cases (incidence rate of DVT was 3.81% ) of DVT in the experimental group and 21 cases ( incidence rate of DVT was 14.29% ) of DVT in the control group.The difference was statistically significant (x2 =13.75,P < 0.01 ).Conclusions Risk evaluation of DVT and nursing interventions could effectively decrease the incidence rate of DVT.

  19. 人工髋关节置换术后下肢深静脉血栓形成的预防与护理%Prevention and Nursing of Deep Venous Thrombosis After Artificial hip Replacement

    Institute of Scientific and Technical Information of China (English)

    付朝红

    2015-01-01

    目的:探讨人工髋关节置换术后下肢深静脉血栓形成(DVT)的预防与护理措施。方法对78例人工髋关节置换术后的患者采用围术期预防、术后综合护理等措施预防DVT的发生。结果78例患者仅1例偏瘫的高龄患者出院1个月后发生DVT,经溶栓、抗凝、理疗等综合治疗及护理,病情缓解出院,未发生肺栓塞及脑栓塞等严重并发症。结论综合预防及护理可有效防止人工关节置换术后患者发生DVT。%Objective To discuss the nursing and prevention measures for the lower limb deep venous throm- bosis(DVT)in the patients with artificial hip joint re-placement.Methods In 78 patients with artificial hip joint replacement operation period after the early prevention,the incidence of postoperative comprehensive nursing measures to prevent DV.Results In 78 patients,only one case of hemiplegia elderly patient occurred the DVT after discharged a month later.With the treatment and nursing of thrombolysis,anticoagulation,physiotherapy and other comprehensive,no serious complication of pulmonary embolism and cerebral embolism.Conclusion Comprehensive prevention and nursing measures can effectively prevent DVT in patients after artificial joint replacement in perioperation period.

  20. Estudo comparativo entre rivaroxaban e enoxaparina na profilaxia de tromboembolismo venoso profundo em pacientes submetidos à artroplastia total do quadril Comparative study between rivaroxaban and enoxaparin in deep venous thromboembolism prophylaxis in patients submitted to total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Pedro Silva Kanan

    2008-08-01

    profunda e tromboembolismo pulmonar.OBJECTIVE: To compare the effectiveness and safety of rivaroxaban to those of enoxaparin for the prophylaxis of deep venous thrombosis (DVT after total hip arthroplasty. METHODS: From September 2006 to April 2007, at the Orthopedics and Traumatology Clinic of the Hospital Complex of the Santa Casa of Porto Alegre, State of Rio Grande do Sul, a randomized, double-blind clinical trial was carried out in which 67 patients were selected (n = 67, all of them submitted to total hip arthroplasty (ATQ. Of these patients, two were excluded for lack of adherence to the prophylaxis proposed after hospital release (n = 65. One of the groups was given subcutaneous 40 mg enoxaparin 6 hours to 8 hours before surgery, and after surgery a placebo pill was added, for once a day oral intake, during the first 32 to 36 days. The other group was given oral 10 mg rivaroxaban, once a day, during the first 32 to 36 post-operative days. In order to have the double-blind feature of the study, a subcutaneous placebo injection was given 6 hours to 8 hours before surgery and on the 32 to 36 days following surgery. The main outcome aimed at was the effectiveness in preventing DVT, which was evaluated by bilateral venography carried out between days 32 and 36 after surgery, or through documented symptoms of deep venous thrombosis or pulmonary thromboembolism (PTE. The secondary outcome studied was administration safety, that was evaluated through major bleeding or liver toxicity. RESULTS: Rivaroxaban and enoxaparin showed similar results (the differences were not statistically significant when compared for the reduction of DVT incidence till the 36th post-operative day. There was no difference in blood loss and liver toxicity when the drugs were compared. CONCLUSION: In patients submitted to total hip arthroplasty, rivaroxaban showed as effective and safe as enoxaparin to prevent deep venous thrombosis and pulmonary thromboembolism.

  1. The strong but nonspecific relationship between 18F-FDG uptake in the lower-extremity veins and venous thromboembolism

    DEFF Research Database (Denmark)

    Zhu, Hongyun June; Hess, Søren; Rubello, Domenico;

    2016-01-01

    Venous thromboembolism (VTE) can present as deep vein thrombosis (DVT) and/or acute pulmonary embolism (PE). In fluorine-18 fluorodeoxyglucose (F-FDG) PET/CT, F-FDG activity along the deep veins of the lower extremities (LE) is often observed and, unless it is associated with focal intense activity......±101 and 49±82 days, respectively, and the closest and the most remote F-FDG-PET after the VTE event averaged 58±50 and 122±124 days. The extent of uptake in the LE veins averaged 7±2 for the patients with an acute DVT on LE duplex and 5±3 for those with negative or chronic DVT on LE duplex (P...

  2. Lay Stress on Study of Venous Thromboembolism

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2002-01-01

    @@ Venous thromboembolism (VTE) including deep vein thrombosis(DVT) and pulmonary embolism(PE).Its occurs in about 1 per 1 000 individuals per years.Thrombosis is a serious disorder. It may be fatal by PE (case fatality rate of venous thrombosis is estimated at 1% to 2%)(Figure 1 ). A substantial proportion of these deaths occur in the postoperative period, and many events are fatal before diagnosis can be made and therapy initiated. Just as well, the prophylactic treatment of thrombosis is focused on preventing first events and recurrences through adequate knowledge about risks and risk factors.

  3. Assessment of Venous Thrombosis in Animal Models.

    Science.gov (United States)

    Grover, Steven P; Evans, Colin E; Patel, Ashish S; Modarai, Bijan; Saha, Prakash; Smith, Alberto

    2016-02-01

    Deep vein thrombosis and common complications, including pulmonary embolism and post-thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here, we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro-computed tomography, and high-frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition.

  4. Whole genome deep sequencing of HIV-1 reveals the impact of early minor variants upon immune recognition during acute infection.

    Directory of Open Access Journals (Sweden)

    Matthew R Henn

    Full Text Available Deep sequencing technologies have the potential to transform the study of highly variable viral pathogens by providing a rapid and cost-effective approach to sensitively characterize rapidly evolving viral quasispecies. Here, we report on a high-throughput whole HIV-1 genome deep sequencing platform that combines 454 pyrosequencing with novel assembly and variant detection algorithms. In one subject we combined these genetic data with detailed immunological analyses to comprehensively evaluate viral evolution and immune escape during the acute phase of HIV-1 infection. The majority of early, low frequency mutations represented viral adaptation to host CD8+ T cell responses, evidence of strong immune selection pressure occurring during the early decline from peak viremia. CD8+ T cell responses capable of recognizing these low frequency escape variants coincided with the selection and evolution of more effective secondary HLA-anchor escape mutations. Frequent, and in some cases rapid, reversion of transmitted mutations was also observed across the viral genome. When located within restricted CD8 epitopes these low frequency reverting mutations were sufficient to prime de novo responses to these epitopes, again illustrating the capacity of the immune response to recognize and respond to low frequency variants. More importantly, rapid viral escape from the most immunodominant CD8+ T cell responses coincided with plateauing of the initial viral load decline in this subject, suggestive of a potential link between maintenance of effective, dominant CD8 responses and the degree of early viremia reduction. We conclude that the early control of HIV-1 replication by immunodominant CD8+ T cell responses may be substantially influenced by rapid, low frequency viral adaptations not detected by conventional sequencing approaches, which warrants further investigation. These data support the critical need for vaccine-induced CD8+ T cell responses to target more

  5. 人工髋关节置换后深静脉血栓形成影响因素的回顾分析%Retrospective analysis of deep venous thrombotic risk factors in prosthetic hip surgery

    Institute of Scientific and Technical Information of China (English)

    钱文伟; 翁习生; 常晓; 林进; 金今; 张保中; 王炜

    2012-01-01

    背景:目前尚缺少严格遵照进行血栓预防的大宗人工髋关节置换后深静脉血栓栓塞症发生情况的报道.目的:调查人工髋关节置换患者在进行规范预防性抗凝治疗后下肢深静脉血栓的发生情况.方法:纳入2005-01/2010-07于北京协和医院骨科接受人工髋关节置换的患者,对置换后出现下肢深静脉血栓形成者进行回顾性分析,包括高危因素、预防措施、症状特点、治疗方案及转归.结果与结论:共纳入670例人工髋关节置换患者,其中16例发生下肢深静脉血栓,11例为人工股骨头置换患者,5例为单侧全髋关节置换患者.诊断分布为股骨颈骨折14例,股骨头无菌性坏死1例,血友病性关节炎1例.其合并症1~4个,包括高血压、糖尿病、类风湿性关节炎、慢性肾功能不全等.围手术期皆应用规范物理、药物疗法预防下肢深静脉血栓形成.14例表现为下肢肿胀、疼痛;2例以肺栓塞为首发症状.多数预后良好;1例死于与下肢深静脉血栓形成无关的肺部感染,1例抗凝治疗后并发脑出血导致植物生存状态.提示进行规范预防治疗可以降低下肢深静脉血栓形成发生率,但仍不能完全杜绝其发生.髋部骨折、长期卧床、高龄、代谢性内科疾病仍是下肢深静脉血栓形成的高危因素.%BACKGROUND: It is rarely reported that the occurrence of deep venous thromboembolism after artificial hip replacement in the patients group which is strictly complied with “China's major orthopedic surgery venous thromboembolism prevention guidelines”for thromboprophylaxis.OBJECTIVE: To investigate the morbidity of deep venous thrombosis (DVT) in patients who underwent artificial hip replacement for standard prophylactic anticoagulant therapy.METHODS: The data of patients who underwent artificial hip replacement from Department of Orthopedics, Peking Union Medical College Hospital were selected. Then patients who occurred DVT after

  6. Risk Factors and Nursing Methods for Patients Developing Deep Venous Thrombosis and Staying in Bed After Orthopaedic Surgery%骨科术后卧床病人深静脉血栓形成的危险因素及护理对策

    Institute of Scientific and Technical Information of China (English)

    张金荣; 王东辉; 王秀丽; 刘雪丽; 孙亚杰

    2015-01-01

    目的:探讨骨科术后卧床病人深静脉血栓形成的危险因素及相关的护理对策。方法将2013年11月至2014年12月手术后发生深静脉血栓形成的病例60例,进行整理分析资料,找出相关危险因素,统计出发生率。结果脑血管病因素占34%,肿瘤因子占11.67%,创伤严重占34%,患肢静脉输液占8.33%,患肢制动占13.33%。结论骨科术后卧床病人深静脉血栓形成的危险因素中脑血管病因素及创伤严重所占比例最高,要引起高度重视,但是在患肢进行静脉输液这一原因也不可忽视,同时患肢制动也要引起骨科护士的注意,要及时采取相应的措施,减少发生率是主要目的。%Objective To investigate the risk factors and nursing methods for patients developing deep venous thrombosis and sta-ying in bed after orthopaedic surgery.Methods 60 cases with deep venous thrombosis after surgery from November 2013 till Decem-ber 2014 were analyzed, related risk factors found out and the incidence calculated.Result Risk factors include cerebral vascular disease (34%), tumor (11.67%), serious trauma (34%), limb venous infusion (8.33%) and limb braking (13.33%).Con-clusion Among all the factors causing deep venous thrombosis for patients staying in bed after orthopaedic surgery, cerebral vascular disease consists of the highest percentage, which requires close attention.However, limb venous infusion can not be ignored and meanwhile limb brake needs to be cared for by nurses, so that corresponding measures can be taken in time to reduce the incidence of the disease.

  7. Clinical efficient of encircling constriction of superficial femoral vein in the treatment of primary deep venous insufficiency on a report of 187 cases%下肢股浅静脉瓣膜环缩术治疗原发性深静脉瓣膜功能不全187例效果分析

    Institute of Scientific and Technical Information of China (English)

    谷军保; 鲍学斌; 马钊

    2012-01-01

    Objective To evaluate the therapeutic effect of encircling constriction of superficial femoral vein in the treatment of primary deep venous insuficiency(PDVI).Methods From Jan.2004 to Jun.2011,187 patients( 196 lower extremities)with primary deep venous insufficiency were treated with encircling constriction of venous wall at the first pair of superficial femoral venous valve pulse superficial varicose stripping.Results The 183 limbs in 176 patients were followed-up from 7 months to 8 years,with a mean period for 63.5 months.Ninety-four point one percent of the patients were followed up (176/187).Clinical symptomatic improvement achieved in 87.4% ( 160/183 ) of the lower extremities.There was 2.2% ( 4/183 ) of recurrence of the varicose vein,9.3% ( 17/183 ) of light edema,8% ( 2/25 ) of recurrence of ulcer.Conclusion Encircling constriction of superficial femoral vein is an effective method in the treatment of primary deep venous valve insufficiency.%目的 评估应用股浅静脉瓣膜环缩术治疗原发性下肢深静脉瓣膜功能不全的效果.方法 回顾性总结2004年1月至2011年6月,我院187例(196条肢体)原发性下肢深静脉瓣膜功能不全患者采用股浅静脉第一对瓣膜环缩加曲张浅静脉剥脱术治疗的临床资料.结果 176例(183条肢体)术后随访7个月~8年,中位随访时间63.5个月,随访率94.1% (176/187);临床症状明显缓解,疗效良好160条,占随访肢体87.4%( 160/183);术后出现浅静脉曲张复发4条,占2.2% (4/183);轻度肿胀17条,占9.3% (17/183);溃疡复发2条,占8% (2/25).结论 股浅静脉瓣膜环缩术是治疗原发性下肢深静脉瓣膜功能不全的有效方法.

  8. Superficial Venous Thrombosis complicated with Deep Venous Thrombosis in 66 Cases Treated by Inter-nal and External Treatment%内外合治血栓性浅静脉炎并发深静脉血栓形成66例

    Institute of Scientific and Technical Information of China (English)

    姜振; 张玥; 李华文; 张玉冬

    2016-01-01

    目的:观察内外合治血栓性浅静脉炎(SVT)并发深静脉血栓形成(DVT)的疗效。方法:选取66例SVT合并DVT患者,调查其发病的一般资料,给予基础的抗凝、溶栓治疗,并根据中医辨证给予不同汤剂,同时配合马黄酊涂擦和冰硝散外敷,监测D-二聚体、纤维蛋白原水平,用彩超评价静脉再通情况。结果:本组治愈38例,显效23例,有效5例,显愈率92.42%。D-二聚体、纤维蛋白原水平较治疗前降低(P<0.05)。SVT、DVT静脉通畅度评分治疗后14 d分别为(1.06±0.24)、(3.08±2.70),28 d分别为(0.88±0.37)、(2.03±2.0),与治疗前比较显著降低(P<0.01)。结论:静脉曲张和SVT是DVT不可忽视的危险因素。针对SVT合并DVT采取内外合治的中西医结合治疗方案,可取得满意的疗效,明显改善患肢静脉再通情况。%Objective To observe the curative effect of internal and external treatment on superficial ve⁃nous thrombosis(SVT) complicated with deep venous thrombosis(DVT). Methods Sixty-six patients of SVT complicated with DVT were given the treatment of basic anticoagulation, thrombolysis, and different herbal medi⁃cine based on syndrome differentiation. At same time, Mahuang tincture was rubbed and Bingxiao powder agent was used for external application. D-dimer, fibrinogen and vein colour Doppler ultrasonography were periodical⁃ly monitored. Results In this group, 38 cases were cured, 23 cases were markedly effective, 5 cases were ef⁃fective, and the cured and markedly effective rate was 92.42%. D-dimer and fibrinogen were decreased significantly than before treatment(P<0.05). SVT and DVT venous patency score after treatment were 1.06 ± 0.24, 3.08 ± 2.70 at 14 days and 0.88 ± 0.37, 2.03±2.0 at 28 days, respectivelly. There were signifi⁃cant differences compared with before treatment. Conclusion Varicose and SVT are the risk factors of DVT that cannot be ignored. The

  9. Negative spiral CT in acute pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, T.; Olausson, A. [Karolinska Hospital, Stockholm (Sweden). Dept. of Thoracic Radiology; Johnsson, H. [Karolinska Hospital, Stockholm (Sweden). Dept. of Internal Medicine; Nyman, U. [County Hospital, Trelleborg (Sweden). Dept. of Radiology; Aspelin, P. [Huddinge Univ. Hospital (Sweden). Dept. of Radiology

    2002-09-01

    Purpose: To retrospectively evaluate the clinical outcome of non-anticoagulated patients with clinically suspected acute pulmonary embolism (PE) and no symptoms or signs of deep venous thrombosis (DVT) following a negative contrast medium-enhanced spiral CT of the pulmonary arteries (s-CTPA). Material and Methods: During a 24-month period, 739 of 751 patients underwent s-CTPA with acceptable diagnostic quality for clinically suspected acute PE. All patients who had a CT study not positive for PE were followed up with a questionnaire, a telephone interview and review of all medical reports, including autopsies and death certificates for any episodes of venous thromboembolism (VTE) during a 3-month period. Results: PE was diagnosed in 158 patients. Of the remaining 581 patients with a negative s-CTPA, 45 patients were lost to follow-up. 88 patients were excluded because of anticoagulation treatment (cardiac disorder n=32, chronic VTE or acute symptomatic DVT n=31, PE diagnosed at pulmonary angiography n=1, thrombus prophylaxis during diagnostic work-up or other reasons than VTE n=24) and 7 patients undergoing lower extremity venous studies because of symptoms of DVT (all negative). Thus, 441 patients with a negative s-CTPA and no DVT symptoms, venous studies or anticoagulant treatment constituted the follow-up cohort. Four of these patients had proven VTE (all PE) during the 3-month follow-up period. Two of the PE episodes contributed to the patient's death. Conclusion: Patients with clinically suspected acute PE, no symptoms or signs of DVT and a negative single slice s-CTPA using 3-5 mm collimation, may safely be left without anticoagulation treatment unless they are critically ill, have a limited cardiopulmonary reserve and/or if a high clinical suspicion remains.

  10. Recent research on venous thromboembolism in China: a brief report from China Venous Thromboembolism Study Group

    Institute of Scientific and Technical Information of China (English)

    ZHAI Zhen-guo; ZHAN Xi; YANG Yuan-hua; WANG Chen

    2010-01-01

    @@ Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thrombo-embolism (PTE), carries significant mortality and morbidity. As a result of the increasing awareness and improvement in diagnostic facilities, the hospital admissions have increased dramatically in China. Recent publications have reported the increasing incidences of PTE and DVT in hospitalized patients.~(1-3)

  11. 产科剖宫产术后下肢深静脉血栓管理中的危险因素与应对措施分析%Analysis of Risk Factors and Countermeasures of Deep Venous Thrombosis Management after the Obstetrical Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    张小勤; 文飞

    2016-01-01

    Objective To research and discuss the risk factors and countermeasures of deep venous thrombosis manage-ment after the obstetrical caesarean section and provide basis for enhancing postoperative management and predicting, diag-nosing and treating the deep venous thrombosis after the caesarean section. Methods 40 cases of patients with deep venous thrombosis after caesarean section diagnosed and treated in the department of gynaecology and obstetrics of our hospital were selected as the observation group and 40 cases of patients without deep venous thrombosis were selected as the control group, and the observation group implemented risk management model, the control group implemented the general manage-ment measures, and the relevant risk factors of the two groups were observed, compared and analyzed and the corresponding countermeasures were made. Results The body mass index, mental labour profession, complications and plasma D-Dimer level were the independent risk factors of deep venous thrombosis after the caesarean section. Conclusion Active weight control, strengthening exercise, treating complications and other risk factors are vital to enhancing postoperative manage-ment, diagnosing and treating the deep venous thrombosis after the caesarean section, which is worth further promotion and application in clinic.%目的:研究探讨产科剖宫产术后管理中的危险因素与应对措施,为加强术后管理,预防诊治剖宫产术后下肢深静脉血栓等并发症提供依据。方法分别选取于该院妇产科同期住院诊治的40例剖宫产术后合并下肢深静脉血栓患者为观察组及40例剖宫产术后无下肢深静脉血栓患者为对照组,观察与比较分析两组患者管理中出现的相关危险因素并制定应对措施。结果体质量指数、脑力劳动性职业、合并症及血浆D-二聚体水平是导致剖宫产术后出现下肢深静脉血栓的独立危险因素。结论积极控制体重、加强运

  12. Clinical Observation on 16 Cases of Varicose Veins of Lower Extremity with Deep Venous Valve Insufficiency Treated by Chinese Herbs Washing Method%中药泡洗治疗下肢静脉曲张合并深静脉瓣膜功能不全16例临床观察

    Institute of Scientific and Technical Information of China (English)

    吴玉泉

    2011-01-01

    Objective: To observe the clinical effects of varicose veins of lower extremity with deep venous valve insufficiency treated by Chinese herbs washing method. Methods: 16 patients of varicose veins of lower extremity with deep venous valve insufficiency with typical clinical symptoms were selected, using the washing method by self-made Chinese herbal formula to evaluate the clinical effects two months after the treatment. Results: Improvements were made in the clinical symptoms among all patients, with a total 100% effective rate. Conclusion: The Chinese herbs washing method had good effects on symptoms improvement of varicose veins of lower extremity with deep venous valve insufficiency, which made a good attempt on varicose veins of lower extremity treated by external method of traditional Chinese medicine.%目的:探讨中药泡洗治疗下肢静脉曲张合并深静脉瓣膜功能不全的临床疗效.方法:选取16例具有临床典型症状的下肢静脉曲张合并深静脉瓣膜功能不全的患者,以自拟中药方剂进行泡洗治疗,2个月后对临床疗效及临床症状的改善进行评价.结果:所有患者的症状均有所改善,总有效率100%.结论:中药泡洗对下肢静脉曲张合并深静脉瓣膜功能不全的症状改善具有较好的效果,在下肢静脉曲张的中医外治方面作出了有益的尝试.

  13. Compensatory dilatation of the Azygos Venous system Secondary To Superior Vena Cava Occlusion.

    Science.gov (United States)

    Paoletti, Francesco; Pellegrino, Valeria; Antonelli, Melissa; Ripani, Umberto; Mosca, Stefano; Durì, Davide; Galzerano, Antonio

    2009-01-01

    Superior vena cava (SVC) occlusion can be clinically recognized in the acute setting when the stenosing process does not allow the development of collateral venous channels, which guarantee the venous drainage to the right heart. On the contrary, when the obstruction develops progressively, the diagnosis of SVC obstruction may remain undiagnosed. In the present case, the presence of SVC thrombosis was purely coincidental. In fact, the obstruction was first noticed on diagnostic tests performed because of the malfunction of a totally implantable Porth a Cath placed into the superior vena cava (through right subclavian access), five years before, in a patient suffering from non-Hodgkin disease. Venography is the most appropriate diagnostic methodology which reveals the presence of a dilated azygos vein as a compensatory mechanism. Comparison with computed tomography allows to confirm the diagnosis and to identify the possible causes. Dilatation of the azygos vein, secondary to superior vena cava thrombosis, although a rare event, should be taken into consideration in those patients with CVC and who present with frequent episodes of deep venous thrombosis.

  14. Lifestyle and venous thrombosis

    NARCIS (Netherlands)

    Pomp, Elisabeth Rebekka

    2008-01-01

    In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA study), a large population-based case-control study, we investigated lifestyle factors as risk factors for venous thrombosis. Overweight, smoking and alcohol consumption were addressed and pregnancy and

  15. 514例下肢深静脉血栓形成的发病因素分析%Etiologic Factors Analysis in 514 Cases of Lower Extremity Deep Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    张榜; 崔炎; 周斯

    2013-01-01

      Objective To understand the clinical characteristics of deep venous thrombosis (DVT) and its associated risk factors. Methods Retrospective analysis of the clinical data of 514 cases of DVT. Results DVT usually involved the left limbs of people between 20 to 30 years old. The incidence of women was higher than that of men in the same age (P<0.01). The common risk factors contains: age≥40 years (74.9%), smoking (47.86%), surgery(21.21%), prolonged bed rest or little activity(17.12%), trauma or fractures(14.4%), obesity (9.53%), pregnancy or postpartum(8.95%), tumor(6.03%),etc. Conclusion DVT is a disease implicating many synergistic factors, early detection and prevention of risk factors can reduce the incidence of DVT.%  目的:了解下肢深静脉血栓形成(DVT)发病的临床特点及相关的危险因素。方法:对514例DVT患者的临床资料进行回顾性分析。结果:DVT易累及左侧肢体,女性20~30岁发病率大于同年龄段男性(P<0.01),常见的危险因素有年龄≥40岁(74.9%)、吸烟(47.86%)、手术(21.21%)、长期卧床或少活动(17.12%)、外伤或骨折(14.4%)、肥胖(9.53%)、妊娠/产后(8.95%)、肿瘤(6.03%)等。结论:DVT是一种多因素协同参与的疾病,早期发现危险因素和早期预防可以降低DVT的发病率。

  16. Reason Analysis and Prevention Methods of Deep Venous Thrombosis after Major Orthopedic Surgery%骨科大手术后下肢深静脉血栓形成的原因分析及防治方法研究

    Institute of Scientific and Technical Information of China (English)

    唐旭

    2014-01-01

    To investigate reason analysis and prevention methods of deep venous thrombosis after major orthopedic surgery.Methods:80 cases of patients underwent major orthopedic surgery in our hospital from February 2011 to February 2013,the patients were randomly divided into prevention group and control group,with 40 cases in each group.The control group was given conventional therapy,and the prevention group was given targeted prevention measures on the basis of the control group.The incidence of deep venous thrombosis and satisfaction degree of patients after major orthopedic surgery were compared.Results:The incidence of deep venous thrombosis of the prevention group was 2.5%,and the incidence of deep venous thrombosis of the control group was 12.5%.The two groups of patients with deep vein the incidence of thrombosis significant difference(P<0.05),with statistical significance.The limb swelling degree of experimental group post-treatment was improved significantly than control group (P<0.05).The satisfaction degree of the prevention group was 97.5%,and the satisfaction degree of the control group was 75.0%.The two groups of patients with deep vein the incidence of thrombosis significant difference(P<0.05),with statistical significance.Conclusion:To take effective preventive measures actively can significantly reduce the incidence of deep venous thrombosis after major orthopedic surgery will be worthy of popularization and application.%目的:探讨骨科大手术后下肢深静脉血栓形成的原因分析及防治方法。方法:选取我院自2011年2月~2013年2月收治的80例行骨科大手术患者,按照随机数字表法分为防治组和对照组各40例,对照组给予常规治疗,防治组在对照组基础上给予针对性防治措施,对两组患者术后下肢深静脉血栓发生率及满意度进行比较。结果:防治组下肢深静脉血栓发生率为12.5%,对照组下肢深静脉血栓发生率为45.0%,两组患者术后下肢

  17. Deep vein thrombosis.

    Science.gov (United States)

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  18. Contribution of recurrent venous thrombosis and inherited thrombophilia to the pathogenesis of postthrombotic syndrome.

    Science.gov (United States)

    Kreidy, Raghid

    2015-01-01

    Postthrombotic syndrome (PTS) is a common complication of deep vein thrombosis. This study aims to assess the role of recurrent venous thrombosis and inherited thrombophilia in the pathogenesis of PTS. A series of 206 patients diagnosed with lower extremity venous thrombosis were retrospectively reviewed. The PTS was observed in 30.58% of the patients. Recurrent venous thrombosis was identified in 3.4% of the patients without PTS and in 33.3% of patients with PTS (P thrombophilia alone or in association with recurrent venous thrombosis was more commonly detected when PTS was moderate to severe (P = .04 and thrombophilia is present either alone or in association with recurrent venous thrombosis.

  19. Multiple venous thrombosis complicating central venous cannulation in a non cancer patient - a case report.

    Science.gov (United States)

    Peters, Ce; Menkiti, Id; Desalu, I; Thomas, Mo

    2013-01-01

    Central venous catheterization is a common procedure for critically ill patients. Like all procedures, it has its complications, one of which is thrombosis. Reports of thrombosis are commoner among cancer patients. We present a 37 year old non cancer patient who developed thrombi in both right and left internal jugular veins, 10 and 13 days respectively after insertion of central venous catheter. This was detected by ultrasound scans of the neck while attempting re-cannulation for parenteral feeding. She also had left lower limb deep venous thrombosis, confirmed by doppler scan, which was managed with low molecular weight heparin and warfarin. The patient was subsequently treated with streptokinase. A repeat scan of the internal jugular veins 4 days after thrombolysis revealed a reduction in size of the thrombi. Symptoms of deep venous thrombosis improved and she was transferred to the wards where she made remarkable improvement. This case illustrates the potential usefulness of ultrasound guided-central line insertion in patients who have had central venous lines inserted previously in order to detect thrombi.

  20. Developmental Venous Anomaly With Asymmetrical Basal Ganglia Calcification: Two Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sarp

    2015-07-01

    Full Text Available Developmental venous anomaly (DVA is a common lesion formerly known as venous angioma. DVAs drain normal brain parenchyma; however, parenchymal abnormalities surrounding DVAs have been reported. Unilateral putamen and caudate calcification in the drainage territory of DVAs has so far been reported in 7 cases, all with deep venous drainage. We present two additional cases of DVAs, one with superficial and the other one with deep venous drainage, associated with basal ganglia calcifications. We emphasize that DVAs should be in the differential diagnosis of unilateral basal ganglia calcifications.

  1. Microbial biofilms on needleless connectors for central venous catheters: comparison of standard and silver-coated devices collected from patients in an acute care hospital.

    Science.gov (United States)

    Perez, Elizabeth; Williams, Margaret; Jacob, Jesse T; Reyes, Mary Dent; Chernetsky Tejedor, Sheri; Steinberg, James P; Rowe, Lori; Ganakammal, Satishkumar Ranganathan; Changayil, Shankar; Weil, M Ryan; Donlan, Rodney M

    2014-03-01

    Microorganisms may colonize needleless connectors (NCs) on intravascular catheters, forming biofilms and predisposing patients to catheter-associated infection (CAI). Standard and silver-coated NCs were collected from catheterized intensive care unit patients to characterize biofilm formation using culture-dependent and culture-independent methods and to investigate the associations between NC usage and biofilm characteristics. Viable microorganisms were detected by plate counts from 46% of standard NCs and 59% of silver-coated NCs (P=0.11). There were no significant associations (P>0.05, chi-square test) between catheter type, side of catheter placement, number of catheter lumens, site of catheter placement, or NC placement duration and positive NC findings. There was an association (P=0.04, chi-square test) between infusion type and positive findings for standard NCs. Viable microorganisms exhibiting intracellular esterase activity were detected on >90% of both NC types (P=0.751), suggesting that a large percentage of organisms were not culturable using the conditions provided in this study. Amplification of the 16S rRNA gene from selected NCs provided a substantially larger number of operational taxonomic units per NC than did plate counts (26 to 43 versus 1 to 4 operational taxonomic units/NC, respectively), suggesting that culture-dependent methods may substantially underestimate microbial diversity on NCs. NC bacterial communities were clustered by patient and venous access type and may reflect the composition of the patient's local microbiome but also may contain organisms from the health care environment. NCs provide a portal of entry for a wide diversity of opportunistic pathogens to colonize the catheter lumen, forming a biofilm and increasing the potential for CAI, highlighting the importance of catheter maintenance practices to reduce microbial contamination.

  2. Computed Tomograpy Venography diagnosis of iliocaval venous obstruction in advanced chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Fabio Henrique Rossi

    2014-12-01

    Full Text Available Objective:Iliocaval obstruction is associated with venous hypertension symptoms and may predispose to deep venous thrombosis (DVT. Ultrasonography may fail to achieve noninvasive diagnosis of these obstructions. The possibility of using Computed Tomography Venography (CTV for these diagnoses is under investigation.Methods:Patients with CVI graded at CEAP clinical classes 3 to 6 and previous treatment failure underwent evaluation with CTV. Percentage obstruction was rated by two independent examiners. Obstruction prevalence and its associations with risk factors and CEAP classification were analyzed.Results:A total of 112 limbs were prospectively evaluated. Mean patient age was 55.8 years and 75.4% were women. Obstructions involved the left lower limb in 71.8% of cases and 35.8% of patients reported a medical history of deep venous thrombosis. Overall, 57.1% of imaging studies demonstrated venous obstruction of at least 50% and 10.7% showed obstruction of >80%. The only risk factor that was found to be independently associated with a significantly higher incidence of >50% venous obstruction was a medical history of DVT (p=0.035 (Fisher's exact test. There was a positive relationship between clinical classification (CEAP and degree of venous obstruction in the limbs studied (Chi-square test for linear trend; p=0.011.Conclusion:Patients with advanced CVI are often affected by obstructions in the iliocaval venous territory and CTV is able to diagnose the degree of obstruction. There is a positive association between degree of obstruction and both previous history of DVT and severity of symptoms of CVI.

  3. 下肢深静脉血栓发病风险的临床等级评估%Clinical grading of risk factors for deep venous thrombosis in lower extremity

    Institute of Scientific and Technical Information of China (English)

    李娟; 李俊来; 高德伟; 万文博; 刘小平; 唐杰

    2013-01-01

      目的分析下肢深静脉血栓(lower extremity deep vein thrombosis,LDVT)发病风险因素,尝试建立下肢深静脉血栓发病风险的临床评分分级系统.方法回顾性分析我院2010年10月1日-11月30日疑似下肢深静脉血栓的各科住院患者共677例,对11项风险因素进行等级评估,计算每项风险因素的OR值及赋值,对每位研究对象进行综合评分,建立量化分级系统.结果发病因素评分为2、3、4、5、6、7、8、9、10、11、12分的各组中,血栓发生构成比分别为11.34%、12.63%、18.18%、26.23%、30.65%、36.84%、40.31%、52.08%、57.78%、64.44%、81.58%.通过ROC曲线得出7分为区分血栓和未出现血栓的最佳界点.初步建立分级系统≤3分为低度可疑LDVT,4~6分为中度可疑LDVT,≥7分为高度可疑LDVT.结论本研究建立的LDVT风险评分系统能够为临床评价LDVT发病危险程度提供初步较可靠的依据.%Objective To analyze the risk factors for lower extremity deep venous thrombosis (LDVT) and establish its clinical scoring system. Methods Clinical data about 677 patients with suspected LDVT in lower extremity admitted to our hospital from October 2010 to November 2010 were retrospectively analyzed. Eleven risk factors were assessed according to their grading. OR value of each factor was calculated. A quantitative grading system was established according to the comprehensive score of each patient. Results The incidence of LDVT in lower extremity was 11.34%, 12.63%, 18.18%, 26.23%, 30.65%, 36.84%, 40.31%, 52.08%, 57.78%, 64.44%, and 81.58%respectively in the patients with a risk factor score of 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12. A score of 7 as shown on ROC curve could show the best point in lower extremity with or without LDVT. A grading system with a score≤3, 4-6 and≥7 was established for mild, moderate and severe LDVT, respectively. Conclusion The LDVT risk scoring system we established in this study can provide preliminary

  4. Effect of comprehensive nursing on deep venous thrombosis after operation in hip fracture patients%综合护理措施对髋部骨折患者术后深静脉血栓的影响分析

    Institute of Scientific and Technical Information of China (English)

    王海燕

    2014-01-01

    目的:探讨综合护理措施对预防髋部骨折患者术后深静脉血栓(DVT)形成的效果。方法将105例髋部骨折手术患者随机分成观察组53例及对照组52例,对照组实施围术期常规护理,观察组在常规护理的基础上实施综合护理,比较2组患者疾病知识知晓率、健康行为依从率、术后深静脉血栓形成发生率、下肢疼痛及肿胀发生率、住院天数。结果观察组疾病知识知晓率、治疗依从率及坚持功能锻炼率均显著高于对照组(P <0.01);术后 DVT 发生率、下肢疼痛及肿胀发生率、住院天数均显著低于对照组(P <0.05或 P <0.01)。结论综合护理措施能够有效提高患者疾病知识知晓率及健康行为依从率,降低术后 DVT 形成及下肢疼痛、肿胀发生率,从而促进康复进程、缩短住院时间。%Objective To study the effect of comprehensive nursing on deep venous throm-bosis after operation in hip fracture patients.Methods 105 patients with hip fracture surgery were divided into observation group (53 patients)and control group (52 patients).The control group was given routine nursing while the observation group was given comprehensive nursing.Aware of knowledge about diseases,compliance rate of health behavior,incidence of postoperative deep vein thrombosis (DVT),the incidence rate of lower limb pain and swelling and hospitalization time were compared.Results Knowledge about the disease,treatment compliance rate,persistence rate of functional exercise in the observation group were significantly higher than that of control group (P <0.01).Postoperative DVT,lower limb pain and swelling and hospitalization time were significantly lower than that in the control group (P <0.05 or P <0.01).Conclusion Compre-hensive nursing intervention can effectively improve disease awareness of patients and health behav-ior compliance rate,reduce the incidence rate of postoperative DVT formation as

  5. The correlation between the color Doppler ultrasonography and the TCM syndrome differentiation typing of primary deep venous insufficiency in lower limb%彩色多普勒超声表现与原发性下肢深静脉瓣膜功能不全辨证分型的相关性

    Institute of Scientific and Technical Information of China (English)

    赵晖; 刘艳; 王朝歆; 杨玲

    2012-01-01

    Objective: To investigate the correlation between the color Doppler ultrasonography and the TCM syndrome differen -tiation typing of primary deep venous insufficiency in lower limb. Methods:608 cases with primary deep venous insufficiency in lower limb were divided into two groups according to the TCM syndrome differentiation typing :syndrome of spleen deficiency with dampness retention group (group A)and the syndrome of damp-heat downward diffusion group (group B). They all had the color Doppler ultrasonography ;and the vein diameter ,the venous flow rate ,the venous reflux time and the reflux rate were ob -served. Results :The spleen deficiency with dampness was characterized as the normal vein diameter and venous flow rate ,the reflux time of less than 2 s ,the reflux rate of less than 30 cm/s and the involvement of a group of valve ;while the dampness-heat diffusing downward was characterized as the increased vein diameter ,the normal venous flow rate and the reflux time of more than 4 s ,the reflux rate of more than 30 cm/s and the involvement of more than two groups of valve. Conclusions :The color Doppler ultrasonography is highly correlated with the TCM syndrome differentiation typing of primary deep venous insufficien -cy in lower limb.%目的:探讨彩色多普勒超声表现与原发性下肢深静脉瓣膜功能不全中医辨证分型的相关性.方法:对550 例(608条)原发性下肢深静脉瓣膜功能不全患者按中医辨证分为2组:脾虚湿阻证组和湿热下注证组,分别行彩色多普勒超声检查,观察2组静脉管径、流速、返流的时间、返流速度.结果:脾虚湿阻证组的静脉管径、静脉流速均在正常范围,返流时间多小于2 s,返流速度多小于30 cm/s,病变多累及1组瓣膜;湿热下注证组表现为静脉管径增宽、静脉流速在正常范围、返流时间多大于4 s,返流速度多大于30 cm/s,病变多累及2组以上瓣膜.结论:彩色多普勒超声表现与原发性下肢深

  6. Epidemiology and Risk Factors for Venous Thrombosis

    OpenAIRE

    Cushman, Mary

    2007-01-01

    Venous thrombosis, including deep vein thrombosis and pulmonary embolism, occurs at an annual incidence of about 1 per 1000 adults. Rates increase sharply after around age 45 years, and are slightly higher in men than women in older age. Major risk factors for thrombosis, other than age, include exogenous factors such as surgery, hospitalization, immobility, trauma, pregnancy and the puerperium and hormone use, and endogenous factors such as cancer, obesity, and inherited and acquired disorde...

  7. Feasibility and safety of rehabilitation after venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Noack F

    2015-07-01

    Full Text Available Frank Noack,1,2 Bernd Schmidt,1 Mroawan Amoury,2 Dietrich Stoevesandt,3 Stephan Gielen,4 Birgit Pflaumbaum,5 Christiane Girschick,5 Heinz Völler,6 Axel Schlitt5,7 1Department of Medicine I, 2Department of Emergency Medicine, 3Department of Diagnostic Radiology, 4Department of Medicine III, University Clinic Halle (Saale, Halle, Germany; 5Department of Cardiology and Pulmology, Paracelsus-Harz-Clinic Bad Suderode, Quedlinburg, Germany; 6Klinik am See, Rüdersdorf, Germany; 7Medical Faculty, Martin Luther University Halle, Wittenberg, Germany Background: Venous thromboembolism is a life-threatening disease. In survivors, different degrees of functional complaints need to be restored or prevented (eg, post-thrombotic syndrome, pulmonary hypertension. Therefore, rehabilitation after venous thromboembolism is recommended in Germany. However, a structured rehabilitation program has not been defined for this indication. Here, we present the experience of a single rehabilitation center. Methods: Data from consecutive pulmonary embolism (PE patients who were referred for a 3-week inpatient rehabilitation program from 2006 to 2014 were retrospectively evaluated. Results: In all, 422 patients were identified. The mean age was 63.9±13.5 years, the mean body mass index (BMI was 30.6±6.2 kg/m2, and 51.9% were female. Deep vein thrombosis according to PE was known for 55.5% of all patients. We applied a wide range of therapeutic interventions such as bicycle training with monitored heart rate in 86.7%, respiratory training in 82.5%, aquatic therapy/swimming in 40.1%, and medical training therapy in 14.9% of all patients. Adverse events (AEs occurred in 57 patients during the 3-week rehabilitation period. The most common AEs were cold (n=6, diarrhea (n=5, and infection of the upper or lower respiratory tract that was treated with antibiotics (n=5. However, three patients under anticoagulation therapy suffered from bleeding, which was clinically relevant in

  8. Idiopathic venous thromboembolism and thrombophilia

    OpenAIRE

    Sinescu, C; Hostiuc, M; Bartos, D.

    2011-01-01

    During the past decade idiopathic venous thromboembolism has become a separate entity, a chronic illness which has required prolonged anticoagulation and other prevention strategies to avoid recurrences. This article reviews recent developments regarding unprovoked venous thromboembolism and its relation with thrombophilia. In the beginning, the latest definition of idiopathic venous thromboembolism is presented. The article continues with statistics about thrombophilia, related venous thromb...

  9. Brief discussion of influencing factors and ursing intervention for femoral venous catheterization-related lower extremity deep vein thrombosis%浅谈股静脉置管相关的下肢深静脉血栓形成的影响因素及护理干预

    Institute of Scientific and Technical Information of China (English)

    丛文青

    2015-01-01

    Occurrence of femoral venous catheterization-related lower extremity deep vein thrombosis (DVT) is affected by multiple factors. Correct cognition of thrombosis by nurse, individual difference of patients, nursing health education, maintenance of catheter are all the important factors. Therefore, implement of comprehensive nursing intervention measures provides active and effective effect in reducing incidence of femoral venous catheterization-related lower extremity deep vein thrombosis.%股静脉置管相关的下肢深静脉血栓(DVT)的发生受多种因素影响。护士对血栓形成的正确认知、患者个体差异、护理健康教育、导管的维护等各个环节都起着至关重要的作用。因此,采取全面的护理干预措施,对降低股静脉置管相关的下肢深静脉血栓的发生率,起着积极、有效的作用。

  10. The Saudi Clinical Practice Guideline for the treatment of venous thromboembolism

    Science.gov (United States)

    Al-Hameed, Fahad M.; Al-Dorzi, Hasan M.; Al-Momen, Abdulkarim M.; Algahtani, Farjah H.; Al-Zahrani, Hazzaa A.; Al-Saleh, Khalid A.; Al-Sheef, Mohammed A.; Owaidah, Tarek M.; Alhazzani, Waleed; Neumann, Ignacio; Wiercioch, Wojtek; Brozek, Jan; Schünemann, Holger; Akl, Elie A.

    2015-01-01

    Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is commonly encountered in daily clinical practice. After diagnosis, its management frequently carries significant challenges to the clinical practitioner. Treatment of VTE with the inappropriate modality and/or in the inappropriate setting may lead to serious complications and have life-threatening consequences. As a result of an initiative of the Ministry of Health of the Kingdom of Saudi Arabia, an expert panel led by the Saudi Association for Venous Thrombo-Embolism (a subsidiary of the Saudi Thoracic Society) and the Saudi Scientific Hematology Society with the methodological support of the McMaster University Guideline working group, this clinical practice guideline was produced to assist health care providers in VTE management. Two questions were identified and were related to the inpatient versus outpatient treatment of acute DVT, and the early versus standard discharge from hospital for patients with acute PE. The corresponding recommendations were made following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. PMID:26219456

  11. Venous thromboembolism in cancer patients

    Directory of Open Access Journals (Sweden)

    Mehmet Fuat Eren

    2013-09-01

    Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

  12. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  13. Central venous catheter - flushing

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - dressing change Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/22/2016 Updated by: ...

  14. 烧伤患者深静脉血栓发生情况及其影响因素%Prevalence of deep venous thrombosis in burn patients and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    高凤英; 习耀锋; 郑明霞; 乔芬

    2016-01-01

    Objective To investigate the prevalence of deep venous thrombosis (DVT) in burn patients,and to explore its influencing factors.Methods Clinical data of 2 506 burn patients admitted to our ward from January 2009 to January 2014,conforming to the study criteria,were retrospectively analyzed.Patients were divided into DVT group (n =26) and non-DVT group (n =2 480) according to whether or not DVT occurred during hospitalization.The incidence of DVT was calculated.The diagnosis time and type of DVT were recorded.The data of gender,age,depth of burn,total burn area,location of injury,cause of injury,infection of wound,venous transfusion of fluid (hypertonic solution and blood),location of intravenous catheterization,skin grafting,timing of first skin grafting after injury,D-dimer,bedridden duration after injury among patients between two groups were compared with chi-square test and Wilcoxon test.Indexes with statistically significant differences between two groups were selected,and they were processed with multivariate logistic stepwise regression analysis to screen the independent risk factors of DVT.Results (1) The incidence of DVT was 1.04% (26/2 506).The diagnosis time of DVT was 16-62(40 ± 12)d,and patients diagnosed as having DVT after the 20th day post injury accounted for 92.3% (24/26).All DVT occurred in lower limbs,with 1 case of central type,24 cases of peripheral type,and 1 case of mixed type.(2) There were no statistically significant differences in gender,location of injury (upper limbs,trunk,head and face),cause of injury,jugular vein catheterization,skin grafting,and timing of first skin grafting after injury among patients between two groups (withx 2 values from 1.853 to 3.742,Z =3.342,P values above 0.05).There were statistically significant differences in age,depth of burn,total burn area,burn in lower limbs,infection of wound,venous transfusion of hypertonic solution and blood,femoral vein and subclavian vein catheterization

  15. Venous Thromboembolism and Risk of Idiopathic Interstitial Pneumonia A Nationwide Study

    DEFF Research Database (Denmark)

    Sode, Birgitte Margareta; Dahl, Morten; Nielsen, Sune Fallgaard;

    2010-01-01

    Danish registries. Measurements and Main Results: Age-standardized incidence rates per 10,000 person-years for idiopathic interstitial pneumonia were higher among those ever diagnosed with venous thromboembolism (1.8; n = 158,676), pulmonary embolism (2.8; n = 70,586), and deep venous thrombosis only (1...... embolism, and 1.3 (95% CI, 1.2-1.4) in those ever diagnosed with deep venous thrombosis only, compared with control subjects. Corresponding hazard ratios in those ever diagnosed with venous thromboembolism stratified in those ever and never treated with anticoagulants were 1.4(95% CI, 1.2-1.6) and 2.8 (95......Rationale: Idiopathic interstitial pneumonia is characterized by pulmonary fibrosis and high mortality. Objectives: We examined the association between ever-diagnosed venous thromboembolism and risk of incident idiopathic interstitial pneumonia. Venous thromboembolism was taken as a proxy...

  16. Follow-up Study of Thermotherapy with Traditional Chinese Medicine to Prevent Deep Venous Thrombosis with Stroke%中药烫熨预防脑卒中下肢深静脉血栓形成随访研究

    Institute of Scientific and Technical Information of China (English)

    陈丹; 梁妮; 王棕可

    2011-01-01

    目的:研究中药烫熨预防脑卒中后下肢深静脉血栓形成治疗3个月后评分.方法:(1)对象:2008年3月一2009年8月广西中医学院第一附属医院神经内科的住院脑卒中患者共284名.(2)方式:缺血性脑卒中188例,随机分常规治疗组、低分子肝素组、热疗组、中药烫熨组干预,出血性脑卒中96例随机分入常规治疗组、热疗组、中药烫熨组干预.疗程均为10天.3个月后随访.(3)评价:评分.结果:缺血性脑卒中入组情况4组相似(P>0.05),3个月随访,中药烫熨组评分高于常规治疗组和热疗组(P<0.05),且有显著差异.与低分子肝素组无明显差别(P>0.05).出血性脑卒中入组情况3组相似(P>0.05),3个月随访,中药烫熨组评分高于常规治疗组和热疗组(P<0.05),且有显著差异.结论:中药烫熨可有效提高患者病后的生活质量,有助患者进行康复治疗,降低致残率.且无严重不良反应,值得推广使用.%Objective: Study of "ADL" score 3 months after treatment, that was thermotherapy with traditional chinese medicine to prevent deep venous thrombosis with stroke. Method: 284 cases with stroke admitted to the department of neurology in the first affiliated hospital of Guangxi traditional Chinese medicine university between March 2008 and August 2009 were consecutively investigated. 188 patients with cerebral arterial thrombosis were randomly divided into conventional therapy group, thermotherapy group, Low Molecular Heparin group, thermotherapy with traditional Chinese medicine group. 96 cases of cerebral arterial thrombosis were randomly divided into conventional therapy group, thermotherapy group,thermotherapy with traditional Chinese medicine group. Course of treatment were 10 day. "ADL" score was given after follow-up 3 months later. Results: The cases of cerebral arterial thrombosis were similar pretreatment ( P>0.05 ). "ADL" score of thermotherapy with traditional Chinese medicine group was higher

  17. Effect of Different Anesthesia on Deep Venous Thrombosis after Orthopedic Surgery%不同麻醉方法对骨科手术患者深静脉血栓形成的影响

    Institute of Scientific and Technical Information of China (English)

    姚杰; 孟尽海; 王文娟; 刘斐; 吴燕; 王春生

    2013-01-01

    Objective To investigate the effects of different anesthesia on deep venous thrombosis (DVT) after orthopedic surgery. Methods Charts from consecutive patients who underwent orthopedic surgery from January 1 , 2008, to December 31 , 2010, at a large Chinese teaching hospital were reviewed using standardized case report forms. The incidence of DVT after orthopedic surgery in general anesthesia, spinal - epidural anesthesia and regional block anesthesia were compared. Results This investigation included 4892 patients and 204 patients developed DVT (incidence = 4.17% ). The incidence of DVT in the group of general anesthesia was higher than in those of spinal - epidural anesthesia, regional block anesthesia and no anesthesia (P 0.05). The counts of white blood cell, neutrophil and monocyte of the group after general anesthesia were higher than those of spinal - epidural anesthesia and regional block anesthesia(P<0. 05 ). Conclusion The incidence of DVT in the group of general anesthesia is higher than spinal -epidural anesthesia. In addition, regional block anesthesia and no anesthesia were similar. Inflammatory cell in the group of general anesthesia are higher than that in group of spinal - epidural anesthesia, regional block anesthesia and no anesthesia.%目的 研究不同麻醉方法对深静脉血栓(DVT)的影响.方法 以4892例骨科住院患者病例资料为研究对象进行回顾性分析,比较全身麻醉组、椎管内麻醉组、区域阻滞组DVT的发生率.结果 4892例患者中204例发生DVT,总发生率为4.17%,全麻组DVT的发生率高于椎管内组、区域阻滞组和未行麻醉组(P<0.01);椎管内组DVT的发生率高于区域阻滞组(P<0.05).区域阻滞组和未行麻醉组DVT的发生率相当,差异无统计学意义(P>0.05).全身麻醉组患者术后白细胞、中性粒细胞、单核细胞计数高于椎管内麻醉组和区域阻滞麻醉组(P<0.05).结论 全身麻醉后患者深静脉血栓的发生率最高,

  18. 妊娠合并深静脉血栓形成的病因及临床治疗%Risk factors and therapeutic strategies of deep venous thrombosis during pregnancy

    Institute of Scientific and Technical Information of China (English)

    王劲松; 胡作军; 徐向东; 殷恒讳; 吕伟明; 李晓曦; 王深明

    2010-01-01

    目的 探讨妊娠合并深静脉血栓形成(DVT)的病因和治疗措施.方法 回顾性分析中山大学附属第一医院1991-2010年29例住院妊娠合并DVT患者的临床资料,从诱因、病变部位、治疗方法 、预后以及妊娠情况进行分析.结果 DVT在早期妊娠期的发生率为69.0%(20/29).首位诱因为既往DVT病史,占所有诱发因素的24%(7/29);发生多左下肢,发生率为82.8%(24/29).抗凝是治疗的主要原则,首诊均采用肝素或低分子肝素(LMWH)抗凝治疗.7例患者一直采用LMWH治疗直至分娩前,胎儿发育正常;11例早期、2例中期患者于妊娠中期改为口服华法令,至孕34周左右改为LMWH,其中4例胎儿死亡,其余胎儿发育正常;9例早期患者选择终止妊娠.结论 出于孕妇和胎儿的安全考虑,妊娠DVT的治疗与一般DVT患者不同,LMWH或肝素抗凝是妊娠DVT治疗的安全有效措施.临床工作中应重视该疾病治疗的特殊性.%Objective To summarize the epidemiology and risk factors of deep venous thrombosis (DVT) during pregnancy and develop therapeutic strategies. Methods Twenty-nine pregnant women with DVT were admitted into our hospital between 1991 and 2010. And their clinical data were retrospectively reviewed. Results Among all cases, the occurrence (69%, 20/29) of DVT in the first trimester was highest as compared with those in the second and third trimesters. A previous history of DVT was a leading risk factor ( 24%, 7/29 ) . Twenty-four cases ( 82. 8%, 24/29 ) involved left lower extremities.Anticoagulation was the primary therapy. All cases were initially intravenously administrated with unfractioned heparin (UFH) or injected subcutaneously with low-molecule-weight heparin (LMWH).LMWH continued throughtout pregnancy in 7 cases. The fetus had a normal development. Due to financial problems, 11 cases in the first trimester and 2 cases in the second trimester switched to oral warfarin from LMWH after the initial treatment. And

  19. Mesenteric venous thrombosis after prolonged air travel-a case report

    Institute of Scientific and Technical Information of China (English)

    Joaqun Salas-Coronas; Jos L Serrano-Carrillo; Ana B Lozano-Serrano; Jos C Snchez-Snchez; Leticia Miras-Lucas; Rosario Prez-Moyano

    2014-01-01

    We present a case of acute mesenteric venous thrombosis after a long distance flight in a traveller presenting with abdominal pain, diarrhoea and vomiting within 48 h of prolonged immobility situation. Venous thrombosis in the lower limbs and venous thromboembolism has been clearly associated with prolonged air travel (economy class syndrome). Thrombosis was diagnosed by computed tomography of the abdomen, and after starting anticoagulant therapy with acenocumarol, symptoms yielded completely in a few weeks. The study of thrombophilia was negative, although the existence of two first-degree relatives (mother and grandmother) with a history of venous thrombosis with a history of venous thrombosis makes it likely a situation of inherited thrombophilia. Although exceptional, mesenteric venous thrombosis should be considered in travellers with acute abdominal pain after prolonged air travel when there are thrombophilic conditions.

  20. Mesenteric venous thrombosis after prolonged air travel-a case report

    Directory of Open Access Journals (Sweden)

    Joaquín Salas-Coronas

    2014-07-01

    Full Text Available We present a case of acute mesenteric venous thrombosis after a long distance flight in a traveller presenting with abdominal pain, diarrhoea and vomiting within 48 h of prolonged immobility situation. Venous thrombosis in the lower limbs and venous thromboembolism has been clearly associated with prolonged air travel (economy class syndrome. Thrombosis was diagnosed by computed tomography of the abdomen, and after starting anticoagulant therapy with acenocumarol, symptoms yielded completely in a few weeks. The study of thrombophilia was negative, although the existence of two first-degree relatives (mother and grandmother with a history of venous thrombosis with a history of venous thrombosis makes it likely a situation of inherited thrombophilia. Although exceptional, mesenteric venous thrombosis should be considered in travellers with acute abdominal pain after prolonged air travel when there are thrombophilic conditions.

  1. Arterial and Venous Thrombosis in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Andrew D. Blann

    2011-01-01

    Full Text Available The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin, especially in high risk groups (such as those who are immobile and on high dose chemotherapy, may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.

  2. Effect of continuous venous-venous hemofiltration on patients with severe acute pancreatitis and nursing%连续静-静脉血液滤过对重症急性胰腺炎患者的疗效分析及护理干预

    Institute of Scientific and Technical Information of China (English)

    张志兰; 徐建婷; 苏冰连; 谢月霞

    2011-01-01

    目的 观察连续静-静脉血液滤过(CVVH)治疗重症急性胰腺炎(SAP)的治疗作用及监护措施.方法 将2004年8月至2006年8月15例SPA患者作为对照组,2006年9月至2010年8月20例SPA患者为观察组,对照组采用常规治疗方法,观察组在常规治疗的基础上,采用连续床边血液滤过,观察2组患者治疗前后体温、心率、呼吸、血压及精神症状和腹部体征,监测肝肾功能,并进行APACHEⅡ评分.结果 观察组治疗后体温、心率、呼吸、血压、腹部症状、临床指标、APACHE Ⅱ评分与对照组比较差异显著,观察组治疗10 d后多器官功能障碍综合征(MODS)、多器官功能衰竭(MOF)的发生率明显低于对照组.结论 采用连续静-静脉血液滤过可早期纠正SAP引起的全身炎性反应,改善全身状况,并能有效防止并发症的发生,正规的技术操作及精心护理能保证CVVH顺利进行,减少CVVH引起的并发症.%Objective To observe continuous venous-venous hemofiltration (CVVH) for treatments and cares of severe acute pancreatitis(SAP). Methods From August 2004 to August 2006, 15 cases with SAP were in conventional treatment (the control group), from September 2006 to August 2010, 20 cases with SAP were nursed with CVVH(the observation group). We surveyed patients' vital signs (including body temperature, heart rate, breathing and blood pressure),mental symptoms, abdominal signs and monitored liver and kidney functions. Additionally we executed APACHE Ⅱ scores. We analyzed them retrospectively. Results The afore - mentioned indexes of two groups were significant in statistics, the observation group had lower incidence of MODS、MOF than the control group after 10 days caring. Conclusions The CVVH could correct systemic inflammatory reaction of SAP and prevent complications. Standard technical operation and intensive nursing can ensure smooth process of CVVH and decrease complications caused by CVVH.

  3. [Homocysteine and venous thromboembolism].

    Science.gov (United States)

    Monnerat, C; Hayoz, D

    1997-09-06

    Congenital homocysteinuria is a rare inherited metabolic disorder with early onset atherosclerosis and arterial and venous trombosis. Moderate hyperhomocysteinemia is more frequently encountered and is recognized as an independent cardiovascular risk factor. Several case-control studies demonstrate an association between venous thromboembolism and moderate hyperhomocysteinemia. A patient with moderate hyperhomocysteinemia has a 2-3 relative risk of developing an episode of venous thromboembolism. The occurrence of mild hyperhomocysteinemia in heterozygotes for the mutation of Leiden factor V involves a 10-fold increase in the risk of venous thromboembolism. The biochemical mechanism by which homocysteine may promote thrombosis is not fully recognized. Homocysteine inhibits the expression of thrombomodulin, the thrombin cofactor responsible for protein C activation, and inhibits antithrombin-III binding. Treatment with folic acid reduces the plasma level of homocysteinemia, but no study has demonstrated its efficacy in reducing the incidence of venous thromboembolism or atherosclerosis. Hyperhomocysteinemia should be included in the screening of abnormalities of hemostasis and thrombosis in patients with idiopathic thromboembolism, and mild hyperhomocysteinemia may justify a trial of folic acid.

  4. Ileofemoral venous thrombectomy.

    Science.gov (United States)

    Lindhagen, J; Haglund, M; Haglund, U; Holm, J; Scherstén, T

    1978-01-01

    Twentyeight patients with ileofemoral venous thrombosis were treated surgically. Five of the patients had moderate degree of venous congestion, 18 patients had phlegmasia alba dolens and five patients had phlegmasia coerulea dolens. The mean age was 54 years, range 15-80 years, and 15 were men and 13 were women. In all cases the thrombosis was verified by phlebography. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. Peroperative phlebography was used in most cases to guarantee complete extraction of thrombotic material. No operative pulmonary embolism or mortality was encountered. Postoperative continuous heparin infusion in the thrombectomized segment was used for the first week followed by dicumarol treatment. The patients were followed from 6 months to 4 years postoperatively. In two patients thrombectomy was not possible to perform. One of these patients developed a pronounced postthrombotic syndrome, the other developed venous congestion of more moderate degree. Excellent long-term time results were obtained in 82% of the patients and satisfactory in 14%. Thrombectomy is an efficient treatment of ileofemoral venous thrombosis.

  5. Catheter-directed thrombolysis in the treatment of iliofemoral venous thrombosis. A review

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jensen, Leif Panduro; Bækgaard, Niels

    2010-01-01

    Patients with acute iliofemoral venous thrombosis treated with anticoagulation only are at high risk of developing postthrombotic syndrome. Immediate removal of the thrombus by catheter-directed thrombolysis (CDT) may increase patency, prevent damage of the venous valves, and prevent reflux and P...

  6. 戴戒术与单纯浅静脉剥脱术治疗原发性下肢深静脉瓣膜功能不全的比较%Comparison between encircling constriction and simple superficial vein stripping in treatment of lower limb deep venous valve insufficiency

    Institute of Scientific and Technical Information of China (English)

    张鸿源; 管圣; 包文; 段永亮

    2012-01-01

    目的:比较股浅静脉戴戒术与单纯性浅静脉剥脱术治疗下肢深静脉瓣膜功能不全的疗效.方法:将2010年03月-2011年1月收治的48例下肢深静脉瓣膜功能不全伴静脉曲张患者随机分为观察组(股浅静脉戴戒术联合大隐静脉高位结扎剥脱术)和对照组(传统大隐静脉高位结扎剥脱术),通过彩色多普勒检测两组术前及术后股总静脉血管内径、平均血流速度及Valsalva试验下反流持续时间的变化.结果:与术前比较,术后两组患者的静脉瓣膜功能及血流动力学均明显改善,表现为股总静脉管径缩小、平均血流速度增快、静脉血流反流时间缩短(均P<0.05),但观察组上述3个变量手术前后变化程度(差值)均明显大于照组(均P<0.05).结论:两种手术方式均是治疗下肢深静脉瓣膜功能不全的有效手段,但戴戒术的治疗效果优于单纯性浅静脉剥脱术.%Objective: To compare the clinical efficacies between encircling constriction of superficial femoral vein and simple superficial vein stripping in treatment of valve incompetence of the lower limb deep veins. Methods: Forty-eight patients with lower limb deep venous valve insufficiency and varicose veins admitted from March 2010 to January 2011 were randomly assigned to observation group (undergoing encircling constriction of superficial femoral vein combined with high ligation and stripping of the great saphenous vein) and control group (receiving high ligation and stripping of the great saphenous vein only). The inner diameter and average blood flow velocity of the common femoral vein and venous reflux time in response to Valsalva maneuver of the patients in the two groups were measured by color Doppler sonography before and after operation.Results: Compared with the data before operation, the function of venous valves and hemodynamic state of the patients in both groups were significantly improved after operation, as evidenced by the reduced

  7. Hormonal contraception and venous thromboembolism

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Milsom, Ian; Geirsson, Reynir Tomas;

    2012-01-01

    New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published.......New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published....

  8. Value of CT pulmonary arteriography and venography in the evaluation of venous thromboembolism in a multiracial Asian population

    Institute of Scientific and Technical Information of China (English)

    Yeong Ji Lee; Rozman Zakaria; Zaleha Abdul Manaf; Zahiah Mohamed; Yeong Yeh Lee

    2013-01-01

    Background There is increasing evidence that CT pulmonary arteriography and venography allow a better diagnostic yield for deep vein thrombosis (DVT) in suspected acute pulmonary embolism (PE).The aim was to investigate the value for using such an approach in a multiracial Asian population.Methods A total of 135 consecutive subjects with clinically suspected PE in various clinical settings (postoperative in 23 subjects) were referred and evaluated for venous thromboembolism using CT pulmonary arteriography and venography in a tertiary hospital,Malaysia.The distribution of DVT was assessed based on the frequency rate of thrombosis in a particular anatomical region (inferior vena cava,pelvic,femoral and popliteal).Results In 130 subjects,excluding 5 subjects having poor images,both DVT and PE were detected in 11.5% (15/130) subjects and DVT alone was detected in 6.9% (9/130) subjects giving a combined rate of venous thromboembolism of 18.4%.A history of malignancy was significantly associated with positive scans,P=0.02.It was found that left pelvic veins (18.2%) and left femoral veins (19.5%) were more commonly thrombosed in this population.Conclusion CT pulmonary arteriography and venography is a useful technique in the evaluation of venous thromboembolism in a multi-racial Asian population.

  9. Analysis on the Cause of Formation and Operation Period Nursing of Deep Venous Thrombosis of Lower Extremity in Patients with Pelvic Peri-operation%妇科患者行盆腔手术围手术期下肢深静脉血栓形成原因与护理对策

    Institute of Scientific and Technical Information of China (English)

    何克英; 曹述敏

    2014-01-01

    Objective To explore the causes of gynecological pelvic surgery perioperative deep venous thrombosis, and to develop appropriate responses to their care causes. Methods After the formation of the patients in our hospital between January 2008 to 31 December 31 January 2014 in our hospital gynecological pelvic surgery in 67 cases of deep vein thrombosis. Conduct analysis of its causes thrombosis, and make the appropriate statistics, statistical data for comparison.Results 67 patients in the intimal damage and deep venous thrombosis occur ed 28 cases, accounting for 41.8%pairwise comparison, the proportion of intimal damage than other classes ( <0.05), and the dif erence meaningful. Conclusion The statistical results showed intimal damage is the leading cause of deep vein thrombosis formation, take appropriate measures to address its causes intensive care, obstetrics and gynecology pelvic ef ective in preventing perioperative deep vein thrombosis.%目的:探究妇科行盆腔手术围术期患者下肢深静脉血栓形成的原因,针对其形成原因制定相应的护理对策。方法对我院2008年1月31日~2014年1月31日在我院妇科进行盆腔手术后形成深静脉血栓的患者67例。对其血栓形成的原因进行分析,并作出相应的统计,对统计数据进行比较。结果67例患者中静脉内膜受损而发生下肢深静脉栓塞的有28例,占41.8%,两两比较,静脉内膜受损所占比例高于其他类(P<0.05),且差异有意义。结论由统计结果显示,静脉内膜受损是深静脉栓塞形成的首要原因,针对其原因采取相应的重点护理措施,能有效预防妇产科行盆腔手术围术期下肢深静脉血栓形成。

  10. Effect of intermittent pneumatic pressure pump on preventing postoperative deep venous thrombosis in the elderly patients with lung cancer%间歇性充气压力泵在预防老年肺癌术后深静脉血栓形成的效果观察

    Institute of Scientific and Technical Information of China (English)

    宋秀娟

    2013-01-01

    Objective To investigate the effect of intermittent pneumatic pressure pump on the prevention of postoperative deep vein thrombosis(DVT)in elderly patients with lung cancer.Methods One hundred and fifteen lung cancer patients were divided into the control group(n=59)and the test group(n=56).The control group received routine nursing care for the prevention of DVT and the test group were managed with intermittent pneumatic pressure pump apart from the routine nursing as in the control one.The two groups were compared in terms of deep phlebothrombosis and edema of lower limbs.Result There were significant differences between the groups in deep phlebothrombosis and edema of lower limbs as well as the incidence of DVT(P<0.05).Conclusion Intermittent pneumatic pressure pump can prevent postoperative deep venous thrombosis effectively.%  目的探讨间歇性充气压力泵在老年肺癌术后预防深静脉血栓(deep venous thrombosis,DVT)的应用效果。方法将115例肺癌术后患者分为对照组59例和试验组56例,对照组采用常规护理预防DVT,试验组采用在常规护理的基础上加用间歇性充气压力泵预防DVT。观察术后两组患者下肢深静脉血栓和水肿情况。结果两组患者下肢肿胀、DVT发生情况比较,差异具有统计学意义(均P<0.05)。结论应用间歇性充气压力泵能有效预防术后深静脉血栓的形成。

  11. Effective management of venous thromboembolism in the community: non-vitamin K antagonist oral anticoagulants

    Directory of Open Access Journals (Sweden)

    Patel R

    2016-05-01

    Full Text Available Raj Patel Department of Haematological Medicine, King's Thrombosis Centre, King's College Hospital, London, UK Abstract: Anticoagulation therapy is essential for the effective treatment and secondary prevention of venous thromboembolism (VTE. For many years, anticoagulation for acute VTE was limited to the use of initial parenteral heparin, overlapping with and followed by a vitamin K antagonist. Although highly effective, this regimen has several limitations and is particularly challenging when given in an ambulatory setting. Current treatment pathways for most patients with deep-vein thrombosis typically involve initial hospital or community-based ambulatory care with subsequent follow-up in a secondary care setting. With the introduction of non-vitamin K antagonist oral anticoagulants (NOACs into routine clinical practice, it is now possible for the initial acute management of patients with deep-vein thrombosis to be undertaken by primary care. As hospital admissions associated with VTE become shorter, primary care will play an increasingly important role in the long-term management of these patients. Although the NOACs can potentially simplify patient management and improve clinical outcomes, primary care physicians may be less familiar with these new treatments compared with traditional therapy. To assist primary care physicians in further understanding the role of the NOACs, this article outlines the main differences between NOACs and traditional anticoagulation therapy and discusses the benefit–risk profile of the different NOACs in the treatment and secondary prevention of recurrent VTE. Key considerations for the use of NOACs in the primary care setting are highlighted, including dose transition, risk assessment and follow-up, duration of anticoagulant therapy, how to minimize bleeding risks, and the importance of patient education and counseling. Keywords: venous thromboembolism, oral anticoagulant, prevention, treatment, primary

  12. Efficacy of Lower-Extremity Venous Thrombolysis in the Setting of Congenital Absence or Atresia of the Inferior Vena Cava

    Energy Technology Data Exchange (ETDEWEB)

    Ganguli, Suvranu, E-mail: sganguli@partners.org; Kalva, Sanjeeva; Oklu, Rahmi; Walker, T. Gregory; Datta, Neil [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States); Grabowski, Eric F. [Massachusetts General Hospital and Harvard Medical School, Division of Hematology and Oncology, Department of Pediatrics (United States); Wicky, Stephan [Massachusetts General Hospital and Harvard Medical School, Division of Vascular Imaging and Intervention, Department of Imaging (United States)

    2012-10-15

    Purpose: A rare but described risk factor for deep venous thrombosis (DVT), predominately in the young, is congenital agenesis or atresia of the inferior vena cava (IVC). The optimal management for DVT in this subset of patients is unknown. We evaluated the efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) followed by systemic anticoagulation in the treatment of acute lower-extremity DVT in the setting of congenital IVC agenesis or atresia. Materials and Methods: Between November of 2005 and May of 2010, six patients (three women [average age 21 years]) were referred to our department with acute lower-extremity DVT and subsequently found to have IVC agenesis or atresia on magnetic resonance imaging. A standardized technique for PCDT (the Angiojet Rheolytic Thrombectomy System followed by the EKOS Microsonic Accelerated Thrombolysis System) was used for all subjects. Successful thrombolysis was followed by systemic heparinization with transition to Coumadin or low molecular-weight heparin and compression stockings. Subjects were followed-up at 1, 3, and then every 6 months after the procedure with clinical assessment and bilateral lower-extremity venous ultrasound. Results: All PCDT procedures were technically successful. No venous stenting or angioplasty was performed. The average thrombolysis time was 28.6 h (range 12-72). Two patients experienced heparin-induced thrombocytopenia, and one patient developed a self-limited knee hemarthrosis, No patients were lost to follow-up. The average length of follow-up was 25.8 {+-} 20.2 months (range 3.8-54.8). No incidence of recurrent DVT was identified. There were no manifestations of postthrombotic syndrome. Conclusions: PCDT followed by systemic anticoagulation and the use of compression stockings appears to be safe and effective in relatively long-term follow-up treatment of patients who present with acute DVT and IVC agenesis or atresia.

  13. 老年髋膝关节置换术后患者下肢深静脉血栓风险评估及护理%Risk Assessment and Nursing of Deep Venous Thrombosis in the Elderly Patients with Hip Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    秦柳花

    2014-01-01

    本文主要探讨老年髋膝关节置换术后下肢深静脉血栓形成(DVT)的风险评估及护理方法.对入院后的老年髋膝关节置换术后患者进行严密的观察,并进行血栓危险因素风险评估,同时做好术中预防监测、术后采取患肢早期功能锻炼、相关知识宣教等护理措施,促进肢体的血液循环并联合药物应用来达到预防静脉血栓的效果,从而减轻患者的痛苦、减少并发症的发生.%This paper mainly discusses the risk assessment and nursing care of deep venous thrombosis (DVT) in the elderly patients with hip knee arthroplasty. Make close observation and risk assessment of risk factors on thrombosis for elderly patients with hip knee arthroplasty after admission; while making intraoperatie prevention monitoring, taking early limb function exercise after operation, the related nursing measures, such as related education to promote body blood circulation and drug application to achieve the effect of preventing venous thrombosis;thereby relieving the suffering of patients and reducing the occurrence of complications.

  14. Acute effects of deep breathing for a short duration (2-10 minutes) on pulmonary functions in healthy young volunteers.

    Science.gov (United States)

    Sivakumar, G; Prabhu, Krishnamoorthi; Baliga, Rekha; Pai, M Kirtana; Manjunatha, S

    2011-01-01

    Breathing is the most vital function for maintenance of life. Slow and deep breathing is an integral part of Pranayama and it reduces dead space ventilation and renews air throughout the lungs. The reported beneficial effects of deep breathing as a part of either long term or short term practice of Pranayama are well documented. However our knowledge about the effects of a few minutes' of deep breathing on human ventilatory parameters is poor. In the present study, we examined the relationship between exposure to short duration of deep breathing and performance on pulmonary function tests before and after the deep breathing. The study was conducted in a homogenous group of 12 volunteers containing 4 females and 8 males who were well trained in pulmonary function testing (PFT) before the start of the study. The volunteers performed deep breathing (DB) exercise for 2, 5 and 10 minutes at the rate of 6 breaths per minute under guidance, and the duration of DB exercise for that day was randomly selected for each group. PFT was done before and after the DB exercise. There was a significant (P vital capacity (VC) after 2 and 5 minutes' DB exercise and a consistent improvement in tidal volume (TV) and minute ventilation (MV) after the DB exercise in all the three groups, though it wasn't statistically significant. There was a significant (P vital capacity (FVC) after 2 minutes' of DB exercise and a consistent increase in all the three groups in forced inspiratory vital capacity (FIVC) and peak inspiratory flow rate (PIFR), though this increase was not statistically significant. This shows that deep breathing exercise, even for a few minutes' duration is beneficial for the lung functions.

  15. A COMPARATIVE STUDY BETWEEN THE EFFICACIES OF ULTRASOUND THERAPY WITH CRYOKINETICS VERSUS ULTRASOUND THERAPY WITH SOFT TISSUE MASSAGE (DEEP FRICTION MASSAGE IN ACUTE SUPRASPINATUS TENDINITIS

    Directory of Open Access Journals (Sweden)

    Shivakumar

    2014-04-01

    Full Text Available BACKGROUND: Supraspinatus tendinitis is the non-traumatic, inflammatory and degenerative changes of tendon. This condition is common in athletes involving repetitive overhead activities like bowling, swimming, and javelin throw etc. and even in persons involving these repetitive overhead activities at their work places. The pain and discomfort associated with this condition have a dramatic impact on physical mobility and function. This study was done to assess the effectiveness of ultrasound and cryokinetics versus ultrasound and soft tissue massage (deep friction massage in patients suffering from acute supraspinatus tendinitis. AIMS: To compare the efficacy of ultrasound therapy with cryokinetics versus ultrasound therapy with soft tissue massage (deep fiction massage in acute supraspinatus tendinitis. METHODS AND MATERIALS: It is a comparative experimental study dividing in to two groups. 60 subjects aged between 30-60 years 30 in each group. Group A: (n=30:- Treated with ultrasound therapy and cryokinetics Group B: (n=30:- Treated with ultrasound therapy and soft tissue massage (deep