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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. 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...

  3. 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

  4. 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.

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

    Science.gov (United States)

    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. 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.

  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

    2016-01-01

    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 P<0.05). The incidence of postoperative PTS in the CDT group (17.9%) was significantly lower in comparison to the ST group (51.85%) during the follow-up (P=0.007). CONCLUSIONS Catheter-directed thrombolysis via the small saphenous veins is an effective, safe, and feasible approach for treating acute deep venous thrombosis. PMID:27552357

  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. 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

    -PA, without affecting the ability to activate coagulation Factor VII (FVII). Previous studies have investigated the association of the 1601GA genotype with incidence and progression of carotid stenosis and deep venous thrombosis (DVT). The present study is the first to evaluate the potential association...

  12. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    Directory of Open Access Journals (Sweden)

    Saranat Orrapin

    2016-01-01

    Full Text Available Chronic traumatic arteriovenous fistula (AVF commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1 and shotgun wounds (case 2. Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance.

  13. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities.

    Science.gov (United States)

    Orrapin, Saranat; Arworn, Supapong; Rerkasem, Kittipan

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT) in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance. PMID:27293948

  14. 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

  15. 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.

  16. Prothrombin Gene G20210A Mutation in Acute Deep Venous Thrombosis Patients with Poor Response to Warfarin Therapy

    OpenAIRE

    Attia, F.M; Mikhailidis, D. P.; Reffat, S.A

    2009-01-01

    Aim: The pathogenesis of deep venous thrombosis (DVT) involves an interaction between hereditary and acquired factors. Prothrombin gene mutation is one of the hereditary risk factors. We evaluated the frequency of the prothrombin gene mutation in patients with DVT and its relation to oral warfarin anticoagulant therapy response. Methods: Prothrombin gene mutation was looked for in 40 DVT patients with poor response to warfarin. The results were compared with 40 DVT patients with a normal resp...

  17. [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

  18. 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.

  19. 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

  20. [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

  1. [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

  2. 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.

  3. 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...... in the general population. METHODS: We included 54628 participants from the Copenhagen City Heart Study (1981-83) and the Copenhagen General Population Study (2004-12), all with a measured concentration of IgM rheumatoid factor and without autoimmune rheumatic disease or venous thromboembolism. The main outcome...... 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

  4. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  5. 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

    Energy Technology Data Exchange (ETDEWEB)

    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

  6. 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.

  7. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    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...... 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...

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Deep venous thrombosis and pulmonary embolism following physical restraint

    DEFF Research Database (Denmark)

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

    2005-01-01

    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...... 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...

  13. 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.

  14. 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.

  15. 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...

  16. 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.)

  17. 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.

  18. 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.

  19. 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

  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. 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.)

  2. 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.

  3. 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.

  4. Relationship between deep venous thrombosis and pulmonary embolism by radionuclide techniques in 150 patients

    International Nuclear Information System (INIS)

    Objective: This study was to evaluate the relationship between deep venous thrombosis and pulmonary embolism assessed by radionuclide imaging. Methods: One hundred and fifty patients with pulmonary embolism from September 1997 to September 2001 were included. Pulmonary perfusion/ventilation imaging and deep venous radionuclide venography was performed in all patients. There were 87 men, and 63 women, with an average age 39±18 years. Of them, 26 underwent pulmonary arteriography. Eleven patients had X Ray phleography of lower extremities, 18 patients had Impedence plethymography (IPG), and 36 patients had lower limb ultrasound study. Results: Out of 150 patients with pulmonary embolism, 128 (85.5%) had lower limb venous pathological changes. Among them, 100 patients had risk factors of deep venous thrombosis (78.3%). 120 patients had proximal vein (80.0%). The agreement between radionuclide venography and X Ray phleography of lower extremities UCG and IPG was 90.9%, 70.2% and 80.0% respectively. Conclusions: Our results indicate that DVT was one of most important cause for acute pulmonary embolism, and thrombosis is mostly located in the proximal veins

  5. Twenty cases of acute cerebral infarction complicated with deep venous thrombosis in lower limb%急性脑梗死并发下肢深静脉血栓形成20例

    Institute of Scientific and Technical Information of China (English)

    麦卫华; 王俊峰; 刘汉伟; 韩蓉蓉

    2011-01-01

    目的 探讨急性脑梗死患者并发下肢深静脉血栓形成(LDVT)的发病原因、临床特点及诊治方法.方法 对我科收治的20例急性脑梗死并发LDVT患者的病例资料进行回顾性分析.结果 20例脑梗死并发LDVT患者中,65岁以上占55%,血清纤维蛋白原增高者占65%,红细胞压积升高者占45%.瘫痪侧肢体LDVT发生率为75%,健侧肢体为10%.左侧LDVT占60%,右侧LDVT占25%.脑梗死后1周内LDVT发生率最高(55%).LDVT发病3 d内的4例患者行尿激酶溶栓治疗,LDVT发病3-14 d的14例患者行低分子肝素抗凝治疗,两组治愈显效率比较差异无统计学意义(75%V8 57%,P>0.05).结论 高龄、血液粘滞度增高、长期卧床及解剖因素等均是急性脑梗死患者发生LDVT的重要原因.溶栓与抗凝治疗疗效类似,均为治疗LDVT的有效手段.急性脑梗死患者早期防治LDVT具有重要意义.%Objective To investigate the etiological factors, clinical characteristics, diagnosis and treatment of deep venous thrombosis in lower limb ( LDVT) in patients with acute cerebral infarction (CI).Methods Clinical datas of twenty cases of acute CI complicated with LDVT who were hospitalized in our department were analyzed retrospectively. Results Among these 20 cases, the percentage of patients over 65 years old was fifty - five. The percentages of patients with increased serum fibrinogen and hematocrit were sixty - five and forty - five respectively. The incidence rates of LDVT happened in palsy and normal limbs were 75% and 10% , respectively. The percentage of DVT in left lower limb was sixty, while that in right lower limb was twenty - five. The incidence rate of LDVT within one week after acute CI was the highest (55% ). Four cases with LDVT happened within three days received thrombolysis therapy by urokinase. Fourteen cases with LDVT happened in three to fourteen days received anticoagulant therapy by low molecular heparin. Healing rates between the two groups were

  6. 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.

  7. 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

  8. Iodine-123 miniplasmin for the detection of deep venous thrombosis

    International Nuclear Information System (INIS)

    Human plasminogen (MW 90'000) is cleaved by elastase into several fragments, including one with a molecular weight of 38'000 (mini-plasminogen). This fragment retains sufficiently preserved fibrin binding sites but lacks the affinity for α2-antiplasmin. Therefore radiolabelled miniplasmin was tested in 21 patients with suspected deep venous thrombosis, in 5 patients with lymphedema and in 5 healthy controls for its potential use as fast marker of deep venous thrombosis. 250 μCi of Iodine-123 miniplasmin was given i.v. after previous activation with 3000 IU urokinase. The tracer distribution was measured 15, 30 and 60 minutes after injection at 10 points over each leg. The mean left/right ratio obtained in the 5 volunteers was 1.04 (range 0.89-1.12). In the patients the test was considered positive when the left/right ratio was greater than 1.15 or smaller than 0.85 at two adjacent locations and in two consecutive measuring times. In the 21 patients studied both tests gave concurrent results in 19, while in one patient with a positive and in one patient with a negative phlebography the miniplasmintest gave opposite results. In 4 of the 5 patients with edema and no thrombosis the miniplasmintest was negative. Most positive tests were conclusive as early as 15 minutes after injection of miniplasmin. The sensitivity was calculated to be 90% and the specificity 85%. Therefore Iodine-123 miniplasmin has been estimated as a fast, non invasive marker for the diagnosis of deep venous thrombosis and preliminary clinical studies with scintigraphy have been performed on over 50 patients. Evaluation gave a sensitivity between 40% and 86% and a specificity between 62% and 100%. Clinical studies have not been continued. Since I-123 miniplasmin is not available around the clock, it can't be used in emergency diagnosis. (author) 2 figs., 5 tabs., 30 refs

  9. [Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jørgensen, Maja; Just, Sven Richardt Lundgren;

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thr...... thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis Udgivelsesdato: 2008/5/19...

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

    OpenAIRE

    Eric Swanson, MD

    2015-01-01

    Background: Our understanding of the pathophysiology of venous thromboembolism is largely based on the experience of orthopedic patients undergoing total joint replacement. Little is known regarding the natural history of venous thromboembolism in plastic surgery outpatients. Today, ultrasound screening, including compression and Doppler color flow imaging, represents the standard for detecting deep venous thromboses. Methods: Ultrasound screening was offered to 200 consecutive plastic sur...

  11. 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.

  12. 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.

  13. 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.

  14. [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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Factor V Leiden Is Associated with Higher Risk of Deep Venous Thrombosis of Large Blood Vessels

    Science.gov (United States)

    Arsov, Todor; Miladinova, Daniela; Spiroski, Mirko

    2006-01-01

    Aim To determine the prevalence of factor V Leiden mutation in patients with different presentation of venous thromboembolic disease and healthy individuals in the Republic of Macedonia. Methods The retrospective case-control study involved 190 patients with venous thromboembolic disease and 200 healthy individuals, who were screened for the presence of factor V Leiden mutation, using a polymerase chain reaction-restriction fragment length polymorphism method. The prevalence of factor V Leiden was analyzed according to the localization of thrombosis, presence of risk factors, and family history of thrombosis. The odds of deep venous thrombosis were calculated with respect to the presence of factor V Leiden mutation. Results The prevalence of factor V Leiden mutation among patients with venous thromboembolic disease was 21.1%, compared with 5.5% in the healthy individuals. Factor V Leiden positive patients had the first episode of deep venous thrombosis at a younger age, and the prevalence of the mutation was the highest among patients with a positive family history of thrombosis (33.9%, P = 0.003) and in patients with deep venous thrombosis affecting a large blood vessel (37.7%, P = 0.001). The prevalence of factor V Leiden mutation was lower in patients with calf deep venous thrombosis and primary thromboembolism (13.3% and 13.1%, respectively; P>0.05). The odds ratio for iliofemoral or femoral deep venous thrombosis in factor V Leiden carriers was 10.4 (95% confidence interval, 4.7-23.1). Conclusion The prevalence of factor V Leiden mutation was high in patients with venous thromboembolic disease and healthy individuals in the Republic of Macedonia. Factor V Leiden carriers have the highest odds of developing deep venous thrombosis affecting a large venous blood vessel. PMID:16758522

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. Chronic Stress Facilitates the Development of Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. [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.

  7. Hickman to central venous catheter: A case of difficult venous access in a child suffering from acute lymphoblastic leukemia

    Science.gov (United States)

    Chakraborty, Arunangshu; Agrawal, Sanjit; Datta, Taniya; Mitra, Suparna; Khemka, Rakhi

    2016-01-01

    Chemotherapy in children suffering from cancer usually requires placement of an indwelling central venous catheter (CVC). A child may need to undergo repeated procedures because of infection and occlusion of previous access devices. We present a case of CVC insertion in a child suffering from acute lymphoblastic leukemia where an innovative technique was employed. PMID:27695218

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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...

  10. Epidemiology of deep venous thrombosis during pregnancy and puerperium in Sudanese women

    OpenAIRE

    Gader, Asha A; Abed Elrahium D Haggaz; Ishag Adam

    2009-01-01

    Asha A Gader1, Abed Elrahium D Haggaz2, Ishag Adam11Faculty of Medicine, University of Khartoum, Sudan; 2Department of Obstetrics and Gynecology, Faculty of Medicine University of Elfasher, SudanBackground: Deep venous thrombosis (DVT) and venous  hromboembolism (VTE) is a major health problem with high mortality worldwide. Patients at risk must be identified and given appropriate prophylaxis in order to decrease the mortality.Objective: To investigate the prevalence of DVT in pregna...

  11. Epidemiology of deep venous thrombosis during pregnancy and puerperium in Sudanese women

    OpenAIRE

    Adam, Ishag

    2008-01-01

    Asha A Gader1, Abed Elrahium D Haggaz2, Ishag Adam11Faculty of Medicine, University of Khartoum, Sudan; 2Department of Obstetrics and Gynecology, Faculty of Medicine University of Elfasher, SudanBackground: Deep venous thrombosis (DVT) and venous  hromboembolism (VTE) is a major health problem with high mortality worldwide. Patients at risk must be identified and given appropriate prophylaxis in order to decrease the mortality.Objective: To investigate the prevalence of DVT in pregna...

  12. 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

  13. Incidence of deep vein thrombosis and quality of venous thromboembolism prophylaxis

    Directory of Open Access Journals (Sweden)

    Alberto Okuhara

    2014-01-01

    Full Text Available OBJECTIVE: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures. METHODS: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model. To assess the quality of prophylaxis we compared the adopted measures with the prophylaxis guidelines of the American College of Chest Physicians. RESULTS: the overall incidence of deep venous thrombosis was 7.5%. As for the risk groups, 10.8% were considered low risk, 14.9%moderate risk, 24.3% high risk and 50.5% very high risk. Prophylaxis of deep venous thrombosis was correct in 57.7%. In groups of high and very high risk, adequate prophylaxis rates were 72.2% and 71.6%, respectively. Excessive use of chemoprophylaxis was seen in 68.7% and 61.4% in the low and moderate-risk groups, respectively. CONCLUSION: although most patients are deemed to be at high and very high risk for deep vein thrombosis, deficiency in the application of prophylaxis persists in medical practice.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. Animal Model of Acute Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Purpose: To develop an animal model of acute deep vein thrombosis (DVT). Methods: In part I of the study nine juvenile domestic pigs were used. Each external iliac vein was transluminally occluded with a balloon catheter. Thrombin was infused through a microcatheter in one leg according to one of the following protocols: (1) intraarterial (IA): 1250 U at 25 U/min in the common femoral artery (n= 3); (2) intravenous (IV): 5000 U in the popliteal vein at 500 U/min (n= 3), or at 100 U/min (n= 3). Saline was administered in the opposite leg. After the animals were killed, the mass of thrombus in the iliofemoral veins was measured. The pudendoepiploic (PEV), profunda femoris (PF), and popliteal veins (PV) were examined. Thrombosis in the tributaries of the superficial femoral vein (SFVt) was graded according to a three-point scale (0, +, ++). In part II of the study IV administration was further investigated in nine pigs using the following three regimens with 1000 U at 25 U/min serving as the control: (1) 1000 U at 100 U/min, (2) 250 U at 25 U/min, (3) 250 U at 6.25 U/min. Results: All animals survived. In part I median thrombus mass in the test limbs was 1.40 g as compared with 0.25 g in the controls (p= 0.01). PEV, PFV and PV were thrombosed in all limbs infused with thrombin. IV infusion was more effective in inducing thrombosis in both the parent veins (mass 1.32-1.78 g) and SVFt (++ in 4 of 6 legs), as compared with IA infusion (mass 0.0-1.16 g; SFVt ++ in 1 of 3 legs). In part II thrombus mass in axial veins ranged from 1.23 to 2.86 g, and showed no relationship with the dose of thrombin or the rate of infusion. Tributary thrombosis was less extensive with 250 U at 25 U/min than with the other regimens. Conclusion: Slow distal intravenous thrombin infusion in the hind legs of pigs combined with proximal venous occlusion induces thrombosis in the leg veins that closely resembles clinical DVT in distribution

  20. 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...

  1. 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…

  2. 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

  3. The spectrum of presentations of venous infarction caused by deep cerebral vein thrombosis

    NARCIS (Netherlands)

    van den Bergh, Walter M; van der Schaaf, Irene; van Gijn, Jan

    2005-01-01

    The classic features of thrombosis of the deep cerebral venous system are severe dysfunction of the diencephalon, reflected by coma and disturbances of eye movements and pupillary reflexes, resulting in poor outcome. However, partial syndromes without a decrease in the level of consciousness or brai

  4. 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)

  5. 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. PMID:26595005

  6. 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.

  7. 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.

  8. Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

    Science.gov (United States)

    Bansal, Hanish; Chaudhary, Ashwani; Mahajan, Anuj; Paul, Birinder

    2016-01-01

    Cerebral venous sinus thrombosis is a rare type of stroke primarily affecting young women. Diagnosis is generally delayed or overlooked due to a wide spectrum of clinical symptoms. Subdural hematoma secondary to cerebral venous sinus thrombosis is very rare. We report a case of 40-year-old female with cerebral venous sinus thrombosis who presented to us with an acute subdural hematoma and subarachnoid hemorrhage besides venous infarct. Management of such patients is complicated due to the rarity of the condition and contraindication for the use of anticoagulation. We conducted a thorough literature search through PubMed and could find only nine cases of spontaneous subdural hematoma secondary to cerebral venous sinus thrombosis. PMID:27057237

  9. 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).

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.)

  15. 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.

  16. 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

  17. 髂腹股沟入路手术相关急性医源性下肢深静脉血栓形成的临床诊治11例%Treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    孔凡国; 韩松辉; 李跃京; 刘锋卫

    2015-01-01

    目的 探讨髂腹股沟入路相关急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的病因、临床特点及诊疗经验.方法 回顾性分析河南省洛阳正骨医院2008年1月至2013年12月诊治的11例髂腹股沟手术入路相关急性医源性下肢DVT患者的临床特点及治疗措施.结果 11例复杂髋臼骨折病例,行髂腹股沟(ilioninguinal)入路手术7例,联合Kocher-Langenbeck入路4例,术后3d内并发患肢DVT,均经数字减影血管造影(digital subtraction angiography,DSA)证实了DVT与髂腹股沟入路手术关系密切,11例均在髂腹股沟段出现静脉狭窄,狭窄段远侧血栓形成9例,上下侧均有血栓形成2例,1例合并髂静脉广泛闭塞,1例合并股静脉广泛闭塞,均放置可回收型下腔静脉滤器,同期行经导管推注尿激酶接触溶栓治疗,溶栓治疗5~12d,平均(8.0±2.3)d,血栓完全溶解8例,少量残留3例,闭塞髂股静脉完全开通,随访6~18个月,平均(10±4)个月,无DVT复发及PTS发生.结论 髂腹股沟入路手术可对术区髂股静脉造成严重影响,是导致急性下肢深静脉血栓形成的重要原因,下腔静脉滤器保护下接触溶栓疗效确切.%Objective To evaluate the treatment of ilioinguinal approach surgery associated acute iatrogenic deep venous thrombosis (DVT).Methods The clinical data and treatment of 11 patients with ilioinguinal approach surgery associated acute iatrogenic DVT were analyzed.Results These 11 patients initially suffered from complicated acetabulum fracture,7 cases were treated by single ilioinguinal approach surgery and the other 4 cases were combined with Kocher-Langenbeck approach.In 3 days after surgery,DVTs were found by Doppler sonography,and all the DVTs were proved having closed relationships with ilioinguinal approach through digital subtraction angiography(DSA):iliac-femoral veins appeared stenosis at ilioinguinal segment in all the 11 cases,DVTs were found distal to the stenosis in 9

  18. 导管溶栓术治疗急性下肢深静脉血栓形成116例%Catheter Directed Thrombolysis for Treatment of Acute Deep Venous Thrombosis of the Lower Extremity of the Effect and Safety Analysis in 116 Cases

    Institute of Scientific and Technical Information of China (English)

    高建国; 张弘; 张青云; 陈磊; 冯洋; 杜建青; 姜海军

    2013-01-01

    Objective To investigate the catheter thrombolysis for acute deep venous thrombosis of the lower extremity of the effect and safety of. Methods A hundred and sixteen cases of acute lower extremity deep venous thrombosis patients with catheter thrombolysis therapy. Results All patients were successfully imported thrombolysis catheter,a 100% success rate. The immediate postoperative inferior vena cava angiography revealed filter are smooth, no obvious dislodged thrombus imaging, in patients with CDT period of treatment is 2-7 d,length of hospital stay was 7-15 d,6 patients with gingival bleeding,4 cases of subcutaneous bruises, in 2 patients after the puncture point compression hemostasis after oozing, classics, without lung arterial embolism. After thrombolysis, the contralateral thigh and calf circumference difference was smaller than before thrombolysis, after treatment of the patency of the score was significantly higher than before treatment, patency improved degree of (55±4)% , above the difference was statistically significant ( P < 0. 05). Conclusion CDT treatment DVT simple clinical operation, reducing the thrombolytic drug dosage, obvious curative effectless complications, can significantly improve the quality of life of patients,reduce the sequelae. But the long-term efficacy remains to be further observation.%目的 探讨导管溶栓术治疗急性下肢深静脉血栓形成的效果及安全性.方法 对116例急性下肢深静脉血栓患者采用导管溶栓术进行治疗.结果 所有患者均成功导入溶栓导管,成功率100%.术后即刻下腔静脉造影显示滤器内均通畅,无明显血栓脱落影像;患者导管溶栓术治疗时间2~7 d;住院时间为7~15 d;6例牙龈出血、4例皮下瘀青,2例患者术后穿刺处渗血,经压迫后止血,无肺动脉栓塞发生;溶栓后患、健侧大腿和小腿周径差明显小于溶栓前,治疗后的通畅度评分显著高于治疗前,通畅改善度为(55±4)%.结论 导管溶栓

  19. 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.

  20. Hemogram parameters for predicting pulmonary embolism in patients with deep venous thrombosis

    OpenAIRE

    Kaya H; Kurt R

    2015-01-01

    Hakki Kaya, Recep KurtDepartment of Cardiology, Cumhuriyet University Medical School, Sivas, TurkeyWe read the article of Sevuk et al,1 published in the August 2015 issue of your journal, with great interest. The authors concluded that percentage change in serial measurements of mean platelet volume (MPV) and platelet-distribution width (PDW) is valuable in predicting the development of pulmonary thromboembolism in patients with a previous history of deep venous thrombosis (DVT). In a similar...

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

    OpenAIRE

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

    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 conduct...

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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. PMID:26804599

  7. 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.

  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. Acute venous thrombosis of a renal transplant: early detection with color Doppler sonography.

    Science.gov (United States)

    Danse, E; Malaise, J; Mourad, M; Cosyns, J P

    2009-01-01

    The observation of a recent case of an acute venous thrombosis of a renal transplant is the opportunity to review and present the role of color Doppler sonography for the early detection of such a severe and uncommon complication. PMID:19534237

  10. Peripheral and Central Venous Blood Glucose Concentrations in Dogs and Cats with Acute Arterial Thromboembolism

    OpenAIRE

    S. Klainbart; Kelmer, E.; Vidmayer, B.; Bdolah‐Abram, T.; Segev, G.; Aroch, I.

    2014-01-01

    Background Acute limb paralysis because of arterial thromboembolism (ATE) occurs in cats and less commonly in dogs. ATE is diagnosed based on physical examination findings and, occasionally, advanced imaging. Hypothesis/Objectives Peripheral, affected limb venous glucose concentration is decreased in ATE, whereas its systemic concentration is within or above reference interval. Animals Client‐owned cats and dogs were divided into 3 respective groups: acute limb paralysis because of ATE (22 ca...

  11. 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.

  12. The adherence to initial processes of care in elderly patients with acute venous thromboembolism.

    Directory of Open Access Journals (Sweden)

    Anna K Stuck

    Full Text Available We aimed to assess whether elderly patients with acute venous thromboembolism (VTE receive recommended initial processes of care and to identify predictors of process adherence.We prospectively studied in- and outpatients aged ≥65 years with acute symptomatic VTE in a multicenter cohort study from nine Swiss university- and non-university hospitals between September 2009 and March 2011. We systematically assessed whether initial processes of care, which are recommended by the 2008 American College of Chest Physicians guidelines, were performed in each patient. We used multivariable logistic models to identify patient factors independently associated with process adherence.Our cohort comprised 950 patients (mean age 76 years. Of these, 86% (645/750 received parenteral anticoagulation for ≥5 days, 54% (405/750 had oral anticoagulation started on the first treatment day, and 37% (274/750 had an international normalized ratio (INR ≥2 for ≥24 hours before parenteral anticoagulation was discontinued. Overall, 35% (53/153 of patients with cancer received low-molecular-weight heparin monotherapy and 72% (304/423 of patients with symptomatic deep vein thrombosis were prescribed compression stockings. In multivariate analyses, symptomatic pulmonary embolism, hospital-acquired VTE, and concomitant antiplatelet therapy were associated with a significantly lower anticoagulation-related process adherence.Adherence to several recommended processes of care was suboptimal in elderly patients with VTE. Quality of care interventions should particularly focus on processes with low adherence, such as the prescription of continued low-molecular-weight heparin therapy in patients with cancer and the achievement of an INR ≥2 for ≥24 hours before parenteral anticoagulants are stopped.

  13. 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.

  14. 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.

  15. Hemogram parameters for predicting pulmonary embolism in patients with deep venous thrombosis

    Directory of Open Access Journals (Sweden)

    Kaya H

    2015-11-01

    Full Text Available Hakki Kaya, Recep KurtDepartment of Cardiology, Cumhuriyet University Medical School, Sivas, TurkeyWe read the article of Sevuk et al,1 published in the August 2015 issue of your journal, with great interest. The authors concluded that percentage change in serial measurements of mean platelet volume (MPV and platelet-distribution width (PDW is valuable in predicting the development of pulmonary thromboembolism in patients with a previous history of deep venous thrombosis (DVT. In a similar study conducted by Braekkan et al2 (Tromsø Study, MPV on admission was shown to predict pulmonary thromboembolism.  Read the original paper here

  16. 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.

  17. 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.

  18. Interpretation of peripheral venous duplex testing.

    Science.gov (United States)

    Barleben, Andrew; Bandyk, Dennis F

    2013-01-01

    Venous duplex ultrasound and plethysmography are used to evaluate patients for suspected deep venous thrombosis (DVT) or venous insufficiency symptoms. Testing can provide clinicians with detailed information on location, extent, and severity of venous conditions before and after treatment. Duplex ultrasound can image the venous system from the vena cava to the peripheral veins, including veins of the calf musculature, and is the recommended technique to diagnose DVT. Accurate interpretation of venous testing requires an understanding of venous hemodynamics, including normal flow phasicity with cardiac and respiratory motion and the changes produced by acute DVT. Duplex scanning provides a roadmap of vein anatomy similar to contrast venography and essential hemodynamic information about the presence of proximal obstruction, vein valve function, and perforator vein reflux. Indications for testing include the diagnosis of acute/chronic DVT and evaluation of patients with venous insufficiency manifested as edema, varicose veins, or ambulatory venous hypertension. Venous plethysmography, an indirect physiologic test, can be used to estimate severity of obstructive or reflux venous pathophysiology and document improvement in venous hemodynamics after intervention. Using criteria based on ultrasound imaging and physiologic testing, venous conditions producing a swollen or painful limb can be accurately determined and aid in appropriate treatment selection. PMID:24636608

  19. 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....

  20. Dabigatran etexilate: a review of its use in the treatment of acute venous thromboembolism and prevention of venous thromboembolism recurrence.

    Science.gov (United States)

    Greig, Sarah L; McKeage, Kate

    2014-10-01

    Dabigatran etexilate (Pradaxa(®), Prazaxa(®)) has recently been approved for the treatment of acute venous thromboembolism (VTE) and prevention of VTE recurrence. Dabigatran etexilate is an oral prodrug of dabigatran, a selective, reversible, competitive, direct thrombin inhibitor. Dabigatran etexilate has a wide therapeutic range that allows for fixed-dose administration without the need for routine monitoring, a requirement of standard vitamin K antagonist (VKA) therapy. In randomized phase III trials in patients with acute VTE (RE-COVER and RE-COVER II), long-term treatment with oral dabigatran etexilate 150 mg twice daily for 6 months after initial parenteral anticoagulation was noninferior to dose-adjusted warfarin with regard to the incidence of recurrent symptomatic VTE or related death. In randomized trials of patients with previously treated VTE, extended dabigatran etexilate treatment was noninferior to warfarin (RE-MEDY) and significantly more effective than placebo (RE-SONATE) with regard to the incidence of recurrent VTE or related death. Dabigatran etexilate was generally well tolerated, with a similar incidence of major bleeding to that with warfarin in individual studies (although pooled data showed a significantly lower incidence in patients with acute VTE), and significantly lower incidences of the combined endpoint of major or clinically relevant nonmajor bleeding and of any bleeding than with warfarin. However, in the RE-SONATE trial, dabigatran etexilate was associated with a higher risk of bleeding than placebo. In conclusion, dabigatran etexilate is a valuable treatment option for acute VTE and prevention of VTE recurrence, providing an effective and convenient alternative to standard VKA therapy with the potential for a lower overall rate of bleeding. PMID:25270377

  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. 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.

  3. 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

  4. Venous thromboembolism (VTE) risk assessment and prophylaxis in acute orthopaedic admissions: improving compliance with national guidelines

    OpenAIRE

    Watts, Laura; Grant, David

    2013-01-01

    “Each year over 25,000 people die from Venous Thromboembolism (VTE) contracted in hospital. This is more than the combined total of deaths from breast cancer, AIDS and traffic accidents”. (1) Orthopaedic patients are at particular risk of VTE. In 2011, the project team carried out an audit into compliance with national VTE assessment guidelines on all acute trauma and orthopaedic admissions during a two week period at a District General Hospital. The study demonstrated that compliance was ini...

  5. {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.)

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

    Directory of Open Access Journals (Sweden)

    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

  7. 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.

  8. 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.

  9. 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.)

  10. Application of vascular enhancement technology combined with panoramic ultrasound imaging in the interventional treatment of acute deep venous thrombosis of lower limbs%血管增强技术联合全景超声成像在下肢急性深静脉血栓介入治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    亓培君; 崔建华; 王兴田; 李立杰; 贺烨

    2011-01-01

    Objective To investigate the application value of ultrasonic vascular enhancement technology (VET) combined with panoramic ultrasound imaging (PUl) in the interventional treatment of acute deep venous thrombosis (ADVT)of lower limbs. Methods VET and PUl were used to detect 48 veins of lower limbs in 46 patients with ADVT of lower limbs during interventional procedures. The acquired images were compared with those obtained with 2D ultrasound, CDFI and DSA. Then the thrombolytic catheter was moved under dynamic monitoring of VET. Resalts VET could show catheter in the cavity and its top position, boundary contour of undissolved thrombus, small mural thrombus, vascular wall and ambient collateral circulation clearly with less artifacts and interferences. The image quality was better than that of 2D ultrasound and CDFI (P<0. 05). Compared with DSA, the coincident rate of VET with DSA was 87. 50% (42/48) for the diameter of the recanalized lumen of femoral vein in the same narrow portion tangent, of 2D ultrasound and CDFI with DSA was 37. 50% (18/48,x2=25. 60, P<0. 05). Panoramic images of VET were clear and informative. VET could show the movement of catheter in cavity clearly in dynamic conditions, and under its surveillance, the lateral hole of thrombolytic catheter was put to the vein that contained thrombus accurately. Conclusion VET combined with PUl has great clinical application value in the interventional treatment of ADVT of lower limbs.%目的 探讨超声血管增强技术(VET)联合全景超声成像(PUI)在下肢急性深静脉血栓(ADVT)介入治疗中的应用价值.方法 应用VET及PUI对46例接受下肢ADVT介入治疗患者的48侧下肢血管进行检查,将图像与二维超声及CDFI、DSA进行对比分析,并在VET动态监视下移动溶栓导管.结果 VET图像可清晰显示管腔内导管及其头端位置、未溶血栓边界轮廓、附壁小血栓、血管壁情况及周围侧支循环等,伪像和干扰减少,图像质量评

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

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    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.

  12. 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.

  13. Hypereosinophilic syndrome presenting with multiple organ infiltration and deep venous thrombosis

    Science.gov (United States)

    Gao, Su-jun; Wei, Wei; Chen, Jiang-tao; Tan, Ye-hui; Yu, Cheng-bao; Litzow, Mark Robert; Liu, Qiu-ju

    2016-01-01

    Abstract Background: Hypereosinophilic syndrome (HES) can be fatal, particularly when eosinophils infiltrate vital organs and/or if extensive thrombosis develops. However there are no standard recommendations for the use of anticoagulant therapy of HES in the setting of thrombosis. Methods: We herein present a case of a 46-year-old female who presented with marked peripheral eosinophilia with symptoms of multi-organ infiltration and extensive deep venous thrombosis (DVT). In this case, evaluation was carried out before the diagnosis was established, and timely standard-dose corticosteroids combined with a new oral anticoagulant (NOAC) therapy were carried out. Results: These measures resulted in a rapid response and long-term disease control. Conclusion: Although there are no data to support which anticoagulant is preferred in this setting, this case indicates that the new oral anticoagulants may play an important role in the treatment of thrombosis in HES. PMID:27583887

  14. 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.

  15. Controversies in venous thromboembolism: the unique case of isolated distal deep vein thrombosis.

    Science.gov (United States)

    Porfidia, Angelo; Carnicelli, Annamaria; Bonadia, Nicola; Pola, Roberto; Landolfi, Raffaele

    2016-09-01

    Venous thromboembolism (VTE) represents the third leading cause of cardiovascular mortality, and it is the main cause of preventable mortality in hospitalized patients. Among VTE, there is the unique case of isolated distal deep vein thrombosis (IDDVT), which still lacks an agreement in terms of optimal therapeutic strategy. Although most IDDVTs are self-limiting and associated with a very low risk of embolic complications, still not all IDDVTs can be safely identified as stable. Lack of strong scientific evidence, fear of thromboembolic complications, and risk of bleeding upon initiation of anticoagulant treatment result in very heterogeneous therapeutic strategies among physicians. Here, we provide a comprehensive review of the literature, highlight the many controversial issues regarding IDDVTs, and call for a consensus of experts aimed to shed new light on the gray areas of IDDVT management and therapy. PMID:27126683

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

    Science.gov (United States)

    Kitchen, Levi; Lawrence, Matthew; Speicher, Matthew; Frumkin, Kenneth

    2016-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  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. 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。

  20. 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.......6-3.3]). In the GPA cohort, 70% of the vascular events occurred during phases with active vasculitis. CONCLUSION: The present study confirms that GPA patients have a markedly increased risk of venous thromboembolism. We did not observe an increased risk of stroke in our cohort. Thus, our observations demonstrate...

  1. 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.

  2. Venous thromboses and thromboembolism in acute stroke: risk factors, diagnosis, treatment, and prevention

    Directory of Open Access Journals (Sweden)

    Andrei Viktorovich Fonyakin

    2013-01-01

    Full Text Available Stroke patients among all patients with somatic diseases are at one of the highest risks for venous thromboembolism (VTE. The proven risk factors for venous thrombosis in stroke are prolonged immobilization, elderly age, obesity, diabetes mellitus, and inherited coagulopathies. If no drug prevention is done, the course of stroke is complicated by deep vein thrombosis (DVT in 75% of the immobilized patients and pulmonary thromboembolism develops in 20%. At present there are mechanical, pharmacological, and combined DVT prevention strategies that may considerably lower the rate of pulmonary embolism. In stroke patients, the use of low-molecular-weight heparins (LMWH reduces therisk of DVT, without increasing the risk of hemorrhagic complications. Novel oral anticoagulants used to treat venous thrombosis and VTE in stroke patients are an equivalent alternative to LMWH therapy. Treatment with novel oral anticoagulants to prevent recurrent VTE is effective and safe and may be continued up to 1–2 years.

  3. Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

    International Nuclear Information System (INIS)

    Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts

  4. Acute cerebrovascular incident in a young woman: Venous or arterial stroke? – Comparative analysis based on two case reports

    Science.gov (United States)

    Sleiman, Katarzyna; Zimny, Anna; Kowalczyk, Edyta; Sąsiadek, Marek

    2013-01-01

    Summary Background Cerebrovascular diseases are the most common neurological disorders. Most of them are arterial strokes, mainly ischemic, less often of hemorrhagic origin. Changes in the course of cerebral venous thrombosis are less common causes of acute cerebrovascular events. Clinical and radiological presentation of arterial and venous strokes (especially in emergency head CT) may pose a diagnostic problem because of great resemblance. However, the distinction between arterial and venous stroke is important from a clinical point of view, as it carries implications for the treatment and determinates patient’s prognosis. Case Report In this article, we present cases of two young women (one with an acute venous infarction, the second with an arterial stroke) who presented with similar both clinical and radiological signs of acute vascular incident in the cerebral cortex. We present main similarities and differences between arterial and venous strokes regarding the etiology, clinical symptoms and radiological appearance in various imaging techniques. Conclusions We emphasize that thorough analysis of CT (including cerebral vessels), knowledge of symptoms and additional clinical information (e.g. risk factors) may facilitate correct diagnosis and allow planning further diagnostic imaging studies. We also emphasize the importance of MRI, especially among young people, in the differential diagnosis of venous and arterial infarcts. PMID:24505227

  5. Detection of deep venous thrombosis in an experimental animal model using radioactive labelled tirofiban GPIIb/IIIa inhibitor

    International Nuclear Information System (INIS)

    Detection of acute deep venous thrombosis (DVT), including biochemical information on thrombus formation, is one of the most important issues in clinical nuclear medicine. Thus, development of radiolabelled small peptide or peptidomimetic ligands that can bind platelets and their specific expressed receptor have been suggested as a new approach to detect clot location and, more essentially, determine the age and morphology of the evolving thrombus. This new approach has focused on the use of a series of radiolabelled platelet GPIIb/IIIa receptor antagonists. Tirofiban N-(butylsulfonyl)- 4-O-(4-(4-piperidyl)-L-tyrosine is a non-peptide tyrosine derivate. The aim of the study was to introduce radioactive labelled tirofiban as a specific imaging agent for acute DVT. Iodine-125-tirofiban labelling was performed using the Iodo-gen method with a >95% yield. Technetium-99-tirofiban labelling in the presence of a stannous reducing agent was obtained with a >95% yield. Both labelled preparations have a fast blood clearance in the normal rat model (without induced thrombosis). More than 80% of the injected dose was eliminated from the circulation in the first hour after injection. Biodistribution and visualization of the labelled molecule was carried out using an experimental model of thrombosis in the male Wistar rat. Planar images were obtained 30 min and 60 min after application of 2-6 x 106 counts/min 99mTc-tirofiban, as well as 2 h and 24 h after application of 1.6-2.1 x 106 counts/min in the rat's tail vein. Sensitivity and specificity were determined using the ratio 'left leg positive for DVT' and 'right leg negative for DVT'. The obtained ratio was 1.76 after 1 h, 1.99 after 3 h and 2.06 after 24 h in the case of iodine labelled tirofiban, and 1.54 after 30 min and 5.04 after 60 min with 99mTc-tirofiban. These values were considered as positive in the detection of acute DVT. The results from experimental studies show that radiolabelled tirofiban could be helpful in

  6. Return to normal of sup(99m)Tc-plasmin test after deep venous thrombosis and its relationship to vessel wall fibrinolysis

    Energy Technology Data Exchange (ETDEWEB)

    Edenbrandt, C.M.; Hedner, U.; Tengborn, L.; Nilsson, J.; Ohlin, P.

    1986-08-01

    Fourteen patients with deep venous thrombosis (DVT) and a positive sup(99m)Tc-plasmin test were followed up to determine how soon a negative test was obtained. Localization and extension of the thrombi were determined by phlebography. Plasminogen activator activity in vein walls and local fibrinolytic activity after venous occlusion were measured in order to find out what the prerequisites for impaired thrombolysis are. The time required to obtain a negative sup(99m)Tc-plasmin test showed considerable variation, ranging from less than 1 week to more than 6 months. The sup(99m)Tc-plasmin test had returned to normal in 64% of the patients after 6 months. No relationship was found between vessel wall fibrinolysis and time to normalization. Instead, we found an association between the time to normalization of the sup(99m)Tc-plasmin test and the size of the thrombus, according to phlebography, as well as between the time to normalization of the sup(99m)Tc-plasmin test and the extension of leg points with a positive sup(99m)Tc-plasmin test at admission. The finding of abnormal sup(99m)Tc-plasmin test results more than 6 months after acute DVT is of practical importance and warrants caution when evaluating patients with symptoms and signs suggestive of acute recurrent DVT.

  7. 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

  8. Predicting venous insufficiency in flaps raised on the deep inferior epigastric system using computed tomography (CT) angiography.

    Science.gov (United States)

    Wagels, M; Pillay, R; Saylor, A; Vrtik, L; Senewiratne, S

    2015-12-01

    Computed Tomography Angiogram (CTA) has become a routine part of pre-operative assessment of vascular anatomy and design in perforator flaps. We conducted a retrospective cohort study of flap raised on the deep inferior epigastric system (DIES) at our institution in order to identify CTA signs that might predict venous congestion in these flaps. 98 consecutive patients who had 124 DIES flaps raised from 2008 to 2012 were studied. Of these 124 flaps, four (3.2%) developed venous congestion. Our results showed that a Superficial Inferior Epigastric Vein (SIEV) that is larger than the DIEV at origin is highly predictive of congestion (5.2 vs 3.5 mm, p = 0.007). The findings of an axial non-arborising superficial system (96.7% vs 0, p flap failure with patients, and contingency planning to augment venous drainage with the superficial system if required. PMID:26375461

  9. 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.

  10. 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.

  11. 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

  12. 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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. The 125I-fibrinogen uptake test in the diagnosis of deep venous thrombosis of the lower limbs

    International Nuclear Information System (INIS)

    After a brief review of development of the labelled fibrinogen uptake test for the diagnosis of deep venous thrombosis of the legs, details of methodology is presented. To illustrate the use of the fibrinogen uptake test a case is reported and the value, limitations and indications of this method, that has changed the concepts about natural history and incidence of this important disease, are discussed. (Author)

  20. 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...... ascending phlebography was used as reference procedure, and the criteria for deep venous thrombosis were intraluminal filling defects at phlebography. Six patients developed unilateral deep venous thrombosis. All three screening procedures revealed many false positive and several false negative results....... 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....

  1. The programmed nursing care for lower extremity deep venous thrombus patients receiving interventional thrombolysis: its effect on living quality

    International Nuclear Information System (INIS)

    Objective: Tu study the effect of comprehensive programmed nursing intervention on the living quality in patients with lower extremity deep venous thrombus who receive interventional thrombolysis therapy. Methods: A total of 60 patients receiving interventional thrombolysis due to lower extremity deep venous thrombus were randomly and equally divided into two groups. Patients in study group (n=30) was treated with comprehensive programmed nursing intervention in addition to the conventional therapy and routine nursing care, while patients in control group (n=30) was treated with the conventional therapy and routine nursing care only. The conventional therapy and routine nursing care included the nursing assessment before the operation, observation of the vital signs and the cooperation psychological care during the operation, the performance of medication according to the doctor's orders after the operation, etc. The comprehensive programmed nursing intervention included the nursing assessment of the patient before operation and the scientifically making of the nursing plan, which mainly referred to the cognitive behavior, the psychological care and the health education. They were systematically carried out during the perioperative period. One month after discharge the patients were asked to pay a return visit. The living quality was evaluated with relevant standards, and the results were compared between the two groups. Results: The score of living quality in the study group was significantly higher than that in the control group (P<0.01). Conclusion: The comprehensive programmed nursing intervention can significantly improve the living quality of lower extremity deep venous thrombosis patients who receive interventional thrombolysis therapy. (authors)

  2. 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.

  3. 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

  4. 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.

  5. Absence of inferior vena cava in 14-year old boy associated with deep venous thrombosis and positive Mycoplasma pneumoniae serum antibodies- a case report

    OpenAIRE

    Kalicki, Boleslaw; Sadecka, Monika; Wawrzyniak, Agata; Kozinski, Piotr; Dziekiewicz, Miroslaw; Jung, Anna

    2015-01-01

    Background Absence of the inferior vena cava is a rare vascular anomaly, which usually remains asymptomatic in childhood. It is recognized as the risk factor for deep venous thrombosis, since the collateral circulation does not provide adequate drainage of the lower limbs. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in school-aged children and adolescents. Mycoplasma pneumoniae infection might be associated with deep venous thrombosis but its pathophysiology remain...

  6. Detection of experimental pulmonary thrombosis and deep venous thrombosis by 99Tcm-DMP444

    International Nuclear Information System (INIS)

    Objective: To evaluate 99Tcm-dimethyl phthalate (DMP) 444 scintigraphy for detection of PE and deep venous thrombosis (DVT) in animal models. Methods: The experimental PE and DVT were induced in 5 dogs. Venous blood samples (1 ml) were collected at 30 s, 2 min, 3 min, 4 min, 5 min, 10 min, 15 min, 30 min, 60 min, 90 min and 120 min respectively after the tracer injection. The collected blood samples were weighed and counted for radioactivity in a γ-counter. The radioactivity was expressed as a percentage of the initial (30 s) activity. The blood clearance rate at each time point was obtained. The images of lungs and legs were acquired at 15, 30, 60, 90 and 120 min after the injection. ROI was drawn on PE, DVT, lung, contralateral femoral vein and lateral thigh for calculating the radioactivity ratios of PE/lung (P/L), DVT/blood (D/B) and DVT/muscle (D/M). PE and DVT were removed, weighed and counted for radioactivity ex vivo to determine the % ID/g. Data at different time points were compared by one-way repeated measures analysis of variance. Results: Blood clearance rate of 99Tcm-DMP444 was (65.4 ± 3.9) % at 120 min after the injection. The radioactivity ratios of PE and DVT increased over time, and the radioactivity ratios of P/L, D/B and D/M increased from 2.41 ±0.28, 1.67 ±0.33, 2.20 ±0.14 at 15 min to 3.96 ± 0.64, 2.56 ± 0.57, 3.90 ± 0.95 at 120 min, after the injection respectively (F=14.57, 7.68, 9.37, all P<0.05). The % ID/g of PE and DVT was 0.085 ± 0.023 and 0.054 ± 0.018 respectively. Conclusion: 99Tcm-DMP444 may become a potential radiopharmaceutical agent for noninvasively detecting PE and DVT. (authors)

  7. 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.

  8. 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...... children hospitalized from January 2000 to March 2008 with newly diagnosed ALL and with double-lumen total implantable devices (TIDs) or tunneled external catheters (TEs) were included retrospectively. We only used data related to the patient's first catheter. RESULTS: We included 98 children; 35 received...... a TID and the remaining 63 received a TE. A total number of 29,566 catheter days and 93 catheter-associated blood stream infections (CABSI) was identified. We found a CABSI rate of 3.1/1,000 catheter days (5.4/1,000 catheter days for TEs and 1.4/1,000 catheter days for TIDs, incidence rate ratio (IRR) 3...

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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。

  14. 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.

  15. D-dimer testing: advantages and limitations in emergency medicine for managing acute venous thromboembolism.

    Science.gov (United States)

    Siragusa, Sergio

    2006-01-01

    D-dimer values can be rapidly determined and used for the management of acute venous thromboembolism (VTE). However, its role in the setting of emergency still remains unclear and inappropriate testing is a significant clinical problem. This review discusses the currently used assays, clinical indications, and limitations of D-dimer measurement. Studies in English language were identified by searching PubMed from December 1985 to December 2005. Available literature on D-dimer was identified from Medline, along with cross referencing from the reference lists of major articles and reviews on this subject. Among 56 articles collected, 14 papers, 4 overviews and 1 systemic review were selected accordingly to predefined criteria. Data synthesis shows that D-dimer testing has sufficient diagnostic accuracy for ruling out acute VTE if used in combination with standardised clinical judgement. D-dimer seems to be also a useful tool for managing suspected VTE patients in absence of immediate imaging. Attention should be paid to exclude conditions that may affect the accuracy of the test, such as concomitant disease, heparin administration and symptom duration >15 days. Although enzyme-linked immunosorbent assay determination has the highest accuracy, immunoturbidimetric assay seems the most suitable on an emergency basis because of its rapid performance. In conclusion, at present D-dimer testing can be safely used in the management of acute VTE in emergency medicine. However, because of its heterogeneity related to the method used and setting implemented, it is preferable to assess D-dimer accuracy before its implementation in management strategies for VTE. PMID:16941816

  16. 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.

  17. 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.

  18. Anticoagulation Management Practices and Outcomes in Elderly Patients with Acute Venous Thromboembolism: A Clinical Research Study.

    Directory of Open Access Journals (Sweden)

    Charlène Insam

    Full Text Available Whether anticoagulation management practices are associated with improved outcomes in elderly patients with acute venous thromboembolism (VTE is uncertain. Thus, we aimed to examine whether practices recommended by the American College of Chest Physicians guidelines are associated with outcomes in elderly patients with VTE. We studied 991 patients aged ≥65 years with acute VTE in a Swiss prospective multicenter cohort study and assessed the adherence to four management practices: parenteral anticoagulation ≥5 days, INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulation, early start with vitamin K antagonists (VKA ≤24 hours of VTE diagnosis, and the use of low-molecular-weight heparin (LMWH or fondaparinux. The outcomes were all-cause mortality, VTE recurrence, and major bleeding at 6 months, and the length of hospital stay (LOS. We used Cox regression and lognormal survival models, adjusting for patient characteristics. Overall, 9% of patients died, 3% had VTE recurrence, and 7% major bleeding. Early start with VKA was associated with a lower risk of major bleeding (adjusted hazard ratio 0.37, 95% CI 0.20-0.71. Early start with VKA (adjusted time ratio [TR] 0.77, 95% CI 0.69-0.86 and use of LMWH/fondaparinux (adjusted TR 0.87, 95% CI 0.78-0.97 were associated with a shorter LOS. An INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulants was associated with a longer LOS (adjusted TR 1.2, 95% CI 1.08-1.33. In elderly patients with VTE, the adherence to recommended anticoagulation management practices showed mixed results. In conclusion, only early start with VKA and use of parenteral LMWH/fondaparinux were associated with better outcomes.

  19. 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

  20. Low-molecular-weight heparins in the treatment of venous thromboembolism

    OpenAIRE

    Huisman Menno V; Ageno Walter

    2000-01-01

    Abstract Venous thromboembolism is a common disease that is associated with considerable morbidity if left untreated. Recently, low-molecular-weight heparins (LMWHs) have been evaluated for use in acute treatment of deep venous thrombosis and pulmonary embolism. Randomized studies have shown that LMWHs are as effective as unfractionated heparin in the prevention of recurrent venous thromboembolism, and are as safe with respect to the occurrence of major bleeding. A pooled analysis did not sho...

  1. 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.

  2. [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.

  3. Venous Thromboembolic Disease

    OpenAIRE

    Jaff, Michael R

    2002-01-01

    Physicians understand the importance of prompt diagnosis and therapy of venous thromboembolism. This is a common and potentially deadly disease. Many patients may have no symptoms of this disorder, yet face a significant risk of serious complications if undiagnosed and untreated. Venous duplex ultrasonography has become the diagnostic test of choice for deep venous thrombosis. Quantitative d-dimer levels may be very helpful in establishing the diagnosis of venous thrombosis. Helical (spiral) ...

  4. Venous insufficiency

    Science.gov (United States)

    Chronic venous insufficiency; Chronic venous stasis; Chronic venous disease ... blood moving forward toward the heart. With chronic venous insufficiency, vein walls are weakened and valves are damaged. ...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Fate of Central Venous Catheters Used for Acute Extracorporeal Treatment in Critically Ill Pediatric Patients: A Single Center Experience.

    Science.gov (United States)

    Rus, Rina R; Premru, Vladimir; Novljan, Gregor; Grošelj-Grenc, Mojca; Ponikvar, Rafael

    2016-06-01

    Renal replacement treatment (RRT) is required in severe acute kidney injury, and a functioning central venous catheter (CVC) is crucial. Twenty-eight children younger than 16 years have been treated at the University Medical Centre Ljubljana between 2003 and 2012 with either acute hemodialysis (HD) and/or plasma exchange (PE), and were included in our study. The age of the patients ranged from 2 days to 14.1 years. Sixty-six CVCs were inserted (52% de novo, 48% guide wire). The sites of insertion were the jugular vein in 20% and the femoral vein in 80%. Catheters were in function from 1 day to 27 days. The most common cause for CVC removal or exchange was catheter dysfunction (50%). CVCs were mostly inserted in the femoral vein, which is the preferred site of insertion in acute HD/PE because of the smaller number of complications. PMID:27312920

  10. 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.

  11. Asymptomatic deep venous thrombosis in the calf: accuracy and limitations of ultrasonography as a screening test after total knee arthroplasty.

    Science.gov (United States)

    Vanninen, R; Manninen, H; Soimakallio, S; Katila, T; Suomalainen, O

    1993-03-01

    Patients who have recently undergone total knee arthroplasty are at high risk of developing deep venous thrombosis (DVT) in the calf. The clinical diagnosis of DVT is difficult in these patients owing to recent operation. A combination of compression ultrasonography (US) and colour flow imaging was used as a screening method of asymptomatic DVT in 51 patients who had undergone total knee replacement surgery. Both limbs were examined by US from the common femoral vein to the ankle approximately 7 days after operation and the results were compared with bilateral venography. 12 patients (24%) developed infrapopliteal DVT on the operated side, in two cases the thrombosis extended to the lower part of popliteal vein. One patient had bilateral thrombosis. US showed sensitivity of 77%, specificity of 96% and overall accuracy of 93%. US seems to be a useful screening method for DVT after knee replacement operation. PMID:8472111

  12. 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...

  13. 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. PMID:23168510

  14. Acute effects of haemodialysis on central venous and arterial pressure characteristics

    OpenAIRE

    Thalhammer, Christoph; Segerer, Stephan; Augustoni, Marlene; Jacomella, Vincenzo; Clemens, Robert K; Wüthrich, Rudolf P.; Amann-Vesti, Beatrice R; Husmann, Marc

    2015-01-01

    BACKGROUND Hemodynamic stability of patients during dialysis sessions is of pivotal importance in daily practice and accurate determination of dry weight (DW) remains a challenge. Little information is available about central venous and aortic pressure during dialysis. In this pilot study we used a new non-invasive technique to describe the changes in central venous pressure (CVP) during dialysis. METHODS An ultrasound-assisted silicon-based pressure-manometer was used at the contralateral...

  15. 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.

  16. 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

  17. 下肢深静脉血栓形成介入治疗规范的专家共识%The consensus among Chinese interventional experts on the standard of interventional therapy for deep venous thrombosis of lower extremity

    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

    This paper aims to introduce the indications and contraindications of catheter-directed thrombolysis, percutaneous mechanical thrombectomy, balloon angioplasty and stent implantation for deep venous thromhosis of lower extremity, and also aims to summarize and to illustrate the manipulating procedure, the points for attention, the perioperative complications and preventions in performing different kind of interventional technique. Great importance is attached to the interventional therapy for both acute and subacute deep venous thrombosis of lower extremity in order to effectively reduce the occurrence of post-thrombosis syndrome. (J Intervent Radiol, 2011 , 20 : 505-510)%提出经导管溶栓治疗、机械性血栓消除术、球囊血管成形术及支架植入术治疗下肢深静脉血栓形成的适应证和禁忌证,对各种介入技术的操作步骤、注意事项、围手术期处理和并发症防治进行归纳和说明.强调重视急性期和亚急性期DVT的介入治疗,以减少血栓形成后综合征的发生率.

  18. 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.

  19. 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.

  20. 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

  1. 下肢深静脉血栓形成的临床护理体会%Clinical nursing experience of deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    马敏

    2011-01-01

    Objective : To study the deep venous thrombosis causes and nursing. Methods : To carry out a summary on 38 cases of deep venous thrombosis in patients with specific clinical nursing practice and experience. Results :33 cases were cured, 5 cases improved. Conclusion : After careful nursing and providing specific nursing countermeasure can help patients recover as soon as possihle.%目的:探讨下肢深静脉血栓形成的原因及护理体会.方法:对38例下肢深静脉血栓患者临床护理的具体做法及体会进行总结.结果:治愈33例,好转5例.结论:经过细心护理,提供针对性护理对策,帮助患者尽快恢复健康.

  2. 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.

  3. 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.

  4. 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

    International Nuclear Information System (INIS)

    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

  5. 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.

  6. 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;

    2015-01-01

    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) ...

  7. 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. PMID:23775628

  8. 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.

  9. 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.

  10. 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.

  11. 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)....

  12. 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。

  13. 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.

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

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    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.)

  15. 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.

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    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.

  16. 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).

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

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    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.

  18. 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.

  19. 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.

  20. Predicted burden of venous disease.

    Science.gov (United States)

    Onida, Sarah; Davies, Alun Huw

    2016-03-01

    Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. These risk factors also lead to an increased risk of developing superficial and/or deep venous insufficiency, increasing disease prevalence and morbidity. In this chapter, the authors review the current and future burden of chronic venous disease from an epidemiological, quality of life and economic perspective. PMID:26916773

  1. 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.

  2. 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.

  3. 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

  4. Impairment of Venous Drainage on Extracorporeal Membrane Oxygenation Secondary to Air Trapping in Acute Asphyxial Asthma.

    Science.gov (United States)

    Niimi, Kevin S; Lewis, Leslie S; Fanning, Jeffrey J

    2015-06-01

    The inability to adequately support a patient on extracorporeal membrane oxygenation (ECMO) due to impaired drainage is not an uncommon occurrence during support. Typically, the causes include hypovolemia, kinks in the circuit, cannula malposition, or inadequate cannula size. In this report we present an uncommon etiology of this problem. A 3-year-old female presented to our hospital in status asthmaticus and pulseless electrical activity (PEA). This was a result of dynamic hyperinflation of the lungs causing physical obstruction of venous return to the heart. Upon initiating venoarterial (VA) ECMO, we experienced inadequate drainage that did not improve despite multiple interventions. This resolved with the addition of an inhaled anesthetic gas to treat this patient's severe bronchospasm. This case illustrates the importance of considering a patient's physiology or disease state and how that may affect the mechanics of ECMO support. PMID:26405359

  5. Treatment of pulmonary embolism and prevention of recurrence by placement of vena cava filters in prevention of deep venous thrombosis: Case report

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    Vučićević-Trobok Jadranka

    2002-01-01

    Full Text Available Introduction In patients with pulmonary thromboembolism it is clinical to suspect the disease, establish the diagnosis and initiate anticoagulation treatment as early as possible in order to prevent relapses, which may be fatal. Deep venous thrombosis of lower extremities is the most common site of origin, which initially may remain obscure. Case report Two weeks prior to admission the patient had right-sided chest pain accompanied with dyspnea, interpreted and treated as pleuropneumonia. Pulmonary thromboembolism was suspected due to clinical symptoms, chest X-ray, elevated enzyme levels findings, blood gas analysis with hypoxemia and ECG with right heart overload. The diagnosis of pulmonary thromboembolism confirmed by lung scintigraphy presented with perfusion defects. After twenty days of heparin therapy, the patient developed left leg edema. Ultrasound screening confirmed bilateral iliac-femoral popliteal vein thrombosis of iliacofemoropopliteal veins bilaterally. Phlebography performed via jugular vein disclosed thrombotic material in the right common iliac vein, as well as in the vena cava inferior. In the course of the procedure vena cava filter has been placed. Discussion Although the patient was receiving anticoagulation heparin therapy, he developed pulmonary thromboembolism relapse and deep venous thrombosis. In our patient, vena cava filter placement was aimed at preventing pulmonary thromboembolism relapse. Since a deficit of S protein was also established, the patient is unfortunately likely to develop thrombosis at other sites as well. Conclusion In our patient pulmonary thromboembolism was a consequence of deep venous thrombosis, and the diagnosis was established by ultrasound screening of the lower extremities and confirmed by phlebography. During phlebography vena cava filter was placed in order to prevent pulmonary thromboembolism.

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

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    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

  7. 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.

  8. 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

  9. 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.

  10. Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study

    OpenAIRE

    Liu, Kai; Meng, Jiaxiang; Yang, Shuofei; Liu, Baochen; Ding, Weiwei; Wu, Xingjiang; Li, Jieshou

    2015-01-01

    Objective This study aims to evaluate the clinical outcomes of transcatheter thrombolysis in acute superior mesenteric venous thrombosis (ASMVT) associated with bowel necrosis. Methods A retrospective study of six patients with ASMVT treated with catheter-directed thrombectomy/thrombolysis and damage control surgery at Jinling Hospital (Nanjing, China) between 2010 and 2013 was conducted. Demographics, past medical history, risk factors, therapeutic methods and effects, mortality, and follow-...

  11. 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.

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

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    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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Nursing of deep venous thrombosis after catheter directed thrombolysis%下肢深静脉血栓形成导管溶栓的术后护理

    Institute of Scientific and Technical Information of China (English)

    王洁; 黄庆红

    2011-01-01

    Objective To discuss the nursing of deep venous thrombosis treated with inferior vena cava filter implantation and catheter directed thrombolysis. Methods To summarize the experience of how to observe the effects and nursing 37 patients with deep venous thrombosis after inferior vena cava filter implantation with catheter directed thrombolysis. Results All these 37 patients gained effective treatment, the limb swelling subsided and there were no pulmonary embolism. Conclusion To give patients active, careful and effective nursing is important for successful treatment after they accept inferior vena cava filter implantation with catheter directed thrombolysis.%目的 探讨下腔静脉滤器置入联合导管溶栓治疗下肢深静脉血栓的护理.方法 总结37例下肢深静脉血栓形成患者置入下腔静脉滤器联合导管溶栓治疗的疗效及护理.结果 37例下腔静脉滤器置入联合导管溶栓的患者均得到有效的治疗,患肢肿胀消退,未发生肺栓塞.结论 下腔静脉滤器置入联合导管溶栓后积极、细致、有效的护理是保证治疗成功的重要环节.

  18. The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population

    International Nuclear Information System (INIS)

    Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; in 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients

  19. The use of indium-111 labeled platelet scanning for the detection of asymptomatic deep venous thrombosis in a high risk population

    Energy Technology Data Exchange (ETDEWEB)

    Siegel, R.S.; Rae, J.L.; Ryan, N.L.; Edwards, C.; Fortune, W.P.; Lewis, R.J.; Reba, R.C. (George Washington Univ. Medical Center, Washington, DC (USA))

    1989-11-01

    Five hundred indium-111 labeled platelet imaging studies (387 donor and 113 autologous) were performed postoperatively in 473 patients who had undergone total hip replacement, total knee replacement, or internal fixation of a hip fracture to detect occult deep venous thrombosis. All patients had been anticoagulated prophylactically with aspirin, warfarin sodium (Coumadin), or dextran. Thirty-four possible cases of proximal deep venous thrombosis were identified in 28 asymptomatic patients. To verify the scan results, 31 venograms were performed in 25 patients (three refused). In 21 of 31 cases, totally occlusive thrombi were detected; in 5 cases, partially occlusive thrombi were detected; in 5 cases, no thrombus was seen. No patient who had a negative scan nor any patient who had a verified positive scan (and received appropriate heparin therapy) subsequently developed symptoms or signs of pulmonary embolism. One hundred forty-one indium study patients also underwent Doppler ultrasonography/impedance plethysmography (Doppler/IPG) as a comparative non-invasive technique. In 137 cases, the results of the indium study and Doppler/IPG studies were congruent. The indium study had no false negative results that were detected by Doppler/IPG. No patient had any clinically evident toxicity. These results suggest that indium-111 labeled platelet scanning is a safe, noninvasive means for identifying DVT in high risk patients.

  20. CATCH: a randomised clinical trial comparing long-term tinzaparin versus warfarin for treatment of acute venous thromboembolism in cancer patients

    International Nuclear Information System (INIS)

    Low-molecular-weight heparin (LMWH) is recommended and commonly used for extended treatment of cancer-associated thrombosis (CAT), but its superiority over warfarin has been demonstrated in only one randomised study. We report here the rationale, design and a priori analysis plans of Comparison of Acute Treatments in Cancer Haemostasis (CATCH; NCT01130025), a multinational, Phase III, open-label, randomised controlled trial comparing tinzaparin with warfarin for extended treatment of CAT. The primary objective is to assess the efficacy of tinzaparin in preventing recurrent venous thromboembolism (VTE) in patients with active cancer and acute, symptomatic proximal deep vein thrombosis and/or pulmonary embolism. The secondary objectives are to determine: safety of tinzaparin given over 6 months; clinical and laboratory markers for recurrent VTE and/or major bleeding; 6-month overall mortality; incidence and severity of post-thrombotic syndrome; patient-reported quality of life; and healthcare resource utilisation. Nine hundred patients are randomised to receive tinzaparin 175 IU/kg once daily for 6 months or initial tinzaparin 175 IU/kg once daily for 5–10 days and dose-adjusted warfarin (target INR 2.0–3.0) for 6 months. The primary composite outcome is time to recurrent VTE, including incidental VTE and fatal pulmonary embolism. All patients are followed up to 6 months or death, whichever comes sooner. Blinded adjudication will be performed for all reported VTE, bleeding events and causes of death. Efficacy will be analysed using centrally adjudicated results of all patients according to intention-to-treat analysis. An independent Data Safety Monitoring Board is reviewing data at regular intervals and an interim analysis is planned after 450 patients have completed the study. The results will add significantly to the knowledge of the efficacy, safety and cost effectiveness of tinzaparin in the prevention of recurrent VTE in patients with cancer and thrombosis

  1. 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.

  2. 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。

  3. 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。

  4. 双侧全膝关节置换后下肢深静脉血栓形成与高血压的关系%Correlation between hypertension and deep venous thrombosis after bilateral total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    王培丞; 曹力; 杨德盛; 胥伯勇; 郭文涛; 艾力•热黑

    2015-01-01

      结果与结论:共纳入525例患者,高血压组219例,对照组306例。全膝关节置换后20例患者发生下肢深静脉血栓,发生率为3.8%,其中高血压组发生下肢深静脉血栓13例(2.5%),对照组发生下肢深静脉血栓7例(1.3%)。通过卡方检验分析,高血压组全膝关节置换后发生下肢深静脉血栓的风险是对照组患者的2.7倍,差异有显著性意义(P OBJECTIVE:To observe whether hypertension would influence the occurrence of deep venous thrombosis in patients who underwent total knee arthroplasty. METHODS:A retrospective analysis was performed among patients underwent total knee arthroplasty in Department of Joint Surgery, the First Affiliated Hospital of Xinjiang Medical University from September 2010 to March 2014. Patients were divided into hypertension group and control group based on their medical history of hypertension. Doppler ultrasonography was applied to detect both lower extremities among these patients after operation, to diagnose if there was any evidence of deep venous thrombosis. The incidence of deep venous thrombosis in the two groups was compared. The correlation of hypertension and deep venous thrombosis was analyzed. RESULTS AND CONCLUSION:A total of 525 patients were involved in this study, including 219 in hypertension group and 306 in control group. Among them, 20 patients appeared deep venous thrombosis and the incidence rate was 3.8%. 13 patients in the hypertension group (2.5%) and 7 patients in the control group (1.3%) developed deep venous thrombosis. Chi-square test showed that, the risk of deep venous thrombosis in the hypertension group was 2.7 times of that in the control group, and the differences were statistical y significant between the two groups (P<0.05). Hypertensive patients suffer a higher incidence rate of deep venous thrombosis after total knee arthroplasty compared with those with normal blood pressure.

  5. Venous thrombosis.

    Science.gov (United States)

    Wolberg, Alisa S; Rosendaal, Frits R; Weitz, Jeffrey I; Jaffer, Iqbal H; Agnelli, Giancarlo; Baglin, Trevor; Mackman, Nigel

    2015-01-01

    Venous thromboembolism (VTE) encompasses deep-vein thrombosis (DVT) and pulmonary embolism. VTE is the leading cause of lost disability-adjusted life years and the third leading cause of cardiovascular death in the world. DVT leads to post-thrombotic syndrome, whereas pulmonary embolism can cause chronic pulmonary hypertension, both of which reduce quality of life. Genetic and acquired risk factors for thrombosis include non-O blood groups, factor V Leiden mutation, oral contraceptive use, hormone replacement therapy, advanced age, surgery, hospitalization and long-haul travel. A combination of blood stasis, plasma hypercoagulability and endothelial dysfunction is thought to trigger thrombosis, which starts most often in the valve pockets of large veins. Animal studies have revealed pathogenic roles for leukocytes, platelets, tissue factor-positive microvesicles, neutrophil extracellular traps and factors XI and XII. Diagnosis of VTE requires testing and exclusion of other pathologies, and typically involves laboratory measures (such as D-dimer) and diagnostic imaging. VTE is treated with anticoagulants and occasionally with thrombolytics to prevent thrombus extension and to reduce thrombus size. Anticoagulants are also used to reduce recurrence. New therapies with improved safety profiles are needed to prevent and treat venous thrombosis. For an illustrated summary of this Primer, visit: http://go.nature.com/8ZyCuY. PMID:27189130

  6. Short- and Long-Term Prognostic Implications of Jugular Venous Distension in Patients Hospitalized With Acute Heart Failure.

    Science.gov (United States)

    Chernomordik, Fernando; Berkovitch, Anat; Schwammenthal, Ehud; Goldenberg, Ilan; Rott, David; Arbel, Yaron; Elis, Avishai; Klempfner, Robert

    2016-07-15

    The present study was designed to assess the role of jugular venous distension (JVD) as a predictor of short- and long-term mortality in a "real-life" setting. The independent association between the presence of admission JVD and the 30-day, 1- and 10-year mortality was assessed among 2,212 patients hospitalized with acute heart failure (HF) who were enrolled in the Heart Failure Survey in Israel (2003). Independent predictors of JVD finding in study patients included: the presence of significant hyponatremia (odds ratio [OR] 1.48; p = 0.03), reduced left ventricular ejection fraction ([LVEF] OR 1.24; p = 0.03), anemia (OR 1.3; p = 0.01), New York Heart Association III to IV (OR 1.34; p 75 years (OR 1.32; p = 0.01). The presence of JVD versus its absence at the time of HF hospitalization was associated with increased 30-day mortality (7.2% vs 4.9%, respectively; p = 0.02), 1-year (33% vs 28%, respectively; p <0.001), and greater 10-year mortality (91.8% vs 87.2%, respectively; p <0.001). Consistently, interaction term analysis demonstrated that the presence of JVD at the time of the index HF hospitalization was independently associated with a significant increased risk for 10-year mortality, with a more pronounced effect among younger patients, patients with reduced LVEF, preserved renal function, and chronic HF. In conclusion, in patients admitted with HF, JVD is associated with specific risk factors and is independently associated with increased risk of both short- and long-term mortality. These findings can be used for improved risk assessment and management of this high-risk population. PMID:27287063

  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. Evaluation of the Effects of Honey on Acute-Phase Deep Burn Wounds

    OpenAIRE

    Nakajima, Yukari; Mukai, Kanae; Nasruddin; kOMATSU, Emi; Iuchi, Terumi; Kitayama, Yukie; Sugama, Junko; Nakatani, Toshio

    2013-01-01

    This study aimed to clarify the effects of honey on acute-phase deep burn wounds. Two deep burn wounds were created on mice which were divided into four groups: no treatment, silver sulfadiazine, manuka honey, and Japanese acacia honey. Wound sizes were calculated as expanded wound areas and sampled 30 minutes and 1–4 days after wounding for histological observation. The wound sections were subjected to hematoxylin and eosin and immunohistological staining to detect necrotic cells, apoptotic ...

  10. 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,

  11. 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.

  12. 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.

  13. 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。

  14. 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, being female, or ...

  15. 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.

  16. 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.

  17. 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.

  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. 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。

  20. 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 mutant allele G (P mutant genotypes were associated with increased levels of sEPCR. Although in 4678G/C, our results demonstrated that the mutant genotype (CC) was considered as a protective 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. PMID:26340463

  1. 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.

  2. 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)

  3. Unusual Case of Cerebral Venous Sinus Thrombosis in Patient with Ulcerative Colitis in Remission.

    Science.gov (United States)

    Meher, Lalit Kumar; Dalai, Siba Prasad; Panda, Sameer; Hui, Pankaj Kumar; Nayak, Sachidananda

    2016-05-01

    Ulcerative colitis (UC) is an idiopathic autoimmune inflammatory disease of the gastrointestinal tract. Cerebral venous sinus thrombosis along with deep vein thrombosis, pulmonary embolism and arterial thrombosis have occasionally been reported as a complication in the active phase of UC being attributed to its pro-thrombotic state. This paper depicts a 38-year-old female with a history of UC in remission who developed sudden onset headache, blurring of vision and seizures. Subsequent diagnosis of cerebral venous sinus thrombosis was made with MRI venography and treated with low molecular weight heparin with complete resolution of symptoms. The highlights of this case underscore the importance of evaluating cerebral venous sinus thrombosis as a cause of acute onset neurological deterioration in a setting of inflammatory bowel disease. It also emphasizes on the hypothesis that the risk of venous thrombosis or other hypercoagulable states have no direct relationship with the disease activity or flare-up. PMID:27437291

  4. 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.

  5. A frequência da utilização de profilaxia para trombose venosa profunda em pacientes clínicos hospitalizados The frequency of using prophylaxis to deep venous thrombosis among clinical hospitalized patients

    Directory of Open Access Journals (Sweden)

    Guilherme Benjamin Brandão Pitta

    2010-12-01

    Full Text Available CONTEXTO: A profilaxia para trombose venosa profunda (TVP está sendo subutilizada, ainda que seja a causa mais comum de mortalidade hospitalar passível de prevenção. Assim, é relevante responder à pergunta de pesquisa: qual a frequência da utilização de profilaxia para TVP em pacientes clínicos hospitalizados? OBJETIVO: Determinar a frequência da utilização de profilaxia para TVP em pacientes clínicos hospitalizados. A hipótese foi de 20%. MÉTODOS: Tipo de estudo: Estudo transversal de frequência. Local: Hospital Geral do Estado Dr. Osvaldo Brandão Vilela, Maceió, Alagoas. Amostra: Foram incluídos os pacientes clínicos e excluídos os menores de 18 anos, as gestantes e os pacientes hospitalizados há menos de 72 horas. Variável primária: a frequência da utilização de profilaxia para TVP. Variáveis secundárias: a frequência da utilização de métodos físicos e farmacológicos para a prevenção de TVP. Métodos estatísticos: O tamanho da amostra foi de 246 indivíduos (proporção=20%, precisão absoluta=5%, nível de significância=5%. Foram utilizados o teste do qui-quadrado e o intervalo de confiança de 95%. RESULTADOS: A frequência da utilização de profilaxia para TVP foi 33% (80/246; IC95% 2 a 38. A frequência da utilização de métodos físicos para a prevenção de TVP foi 17% (41/246; IC95% 12 a 21 e de métodos farmacológicos foi 26% (64/246; IC95% 21 a 31. CONCLUSÃO: A frequência da utilização de profilaxia para TVP em pacientes clínicos hospitalizados foi 33%.CONTEXT: The prophylaxis to deep venous thrombosis is being underused, although this disease be the most common cause of intrahospital mortality that could be prevented. Thus, it is relevant to answer the research question: what is the frequency of use of prophylaxis to deep venous thrombosis among clinical hospitalized patients? OBJECTIVE: To determine the frequency of use of prophylaxis to deep venous thrombosis in clinical

  6. 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.

  7. 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.

  8. 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.

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

    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.

  10. 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.)

  11. Multiple simultaneous venous and arterial thromboses in a patient with factor V Leiden disorder: Detection by multislice computed tomography

    Science.gov (United States)

    Sayin, Bige; Durakoğlugil, Tuğba; Akmangit, İlkay; Vural, Murat; Elverici, Eda

    2015-01-01

    Arterial thrombosis is extremely rare in patients with factor V Leiden (FVL) mutation. Recent advances in multislice computed tomography (MSCT) technology facilitated diagnosis of thromboembolic events accurately without delay. We report a patient with FVL mutation and acute bilateral lower extremity deep venous thromboses, pulmonary thromboembolism, and acute left anterior descending artery thrombosis, all diagnosed by MSCT. MSCT has been utilized for prompt diagnosis of the concomitant thrombotic pathologies simultaneously. PMID:25838926

  12. 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.

  13. 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

  14. Epidemiology of recurrent venous thrombosis

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    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.

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

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    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

  16. 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.

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

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    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. 

  18. [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.

  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

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    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. 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].

  1. Venous thromboembolism: The intricacies

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    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.

  2. The prediction role of D-dimer in recurrence of venous thromboembolism 1-year after anticoagulation discontinuing following idiopathic deep vein thrombosis

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    Babak Tamizifar

    2014-01-01

    Full Text Available Background: After discontinuing oral anticoagulant therapy (OAT, the recurrence of venous thromboembolism (VTE is greatest in the 1 st year and gradually diminishes. D-dimer assay was proposed to be effective in selecting patients with idiopathic DVT. The aim of this study was to determine the rate of VTE recurrence after discontinuing OAT according to the results of D-dimer. Materials and Methods: This prospective study was conducted in patients with a first episode of symptomatic proximal deep vein thrombosis (DVT who had received OAT for at least 3 months. Patients were re-evaluated at 1 st , 6 th and 12 th months of their follow-up. At the first (T0 and 30-day (T1 visits, venous blood samples were taken for D-dimer test. At each follow-up visit, we examined patients for clinical symptoms or signs of recurrent VTE, bleeding, postthrombotic manifestations, adherence to treatment, and concomitant analgesic or antiinflammatory therapy. The endpoint outcomes were VTE recurrence and complete of this survey follow-ups. Results: A total of 68 eligible patients was enrolled. Four patients (two patients need to use long-term oral anticoagulation, and two patients lost their first follow-up were excluded. At T0, D-dimer and compression ultrasonongraphy (CUS was normal in 28 patients (44%. Moreover, 36 patients had abnormal D-dimer but normal CUS. A follow-up of 12 months was available in 44 patients. During the follow-up, three recurrent events were recorded. All Recurrent events were ipsilateral DVT. Among these index cases, all had an abnormal D-dimer at either T0 and/or T1. The recurrence rate was higher in males than in females (8.6% vs. 2.2%, P = 0.04 with an abnormal D-dimer at T0 and/or T1 with a multivariate hazard ratio of 2.1 (95% confidence intervals [CI]: 1.2-5.2; P = 0.02. Patients older than 65 years had a higher rate of events than younger and hazard ratio was about 3.8 (95% CI: 2.1-4.2; P = 0.02. Patients with recurrences had higher

  3. Incidence of deep venous thrombosis after gynaecological laparoscopy%腹腔镜术后深静脉血栓的研究

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    目的研究妇科腹腔镜术后深静脉血栓的发生率。 方法在澳大利亚悉尼Liverpool医院1997年5月~1997年9月72例妇科腹腔镜手术采用Doppler超声检查静脉血流的通畅性和血管腔内的回声团用以诊断深静脉血栓。61例患者充气时间60分钟为大手术组。每例患者在术后24小时内及术后7天行两次超声Doppler检查,所有72人均行术后24小时内的超声Doppler检查,小手术组61例中40例、大手术组11例中9例行二次超声检查。23例未行二次超声检查者均行电话随访。 结果在我们的研究中两组患者均未发现DVT。本文同时报道北京复兴医院一例腹腔镜下右卵巢巧克力囊肿剥除术、左卵巢及部分输卵管切除术患者术后并发DVT,其诊断及治疗经过。 结论这项研究证实妇科腹腔镜手术DVT虽发生率极低,一旦发生需及时诊治,以免发生肺栓塞等致命并发症。%Objective To evaluate the incidence of deep venous thrombosis (DVT) after gynaecological laparoscopy. Methods The incidence of DVT was studied in 72 consecutive patients who underwent gynaecological laparoscopy in the Liverpool Health Service between May and September 1997. B-mode ultrasound supplemented by Doppler was used to examine venous patency and intraluminal echoes to diagnose DVT. Sixty-one patients who had pneumoperitoneum less than 60 minutes were classified a minor procedure and 11 who had pneumoperitoneum more than 60 minutes were classified as major procedure. Two Doppler ultrasound scans were planned for every patient. The first one was done within 24 hours and the second was performed on day 7 post-surgery. All 72 patients had the first scan and 40 out of 61 in the minor procedure group and 9 out of 11 in the major procedure had the second scan. Twenty-three patients who did not come for the second scan were followed up by phone. Results No DVT was found in our study. Conclusion This study confirms an

  4. 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.

  5. 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

  6. 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

  7. Evaluation of the Effects of Honey on Acute-Phase Deep Burn Wounds

    Directory of Open Access Journals (Sweden)

    Yukari Nakajima

    2013-01-01

    Full Text Available This study aimed to clarify the effects of honey on acute-phase deep burn wounds. Two deep burn wounds were created on mice which were divided into four groups: no treatment, silver sulfadiazine, manuka honey, and Japanese acacia honey. Wound sizes were calculated as expanded wound areas and sampled 30 minutes and 1–4 days after wounding for histological observation. The wound sections were subjected to hematoxylin and eosin and immunohistological staining to detect necrotic cells, apoptotic cells, neutrophils, and macrophages. The no treatment group formed a scar. The redness around the wound edges in the silver sulfadiazine group was the most intense. All groups exhibited increased wound areas after wounding. The proportions of necrotic cells and the numbers of neutrophils in the manuka and acacia honey groups were lower than those in the no treatment and silver sulfadiazine groups until day 3; however, there were no significant differences between all groups on day 4. These results show that honey treatment on deep burn wounds cannot prevent wound progression. Moreover, comparing our observations with those of Jackson, there are some differences between humans and animals in this regard, and the zone of hyperemia and its surrounding area fall into necrosis, which contributes to burn wound progression.

  8. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    OpenAIRE

    Saranat Orrapin; Supapong Arworn; Kittipan Rerkasem

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases...

  9. 彩色多普勒超声对下肢深静脉血栓的诊断价值%Evaluation of color Doppler ultrasound in diagnosing lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    温赐祥; 陈雪松; 徐晓红

    2008-01-01

    Objective To observe reliability of color Doppler ultrasound in diagnosis lower extremity deep venous thrombosis(DVT).Methods 45 lower limbs in 41 cases suspected as deep venous thrombosis were examined by CDFI.The results were analyzed.Results In this group,26 cases of 41 were found venous thrombosis, 11 cases in the right and 4 cases in both.The most common site of venous thrombosis was the left lower limbs.The femoral vein,superficial femoral vein ,deep femoral vein, popliteal vein were involved frequently.Hyper-echo or hypo-echo masses were seen in the lumen.Thin blood flow or no blood flow was observed in color Doppler.Slow velocity was detected or the velocity was not changed with deep breath in pulse Doppler.Conclusion Color Doppler ultrasound has high reliability in diagnosing lower extremity DVT.It an excellent diagnostic tool in clinical treatment of such disease.%目的 观察彩色多普勒超声(CDFI)对下肢深静脉血栓(DVT)形成诊断的可靠性.方法 用CDFI对41例共45条患肢行下肢深静脉彩色多普勒超声检测,并对结果进行分析.结果 41例患者中左下肢DVT 26例,右下肢DVT 11例,双下肢DVT 4例;左下肢的发病率明显高于右下肢,常累及股总静脉、股浅静脉、股深静脉、胴静脉,声像图特点为管腔内探及实性高或低回声团块充填,脉冲多普勒血流速度减慢或无血流且不受呼吸及远端肢体挤压影响.结论 彩色多普勒超声检查对DVT形成是一种可靠的诊断依据,对临床治疗有较好的指导作用.

  10. 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。

  11. 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

  12. Low-molecular-weight heparins in the treatment of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Huisman Menno V

    2000-08-01

    Full Text Available Abstract Venous thromboembolism is a common disease that is associated with considerable morbidity if left untreated. Recently, low-molecular-weight heparins (LMWHs have been evaluated for use in acute treatment of deep venous thrombosis and pulmonary embolism. Randomized studies have shown that LMWHs are as effective as unfractionated heparin in the prevention of recurrent venous thromboembolism, and are as safe with respect to the occurrence of major bleeding. A pooled analysis did not show substantial differences among different LMWH compounds used, but no direct comparison of the different LMWHs is currently available. Finally, in patients with pulmonary embolism, there is a relative lack of large studies of daily practice. It could be argued that large prospective studies, in patients who were treated with LMWHs from the moment of diagnosis, are needed.

  13. Low-molecular-weight heparins in the treatment of venous thromboembolism

    Science.gov (United States)

    Ageno , Walter; Huisman, Menno V

    2000-01-01

    Venous thromboembolism is a common disease that is associated with considerable morbidity if left untreated. Recently, low-molecular-weight heparins (LMWHs) have been evaluated for use in acute treatment of deep venous thrombosis and pulmonary embolism. Randomized studies have shown that LMWHs are as effective as unfractionated heparin in the prevention of recurrent venous thromboembolism, and are as safe with respect to the occurrence of major bleeding. A pooled analysis did not show substantial differences among different LMWH compounds used, but no direct comparison of the different LMWHs is currently available. Finally, in patients with pulmonary embolism, there is a relative lack of large studies of daily practice. It could be argued that large prospective studies, in patients who were treated with LMWHs from the moment of diagnosis, are needed. PMID:11714421

  14. 急诊深静脉穿刺置管206例临床分析%Application of emergency deep venous catheterization outside the operation room

    Institute of Scientific and Technical Information of China (English)

    祝义军; 封卫征; 史东平

    2007-01-01

    Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.%目的 比较手术室外行急诊颈内静脉与股静脉穿刺置管的优缺点.方法 手术室外行急诊深静脉穿刺置管患者206例,按照首次穿刺的血管分为右颈内静脉组110例和右股静脉组96例.分别记录2组的首次置管成功率、操作完成时间和并发症发生情况.采用SAS 6.04软件包对2组数据行t检验和非参数统计分析.结果 2组患者的病情、年龄、体重、性别相似,最终均完成深静脉穿刺置管,无气胸、心跳骤停等发生.右颈内静脉组首次成功率为88

  15. 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。

  16. 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.

  17. 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.

  18. 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.

  19. 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。

  20. 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.

  1. 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.

  2. Deep Hypothermic Circulatory Arrest with Lung Perfusion/Ventilation in a Patient with Acute Type A Aortic Dissection

    Directory of Open Access Journals (Sweden)

    Yiliam F. Rodriguez-Blanco

    2012-01-01

    Full Text Available A 50-year-old black male presented with acute type A aortic dissection. Surgical repair was performed under deep hypothermic circulatory arrest (DHCA with lung perfusion/ventilation throughout the procedure. Details of the lung perfusion technique and its potential benefits and drawbacks are discussed.

  3. Deep Hypothermic Circulatory Arrest with Lung Perfusion/Ventilation in a Patient with Acute Type A Aortic Dissection

    OpenAIRE

    Yiliam F Rodriguez-Blanco; Lester Garcia; Tania Brice; Marco Ricci; Salerno, Tomas A.

    2012-01-01

    A 50-year-old black male presented with acute type A aortic dissection. Surgical repair was performed under deep hypothermic circulatory arrest (DHCA) with lung perfusion/ventilation throughout the procedure. Details of the lung perfusion technique and its potential benefits and drawbacks are discussed.

  4. High-frequency ultrasound in diagnosis of acute isolated calf muscle venous thrombosis%47例急性孤立性小腿肌间静脉血栓的高频彩超特征分析

    Institute of Scientific and Technical Information of China (English)

    龚倩; 段青

    2012-01-01

    Objective To explore the diagnostic value of high-frequency ultrasound on acute isolated calf muscle venous thrombosis. Methods A retrospective analysis was made on the ultrasonographical features of 47 patients with acute isolated calf muscle venous thrombosis and then follow-up of clinical outcome. Results There were 47 patients with acute isolated calf muscle venous thrombosis whose High-frequency ultrasonography confirmed with the clinical or imaging studies. The coincidence rate was 100% (47/47). Typical sonographic features! calf muscle venous lumen dilated, tortuous, anechoic lumen or hypoechoic filling. Long axis of the tree-like low-cut surface echo, heard more than one muscle cross-section appears as round or oval hypoechoic. Conclusion High-frequency ultrasonography is accurate and reliable method in the diagnosis of acute isolated calf muscle venous thrombosis.%目的 探讨高频彩超对急性孤立性小腿肌间静脉血栓的诊断价值.方法 回顾性分析高频彩超诊断的47例急性孤立性小腿肌间静脉血栓的声像图特征,并与临床随访结果进行对比评价.结果 高频彩超检出的47例急性孤立性小腿肌间静脉血栓,均经临床证实,超声诊断准确率为100% (47/47例).典型声像图特征:小腿肌肉间静脉管腔明显扩张,迂曲,管腔内可见无回声或低回声充填.长轴切面呈树枝样低回声,横断面显示肌肉多个圆形或椭圆形低回声.探头加压不能压闭或部分关闭,管腔内无血流信号充盈.结论 高频彩超是诊断急性孤立性小腿肌间静脉血栓较准确、可靠的方法,具有重要的临床价值.

  5. 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

    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 lungs and deep veins...... with pulmonary oedema, 1 had pericardial effusion, 1 had massive pleural effusion, 5 had empyema and 4 had pulmonary embolism. Conclusion: Focused sonography of the heart, lungs and deep veins is a highly feasible and non-invasive bedside method. In acute admitted patients with respiratory symptoms, it may help...

  6. 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.

  7. The comparison of stroke volume variation with central venous pressure in predicting fluid responsiveness in septic patients with acute circulatory failure

    Directory of Open Access Journals (Sweden)

    Santhalakshmi Angappan

    2015-01-01

    Full Text Available Purpose: The present study was designed to investigate the efficacy of stroke volume variation (SVV in predicting fluid responsiveness and compare it to traditional measures of volume status assessment like central venous pressure (CVP. Methods: Forty-five mechanically ventilated patients in sepsis with acute circulatory failure. Patients were not included when they had atrial fibrillation, other severe arrhythmias, permanent pacemaker, or needed mechanical cardiac support. Furthermore, excluded were patients with hypoxemia and a CVP >12. Patients received volume expansion in the form of 500 ml of 6% hydroxyethyl starch. Results: The volume expansion-induced increase in  cardiac index (CI was >15% in 29 patients (labeled responders and <15% in 16 patients (labeled nonresponders. Before volume expansion, SVV was higher in responders than in nonresponders. Receiver operating characteristic curves analysis showed that SVV was a more accurate indicator of fluid responsiveness than CVP. Before volume expansion, an SVV value of 13% allowed discrimination between responders and nonresponders with a sensitivity of 78% and a specificity of 89%. Volume expansion-induced changes in CI weakly and positively correlated with SVV before volume expansion. Volume expansion decreased SVV from 18.86 ± 4.35 to 7.57 ± 1.80 and volume expansion-induced changes in SVV moderately correlated with volume expansion-induced changes in CI. Conclusions: When predicting fluid responsiveness in mechanically ventilated patients in septic shock, SVV is more effective than CVP. Nevertheless, the overall correlation of baseline SVV with increases in CI remains poor. Trends in SVV, as reflected by decreases with volume replacement, seem to correlate much better with increases in CI.

  8. 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.

  9. 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

  10. 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.

  11. Profilaxia da trombose venosa profunda: aplicação prática e conhecimento teórico em um hospital geral Deep venous thrombosis prophylaxis: practical application and theoretical knowledge in a general hospital

    Directory of Open Access Journals (Sweden)

    Cristiano Almeida Pereira

    2008-03-01

    ção para recebê-la, tornando necessária a implementação de um programa de educação continuada sobre o tema.BACKGROUND: Although this work belongs to the area of vascular surgery, it is relevant to all clinical and surgical specialties due to the clinical importance of deep venous thrombosis and its main complication, pulmonary embolism. OBJECTIVES: To verify whether pharmacological prophylaxis of deep venous thrombosis is being adequately and routinely used in our service and to evaluate physicians' knowledge about the indications of deep venous thrombosis chemoprophylaxis. METHODS: A prospective study was accomplished including 850 patients hospitalized from March to May 2007 at Hospital Geral de Roraima. Clinical, pharmacological and surgical factors were researched. Risk stratification and evaluation of prophylaxis were established according to the classification suggested by the Brazilian Society of Angiology and Vascular Surgery and to the protocol developed by Caiafa in 2002. Physicians answered a questionnaire and analyzed three hypothetical clinical cases. Data were tabled and statistically analyzed with the support of the software Epi-Info 2002®. RESULTS: Of the 850 patients surveyed, 557 (66.66% were clinical and 293 (33.34% were surgical patients. Of the total, 353 (41.56% had low risk, 411 (48.32% medium risk and 86 (10.12% high risk for development of deep venous thrombosis. Of the 497 patients that needed to receive chemoprophylaxis for deep venous thrombosis, only 120 (24% received it and of these, 102 (85% received it adequately. Any patient who did not need prophylaxis received it. Clinical physicians prescribed prophylaxis more frequently and correctly than surgeons, although the latter have demonstrated better theoretical knowledge of the theme. In general, theoretical knowledge on deep venous thrombosis was insufficient. CONCLUSIONS: In our hospital, chemoprophylaxis for deep venous thrombosis is underused in patients indicated for receiving it

  12. New anticoagulants for the treatment of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Caio Julio Cesar dos Santos Fernandes

    2016-04-01

    Full Text Available Worldwide, venous thromboembolism (VTE is among the leading causes of death from cardiovascular disease, surpassed only by acute myocardial infarction and stroke. The spectrum of VTE presentations ranges, by degree of severity, from deep vein thrombosis to acute pulmonary thromboembolism. Treatment is based on full anticoagulation of the patients. For many decades, it has been known that anticoagulation directly affects the mortality associated with VTE. Until the beginning of this century, anticoagulant therapy was based on the use of unfractionated or low-molecular-weight heparin and vitamin K antagonists, warfarin in particular. Over the past decades, new classes of anticoagulants have been developed, such as factor Xa inhibitors and direct thrombin inhibitors, which significantly changed the therapeutic arsenal against VTE, due to their efficacy and safety when compared with the conventional treatment. The focus of this review was on evaluating the role of these new anticoagulants in this clinical context.

  13. Chemo-radiotherapy for localized pancreatic cancer: increased dose intensity and reduced acute toxicity with concomitant radiotherapy and protracted venous infusion 5-fluorouracil

    International Nuclear Information System (INIS)

    Purpose: Although concomitant radiotherapy (RT) and bolus 5-Fluorouracil (5-FU) have been shown to improve survival in patients with resectable or locally advanced pancreatic cancer, most patients will eventually succumb to their disease. Since 1994, we have attempted to improve efficacy by administering 5-FU by protracted venous infusion (PVI). This study compares the dose intensity and acute toxicity of our current regimen utilizing 5-FU by PVI with our prior regimen of radiotherapy and bolus 5-FU. Materials and Methods: Since January, 1986, 77 patients with resectable or locally advanced adenocarcinoma of the pancreas were treated with radiation therapy. Thirteen received radiation therapy alone or a planned split-course treatment and were therefore excluded from this study. The remaining 64 patients were treated with continuous course RT and concurrent 5-FU by bolus injection for 3 days during weeks 1 and 5 (n=44) or by PVI 5-FU throughout the entire course of radiotherapy (n=20). Patients were treated on 6 or 15 MV linear accelerators with 3-4 custom shaped fields to target doses of 40-50 Gy following pancreaticoduodenectomy or 50-60 Gy for locally advanced disease. 5-FU target doses were 500 mg/m2 for bolus injection and 200-225 mg/m2/day for PVI. Dose intensity was assessed for both 5-FU and radiotherapy by calculating total doses (mg/m2 and Gy, respectively) and dose/week of treatment. The Cooperative Group Common Toxicity Scale was used to score acute hematologic and gastrointestinal toxicity. Only those endpoints which could be reliably and objectively quantified (e.g. blood counts, weight loss, treatment interruption) were evaluated. Patients with resectable and locally advanced disease were jointly and independently evaluated. Results: The patient characteristics and radiotherapy treatment techniques were similar between the two treatment groups. The mean irradiated volume was 1,323 cm3 (95% CI: 1,210-1,436). Chemotherapy and radiotherapy dose intensity

  14. 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.)

  15. Cerebral venous thrombosis in childhood

    International Nuclear Information System (INIS)

    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.)

  16. 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)

  17. 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...... computed tomography with PE protocol, or who had undergone the placement of an inferior vena cava filter between 27 April 2010 and 7 January 2013 and who had also undergone one or more F-FDG-PET scan(s) that included the LE. Seventeen patients without venous F-FDG uptake were added as controls. F......=nonsignificant). Two patients (n=3 and 10) were negative for VTE events and had an extent of 0. The number of positive events correlated slightly with the extent of venous uptake (r=0.69). The 17 control patients without venous uptake on F-FDG-PET had no history of VTE. There was an association between LE venous...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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)

    Glueck, Charles J.; Lee, Kevin; Prince, Marloe; Jetty, Vybhav; Shah, Parth; Wang, Ping

    2016-01-01

    Background: When exogenous testosterone or treatments to elevate testosterone (human chorionic gonadotropin [HCG] or Clomid) are prescribed for men who have antecedent thrombophilia, deep venous thrombosis and pulmonary embolism often occur and may recur despite adequate anticoagulation if testosterone therapy is continued. Case Presentation: A 55-year-old white male was referred to us because of 4 thrombotic events, 3 despite adequate anticoagulation over a 5-year period. We assessed interactions between thrombophilia, exogenous testosterone therapy, and recurrent thrombosis. In 2009, despite low-normal serum testosterone 334 ng/dL (lower normal limit [LNL] 300 ng/dL), he was given testosterone (TT) cypionate (50 mg/week) and human chorionic gonadotropin (HCG; 500 units/week) for presumed hypogonadism. Ten months later, with supranormal serum T (1385 ng/dL, upper normal limit [UNL] 827 ng/dL) and estradiol (E2) 45 pg/mL (UNL 41 pg/mL), he had a pulmonary embolus (PE) and was then anticoagulated for 2 years (enoxaparin, then warfarin). Four years later, on TT-HCG, he had his first deep venous thrombosis (DVT). TT was stopped and HCG continued; he was anticoagulated (enoxaparin, then warfarin, then apixaban, then fondaparinux). One year after his first DVT, on HCG, still on fondaparinux, he had a second DVT (5/315), was anticoagulated (enoxaparin + warfarin), with a Greenfield filter placed, but 8 days later had a second PE. Thrombophilia testing revealed the lupus anticoagulant. After stopping HCG, and maintained on warfarin, he has been free of further DVT-PE for 9 months. Conclusion: When DVT-PE occur on TT or HCG, in the presence of thrombophilia, TT-HCG should be stopped, lest DVT-PE reoccur despite concurrent anticoagulation. PMID:27536705

  3. 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.

  4. Venous thrombosis in athletes.

    Science.gov (United States)

    Grabowski, Gregory; Whiteside, William K; Kanwisher, Michael

    2013-02-01

    Because deep vein thrombosis (DVT) can occur following orthopaedic procedures, knowledge of hereditary and acquired risk factors for DVT is essential. Hereditary forms of thrombophilia include factor V Leiden and prothrombin G20210A mutations, and deficiencies of antithrombin III, protein C, and protein S. Acquired risk factors include but are not limited to trauma, immobilization, and surgical procedures. In general, athletes have a low risk of venous thrombosis; however, this population is exposed to many acquired thrombogenic risk factors, including hemoconcentration, trauma, immobilization, long-distance travel, and the use of oral contraceptives. Thus, orthopaedic surgeons should consider screening athletes for thrombogenic risk factors, including history of venous thrombosis, hypercoagulable disorders, or high altitude exercise, during preparticipation physicals and preoperative examinations. If a patient is determined to be at high risk of DVT, preventive measures such as physical antithrombotic measures and/or low-molecular-weight heparin should be instituted. If an athlete develops a DVT, a risk factor assessment should be conducted along with anticoagulation treatment in accordance with the American College of Chest Physicians guidelines. PMID:23378374

  5. 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.)

  6. 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. PMID:24681523

  7. 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.

  8. 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

  9. Value of venous color flow duplex scan as initial screening test for geriatric inpatients with clinically suspected pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Kreidy R

    2011-09-01

    Full Text Available Raghid Kreidy1, Elias Stephan2, Pascale Salameh3, Mirna Waked4 1Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, Beirut, Lebanon; 2Department of Geriatrics, Saint George Hospital, University Medical Center, University of Balamand, Beirut, Lebanon; 3Laboratory of Clinical and Epidemiological Research, Faculty of Pharmacy, Lebanese University, 4Department of Pulmonary Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, Lebanon Aim: The contribution of lower extremity venous duplex scan to the diagnostic strategy for pulmonary embolism has been demonstrated by many authors. However, the positive diagnostic value of this noninvasive test in clinically suspected pulmonary embolism is not very high (10%–18%. Since thromboembolic risks increase considerably in hospitalized patients with advanced age, this study aims to determine the importance of lower extremity venous color flow duplex scan in this particular subgroup of patients with clinically suspected pulmonary embolism. The effects of clinical presentation and risk factors on the results of duplex scan have been also studied. Methods: Between July 2007 and January 2010, 95 consecutive Lebanese geriatric ($60 years of age inpatients with clinically suspected pulmonary embolism assessed in an academic tertiary-care center for complete lower extremity venous color flow duplex scan were retrospectively reviewed. Age varied between 60 and 96 years (mean, 79.9 years. Forty patients were males and 55 females. Absence of compressibility was the most important criteria for detecting acute venous thrombosis. Results: Out of 95 patients, 33 patients (34.7% were diagnosed with recent deep venous thrombosis of lower extremities (14 proximal and 19 distal using complete venous ultrasound. Nine of these 33 patients (27.2% had a history of venous thromboembolism and eleven (33.3% presented with edema of lower

  10. A modified total arch replacement combined with a stented elephant trunk implantation for acute type A dissection under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion

    OpenAIRE

    Yang, Su-Min; Xu, Ping; Cheng-xiang LI; Huang, Qiang; Gao, Hong-Bo; Li, Zhen-Fu; Chang, Qing

    2014-01-01

    Objectives Since the optimal management of patients with acute aortic dissection is unclear, this study analyzed total arch replacement combined with stented elephant trunk implantation in the treatment of acute type A aortic dissection. Methods Between February 2008 and February 2013, 86 consecutive patients admitted to our hospital for acute type A dissection underwent total arch replacement combined with stented elephant trunk implantation under deep hypothermic circulatory arrest. The Ben...

  11. 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.

  12. 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

  13. Venous port catheter dislocation as an unusual cause of pneumonia

    Directory of Open Access Journals (Sweden)

    Umut Serhat Sanrı

    2014-06-01

    Full Text Available The use of central venous port catheter is a very useful method for long-term therapy in patients with malignancy. Catheter insertion technique and maintenance of equipment is very important to the prevention of catheter-related complications. The most frequent complications are deep venous thrombosis, port infection, catheter obstruction. İn this article, pneumonia occurrence after chemotherapy infusion in a patient who has a completely extravasated central venous port catheter discussed.

  14. 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

  15. 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

  16. 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.

  17. 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%)

  18. 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

  19. 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.

  20. The management of acute venous thromboembolism in clinical practice – study rationale and protocol of the European PREFER in VTE Registry

    OpenAIRE

    Agnelli, Giancarlo; Gitt, Anselm K; Bauersachs, Rupert; Fronk, Eva-Maria; Laeis, Petra; Mismetti, Patrick; Monreal, Manuel; Willich, Stefan N.; Wolf, Wolf-Peter; Cohen, Alexander T.; ,

    2015-01-01

    Background Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improv...

  1. 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

  2. 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。

  3. 探讨彩色多普勒超声对下肢深静脉血栓的临床应用价值%An Applied Study of Color Doppler Ultrasound to Deep Venous Thrombosis of the Lower Extremity

    Institute of Scientific and Technical Information of China (English)

    梁虹

    2013-01-01

    Objective to study the applied value of Color Doppler Ultrasound to the formation of Deep Venous Thrombosis of the Lower Extremity(DVT), to provide the basis for clinical diagnosis and treatment. Method the blood vessel wall, the echo of lumen and the circumscription of lesion of 69 cases with DVT were detected by two-dimension, color Doppler and spectra Doppler. Results Calf muscle venous plexus thrombosis in 22 cases, calf deep vein thrombosis 13 cases, femoral vein-popliteal vein thrombosis in 22 cases, iliac vein thrombosis in 9 cases. The accurate rate of Ultrasonic Diagnosis was 95.7%.Conclusion the Color Doppler Ultrasound could supply more accurate judgments to location, staging, and obstruction of DVT and track the continuous evolution of the lesion and then determines the clinical effect of treatment, so it was the preferred methods to diagnose the DVT.%  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,为临床提供诊治依据。方法应用二维、彩色多普勒、频谱多普勒对69例下肢深静脉血栓形成患者血管壁、管腔内回声及病变受累范围进行检测。结果小腿肌肉静脉丛血栓22例,小腿深静脉血栓13例,股静脉-腘静脉血栓22例,髂静脉血栓9例,超声诊断的准确率为95.7%。结论彩色多普勒超声对下肢深静脉血栓部位、分期、管腔阻塞情况可提供较为准确的判断,并连续跟踪观察其病变演变情况,判断临床诊疗效果,是下肢深静脉血栓首选的检查方法。

  4. 凝血过筛检测在深静脉血栓形成防治中的意义%Study on the Coagulation Change in Patients with Deep Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    杨琴; 曹军皓; 阎有功

    2011-01-01

    目的 探讨深静脉血栓形成(DVT)患者凝血5项过筛试验的变化及其临床意义,以利于DVT的诊断及治疗监测.方法 采用ACL TOP型全自动血凝分析仪测定aPTT、PT、TT、Fbg、INR.结果 检测92例DVT患者凝血5项过筛试验均有不同程度的异常,其中检测的38例治疗前病例aPTT为26.6±2.93 s,Fbg含量为4.86±1.71 g/L,较之治愈组的54例aPTT 43.3±8.90 s、Fbg含量2.43±0.81 g/L,65例正常人组aPTT 29.8±2.92 s、Fbg含量3.21±0.68 g/L组间差异有极显著意义.结论 凝血5项过筛试验对DVT患者是否存在血栓前状态判断和抗血栓治疗的监测有重要临床意义.%Objective To investigate the coagulation change and its clinical significance in patients with deep venous thrombosis ( DVT) . Methods The contents of aPTT , PT ,TT , Fbg and INR were measured by American IL automatic analyzer (ACL TOP) . Results ACL TOP was used to detect the aPTT, PT, TT,Fbg and INR in 92 patients with deep venous thrombosis and the results of aPTT, PT, TT, Fbg,INR were significantlr abnormality. The contents of aPTT 26. 6 ±2. 93 s and Fbg 4. 86 ± 1. 71 g/L in group of 38 pretherapy group were significantly difference than those of curing and normal controls. Conclusion To investigate the coagulation change of patients with DVT and prethrombotic state( PTS) decision and antithromb therapy were con- sanguineously correlative to the high- frequency.

  5. 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.)

  6. The relationship of intracranial venous pressure to hydrocephalus.

    Science.gov (United States)

    Portnoy, H D; Branch, C; Castro, M E

    1994-01-01

    Little is known about intracranial venous pressure in hydrocephalus. Recently, we reported that naturally occurring hydrocephalus in Beagle dogs was associated with an elevation in cortical venous pressure. We proposed that the normal pathway for cerebrospinal fluid (CSF) absorption includes transcapillary or transvenular absorption of CSF from the interstitial space and that the increase in cortical venous pressure is an initial event resulting in decreased absorption and subsequent hydrocephalus. Further analysis, however, suggests that increased cortical venous pressure reflects the effect of the failure of transvillus absorption with increase in CSF pressure on the venous pressure gradient between ventricle and cortex. Normally, the cortical venous pressure is maintained above CSF pressure by the Starling resistor effect of the lateral lacunae. A similar mechanism is absent in the deep venous system, and thus the pressure in the deep veins is similar to that in the dural sinuses. Decreased CSF absorption causes an increase in CSF pressure followed by an increase in cortical venous pressure without a similar increase in periventricular venous pressure. The periventricular CSF to venous (transparenchymal) pressure (TPP) gradient increases. In contrast, cortical vein pressure remains greater than CSF pressure (negative TPP). The elevated periventricular TPP gradient causes ventricular dilatation and decreased periventricular cerebral blood flow (CBF), a condition that persists even if the CSF pressure returns to normal, particularly if tissue elastance is lessened by tissue damage. If deep CBF is to be maintained, periventricular venous pressure must increase. Since the veins are in a continuum, cortical venous pressure will further increase above the CSF pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8194060

  7. 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.

  8. 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

  9. 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

    OpenAIRE

    Cho, Eun-Suk; Chung, Jae-Joon; Kim, Sungjun; Kim, Joo Hee; Yu, Jeong-Sik; Yoon, Choon-Sik

    2013-01-01

    Objective 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. Materials and Methods 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 3...

  10. 导管接触溶栓治疗深静脉血栓形成的研究进展%The Research Progress of Catheter-directed Thrombolysis in the Treatment of Deep Venous Thrombosis

    Institute of Scientific and Technical Information of China (English)

    姜振; 张玥; 颜征

    2016-01-01

    In recent years,the incidence of deep venous thrombosis is increasing.With the development of interventional technology,catheter-directed thrombolysis is an important way to promote the development of thrombosis.In the past few years,the research of catheter directed thrombolysis is reviewed in this paper.The feasibility,effectiveness and safety of catheter directed thrombolysis were discussed from four aspects:the way of thrombolytic therapy,the application of thrombolytic therapy,the application of thrombolytic agents and the complications.%近年来深静脉血栓形成的发病率不断攀升,随着介入技术的发展,导管接触溶栓因其微创、高效而成为促进血栓再通的重要方式。现将近几年学者针对导管接触溶栓的研究进行综述,从溶栓途径、溶栓入路、溶栓药物的应用及并发症四个方面探讨导管接触溶栓治疗的可行性、有效性及安全性。

  11. 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

  12. 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。

  13. 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.

  14. Color Doppler flow imaging in the application of the primary deep venous incompetence%彩色多普勒超声在原发性下肢深静脉瓣功能不全中的应用

    Institute of Scientific and Technical Information of China (English)

    汪元芳; 吴亚群; 李开艳; 黄道中; 张青萍

    1999-01-01

    目的 应用彩色多普勒超声诊断原发性下肢深静脉瓣功能不全.方法 应用彩色多普勒超声检测了22个病人(36条腿)和15个正常人(30条腿)的下肢股浅静脉、腘静脉瓣及内径、彩色返流信号、血流频谱及时间平均流速(TAV).结果 22个深静脉瓣功能不全的病人均有股浅静脉[(9.36±2.0)mmvs(5.35±1.0)mm;P<0.001]和腘静脉[(9.90±2.3)mm vs(5.06±1.4)mm,P<0.01]的扩张;TAV股浅静脉[(3.90±2.3)cms vs(6.50±2.2)cm/s]和腘静脉[(2.75±21)cm/s vs(5.75±2.3)cm/s,P<0.001]明显减慢.在Valsalva's或平静呼吸时显示有彩色返流信号,脉冲多普勒显示呈双向频谱,其中,股浅静脉瓣3例,腘静脉瓣14例,双瓣19例.正常组胭静脉瓣1例.二组差别有极显著意义.结论 彩色多普勒超声能明确瓣膜的返流的部位及返流程度,诊断下肢深静脉瓣功能不全.对外科合理地选择手术方式及部位,并在术后观察疗效.%Objective To Diagnose the primary deep venous incompetence by color Doppler flow imaging(CDFI).Methods Valvular competence of deep veins in 22 patients(36 limbs)and 15 normal cases (30limbs)were studied with CDFI.Results The results showed dilation in all of the lumens of the femoral veins[(9.36±2.0)mm vs(5.35±1.0)mm,P<0.001] and popliteal veins[(9.90±2.3)mm vs(5.06±1.4)mm,P<0.01],time average velocity(TAV)was obviously reduced in the femoral vein[(3.90±2.3)cm/s vs(5.75±2.9)cm/s,P<0.001] and popliteal veins[(2.75±2.1)cm/s vs(5.75±2.9)cm/s]with primary deep venous incompetence(PDVI).CDFI revealed reflux and Dopper spectrum showed that wave pattern from both up and down the baseline in the pulse Doppler during breathing and vasalva maneuver in 3 cases of alone the fenioral valve,14 cases of alone the popliteal,19 cases of both femoral and popliteal valve with PDVI,and one case of the popliteal in normal limbs.There were significant difference between the PDVI and normal group.Concl usions The primary deep venous incompetence

  15. 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.

  16. 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. PMID:23162226

  17. 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

  18. Acute deep brain stimulation in the thalamic reticular nucleus protects against acute stress and modulates initial events of adult hippocampal neurogenesis.

    Science.gov (United States)

    Magdaleno-Madrigal, Víctor Manuel; Pantoja-Jiménez, Christopher Rodrigo; Bazaldúa, Adrián; Fernández-Mas, Rodrigo; Almazán-Alvarado, Salvador; Bolaños-Alejos, Fernanda; Ortíz-López, Leonardo; Ramírez-Rodriguez, Gerardo Bernabé

    2016-11-01

    Deep brain stimulation (DBS) is used as an alternative therapeutic procedure for pharmacoresistant psychiatric disorders. Recently the thalamic reticular nucleus (TRN) gained attention due to the description of a novel pathway from the amygdala to this nucleus suggesting that may be differentially disrupted in mood disorders. The limbic system is implicated in the regulation of these disorders that are accompanied by neuroplastic changes. The hippocampus is highly plastic and shows the generation of new neurons, process affected by stress but positively regulated by antidepressant drugs. We explored the impact of applying acute DBS to the TRN (DBS-TRN) in male Wistar rats exposed to acute stress caused by the forced-swim Porsolt's test (FST) and on initial events of hippocampal neurogenesis. After the first session of forced-swim, rats were randomly subdivided in a DBS-TRN and a Sham group. Stimulated rats received 10min of DBS, thus the depressant-like behavior reflected as immobility was evaluated in the second session of forced-swim. Locomotricity was evaluated in the open field test. Cell proliferation and doublecortin-associated cells were quantified in the hippocampus of other cohorts of rats. No effects of electrode implantation were found in locomotricity. Acute DBS-TRN reduced immobility in comparison to the Sham group (pcell proliferation (Ki67 or BrdU-positive cells; p=0.02, p=0.02) and the number of doublecortin-cells compared to the Sham group (p<0.02). Similar effects were found in rats previously exposed to the first session of forced-swim. Our data could suggest that TRN brain region may be a promising target for DBS to treat intractable depression. PMID:27435420

  19. 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.)

  20. Rebound of affective symptoms following acute cessation of deep brain stimulation in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Ooms, Pieter; Blankers, Matthijs; Figee, Martijn; Mantione, Mariska; van den Munckhof, Pepijn; Schuurman, P Richard; Denys, D.

    2014-01-01

    BACKGROUND: Deep brain stimulation (DBS) is regarded as an effective way to treat refractory obsessive-compulsive disorder (OCD). Little is known about the effects of DBS cessation following a longer period of stimulation. OBJECTIVE: To determine the relapse and rebound effects of psychiatric sympto

  1. 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.

  2. The diagnostic accuracy of magnetic resonance venography in the detection of deep venous thrombosis: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Aim: To search the literature for further evidence for the use of magnetic resonance venography (MRV) in the detection of suspected DVT and to re-evaluate the accuracy of MRV in the detection of suspected deep vein thrombosis (DVT). Materials and methods: PubMed, EMBASE, Scopus, Cochrane, and Web of Science were searched. Study quality and the risk of bias were evaluated using the QUADAS 2. A random effects meta-analysis including subgroup and sensitivity analyses were performed. Results: The search resulted in 23 observational studies all from academic centres. Sixteen articles were included in the meta-analysis. The summary estimates for MRV as a diagnostic non-invasive tool revealed a sensitivity of 93% (95% confidence interval [CI]: 89% to 95%) and specificity of 96% (95% CI: 94% to 97%). The heterogeneity of the studies was high. Inconsistency (I2) for sensitivity and specificity was 80.7% and 77.9%, respectively. Conclusion: Further studies investigating the use of MRV in the detection of suspected DVT did not offer further evidence to support the replacement of ultrasound with MRV as the first-line investigation. However, MRV may offer an alternative tool in the detection/diagnosis of DVT for whom ultrasound is inadequate or not feasible (such as in the obese patient). -- Highlights: •We aimed to search the literature for evidence for the use of MRV in the detection of suspected DVT. •We questioned the use of MRV in special populations like the obese where contrast venography may not be feasible or safe. •MRV may not replace ultrasound as the first-line modality for DVT detection. •Consider MRV use in special populations like the obese where other diagnostic tools are not feasible. •Studies to compare MRV vs. ultrasound as a screening tool for DVT in the obese should be considered

  3. Spontaneous iliopsoas muscle haematoma as a complication of anticoagulation in acute cerebral venous thrombosis: to stop or not to stop (the anticoagulation)?

    Science.gov (United States)

    Fernandes, Carina; Pereira, Pedro; Rodrigues, Miguel

    2015-01-01

    Spontaneous iliopsoas muscle haematoma is an infrequent complication of anticoagulation, potentially causing neurological dysfunction through compression of the femoral nerve or lumbar plexus. The authors report the case of a puerperal woman admitted for an extensive cerebral venous thrombosis. Anticoagulation was started, with clinical improvement. The patient later reported low back pain irradiating to the right thigh and developed neurological impairment consistent with lumbar plexus dysfunction. A pelvic CT scan revealed a right iliopsoas muscle haematoma. Considering the risk of anticoagulation suspension, a conservative approach was chosen, with maintenance of anticoagulation. Clinical and functional improvement occurred, with mild right hip and knee flexion paresis as sequelae. Anticoagulation complications are challenging, especially when interruption of anticoagulation may threaten vital and functional outcomes. Therefore, a careful evaluation is essential, since no clinical guidelines are available. In this case, continuing anticoagulation provided a good functional outcome. PMID:25750219

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. Efficacy analysis of drug therapy in 150 cases with lower extremity deep venous thrombosis%下肢深静脉血栓形成药物治疗150例疗效分析

    Institute of Scientific and Technical Information of China (English)

    文雪刚; 李华; 黎亮; 付武君; 陈蓁臻; 邓峰

    2012-01-01

    Objective To explore the approach and efficacy of drug therapy in patients with lower extremity deep venous thrombosis. Methods Retrospectively analyze the data of drug therapy in i50 LDVT patients from May 2005 to July 20i0,the period of onset was from i day to i month,all were single limb attacked,peripheral type in 60 cases, 85 cases of iliac and femoral type, mixed type in 5 cases. All cases by lower extremity vascular ultrasound were confirmed. Treatment time was 10 ~ 14 clays without inferior vena cava filter. Results 130 patients eliminated edema completely during treatment, 2 weeks later,repeated Doppler ultrasound examination, blood stream was almost expedite; 20 cases with limb mild swelling,Doppler ultrasonic examination in iliac femoral venous short segment occlusion,were given the warfarin maintenance treatment and elastic stockings protection treatment for 6 months to 1 years. All cases were followed up for 12 to 18 months, limb edema eliminated significantly with no pulmonary embolism complications. Conclusion The medication for lower extremity deep vein thrombosis was safe and effectual.%目的 探讨下肢深静脉血栓形成药物治疗的方法 、疗效.方法 回顾分析2005年5月至2010年7月对150例LDVT患者药物治疗资料,发病时间1 d~1个月,均为单肢发病,周围型60例,髂股型85例,混合型5例,全部病例经下肢血管彩超及静脉造影检查证实.治疗期间均未置放下腔静脉滤器,予抗凝、溶栓等治疗,时间10~14 d.结果 130例患者治疗期间患者水肿完全消退,2周后复查Doppler超声基本全程通畅;20例患者患肢轻度肿胀,Doppler超声复查存在髂股静脉短段闭塞,给予华法林维持治疗及弹力袜保护治疗6个月至1年.所有病例均获随访12~18个月,患肢肿胀明显消退,均无肺栓塞并发症.结论 下肢深静脉血栓形成药物治疗安全、效果肯定.

  9. 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.

  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. A case of hepatic portal venous gas due to viral gastroenteritis

    Directory of Open Access Journals (Sweden)

    Mirmanesh M

    2013-10-01

    Full Text Available Michael Mirmanesh,1 Quoc-Sy Nguyen,1 Alexey Markelov2 1Drexel University College of Medicine, Philadelphia, PA, USA; 2Department of Surgery, Easton Hospital, Easton, PA, USA Introduction: Hepatic portal venous gas is the presence of gas within the portal venous system that can result from a variety of insults to the gastrointestinal system, and which may be a diagnostic clue to ominous abdominal pathologies, such as acute bowel ischemia or necrosis. Case: We report a case of a 71-year-old man with acute onset abdominal pain whose initial radiologic testing showed extensive portal venous gas. The patient was managed conservatively with resolution of portal venous gas on day 2 of hospitalization. The findings were consistent with a final diagnosis of hepatic portal venous gas caused by viral gastroenteritis. Conclusion: History and physical examination along with presenting signs and symptoms, in conjunction with imaging studies, are vital to delineate the cause of hepatic portal venous gas. In the absence of alarming signs and symptoms, hepatic portal venous gas can be conservatively managed without the need for invasive surgical exploration. Keywords: hepatic portal venous gas, portal venous gas, portal venous air, hepatic venous gas, hepatic venous air, gastroenteritis

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Negative spiral CT in acute pulmonary embolism

    International Nuclear Information System (INIS)

    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

  17. 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.

  18. 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

  19. Deep venous thrombosis after greater saphenous vein ligation and stripping%大隐静脉高位结扎剥脱术后深静脉血栓形成12例分析

    Institute of Scientific and Technical Information of China (English)

    董典宁; 吴学君; 张十一; 种振岳; 金星

    2012-01-01

    目的 探讨大隐静脉高位结扎剥脱术后深静脉血栓形成(deep venous thrombosis,DVT)的临床特点、病因及预防措施.方法 回顾性分析收治的12例行大隐静脉高位结扎剥脱术后合并DVT患者的临床特点及诊疗方法,并讨论病因及预防措施.结果 12例DVT患者中7例为中央型,2例为周围型,3例为混合型.DVT合并肺栓塞2例.10例中央型和混合型DVT的肢体增粗症状严重,肢围差距均>5 cm.9例行下腔静脉滤器(inferior vena cava filter,(IV)CF)保护下的腘静脉置管溶栓术( catheter-directed thrombolysis,CDT)治疗,其中l例介入造影过程中发现左股静脉突然中断,中转手术行股静脉探查修复术、CDT及髂静脉支架植入术;8例发现左髂静脉压迫综合征的影像学表现,其中6例在CDT治疗后行髂静脉支架植入术.1例结合术前彩超及造影所见考虑为右大隐静脉残端血栓蔓延至股静脉,行股静脉切开取栓治疗.2例周围型DVT行抗凝为主的综合性药物治疗.本组12例DVT患者均取得较好的近期疗效.结论 手术损伤股静脉、大隐静脉残端过长、左髂静脉压迫综合征是大隐静脉高位结扎剥脱术后DVT的临床常见原因.术前明确下肢慢性静脉功能不全的病变类型、术中仔细操作、术后早期下床活动至关重要.%Objective To report deep venous thrombosis (DVT) after greater saphenous vein ligation and stripping and to evaluate diagnosis,treatment and prophylaxis. Methods The clinical characteristics, diagnosis and treatment of 12 inpatients with postoperative DVT were analyzed retrospectively. Results Of these 12 cases there were 7 cases of central type DVT,2 cases of peripheral DVT,and 3 cases of mixed type DVT.Secondary pulmonary embolism was complicated in 2 cases.Clinical symptoms in these 10 cases of proximal DVT were all severe.Catheter-directed thrombolysis(CDT) through the ipsilateral popliteal vein with protective(IV)CF was applied for these

  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. 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.

  2. 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。

  3. Diet as prophylaxis and treatment for venous thromboembolism?

    OpenAIRE

    Cundiff David K; Agutter Paul S; Malone P; Pezzullo John C

    2010-01-01

    Abstract Background Both prophylaxis and treatment of venous thromboembolism (VTE: deep venous thrombosis (DVT) and pulmonary emboli (PE)) with anticoagulants are associated with significant risks of major and fatal hemorrhage. Anticoagulation treatment of VTE has been the standard of care in the USA since before 1962 when the U.S. Food and Drug Administration began requiring randomized controlled clinical trials (RCTs) showing efficacy, so efficacy trials were never required for FDA approval...

  4. Acute pulmonary embolism caused by enlarged uterine leiomyoma: A rare presentation

    OpenAIRE

    Khademvatani, Kamal; Rezaei, Yousef; Kerachian, Abdollah; Seyyed-Mohammadzad, Mir Hossein; Eskandari, Ramin; Rostamzadeh, Alireza

    2014-01-01

    Patient: Female, 42 Final Diagnosis: Acute pulmonary embolism Symptoms: Chest pain • dyspnea Medication: Streptokinase • Warfarin Clinical Procedure: — Specialty: Cardiology and Neoplasm Objective: Management of emergency care Background: Deep venous thrombosis (DVT) and subsequent pulmonary embolism (PE) caused by pelvic vein compression are rare and life-threatening complications of leiomyoma of the uterus. Case Report: We report a 42-year-old virgin woman with a history of leiomyoma who pr...

  5. 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...... 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...

  6. 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

  7. 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

  8. 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.

  9. Changes in respiratory elastance after deep inspirations reflect surface film functionality in mice with acute lung injury.

    Science.gov (United States)

    Takahashi, Ayuko; Bartolák-Suki, Erzsébet; Majumdar, Arnab; Suki, Béla

    2015-08-01

    Pulmonary surfactant reduces surface tension in the lung and prevents alveolar collapse. Following a deep inspiration (DI), respiratory elastance first drops then gradually increases due to surface film and tissue viscoelasticity. In acute lung injury (ALI), this increase is faster and governed by alveolar collapse due to increased surface tension. We hypothesized that the rate of increase in elastance reflects the deficiency of surfactant in the lung. To test this, mice were ventilated before (baseline) and after saline lavage obtained by injecting 0.8 ml and withdrawing 0.7 ml fluid (severe ALI) or injecting 0.1 ml (mild ALI). After two DIs, elastance was tracked for 10 min followed by a full lavage to assess surfactant proteins B (SP-B) and C (SP-C) content. Following 2 DIs, the increases in elastance during 10 min ventilation (ΔH) were 3.60 ± 0.61, 5.35 ± 1.04, and 8.33 ± 0.84 cmH2O/ml in baseline mice and mice with mild and severe ALI, respectively (P surface film functionality in lavage-induced ALI in mice. This method could prove useful in clinical situations such as diagnosing surfactant problems, monitoring recovery from lung injury or the effectiveness of surfactant therapy. PMID:26066828

  10. Comparison of two treatments for primary deep venous valve incompetence%两种不同手术方式治疗原发性下肢深静脉瓣膜功能不全的对比研究

    Institute of Scientific and Technical Information of China (English)

    曹廷宝; 韩晓鹏; 李东伟; 闫龙; 李坤; 魏登文; 刘宏斌

    2016-01-01

    Objective To compare the efficacy and the complications of TriVex phlebectomy combined with endovenous laser treatment (EVLT) and traditional high ligation and stripping of the great saphenous vein combined with encircling constriction of the superficial femoral vein in the treatment of primary deep venous insufficiency (PDVI). Methods From February 2010 to July 2014, 108 PDVI patients (137 legs) with CEAP classification C2~4 level in our centre were randomly divided into experiment group (TriVex phlebectomy combined with EVLT) and control group (traditional high ligation and stripping of great saphenous vein combined with encircling constriction of superficial femoral vein ). The clinical efficacy and postoperative complications of two groups were compared and analyzed. Results Symptoms of all patients were improved in different degrees and the effective rate was 100%. The treatments of two groups could controlled blood reflux effectively. The therapeutic effect of the experiment group was much better than that of control group in surgery time , blood loss in surgery , hospital stays , number of incision and postoperative lymphedema (P<0.05). There were no statistically significant differences in incision infection , subcutaneous ecchymosis, induration, skin numbness and deep vein thrombosis between two groups. Conclusion Both surgical operations are safe and effective in treatment of PDVI. However , TriVex phlebectomy combined with EVLT has advantages of little trauma and quick recovery , which is worth to be popularized.%目的:比较TriVex旋切术联合腔内激光与大隐静脉高位结扎剥脱术联合股浅静脉戴戒术治疗原发性下肢深静脉瓣膜功能不全(PDVI)的疗效和并发症。方法将2010年2月至2014年7月本院收治CEAP分级为C4级以下108例PDVI患者(137条患肢),分为观察组(TriVex 旋切术联合腔内激光治疗)和对照组(传统大隐静脉高位结扎剥脱术联合股浅静脉戴戒术),

  11. Change of microbiological composition of deminer-alized dentin from the bottom of carious cavity during the course of treatment of acute deep caries in children

    Directory of Open Access Journals (Sweden)

    Kazakova L.N.

    2013-09-01

    Full Text Available Purpose: to compare the antimicrobial efficacy of chlorhexidine bigluconate used in different forms for the treatment of acute deep caries, to define the percentage of complications in the treatment of acute deep caries in children on the stage of its development in 6 and 12 months. Material and methods: Bacteriological study of demineralized dentin taken from the bottom of «the work space» by the sterile instrument, clinical monitoring of children after 6 and 12 months. Results. A significant reduction of colonies forming odontopathogenic and opportunistic microorganisms during the application of the film «Diplen» and a high percentage of favorable outcomes over the period of follow-up in the second study group. Conclusion. Qualitative etiological treatment conducted in a timely manner taking into account the structural features of hard and soft tissues of the tooth, creates the conditions for full formation of all tooth tissues.

  12. 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

  13. 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...

  14. 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.

  15. 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。

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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

  2. 肾病综合征并发深静脉血栓和(或)肺栓塞临床分析%Clinical analysis of deep venous thrombosis and (or) pulmonary embolism in nephrotic syndrome

    Institute of Scientific and Technical Information of China (English)

    王亚芬; 孙东; 柳彩侠; 冯锦红; 崔爱东

    2011-01-01

    Objective To explore the related risk factors, diagnosis and treatment of nephrotic syndrome (NS)complicated with deep venous thrombosis (DVT) and (or) pulmonary embolism (PE). Methods A retrospective study was conducted on the clinical data of 10 cases of nephrotic syndrome complicated with DVT and (or) PE, which was compared with 50 synchronous cases of nephrotic syndrome with no thrombosis as to age (AGE) , plasma albumin ( ALB ), 24 - hour urine protein ( 24 - UP), total cholesterol ( CHOL), triglyceride ( TG), platelet (PLT) and fibrinogen (FIB). Results In the thrombosis group, 6 patients underwent renal biopsy , 3 of whom had membranous nephropathy. There were significant differences in the indicators such as AGE , ALB, 24 - UP, FIB between the thrombosis group and the non -thrombosis group (P< 0.05 ); the differences in CHOL, TG and PLT had no statistical significance (P>0.05 ). The thrombi disappeared in the thrombosis group following a series of therapies including anticoagulation , thrombolysis, implantation of inferior vena cava filter (IVCF) , etc. Conclusion AGE, ALB, 24 - UP and FIB play very important roles in the formation off DVT and (or) PE in NS. Membranous nephropathy is the most common pathological type in NS with thromboembolism. In cases of NS complicated with DVT and (or) PE, anticoagulation, thrombolysis or interventional therapy should be conducted as required. Implantation of IVCF is an effective method to prevent DVT leading to PE .%目的 探讨肾病综合征(nephrotic syndrome,NS)并发深静脉血栓形成 (DVT)和(或)肺栓塞(PE)的相关危险因素及诊治体会.方法 对10例确诊的NS并发DVT和(或)PE患者(血栓组)的临床资料进行回顾性分析,并与同期50例NS无血栓患者(无血栓组)的年龄(AGE)、血浆白蛋白(ALB)、24小时尿蛋白定量(24-UP)、总胆固醇(CHOL)、三酰甘油(TG)、血小板(PLT)、纤维蛋白原(FIB)等指标进行比较.结果 血栓组10例,肾活检6

  3. 肾移植后下肢深静脉血栓2例☆%Deep venous thrombosis in the lower extremities following renal transplantation in two patients

    Institute of Scientific and Technical Information of China (English)

    郝俊文; 宋华; 林长胜; 刘少鸽; 刘仰东; 李香铁

    2011-01-01

    背景:肾移植患者存在引发下肢深静脉血栓的诸多危险因素,如何有效降低该并发症的发生,并对其做出及时诊断、正确处理,对临床有重要的指导意义.目的:探讨肾移植患者下肢深静脉血栓的诊断、治疗及预防.方法:回顾性分析2例肾移植后发生下肢深静脉血栓患者的诊断依据及治疗效果,并对相关文献进行复习.结果与结论:依据病史、超声确诊的两例患者经及时的治疗(包括抗凝、溶栓等),均在六七天内患肢肿胀基本消退,彩超检查下肢深静脉血流通畅,患者完全康复,肾功能正常.提示,肾移植患者有引发下肢深静脉血栓的较多危险因素,彩色多普勒超声是最佳诊断措施,规范及时的抗凝、溶栓治疗可取得满意效果.对肾移植术后高危患者应采取一定的预防措施.%BACKGROUND: Renal transplantation recipients are exposed to greater risks of developing deep venous thrombosis in the lower extremities (LDVT). How to effectively reduce this complication following renal transplantation and prompt diagnosis and correct treatment has an important significance.OBJECTIVE: To investigate the diagnosis, treatment and prevention of LDVT following renal transplantation.METHODS: To retrospectively analyze the diagnosis and treatment of two renal transplantation recipients who developed LDVT and to review the relative literatures.RESULTS AND CONCLUSION: The two patients were diagnosed by color Doppler ultrasound examination and systemic medical history review. After timely and effective treatments including anticoagulation and thrombolysis, the two cases recovered at 6 and 7 days after treatment, showing evidence of establishment of efficient collateral circulation, as found in color Doppler ultrasound examination, and renal function was normal. The results demonstrated that renal transplantation recipients are exposed to greater risks of developing LDVT, for which color Doppler ultrasound

  4. 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....

  5. 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.

  6. VENOUS INSUFFICIENCY AND THROMBOEMBOLIC DISEASE IN BARIATRIC SURGERY PATIENTS

    Directory of Open Access Journals (Sweden)

    Bonno van BELLEN

    2013-09-01

    Full Text Available Context Morbid obesity is associated with various co-morbidities, including chronic venous insufficiency. Bariatric surgery is the only effective treatment for morbid obesity, but with potential risks and possible complications, including venous thromboembolism. Objective To determine the prevalence of clinical and ultrasonographic signs of chronic venous insufficiency in morbid obese patients in preparation for bariatric surgery and the incidence of post-operative venous thromboembolic disease. Methods Patients on work-up for bariatric surgery of Centro Terapêutico Especializado em Fígado (CETEFI and Pro-Gastro surgical teams of the Hospital Beneficência Portuguesa de São Paulo were included. The analysed data were pre-operative findings for venous insufficiency (CEAP - clinical, etiological, anatomical, physiopathologic - classification and venous ultrassonographic findings, type of surgery (open or laparoscopic, abdominal circumference, body mass index (BMI and post-operative ultrassonography search for venous insufficiency and deep venous thrombosis. Results Between March 2007 and December 2009, 95 patients candidates for bariatric surgery had clinical and duplex scan evaluation of the lower limbs venous system. Of the 95 patients, 53 were submitted to the surgical procedure. There was a predominance of women (77.9%, the average age was 38.5 years, average preoperative weight 124.6 kg and average BMI of 45.5 kg/m2. Regarding obesity, 16.8% were obese, and 83.1% were morbidly obese. In relation to the venous findings, 86.3% of the patients did fit CEAP classification less than 3 and 13.7% greater than or equal to 3. Among the post-operative complications, there were four cases of wound infection. Three patients developed post-operative distal venous thrombosis (7.5%, but no one had clinically manifested pulmonary embolism. Conclusion No relation between BMI, CEAP classification and venous ultrassonographic findings were found. Although

  7. 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

  8. 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.

  9. Absence of venous valves in mice lacking Connexin37.

    Science.gov (United States)

    Munger, Stephanie J; Kanady, John D; Simon, Alexander M

    2013-01-15

    Venous valves play a crucial role in blood circulation, promoting the one-way movement of blood from superficial and deep veins towards the heart. By preventing retrograde flow, venous valves spare capillaries and venules from being subjected to damaging elevations in pressure, especially during skeletal muscle contraction. Pathologically, valvular incompetence or absence of valves are common features of venous disorders such as chronic venous insufficiency and varicose veins. The underlying causes of these conditions are not well understood, but congenital venous valve aplasia or agenesis may play a role in some cases. Despite progress in the study of cardiac and lymphatic valve morphogenesis, the molecular mechanisms controlling the development and maintenance of venous valves remain poorly understood. Here, we show that in valved veins of the mouse, three gap junction proteins (Connexins, Cxs), Cx37, Cx43, and Cx47, are expressed exclusively in the valves in a highly polarized fashion, with Cx43 on the upstream side of the valve leaflet and Cx37 on the downstream side. Surprisingly, Cx43 expression is strongly induced in the non-valve venous endothelium in superficial veins following wounding of the overlying skin. Moreover, we show that in Cx37-deficient mice, venous valves are entirely absent. Thus, Cx37, a protein involved in cell-cell communication, is one of only a few proteins identified so far as critical for the development or maintenance of venous valves. Because Cxs are necessary for the development of valves in lymphatic vessels as well, our results support the notion of common molecular pathways controlling valve development in veins and lymphatic vessels.

  10. 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

  11. Homocysteine and venous thrombosis : studies into risk and therapy

    NARCIS (Netherlands)

    Willems, Huub Pieter Jan

    2006-01-01

    Homocysteine is a risk factor for venous thrombosis. Elevated concentrations can be treated with folic acid, vitamin B6 and vitamin B12. The main study (chapter 9) in this thesis is a randomized placebo-controlled trial in which patients with a first event of deep-vein thrombosis or pulmonary emboli

  12. How I treat pregnancy-related venous thromboembolism

    NARCIS (Netherlands)

    S. Middeldorp

    2011-01-01

    Venous thromboembolism (VTE) complicates ~ 1 to 2 of 1000 pregnancies, with pulmonary embolism being a leading cause of maternal mortality and deep vein thrombosis an important cause of maternal morbidity, also on the long term. However, a strong evidence base for the management of pregnancy-related

  13. Statin treatment and risk of recurrent venous thromboembolism

    DEFF Research Database (Denmark)

    Nguyen, Cu Dinh; Andersson, Charlotte; Jensen, Thomas Bo;

    2013-01-01

    Objectives Statins may decrease the risk of primary venous thromboembolism (VTE), that is, deep vein thrombosis (DVT) and pulmonary embolism (PE) but the effect of statins in preventing recurrent VTE is less clear. The aim of this study was therefore to investigate the association between statin ...

  14. 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。

  15. 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.

  16. Contraception-related deep venous thrombosis and pulmonary embolism in a 17-Year-old girl heterozygous for factor V leiden, prothrombin G20210A mutation, MTHFR C677T and homozygous for PAI-1 mutation: report of a family with multiple genetic risk factors and review of the literature.

    Science.gov (United States)

    Lenicek Krleza, Jasna; Jakovljevic, Gordana; Bronic, Ana; Coen Herak, Désirée; Bonevski, Aleksandra; Stepan-Giljevic, Jasminka; Roic, Goran

    2010-01-01

    We present the case of a 17-year-old girl who suddenly woke up with localized pain in the left groin and the inability to twist her leg. After comprehensive physician and laboratory examinations, deep venous thrombosis with consequent pulmonary embolism was ascertained. She had not experienced any recent trauma, but she had started to take oral contraceptives 6 months prior to the onset of the symptoms. Her parents and sisters had been asymptomatic throughout their lives, but the family history revealed a few thromboembolic accidents. Using DNA analysis, heterozygosity for factor V Leiden, prothrombin gene mutation G20210A and methylenetetrahydrofolate reductase C677T, as well as the homozygous 4G/4G genotype in the plasminogen activator inhibitor 1 were identified in our patient. Subsequently, DNA analysis was performed in all living family members, and multiple factors associated with thrombophilia were discovered. Our case confirms the multifactorial cause of thromboembolic events and emphasizes the importance of oral contraceptive use in the onset of venous thrombosis, especially in teenage females. In addition, this case indicates that teenage females with a family history of thrombosis who are making choices about contraception could most likely benefit from advanced thrombophilia testing. PMID:20664190

  17. Oak Forest Responses to Episodic-Seasonal-Drought, Chronic Multi-year Precipitation Change and Acute Drought Manipulations in a Region With Deep Soils and High Precipitation

    Science.gov (United States)

    Hanson, Paul J.; Wullschleger, Stan D.; Todd, Donald E.; Auge, Robert M.; Froberg, Mats; Johnson, Dale W.

    2010-05-01

    Implications of episodic-seasonal drought (extremely dry late summers), chronic multi-year precipitation manipulations (±33 percent over 12 years) and acute drought (-100 percent over 3 years) were evaluated for the response of vegetation and biogeochemical cycles for an upland-oak forest. The Quercus-Acer forest is located in eastern Tennessee on deep acidic soils with mean annual temperatures of 14.2 °C and abundant precipitation (1352 mm y-1). The multi-year observations and chronic manipulations were conducted from 1993 through 2005 using understory throughfall collection troughs and redistribution gutters and pipes. Acute manipulations of dominant canopy trees (Quercus prinus; Liriodendron tulipifera) were conducted from 2003 through 2005 using full understory tents. Regional and severe late-summer droughts were produced reduced stand water use and photosynthetic carbon gain as expected. Likewise, seedlings and saplings exhibited reduced survival and cumulative growth reductions. Conversely, multi-year chronic increases or decreases in precipitation and associated soil water deficits did not reduce large tree basal area growth for the tree species present. The resilience of canopy trees to chronic-change was the result of a disconnect between carbon allocation to tree growth (an early-season phenomenon) and late-season drought occurrence. Acute precipitation exclusion from the largest canopy trees also produced limited physiological responses and minimal cumulative growth reductions. Lateral root water sources were removed through trenching and could not explain the lack of response to extreme soil drying. Therefore, deep rooting the primary mechanism for large-tree resilience to severe drought. Extensive trench-based assessments of rooting depth suggested that ‘deep' water supplies were being obtained from limited numbers of deep fine roots. Observations of carbon stocks in organic horizons demonstrated accumulation with precipitation reductions and

  18. L-Asparaginase Therapy with Concomitant Cranial Venous Thrombosis: Can Mri Help Avoiding Stroke

    International Nuclear Information System (INIS)

    To prospectively use MRI in the early detection of intracranial sino-venous thrombosis during the L-asparaginase induction therapy of acute leukemia thus preventing the evolution of brain venous infarct. Materials and Methods: The study population consisted of seventy patients receiving L-asparaginase induction therapy for acute leukemia in the National Cancer Institute of Cairo University presenting with clinical neurological signs suggestive of aseptic intracranial venous thrombosis. All the patients were studied by 1.5 Tesla magnet using conventional MRI pulse sequences and MR veno graphic studies. The imaging findings were processed as regards the detection of venous thrombosis, its signal criteria and the evaluation of any companion brain parenchymal ischemic insults. Results: Eleven patients were diagnosed with d ural venous sinus thrombosis with subsequent specific signal pattern of the thrombus that could be linked to the duration of thrombosis. The MR veno graphic studies detected the thrombosis in nine cases out of eleven. Ten cases scored brain parenchymal signal abnormality that could indicate infarction, eight of them were hemorrhagic in nature. Conclusion: L-asparaginase therapy is accompanied by high risk of venous thrombosis that could involve the intra-cranial sino-venous structures. MRI could be used effectively in the early diagnosis of such serious, curable complication using a combination of conventional spin echo pulse sequences and MR veno graphic studies. Hemorrhagic venous infarcts should draw the attention to underlying established venous thrombosis.

  19. Analysis on the risk factors of lower extremity deep venous thrombosis after cesarean section%剖宫产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)

    高丹丽; 杨小杰; 林黎明

    2012-01-01

    Objective: To explore the risk factors of lower extremity deep venous thrombosis ( LEDVT) after cesarean section. Methods: A total of 20 998 patients who underwent cesarean section in Tangshan maternal and child health hospital, Tangshan workers hospital, and Xiehe hospital from January 2008 to January 2012 were selected, related tests were carried out before cesarean section, then color ultrasonography of bilateral lower extremities was performed at 2 - 7 days after cesarean section; except the patients with LEDVT, two times of peoples were selected from the whole population as control group; the influencing factors of LEDVT were analyzed by univariate and multivariate logistic regression analysis. Results; A total of 716 postoperative patients met the diagnostic criteria of LEDVT, the incidence of LEDVT was 3. 41%. Among the measurement data, the body mass index (BMI) , activated partial thromboplastin time ( APTT) , fibrinogen, D - dimer, antithrombin Ⅲ , and C — reactive protein ( CRP) in case group were statistically significantly higher than those in control group. Among the enumeration data, the incidences of LEDVT in the patients with the histories of hypertension, diabetic mellitus, smoking, thrombus, and oral administration of contraceptive were significantly higher than those in control group. Univariate logistic regression analysis showed that age, BMI, APTT, D - dimer, antithrombin Ⅲ , CRP, the medical histories of hypertension, diabetic mellitus, smoking, thrombus, and oral administration of contraceptive, and lacking sports were the independent risk factors of LEDVT; multivariate logistic regression analysis showed that age, BMI, D - dimer, antithrombin Ⅲ , and CRP were the independent risk factors of LEDVT. Conclusion: The incidence of LEDVT after cesarean section was high; the occurrence of LEDVT was correlated with age, BMI, D - dimer, antithrombin Ⅲ , and CRP. It is suggested to screen LEDVT routinely at 2 -7 days after cesarean section

  20. Normal venous circulation of the gastroesophageal junction. A route to understanding varices.

    Science.gov (United States)

    Vianna, A; Hayes, P C; Moscoso, G; Driver, M; Portmann, B; Westaby, D; Williams, R

    1987-10-01

    A study into the normal anatomy of the venous circulation of the gastroesophageal junction was undertaken using three complementary techniques (radiology, corrosion casting, and morphometry). Four distinct zones of venous drainage were defined as follows: (a) gastric zone, characterized by a longitudinal venous distribution; (b) palisade zone, composed of parallel vessels arranged in groups, lying mainly within the lamina propria; (c) perforating zone, characterized by "treble clef" shaped veins, which collect and channel blood into extrinsic veins; and (d) truncal zone, composed of four or five deep lying descending veins. This venous system appeared to be mainly distributed within the esophageal mucosal folds. The anatomic pattern suggests that venous flow is bidirectional at the palisade zone, which acts as a high-resistance watershed region between the portal and azygos systems. In patients with portal hypertension this normal vascular system has to accommodate greatly increased venous flow, and the anatomy as demonstrated here offers insight into variceal development. PMID:3623028

  1. Catheter-directed thrombolysis for acute superior mesenteric venous thrombosis via superior mesenteric vein and artery%急性肠系膜上静脉血栓的动静脉联合导管溶栓治疗

    Institute of Scientific and Technical Information of China (English)

    杨硕菲; 吴性江; 黎介寿

    2014-01-01

    superior mesenteric venous thrombosis (SMVT), which is conducted mainly through percutaneous transhepatic , transjugular intrahepatic, or superior mesen-teric artery approach .This study is to assess the feasibility , effectiveness and safety of catheter-directed thrombolysis via the superior mesenteric vein and artery for acute SMVT . Methods We retrospectively reviewed 8 cases of acute extensive SMVT treated by tran-scatheter thrombolysis via superior mesenteric vein and artery in our institute .We collected and analyzed the general information , case history, etiology, risk factors, imaging characteristics, treatment procedures, complications, and follow-up data of the patients summa-rized the experience in the treatment of acute extensive SMVT by catheter-directed thrombolysis . Results Technical success was a-chieved with substantial symptoms improvement after thrombolytic therapy in all the cases .The local urokinase infusion via the superior mesenteric artery and vein was performed for (6.13 ±0.83) and (12 ±2.51) d.Four patients required delayed localized bowel resection of (1.63 ±0.48) m, with satisfactory recovery after intensive care and organ function support .Contrast-enhanced CT scan and portogra-phy demonstrated complete thrombus resolution in all the patients before discharged after a hospital stay of (19.25 ±4.89) d.Minor bleeding at the puncture site occurred in 2 cases and sepsis developed in another 2 postoperatively .No recurrence and complications were ob-served during the follow-up of (12.13 ±0.99) mo. Conclusion For acute extensive SMVT , catheter-directed thrombolytic therapy via superior mesenteric vein and artery can accelerate thrombus resolution , stimulate collateral vessel development , reverse extensive intestinal is-chemia, avert bowel resection , localize infarcted bowel segment to pre-vent short bowel syndrome , and effectively speed up the recovery and significantly increase the survival rate of the patients .

  2. The Alterations of Plasma ET-l, NO Post Laser Treatment in Patients with Primary Deep Venous Insufficiency%原发性下肢深静脉瓣膜功能不全激光微创治疗术后血浆ET-1、NO水平的变化

    Institute of Scientific and Technical Information of China (English)

    王春喜; 牛磊; 顾瑛; 韩丽娜; 曾晶; 周静

    2011-01-01

    目的:探讨原发性深静脉瓣膜功能不全患者血浆内皮素-1(endothelin-1,ET-1)、一氧化氮(nitric oxide,NO)水平的变化及与病情轻重和临床治疗的关系.方法:分别选择495例原发性深静脉瓣膜功能不全住院患者和495例同期同龄同性别健康查体者,分别抽取空腹静脉血,制备相关标本,采用放射免疫分析和Griss方法测定血浆ET-1、NO,利用密度梯度法测定血液循环血管内皮细胞计数(circulating endothelial cells counting,CEC)同时测定手术后临床治愈时血浆CEC、ET-1、NO水平.结果:495例病人血浆ET-1水平和血中CEC水平均高于正常对照组,而NO水平则低于正常人水平,且以重症患者最明显.术后2周均达到临床治愈时,其血浆ET-1水平和血中CEC水平明显降低,而NO水平则明显升高,恢复正常或接近正常人水平.结论:检测血液中CEC、ET-1和NO水平有助于了解病情轻重,了解疾病进程,动态观察血液中CEC、ET-1和NO水平有助于了解临床治疗效果.%Objectivo To investigate the alterations of plasma endothelin-1 ( ET-1 ), nitric oxide( NO ), circulating endothelial cells counting ( CEC ) in patienrts with primary deep venous insufficiency, and to investigate the relationship between such alteration and illness. Methods The plasma samples were obtained from 495 cases with primary deep venous insufficiency and from 495 healthcontrols, and the levels of ET-l, NO, CEC were determined by radialmmtmoassay, Gress method and density gradient method respectively. Results The level of plasma ET-1 and blood CEC in 495 patients with primary deep venous insufficiency wine significantly higher than those in contrals. The level of plasma NO was significantly lower than that in controls. Two weeks after operation, the level of plasma ET-1 and blood CEC were significantly decreased and the plasma NO contents was significantly increased, which was closely returned to nomal levels. Conclusion It is hallpflul to

  3. Unilateral Pseudotumoral Presentation of Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-09-01

    Full Text Available Cerebral venous thrombosis (CVT is an unusual cause of stroke. It is more common in middle-aged women and deep CVT lesions are usually bilateral. CVT can have very diverse clinical presentations and mimic other conditions. We report two women with CVT initially diagnosed as tumors (unilateral pseudotumoral presentation of CVT successfully treated with intravenous heparin. Early diagnosis was important and completely reversed the symptoms. The diagnosis of CVT should be remembered when clinical picture is compatible even if brain imaging suggests unilateral tumor.

  4. Role of Tissue Factor in Venous Thrombosis

    Science.gov (United States)

    Manly, David A.; Boles, Jeremiah; Mackman, Nigel

    2011-01-01

    Venous thromboembolism (VTE) is a leading cause of morbidity and mortality worldwide. However, the mechanisms by which clots are formed in the deep veins have not been determined. Tissue factor (TF) is the primary initiator of the coagulation cascade and is essential for hemostasis. Under pathological conditions, TF is released into the circulation on small-membrane vesicles termed microparticles (MPs). Recent studies suggest that elevated levels of MPTF may trigger thrombosis. This review provides an overview of the role of TF in VTE. PMID:20690821

  5. Direct oral anticoagulants and venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Massimo Franchini

    2016-09-01

    Full Text Available Venous thromboembolism (VTE, consisting of deep vein thrombosis and pulmonary embolism, is a major clinical concern associated with significant morbidity and mortality. The cornerstone of management of VTE is anticoagulation, and traditional anticoagulants include parenteral heparins and oral vitamin K antagonists. Recently, new oral anticoagulant drugs have been developed and licensed, including direct factor Xa inhibitors (e.g. rivaroxaban, apixaban and edoxaban and thrombin inhibitors (e.g. dabigatran etexilate. This narrative review focusses on the characteristics of these direct anticoagulants and the main results of published clinical studies on their use in the prevention and treatment of VTE.

  6. Doppler ultrasound study and venous mapping in chronic venous insufficiency.

    Science.gov (United States)

    García Carriazo, M; Gómez de las Heras, C; Mármol Vázquez, P; Ramos Solís, M F

    2016-01-01

    Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.

  7. Experimental study on the pathogenesis of deep venous thrombosis in lower limbs following artificial total hip replacement%人工全髋关节置换术后下肢深静脉血栓形成原因的实验观察

    Institute of Scientific and Technical Information of China (English)

    杨景武; 史晓林

    2005-01-01

    不良事件及副反应:3例出血达1 000 mL.为充分暴露手术视野,用拉钩阻挡肌肉等组织,即造成血管的长期积压,血流迟缓.结论:人工全髋置换术易损伤髋臼血管内壁,从而导致血流减慢和血小板聚集,最终促使血栓形成.同时术中失血多,使血液黏稠导致血栓形成.根据易损伤区及安全区模式图可知,下肢深静脉血栓是可以减少的.%BACKGROUND:Deep venous thrombosis has already been recognized as an important serious postoperative complication because it can cause fatal pulmonary embolism and long-term deep venous dysfunction. With the constant development of artificial joint operation and the popularization of such surgery, much attention has been paid to the formation of deep venous thrombosis following artificial joint replacement.OBJECTIVE: To observe the anatomical property of acetabular surrounding arteries and veins, as well as their injury during total hip replacement,so as to explore the cause of deep venous thrombosis in lower limbs following artificial total hip replacement.DESIGN: Single sample observation and before-after self-control.SETTING: Gross anatomy was carried out in the anatomical laboratory of the Medical School of Huzhou Teachers' College; total hip replacement was carried out in the Orthopedic Department, Xinhua Hospital of Zhejiang Traditional Chinese Medicine College.PARTICIPANTS: Pelvic samples were collected from 60 normal adult corpuses (30 from men and 30 from women); meanwhile, 30 patients (18 males and 12 females) received total hip replacement in the Orthopedic Department of Xinhua Hospital, Zhejiang Traditional Chinese Medicine College, between March 2002 and August 2003.METHODS: Gross anatomy was carried out at the anatomical laboratory in the Medical School of Huzhou Teachers' College between March and May 2003. The running course of bilateral external iliac artery and vein, as well as the relationship between the branches of femoral artery and vein and acetabulum were

  8. Predictors of Venous Thromboembolic Events Associated with Central Venous Port Insertion in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Christine Hohl Moinat

    2014-01-01

    Full Text Available Insertion of central venous port (CVP catheter in the cancer population is associated with increased incidence of venous thromboembolic events (VTE. However, trials have shown limited benefit of antithrombotic treatment to prevent catheter-related venous thrombosis. This prospective observational cohort study was designed to assess the incidence of VTE closely related to CVP implantation in patients with cancer and undergoing chemotherapy, and to identify a high risk subgroup of patients. Between February 2006 and December 2011, 1097 consecutive cancer patients with first CVP implantation were included. Catheter-related VTE were defined as deep venous thrombosis in the arm, with or without pulmonary embolism (PE, or isolated PE. The incidence of CVP-associated VTE was 5.9% (IC95 4.4–7.3% at 3 months, and 11.3% (IC95 9.4–13.2% at 12 months. The incidence of any VTE was 7.6% (IC95 6.0–9.3% at 3 months, and 15.3% (IC95 13.1–17.6% at 12 months. High Khorana risk score and lung cancer were significant predictors of 3 month VTE. In conclusion, this large cohort study of patients with first CVP catheter implantation confirms the high incidence of VTE associated with the CVP implantation and allow identifying high risk patients who may benefit from thromboprophylaxis.

  9. Predicting the Risk of Venous Thromboembolism Recurrence

    OpenAIRE

    Heit, John A.

    2012-01-01

    Venous thromboembolism (VTE) is a chronic disease with a 30% ten-year recurrence rate. The highest incidence of recurrence is in the first 6 months. Active cancer significantly increases the hazard of early recurrence, and the proportions of time on standard heparin (APTT≥0.2 anti-Xa U/mL) and warfarin (INR≥2.0) treatment, significantly reduce the hazard. The acute treatment duration does not affect recurrence risk after treatment is stopped. Independent predictors of late recurrence include ...

  10. Fish Intake and Venous Thromboembolism: A Systematic Literature Review.

    Science.gov (United States)

    Mattiuzzi, Camilla; Cervellin, Gianfranco; Franchini, Massimo; Lippi, Giuseppe

    2016-05-01

    Diet plays an important role in modulating the risk of arterial and venous thrombosis. Several lines of evidence attest that consumption of fish and its compounds, especially omega-3 fatty acids, may be effective to decrease the cardiovascular risk. Since the pathogenesis of arterial and venous thrombosis share some common aspects, we performed a systematic review of published clinical studies that investigated the association between fish intake and venous thrombosis. An electronic search was carried out in Medline, Scopus, and ISI Web of Science using the key words "fish" OR "seafood" AND "venous thromboembolism" OR "deep vein thrombosis" OR "pulmonary embolism", with no language or date restriction. Overall, 6 studies (5 prospective and 1 case-control) were finally identified. In only 1 small case-control study, a larger intake of total fish was found to be negatively associated with the risk of venous thromboembolism. No association was found in 4 large prospective studies, whereas a positive association was observed in the remaining. No substantial difference was also noticed between intake of fatty or lean fish. Taken together, the current epidemiological evidence does not support the existence of a significant effect of total fish consumption on the risk of venous thromboembolism. PMID:25962392

  11. Ethanol sclerotherapy of peripheral venous malformations

    International Nuclear Information System (INIS)

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur

  12. Ethanol sclerotherapy of peripheral venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, U. E-mail: rimonu@sheba.health.gov.il; Garniek, A.; Galili, Y.; Golan, G.; Bensaid, P.; Morag, B

    2004-12-01

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur.

  13. Current and emerging strategies in the management of venous thromboembolism: benefit–risk assessment of dabigatran

    Directory of Open Access Journals (Sweden)

    Fanola CL

    2015-05-01

    Full Text Available Christina L Fanola Department of Cardiovascular and Vascular Medicine, Boston University School of Medicine, Boston, MA, USA Abstract: Venous thromboembolism (VTE is a disease state that carries significant morbidity and mortality, and is a known cause of preventable death in hospitalized and orthopedic surgical patients. There are many identifiable risk factors for VTE, yet up to half of VTE incident cases have no identifiable risk factor and carry a high likelihood of recurrence, which may warrant extended therapy. For many years, parenteral unfractionated heparin, low-molecular weight heparin, fondaparinux, and oral vitamin K antagonists (VKAs have been the standard of care in VTE management. However, limitations in current drug therapy options have led to suboptimal treatment, so there has been a need for rapid-onset, fixed-dosing novel oral anticoagulants in both VTE treatment and prophylaxis. Oral VKAs have historically been challenging to use in clinical practice, with their narrow therapeutic range, unpredictable dose responsiveness, and many drug–drug and drug–food interactions. As such, there has also been a need for novel anticoagulant therapies with fewer limitations, which has recently been met. Dabigatran etexilate is a fixed-dose oral direct thrombin inhibitor available for use in acute and extended treatment of VTE, as well as prophylaxis in high-risk orthopedic surgical patients. In this review, the risks and overall benefits of dabigatran in VTE management are addressed, with special emphasis on clinical trial data and their application to general clinical practice and special patient populations. Current and emerging therapies in the management of VTE and monitoring of dabigatran anticoagulant-effect reversal are also discussed. Keywords: novel oral anticoagulants, dabigatran, venous thromboembolism, deep venous thrombosis, pulmonary embolism, oral anticoagulation

  14. Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome

    International Nuclear Information System (INIS)

    To investigate cerebral venous thrombosis (CVTR) clinical presentations, risk factors, and response to treatment in Saudi Arabia. Retrospective analysis of the King Farad Medical City, Riyadh, acute stroke database from April 2005 through February 2008 revealed 22 patients with CVTR. Hyper coagulable work-up and neuroimaging were performed. Sixteen patients were female (72.7%), and the median age was 35 years. Clinical presentations included: headache (77.3%), seizures (54.5%), focal neurological signs (54.5%), and decreased level of consciousness (50%). Over two-thirds (n=11; 69%) of female patients had a history of oral contraceptive use, which was the most common risk factor. Protein S deficiency (n=3), anti phospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n=1), rhinocerebral mucormycosis (n=1), leukemia (n=1), non-Hodgkin's lymphoma (n=1), sepsis (n=1), and unknown (n=6) were causes. Affected areas included superior sagittal (n=13), transverse (n=16), sigmoid (n=14), straight (n=6), and cavernous sinus (n=1); internal cerebral vein (n=2); vein of Galen (n=3); cortical veins (n=10); and internal jugular vein (n=12). Two patients had quadriparesis, and 2 patients died. The remainder (n=18, 81.8%) improved. Bilateral hemorrhagic presentation or venous infarction, deep venous system thrombosis, and underlying malignancy had less favorable results. Presentations in our series were similar to those in other reports, although altered consciousness and seizures were more common. Cortical vein involvement was also higher than commonly reported. Oral contraceptive use was a primary risk factor in female patients. Outcomes were favorable in 81.8% of patients. (author)

  15. Transhepatic venous catheters for hemodialysis

    OpenAIRE

    Mohamed El Gharib; Gamal Niazi; Waleed Hetta; Yahya Makkeyah

    2014-01-01

    Purpose: To describe our experience with the technique of transhepatic venous access for hemodialysis and to evaluate its functionality and complications. Patients and methods: From March 2012 till October 2012, 23 patients with age ranging from 12 to 71 years old having end-stage renal disease (ESRD) were included in our study and were subjected to transhepatic venous catheter insertion. In 21 patients there were not any remaining patent peripheral venous accesses. In 2 patients there wer...

  16. The long-term result of hemodynamics and valvular function after endovenous laser ablation of varicose veins in the primary deep venous insufficiency%曲张浅静脉激光闭合术对原发性深静脉功能不全中远期血流动力学和瓣膜功能的影响

    Institute of Scientific and Technical Information of China (English)

    王艳华; 殷敏毅; 张培华

    2012-01-01

      目的观察曲张浅静脉激光闭合术对下肢原发性深静脉功能不全中、远期血流动力学和瓣膜功能的影响.方法选择2010年1月-12月接受曲张浅静脉激光闭合术治疗的854例下肢原发性深静脉功能不全病例,应用彩色多普勒超声评估术前和术后1、6和12个月时,股浅静脉第一对瓣膜静脉反流指数的变化.结果321例术前轻度瓣膜反流患者,在术后1、6和12个月时的瓣膜反流改善率分别为57.6%、72.0%和86.9%.301例中度瓣膜反流患者和232例重度瓣膜反流患者,在术后1、6和12个月时瓣膜反流改善率分别为15.0%、23.6%、26.2%和8.2%、13.4%和19.4%.轻度瓣膜反流患者术后瓣膜反流改善率与中度和重度患者相比,差异均有统计学意义(P 均<0.05).结论曲张浅静脉激光闭合术能够有效改善股浅静脉第一对瓣膜轻度反流患者的瓣膜反流程度.%  Objective To observe the long-term results of hemodynamics and valvular function after endovenous laser ablation of varicose veins in the primary deep venous insufficiency. Methods Between January and December 2010,854 patients diagnosed as primary deep venous insufficiency had their varicose veins treated by endovenous laser ablation. Color doppler ultrasound was used to measure the venous reflux index of the first valve of superficial femoral vein pre-and post-operative, at 1,6 and 12 months after surgery. Results The correction rate of valvular reflux in mild reflux cases were 57.6%,72.0% and 86.9% respectively at 1,6 and 12 months after surgery. The results of moderate and severe reflux cases were 15.0%,23.6%,26.2% and 8.2%,13.4%,19.4% respectively. The correction rate of valvular reflux in mild reflux cases after operation was better than the moderate and severe groups(both P <0.05). Conclusion Endovenous laser ablation of varicose veins can correct the deep venous incompetence of the lower extremity in mild reflux groups.

  17. Epidemiological study of venous thromboembolism in a big Danish cohort

    DEFF Research Database (Denmark)

    Severinsen, Marianne Tang; Kristensen, Søren Risom; Overvad, Kim;

    Introduction: Epidemiological data on venous thromboembolism (VT), i.e. pulmonary emboli (PE) and deep venous thrombosis (DVT) are sparse. We have examined VT-diagnoses registered in a big Danish Cohort study.  Methods: All first-time VT diagnoses in The Danish National Patient Register were...... identified among participants in the Danish cohort study "Diet, Cancer and Health" in which 57,053 50-64 years old persons were included 1993-7. Medical records were retrieved and reviewed by an experienced physician using a detailed standardized form, and information on the diagnostic work-up and presence...

  18. A rare cause of cerebral venous thrombosis: cryptococcal meningoencephalitis.

    Science.gov (United States)

    Senadim, Songul; Alpaydin Baslo, Sezin; Tekin Güveli, Betül; Dedei Daryan, Metin; Kantaroglu, Elif; Ozturk, Oya; Atakli, Dilek

    2016-07-01

    Cryptococcal meningoencephalitis (CM) is a serious central nervous system infection caused by Cryptococcus neoformans, seen mostly in immunocompromised hosts and less in immunocompetent patients. The vast majority of cryptococcosis cases are seen as human immunodeficiency virus infections with advanced immunosuppression. Meningitis and meningoencephalitis are the most common clinical manifestations. Nevertheless, immunocompetent patients with CM are rarely reported. Cerebral venous sinus thrombosis is a rare complication of CM. Here, we report an immunocompetent patient with CM from a non-endemic area, who presented with an acute onset and atypical symptoms associated with cerebral venous thrombosis. PMID:27025504

  19. Radionuclide plethysmography and Tc-99m red blood cell venography in venous thrombosis: comparison with contrast venography

    International Nuclear Information System (INIS)

    Radionuclide plethysmography (RPG) is a new technique that uses Tc-99m labelled red blood cells to ascertain changes in venous volumes by detecting the change in counts in response to the inflation and deflation of proximal thigh cuffs. Diagnosis of ileofemoral venous occlusion is possible using this technique, which also provides kinetic data of venous outflow. A range of normal values was defined in 19 subjects for per cent change in venous capacitance and venous outflow. Twenty-one patients with suspected deep venous thrombosis were studied prospectively using RPG, radionuclide venography (RV), and contrast venography (CV) to establish the usefulness of RPG alone and in combination with RV in the diagnosis of deep venous thrombosis. RPG proved to be a reliable technique for the diagnosis of ileofemoral venous thrombosis (sensitivity, 91%; specificity, 100%). RV was less sensitive (73%) and less specific (93%) in diagnosing that condition. When RPG is used as the criterion for the detection of ileofemoral vein thrombosis and RV is used as the criterion for the detection of calf vein thrombosis, the combined techniques show improved sensitivity (92%) and specificity (93%) for the detection of all deep venous thromboses

  20. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    Science.gov (United States)

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  1. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  2. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  3. Deep vein thrombosis and pulmonary embolism in the Chinese population

    OpenAIRE

    Nandi, PL; Li, WS; Leung, R.; Chan, HT; Chan, J

    1998-01-01

    Deep vein thrombosis and pulmonary embolism is a well-recognised major health problem in the West. There is a deep-rooted belief among clinicians that deep vein thrombosis is rare in Asians, particularly in the Chinese population. However, it appears that the incidence of venous thrombosis and pulmonary embolism is increasing in Chinese patients. Prophylaxis reduces the incidence of venous thrombosis by 66% and of pulmonary embolism by 50%Ը? prophylaxis should therefore be considered for Chin...

  4. Analysis of disease patterns and cost of treatments for prevention of deep venous thrombosis after total knee or hip replacement: results from the Practice Analysis of THromboprophylaxis after Orthopaedic Surgery (PATHOS study

    Directory of Open Access Journals (Sweden)

    Degli Esposti L

    2012-12-01

    Full Text Available Luca Degli Esposti,1 Guido Didoni,2 Teresa Simon,3 Stefano Buda,1 Diego Sangiorgi,1 Ezio Degli Esposti11CliCon Health, Economics and Outcomes Research, Ravenna, Italy; 2BMS Italy, Rome, Italy; 3BMS Global, Princeton, NJ, USAIntroduction: Venous thromboembolism (VTE is a well-known complication of total hip replacement (THR and total knee replacement (TKR. Various drugs have been introduced in an attempt to reduce the mortality as well as the short-term and long-term morbidity associated with the development of VTE. The aim of this study was to analyze drug utilization for thromboprophylaxis and the cost of illness in real clinical practice in patients with THR or TKR.Materials and methods: A multicenter, retrospective, observational cohort study based on local health unit administrative databases was conducted. All patients (≥18 years old discharged for THR/TKR procedures between January 1, 2007 and December 31, 2008 were included in the study. The date of first hospital discharge was the index date; patients were followed up for a period of 12 months.Results: A total of 10,389 patients were included: 3516 males (33.8%, 69.4 ± 10.4 years and 6873 females (66.2%, 71.7 ± 9.0 years, of which 5483 (52.8% were discharged for THR and 4906 (47.2% for TKR. First antithrombotic treatments after discharge were enoxaparin (3937, 37.9%, heparin (3752, 36.1%, antiplatelet agents (658, 6.3%, vitamin K antagonists (276, 2.7%, fondaparinux (136, 1.3%, combinations (185, 1.8%, and no therapy (1445, 13.9%. Overall, we observed 2347 (22.6% treatment changes; median duration of antithrombotic treatment was 23 days (range 11–47 for THR and 22 days (range 11–46 for TKR. During the follow-up period, we observed 129 cases of VTE (120 per 10,000 patients, five post-thrombotic syndrome (4.8 per 10,000 patients, and three heparin-induced thrombocytopenia (2.9 per 10,000 patients. Median cost for both THR and TKR was €9052.00 (range €8063.00–€9084.96, with

  5. [Pain in venous thrombosis of the leg].

    Science.gov (United States)

    Henriet, J P

    1992-01-01

    According to D. Reinharez, pain and edema are the commonest presenting symptoms in phlebology. Pain is one of the most classical symptoms of an ordinary deep venous thrombosis, a valuable feature when present, in the form of deep tension, heaviness, swelling and a feeling of dead weight. It is often absent or slight. It may consist merely of a dull cramp, or of an "undefinable" (C. Bourde) odd, heavy leg. It generally affects the calf but may involve the sole of the foot, the heel, the thigh, the groin or even the true pelvis. This feeling, although "imprecise and variable" (P. Wallois, P. Griton) is highly suggestive. It increases on standing and walking in the form of unilateral uncomfortable tension, heaviness or painful swelling, which maybe a source of worry or even anxiety to the patient. Tenderness on palpation of venous tracts and their stretching is more suggestive. In the opinion of M. Duruble, Neuhof's sign (feeling of tender fullness of the calf) is more reliable than Homans' sign (pain in the calf caused by passive dorsiflexion of the foot, with the lower limb in extension) which essentially stretches only the posterior tibial venous system. The value of Sigg's sign (pain in the popliteal fossa on passive extension of the knee) is controversial. Far more rare is phlegmasia coerulea dolens or Grégoire's blue leg, complicating phlegmasia alba dolens or of sudden onset, with initial very severe or even "intolerable" pain (J.J. Pinot) in Scarpa's triangle, rapidly spreading to the limb. In varicose phlebitis (M. Perrin) or superficial thrombophlebitis or varico-phlebitis (A.A. Ramelet) or superficial venitis (J.P. Henriet), pain most often consists of moderate burning tension overlying the thrombosed vein(s), increased by palpation and mobilisation. Sometimes severe initially, it is exacerbated by the slightest touch. In total, pain, regardless of its characteristics, its site and/or its severity, is one of the most constant clinical features of venous

  6. Urinary hemosiderin: role in evaluation of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2012-08-01

    Full Text Available Chronic venous insufficiency (CVI leads to skin changes with dermal hemosiderin deposition. We studied the presence of hemosiderin in the urine to assess if this could be used as a biochemical marker for CVI. Hereby we present a case control study conducted in a tertiary care centre in South India. There were 100 cases with evidence of advanced CVI (the Clinical-Etiology-Anatomy-Pathophysiology classification: C5, C6 confirmed by duplex scanning. Controls were 50 patients with leg ulcers due to other etiologies. All patients were subjected to urinary hemosiderin testing. In all 100 patients with CVI (C5 and C6 disease axial venous reflux was confirmed by duplex ultrasound. Superficial venous reflux was noted in 71% of patients and deep venous reflux in 54.%. Primary venous insufficiency was the etiology in 81% of patients. Only 4/100 patients had detectable amounts of hemosiderin in the urine. Urine hemosiderin testing to determine presence or absence of CVI yielded the following values: positive predictive value-80%; negative predictive value-33%; sensitivity-4% and specificity-98%. The test could not be recommended as a marker of CVI. In Indian patients urinary hemosiderin is not a useful screening test in CVI.

  7. Venous and arterial thrombosis: Two aspects of the same disease?

    Directory of Open Access Journals (Sweden)

    Paolo Prandoni

    2009-01-01

    Full Text Available Paolo PrandoniDepartment of Cardiothoracic and Vascular Sciences, Thromboembolism Unit, University Hospital of Padua Padua, ItalyAbstract: An increasing body of evidence suggests the likelihood of a link between venous and arterial thrombosis. The two vascular complications share several risk factors, such as age, obesity, diabetes mellitus, blood hypertension, hypertriglyceridemia, and metabolic syndrome. Moreover, there are many examples of conditions accounting for both venous and arterial thrombosis, such as the antiphospholipid antibody syndrome, hyperhomocysteinemia, malignancies, infections, and the use of hormonal treatment. Finally, several recent studies have consistently shown that patients with venous thromboembolism are at a higher risk of arterial thrombotic complications than matched control individuals. We, therefore, speculate the two vascular complications are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Future studies are needed to clarify the nature of this association, to assess its extent, and to evaluate its implications for clinical practice.Keywords: venous thromboembolism, deep vein thrombosis, pulmonary embolism, myocardial infarction, ischemic stroke, atherosclerosis

  8. 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...... a relative risk of 3.08 (95% confidence interval [CI] 2.80-3.39) as compared with the general population. The risk was higher for both men (SIR 3.36, 95% CI 2.96-3.82) and women (SIR 2.81, 95% CI 2.45-3.23). The risk was similar among siblings of index cases with venous thrombosis and those of index cases...... embolism born after 1952. We used the Danish National Registry of Patients covering all Danish hospitals, for the years 1977 through 2009, to identify index cases of venous thromboembolism, and assessed the incidence among their siblings. We compared standardized incidence ratios (SIRs) of the observed...

  9. Wound care in venous ulcers.

    Science.gov (United States)

    Mosti, G

    2013-03-01

    -to-heal leg ulcers such as large, deep, infected and long-lasting venous ulcers, sharp debridement and skin grafting may favour and shorten ulcer healing. PMID:23482540

  10. Venous thromboembolism in women

    DEFF Research Database (Denmark)

    Group, ESHRE Capri Workshop; Skouby, Sven Olaf

    2013-01-01

    BACKGROUND Venous thromboembolism (VTE) is a specific reproductive health risk for women. METHODS Searches were performed in Medline and other databases. The selection criteria were high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed...... is associated with an inherited thrombophilia in men and women. Changes in the coagulation system and in the risk of clinical VTE in women also occur during pregnancy, with the use of reproductive hormones and as a consequence of ovarian stimulation when hyperstimulation syndrome and conception occur together...... therapy (HRT) increases the VTE risk 2- to 4-fold. There is a synergistic effect between thrombophilia and the various reproductive risks. Prevention of VTE during pregnancy should be offered to women with specific risk factors. In women who are at high risk, CHC and HRT should be avoided. CONCLUSIONS...

  11. Assessment of coagulation function and ultrasound features after reteplase and recombinant streptokinase thrombolysis of lower extremity deep venous thrombosis%瑞替普酶和重组链激酶溶栓治疗下肢深静脉血栓的凝血功能及超声特征评估

    Institute of Scientific and Technical Information of China (English)

    熊伟

    2016-01-01

    Objective:To assess coagulation function and ultrasound features after reteplase and recombinant streptoki-nase thrombolysis of lower extremity deep venous thrombosis.Methods:A total of 78 patients with lower extremity deep ve-nous thrombosis who were treated in our hospital were selected as research subjects and divided into observation group (39 ca-ses)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 evalua-ted 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 (P <0.05);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-se-lectin,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 (P < 0.05 ).Conclusion:Reteplase for thrombolysis of lower extremity deep venous thrombosis has more distinguished effects on dissolving thrombus as well as optimizing body's coagulation,inflammatory sys-tem state and other aspects,and is a more ideal thrombolytic drug.%目的::评估瑞替普酶和重组链激酶溶栓治疗下肢深静脉血栓的凝血功能及超声特征.方法:取本院收治的78例下肢深静脉血栓患者作为研究对象,根据具体治疗方案不同被分为观察组及对照组各39例.对照组接受重组链激酶溶栓治疗,观察组接受瑞替普酶溶栓治疗,经彩色多普勒超声检查及循环血检测后评价两种溶栓方式的效果.结果:观察组接受治疗后超声显示血栓完全再通率高于对照组(P <0.05);观察组的溶栓治疗后血浆 PT、APTT、TT 值高于对照组,FIB、D-D、NO、ET、E-选

  12. Clinical curative effect observation of continuous transfusion of heparin sodium combined with urokinase and warfarin by micropump in the treatment of deep venous thrombosis%微量泵持续输注肝素钠联合尿激酶、华法林治疗下肢深静脉血栓形成的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    赵晓玲; 王明; 陈建明

    2016-01-01

    Objective:To investigate the clinical curative effect of continuous transfusion of heparin sodium combined with urokinase and warfarin by micropump in the treatment of deep venous thrombosis.Methods:86 cases of patients with deep venous thrombosis were divided into two groups randomly.The treatment group was treated with continuous transfusion of heparin sodium combined with urokinase and warfarin by micropump on the basis of conventional treatment,the control group was treated with urokinase,warfarin and low molecular heparin calcium on the basis of conventional treatment,the cure rate and effective rate of the two groups were compared.Results:The cure rate of the treatment group was 72.5%,and the total effective rate was 89.7%.The cure rate of the control group was 60.2%,and the total effective rate was 78.9%.The difference of clinical curative effect between the two groups was statistically significant(P<0.05).No serious bleeding events occurred in the two groups.Conclusion:The clinical curative effect of continuous transfusion of heparin sodium combined with urokinase and warfarin by micropump in the treatment of deep venous thrombosis was significantly better than that of low molecular heparin calcium combined with urokinase and warfarin,and the bleeding events were not significantly increased.%目的:探讨微量泵持续输注肝素钠联合尿激酶、华法林治疗下肢深静脉血栓形成的临床效果.方法:收治下肢深静脉血栓形成患者86例,随机分为两组.治疗组在常规治疗基础上,以微量泵持续输注肝素钠联合尿激酶、华法林,对照组在常规治疗基础上给予尿激酶、华法林、低分子肝素钙,比较两组治愈率及有效率.结果:治疗组治愈率 72.5%,总有效率 89.7%.对照组治愈率 60.2%,总有效率 78.9%.两组临床疗效比较,差异具有统计学意义(P<0.05).两组均未出现严重出血事件.结论:微量泵持续输注肝素钠联合尿激酶、华法林治疗下肢深静

  13. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

    Directory of Open Access Journals (Sweden)

    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  14. CT imaging in acute pulmonary embolism: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, Joachim E.; Mahnken, Andreas H.; Das, Marco; Guenther, Rolf W. [University of Technology (RWTH), Department of Diagnostic Radiology, University Hospital, Aachen (Germany); Kuettner, Axel [Eberhard Karls University, Department of Diagnostic Radiology, Tuebingen (Germany); Lell, Michael [Friedrich Alexander University, Department of Diagnostic Radiology, Erlangen (Germany)

    2005-05-01

    Computed tomography pulmonary angiography (CTA) has increasingly become accepted as a widely available, safe, cost-effective, and accurate method for a quick and comprehensive diagnosis of acute pulmonary embolism (PE). Pulmonary catheter angiography is still considered the gold standard and final imaging method in many diagnostic algorithms. However, spiral CTA has become established as the first imaging test in clinical routine due to its high negative predictive value for clinically relevant PE. Despite the direct visualization of clot material, depiction of cardiac and pulmonary function in combination with the quantification of pulmonary obstruction helps to grade the severity of PE for further risk stratification and to monitor the effect of thrombolytic therapy. Because PE and deep venous thrombosis are two different aspects of the same disease, additional indirect CT venography may be a valuable addition to the initial diagnostic algorithm - if this was positive for PE - and demonstration of the extent and localization of deep venous thrombosis has an impact on clinical management. Additional and alternate diagnoses add to the usefulness of this method. Using advanced multislice spiral CT technology, some practitioners have advocated CTA as the sole imaging tool for routine clinical assessment in suspected acute PE. This will simplify standards of practice in the near future. (orig.)

  15. Hormonal contraception and risk of venous thromboembolism: national follow-up study

    DEFF Research Database (Denmark)

    2009-01-01

    -49 with no history of cardiovascular or malignant disease. MAIN OUTCOME MEASURES: Adjusted rate ratios for all first time deep venous thrombosis, portal thrombosis, thrombosis of caval vein, thrombosis of renal vein, unspecified deep vein thrombosis, and pulmonary embolism during the study period. RESULTS: 10......OBJECTIVE: To assess the risk of venous thrombosis in current users of different types of hormonal contraception, focusing on regimen, oestrogen dose, type of progestogen, and route of administration. DESIGN: National cohort study. SETTING: Denmark, 1995-2005. PARTICIPANTS: Danish women aged 15.......4 million woman years were recorded, 3.3 million woman years in receipt of oral contraceptives. In total, 4213 venous thrombotic events were observed, 2045 in current users of oral contraceptives. The overall absolute risk of venous thrombosis per 10 000 woman years in non-users of oral contraceptives was 3...

  16. Chronic venous insufficiency patterns in lower extremity veins detected by Doppler Ultrasound

    Directory of Open Access Journals (Sweden)

    Özhan Özgür

    2013-12-01

    Full Text Available Objective: The aim of this study was to reveal patterns ofchronic venous insufficiency of lower extremity detectedby color Doppler ultrasound and clarify its clinical implicationsin the patients with varicose veins symptoms.Methods: Between 2006 to 2011, a total of 2006 patientspresented with symptoms of venous insufficiency wereincluded in study. A total of 3938 lower extremity venoussystems were examined using color Doppler US. Weclassified four patterns considering combinations of superficialand deep venous insufficiency.Results: Of 2006 patients, 966 had either single venousinsufficiency (790, 82% or combined insufficiency (176,18%. Superficial venous insufficiency was observedat the saphenoefemoral junction (SFJ in 25.5%, at theGreat Saphenous Vein (GSV in 57.6%, at the GiacominiVein in 2.4%, at the saphenopopliteal junction in 1.8% andfinally at the Small Saphenous Vein (SSV in 9.1% of thepatients. We found multilevel venous insufficiency showingconnections at the rate of 51%. We described fourpatterns as Pattern 1: SFJ insufficiency combined withGSV (97.9%, GSV branching (7.1%, and perforatingvein (20.8% insufficiency, Pattern 2: Deep venous insufficiencycombined with SFJ (63.6%, GSV (76.4%, andSSV (16.4% insufficiency, Pattern 3: SPJ insufficiencycombined with SSV insufficiency (95.5% and Pattern 4:Giacomini Vein insufficiency combined with GSV (67.9%and SSV (75% insufficiency.Conclusion: Chronic venous insufficiency may show fourdifferent patterns. Our results revealed that SFJ and GSVinsufficiency combination and deep venous insufficiencyand GSV insufficiency combinations are the most commoninsufficiency patterns seen in lower extremity.Key words: Doppler ultrasound, varicose veins, venous insufficiency

  17. Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis

    DEFF Research Database (Denmark)

    Blinkenberg, M; Akeson, P; Sillesen, H;

    2012-01-01

    The traditional view that multiple sclerosis (MS) is an autoimmune disease has recently been challenged by the claim that MS is caused by chronic cerebrospinal venous insufficiency (CCSVI). Although several studies have questioned this vascular theory, the CCSVI controversy is still ongoing. Our...... aim was to assess the prevalence of CCSVI in Danish MS patients using sonography and compare these findings with MRI measures of venous flow and morphology....

  18. Improving adherence to venous thromoembolism prophylaxis using multiple interventions

    Directory of Open Access Journals (Sweden)

    Al-Tawfiq Jaffar

    2011-01-01

    Full Text Available Objective : In hospital, deep vein thrombosis (DVT increases the morbidity and mortality in patients with acute medical illness. DVT prophylaxis is well known to be effective in preventing venous thromoembolism (VTE. However, its use remains suboptimal. The objective of this study was to evaluate the impact of quality improvement project on adherence with VTE prophylaxis guidelines and on the incidence of hospital-acquired VTEs in medical patients. Methods : The study was conducted at Saudi Aramco Medical Services Organization from June 2008 to August 2009. Quality improvement strategies included education of physicians, the development of a protocol, and weekly monitoring of compliance with the recommendations for VTE prophylaxis as included in the multidisciplinary rounds. A feedback was provided whenever a deviation from the protocol occurs. Results : During the study period, a total of 560 general internal medicine patients met the criteria for VTE prophylaxis. Of those, 513 (91% patients actually received the recommended VTE prophylaxis. The weekly compliance rate in the initial stage of the intervention was 63% (14 of 22 and increased to an overall rate of 100% (39 of 39 (P = 0.002. Hospital-acquired DVT rate was 0.8 per 1000 discharges in the preintervention period and 0.5 per 1000 discharges in the postintervention period, P = 0.51. However, there was a significant increase in the time-free period of the VTE and we had 11 months with no single DVT. Conclusion : In this study, the use of multiple interventions increased VTE prophylaxis compliance rate.

  19. 125I-fibrinogen scanning, perfusion/ventilation scintigraphy and prophylaxis with low-dosage heparin therapy in acute medical conditions

    International Nuclear Information System (INIS)

    The diagnostic specificity of 125I-fibrinogen scanning ranges between 0.69 and 0.93. Patients with a deep-venous thrombosis diagnosed by this method have a significantly increased incidence of a perfusion/ventilation scintigrafically verified pulmonary embolism. The diagnostic specificity of a perfusion/ventilation scintigrafy ranges between 0.76 and 1.00. However, what is the clinical significance of a positive perfusion/ventilation scintigrafy, when used as a screening procedure. In patients with myocardial infarction, low-dose heparin results in reduced incidence of 125I-fibrinogen scan diagnosed deep-venous thrombosis. However, most recent papers do not show any significant reduction. Clinical trials with randomizaton according to different risk groups are required in order to clarify whether these groups will benefit from prophylaxis with low-dose heparin. As low-dose heparin has resulted in significantly increased incidence of wound-haematomas in surgical patients, we do not find the treatment advisible in patients with acute stroke, as long as one can not distinguish between haemorrhagic and thrombotic vascular insult, even though the prophylaxis reduces the incidence of deep-venous thrombosis significantly. Patient-groups with other acute internal medical diseases are not yet adequatly investigated. (author)

  20. Recent advances in the management of venous thromboembolism

    OpenAIRE

    Ageno, Walter

    2010-01-01

    Venous thromboembolism (VTE) is a spectrum of diseases that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Anticoagulant treatment is the mainstay of therapy for VTE. Unfractionated heparin (UFH) or low molecular weight heparin (LMWH) followed by vitamin K antagonists have been the treatment of choice for most patients with VTE, with the aim to prevent thrombus extension or embolization and recurrent VTE. Fondaparinux, a selective, indirect, parenteral factor Xa inhibitor, i...

  1. Venous Thromboembolism and Atherosclerosis link

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2011-01-01

    @@ Past always venous thrombosis and arterial thrombo-sis as a separate system to be discussed, the main reason is because there is between the anatomical and pathologi-cal physiological differences, the clinical manifestations are very different.

  2. Acute Lymphoblastic Leukemia in a Young Adult Presenting as Hepatitis and Acute Kidney Injury

    Science.gov (United States)

    Heincelman, Marc; Karakala, Nithin; Rockey, Don C.

    2016-01-01

    Acute lymphoblastic leukemia (ALL) in adults is a relatively rare malignancy. The typical presentation includes signs and symptoms associated with bone marrow failure, including fevers, infections, fatigue, and excessive bruising. In this article, we report an unusual systemic presentation of ALL in a previously healthy 18-year-old man. He initially presented with several-day history of nausea and vomiting, 10-pound weight loss, and right upper quadrant abdominal pain with evidence of acute hepatocellular liver injury (elevations in aspartate aminotransferase/alanine aminotransferase) and elevation in serum creatinine. Further history revealed that he just joined the Marine Corp; in preparation, he had been lifting weights and taking protein and creatine supplements. A complete serological evaluation for liver disease was negative and creatine phosphokinase was normal. His aspartate aminotransferase and alanine aminotransferase declined, and he was discharged with expected improvement. However, he returned one week later with continued symptoms and greater elevation of aminotransferases. Liver biopsy was nondiagnostic, revealing scattered portal and lobular inflammatory cells (primarily lymphocytes) felt to be consistent with drug-induced liver injury or viral hepatitis. Given his elevated creatinine, unresponsive to aggressive volume expansion, a kidney biopsy was performed, revealing normal histology. He subsequently developed an extensive left lower extremity deep venous thrombosis. Given his deep venous thrombosis, his peripheral blood was sent for flow cytometry, which revealed lymphoblasts. Bone marrow biopsy revealed 78% blasts with markers consistent with acute B-cell lymphoblastic leukemia. This report emphasizes that right upper quadrant abdominal pain with liver test abnormalities may be the initial presentation of a systemic illness such as ALL.

  3. 介入导管直接溶栓与静脉溶栓并抗凝治疗下肢深静脉血栓的对比研究/%Comparative study between intervention transcatheter direct thrombolysis and vein thrombolysis plus anti-coagulation therapy for treating lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    徐国建

    2015-01-01

    目的:对比导管直接溶栓和静脉溶栓加抗凝治疗下肢深静脉血栓的临床疗效。方法:选择符合纳入标准的下肢深静脉血栓患者61人,随机分为介入直接溶栓组(30例,介入组)和静脉溶栓+抗凝组(溶栓+抗凝组,31例)。治疗4周为一疗程。结果:介入组总有效率为93.33%,显著高于溶栓+抗凝组的64.52%(χ2=4.987,P =0.032)。两组治疗前血液流变学指标差异无统计学意义(P >0.05)。与治疗前比较,治疗后介入组全血高切粘度、全血低切粘度、血浆粘度及纤维蛋白原水平均显著降低(P 均<0.05);溶栓+抗凝组只有血浆粘度、纤维蛋白原水平显著降低(P 均<0.05);与溶栓+抗凝组比较,治疗后介入组全血低切粘度[(12.10±2.13)mPa·s 比(11.08±1.67)mPa·s]和血浆粘度[(1.85±0.13)mPa·s 比(1.31±0.09)mPa·s]显著降低(P 均<0.05)。治疗后介入组血管开通总有效率为90.00%,显著高于溶栓+抗凝组的61.29%,χ2=4.173,P =0.047。结论:对于急性期深静脉血栓形成并且无手术禁忌证的患者,导管直接溶栓疗效更显著,能明显改善血液流变学和提高血管开通率,可推荐为临床首选。%Objective:To compare the therapeutic effect of intervention transcatheter direct thrombolysis and vein thrombolysis and anti-coagulation drugs on lower extremity deep venous thrombosis (DVT).Methods:A total of 61 patients with lower extremity DVT accorded with inclusion standards were selected.They were randomly divided in-to intervention transcatheter direct thrombolysis group (n=30,intervention group)and vein thrombolysis and anti-coagulation group (n=31,thrombolysis+anti-coagulation group).Patients were treated for four weeks as a course. Results:Total effective rate of intervention group was significantly higher than that of thrombolysis+anti-coagula-tion group (93.33% vs.64.52%),χ2

  4. Curative effect of dabigatran etexilate versus low molecular weight heparin to prevent lower extremity deep venous thrombosis following femoral head prosthetic replacement%达比加群酯与低分子肝素预防髋关节置换术后下肢深静脉血栓的作用比较

    Institute of Scientific and Technical Information of China (English)

    赵伟; 曲虹; 丁美精; 胡小辉

    2016-01-01

    Objective To observe the clinical effects and security of low molecular weight heparin and dabigatran etexilate against deep venous thrombosis( DVT) following femoral head prosthetic replacement. Methods Totally 73 femoral head prosthetic replacement pa-tients were randomized into three groups: routine treatment group with 24 cases, dabigatran etexilate group with 25 cases and low heparin group with 24 cases. Change of platelet count and prothrombin time of the patients in three groups were observed and compared. Occurrence of DVT was observed under color Doppler of lower limbs. Results There was significant differences in DVT prevention between routine treat-ment group,the dabigatran etexilate group and low heparin group groups ( ( P 0.05)。 DE组和LMWH组在治疗期间均无严重出血。结论达比加群酯与低分子肝素均具有较好的预防髋关节置换后DVT的发生,达比加群酯疗效及安全性与低分子肝素作用相当。

  5. Dabigatran for the treatment of venous thromboembolism.

    Science.gov (United States)

    Schellong, Sebastian M

    2015-08-01

    Venous thromboembolism (VTE) is a major cause of morbidity and mortality, and individuals with a first VTE are at risk of recurrent VTE. VTE treatment is divided into three phases: a first short phase of acute (traditionally parenteral) anticoagulation, followed by a second maintenance phase with an oral anticoagulant, which may be continued into a third extended maintenance phase in patients considered to be at increased risk of recurrent VTE. Vitamin K antagonists are effective oral anticoagulants but have well-known limitations; non-vitamin K oral anticoagulants including dabigatran etexilate (DE) were therefore developed. DE was approved for VTE treatment on the basis of an extensive clinical trial program that evaluated DE during both the maintenance phase and the extended maintenance phase of VTE treatment. This article provides a comprehensive overview of DE in VTE treatment, from its preclinical characteristics and pharmacokinetic properties to its efficacy and safety in major clinical trials.

  6. The Acute Effects of Deep Tissue Foam Rolling and Dynamic Stretching on Muscular Strength, Power, and Flexibility in Division I Linemen.

    Science.gov (United States)

    Behara, Brandon; Jacobson, Bert H

    2015-06-24

    A recent strategy to increase sports performance is a self-massage technique called myofascial release using foam rollers. Myofascial restrictions are thought to be brought on by injuries, muscle imbalances, over recruitment, and/or inflammation, all of which can decrease sports performance. The purpose of this study was to compare the acute effects of a single-bout of lower extremity self-myofascial release using a custom deep tissue roller (DTR) and a dynamic stretch protocol. Subjects consisted of NCAA Division 1 offensive linemen (n=14) at a Midwestern university. All players were briefed on the objectives of the study and subsequently signed an approved IRB consent document. A randomized crossover design was used to assess each dependent variable (vertical jump power and velocity, knee isometric torque, and hip range of motion was assessed before and after: a) no treatment, b) deep tissue foam rolling, c) dynamic stretching. Results of repeated measures ANOVA yielded no pre- to post-test significant differences (p>0.05) among the groups for VJ peak power (p=.45), VJ average power (p=.16), VJ peak velocity (p=.25), VJ average velocity (p=.23), peak knee extension torque (p=0.63), average knee extension torque (p=0.11), peak knee flexion torque (p=0.63), or average knee flexion torque (p=0.22). However hip flexibility was statistically significant when tested after both dynamic stretching and foam rolling (p=0.0001). While no changes in strength or power was evident increase flexibility following DTR may be used interchangeably with traditional stretching exercises.

  7. Deep Sequencing Reveals Novel Genetic Variants in Children with Acute Liver Failure and Tissue Evidence of Impaired Energy Metabolism

    Science.gov (United States)

    Valencia, C. Alexander; Wang, Xinjian; Wang, Jin; Peters, Anna; Simmons, Julia R.; Moran, Molly C.; Mathur, Abhinav; Husami, Ammar; Qian, Yaping; Sheridan, Rachel; Bove, Kevin E.; Witte, David; Huang, Taosheng; Miethke, Alexander G.

    2016-01-01

    Background & Aims The etiology of acute liver failure (ALF) remains elusive in almost half of affected children. We hypothesized that inherited mitochondrial and fatty acid oxidation disorders were occult etiological factors in patients with idiopathic ALF and impaired energy metabolism. Methods Twelve patients with elevated blood molar lactate/pyruvate ratio and indeterminate etiology were selected from a retrospective cohort of 74 subjects with ALF because their fixed and frozen liver samples were available for histological, ultrastructural, molecular and biochemical analysis. Results A customized next-generation sequencing panel for 26 genes associated with mitochondrial and fatty acid oxidation defects revealed mutations and sequence variants in five subjects. Variants involved the genes ACAD9, POLG, POLG2, DGUOK, and RRM2B; the latter not previously reported in subjects with ALF. The explanted livers of the patients with heterozygous, truncating insertion mutations in RRM2B showed patchy micro- and macrovesicular steatosis, decreased mitochondrial DNA (mtDNA) content acidosis was found to carry two heterozygous variants in ACAD9, which was associated with isolated complex I deficiency and diffuse hypergranular hepatocytes. The two subjects with heterozygous variants of unknown clinical significance in POLG and DGUOK developed ALF following drug exposure. Their hepatocytes displayed abnormal mitochondria by electron microscopy. Conclusion Targeted next generation sequencing and correlation with histological, ultrastructural and functional studies on liver tissue in children with elevated lactate/pyruvate ratio expand the spectrum of genes associated with pediatric ALF. PMID:27483465

  8. Acute survivorship of the deep-sea coral Lophelia pertusa from the Gulf of Mexico under acidification, warming, and deoxygenation

    Science.gov (United States)

    Lunden, Jay J.; McNicholl, Conall G.; Sears, Christopher R.; Morrison, Cheryl; Cordes, Erik E.

    2014-01-01

    Changing global climate due to anthropogenic emissions of CO2 are driving rapid changes in the physical and chemical environment of the oceans via warming, deoxygenation, and acidification. These changes may threaten the persistence of species and populations across a range of latitudes and depths, including species that support diverse biological communities that in turn provide ecological stability and support commercial interests. Worldwide, but particularly in the North Atlantic and deep Gulf of Mexico, Lophelia pertusa forms expansive reefs that support biological communities whose diversity rivals that of tropical coral reefs. In this study, L. pertusa colonies were collected from the Viosca Knoll region in the Gulf of Mexico (390 to 450 m depth), genotyped using microsatellite markers, and exposed to a series of treatments testing survivorship responses to acidification, warming, and deoxygenation. All coral nubbins survived the acidification scenarios tested, between pH of 7.67 and 7.90 and aragonite saturation states of 0.92 and 1.47. However, net calcification generally declined with respect to pH, though a disparate response was evident where select individuals net calcified and others exhibited net dissolution near a saturation state of 1. Warming and deoxygenation both had negative effects on survivorship, with up to 100% mortality observed at temperatures above 14°C and oxygen concentrations of approximately 1.5 ml· l−1. These results suggest that, over the short-term, climate change and OA may negatively impact L. pertusa in the Gulf of Mexico, though the potential for acclimation and the effects of genetic background should be considered in future research.

  9. Acute survivorship of the deep-sea coral Lophelia pertusa from the Gulf of Mexico under acidification, warming, and deoxygenation

    Directory of Open Access Journals (Sweden)

    Jay J Lunden

    2014-12-01

    Full Text Available Changing global climate due to anthropogenic emissions of CO2 are driving rapid changes in the physical and chemical environment of the oceans via warming, deoxygenation, and acidification. These changes may threaten the persistence of species and populations across a range of latitudes and depths, including species that support diverse biological communities that in turn provide ecological stability and support commercial interests. Worldwide, but particularly in the North Atlantic and deep Gulf of Mexico, Lophelia pertusa forms expansive reefs that support biological communities whose diversity rivals that of tropical coral reefs. In this study, L. pertusa colonies were collected from the Viosca Knoll region in the Gulf of Mexico (390 to 450 m depth, genotyped using microsatellite markers, and exposed to a series of treatments testing survivorship responses to acidification, warming, and deoxygenation. All coral nubbins survived the acidification scenarios tested, between pH of 7.67 and 7.90 and aragonite saturation states of 0.92 and 1.47. However, calcification generally declined with respect to pH, though a disparate response was evident where select individuals net calcified and others exhibited net dissolution near a saturation state of 1. Warming and deoxygenation both had negative effects on survivorship, with up to 100% mortality observed at temperatures above 14ºC and oxygen concentrations of approximately 1.5 ml·l-1. These results suggest that, over the short-term, climate change and OA may negatively impact L. pertusa in the Gulf of Mexico, though the potential for acclimation and the effects of genetic background should be considered in future research.

  10. Observer agreement of lower limb venous reflux assessed by duplex ultrasound scanning using manual and pneumatic cuff compression in patients with chronic venous disease and controls

    DEFF Research Database (Denmark)

    Broholm, R; Kreiner, S; Bækgaard, Niels;

    2011-01-01

    The study aimed to evaluate observer agreement between two experienced ultrasound operators examining deep venous reflux assessed by duplex ultrasound (DU) using either manual or pneumatic cuff compression. In addition, the two methods were compared with each other with regard to immediate...

  11. Antithrombin Cambridge II(A384S) mutation frequency and antithrombin activity levels in 120 of deep venous thrombosis and 150 of cerebral infarction patients in a single center in Southern China.

    Science.gov (United States)

    Zhang, Guang-sen; Tang, Yang-ming; Tang, Mei-qing; Qing, Zi-Ju; Shu, Chang; Tang, Xiang-qi; Deng, Ming-yang; Tan, Li-ming

    2010-09-01

    Antithrombin Cambridge II(A384S) mutation shows a relatively high frequency in western population. Some studies suggest that the mutation is an independent genetic risk factor both for deep vein thrombosis (DVT) and for arterial thrombosis, but whether the mutation has racial difference or has a general significance for thrombophilia remains unclear. In this study we performed an analysis of the prevalence of the mutation in Chinese southern population; Also, the antithrombin activity levels were evaluated in each investigated individual. The studies included 120 patients with DVT, 150 patients with cerebral infarction, and 110 controls. The mutation was detected using polymerase chain reaction/PvuII restrictive fragment length polymorphism procedures. Antithrombin activity assay was done using chromogenic substrate method. The results showed that no antithrombin Cambridge II mutation was detected in all three groups (DVT, cerebral infarction and controls), the incidence was 0/380. Plasma antithrombin activity was 91.37% +/- 16.15% in the DVT patients and 102.68% +/- 13.10% in the controls; the antithrombin activity was significantly reduced in the DVT group (P Cambridge II mutation has a racial difference, and may not be a valuable risk factor of thrombophilia in Asian population, and antithrombin deficiency remains a major genetic risk factor for DVT patients in China.

  12. Differential benefit risk assessment of DOACs in the treatment of venous thromboembolism: focus on dabigatran

    Directory of Open Access Journals (Sweden)

    Leung TS

    2015-07-01

    Full Text Available Timothy S Leung,1 Ernest H Law2 1Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; 2Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA Abstract: Venous thromboembolism includes deep vein thrombosis and pulmonary embolism and is a serious medical condition that requires anticoagulation as part of treatment. Currently, standard therapy consists of parenteral anticoagulation followed by a vitamin K antagonist (VKA. The pharmacokinetic and pharmacodynamic profiles of the direct oral anticoagulants (DOACs differ from VKAs, which overcome some of the limitations of VKAs and have practical implications on their use in clinical situations. Dabigatran is a prodrug that undergoes primarily renal elimination and does not affect cytochrome P450 enzymes. Assays to quantify the degree of anticoagulation and the therapeutic level of DOAC are either unavailable for routine clinical use or require specific calibration. Routine monitoring of DOACs is not recommended at this time. Dabigatran, rivaroxaban, and apixaban are DOACs that have been studied for treatment of venous thromboembolism. Clinical trials comparing DOACs with standard therapy have shown them to be non-inferior for acute and extended therapy. Each DOAC has a unique benefit and harm profile that should be considered prior to use. The distinguishing characteristics of dabigatran include a requirement of parenteral anticoagulation prior to acute treatment, clinical trial results comparing it with a VKA for extended treatment, association with upper gastrointestinal adverse events, and increased risk of gastrointestinal bleed. Rivaroxaban is the only DOAC that has once-daily dosing while apixaban is the only DOAC that has lower risk of overall, major, and gastrointestinal bleeding compared with VKA. A common drawback of DOACs is the lack of an available reversal agent. Clinical trials of

  13. Research progress in early test indexes of deep venous thrombosis%深静脉血栓形成早期试验指标的研究进展

    Institute of Scientific and Technical Information of China (English)

    黄子健(综述); 霍景山(审校)

    2016-01-01

    Diagnosis of deep vein thrombosis (DVT) depends on imaging examination, but imaging examination has a time lag for disease diagnosis. Laboratory test indexes have important value in early detection and helping in the diagnosis of DVT. Since there are a wide variety of test indexes for DVT with different standards in clinical practice, the authors in this article, based on literature review, address some test indexes that include D-dimer, ifbrinogen, C-reactive protein, high-sensitivity C-reactive protein, VEGF and Slit2 protein, intending to look for highly sensitive and speciifc test indexes for providing valuable information to assist clinical decision making in diagnosis and treatment of DVT.%深静脉血栓形成(DVT)的明确诊断有赖于影像学检查,但影像学检查对疾病确诊存在滞后性。试验指标在早期发现、协助诊断DVT具有非常重要的价值。临床上诊断DVT的试验指标种类繁多,标准不一,笔者结合文献对部分试验指标如:D-二聚体、纤维蛋白原、C-反应蛋白、超敏C-反应蛋白、血管内皮生长因子、Slit2蛋白等的研究进行综述,旨在寻找特异性及敏感性均较高的试验指标,为DVT的临床诊治决策提供有价值的证据。

  14. Hormonal contraceptives and venous thrombosis

    OpenAIRE

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thrombotic event and to provide an overview of the risk of venous thrombosis per combined oral contraceptive. We found that the UGT2B7 gene in the first-pass metabolism may at least in part explain the r...

  15. [Automatic regulator of venous pressure and venous outflow in the perfusion system].

    Science.gov (United States)

    Smirnov, L M; Levinskiĭ, M M; Kharnas, S Sh; Cherniak, V A

    1976-01-01

    A scheme for automatic regulation of the venous pressure and venous blood outflow during extracorporeal circulation is proposed. The system consists of a photoelectric sensor placed on a tube led out of the major venous trunkline, a converter and an electromechanical eccentric clamp that compresses the venous trunkline, all of which secures stabilization of the controlled values.

  16. Different Finite Durations of Anticoagulation and Outcomes following Idiopathic Venous Thromboembolism: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Aaron B. Holley

    2010-01-01

    Full Text Available Introduction. Controversy remains over the optimal length of anticoagulation following idiopathic venous thromboembolism. We sought to determine if a longer, finite course of anticoagulation offered additional benefit over a short course in the initial treatment of the first episode of idiopathic venous thromboembolism. Data Extraction. Rates of deep venous thrombosis, pulmonary embolism, combined venous thromboembolism, major bleeding, and mortality were extracted from prospective trials enrolling patients with first time, idiopathic venous thromboembolism. Data was pooled using random effects meta-regression. Results. Ten trials, with a total of 3225 patients, met inclusion criteria. For each additional month of initial anticoagulation, once therapy was stopped, recurrent venous thromboembolism (0.03 (95% CI: −0.28 to 0.35; =.24, mortality (−0.10 (95% CI: −0.24 to 0.04; =.15, and major bleeding (−0.01 (95% CI: −0.05 to 0.02; =.44 rates measured in percent per patient years, did not significantly change. Conclusions: Patients with an initial idiopathic venous thromboembolism should be treated with 3 to 6 months of secondary prophylaxis with vitamin K antagonists. At that time, a decision between continuing with indefinite therapy can be made, but there is no benefit to a longer (but finite course of therapy.

  17. Single Superficial versus Dual Systems Venous Anastomoses in Radial Forearm Free Flap: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Shuang Bai

    Full Text Available The radial forearm free flap (RFFF has been widely used with increasing frequency in head and neck reconstruction following extirpative surgery. The controversy of the venous anastomoses patterns still exists. Thus, we conducted a meta-analysis to assess the relationship between the venous anastomoses patterns and venous compromise.MEDLINE, PubMed, Web of Science, and Wanfang databases were searched for studies reporting the different venous anastomoses patterns of the RFFF. A meta-analysis was conducted using the random effects models. Publication bias and sensitivity analysis were also assessed.6 studies with 992 cases were included in this meta-analysis. The dual anastomosis group tended to have a lower incidence of venous compromise (RR = 1.39. However, the difference was not statistically significant (95%CI: 0.59, 3.24.This meta-analysis indicated that performing dual venous anatomoses consisting of superficial and deep systems conferred a tendency of the reduction with regard to venous compromise.

  18. Clinical Research of High Dose Long-pulsed Laser on Venous Malformations in Deep Skin Under the Condition of Controlling Low Temperature%控低温大剂量长脉冲激光治疗皮肤深部静脉畸形的临床研究

    Institute of Scientific and Technical Information of China (English)

    陈深; 严煜林; 韦妮波; 郑凤丽; 官英勇; 李伟强

    2014-01-01

    Objective:To explore the therapeutic effects and adverse reactions of high dose long-pulsed laser on venous malformation in deep skin under the condition of controlling low temperature. Method:Patients were divided into two groups,one group were treated with long-pulsed laser under usual temperature, and the other group were treated with long-pulsed laser under the conditions of controlling low temperature. Observing the therapeutic effect and adverse reaction of two groups under different conditions. Results:Compared with usual temperature,treatment dose can increase 10~20 J /cm2,continuous intensity of treatment and total energy can increase 10 times,pain and side effect were less under the condition of controlling low temperature. After 6 to 10 times of treatment,there were 42.00 percent of cure rate,33.33 percent of show efficiency rate,21.07 percent of effective rate,94.74 percent of the total effective rate and 10.11 percent of adverse reaction rate. Conclusion:Venous malformations in deep skin can be treated with high dose long-pulsed laser under the condition of controlling low temperature. It can improve curative effect,and reduce pain and adverse reactions. So it should be widely used in clinic.%目的:探讨皮肤深部静脉畸形在瘤体控低温条件下应用长脉冲激光治疗的疗效和不良反应。方法:将皮肤深部静脉畸形分别采用常温和瘤体控低温条件下进行长脉冲激光治疗,观察两组瘤体在不同条件下其治疗效果和不良反应。结果:瘤体在控低温技术比常温下应用长脉冲激光治疗,其治疗剂量可以增大10~20 J/cm2,连续治疗强度和总能量可增大10倍,患者本人的痛觉感减轻,不良反应更少。经过8~10次治疗,治愈率为42%,显效率为33.33%,有效率为21.07%,总有效率为94.74%,不良反应率10.11%。结论:皮肤深部静脉畸形在瘤体控低温条件下可使用大剂量长脉冲激光治疗,疗效满意,痛

  19. LWMH与VKA对DVT患者院外抗凝效益-风险对比%Investigation on benefit-risk ratio in patients with deep venous thrombosis continued to be treated with anticoagulation outside hospital: Comparison on the clinical application between low molecule weight heparin and vitamin K antagonists

    Institute of Scientific and Technical Information of China (English)

    裴志杰; 张兰; 尔启东

    2012-01-01

    [Objective] By comparing the benefit-risk ratioin patients with deep venous thrombosis (DVT), continued to be treated with low molecule weight heparin (LMWH) or vitamin K antagonists (VKA), to explore the more effective, safe and convenient therapeutic regimen. [Methods] Patients fit the standard in this study from December 2008 to March 2011 were randomly divided into two groups. Patients in Group A were treated with Low-molecular-weight heparins calcium injection, and Warfarin in Group B. A follow-up visit was perpormed every two months for half a year, the content including whether there was bleed, heparin-induced thrombocytopenia (HIT), and the recrudescence event occurs, in this period hemoglutination function and platelet count were monitored regularly, and according to the date to make adjustment in medication plan. [ Results] Effective anticoagulation was obtained in the two groups, and the incidence rate of side effect in group A was lower than that in group B obviously (P 0.05), but along with the anticoagulant time expand, the hemorrhage rate increasedin the two groups. However, in the DVT recrudescence patient The rate in ilio-femoral vein was the highest, next was femoral vein, and finally was popliteal vein. Patient treated with LMWH revealed a better compliance. [Conclusion] Using LWMH for patients with DVT outside hospital continuely revealed reliable result and high medication security, low side effect, simple operation and monitor, so it is better in benefit-risk than using VKA.%[目的]通过对经住院治疗后下肢深静脉血栓形成(deep venous thrombosis,DVT)患者院外分别继续应用低分子肝素(low molecule weight heparin,LMWH)或维生素K拮抗剂(vitamin K antagonists,VKA)的效益-风险比的对比研究,探讨较为有效、安全、简便的抗凝方案.[方法]将2008年12月-2011年3月符合纳入标准的患者随机分为A组(应用低分子肝素钙)和B组(应用华法林),并随访6个月,期间通过定期监测

  20. Venous Thromboembolism Prophylaxis in Plastic Surgery: A Literature Review.

    Science.gov (United States)

    Hernandez, Sergio; Valdes, Jorge; Salama, Moises

    2016-06-01

    Venous thromboembolism (VTE) is a major health concern because it increases morbidity and mortality after a surgical procedure. A number of well-defined, evidence-based guidelines are available delineating suitable use of prophylaxis to prevent deep vein thrombosis and pulmonary embolism. Despite the available literature, there are clear gaps between recommendations and clinical practice, affecting the incidence of VTE. Plastic surgeons underuse the substantiated literature and risk stratification tools that are available to decrease the incidence of VTE in the office-based surgical setting because of fear of bleeding or hematoma complications postoperatively. Venous thromboembolism creates an economic burden on both the patient and the healthcare system. The intent of this literature review is to determine existing VTE risk using assessment models available to aid in the implementation of protocols for VTE prevention, specifically for high-risk cosmetic surgical patients in office-based settings.