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Sample records for juxtahepatic venous injuries

  1. Severe Juxtahepatic Venous Injury: Survival after Prolonged Hepatic Vascular Isolation Without Shunting

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    J. E. J. Krige

    1990-01-01

    Full Text Available Survival following major juxtahepatic venous injury is rare in blunt liver trauma despite the use of intracaval shunting. Prolonged liver arterial inflow control, total hepatic venous isolation and lobectomy without shunting was used in a patient to repair a combined vena caval and hepatic venous injury after blunt liver injury. An extended period of normothermic hepatic ischemia was tolerated. Early recognition of retrohepatic venous injury and temporary liver packing to control bleeding and correct hypovolemia are essential before caval occlusion. Hepatic vascular isolation without shunting is an effective simple alternative technique allowing major venous repair in complex liver trauma.

  2. Management of Peripheral and Truncal Venous Injuries

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    Triantafillos G. Giannakopoulos

    2017-08-01

    Full Text Available Civilian injuries are increasing according to the World Health Organization, and this is attributed mainly to road traffic accidents and urban interpersonal violence. Vascular injuries are common in these scenarios and are associated with high morbidity and mortality rates. Associated peripheral venous trauma is less likely to lead to death and controversy remains whether ligation or repair should be the primary approach. Conversely, non-compressible truncal venous insult can be lethal due to exsanguination, thus a high index of suspicion is crucial. Operative management is demanding with fair results but recent endovascular adjuncts demonstrate promising results and seem to be the way forward for these serious conditions.

  3. Venous injury in abusive head trauma

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    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  4. Venous injury in abusive head trauma

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    Choudhary, Arabinda K.; Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B.; Dias, Mark S.

    2015-01-01

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  5. Current concepts in repair of extremity venous injury.

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    Williams, Timothy K; Clouse, W Darrin

    2016-04-01

    Extremity venous injury management remains controversial. The purpose of this communication is to offer perspective as well as experiential and technical insight into extremity venous injury repair. Available literature is reviewed and discussed. Historical context is provided. Indication, the decision process for repair, including technical conduct, is delineated. In particular, the authors' experiences in both civilian and wartime injury are used for perspective. Extremity venous injury repair was championed within data from the Vietnam Vascular Registry. However, patterns of extremity venous injury differ between combat and civilian settings. Since Vietnam, civilian descriptive series opine the benefits and potential complications associated with both venous injury repair and ligation. These surround extremity edema, chronic venous insufficiency, thromboembolism, and limb loss. Whereas no clear superiority in either approach has been identified to date, there appears to be no increased risk of pulmonary embolism or chronic venous changes with repair. Newer data from the wars in Iraq and Afghanistan and meta-analysis have reinforced this and also have suggested limb salvage benefit for extremity venous repair in combined arterial and venous injuries in modern settings. The patient's physiologic state and associated injury drive five triage categories suggesting vein injury management. Vein repair thrombosis occurs in a significant proportion, yet many recanalize and possibly have a positive impact on limb venous return. Further, early decompression favors reduced blood loss, acute edema, and inflammation, supporting collateral development. Large soft tissue injury minimizing collateral capacity increases the importance of repair. Constructs of repair are varied with modest differences in patency. Venous shunting is feasible, but specific roles remain nebulous. An aggressive posture toward extremity venous injury repair seems justified today because of the likely

  6. Isolated traumatic brain injury and venous thromboembolism.

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    Van Gent, Jan-Michael; Bandle, Jesse; Calvo, Richard Y; Zander, Ashley L; Olson, Erik J; Shackford, Steven R; Peck, Kimberly A; Sise, C Beth; Sise, Michael J

    2014-08-01

    Traumatic brain injury (TBI) is considered an independent risk factor of venous thromboembolism (VTE). However, the role of TBI severity in VTE risk has not been determined. We hypothesized that increased severity of brain injury in patients with isolated TBI (iTBI) is associated with an increased incidence of VTE. The records of patients admitted from June 2006 to December 2011 were reviewed for injury data, VTE risk factors, results of lower extremity surveillance ultrasound, and severity of TBI. Patients were identified by DRG International Classification of Diseases-9th Rev. codes for TBI, and only those with a nonhead Abbreviated Injury Scale (AIS) score of 1 or lower, indicating minimal associated injury, were included. The association of iTBI and VTE was determined using a case-control design. Among iTBI patients, those diagnosed with VTE (cases) were matched for age, sex, and admission year to those without VTE (controls). Data were analyzed using conditional logistic regression. There were 345 iTBI patients: 41 cases (12%) and 304 controls (88%). A total of 151 controls could not be matched to an appropriate case and were excluded. Of the remaining 153 controls, 1 to 16 controls were matched to each of the 41 VTE cases. Compared with the controls, the cases had a higher mean head-AIS score (4.4 vs. 3.9, p = 0.001) and overall Injury Severity Score (20.4 vs. 16.8, p = 0.001). Following adjustment for all factors found to be associated with VTE (ventilator days, central line placement, operative time > 2 hours, chemoprophylaxis, history of VTE, and history of cancer), the cases were significantly more likely to have a greater head injury severity (head-AIS score ≥ 5; odds ratio, 5.25; 95% confidence interval, 1.59-17.30; p = 0.006). The incidence of VTE in iTBI patients was significantly associated with the severity of TBI. VTE surveillance protocols may be warranted in these high-risk patients, as early detection of VTE could guide subsequent therapy

  7. Deep venous thrombosis in patients with chronic spinal cord injury.

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    Mackiewicz-Milewska, Magdalena; Jung, Stanisław; Kroszczyński, Andrzej C; Mackiewicz-Nartowicz, Hanna; Serafin, Zbigniew; Cisowska-Adamiak, Małgorzata; Pyskir, Jerzy; Szymkuć-Bukowska, Iwona; Hagner, Wojciech; Rość, Danuta

    2016-07-01

    Deep venous thrombosis (DVT) is a well-known complication of an acute spinal cord injury (SCI). However, the prevalence of DVT in patients with chronic SCI has only been reported in a limited number of studies. The aim of our study was to examine the prevalence of DVT in patients with SCI beyond three months after injury. Cross-sectional study. Rehabilitation Department at the Bydgoszcz University Hospital in Poland. Sixty-three patients with SCI that were more than 3 months post injury. The patients, ranging in age from 13 to 65 years, consisted of 15 women and 48 men; the mean age of the patients was 32.1 years. The time from injury varied from 4 to 124 months. Clinical assessment, D-dimer and venous duplex scan. The venous duplex scan revealed DVT in 5 of the 63 patients. The post-injury time in four of the patients varied between 4 and 5 months; one patient was 42 months post-injury. DVT occurred in patients with chronic SCI, mainly by the 6th post injury month.

  8. Multidetector CT of blunt traumatic venous injuries in the chest, abdomen, and pelvis.

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    Holly, Brian P; Steenburg, Scott D

    2011-01-01

    Venous injuries as a result of blunt trauma are rare. Even though current protocols for multidetector computed tomography (CT) of patients with trauma are designed to evaluate primarily the solid organs and arteries, blunt venous injuries may nevertheless be identified, or at least suspected, on the basis of the multidetector CT findings. Venous injuries are associated with high morbidity and mortality rates. Diagnosis of a possible venous injury is crucial because the physical findings of a venous injury are nonspecific and may be absent. This article aims to make the radiologist aware of various venous injuries caused by blunt trauma and to provide helpful hints to aid in the identification of venous injuries. Multidetector CT technology, in combination with interactive manipulation of the raw dataset, can be useful in the creation of multiplanar reconstructed images and in the identification of a venous injury caused by blunt trauma. Familiarity with direct and indirect signs of venous injuries, as well as with examples of blunt traumatic venous injuries in the chest, abdomen, and pelvis, will help in the diagnosis of these injuries.

  9. Venous thromboembolism in acute spinal cord injury patients

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    Saraf Shyam

    2007-01-01

    Full Text Available Background : The western literature on deep vein thrombosis (DVT and pulmonary embolism (PE following spinal cord injury (SCI report an alarmingly high incidence, necessitating thromboprophylaxis. The literature on incidence from the Asian subcontinent is scanty and from India is almost nonexistent. Materials and Methods : Seventy hospitalized acute SCI patients presenting within five days of the injury were included in the present analysis. Forty-two cases were subjected to color Doppler studies and 28 cases had to be subjected to venography due to lack of facility at some point of time. The clinical course of the patients was closely observed during the period of hospitalization. All except 14 were managed nonoperatively. Thromboprophylaxis was not given to any patient at any stage; however, treatment was instituted in those showing the features of DVT on investigations. Results : Twelve patients died during the period of hospitalization. Deep vein thrombosis could be detected in seven patients only, three in the proximal and four in the distal segment of the lower limb and of these three died. Based on the clinical course and positive investigation report in favor of DVT, we presumed that the cause of death in these three patients was pulmonary embolism. In the other nine, in the absence of an autopsy report, the cause of deaths was considered as pulmonary infection, asphyxia, diaphragmatic paralysis, hematemesis, cervicomedullary paralysis etc. Clinical features to diagnose DVT were of little help. Conclusions : There is a much lower incidence (10% of DVT and PE following spinal cord injury (SCI in India than what is reported from the western countries. Higher age group and quadriplegia were the only factors which could be correlated. Deep vein thrombosis extending proximal to the knee was significant. In the absence of autopsy and other screening tests like D-dimer test or 125I fibrogen uptake study, the true incidence of venous

  10. Venous Thromboembolism: A Comparison of Chronic Spinal Cord Injury and General Surgery Patients in a Metropolitan Veterans Affairs Hospital.

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    Moore, Ryan M; Rimler, Jonathan; Smith, Brian R; Wirth, Garrett A; Paydar, Keyianoosh Z

    2016-11-01

    Venous thromboembolic events result in significant morbidity, mortality, and costly therapeutic interventions. As medical resource allocation strategies are becoming more pervasive, appropriate risk stratification and prophylactic regimens are essential. Previous studies have shown a decreased incidence of perioperative venous thromboembolism in the chronic spinal cord injury population. The question remains of whether chronic spinal cord injury is protective against venous thromboembolism. A retrospective review of all cases involving chronic spinal cord injury patients who underwent plastic and reconstructive surgery operations (n = 424) and general surgery patients (n = 777) with a primary outcome of deep venous thrombosis or pulmonary embolism within 90 days of surgery was performed. The incidence of postoperative deep venous thrombosis in the control and spinal cord injury groups was 1.7 percent and 0.2 percent, respectively (p = 0.027). However, such significance was not observed with regard to postoperative pulmonary embolism incidence (p = 0.070). Collectively, the incidence of postoperative venous thromboembolism-specifically, deep venous thrombosis or pulmonary embolism-was significantly greater in the general surgery population (p = 0.014). A nearly 10-fold increased risk of venous thromboembolism was seen among the control group (1.9 percent versus 0.2 percent) despite administration of optimal prophylaxis. This study demonstrates a profoundly low incidence of venous thromboembolism among chronic spinal cord injury patients compared with general surgery patients. Future efforts to elucidate how chronic spinal cord injury confers a protective mechanism may potentially influence the evolution of venous thromboembolism prevention guidelines, and spark the development of alternative prophylactic agents or customized application of prevention efforts.

  11. Venous Thromboembolism Prophylaxis in Outpatient Lower Limb Fractures and Injuries.

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    Ajwani, Sanil H; Shaw, Alex; Naiz, Osamah; Bhaskar, Deepu; Charalambous, Charalambos P

    2016-05-05

    The risk of venous thromboembolism (VTE) is a preventable complication of trauma in ambulatory patients requiring temporary lower limb immobilisation. We introduced a VTE risk assessment and management tool in fracture clinics, to help improve appropriate VTE management of trauma patients that do not require hospitalisation. This was based on guidelines published by the College of Emergency Medicine (UK). Clinicians were asked to follow the screening tool and manage patients as per the pathway. We aimed to determine the rate of VTE risk assessment and management of outpatient fracture patients following the introduction of the new assessment tool. We prospectively evaluated a cohort of lower limb fracture patients presenting to a fracture clinic following the introduction of the new VTE risk assessment group and compared it to a retrospective cohort treated prior to the new tool. Prior to introduction of the new assessment tool only 5 of 30 (16.7%) patients were assessed for VTE risk. After introduction of the VTE screening tool, 27 of 28 patients (96.4%) were assessed for VTE risk (Pfracture clinic to patients with lower limb trauma requiring temporary limb immobilisation can improve VTE risk assessment in accordance with current guidelines.

  12. Prevention of Venous Thrombotic Events in Brain Injury: Review of Current Practices

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    Stuart Glassner

    2013-01-01

    Full Text Available Venous thromboembolic event after traumatic brain injury represents a unique clinical challenge. Physicians must balance appropriate timing of chemoprophylaxis with risk of increased cerebral hemorrhage. Despite an increase in the literature since the 1990s, there are clear disparities in treatment strategies. This review discusses the prominent studies and subsequent findings regarding the topic with an attempt to establish recommendations using the existing evidence-based literature.

  13. Cerebral sinus venous thrombosis in traumatic brain injury

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    Christina Mueller-Hoecker

    2016-04-01

    Full Text Available A 36-year-old, healthy man was admitted to the emergency department with a traumatic brain injury with an injury severity score of 25 points. The head computed tomography revealed a subarachnoidal, epidural hemorrhage as well as a fracture of the occipital calotte. Intracranial pressure (ICP management was installed according to the LUND concept. In the following scan an angiography revealed a thrombosis of the sinus sigmoideus and transversus. Located next to the fractured skull, the thrombosis was highly likely traumatic, caused by the head trauma. As there was only a little congestion of the blood flow, no lysis or thrombectomy was performed. To lower ICP, a craniectomy was performed. After seven days, mechanical ventilation was terminated. Four days later the patient was already stable enough to be discharged from the surgical itensive care unit.

  14. Risk of venous thromboembolism in patients with splenic injury and splenectomy. A nationwide cohort study.

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    Lin, Jiun-Nong; Chen, Hsuan-Ju; Lin, Ming-Chia; Lai, Chung-Hsu; Lin, Hsi-Hsun; Yang, Chih-Hui; Kao, Chia-Hung

    2016-01-01

    The spleen is a crucial organ in humans. However, little is known about the association of venous thromboembolism (VTE) with splenic injury and splenectomy in trauma patients. The aim of this study was to determine the subsequent risk of VTE following splenic injury and splenectomy. A nationwide retrospective cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. We included 6,162 splenic injury patients (3,033 splenectomised and 3,129 nonsplenectomised patients) and 24,648 comparison patients who were selected by frequency match based on sex, age, and the index year during 2000-2006. All patients were followed until the occurrence of VTE, 31 December, 2011, death, or withdrawal from the insurance program. The age of patients with splenic injury was 41.93 ± 16.44 years. The incidence rates of VTE were 11.81, 8.46, and 5.21 per 10,000 person-years in the splenic injury patients with splenectomy, splenic injury patients without splenectomy, and comparison patients, respectively. Compared with the comparison cohort, splenic injury patients with splenectomy exhibited a 2.21-fold risk of VTE (95% confidence interval [CI], 1.43-3.43), whereas those without splenectomy exhibited a 1.71-fold risk of VTE (95% CI, 1.05-2.80). The overall incidence rate of VTE was 1.97-fold higher in the splenic injury cohort than the comparison cohort (95% CI, 1.38-2.81). Although splenectomy increased the risk of VTE 1.35-fold compared with no splenectomy, the difference was not statistically significant (95% CI, 0.74-2.45). These results may alert physicians and patients to the complications of splenic injury and splenectomy.

  15. MRI evidence for altered venous drainage and intracranial compliance in mild traumatic brain injury.

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    Andreas Pomschar

    Full Text Available To compare venous drainage patterns and associated intracranial hydrodynamics between subjects who experienced mild traumatic brain injury (mTBI and age- and gender-matched controls.Thirty adult subjects (15 with mTBI and 15 age- and gender-matched controls were investigated using a 3T MR scanner. Time since trauma was 0.5 to 29 years (mean 11.4 years. A 2D-time-of-flight MR-venography of the upper neck was performed to visualize the cervical venous vasculature. Cerebral venous drainage through primary and secondary channels, and intracranial compliance index and pressure were derived using cine-phase contrast imaging of the cerebral arterial inflow, venous outflow, and the craniospinal CSF flow. The intracranial compliance index is the defined as the ratio of maximal intracranial volume and pressure changes during the cardiac cycle. MR estimated ICP was then obtained through the inverse relationship between compliance and ICP.Compared to the controls, subjects with mTBI demonstrated a significantly smaller percentage of venous outflow through internal jugular veins (60.9±21% vs. controls: 76.8±10%; p = 0.01 compensated by an increased drainage through secondary veins (12.3±10.9% vs. 5.5±3.3%; p<0.03. Mean intracranial compliance index was significantly lower in the mTBI cohort (5.8±1.4 vs. controls 8.4±1.9; p<0.0007. Consequently, MR estimate of intracranial pressure was significantly higher in the mTBI cohort (12.5±2.9 mmHg vs. 8.8±2.0 mmHg; p<0.0007.mTBI is associated with increased venous drainage through secondary pathways. This reflects higher outflow impedance, which may explain the finding of reduced intracranial compliance. These results suggest that hemodynamic and hydrodynamic changes following mTBI persist even in the absence of clinical symptoms and abnormal findings in conventional MR imaging.

  16. Prevention of deep venous thrombosis in patients with acute spinal cord injuries: use of rotating treatment tables

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    Becker, D.M.; Gonzalez, M.; Gentili, A.; Eismont, F.; Green, B.A.

    1987-01-01

    A randomized clinical trial of 15 patients with acute spinal cord injuries was performed to test the hypothesis that rotating treatment tables prevent deep venous thrombosis in this population. Four of 5 control (nonrotated) patients developed distal and proximal thrombi, assessed by 125 I fibrinogen leg scans and impedance plethysmography. In comparison, only 1 of 10 treated (rotated) patients developed both distal and proximal thrombosis. These results suggest but do not prove that rotating treatment tables prevent the development of proximal deep venous thrombosis in spinal cord-injured patients. Larger clinical trials are needed to confirm this heretofore undocumented benefit of rotating treatment tables

  17. Validating the utilisation of venous bicarbonate as a predictor of acute kidney injury in crush syndrome from sjambok injuries

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    David Lee Skinner

    2017-05-01

    Full Text Available Background. Crush injury secondary to sjambok beatings is a well-described phenomenon in southern Africa. Owing to a number of factors, it can result in acute kidney injury (AKI. In 1992, Muckart et al. described a risk stratification system using venous bicarbonate (VB that can be used in the management of these patients. Objective. To validate this score in the modern era of AKI risk stratification. Methods. A retrospective study was performed on a local trauma database from June 2010 to December 2012. All patients with crush injury from sjambok/blunt instrument beatings were included in the analysis. VB was compared with the Kidney Disease Improving Global Outcomes scoring system for AKI. Serum base excess (BE and creatine kinase were also examined as biomarkers. The endpoints were the need for renal replacement therapy (RRT and mortality. Results. Three hundred and ten patients were included. The overall mortality rate was 1.9%, 14.8% of patients had AKI, and 3.9% required RRT. Both VB and BE performed well in RRT prediction, with areas under the receiver operating characteristic curve of 0.847 (95% confidence interval (CI 0.756 - 0.938; p<0.001 and 0.871 (95% CI 0.795 - 0.947; p<0.001, respectively. The sensitivity and specificity of BE were 83.3% and 80.2% at an optimal cut-point of –7.25 mmol/L, while those of VB were 83.3% and 79.5% at an optimal cut-point of 18.85 mmol/L. VB was significantly different across the AKI risk groups (p<0.001, in keeping with the original Muckart risk stratification system. Conclusion. The risk stratification score using VB is valid and should continue to be used as a tool in the management of patients with sjambok injuries. BE performs well in predicting the need for RRT, with a value of <–7.25 mmol/L indicating severe injury.

  18. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

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    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de

    2001-01-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  19. Multiple growing fractures and cerebral venous anomaly after penetrating injuries: delayed diagnosis in a battered child

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    Makkat, S.; Vandevenne, J.E.; Parizel, P.M.; Schepper, A.M. de [Dept. of Radiology, Universitair Ziekenhuis Antwerpen, Edegem (Belgium)

    2001-05-01

    A growing fracture usually results from a skull fracture with dural tear after blunt head trauma during infancy. We present a case of child abuse with multiple growing fractures resulting from penetrating head trauma by scissors. MR imaging confirmed the presence of growing fractures and revealed a presumably post-traumatic venous anomaly (occluded left cavernous sinus and aberrant posterior venous drainage via the internal cerebral veins). Diagnosis of the growing fractures and venous anomaly was delayed until the age of 15 years. Medical expertise should be more readily available to battered children, and MR imaging is advocated in growing skull fracture to exclude associated post-traumatic brain lesions. (orig.)

  20. A systematic review of extravasation and local tissue injury from administration of vasopressors through peripheral intravenous catheters and central venous catheters.

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    Loubani, Osama M; Green, Robert S

    2015-06-01

    The aim of this study was to collect and describe all published reports of local tissue injury or extravasation from vasopressor administration via either peripheral intravenous (IV) or central venous catheter. A systematic search of Medline, Embase, and Cochrane databases was performed from inception through January 2014 for reports of adults who received vasopressor intravenously via peripheral IV or central venous catheter for a therapeutic purpose. We included primary studies or case reports of vasopressor administration that resulted in local tissue injury or extravasation of vasopressor solution. Eighty-five articles with 270 patients met all inclusion criteria. A total of 325 separate local tissue injury and extravasation events were identified, with 318 events resulting from peripheral vasopressor administration and 7 events resulting from central administration. There were 204 local tissue injury events from peripheral administration of vasopressors, with an average duration of infusion of 55.9 hours (±68.1), median time of 24 hours, and range of 0.08 to 528 hours. In most of these events (174/204, 85.3%), the infusion site was located distal to the antecubital or popliteal fossae. Published data on tissue injury or extravasation from vasopressor administration via peripheral IVs are derived mainly from case reports. Further study is warranted to clarify the safety of vasopressor administration via peripheral IVs. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Endovascular repair of inadvertent arterial injury induced by central venous catheterization using a vascular closure device: A case report

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    Kim, So Hee; Jang, Woo Jin; Oh, Ju Heyon; Song, Yun Gyu [Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (Korea, Republic of)

    2017-04-15

    Central venous catheterization can cause various complications. Inadvertent subclavian artery catheterization was performed during insertion of a central venous catheter in a 73-year-old man suffering from panperitonitis due to small-bowel perforation. Endovascular treatment was conducted to treat the injured subclavian artery with a FemoSeal vascular closure device.

  2. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.

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    Cleary, Daniel R; Siler, Dominic A; Whitney, Nathaniel; Selden, Nathan R

    2018-05-01

    OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation

  3. Femoral venous pressure waveform as indicator of phrenic nerve injury in the setting of second-generation cryoballoon ablation.

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    Mugnai, Giacomo; de Asmundis, Carlo; Ströker, Erwin; Hünük, Burak; Moran, Darragh; Ruggiero, Diego; De Regibus, Valentina; Coutino-Moreno, Hugo Enrique; Takarada, Ken; Choudhury, Rajin; Poelaert, Jan; Verborgh, Christian; Brugada, Pedro; Chierchia, Gian-Battista

    2017-07-01

    Femoral venous pressure waveform (VPW) analysis has been recently described as a novel method to assess phrenic nerve function during atrial fibrillation ablation procedures by means of the cryoballoon technique. In this study, we sought to evaluate the feasibility and effectiveness of this technique, with respect to the incidence of phrenic nerve injury (PNI), in comparison with the traditional abdominal palpation technique alone. Consecutive patients undergoing second-generation cryoballoon ablation (CB-A) from June 2014 to June 2015 were retrospectively analyzed. Diagnosis of PNI was made if any reduced motility or paralysis of the hemidiaphragm was detected on fluoroscopy. During the study period, a total of 350 consecutive patients (man 67%, age 57.2 ± 12.9 years) were enrolled (200 using traditional phrenic nerve assessment and 150 using VPW monitoring). The incidence of PNI in the overall population was 8.0% (28/350); of these, eight were impending PNI (2.3%), 14 transient (4.0%), and six persistent (1.7%). Patients having undergone CB-A with traditional assessment experienced 18 phrenic nerve palsies (9.0%) vs two in 'VPW monitoring' group (1.3%; P = 0.002). Specifically, the former presented 12 transient (6.0%) and six persistent (3.0%) phrenic nerve palsies, and the latter exhibited two transient (1.3%; P = 0.03) and no persistent (0%; P = 0.04) phrenic nerve palsies. In conclusion, this novel method assessing the VPW for predicting PNI is inexpensive, easily available, with reproducible measurements, and appears to be more effective than traditional assessment methods.

  4. Deep venous thrombosis and pulmonary embolism in patients with acute spinal cord injury: a comparison with nonparalyzed patients immobilized due to spinal fractures

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    Myllynen, P.; Kammonen, M.; Rokkanen, P.; Boestman, O.L.; Lalla, M.; Laasonen, E.

    1985-01-01

    The occurrence of deep venous thrombosis (DVT) was studied in the series of 23 consecutive patients with acute spinal cord injury and 14 immobilized patients with spinal fractures without paralysis. The incidence of DVT in paralyzed patients was 100% as detected by the 125 I-labeled fibrinogen test and confirmed by contrast venography, and 64% as detected by repeated clinical examinations and confirmed by contrast venography. The respective incidence of DVT in nonparalyzed patients with spinal fractures was 0%. The diagnosis of DVT was reached earlier with the radiofibrinogen test than with the clinical followup (5 days vs. 25 days). Two of the 23 paralyzed patients (9%) developed nonfatal clinical pulmonary embolism (PE). There were no differences in the values of routine coagulation tests. The result justifies prophylactic anticoagulant therapy in all cases of spinal cord injury during the acute post-traumatic phase

  5. High energy injury is a risk factor for preoperative venous thromboembolism in the patients with hip fractures: A prospective observational study.

    Science.gov (United States)

    Park, Jin Sup; Jang, Jae Hoon; Park, Ki Young; Moon, Nam Hoon

    2018-06-01

    The purpose of this study was to identify the incidence of preoperative venous thromboembolism (VTE), and determine if high energy hip fracture affects preoperative VTE occurrence. Three-hundred nine patients (244 low and 61 high energy injuries) treated between March 2015 and March 2017 were included in this study. Indirect multidetector computed tomographic venography for the detection of preoperative VTE was performed at admission. The incidence of preoperative VTE was compared between high and low energy injury hip fractures. Logistic regression analysis was used to identify independent risk factors for preoperative VTE. The overall incidence of preoperative VTE was 18.4% (56 of 305 patients). Preoperative VTE was identified in 17 (27.9%) and 39 (16.0%) patients in the high and low energy injury groups, respectively (p = 0.034). Multivariate logistic regression analysis showed that high energy injury, history of VTE, and myeloproliferative disease were significant predictive factors of preoperative VTE (OR = 2.451; 95% CI = 1.227-4.896, OR = 11.174; 95% CI = 3.500-35.673, OR = 6.936; 95% CI = 1.641-29.321, respectively) CONCLUSION: Because high energy hip fracture is significantly associated with preoperative VTE occurrence, preoperative evaluation and proper thromboprophylaxis should be performed for patients with a high-energy hip fracture. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Venous thromboembolism rates in patients with lower limb immobilization after Achilles tendon injury are unchanged after the introduction of prophylactic aspirin: audit.

    Science.gov (United States)

    Braithwaite, I; Dunbar, L; Eathorne, A; Weatherall, M; Beasley, R

    2016-02-01

    ESSENTIALS: We audited venous thromboembolism (VTE) in Achilles injuries after the use of prophylactic aspirin. We audited 218 patients with Achilles injury requiring lower limb immobilization for ≥ 1 week. Fourteen patients (6.4%, 95% CI 3.6% to 10.5%) developed symptomatic and confirmed VTE. The incidence was similar to the 6.3% identified in the same patient group prior to the use of aspirin. We report a follow-up audit of the incidence of venous thromboembolism (VTE) in patients requiring lower limb immobilization because of Achilles tendon injury, since the introduction of a policy to routinely prescribe 100 mg of aspirin daily. We studied 218 patients aged 18-65 years who attended the Orthopaedic Assessment Unit at Wellington Hospital between January 2013 and December 2014 with Achilles tendon injury requiring lower limb immobilization for ≥ 1 week. Information on assessment of VTE risk, prescription of aspirin and symptomatic VTE occurring within 70 days of immobilization was obtained and compared with the same information collected with the same method in the same patient group between January 2006 and December 2007, before the policy to routinely prescribe aspirin was introduced. A total of 189 of 218 (93%) patients were prescribed aspirin, as compared with 0.5% previously. Fourteen patients (6.4%, 95% confidence interval 3.6-10.5%) developed symptomatic radiologically confirmed VTE (10 distal deep vein thromboses [DVTs], two proximal DVTs, one pulmonary embolism [PE], and one PE with distal DVT). Aspirin was prescribed to all patients who subsequently developed a VTE; in one of 14, a recognized risk factor was documented. The VTE incidence was similar to the 6.3% identified in the previous audit. Lower limb immobilization following Achilles tendon injury confers a high risk of VTE even with aspirin prophylaxis. Consideration should be given to prophylaxis with low molecular weight heparin during lower limb immobilization following Achilles tendon

  7. TREATMENT OF BLUNT LIVER INJURIES IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Ana Kostić

    2003-04-01

    Full Text Available Liver is the largest parenchymatous organ, well vascularized, weighing approximately 1.8-3.0% of the whole body weight. Among all abdominal traumas liver injuries account for 25%. For more serious liver injuries the mortality is around 40% in children below 10 years of age. For lesions of the juxtahepatic veins (three major hepatic veins or the retrohepatic portion of v. cava or for complex, combined intraabdominal injuries, the mortality is even up to 70%.This work analyzed the period 1988-2000 during which there were 19 children admitted and treated for blunt liver injuries at the Clinic of Pediatric Surgery and Orthopedics in Nis; I, II and III scale injuries prevailed (17 cases; 89.4%. These injuries were surgically treated for the most part (17 cases; 89.4%. In 7 children (36.8% there were combined injuries. The lethality was 26.3%-5 cases, with three major complications: two intrahepatic hematomas and one biliary fistula associated with biliary peritonitis and biloma formation.

  8. Effect of cerebral blood flow on consciousness and outcome after head injury. Assessment by jugular bulb venous metabolism and IMP-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Imaizumi, Shigeki; Onuma, Takehide; Motohashi, Osamu; Kameyama, Motonobu; Ishii, Kiyoshi [Sendai City Hospital (Japan)

    2002-10-01

    This study was performed to elucidate the therapeutical value of arteriojugularvenous oxygen difference (AVDO{sub 2}) in the ultra-emergent period after head injury. Rational therapeutic strategy after severe head injury needs information concerning the dynamical change of cerebral blood flow (CBF) and metabolism. We monitored the cerebral venous metabolism within 6 hours after head injury until the day IMP-SPECT was performed. Whole brain cerebral blood flow detected by IMP-SPECT and AVDO{sub 2} at the same day was compared, which restored to the period within 6 hours after head injury. From this procedure, we could outline cerebral blood flow conditions by only AVDO{sub 2} without IMP-SPECT in the ultra-emergent period. Eighty-six patients with head injury who were carried to our emergency center in the period of recent 2 years aged ranging from 15 to 94 years were the subjects. They all performed jugular bulb cannulation within 6 hours after the accident (Martin's phase I: day 0) to know saturation of jugular vein (SjO{sub 2}), AVDO{sub 2} and AVL. They were monitored until the day IMP-SPECT was performed (Martin's phase II; day 1-3 or phase III; day 4-15). The correlation between CBF and AVDO{sub 2}. The effect of CBF and cerebral venous metabolism on consciousness and outcome was also analyzed. CBF and AVDO{sub 2} in phase II and III were reversely correlated (p<0.0001). Normal CBF corresponded with 5.0 vol% in AVDO{sub 2}. AVDO{sub 2} in all cases changed 6.2 vol% at phase I, 4.5 vol% at phase II and 5.1 vol% at phase III. Glasgow comascale (GCS) on admission under 8 (n=47) and over 9 (n=39) significantly differed in AVDO{sub 2} and CBF in the period of II and III. The patients with favorable consciousness showed low AVDO{sub 2} and hyperemia afterwards. Dead cases in phase I (n=19) showed high AVDO{sub 2} and low SjO{sub 2}. The patients with severe disability (SD) (n=13) showed high AVDO{sub 2} and low CBF and the patients with good recovery (GR

  9. Venous Ulcers

    Science.gov (United States)

    Caprini, J.A.; Partsch, H.; Simman, R.

    2013-01-01

    Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence. PMID:26236636

  10. Venous trauma in the Lebanon War--2006.

    Science.gov (United States)

    Nitecki, Samy S; Karram, Tony; Hoffman, Aaron; Bass, Arie

    2007-10-01

    Reports on venous trauma are relatively sparse. Severe venous trauma is manifested by hemorrhage, not ischemia. Bleeding may be internal or external and rarely may lead to hypovolemic shock. Repair of major extremity veins has been a subject of controversy and the current teaching is to avoid venous repair in an unstable or multi-trauma patient. The aim of the current paper is to present our recent experience in major venous trauma during the Lebanon conflict, means of diagnosis and treatment in a level I trauma center. All cases of major venous trauma, either isolated or combined with arterial injury, admitted to the emergency room during the 33-day conflict were reviewed. Out of 511 wounded soldiers and civilians who were admitted to our service over this period, 12 (2.3%) sustained a penetrating venous injury either isolated (5) or combined with arterial injury (7). All injuries were secondary to high velocity penetrating missiles or from multiple pellets stored in long-range missiles. All injuries were accompanied by additional insult to soft tissue, bone and viscera. The mean injury severity score was 15. Severe external bleeding was the presenting symptom in three cases of isolated venous injury (jugular, popliteal and femoral). The diagnosis of a major venous injury was made by a CTA scan in five cases, angiography in one and during surgical exploration in six cases. All injured veins were repaired: three by venous interposition grafts, four by end to end anastomosis, three by lateral suture and two by endovascular techniques. None of the injuries was treated by ligation of a major named vein. Immediate postoperative course was uneventful in all patients and the 30-day follow-up (by clinical assessment and duplex scan) has demonstrated a patent repair with no evidence of thrombosis. Without contradicting the wisdom of ligating major veins in the setup of multi-trauma or an unstable patient, our experience indicates that a routine repair of venous trauma can

  11. Early chemoprophylaxis is associated with decreased venous thromboembolism risk without concomitant increase in intraspinal hematoma expansion after traumatic spinal cord injury.

    Science.gov (United States)

    Chang, Ronald; Scerbo, Michelle H; Schmitt, Karl M; Adams, Sasha D; Choi, Timothy J; Wade, Charles E; Holcomb, John B

    2017-12-01

    After traumatic spinal cord injury (SCI), there is increased risk of venous thromboembolism (VTE), but chemoprophylaxis (PPX) may cause expansion of intraspinal hematoma (ISH). Single-center retrospective study of adult trauma patients from 2012 to 2015 with SCI. VTE diagnosis, death, or discharge within 48 hours. Patients were dichotomized based on early (≤48 hours) heparinoid and/or aspirin PPX. Intraspinal hematoma expansion was diagnosed intraoperatively or by follow-up radiology. We used multivariable Cox proportional hazards to estimate the effect of PPX on risk of VTE and ISH expansion controlling for age, injury severity score (ISS), complete SCI, and mechanism as static covariates and operative spine procedure as a time-varying covariate. Five hundred one patients with SCI were dichotomized into early PPX (n = 260 [52%]) and no early PPX (n = 241 [48%]). Early PPX patients were less likely blunt injured (91% vs 97%) and had fewer operative spine interventions (65% vs 80%), but age (median, 43 vs 49 years), ISS (median 24 vs 21), admission ISH (47% vs 44%), and VTE (5% vs 9%) were similar. Cox analysis found that early heparinoids was associated with reduced VTE (hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.16-0.84) and reduced pulmonary embolism (PE) (HR, 0.20; 95% CI, 0.06-0.69). The estimated number needed to treat with heparinoids was 10 to prevent one VTE and 13 to prevent one PE at 30 days. Early aspirin was not associated with reduced VTE or PE. Seven patients (1%) had ISH expansion, of which four were on PPX at the time of expansion. Using heparinoid and aspirin as time-varying covariates, neither heparinoids (HR, 1.90; 95% CI, 0.32-11.41) nor aspirin (HR, 3.67; 95% CI, 0.64-20.88) was associated with ISH expansion. Early heparinoid therapy was associated with decreased VTE and PE risk in SCI patients without concomitant increase in ISH expansion. Therapeutic, level IV.

  12. History of venous leg ulcers.

    Science.gov (United States)

    Gianfaldoni, S; Wollina, U; Lotti, J; Gianfaldoni, R; Lotti, T; Fioranelli, M; Roccia, M G

    To retrieve the history of venous ulcers and of skin lesions in general, we must go back to the appearance of human beings on earth. It is interesting to note that cutaneous injuries evolved parallel to human society. An essential first step in the pathogenesis of ulcers was represented by the transition of the quadruped man to Homo Erectus. This condition was characterized by a greater gravitational pressure on the lower limbs, with consequences on the peripheral venous system. Furthermore, human evolution was characterized by an increased risk of traumatic injuries, secondary to his natural need to create fire and hunt (e.g. stones, iron, fire, animal fighting). Humans then began to fight one another until they came to real wars, with increased frequency of wounds and infectious complications. The situation degraded with the introduction of horse riding, introduced by the Scites, who first tamed animals in the 7th century BC. This condition exhibited iliac veins at compression phenomena, favouring the venous stasis. With time, man continued to evolve until the modern age, which is characterized by increased risk factors for venous wounds such as poor physical activity and dietary errors (1, 2).

  13. deep venous thrombosis in patients with acute traumatic spinal cord ...

    African Journals Online (AJOL)

    endothelial injury (trauma) and immobility (venous stasis). DVT and ... pressure ulcers, spasticity and autonomic dysreflexia. (3). ... and its complications saves many lives. Accurate and ..... other chronic diseases and pre-existing risk factors.

  14. Fingertip replantations: importance of venous anastomosis and the clinical results.

    Science.gov (United States)

    Hasuo, Takaaki; Nishi, Genzaburo; Tsuchiya, Daiji; Otsuka, Takanobu

    2009-01-01

    Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

  15. Diagnosis of venous disorders

    International Nuclear Information System (INIS)

    Minar, E.

    1993-01-01

    Limited accuracy in the clinic diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutric management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous sytem also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insuffficiency the deep venous system should assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforrating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system. (orig.) [de

  16. Cerebral venous angiomas

    International Nuclear Information System (INIS)

    Agnoli, A.L.; Hildebrandt, G.

    1985-01-01

    Clinical symptoms and radiological signs in 15 patients with cerebral venous malformations are presented and the diagnostic problems discussed. The circulation time in combination with cerebral malformations and angiomas of the scalp are described. CT findings in cases of venous malformations of the brain stem are evaluated. Spot-like enhancement, as well as sharply demarcated round shaped enhancement are characteristic for venous angiomas. Cavernous angiomas usually present as homogenous or inhomogenous round shaped enhanced areas. (Author)

  17. Life-threatening Vesicular Bronchial Injury Requiring Veno-venous Extracorporeal Membrane Oxygenation Rescue in an Electronic Nicotine Delivery System User

    Directory of Open Access Journals (Sweden)

    Thomas Carter

    2017-07-01

    Full Text Available The use of electronic nicotine delivery systems (ENDS is increasing across the United States as tobacco bans increase and more people use these devices in an attempt to quit smoking. They are unregulated by the Food and Drug Administration, and there is significant concern that ENDS could produce several toxic byproducts. In this case a 35-year-old female presented to the emergency department with sudden-onset dyspnea. She denied current tobacco smoking, but she was a user of ENDS. When bronchoscopy was performed, an extensive pattern of suspected chemical injury was noted in her airways. She required transfer to a tertiary center where she required extracorporeal membranous oxygenation. Despite public opinion that ENDS are generally safe, or at least safer than tobacco smoking, contrary evidence is mounting. We postulate that her injuries were likely suffered secondary to use of an ENDS.

  18. Validating the utilisation of venous bicarbonate as a predictor of ...

    African Journals Online (AJOL)

    Background. Crush injury secondary to sjambok beatings is a well-described phenomenon in southern Africa. Owing to a number of factors, it can result in acute kidney injury (AKI). In 1992, Muckart et al. described a risk stratification system using venous bicarbonate (VB) that can be used in the management of these ...

  19. Hypodense bubbles in acute extradural haematomas following venous sinus tear

    International Nuclear Information System (INIS)

    Chee, C.P.; Habib, Z.A.

    1991-01-01

    Between January 1982 and December 1989, 12 patients with 13 acute extradural haematomas as a result of injury involving the venous sinuses were treated by the first author. The CT scan apperances in 6 cases were remarkable in that there were large bubbles of low density in the hyperdense haematomas and liquid blood was found during the operation. The possible underlying pathophysiological changes that gave rise this appearance are discussed. The CT scan appearance and the proximity of the clot to the venous sinuses should alert the neurosurgeon to the high probabilities of venous sinus tear such that proper treatment can be offered. (orig.)

  20. Hypodense bubbles in acute extradural haematomas following venous sinus tear

    Energy Technology Data Exchange (ETDEWEB)

    Chee, C.P.; Habib, Z.A. (Malaya Univ. Hospital, Kuala Lumpur (Malaysia). Neurosurgical and Radiological Services)

    1991-04-01

    Between January 1982 and December 1989, 12 patients with 13 acute extradural haematomas as a result of injury involving the venous sinuses were treated by the first author. The CT scan apperances in 6 cases were remarkable in that there were large bubbles of low density in the hyperdense haematomas and liquid blood was found during the operation. The possible underlying pathophysiological changes that gave rise this appearance are discussed. The CT scan appearance and the proximity of the clot to the venous sinuses should alert the neurosurgeon to the high probabilities of venous sinus tear such that proper treatment can be offered. (orig.).

  1. Reference values for venous and capillary S100B in children

    DEFF Research Database (Denmark)

    Astrand, Ramona; Romner, Bertil; Lanke, Jan

    2011-01-01

    The current management guidelines for pediatric mild head injury (MHI) liberally recommend computed tomography (CT) and frequent admission. Serum protein S100B, currently used in management of adult head injury, has recently shown potential for reducing unnecessary CT scans after pediatric mild h...... head injury. Capillary sampling in children is commonly used when venous sampling fails or is inappropriate. We present reference values for both venous and capillary samples of protein S100B in children....

  2. Chronic venous disorders

    African Journals Online (AJOL)

    The San Valentino Vascular Screening Project conducted in Italy found a ... developed healthcare systems, the cost of treating advanced venous disease ..... tissue inflammation and necrosis. Sclerosing ... and for its tributaries as an alternative.

  3. Prophylaxis of Venous Thrombosis.

    Science.gov (United States)

    Goldhaber, Samuel Z.

    2001-06-01

    Mechanical measures such as graduated compression stockings and intermittent compression boots are available for venous thrombosis prophylaxis, but compliance may be limited. Plantar venous pneumatic compression devices have attained widespread acceptance by both patients and nurses because of their comfort and compact size, but their track record for efficacy is poor. Inferior vena cava filters prevent pulmonary embolism, but do not halt the thrombotic process or prevent venous thrombosis. Pharmacologic prophylaxis traditionally has relied upon minidose unfractionated heparin; however, re-examination is warranted in the face of increasingly ill and complex patients. My opinion is that small, fixed doses of once-daily low molecular weight heparin will eventually replace minidose unfractionated heparin as the standard pharmacologic prophylaxis regimen for most surgical and medical patients. Prolongation of prophylaxis after hospital discharge should receive increased emphasis. Most patients being transferred to a skilled nursing facility should receive venous thromboembolism prophylaxis. Similarly, most patients undergoing total hip or knee replacement should receive prolonged preventive regimens, with at least 1 month of anticoagulation. Despite advances, certain aspects of venous thrombosis prophylaxis remain problematic. First, a surprisingly high number of hospitalized patients develop venous thrombosis because of failed (rather than omitted) prophylaxis. Second, many patients in intensive care have a combination of peripheral vascular disease and active bleeding (usually gastrointestinal) that precludes mechanical or pharmacologic prophylaxis. Third, neurosurgical patients undergoing craniotomy for brain tumors suffer a high rate of venous thrombosis and major pulmonary embolism despite the routine use of combined mechanical and pharmacologic prophylaxis. My opinion is that these three areas, in addition to the hospital culture of prophylaxis, should receive

  4. Brain venous pathologies: MRI findings

    International Nuclear Information System (INIS)

    Salvatico, Rosana; Gonzalez, Alejandro; Yanez, Paulina; Romero, Carlos; Trejo, Mariano; Lambre, Hector

    2006-01-01

    Purpose: To describe MRI findings of the different brain venous pathologies. Material and Methods: Between January 2002 and March 2004, 18 patients were studied 10 males and 8 females between 6 and 63 years old; with different brain venous pathologies. In all cases brain MRI were performed including morphological sequences with and without gadolinium injection and angiographic venous sequences. Results: 10 venous occlusions were found, 6 venous angiomas, and 2 presented varices secondary to arteriovenous dural fistula. Conclusion: Brain venous pathologies can appear in many different clinical contexts, with different prognosis and treatment. In all the cases brain MRI was the best imaging study to disclose typical morphologic abnormalities. (author) [es

  5. Cerebral venous thrombosis

    International Nuclear Information System (INIS)

    Soralova, T.; Sevcikova, H.; Petersky, D.

    2014-01-01

    We decided to process this theme due to its nonspecific clinical features as they often cause diagnostic problems not only to clinicians but also to diagnostic. It is important to think of this disease mainly in young women who administer hormonal contraception. Imaging methods play the crucial role in diagnostic of cerebral venous sinus thrombosis. The gold standard is a native CT of brain which shows the venous sinus thrombosis as a hyperdense lesion in the locus of the sinus (dense triangle sign), CT venography shows the sinus thrombosis as a defect in a contrast filling of the venous sinus (empty delta sign). Other investigative methods are magnetic resonance imaging or MRA. In short we also mention quite a rare but more serious thrombosis of profound cerebral veins v. cerebri magna-Galeni, vv. cerebri internae). The importance of early diagnostic and non specificity of symptoms is presented in 3 clinical cases that are the part of this work. (author)

  6. Direct venous thrombolysis and venous angioplasty in the upper extremity

    International Nuclear Information System (INIS)

    Hollmann, J.P.; Guenther, R.W.

    1987-01-01

    Venous thromboses of stenoses in the upper extremity are often the result of a compression syndrome of the shoulder girdle, the Paget-von Schroetter syndrome, vascular surgery, space-occupying lesions in the mediastinum or the result of catheterisation. Direct venous thrombolysis and venous angioplasty were performed successfully in six patients. (orig.) [de

  7. Chronic venous disease.

    Science.gov (United States)

    Wolinsky, Claire D; Waldorf, Heidi

    2009-11-01

    Identifying characteristic cutaneous findings is important in determining the appropriate management of certain venous diseases. The health care provider should be familiar with the classic description of patterns and distributions of skin manifestations, such as varicose veins, stasis dermatitis, palpable cord, petechiae, and telangiectasias. In addition to the gross appearance of the skin, a skin biopsy may help elucidate a diagnosis. General treatment and prevention of the underlying venous pathology is essential. Furthermore, specific management of skin findings should include therapy to ameliorate progression of disease and symptomatology when warranted.

  8. Central Venous Access

    International Nuclear Information System (INIS)

    Ganeshan, Arul; Warakaulle, Dinuke R.; Uberoi, Raman

    2007-01-01

    Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article

  9. Complication of Hemodialysis Access: A Case Report of Venous Hypertension

    Directory of Open Access Journals (Sweden)

    Sadegh Asadi

    2018-03-01

    Full Text Available Vascular access for dialysis is essential for these patients with end-stage renal disease, improvements in hemodialysis managment have lead to extended life expectancy. The creation and maintenance of hemoaccess occupies a significant portion of most vascular and general surgery practices.Venous hypertension due to arteriovenous fistula is usually secondary to venous outlet obstruction. Side to side proximal artery arteriovenous fistula serves as a certain cause of hemodialysis, but it is rarely reported as a peripheral venous hypertension cause. We are reporting a case with developed venous hypertension having dermal injuries in the arm. The patient underwent successful side-to-side radio cephalic fistula creation in the snuffbox a year ago.

  10. Venous ulcers -- self-care

    Science.gov (United States)

    ... surgery to improve blood flow through your veins. Prevention If you are at risk for venous ulcers, take the steps listed above under Wound Care. ... weight if you are overweight. Manage your blood pressure and cholesterol levels. ... Venous leg ulcers - self-care; Venous insufficiency ulcers - self-care; Stasis ...

  11. Cerebral venous angioma

    International Nuclear Information System (INIS)

    Inagawa, Tetsuji; Taguchi, Haruyoshi; Kamiya, Kazuko; Yano, Takashi; Nakajima, Reiko

    1984-01-01

    This report presents a 27-year-old male patient who was diagnosed as having cerebral venous angioma in the postero-temporal area by CT scan and cerebral angiography. The patient improved by removing angioma with electrocoagulation of medullary veins. (Namekawa, K.)

  12. Superior vena cava obstruction caused by radiation induced venous fibrosis

    NARCIS (Netherlands)

    Van Putten, JWG; Schlosser, NJJ; Vujaskovic, Z; Van der Leest, AHD; Groen, HJM

    Superior vena cava syndrome is most often caused by lung carcinoma. Two cases are described in whom venous obstruction in the superior mediastinum was caused by local vascular fibrosis due to radiotherapy five and seven years earlier. The development of radiation injury to greater vessels is

  13. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    Cardiac output is largely controlled by venous return, the driving force of which is the energy remaining at the postcapillary venous site. This force is influenced by forces acting close to the right atrium, and internally or externally upon the veins along their course. Analogue models of the v......Cardiac output is largely controlled by venous return, the driving force of which is the energy remaining at the postcapillary venous site. This force is influenced by forces acting close to the right atrium, and internally or externally upon the veins along their course. Analogue models...... of the venous system require at least three elements: a resistor, a capacitor and an inductor, with the latter being of more importance in the venous than in the arterial system. Non-linearities must be considered in pressure/flow relations in the small venules, during venous collapse, or low flow conditions...

  14. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Management of venous thromboembolism.

    Science.gov (United States)

    Parakh, R; Kakkar, V V; Kakkar, A K

    2007-01-01

    Venous Thromboembolism is an important healthcare problem the world over, resulting in significant morbidity, mortality and resource expenditure. The rationale for use of thromboprophylaxis is based on solid principles and scientific evidence. Indian perspective on this topic is lacking due to the non-availability of published Indian data. This document reviews the available International and Indian data and discusses the relevance of recommendations for prevention and management of Venous Thromboembolism (VTE) in the Indian context. Meetings of various specialists from different Indian hospitals in the field of Gastrointestinal Surgery, General and Vascular Surgery, Hematology, Intensive Care, Obstetrics and Gynecology, Oncology and Orthopedics were held in the months of August 2005 to January 2006. The guidelines published by American College of Chest Physicians (ACCP), the International Union of Angiology (IUA), and the Royal College of Obstetricians and Gynecologists (RCOG), were discussed during these meetings. The relevance of these guidelines and the practical implications of following these in a developing country like India were also discussed. Any published data from India was collected from data base searches and the results, along with personal experiences of the participating specialists were discussed. The experiences and impressions of the experts during these meetings have been included in this document. Data from recent sources (International Union of Angiology and the National Comprehensive Cancer Network (NCCN) Practice guidelines in Oncology on Venous thromboembolic disease) was subsequently also included in this document. The suggestions formulated in this document are practical, and would intend to serve as a useful practical reference. A number of unanswered questions remain in the field of thromboprophylaxis, and carefully designed research protocols may help answer some of these. Implementation of the suggestions outlined in the document

  16. Venous leg ulcers

    Science.gov (United States)

    2008-01-01

    Introduction Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide, thromboxane alpha2 antagonists, zinc), peri

  17. Assistance protocol for venous ulcers patients: validation of contents

    Directory of Open Access Journals (Sweden)

    Daniele Vieira Dantas

    2013-07-01

    Full Text Available Venous ulcers require complex treatment and are responsible for significant morbidity and mortality rates. This study aims at identifying aspects validated by the jury for the preparation of an assistance protocol for venous ulcer sufferers. It is a descriptive and quantitative research, with 39 professionals (30 nurses, 7 doctors and two physiotherapists, held at the Onofre Lopes University Hospital, between April and July/2010. Data collection began through a questionnaire checklist. Analysis was performed through Statistical Package for Social Science 15.0, assessing compliance with guidelines. Results were the compositional aspects of the protocol: assessment of patient and lesion history/documentation, wound care/perilesional skin, dressing suggestion, use of antibiotics and pain treatment, surgical treatment/medication, improving venous return and relapse prevention, patient referral, professional training and referral/counter-referral. It was concluded that to compose the protocol, aspects related to diagnosis, treatment and injury prevention must be considered.

  18. 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

  19. 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...

  20. Systemic Venous Inflow to the Liver Allograft to Overcome Diffuse Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Cristian Lupascu

    2015-01-01

    Full Text Available Diffuse splanchnic venous thrombosis (DSVT, formerly defined as contraindication for liver transplantation (LT, is a serious challenge to the liver transplant surgeon. Portal vein arterialisation, cavoportal hemitransposition and renoportal anastomosis, and finally combined liver and small bowel transplantation are all possible alternatives to deal with this condition. Five patients with preoperatively confirmed extensive splanchnic venous thrombosis were transplanted using cavoportal hemitransposition (4x and renoportal anastomosis (1x. Median follow-up was 58 months (range: 0,5 to 130 months. Two patients with previous radiation-induced peritoneal injury died, respectively, 18 days and 2 months after transplantation. The three other patients had excellent long-term survival, despite the fact that two of them needed a surgical reintervention for severe gastrointestinal bleeding. Extensive splanchnic venous thrombosis is no longer an absolute contraindication to liver transplantation. Although cavoportal hemitransposition and renoportal anastomosis undoubtedly are life-saving procedures allowing for ensuring adequate allograft portal flow, careful follow-up of these patients remains necessary as both methods are unable to completely eliminate the complications of (segmental portal hypertension.

  1. Cortical venous disease severity in MELAS syndrome correlates with brain lesion development.

    Science.gov (United States)

    Whitehead, M T; Wien, M; Lee, B; Bass, N; Gropman, A

    2017-08-01

    MELAS syndrome is a mitochondrial disorder typified by recurrent stroke-like episodes, seizures, and progressive brain injury. Abnormal mitochondria have been found in arterial walls implicating a vasculogenic etiology. We have observed abnormal cortical vein T2/FLAIR signal in MELAS patients, potentially representing wall thickening and sluggish flow. We sought to examine the relationship of hyperintense veins and brain lesions in MELAS. Imaging databases at two children's hospitals were searched for brain MRIs from MELAS patients. Artifact, sedated exams, and lack of 2D-T2/FLAIR sequences were exclusion criteria. Each exam was assigned a venous score based on number of T2/FLAIR hyperintense veins: 1 = 20. Cumulative brain lesions and venous score in MELAS and aged-matched normal exams were compared by Mann-Whitney test. A total of 106 exams from 14 unique MELAS patients (mean 16 ± 3 years) and 30 exams from normal aged-matched patients (mean 15 ± 3 years) were evaluated. Median venous score between MELAS and control patients significantly differed (3 versus 1; p MELAS group, venous score correlated with presence (median = 3) or absence (median = 1) of cumulative brain lesions. In all 8 MELAS patients who developed lesions, venous hyperintensity was present prior to, during, and after lesion onset. Venous score did not correlate with brain lesion acuity. Abnormal venous signal correlates with cumulative brain lesion severity in MELAS syndrome. Cortical venous stenosis, congestion, and venous ischemia may be mechanisms of brain injury. Identification of cortical venous pathology may aid in diagnosis and could be predictive of lesion development.

  2. Venous hemodynamic changes in lower limb venous disease

    DEFF Research Database (Denmark)

    Lee, Byung Boong; Nicolaides, Andrew N; Myers, Kenneth

    2016-01-01

    ). Their aim was to confirm or dispel long-held hemodynamic principles and to provide a comprehensive review of venous hemodynamic concepts underlying the pathophysiology of lower limb venous disorders, their usefulness for investigating patients and the relevant hemodynamic changes associated with various...... forms of treatment. Chapter 1 is devoted to basic hemodynamic concepts and normal venous physiology. Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep vein thrombosis indicating their pathophysiological and clinical significance. Chapter 3 describes the hemodynamic...... changes that occur in different classes of chronic venous disease and their relation to the anatomic extent of disease in the macrocirculation and microcirculation. The next four chapters (Chapters 4-7) describe the hemodynamic changes resulting from treatment by compression using different materials...

  3. 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.)

  4. VENOUS THROMBOSIS COMPLICATIONS IN THERMAL TRAUMA. A LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    V. S. Borisov

    2016-01-01

    Full Text Available The article analyzes the currently existing data concerning incidence and timing of venous thrombosis development in burn patients. There is no consensus not only on the incidence of this disease amongst burn patients, but also on methods of diagnosis and prevention. For the first time, we raised an issue of the need for formation of risk groups using the scale of prof. Joseph Caprini (USA applied to patients with thermal injury.

  5. Hydrocephalus in cerebral venous thrombosis

    NARCIS (Netherlands)

    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

  6. Venous thromboembolism and arterial complications.

    Science.gov (United States)

    Prandoni, Paolo; Piovella, Chiara; Pesavento, Raffaele

    2012-04-01

    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, smoking, 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Total anomalous pulmonary venous return

    Science.gov (United States)

    ... pulmonary venous return, x-ray References Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, ... 62. Review Date 10/17/2017 Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, ...

  8. In the absence of a central venous catheter, risk of venous thromboembolism is low in critically injured children, adolescents, and young adults: evidence from the National Trauma Data Bank.

    Science.gov (United States)

    O'Brien, Sarah H; Candrilli, Sean D

    2011-05-01

    To describe the incidence and risk factors of venous thromboembolism in a large sample of critical care pediatric, adolescent, and young adult trauma patients. The National Trauma Data Bank-the largest and most complete aggregation of trauma registry data in the United States. Seven hundred eighty-four level I to level IV trauma centers. Patients ≤ 21 yrs of age who spent at least 1 day in a critical care unit during a trauma admission between 2001 and 2005. To characterize differences between patients with and without venous thromboembolism, we extracted variables regarding patient demographics, injury pattern and severity, procedures, total length of stay, and intensive care unit and ventilator days. Odds ratios for predictors of venous thromboembolism were estimated with a logistic regression model. Among the 135,032 critical care patients analyzed, venous thromboembolism was uncommon (6 per 1,000 discharges). Placement of a central venous catheter was a significant predictor of venous thromboembolism (odds ratio = 2.24; p central venous catheter were of even greater magnitude, particularly in adolescents and young adults. The risk of venous thromboembolism in critical care patients without a central venous catheter was central venous access.

  9. Improving venous leg ulcer management

    OpenAIRE

    Weller, Carolina Dragica

    2017-01-01

    This thesis reports several different methods to develop and evaluate complex interventions designed to improve venous leg ulcer management. Chronic venous leg ulcers (VLU) are the most common chronic wound problem in the community. Its health and economic burden is predicted to increase due to ageing of the community and increase in prevalence of diabetes and obesity. Although many patients seek health care for VLU, most do not receive the most effective management. Patients with this condi...

  10. Combined oral contraceptives: venous thrombosis.

    Science.gov (United States)

    de Bastos, Marcos; Stegeman, Bernardine H; Rosendaal, Frits R; Van Hylckama Vlieg, Astrid; Helmerhorst, Frans M; Stijnen, Theo; Dekkers, Olaf M

    2014-03-03

    Combined oral contraceptive (COC) use has been associated with venous thrombosis (VT) (i.e., deep venous thrombosis and pulmonary embolism). The VT risk has been evaluated for many estrogen doses and progestagen types contained in COC but no comprehensive comparison involving commonly used COC is available. To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives. Electronic databases (Pubmed, Embase, Web of Science, Cochrane, CINAHL, Academic Search Premier and ScienceDirect) were searched in 22 April 2013 for eligible studies, without language restrictions. We selected studies including healthy women taking COC with VT as outcome. The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Publications with at least 10 events in total were eligible. The network meta-analysis was performed using an extension of frequentist random effects models for mixed multiple treatment comparisons. Unadjusted relative risks with 95% confidence intervals were reported.Two independent reviewers extracted data from selected studies. 3110 publications were retrieved through a search strategy; 25 publications reporting on 26 studies were included. Incidence of venous thrombosis in non-users from two included cohorts was 0.19 and 0.37 per 1 000 person years, in line with previously reported incidences of 0,16 per 1 000 person years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with non-use (relative risk 3.5, 95% confidence interval 2.9 to 4.3). The relative risk of venous thrombosis for combined oral contraceptives with 30-35 μg ethinylestradiol and gestodene, desogestrel, cyproterone acetate, or drospirenone were similar and about 50-80% higher than for combined oral contraceptives with levonorgestrel. A dose related effect of ethinylestradiol was observed for gestodene

  11. The causes of skin damage and leg ulceration in chronic venous disease.

    Science.gov (United States)

    Smith, Philip Coleridge

    2006-09-01

    Chronic venous disease with skin changes of the leg is a common condition affecting up to 1 in 20 people in westernized countries. The causes of this problem are not fully understood, although research in recent years has revealed a number of important mechanisms that contribute to the disease process. Patients with chronic venous disease suffer persistently raised pressures in their deep and superficial veins in the lower limb. Leucocytes become "trapped" in the circulation of the leg during periods of venous hyper-tension produced by sitting or standing. Studies of the plasma levels of neutrophil granule enzymes shows that these are increased during periods of venous hypertension, suggesting that this causes activation of the neutrophils. Investigation of the leucocyte surface ligands CD11b and CD62L shows that the more activated neutrophils and monocytes are sequestered during venous hypertension. Measurement of plasma levels of the soluble parts of the endothelial adhesion molecules VCAM, ICAM, and ELAM show that these are all elevated in patients with chronic venous disease compared to controls. Following 30 minutes of venous hypertension produced by standing, these levels are further increased. These data suggest that venous hypertension causes neutrophil and monocyte activation, which in turn causes injury to the endothelium. Chronic injury to the endothelium leads to a chronic inflammatory condition of the skin that we know clinically as lipodermatosclerosis. This is mediated by perivascular inflammatory cells, principally macrophages, in the skin microcirculation. These stimulate fibroblasts in the skin leading to tissue remodeling and laying down of fibrous tissue. Vascular endothelial growth factor stimulates proliferation of capillaries within the skin. Skin in this state has the potential to ulcerate in response to minor injury.

  12. Venous chest anatomy: clinical implications

    International Nuclear Information System (INIS)

    Chasen, M.H.; Charnsangavej, C.

    1998-01-01

    This article provides a practical approach to the clinical implications and importance of understanding the collateral venous anatomy of the thorax. Routine radiography, conventional venography, computed tomography (CT), and magnetic resonance (MR) imaging studies provide correlative anatomic models for the demonstration of how interconnecting collateral vascular networks within the thorax maintain venous stability at all times. Five major systems comprise the collateral venous network of the thorax ( Fig. 1 ). These include the paravertebral, azygos-hemiazygos, internal mammary, lateral thoracic, and anterior jugular venous systems (AJVS). The five systems are presented in the following sequence: (a) a brief introduction to the importance of catheter position and malposition in understanding access to the thoracic venous system, (b) the anatomy of the azygos-hemiazygos systems and their relationship with the paravertebral plexus, (c) the importance of the AJVS, (d) 'loop' concepts interconnecting the internal mammary and azygos-hemiazygos systems by means of the lateral thoracic and intercostal veins, and (e) the interconnecting venous networks on the thoracic side of the thoracoabdominal junction. Certain aspects of the venous anatomy of the thorax will not be discussed in this chapter and include (a) the intra-abdominal anastomoses between the superior and inferior vena cavae (IVC) via the internal mammary, lateral thoracic, and azygos-hemiazygos systems (beyond the scope of this article), (b) potential collateral vessels involving vertebral, parascapular, thyroidal, thymic, and other smaller veins that might anastomose with the major systems, and (c) anatomic variants and pitfalls that may mimic pathologic conditions (space limitations). (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  13. Surgical management of venous malformations.

    Science.gov (United States)

    Loose, D A

    2007-01-01

    Among vascular malformations, the predominantly venous malformations represent the majority of cases. They form a clinical entity and therefore need clear concepts concerning diagnosis and treatment. This paper presents an overview of contemporary classification as well as tactics and techniques of treatment. According to the Hamburg Classification, predominantly venous malformations are categorized into truncular and extratruncular forms, with truncular forms distinguished as obstructions and dilations, and extratruncular forms as limited or infiltrating. The tactics of treatment represent surgical and non-surgical methods or combined techniques. Surgical approaches utilize different tactics and techniques that are adopted based on the pathologic form and type of the malformation: (I) operation to reduce the haemodynamic activity of the malformation; (II) operation to eliminate the malformation; and (III) reconstructive operation. As for (I), a type of a tactic is the operation to derive the venous flow. In (II), the total or partial removal of the venous malformation is demonstrated subdivided into three different techniques. In this way, the infiltrating as well as the limited forms can be treated. An additional technique is dedicated to the treatment of a marginal vein. Approach (III) involves the treatment of venous aneurysms, where a variety of techniques have been successful. Long-term follow-up demonstrates positive results in 91% of the cases. Congenital predominantly venous malformations should be treated according to the principles developed during the past decades in vascular surgery, interventional treatment and multidisciplinary treatment. The days of predominantly conservative treatment should be relegated to the past. Special skills and experiences are necessary to carry out appropriate surgical strategy, and the required operative techniques should be dictated by the location and type of malformation and associated findings.

  14. Venous abnormalities demonstrated by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, T; Tsukune, Y; Ashida, H; Tokuda, M; Oyama, Y [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1980-05-01

    CT is capable of demonstrating various venous changes. However, little have been described on this subject in the literature. Examples of various venous abnormalities such as obstructed jugular vein, superior and inferior vena cava (IVC), tumor invasion of IVC and renal vein and venous changes in portal hypertension were presented. It was stressed that noninvasive CT is a good tool in diagnosis of some of venous changes and may be able to eliminate angiography in such cases.

  15. Colorectal cancer with venous tumor thrombosis

    OpenAIRE

    Kensuke Otani; Soichiro Ishihara; Keisuke Hata; Koji Murono; Kazuhito Sasaki; Koji Yasuda; Takeshi Nishikawa; Toshiaki Tanaka; Tomomichi Kiyomatsu; Kazushige Kawai; Hiroaki Nozawa; Hironori Yamaguchi; Toshiaki Watanabe

    2018-01-01

    Summary: Colorectal cancer is seldom accompanied by venous tumor thrombosis, and little is known about the features of venous tumor thrombosis in colorectal cancer. However, some reports show that colorectal cancer patients can develop venous tumor thrombosis and warn clinicians not to overlook this complication. In this report, we perform a review of 43 previously reported cases and investigate the characteristics of colorectal cancer accompanied by venous tumor thrombosis. The histological ...

  16. Familial Clustering of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Sindet-Pedersen, Caroline; Oestergaard, Louise Bruun; Gundlund, Anna

    2016-01-01

    BACKGROUND: Identification of risk factors for venous thromboembolism (VTE) is of utmost importance to improve current prophylactic regimes and treatment guidelines. The extent to which a family history contributes to the risk of VTE needs further exploration. OBJECTIVES: To examine the relative ...

  17. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for

  18. Splanchnic venous thrombosis and pancreatitis.

    Science.gov (United States)

    Nadkarni, Nikhil A; Khanna, Sahil; Vege, Santhi Swaroop

    2013-08-01

    Pancreatitis is an inflammatory process with local and systemic manifestations. One such local manifestation is thrombosis in splanchnic venous circulation, predominantly of the splenic vein. The literature on this important complication is very sparse. This review offers an overview of mechanism of thrombosis, its pathophysiology, diagnosis, and management in the setting of acute as well as chronic pancreatitis.

  19. Venous sinus stenting for pseudotumour cerebri with venous sinus stenosis

    International Nuclear Information System (INIS)

    Chen Huairui; Bai Rulin; Wu Xiaojun; Qi Xiangqian; Mei Qiyong; Lu Yicheng

    2011-01-01

    Objective: To explore the relation between venous sinus stenosis and pseduotumour cerebri and to discuss the efficacy and strategy of venous sinus stenting for its treatment. Methods: Venous sinus stenting was performed in a total of 9 patients with pseudotumour cerebri accompanied by dural sinus stenosis. The clinical data, including the clinical presentations, intracranial pressure, angiographic findings, pressure of dural sinus,methods of treatment and the therapeutic results, were retrospectively analyzed. Results: Bilateral disc edema was seen in all patients. The pressure gradient in the lateral sinuses was obviously high before stenting (22.67±7.25)mmHg in all patients and a reduction in intra-sinus pressure and pressure gradient was also found (5.78±3.77)mmHg. The symptoms associated with intracranial hypertension were gradually improved or disappeared in two weeks after the placement of the stent in all cases, and the intracranial pressure dropped evidently (12.78±5.97)cm H 2 O. Vision was improved in 7 cases at three months, whereas it remained poor in 2 cases despite normalized intracranial pressure. There was no other permanent procedure-related morbidity. The patients were followed up for 3 months to 5 years, and no recurrence developed. Conclusion: Lateral sinus stenting is an effective method for the treatment of pseudotumour cerebri with dural sinus stenosis. (authors)

  20. Radiologically-placed venous ports in children under venous anesthesia

    International Nuclear Information System (INIS)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak

    2015-01-01

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  1. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  2. Mixed Capillary Venous Retroperitoneal Hemangioma

    Directory of Open Access Journals (Sweden)

    Mohit Godar

    2013-01-01

    Full Text Available We report a case of mixed capillary venous hemangioma of the retroperitoneum in a 61-year-old man. Abdominal ultrasonography showed a mass to be hypoechoic with increased flow in color Doppler imaging. Dynamic contrast-enhanced computed tomography revealed a centripetal filling-in of the mass, located anterior to the left psoas muscle at the level of sacroiliac joint. On the basis of imaging features, preoperative diagnosis of hemangioma was considered and the mass was excised by laparoscopic method. Immunohistochemical studies were strongly positive for CD31 and CD34, and negative for calretinin, EMA, WT1, HMB45, Ki67, synaptophysin, and lymphatic endothelial cell marker D2–40. Histologically, the neoplasm was diagnosed as mixed capillary venous hemangioma.

  3. MRI in venous thromboembolic disease

    International Nuclear Information System (INIS)

    Sostman, H.D.; Debatin, J.F.; Spritzer, C.E.; Coleman, R.E.; Grist, T.M.; MacFall, J.R.

    1993-01-01

    We evaluated the ability of magnetic resonance (MR) imaging to detect deep venous thrombosis (DVT) and pulmonary embolism (PE). MR venography was performed on 217 patients suspected of having DVT. Cine-MR imaging of the pulmonary arteries was performed in 14 other patients who were thought to have PE based on other imaging studies. In a third group of 5 patients, MR pulmonary angiograms were performed in the sagittal and coronal planes with a multislice fast gradient recalled echo technique. All but one of the 217 MR venograms were technically adequate. In 72 patients with correlative imaging studies (venography and ultrasound) MR venography was 99% sensitive and 95% specific. On the basis of follow-up (mean 8.3 months), no false-negative MR venograms were detected in an additional 64 patients. In 11 other patients MR revealed a diagnosis other than DVT. Cine-MR showed PE in all 14 patients evaluated. MR pulmonary arteriography demonstrated filling defects consistent with acute PE in 2 of 3 patients with acute PE; in the third patient only a questionable filling defect was seen. Coarctations or webs were found in the pulmonary arteries of both patients with chronic PE. These preliminary data suggest that MR imaging may be able to evaluate both the peripheral venous and the pulmonary arterial component of venous thromboembolic disease. Further technical refinement and more extensive clinical experience will be required to establish the role of this method in diagnosing pulmonary embolism, but MR venography is now used routinely in our hospital for the diagnosis of deep venous thrombosis. (orig.)

  4. Significance of venous anastomosis in fingertip replantation.

    Science.gov (United States)

    Hattori, Yasunori; Doi, Kazuteru; Ikeda, Keisuke; Abe, Yukio; Dhawan, Vikas

    2003-03-01

    Adequate venous outflow is the most important factor for successful fingertip replantation. The authors have attempted venous anastomosis in all cases of fingertip replantation to overcome postoperative congestion. In this article, the significance of venous repair for fingertip replantation is described from the authors' results of 64 complete fingertip amputations in 55 consecutive patients, which were replanted from January of 1996 to June of 2001. The overall survival rate was 86 percent. Of the 44 replantations in zone I, 37 survived, and the success rate was 84 percent. Of the 20 replantations in zone II, 18 survived, and the success rate was 90 percent. Venous anastomosis was attempted in all cases, but it was possible in 39 zone I and in all zone II replantations. For arterial repair, vein grafts were necessary in 17 of the 44 zone I and in one of the 20 zone II replantations; for venous repair, they were necessary in six zone I replantations and one zone II replantation. Postoperative vascular complications occurred in 15 replantations. There were five cases of arterial thrombosis and 10 cases of venous congestion. Venous congestion occurred in nine zone I and one zone II replantations. In five of these 10 replantations, venous anastomosis was not possible. In another five replantations, venous outflow was established at the time of surgery, but occlusion occurred subsequently. Except for the five failures resulting from arterial thrombosis, successful venous repair was possible in 49 of 59 replantations (83 percent). Despite the demand for skillful microsurgical technique and longer operation time, the authors' results using venous anastomosis in successful fingertip replantations are encouraging. By performing venous anastomosis, external bleeding can be avoided and a higher survival rate can be achieved. Venous anastomosis for fingertip replantation is a reliable and worthwhile procedure.

  5. Cerebral sino-venous thrombosis

    International Nuclear Information System (INIS)

    Sayama, Ichiro; Kobayashi, Tsunesaburo; Nakajima, Kenji

    1982-01-01

    Three cases of cerebral sino-venous thrombosis were reported. Repeated CT findings were studied and discussed on account of the treatments for those pathologic conditions. Those of studied cases are; a 22-year-old postpartum woman, a 42-year-old woman with irregular vaginal bleeding, and a 26-year-old man with severe reactive emesis after drinking alcohol. They were treated conservatively. Case 1 died in its acute stage. In the remaining ones, each had an uneventful recovery. CT scan findings of them manifested their exact clinical conditions. These findings were devided into two categories, one was direct signs expressed sino-venous occlusion, the other was indirect signs which appeared as a result of these occlusion. Direct signs cannot always get in every cases with sino-venous occlusion, but as for indirect signs, we can get various changes corresponding to the time taken CT photoes, and they are useful to decide appropriate treatments at that time. Considering suitable treatments for this disease, it is necessary to select most suitable ones according to their pathologic conditions, which may be precisely drawn with CT scans. (J.P.N.)

  6. Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cao Yue, E-mail: yuecao@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Wang Hesheng [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Johnson, Timothy D. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Pan, Charlie [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hussain, Hero [Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Normolle, Daniel; Ben-Josef, Edgar; Ten Haken, Randall K.; Lawrence, Theodore S.; Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-01-01

    Purpose: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. Methods and Materials: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. Results: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. Conclusions: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which

  7. Analysis of the vertebral venous system in relation to cerebral venous drainage on MR angiography

    International Nuclear Information System (INIS)

    Baik, Seung Kug; Sohn, Chul Ho; Kim, Gab Chul; Kim, Yong Sun

    2004-01-01

    In the supine position, cerebral venous drainage occurs primarily through the internal jugular veins, as seen on venous phase cerebral angiography. However, in the erect position, the vertebral venous system represents the major alternative pathway of cerebral venous drainage, while outflow through the internal jugular veins is absent or negligible. The purpose of this study is to evaluate the vertebral venous system and its relationship between the surrounding venous structures using magnetic resonance angiography (MRA) in the case of subjects in the supine position. We retrospectively reviewed the results of 65 patients (M:F = 31: 34, mean age 61.6 years) who underwent multi-phase contrast-enhanced carotid MRA. The imaging studies were performed using a 3.0 T MR unit (TR: 5.2, TE: 1.1, FA: 20, 3.8 thickness, EC: 1). We analyzed the appearance and extent of the vertebral venous system (vertebral venous plexus and vertebral artery venous plexus) and the internal jugular vein on the venous phase images. We also evaluated the main drainage pattern of the cerebral venous drainage and the drainage pattern of the vertebral venous system. The visualized vertebral venous system was defined as either poor, vertebral venous plexus dominant, vertebral artery venous plexus dominant or mixed. In the vertebral venous system, the vertebral artery venous plexus was visualized in 54 cases (83%). The appearance of the visualized vertebral artery venous plexus was symmetrical in 39 cases (72%) and asymmetrical in 15 cases (28%). The extent of the visualized vertebral artery venous plexus was partial in 26 cases (48%) and complete in 28 cases (52%). The vertebral venous plexus was visualized in 62 cases (95%). The appearance of the visualized vertebral artery venous plexus was symmetrical in 43 cases (69%) and asymmetrical in 19 cases (31%). The extent of the visualized vertebral artery venous plexus was partial in 35 cases (56%) and complete in 27 cases (44%). The appearance of the

  8. Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

    NARCIS (Netherlands)

    van Beest, Paul A.; van der Schors, Alice; Liefers, Henriëtte; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michaël A.; Spronk, Peter E.

    2012-01-01

    Objective: The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients. Design: Prospective observational controlled study. Setting: Nonacademic university-affiliated

  9. Clinicoroentgenological diagnosis of chronic venous ovarian insufficiency

    International Nuclear Information System (INIS)

    Grakova, L.S.; Galkin, E.V.; Naumova, E.B.

    1989-01-01

    The paper is devoted to clinicoroentgenological correlations of venous renogonadal hemodynamics in 168 women of reproductive age (151 women with infertility, habitual abortion, disordered menstrual function and 17 patients without disorders of the reproductive tract). Clinicolaboratory investigation was followed by visceral and parietal flebography for the detection of a pathological venous reflux into the ovarian pampiniform plexus. Clinicoroentgenological semiotics of chronic venous ovarian insufficiency was analyzed. Infertility was shown to be the main clinical manifestation of ovarian varicocele

  10. Sonographic detection of portal venous gas

    International Nuclear Information System (INIS)

    Lee, Wang Yul; Lee, S. K.; Cho, O. K.

    1989-01-01

    Portal venous gas suggests underlying bowel disease such as strangulating intestinal obstruction and its demonstration carries with it an important implications with respect to patient management. Radiography has been the gold standard for the detection of portal venous gas. We have experienced two cases of portal venous gas diagnosed by ultrasound. Sonographic findings were floating echoes in the main portal vein and highly echogenic linear or patchy echoes within the hepatic parenchyma. Simple abdominal films of those cases failed to demonstrate gas in the portal venous system

  11. Venous hypertensive myelopathy associated with cervical spondylosis.

    Science.gov (United States)

    Okada, Seiji; Chang, Charles; Chang, Geraldine; Yue, James J

    2016-11-01

    Venous hypertensive myelopathy (VHM) results from spinal vascular malformations of arteriovenous shunting that increases spinal venous pressure, leading to congestive edema and neurologic dysfunction. There has been no report of VHM associated with cervical spondylotic myelopathy (CSM). The aim of this study was to report an extremely rare case of VHM likely due to CSM. This study is a case report and review of the literature. The patient was a 51-year-old man with CSM exhibiting relatively rapid neurologic deterioration with an abnormal expansion of a centromedullary hyperintense lesion on T2-weighted magnetic resonance imaging (MRI) in the absence of traumatic injury. Neurologic examination and radiologic imaging were taken by various means. The patient developed a cervical radiculopathy, followed by gait disturbance and motor weakness. The MRI of the cervical spine demonstrated spinal canal stenosis due to disc bulging and flavum hypertrophy at the C5/C6 and C6/C7 levels as well as hyperintense area over the C5-C7 levels on T2-weighted images. Although decompression surgery was planned, an acute inflammatory process such as transverse myelitis or demyelinating disease other than cord compression was also considered, and the patient received intravenous steroids. His walking improved for several days. However, his symptoms then became significantly worse, and he had difficulty walking. Subsequent MRI demonstrated marked progression of the T2 hyperintense lesion over the C4-T1 vertebral levels. Flow voids were also noted on the dorsal surface of the upper cervical cord on T2-weighted MRI. His lab work, medical history, and the local enhancement on contrast-enhanced MRI indicated low probability of spinal inflammatory diseases. Therefore, the decision was made to perform anterior cervical discectomy and fusion surgery on two levels. Following surgery, his symptoms improved promptly. Our case indicates that VHM could be caused by spondylotic cord compression in the

  12. Hyperthyroidism and cerebral venous thrombosis.

    Science.gov (United States)

    Mouton, S; Nighoghossian, N; Berruyer, M; Derex, L; Philippeau, F; Cakmak, S; Honnorat, J; Hermier, M; Trouillas, P

    2005-01-01

    The demonstration of an underlying prothrombotic condition in cerebral venous thrombosis (CVT) may have important practical consequences in terms of prevention. Thyrotoxicosis through a hypercoagulable state may be a predisposing factor for CVT. The authors present the cases of 4 patients who developed CVT and hyperthyroidism. At the acute stage, hyperthyroidism was associated with an increase in factor VIII (FVIII). At follow-up, FVIII level remained increased in 2 patients. Hyperthyroidism may have an impact on FVIII level. Accordingly in patients with hyperthyroidism and neurological symptoms, the diagnosis of CVT should be considered and an exhaustive coagulation screening may be appropriate. (c) 2005 S. Karger AG, Basel.

  13. Pulmonary venous abnormalities encountered on pre ...

    African Journals Online (AJOL)

    Multidetector computed tomography (MDCT) elegantly renders pulmonary venous anatomy. With increasing numbers of radiofrequency ablation procedures being performed, there is now a greater emphasis on pre-procedure imaging to delineate this anatomy. Pulmonary venous mapping studies can be performed with or ...

  14. REVIEW ARTICLE Venous thromboembolism associated with ...

    Indian Academy of Sciences (India)

    Navya

    2017-03-24

    Mar 24, 2017 ... Venous thromboembolism associated with protein S deficiency due to ... 2 Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland ... It has been long recognized that reduced PS activity is a risk factor for venous ... 1988). Sequencing of PROS1 gene intensified studies of genotype-.

  15. Sex-specific aspects of venous thrombosis

    NARCIS (Netherlands)

    Roach, Rachel Elizabeth Jo

    2014-01-01

    Venous thrombosis is a disease that occurs in 1-2 per 1000 people per year. At the time of their first venous thrombosis, approximately 50% of women are exposed to reproductive risk factors (oral contraception, postmenopausal hormone therapy, pregnancy and the puerperium). In this thesis, we showed

  16. Venous Thromboembolism in Patients With Thrombocytopenia

    DEFF Research Database (Denmark)

    Bælum, Jens Kristian; Ellingsen Moe, Espen; Nybo, Mads

    2017-01-01

    BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing. O...... having thrombocytopenia with VTE seem to be safely treated with anticoagulants without increased occurrence of bleeding....

  17. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi

    2013-01-01

    Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

  18. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T

    2005-01-01

    In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of val...

  19. A BMPy Road for Venous Development.

    Science.gov (United States)

    Goddard, Lauren M; Kahn, Mark L

    2017-09-11

    Detailed molecular pathways for the specific growth of arteries and lymphatic vessels have been identified, but the mechanisms controlling venous vessel growth have been obscure. Tischfield and colleagues (2017) shed new light on this problem by identifying a role for BMP signaling in development of the cerebral venous system. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations

    Directory of Open Access Journals (Sweden)

    Deok Hyeon Ryu

    2018-01-01

    Full Text Available Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1, a single vein (group 2, and 2 or more veins (group 3. Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143. Failures were due equally to venous complications (n=4, 50% and to arterial complications (n=4, 50%. Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689. However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017. Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy.

  1. Multiple venous anastomoses decrease the need for intensive postoperative management in tamai zone I replantations

    Science.gov (United States)

    Ryu, Deok Hyeon; Roh, Si Young; Kim, Jin Soo; Lee, Dong Chul; Lee, Kyung Jin

    2018-01-01

    Background Venous anastomosis is an important component of digital replantation, but is not always feasible, as some cases require external bleeding to treat venous congestion in the replanted tissue. In the present study, we evaluated the relationship between the number of vein anastomoses and the survival rate of Tamai zone I replantations. Methods A retrospective review was performed of all patients who underwent replantation of a fingertip amputation between 2014 and 2016. Patient charts were reviewed for demographic information, the mechanism of injury, the number of venous anastomoses, and the use of anticoagulation, external bleeding, and/or leeches. The cohort was divided into 3 groups depending on the number of venous anastomoses: no veins (group 1), a single vein (group 2), and 2 or more veins (group 3). Survival rates and external bleeding rates were analyzed across the groups. Results The review identified 143 fingertip replantations among 134 patients. The overall survival rate was 94% (135 of 143). Failures were due equally to venous complications (n=4, 50%) and to arterial complications (n=4, 50%). Our analysis did not identify any correlation between the number of veins anastomosed and the replant survival rate (P=0.689). However, a greater number of anastomoses was associated with a significantly lower frequency of external bleeding (P=0.017). Conclusions The number of venous anastomoses was not correlated with the survival rate. However, a greater number of venous anastomoses was associated with a decreased need for external bleeding, corresponding to a significant decrease in the need for postoperative monitoring and leech therapy. PMID:29076329

  2. Combined therapy of Ulmo honey (Eucryphia cordifolia and ascorbic acid to treat venous ulcers

    Directory of Open Access Journals (Sweden)

    Mariano del Sol Calderon

    2015-04-01

    Full Text Available OBJECTIVE: to assess the clinical effect of topical treatment using Ulmo honey associated with oral ascorbic acid in patients with venous ulcers. METHOD: longitudinal and descriptive quantitative study. During one year, 18 patients were assessed who were clinically diagnosed with venous ulcer in different stages, male and female, adult, with a mean injury time of 13 months. Ulmo honey was topically applied daily. The dressing was applied in accordance with the technical standard for advanced dressings, combined with the daily oral consumptions of 500 mg of ascorbic acid. The monitoring instrument is the assessment table of venous ulcers. RESULTS: full healing was achieved in 100% of the venous ulcers. No signs of complications were observed, such as allergies or infection. CONCLUSION: the proposed treatment showed excellent clinical results for the healing of venous ulcers. The honey demonstrated debriding and non-adherent properties, was easy to apply and remove and was well accepted by the users. The described results generated a research line on chronic wound treatment.

  3. [Venous catheter-related infections].

    Science.gov (United States)

    Ferrer, Carmen; Almirante, Benito

    2014-02-01

    Venous catheter-related infections are a problem of particular importance, due to their frequency, morbidity and mortality, and because they are potentially preventable clinical processes. At present, the majority of hospitalized patients and a considerable number of outpatients are carriers of these devices. There has been a remarkable growth of knowledge of the epidemiology of these infections, the most appropriate methodology for diagnosis, the therapeutic and, in particular, the preventive strategies. Multimodal strategies, including educational programs directed at staff and a bundle of simple measures for implementation, applied to high-risk patients have demonstrated great effectiveness for their prevention. In this review the epidemiology, the diagnosis, and the therapeutic and preventive aspects of these infections are updated. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  4. Cerebral venous outflow and cerebrospinal fluid dynamics

    Directory of Open Access Journals (Sweden)

    Clive B. Beggs

    2014-12-01

    Full Text Available In this review, the impact of restricted cerebral venous outflow on the biomechanics of the intracranial fluid system is investigated. The cerebral venous drainage system is often viewed simply as a series of collecting vessels channeling blood back to the heart. However there is growing evidence that it plays an important role in regulating the intracranial fluid system. In particular, there appears to be a link between increased cerebrospinal fluid (CSF pulsatility in the Aqueduct of Sylvius and constricted venous outflow. Constricted venous outflow also appears to inhibit absorption of CSF into the superior sagittal sinus. The compliance of the cortical bridging veins appears to be critical to the behaviour of the intracranial fluid system, with abnormalities at this location implicated in normal pressure hydrocephalus. The compliance associated with these vessels appears to be functional in nature and dependent on the free egress of blood out of the cranium via the extracranial venous drainage pathways. Because constricted venous outflow appears to be linked with increased aqueductal CSF pulsatility, it suggests that inhibited venous blood outflow may be altering the compliance of the cortical bridging veins.

  5. Venous Thromboembolism Within Professional American Sport Leagues.

    Science.gov (United States)

    Bishop, Meghan; Astolfi, Matthew; Padegimas, Eric; DeLuca, Peter; Hammoud, Sommer

    2017-12-01

    Numerous reports have described players in professional American sports leagues who have been sidelined with a deep vein thrombosis (DVT) or a pulmonary embolism (PE), but little is known about the clinical implications of these events in professional athletes. To conduct a retrospective review of injury reports from the National Hockey League (NHL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Football League (NFL) to take a closer look at the incidence of DVT/PE, current treatment approaches, and estimated time to return to play in professional athletes. Descriptive epidemiology study. An online search of all team injury and media reports of DVT/PE in NHL, MLB, NBA, and NFL players available for public record was conducted by use of Google, PubMed, and SPORTDiscus. Searches were conducted using the professional team name combined with blood clot , pulmonary embolism , and deep vein thrombosis . A total of 55 venous thromboembolism (VTE) events were identified from 1999 through 2016 (NHL, n = 22; MLB, n = 16; NFL, n = 12; NBA, n = 5). Nineteen athletes were reported to have an upper extremity DVT, 15 had a lower extremity DVT, 15 had a PE, and 6 had DVT with PE. Six athletes sustained more than 1 VTE. The mean age at time of VTE was 29.3 years (range, 19-42 years). Mean (±SD) time lost from play was 6.7 ± 4.9 months (range, 3 days to career end). Seven athletes did not return to play. Players with upper extremity DVT had a faster return to play (mean ± SD, 4.3 ± 2.7 months) than those with lower extremity DVT (5.9 ± 3.8 months), PE (10.8 ± 6.8 months), or DVT with PE (8.2 ± 2.6 months) ( F = 5.69, P = .002). No significant difference was found regarding time of return to play between sports. VTE in professional athletes led to an average of 6.7 months lost from play. The majority of athletes were able to return to play after a period of anticoagulation or surgery. Those with an upper extremity DVT returned to play

  6. A Case of Arterial and Venous Tear during Single Lead Extraction

    Directory of Open Access Journals (Sweden)

    Michael S. Green

    2016-01-01

    Full Text Available Transcutaneous lead extraction can be associated with significant morbidity and mortality. The risk of causing concomitant arterial and venous injury is rare. We report a case of marginal artery rupture with coronary sinus rupture after a CS lead extraction. A 71-year-old male was admitted for extraction of a 6-year-old implantable cardioverter-defibrillator lead due to fracture from insulation break. During the lead extraction, blood pressure fell precipitously and echocardiographic findings were consistent with pericardial effusion. After unsuccessful pericardiocentesis, open chest sternotomy and evacuation of hematoma was performed. Subsequent surgical repair of several injuries was completed including the distal coronary sinus, a large degloving injury of posterior portion of the heart, and first obtuse marginal branch bleed. This case demonstrates that when performing transcutaneous lead extraction (TLE with laser sheath, a degloving injury can cause arterial rupture with concomitant coronary sinus injury. A multidisciplinary team-based approach can ensure patient safety. Learning Objective. Implantable cardioverter-defibrillator leads will falter over time. With the advancement of new technology for extraction more frequent and serious complications will occur. Active fixation CS leads present unique challenges. In the presence of hemodynamic changes during extraction the occurrence of both an arterial and venous injury must be considered.

  7. Central venous catheters: the role of radiology

    International Nuclear Information System (INIS)

    Tan, P.L.; Gibson, M.

    2006-01-01

    The insertion and management of long-term venous catheters have long been the province of anaesthetists, intensive care physicians and surgeons. Radiologists are taking an increasing role in the insertion of central venous catheters (CVCs) because of their familiarity with the imaging equipment and their ability to manipulate catheters and guide-wires. The radiological management of the complications of CVCs has also expanded as a result. This article reviews the role of radiology in central venous access, covering the detection and management of their complications

  8. Intracranial developmental venous anomaly: is it asymptomatic?

    Science.gov (United States)

    Puente, A Bolívar; de Asís Bravo Rodríguez, F; Bravo Rey, I; Romero, E Roldán

    2018-03-16

    Intracranial developmental venous anomalies are the most common vascular malformation. In the immense majority of cases, these anomalies are asymptomatic and discovered incidentally, and they are considered benign. Very exceptionally, however, they can cause neurological symptoms. In this article, we present three cases of patients with developmental venous anomalies that presented with different symptoms owing to complications derived from altered venous drainage. These anomalies were located in the left insula, right temporal lobe, and cerebellum. The exceptionality of the cases presented as well as of the images associated, which show the mechanism through which the symptoms developed, lies in the low incidence of symptomatic developmental venous anomalies reported in the literature. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. [Emphysematous gastritis with concomitant portal venous air].

    Science.gov (United States)

    Jeong, Min Yeong; Kim, Jin Il; Kim, Jae Young; Kim, Hyun Ho; Jo, Ik Hyun; Seo, Jae Hyun; Kim, Il Kyu; Cheung, Dae Young

    2015-02-01

    Emphysematous gastritis is a rare form of gastritis caused by infection of the stomach wall by gas forming bacteria. It is a very rare condition that carries a high mortality rate. Portal venous gas shadow represents elevation of intestinal luminal pressure which manifests as emphysematous gastritis or gastric emphysema. Literature reviews show that the mortality rate is especially high when portal venous gas shadow is present on CT scan. Until recently, the treatment of emphysematous gastritis has been immediate surgical intervention. However, there is a recent trend of avoiding surgery because of the frequent occurrence of post-operative complications such as anastomosis leakage. In addition, aggressive surgical treatment has failed to show significant improvement in prognosis. Recently, the authors experienced a case of emphysematous gastritis accompanied by portal venous gas which was treated successfully by conservative treatment without immediate surgical intervention. Herein, we present a case of emphysematous gastritis with concomitant portal venous air along with literature review.

  10. VENOUS THROMBOEMBOLISM PROPHYLAXIS – THE OTHER ...

    African Journals Online (AJOL)

    ABSTRACT. Background: There are no local guidelines for prophylaxis against Venous Thrombo-Embolism (VTE). .... of leg ulceration in the age matched general population. (9.6% to ... number of deaths and its cause amongst these patients.

  11. Imaging of head and neck venous malformations

    International Nuclear Information System (INIS)

    Flis, Christine M.; Connor, Stephen E.

    2005-01-01

    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.)

  12. [Venous thromboembolic disease: presentation of a case].

    Science.gov (United States)

    Mirpuri-Mirpuri, P G; Álvarez-Cordovés, M M; Pérez-Monje, A

    2013-01-01

    Venous thromboembolic disease in its clinical spectrum includes both deep vein thrombosis and pulmonary thromboembolism, which is usually a complication of deep vein thrombosis. It is a relatively common disease with significant morbidity and requires an accurate diagnosis. They are numerous risk factors for venous thromboembolism, and there is evidence that the risk of thromboembolic disease increases proportionally to the number of predisposing risk factors present. The primary care physician should know the risk factors and suspect the presence of venous thromboembolic disease when there is a compatible clnical picture. The treatment for this pathology is anticoagulation. We report a patient with cardiovascular risk factors who was seen with pain in the right leg and shortness of breath and referred to the hospital with suspected venous thromboembolism, atrial fibrillation and pleural effusion. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. Fingertip replantation without venous anastomosis.

    Science.gov (United States)

    Chen, Yi-Chieh; Chan, Fuan Chiang; Hsu, Chung-Chen; Lin, Yu-Te; Chen, Chien-Tzung; Lin, Chih-Hung

    2013-03-01

    Replantation of amputated fingertips is a technical challenge, as many salvage procedures fail because no suitable vein in the fingertip is available for anastomosis. In this study, we examined our experience in fingertip replantation in cases without venous anastomosis with our established fingertip replantation treatment protocol. Between August 2002 and August 2010, a retrospective study examined all patients who had undergone fingertip replantation at Chang-Gung Memorial Hospital. All the patients (n = 24) suffered from complete digital amputations at or distal to the interphalangeal joint of the thumb, or distal to distal interphalangeal joint of the fingers. A total of 30 fingertips that were salvaged by microsurgical anastomosis of the digital arteries but not of digital veins were included in this study. On satisfactory arterial anastomosis, a 2-mm incision was made over the fingertip with a number 11 Scalpel blade, and 0.1 to 0.2 mL heparin (5000 IU/mL) was injected subcutaneously around the incision immediately and once per day thereafter to ensure continuous blood drainage from the replanted fingertip. None of the replanted nail plate was removed, and no medical leeches were used. The perfusion of the replanted digits and patient's hemoglobin level were closely monitored. The wound bleeding was maintained until physiologic venous outflow was restored. Of 30 fingertips, 27 (90%) replanted fingertips survived. The average length needed for maintaining external bleeding by chemical leech was 6.8 days (range, 5-10 days). Twelve patients (including a 2-year-old child) received blood transfusions. The average amount of blood transfusion in the 23 adults was 4.0 units (range, 0-16 units) for each patient or 3.29 units (range, 0-14 units) for each digit. A 2-year-old child received 100 mL blood transfusion or 50 mL for each digit. This study showed that a protocol that promotes controlled bleeding from the fingertip is essential to achieve consistent high

  14. Pathophysiology of spontaneous venous gas embolism

    Science.gov (United States)

    Lambertsen, C. J.; Albertine, K. H.; Pisarello, J. B.; Flores, N. D.

    1991-01-01

    The use of controllable degrees and durations of continuous isobaric counterdiffusion venous gas embolism to investigate effects of venous gas embolism upon blood, cardiovascular, and respiratory gas exchange function, as well as pathological effects upon the lung and its microcirculation is discussed. Use of N2O/He counterdiffusion permitted performance of the pathophysiologic and pulmonary microstructural effects at one ATA without hyperbaric or hypobaric exposures.

  15. MR findings of cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Myung Kwan; Chang, Kee Hyun; Han, Moon Hee; Choi, Choong Gom [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    To describe MR findings of cerebral venous sinus thrombosis. We reviewed 11 MR images of six patients with cerebral venous sinus thrombosis. The MR images were retrospectively analyzed in terms of location and signal intensity of the thrombi, parenchymal lesions such as hemorrhage and edema, and changes in follow up study obtained in 4 patients. The thrombus in venous sinus was visualized on MRI in all six patients. The most frequently involved sites were superior sagittal sinus(n=4) and left transverse sinus(n=4). Signal intensity of the thrombus was isointense or hyperintense on both T1- and T2-weighted images with loss of normal signal void of the sinus on all sequences in all patients. Parenchymal lesion was patients in five of six cases, manifested as local hemorrhage in three and edema in three cases(one case overlapped). Local edema seen in three patients was completely resolved on follow up study of seven to 29 days intervals. It is concluded that iso- or high signal intensity with loss of signal void in venous sinus is virtually diagnostic of venous sinus thrombosis. If there are local parenchymal lesions such as hemorrhage and/or edema of unknown causes, cerebral venous sinus thrombosis should be included in differential diagnosis.

  16. Venous catheterization with ultrasound navigation

    International Nuclear Information System (INIS)

    Kasatkin, A. A.; Nigmatullina, A. R.; Urakov, A. L.

    2015-01-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures

  17. Venous catheterization with ultrasound navigation

    Energy Technology Data Exchange (ETDEWEB)

    Kasatkin, A. A., E-mail: ant-kasatkin@yandex.ru; Nigmatullina, A. R. [Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation); Urakov, A. L., E-mail: ant-kasatkin@yandex.ru [Institute of Mechanics Ural Branch of Russian Academy of Sciences, T.Baramzinoy street 34, Izhevsk, Russia, 426067, Izhevsk (Russian Federation); Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation)

    2015-11-17

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  18. Venous, Arterialized-Venous, or Capillary Glucose Reference Measurements for the Accuracy Assessment of a Continuous Glucose Monitoring System.

    Science.gov (United States)

    Kropff, Jort; van Steen, Sigrid C; deGraaff, Peter; Chan, Man W; van Amstel, Rombout B E; DeVries, J Hans

    2017-11-01

    Different reference methods are used for the accuracy assessment of continuous glucose monitoring (CGM) systems. The effect of using venous, arterialized-venous, or capillary reference measurements on CGM accuracy is unclear. We evaluated 21 individuals with type 1 diabetes using a capillary calibrated CGM system. Venous or arterialized-venous reference glucose samples were taken every 15 min at two separate visits and assessed per YSI 2300 STAT Plus. Arterialization was achieved by heated-hand technique. Capillary samples were collected hourly during the venous reference visit. The investigation sequence (venous or arterialized-venous) was randomized. Effectiveness of arterialization was measured by comparing free venous oxygen pressure (PO2) of both visit days. Primary endpoint was the median absolute relative difference (ARD). Median ARD using arterialized-venous reference samples was not different from venous samples (point estimated difference 0.52%, P = 0.181). When comparing the three reference methods, median ARD was also not different over the full glycemic range (venous 9.0% [n = 681], arterialized-venous 8.3% [n = 684], and capillary 8.1% [n = 205], P = 0.216), nor over the separate glucose ranges. Arterialization was successful (PO2 venous 5.4 kPa vs. arterialized-venous 8.9 kPa, P reference measurements did not significantly impact CGM accuracy. Venous reference seems preferable due to its ease of operation.

  19. Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

    NARCIS (Netherlands)

    van Beest, Paul A.; van der Schors, Alice; Liefers, Henriette; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michael A.; Spronk, Peter E.

    2012-01-01

    Objective:  The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients. Design:  Prospective observational controlled study. Setting:  Nonacademic university-affiliated

  20. Prevalence of lower extremity venous duplication

    Directory of Open Access Journals (Sweden)

    Simpson William

    2010-01-01

    Full Text Available Purpose: This retrospective study was performed to determine the prevalence of lower extremity venous duplication using duplex ultrasound in the patient population of a large urban medical center. Materials and Methods: The reports of all lower extremity venous ultrasound examinations performed at our institution between January 1, 2002 and December 31, 2002 were reviewed. Ultrasound examinations that were performed for purposes other than the detection of lower extremity deep vein thrombosis were excluded. The prevalence of duplication and its specific location were recorded. In addition, the prevalence of thrombus and its specific location were also recorded. Results: A total of 3118 exams were performed in 2664 patients. Of the 2664 patients, 2311 had only one examination performed during the study period; 353 patients had more than one examination performed. We found that 10.1% of patients (270/2664 had at least one venous segment duplicated and 5.4% of patients (143/2664 had a thrombus in at least one venous segment. There was a statistically significant difference in the prevalence of both duplication and thrombus with a change in venous segment. Only 0.4% of patients (11/2664 had thrombus within a duplicated segment. Of those who had more than one examination performed, 15.3% (54/353 had the same venous segment(s seen on one examination but not another. Conclusion: Lower extremity venous duplication is a frequent anatomic variant that is seen in 10.1% of patients, but it may not be as common as is generally believed. It can result in a false negative result for deep vein thrombosis.

  1. Cerebral venous thrombosis due to cryptogenic organising pneumopathy with antiphospholipid syndrome worsened by heparin-induced thrombocytopenia.

    Science.gov (United States)

    Hsieh, J; Kuzmanovic, I; Vargas, M I; Momjian-Mayor, I

    2013-07-09

    Cerebral venous thrombosis (CVT) has usually been ascribed to prothrombotic conditions, oral contraceptives, pregnancy, malignancy, infection, head injury or mechanical precipitants. The case reported here illustrates two rare causes of CVT observed in the same patient: the presence of antiphospholipid antibodies associated with an asymptomatic cryptogenic organising pneumopathy (COP) which were considered the origin of the venous cerebral thrombosis and heparin-induced thrombocytopenia (HIT) which was responsible for the worsening of the thrombosis observed a few days after the introduction of treatment. Moreover, we provide here additional positive experience in the treatment of both, CVT and HIT, by fondaparinux with bridging to warfarin given their successful evolution under this anticoagulant option.

  2. Racial differences in venous thromboembolism.

    Science.gov (United States)

    Zakai, N A; McClure, L A

    2011-10-01

    The incidence of venous thrombosis (VTE) varies by race, with African-Americans having over 5-fold greater incidence than Asian-ancestry populations, and an intermediate risk for European and Hispanic populations. Known racial differences in genetic polymorphisms associated with thrombosis do not account for this gradient of risk, nor do known racial variations in environmental risk factors. Data on the incidence of and risk factors for VTE outside of Europe and North America and in non-European ancestry populations are sparse. Common genetic polymorphisms in European-Ancestry populations, such as factor V Leiden and prothrombin G20210A, and environmental risk factors, such as obesity, may account for some of the increased risk in European populations, and high factor VIII, high von Willebrand factor and low protein C levels and increased prevalence of obesity may explain some of the increased risk in African-Americans. The low rates in Asian populations may be partially explained by low clinical suspicion in a perceived low-risk population and lack of access to healthcare in other populations. As risk factors for thrombosis, such as surgery and treatment for cancer, are applicable to more people, as obesity increases in prevalence in the developing world, and as surveillance systems for VTE improve, VTE may increase in previously low-risk populations. While differences in VTE by race due to genetic predisposition will probably always be present, understanding the reasons for racial differences in VTE will help providers develop strategies to minimize VTE in all populations. © 2011 International Society on Thrombosis and Haemostasis.

  3. Central venous obstruction in the thorax

    International Nuclear Information System (INIS)

    Collin, G.; Jones, R.G.; Willis, A.P.

    2015-01-01

    Central venous stenosis and occlusion can occur secondary to a spectrum of conditions ranging from aggressive malignancy to benign extrinsic anatomical compression in otherwise healthy individuals. Irrespective of aetiology, significant morbidity in the acute setting and long term can occur unless prompt accurate diagnosis and appropriate management is initiated, the radiologist being central to both. The present review will provide radiologists with a thorough illustration and explanation of the range of central venous conditions in the thorax (including deep vein thrombosis, thoracic outlet syndrome, haemodialysis, and malignancy related causes), the salient imaging findings and interventional management using case examples from the authors' practice. - Highlights: • We show a range of causes of central venous disease in the thorax. • We provide information about different imaging and management strategies. • We show several cases with successes and complications of endovascular management

  4. The Essentials of Parathyroid Hormone Venous Sampling

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology, NYU School of Medicine (United States); Trerotola, Scott O., E-mail: streroto@uphs.upenn.edu [Perelman School of Medicine of the University of Pennsylvania, Department of Radiology (United States); Sacks, Barry, E-mail: bsacks@bidmc.harvard.edu [Beth Israel Deaconess Medical Center, Department of Interventional Radiology (United States); Oklu, Rahmi, E-mail: oklu.rahmi@mayo.edu [Mayo Clinic, Department of Interventional Radiology (United States); Deipolyi, Amy, E-mail: deipolya@mskcc.org [Memorial Sloan Kettering Cancer Center, Department of Radiology (United States)

    2017-01-15

    Hyperparathyroidism is an excess of parathyroid hormone in the blood due to over-activity of one or more parathyroid gland. Localization of abnormal glands with noninvasive imaging modalities, such as technetium sestamibi scan and cross-sectional imaging, has a high success rate. Parathyroid venous sampling is performed for patients with persistent or recurrent disease after previous parathyroid surgery, when repeat noninvasive imaging studies are negative or discordant. The success of invasive localization studies and results interpretation is dependent on the interventional radiologist’s understanding of the normal and ectopic anatomic locations of parathyroid glands, as well as their blood supply and venous drainage. Anatomic and technical considerations for selective parathyroid venous sampling are reviewed.

  5. Complications of central venous stenosis due to permanent central venous catheters in children on hemodialysis.

    Science.gov (United States)

    Rinat, Choni; Ben-Shalom, Efrat; Becker-Cohen, Rachel; Feinstein, Sofia; Frishberg, Yaacov

    2014-11-01

    Central venous catheters are frequently used as access for hemodialysis (HD) in children. One of the known complications is central venous stenosis. Although this complication is not rare, it is often asymptomatic and therefore unacknowledged. Superior vena cava (SVC) stenosis is obviously suspected in the presence of upper body edema, but several other signs and symptoms are often unrecognized as being part of this syndrome. We describe four patients with various manifestations of central venous stenosis and SVC syndrome. These sometimes life- or organ-threatening conditions include obstructive sleep apnea, unresolving stridor, increased intracranial pressure, increased intraocular pressure, right-sided pleural effusion, protein-losing enteropathy and lymphadenopathy. The temporal relationship of these complications associated with the use of central venous catheters and documentation of venous stenosis, together with their resolution after alleviation of high venous pressure, points to a causal role. We suggest pathophysiological mechanisms for the formation of each of these complications. In patients with occlusion of the SVC, various unexpected clinical entities can be caused by high central venous pressure. As often the etiology is not obvious, a high index of suspicion is needed as in some cases prompt alleviation of the high pressure is mandatory.

  6. [Superficial venous thrombosis. A state of art].

    Science.gov (United States)

    Sándor, Tamás

    2017-01-01

    For a long time superficial thrombophlebitis has been thought to be a rather benign condition. Recently, when duplex ultrasound technique is used for the diagnosis more and more often, the disease is proved to be more dangerous than anticipated. Thrombosis propagates to the deep veins in 6-44% and pulmonary embolism was observed on the patients in 1,5-33%. We can calculate venous thromboembolic complications on every fourth patient. Diagnosis is clinical, but duplex ultrasound examination is mandatory, for estimation of the thrombus extent, for exclusion of the deep venous thrombosis and for follow up. Both legs should be checked with ultrasound, because simultaneous deep venous thrombosis can develop on the contralateral limb. Two different forms can be distinguished: superficial venous thrombosis with, or without varicose veins. In cases of spontaneous, non varicous form, especially when the process is migrating or recurrent, a careful clinical examination is necessery for exclusion of malignant diseases and thrombophilia. The treatment options are summarised on the basis of recent international consensus statements. The American and German guidelines are similar. Compression and mobilisation are cornerstones of the therapy. For a short segment thrombosis non steroidal antiinflammatory drugs are effective. For longer segments low molecular-weight heparins are preferred. Information on the effect of the novel oral anticoagulants for the therapy is lacking but they may appear to be effective in the future for this indication. When thrombus is close to the sapheno-femoral or sapheno-popliteal junction crossectomy (high ligation), or low molecular-weight heparin in therapeutic doses are indicated. The term superficial thrombophlebitis should be discouraged, because inflammation and infection is not the primary pathology. It should be called correctly superficial venous thrombosis in order to avoid the unnecessary administration of antibiotics and the misconception

  7. 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. © 2015 American Heart Association, Inc.

  8. Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; Hiltunen, Sini; Tatlisumak, Turgut; Peters, Guusje M.; Silvis, Suzanne M.; Haapaniemi, Elena; Kruyt, Nyika D.; Putaala, Jukka; Coutinho, Jonathan M.

    2016-01-01

    Background and Purpose-Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis. Methods-Consecutive adult patients with cerebral venous thrombosis were included

  9. Human cerebral venous outflow pathway depends on posture and central venous pressure

    DEFF Research Database (Denmark)

    Gisolf, J; van Lieshout, J J; van Heusden, K

    2004-01-01

    Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R(2) = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the primary pathway...

  10. Pregnancy-related venous thromboembolism and risk of occult cancer

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Veres, Katalin; Horváth-Puhó, Erzsébet

    2017-01-01

    The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected. An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk.......The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected. An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk....

  11. Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates.

    Science.gov (United States)

    Ainsworth, S B; Clerihew, L; McGuire, W

    2007-07-18

    Parenteral nutrition for neonates may be delivered via a short peripheral cannula or a central venous catheter. The latter may either be inserted via the umbilicus or percutaneously. Because of the complications associated with umbilical venous catheter use, many neonatal units prefer to use percutaneously inserted catheters following the initial stabilisation period. The method of parenteral nutrition delivery may affect nutrient input and consequently growth and development. Although potentially more difficult to place, percutaneous central venous catheters may be more stable than peripheral cannulae, and need less frequent replacement. These delivery methods may also be associated with different risks of adverse events, including acquired systemic infection and extravasation injury. To determine the effect of infusion via a percutaneous central venous catheter versus a peripheral cannula on nutrient input, growth and development, and complications including systemic infection, or extravasation injuries in newborn infants who require parenteral nutrition. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (1966 - February 2007), EMBASE (1980 - February 2007), conference proceedings, and previous reviews. Randomised controlled trials that compared the effect of delivering parenteral nutrition via a percutaneous central venous catheter versus a peripheral cannulae in neonates. Data were extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using relative risk, risk difference and mean difference. Four trials eligible for inclusion were found. These trials recruited a total of 368 infants and reported a number of different outcomes. One study showed that the use of a percutaneous

  12. Congenital absence of infrarenal IVC and iliac venous system : Unusual collateral Pathways

    International Nuclear Information System (INIS)

    Lee, Jin Joo; Lee, Byung Hee; Kim, Kie Hwan; Do, Young Soo; Chin, Soo Yil

    1994-01-01

    We present a case with congenital absence of the infrarenal portion of inferior vena cava and iliac venous system, showing unusual venous collaterals including the left ovarian venous collateral via parametrial venous complex, and a mesenteric-periureteric venous connection. The venous collateral pathways were demonstrated by computed tomography and venography

  13. Mechanochemical endovenous ablation and new frontiers in venous intervention

    NARCIS (Netherlands)

    Boersma, D

    2017-01-01

    Venous insufficiency of the lower extremities is a common condition and related to various symptoms, including venous ulcers. The effect of venous insufficiency on patients’ health-related quality of life is substantial and comparable with other chronic diseases such as arthritis, diabetes, and

  14. Erythrocytes and von Willebrand factor in venous thrombosis

    NARCIS (Netherlands)

    Smeets, M.W.J.

    2018-01-01

    Venous thromboembolism represents the third leading vascular disease after myocardial infarction and stroke. Erythrocytes, the most abundant cells in venous thrombi, were thought to be innocent bystanders that become tangled up in the fibrin mesh of venous thrombi. However, this thesis describes

  15. Contribution of MRI in supracardiac total anomalous pulmonary venous drainage

    International Nuclear Information System (INIS)

    Kastler, B.; Germain, P.; Gangi, A.; Klinkert, A.; Dietemann, J.L.; Wackenheim, A.; Livolsi, A.; Willard, D.

    1992-01-01

    A case of supracardiac total anomalous pulmonary venous drainage (TAPVD) in an infant aged 2 1/2 months is presented. Diagnosis was established non invasively by magnetic resonance image (MRI). Not only did MRI precisely depict the anomalous venous pathway but it moreover securely excluded pulmonary venous obstruction. (orig.)

  16. Diagnostics of defeats of venous collectors of brain

    International Nuclear Information System (INIS)

    Timofeeva, T.V.; Polunina, I.S.; Shcherbakova, E.Ya.; Kuldakova, S.V.

    1997-01-01

    Comparative data of transcranial ultrasonic dopplerography (170 patients) and radionuclidous antroscintigraphy (124), received during diagnostics of defects of venous collectors of brain are analyzed. Five variants of defeats of venous collectors (cross, sigmoid, internal of jugular of jugular vein), but also unpaired sine (direct, confluent) are described. Received results permit to reveal interrelation of infringements of venous outflow and increase of intracranial pressure

  17. Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Prince Cheriyan Modayil

    2009-01-01

    Full Text Available Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

  18. A Novel Stretch Sensor to Measure Venous Hemodynamics

    Directory of Open Access Journals (Sweden)

    Syrpailyne Wankhar

    2018-07-01

    Full Text Available Chronic venous insufficiency is a debilitating condition causing varicose veins and venous ulcers. The pathophysiology includes reflux and venous obstruction. The diagnosis is often made by clinical examination and confirmed by Venous Doppler studies. Plethysmography helps to quantitatively examine the reflux and diagnose the burden of deep venous pathology to better understand venous hemodynamics, which is not elicited by venous duplex examination alone. However, most of these tests are qualitative, expensive, and not easily available. In this paper, we demonstrate the potential use of a novel stretch sensor in the assessment of venous hemodynamics during different maneuvers by measuring the change in calf circumference. We designed the stretch sensor by using semiconductor strain gauges pasted onto a small metal bar to form a load cell. The elastic and Velcro material attached to the load cell form a belt. It converts the change in limb circumference to a proportional tension (force of distension when placed around the calf muscle. We recorded the change in limb circumference from arrays of stretch sensors by using an in-house data acquisition system. We calculated the venous volume (VV, venous filling index (VFI, ejection fraction (EF and residual venous volume (RVV on two normal subjects and on two patients to assess venous hemodynamics. The values (VV > 60 ml, VFI 60%, RVV 2ml/s, EF 35% in patients were comparable to those reported in the literature.

  19. The use of arteriovenous anastomosis for venous drainage during Tamai zone I fingertip replantation.

    Science.gov (United States)

    Wu, Fei; Shen, Xiaofang; Eberlin, Kyle R; Sun, Zhibo; Zhou, Xiao; Xue, Mingyu

    2018-03-27

    The purpose of this study was to evaluate outcomes for patients sustaining a distal fingertip amputation who underwent replantation witharteriovenous anastomosis for venous drainage over a one year period at our institution. This technique has been utilized when insufficient veins are identified in the amputated part for standard veno-venous anastomosis. A retrospective study was performed on patients presenting from 2013 to 2014. Guillotine, crush, and avulsion/degloving injuries were included if they underwent fingertip (Tamai Zone I) replantation with arterial anastomosis for vascular inflow and arteriovenous anastomosis for venous drainage. The cases were further classified as Ishikawa subzone I and subzone II. Arteriovenous anastomosis for venous drainage during replantation was used in 45 digits in 35 patients. 41 of the 45 digits underwent successful replantation using this technique (91%). The mean active ROM in the DIP joint of the fingers and in the IP joint of thumbs was 65° and 57°, respectively. Sensory evaluation demonstrated a mean of 6.9 mm s2PD in digits where the digital nerves could be repaired. 11 replanted digits without nerve repair regained some sensory recovery with a mean of 9.6 mm s2PD. 91% of patients were highly satisfied with the appearance of the replanted digits based on Tamai criteria. Arteriovenous anastomosis for venous outflow should be considered during zone I fingertip replantation if sufficient veins are not identified in the amputated part. This technique may allow for more routine and successful distal replantation. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Investigation of cerebral venous outflow in microgravity.

    Science.gov (United States)

    Taibi, A; Gadda, G; Gambaccini, M; Menegatti, E; Sisini, F; Zamboni, P

    2017-10-31

    The gravitational gradient is the major component to face when considering the physiology of venous return, and there is a growing interest in understanding the mechanisms ensuring the heart filling, in the absence of gravity, for astronauts who perform long-term space missions. The purpose of the Drain Brain project was to monitor the cerebral venous outflow of a crew member during an experiment on the International Space Station (ISS), so as to study the compensatory mechanisms that facilitate this essential physiological action in subjects living in a microgravity environment. Such venous function has been characterized by means of a novel application of strain-gauge plethysmography which uses a capacitive sensor. In this contribution, preliminary results of our investigation have been presented. In particular, comparison of plethysmography data confirmed that long duration spaceflights lead to a redistribution of venous blood volume, and showed interesting differences in the amplitude of cardiac oscillations measured at the level of the neck veins. The success of the experiment has also demonstrated that thanks to its easy portability, non-invasiveness, and non-operator dependence, the proposed device can be considered as a novel tool for use aboard the ISS. Further trials are now under way to complete the investigation on the drainage function of the neck veins in microgravity.

  1. Pediatric central venous access devices: nursing interventions

    Directory of Open Access Journals (Sweden)

    Duffy EA

    2017-05-01

    Full Text Available Elizabeth A Duffy, Kathryn N Nelson Department of Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, MI, USA Abstract: A central venous catheter (CVC is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study 

  2. Thermodilution-determined Internal Jugular Venous Flow

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Widmer, Mario; Hilty, Matthias P

    2017-01-01

    PURPOSE: Cerebral blood flow (CBF) increases ~20% during whole body exercise although a Kety-Schmidt-determined CBF is reported to remain stable; a discrepancy that could reflect evaluation of arterial vs. internal jugular venous (IJV) flow and/or that CBF is influenced by posture. Here we test...

  3. Global public awareness of venous thromboembolism

    NARCIS (Netherlands)

    Wendelboe, A. M.; McCumber, M.; Hylek, E. M.; Buller, H.; Weitz, J. I.; Raskob, G.; Angchaisuksiri, P.; Blanco, A. N.; Hunt, B. J.; Kakkar, A.; Konstantinides, S. V.; McLintock, C.; Ozaki, Y.

    2015-01-01

    Data on public awareness about thrombosis in general and venous thromboembolism (VTE) in particular are limited. We aimed to measure the global awareness of thrombosis to address this gap. With Ipsos-Reid, from 22 July to 5 August 2014, we surveyed 800 respondents in their native language from each

  4. Central Venous Occlusion in the Hemodialysis Patient.

    Science.gov (United States)

    Krishna, Vinay Narasimha; Eason, Joseph B; Allon, Michael

    2016-11-01

    Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS. Previously unsuspected CVS may become symptomatic after placement of an ipsilateral vascular access. The likelihood of symptomatic CVS may be affected by the central venous catheter (CVC) location; CVC side; duration of CVC dependence; type, location, and blood flow of the ipsilateral access; and extent of collateral veins. Venous angiography is the gold standard for diagnosis. Percutaneous transluminal angioplasty and stent placement can improve the stenosis and alleviate symptoms, but CVS typically recurs frequently, requiring repeated interventions. Refractory symptomatic CVS may require ligation of the ipsilateral vascular access. Because no available treatment option is curative, the goal should be to prevent CVS by minimizing catheters and central vein instrumentation in patients with chronic kidney disease and dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. Travel and venous thrombosis: a systematic review

    NARCIS (Netherlands)

    Kuipers, S.; Schreijer, A. J. M.; Cannegieter, S. C.; Bueller, H. R.; Rosendaal, F. R.; Middeldorp, S.

    2007-01-01

    In the past decade, numerous publications on the association between venous thrombosis (VT) and travel have been published. Relative and absolute risks of VT after travel, and particularly after travel by air, have been studied in case-control and observational follow-up studies, whereas the effect

  6. Venous thromboembolism: Risk profile and management of ...

    African Journals Online (AJOL)

    Objectives. This study aims to describe the venous thromboembolism (VTE) risk profile of women undergoing elective gynaecological surgery in a tertiary hospital and to audit the VTE prophylaxis prescribed. Methods. One hundred and nine women who underwent elective gynaecological surgery at Kalafong Provincial ...

  7. Urethro-venous intravasation during urethrography

    African Journals Online (AJOL)

    J.M. Ratkal

    Abstract. Retrograde urethrography is a procedure used to evaluate urethral strictures. Urethro-venous intravasation, rarely seen during retrograde urethrography, can result in bacteremia, adverse reactions to contrast agents, renal failure and even pulmonary embolism. We report one such case of a male patient who ...

  8. REVIEW ARTICLE Venous thromboembolism associated with ...

    Indian Academy of Sciences (India)

    Navya

    2017-03-24

    Mar 24, 2017 ... It has been long recognized that reduced PS activity is a risk factor for venous .... individual had PS deficiency type I but was unavailable for DNA .... Influence of PROS1 gene mutations affecting protein S amino-acid 275 on ...

  9. Knowledge, attitude and practice of venous thromboembolism ...

    African Journals Online (AJOL)

    USER

    We aimed to assess the knowledge, attitude and practice of prophylaxis in venous thromboembolism among medical doctors in Usmanu Danfodiyo University Teaching Hospital,. Sokoto, North-West Nigeria. Methodology: The knowledge, attitude and practice of VTE prophylaxis among medical doctors was assessed using ...

  10. Use of computer-assisted design and manufacturing to localize dural venous sinuses during reconstructive surgery for craniosynostosis.

    Science.gov (United States)

    Iyer, Rajiv R; Wu, Adela; Macmillan, Alexandra; Musavi, Leila; Cho, Regina; Lopez, Joseph; Jallo, George I; Dorafshar, Amir H; Ahn, Edward S

    2018-01-01

    Cranial vault remodeling surgery for craniosynostosis carries the potential risk of dural venous sinus injury given the extensive bony exposure. Identification of the dural venous sinuses can be challenging in patients with craniosynostosis given the lack of accurate surface-localizing landmarks. Computer-aided design and manufacturing (CAD/CAM) has allowed surgeons to pre-operatively plan these complex procedures in an effort to increase reconstructive efficiency. An added benefit of this technology is the ability to intraoperatively map the dural venous sinuses based on pre-operative imaging. We utilized CAD/CAM technology to intraoperatively map the dural venous sinuses for patients undergoing reconstructive surgery for craniosynostosis in an effort to prevent sinus injury, increase operative efficiency, and enhance patient safety. Here, we describe our experience utilizing this intraoperative technology in pediatric patients with craniosynostosis. We retrospectively reviewed the charts of children undergoing reconstructive surgery for craniosynostosis using CAD/CAM surgical planning guides at our institution between 2012 and 2016. Data collected included the following: age, gender, type of craniosynostosis, estimated blood loss, sagittal sinus deviation from the sagittal suture, peri-operative outcomes, and hospital length of stay. Thirty-two patients underwent reconstructive cranial surgery for craniosynostosis, with a median age of 11 months (range, 7-160). Types of synostosis included metopic (6), unicoronal (6), sagittal (15), lambdoid (1), and multiple suture (4). Sagittal sinus deviation from the sagittal suture was maximal in unicoronal synostosis patients (10.2 ± 0.9 mm). All patients tolerated surgery well, and there were no occurrences of sagittal sinus, transverse sinus, or torcular injury. The use of CAD/CAM technology allows for accurate intraoperative dural venous sinus localization during reconstructive surgery for craniosynostosis and

  11. Venous infraction of developmental venous anomaly: A case report with perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Youn; Kim, Hye Jeong; Hyun, Su Jeong; Kim, Hee Yeong; Kim, Han Myun; Hwang, Ji Young; Hong, Hye Suk; Woo, Ji Young; Yang, Ik [Dept. of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of); Kim, Eun Soo [Dept. of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)

    2017-06-15

    Developmental venous anomaly (DVA) is a common congenital venous malformation characterized by dilated medullary veins in caput medusa configuration and a draining vein. Despite the high incidence of DVAs, they are benign anatomic variations and rarely cause symptoms. Here, we report computed tomography and magnetic resonance imaging findings with perfusion images of acute infarction from underlying DVA in a 63-year-old female patient who presented with acute onset of neurologic symptoms and recovered without any neurologic deficit.

  12. CT findings of posterior fossa venous angiomas

    International Nuclear Information System (INIS)

    Satoh, Toru; Kinugasa, Kazushi; Nishimoto, Akira; Nishimoto, Ken.

    1986-01-01

    Three cases of posterior fossa venous angiomas were reported, with some comments on the CT findings. Case 1: A 53-year-old woman was admitted for the further examination of a viral meningitis which had appeared three months before. Neurological examination revealed no abnormality. Vertebral angiography, however, demonstrated numerous fine medullary veins, with an enlarged intraparenchymal draining vein, in the right cerebellum; they drained into the petrosal vein, which was characteristic of venous angioma. On the plain CT, part of the draining vein was identified as a slightly high-density node. A curvilinear draining vein was demonstrated by the enhanced CT. Case 2: A 29-year-old man was admitted complaining of headache, vomiting, and atxia. Neurological examination disclosed truncal ataxia. The enhanced CT demonstrated two distinct nodules on the anterior border of the hematoma in the deep median cerebellum, probably corresponding to the draining veins. On the angiogram, a venous angioma was found in the bilateral cerebellum; it drained into the precentral cerebellar veins and ultimately joined the straight sinus via the precentro-vermo-rectal vein. Case 3: A 4-year-old boy was admitted suffering from headache, vomiting, and ataxia. Neurological examination disclosed a co-ordination disturbance of the left side. The enhanced CT demonstrated a curvilinear structure inside the hematoma. Angiography showed a venous angioma in the left cerebellum which drained into the petrosal vein. Computerized angiotomography delineated the characteristic venous structure on the angiogram as many fine, high-density lines (medullary veins) converging to a large intraparenchymal linear structure (central medullary vein) and then to a superficial cortical vein. In all cases, large intraparenchymal draining veins were identified by the conventional CT. (J.P.N.)

  13. Anticoagulation period in idiopathic venous thromboembolism

    International Nuclear Information System (INIS)

    Farraj, Rami S.

    2004-01-01

    The period of anticoagulation of a first episode of idiopathic venous thromboembolism has been 6 months. It is unclear if such patients would benefit from longer treatment, as there appears to be an increased risk of recurrence after anticoagulation is stopped. In a randomized prospective study of 64 patients admitted to King Hussein Medical city, Amman, Jordan, who developed a first episode of venous thromboembolism, 32 patients were given warfarin for 24-months, while 32 patients stopped anticoagulation after completion of 6-months of therapy. Our goal was to determine the effects of extended anticoagulation on rates of recurrence of symptomatic venous thromboembolism and bleeding. The patients were followed for 12-months after stopping anticoagulation. After 24-months, 7 of the 32 patients (21%) who had standard anticoagulation for 6-months had a recurrent episode of thromboembolism compared to one of the 32 patients who received anticoagulation for 24 months (3%). Extended warfarin therapy for 24-months has resulted in an absolute risk reduction of 0.1% (p<0.05). This translates into 8 patients having to be treated for 24-months to avoid one recurrence without increasing the risk of major bleeding. Two patients in each group (6%) had major nonfatal bleeding, all 4 bleeding episodes occurring within the first 3-months of anticoagulation. After 36-months of follow up, the recurrence rate of extended warfarin therapy was only 3 patients (9%), which is a 43% relative reduction in recurrence of thromboembolism compared to standard therapy for 6-months. Patients with first episodes of idiopathic venous thromboembolism have an increased risk of recurrent venous thromboembolism and should be treated with oral anticoagulants for longer than 6-months, probably 24-months. (author)

  14. Computed tomographic manifestations of abdominal and pelvic venous collaterals

    International Nuclear Information System (INIS)

    Pagani, J.J.; Thomas, J.L.; Bernardino, M.E.

    1982-01-01

    Obstruction of blood flow through the inferior vena cava and portal vein may produce venous collaterals. These include the paravertebral venous system and its communications with the ascending lumbar veins and azygous/hemiazygous system; gonadal, periureteric, and other retroperitoneal veins; abdominal wall veins; hemorrhoidal venous plexus; and the portal venous system. The anatomic location of these vessels is discussed. Computed tomography demonstrates them as round or tubular structures that are isodens when compared with other venous structures following contrast material administration. Techniques of examination and methods of differentiation of these vascular structures from other abnormalities, especially lymphadenopathy, are discussed

  15. Normal venous anatomy and physiology of the lower extremity.

    Science.gov (United States)

    Notowitz, L B

    1993-06-01

    Venous disease of the lower extremities is common but is often misunderstood. It seems that the focus is on the exciting world of arterial anatomy and pathology, while the topic of venous anatomy and pathology comes in second place. However, venous diseases such as chronic venous insufficiency, leg ulcers, and varicose veins affect much of the population and may lead to disability and death. Nurses are often required to answer complex questions from the patients and his or her family about the patient's disease. Patients depend on nurses to provide accurate information in terms they can understand. Therefore it is important to have an understanding of the normal venous system of the legs before one can understand the complexities of venous diseases and treatments. This presents an overview of normal venous anatomy and physiology.

  16. Evaluation of hepatic venous pulsatility and portal venous velocity with doppler ultrasonography during the puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Pekindil, Goekhan [Department of Radiology, Trakya University School of Medicine, 22030 Edirne (Turkey); Varol, Fuesun G. [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey); Ali Yuece, M. [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey); Yardim, Turgut [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey)

    1999-03-01

    Objective: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. Methods and material: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the 6th and 8th weeks postpartum. Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. Results: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17% had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. Conclusion: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium, these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period.

  17. Evaluation of hepatic venous pulsatility and portal venous velocity with doppler ultrasonography during the puerperium

    International Nuclear Information System (INIS)

    Pekindil, Goekhan; Varol, Fuesun G.; Ali Yuece, M.; Yardim, Turgut

    1999-01-01

    Objective: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. Methods and material: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the 6th and 8th weeks postpartum. Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. Results: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17% had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. Conclusion: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium, these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period

  18. Lower extremity arterial and venous ulcers.

    Science.gov (United States)

    Sieggreen, Mary

    2005-06-01

    The prevalence of peripheral arterial disease in the general population is high, but the awareness of primary care providers of the disease process is low. The disease is not recognized by primary care providers. Early recognition and treatment of venous diseases that progress to postphlebotic syndrome, such as after a deep vein thrombosis, will prevent venous ulcers that add considerable expense to the health care system. Vascular assessment, including routine ABI measurement of patients who are in risk categories for vascular disease will identify those patients so that prevention programs can be put into place early. Major contributions to the understanding and management of leg ulcers and wound healing have been made in the last decade. However, there is still confusion as to the exact mechanism behind ulcer development and the best method to manage, cure,and prevent these ulcers has yet to be found.

  19. Epidural venous stasis in spinal stenosis

    International Nuclear Information System (INIS)

    Kaiser, M.C.; Capesius, P.; Poos, D.; Gratia, G.; Roilgen, A.; Sandt, G.

    1984-01-01

    Computed tomography permits reliable demonstration of the spinal canal and its contents. Measurements of the sagittal diameter of the bony canal do not take into consideration size, shape and state of intraspinal soft tissue structures, i.e. the thecal sac and its own contents, epidural fat and blood circulation pattern. Three particularly illustrative cases were selected in which obvious epidural venous engorgement was visualized in association with spinal stenosis. The authors think that epidural venous stasis occuring in segmental spinal stenosis is a CT sign of clinically significant narrowing of the neural canal. Accurate recognition of the type of lumbar stenosis together with epidural blood flow alterations permits a better understanding of the existing lesions. Thus, a more precise and specific surgical approach is possible. (orig.)

  20. Deep venous thrombophlebitis following aortoiliac reconstructive surgery

    International Nuclear Information System (INIS)

    Reilly, M.K.; McCabe, C.J.; Abbott, W.M.; Brewster, D.C.; Moncure, A.C.; Reidy, N.C.; Darling, R.C.

    1982-01-01

    One hundred patients undergoing elective aortic surgery were scanned prospectively for development of deep venous thrombosis (DVT). The incidence of DVT in this population was 13%. Eleven patients showed only calf vein thrombosis on venography, whereas two had occlusive iliofemoral thrombus. The correlation between venous Doppler ultrasound and venography was 80%. More importantly, Doppler examination correctly identified both patients with occlusive thrombus. Fibrinogen scanning was associated with a false-positive rate of 31%. Only one patient suffered a nonfatal pulmonary embolus. Fibrinogen scanning has an unacceptably high false-positive rate; however, Doppler ultrasound will identify significant occlusive thrombus without a high false-positive rate. The low incidence of pulmonary emboli does not warrant such definitive measures as prophylactic vena caval interruption

  1. Cerebral venous thrombosis associated with sildenafil intake

    International Nuclear Information System (INIS)

    Miranda Hernández, José Luis; Fernández Cué, Leda; Garzón Cutiño, Lisbel; Gómez Viera, Nelson; Pérez Esquivel, Lianet

    2016-01-01

    A 59 year-old male patient with a history of hypertension and regular consumption of sildenafil entered the service because of acute stroke and headache seizure. Physical examination detected left hemiplegia. By skull nuclear gadolinium magnetic resonance, an expansive lesion is observed which caught heterogeneously contrast. Possible diagnosis of high-grade brain glioma was raised. Right frontoparietal craniotomy was performed and a tumor lesion was not visualized. After ruling out the presence of high-grade glioma, the diagnosis of hemorrhagic venous infarction was assessed. CT angiography and clotting was made to rule out prothrombotic states to justify this disease entity. Special hematology studies were within normal values. The case was concluded as a venous sinus thrombosis associated with the use of sildenafil. (author)

  2. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  3. Epidemiology of cancer-related venous thromboembolism

    OpenAIRE

    Wun, Ted; White, Richard H.

    2009-01-01

    Recent studies have better defined the epidemiology of venous thromboembolism (VTE) in cancer patients. The incidence is highest in patients who have metastatic disease at the time of presentation and who have fast growing, biologically aggressive cancers associated with a poor prognosis. The incidence is also high in patients with haematological cancers. Other specific risk factors that affect the incidence of VTE include undergoing invasive neurosurgery, the number of underlying chronic co-...

  4. Bilateral Pneumothoraces Following Central Venous Cannulation

    OpenAIRE

    Pazos, F.; Masterson, K.; Inan, C.; Robert, J.; Walder, B.

    2009-01-01

    We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right ...

  5. Parenchymal abnormalities associated with developmental venous anomalies

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego; Gailloud, Philippe [Johns Hopkins Hospital, Division of Interventional Neuroradiology, Baltimore, MD (United States); Delavelle, Jacqueline [Geneva University Hospital, Neuroradiology Section, Department of Radiology and Medical Informatics, Geneva (Switzerland); Yilmaz, Hasan; Ruefenacht, Daniel A. [Geneva University Hospital, Section of Interventional Neuroradiology, Department of Clinical Neurosciences, Geneva (Switzerland); Piovan, Enrico; Bertramello, Alberto; Pizzini, Francesca [Verona City Hospital, Service of Neuroradiology, Verona (Italy)

    2007-12-15

    To report a retrospective series of 84 cerebral developmental venous anomalies (DVAs), focusing on associated parenchymal abnormalities within the drainage territory of the DVA. DVAs were identified during routine diagnostic radiological work-up based on magnetic resonance imaging (MRI) (60 cases), computed tomography (CT) (62 cases) or both (36 cases). Regional parenchymal modifications within the drainage territory of the DVA, such as cortical or subcortical atrophy, white matter density or signal alterations, dystrophic calcifications, presence of haemorrhage or a cavernous-like vascular malformation (CVM), were noted. A stenosis of the collecting vein of the DVA was also sought for. Brain abnormalities within the drainage territory of a DVA were encountered in 65.4% of the cases. Locoregional brain atrophy occurred in 29.7% of the cases, followed by white matter lesions in 28.3% of MRI investigations and 19.3% of CT investigations, CVMs in 13.3% of MRI investigations and dystrophic calcification in 9.6% of CT investigations. An intracranial haemorrhage possibly related to a DVA occurred in 2.4% cases, and a stenosis on the collecting vein was documented in 13.1% of cases. Parenchymal abnormalities were identified for all DVA sizes. Brain parenchymal abnormalities were associated with DVAs in close to two thirds of the cases evaluated. These abnormalities are thought to occur secondarily, likely during post-natal life, as a result of chronic venous hypertension. Outflow obstruction, progressive thickening of the walls of the DVA and their morphological organization into a venous convergence zone are thought to contribute to the development of venous hypertension in DVA. (orig.)

  6. Congenital pseudoarthrosis associated with venous malformation

    International Nuclear Information System (INIS)

    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N.; Hamamy, H.; Al-Hadidi, S.

    2007-01-01

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  7. Congenital pseudoarthrosis associated with venous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N. [Jordan University Hospital, Radiology Department, P.O. Box 340621, Amman (Jordan); Hamamy, H. [Endocrinology and Genetics, National Center for Diabetes, Amman (Jordan); Al-Hadidi, S. [Jordan University Hospital, Departments of Orthopedics, Amman (Jordan)

    2007-06-15

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  8. Inflammation and peripheral venous disease. The San Diego Population Study.

    Science.gov (United States)

    Cushman, M; Callas, P W; Allison, M A; Criqui, M H

    2014-09-02

    The inflammatory response to healing in venous thrombosis might cause vein damage and post-thrombotic syndrome. Inflammation may also be involved in venous insufficiency apart from deep-vein thrombosis. We studied the association of inflammation markers with venous insufficiency in a general population sample. We characterised 2,404 men and women in a general population cohort for peripheral venous disease and its severity using physical exam, symptom assessment, and venous ultrasound. Inflammation markers, C-reactive protein (CRP), fibrinogen, interleukin 1-beta (IL-1-beta), IL-8, IL-10, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, monocyte chemoattractant-1 (MCP-1) and vascular endothelial cell growth factor (VEGF) were compared in 352 case participants with peripheral venous disease and 352 controls with no venous abnormalities frequency matched to cases by age, sex and race. Associations were also evaluated including a subset of 108 cases of severe venous disease, as previously defined. Odds ratios (95% CI), for peripheral venous disease for biomarkers in the top quartile (adjusting for age, race, sex, body mass index and history of venous thrombosis) were 1.8 (1.1-3.0), 1.6 (1.0-2.5) and 1.5 (0.9-2.3) for CRP, fibrinogen and IL-10, respectively. Associations were larger considering cases of severe venous disease, with odds ratios for these three analytes of 2.6 (1.2-5.9), 3.1 (1.3-7.3) and 2.2 (1.1-4.4), and for IL-8: 2.4 (1.1-5.2). There was no association of IL-1-beta, ICAM-1, VCAM-1, E-selectin, MCP-1 or VEGF with overall cases or severe venous disease. In conclusion, a subset of inflammation markers were associated with increased risk of peripheral venous disease, suggesting potential therapeutic targets for treatment.

  9. 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.

  10. Ethanol sclerotherapy of peripheral venous malformations

    International Nuclear Information System (INIS)

    Rimon, U.; Garniek, A.; Galili, Y.; Golan, G.; Bensaid, P.; Morag, B.

    2004-01-01

    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

  11. Endovascular treatment of intracranial venous sinus thrombosis

    International Nuclear Information System (INIS)

    Xu Shubin; Liang Zhihui; Cui Jinguo; Tian Huiqin; Li Liang; Chen Feng

    2009-01-01

    Objective: To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis. Methods: Ten patients with intracranial venous sinus thrombosis, confirmed by CT, MRI, MRV and / or DSA and encountered during the period of Aug. 2005-Aug. 2007, were treated with endovascular management after they failed to respond to anticoagulant therapy. Of ten patients, intravenous thrombolysis and mechanical thrombus maceration were carried out in 6, while intravenous thrombolysis, mechanical thrombus maceration together with intra-arterial thrombolysis were employed in 4. After the treatment, the anticoagulant therapy continued for 6 months. The patients were followed up for 12-29 months (mean 21 months). Results: After the treatment, the clinical symptoms and signs were completely or partially relieved in eight patients, including disappearance of headache (n=6) and relive of headache (n=2). No obvious improvement was found in one patient and linguistic function disturbance was seen in the remaining one. Lumbar puncture showed that the cerebrospinal fluid pressure returned to normal in all patients. Neither recurrence of thrombosis nor new symptom of neuralgic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation. Conclusion: Endovascular treatment is an effective and safe procedure for the potentially catastrophic intracranial venous thrombosis. (authors)

  12. Developmental venous anomaly in the newborn brain

    International Nuclear Information System (INIS)

    Horsch, S.; Govaert, P.; Cowan, F.M.; Benders, M.J.N.L.; Groenendaal, F.; Vries, L.S. de; Lequin, M.H.; Saliou, G.

    2014-01-01

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  13. Developmental venous anomaly in the newborn brain

    Energy Technology Data Exchange (ETDEWEB)

    Horsch, S. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Helios Klinikum Berlin-Buch, Department of Neonatology, Berlin (Germany); Govaert, P. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Cowan, F.M. [Hammersmith Hospital, Department of Paediatrics, Imperial College Healthcare NHS Trust, London (United Kingdom); Benders, M.J.N.L.; Groenendaal, F.; Vries, L.S. de [University Medical Centre Utrecht, Wilhelmina Children' s Hospital, Department of Neonatology, Utrecht (Netherlands); Lequin, M.H. [Erasmus MC/Sophia Children' s Hospital, Department of Paediatric Radiology, Rotterdam (Netherlands); Saliou, G. [University Hospital, Department of Neuroradiology, Le Kremlin-Bicetre (France)

    2014-07-15

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  14. Venous access: options, approaches and issues

    International Nuclear Information System (INIS)

    Asch, M.R.

    2001-01-01

    Venous access is an essential part of medical practice. It is needed to obtain blood samples to make the diagnosis and to administer fluids or medicines as part of treatment. Although relatively new in the history of medicine, the placement and maintenance of the various venous access devices now occupies a significant portion of many vascular and interventional radiology practices. Thus, it is important to have a thorough understanding of these devices and their uses. The first long-term venous access devices were used in 1973. These were placed via a surgical cut-down on the subclavian vein. In 1982, the first subcutaneous implantable ports were described. These procedures were initially performed by surgeons, but over the last 5-10 years, both the insertion and management of these devices has shifted to interventional radiologists. Peripherally inserted central catheter (PICC) lines have almost completely supplanted the use of standard central lines (Fig. 1). A number of factors have facilitated this - namely, ready and less expensive room access, outpatient procedure and radiologists' accessibility and familiarity with image-guidance procedures and catheters and guide wires. (author)

  15. Severe hypoxemia during veno-venous extracorporeal membrane oxygenation: exploring the limits of extracorporeal respiratory support

    Directory of Open Access Journals (Sweden)

    Liane Brescovici Nunes

    2014-03-01

    Full Text Available OBJECTIVE: Veno-venous extracorporeal oxygenation for respiratory support has emerged as a rescue alternative for patients with hypoxemia. However, in some patients with more severe lung injury, extracorporeal support fails to restore arterial oxygenation. Based on four clinical vignettes, the aims of this article were to describe the pathophysiology of this concerning problem and to discuss possibilities for hypoxemia resolution. METHODS: Considering the main reasons and rationale for hypoxemia during veno-venous extracorporeal membrane oxygenation, some possible bedside solutions must be considered: 1 optimization of extracorporeal membrane oxygenation blood flow; 2 identification of recirculation and cannula repositioning if necessary; 3 optimization of residual lung function and consideration of blood transfusion; 4 diagnosis of oxygenator dysfunction and consideration of its replacement; and finally 5 optimization of the ratio of extracorporeal membrane oxygenation blood flow to cardiac output, based on the reduction of cardiac output. CONCLUSION: Therefore, based on the pathophysiology of hypoxemia during veno-venous extracorporeal oxygenation support, we propose a stepwise approach to help guide specific interventions.

  16. Self care of patients with chronic venous ulcers in the home environment.

    Directory of Open Access Journals (Sweden)

    Thiago Gonçalves do Nascimento Piropo

    2012-01-01

    Full Text Available The venous ulcer is a skin lesion that affects the lower third of the legs. Is associated with chronic venous insufficiency, is the leading cause of ulcers of the lower limbs. Can interfere with the quality of life of patients, because it generates negative repercussions on social and economic sphere. The aim of this study was to identify self-care in the home environment of patients with venous ulcers, to assess the occurrence of alternative therapy use and verifythe involvement of domestic trauma. Methodologically, this study takes a quantitative and qualitative analytical cross-sectional held at the Clinical School of Physiotherapy, State University of Southwest Bahia / UESB / Jequié-BA, from January 2007 to September 2008. Data were collected through a questionnaire and semi-structured interviews. The results showed that 100% of the participants played self care of their injuries, including with respect to occlusion and bandages when needed. However, 6.25% said they had not received adequate information to perform self-care. Concluded that it is necessary to interact and produce a mechanism between education and health assistance for the development of the practice of self-care in family life at home.

  17. Human cerebral venous outflow pathway depends on posture and central venous pressure

    DEFF Research Database (Denmark)

    Gisolf, J; van Lieshout, J J; van Heusden, K

    2004-01-01

    and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest......Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position...

  18. Endovascular management of a gunshot wound injury to the innominate artery and brachiocephalic vein.

    NARCIS (Netherlands)

    Werre, A.J.; Vliet, J.A. van der; Biert, J.; Blankensteijn, J.D.; Schultze Kool, L.J.

    2005-01-01

    Surgical repair of penetrating injuries of the thoracic outlet with combined arterial and venous involvement is associated with considerable morbidity and mortality. A 37-year-old man presented to the emergency room with a left-sided penetrating zone I neck injury caused by a close-range handgun

  19. Optimal duration of anticoagulation in patients with venous thromboembolism.

    Science.gov (United States)

    Prandoni, Paolo; Piovella, Chiara; Spiezia, Luca; Dalla Valle, Fabio; Pesavento, Raffaele

    2011-07-01

    The risk of recurrent venous thromboembolism (VTE) approaches 40 per cent of all patients after 10 yr of follow up. This risk is higher in patients with permanent risk factors of thrombosis such as active cancer, prolonged immobilization from medical diseases, and antiphospholipid syndrome; in carriers of several thrombophilic abnormalities, including deficiencies of natural anticoagulants; and in patients with unprovoked presentation. Patients with permanent risk factors of thrombosis should receive indefinite anticoagulation, consisting of subtherapeutic doses of low molecular weight heparin in cancer patients, and oral anticoagulants in all other conditions. Patients whose VTE is triggered by major surgery or trauma should be offered three months of anticoagulation. Patients with unprovoked VTE, including carriers of thrombophilia, and those whose thrombotic event is associated with minor risk factors (such as hormonal treatment, minor injuries, long travel) should receive at least three months of anticoagulation. The decision as to go on or discontinue anticoagulation after this period should be individually tailored and balanced against the haemorrhagic risk. Post-baseline variables, such as the D-dimer determination and the ultrasound assessment of residual thrombosis can help identify those patients in whom anticoagulation can be safely discontinued. As a few emerging anti-Xa and anti-IIa compounds seem to induce fewer haemorrhagic complications than conventional anticoagulation, while preserving at least the same effectiveness, these have the potential to open new scenarios for decisions regarding the duration of anticoagulation in patients with VTE.

  20. Sports Injuries

    Science.gov (United States)

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  1. Golf Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Golf Injuries Golf looks like an easy game to ... WHAT TYPES OF INJURIES ARE MOST COMMON IN GOLF? Acute injuries are usually the result of a ...

  2. Core content for training in venous and lymphatic medicine.

    Science.gov (United States)

    Zimmet, Steven E; Min, Robert J; Comerota, Anthony J; Meissner, Mark H; Carman, Teresa L; Rathbun, Suman W; Jaff, Michael R; Wakefield, Thomas W; Feied, Craig F

    2014-10-01

    The major venous societies in the United States share a common mission to improve the standards of medical practitioners, the educational goals for teaching and training programs in venous disease, and the quality of patient care related to the treatment of venous disorders. With these important goals in mind, a task force made up of experts from the specialties of dermatology, interventional radiology, phlebology, vascular medicine, and vascular surgery was formed to develop a consensus document describing the Core Content for venous and lymphatic medicine and to develop a core educational content outline for training. This outline describes the areas of knowledge considered essential for practice in the field, which encompasses the study, diagnosis, and treatment of patients with acute and chronic venous and lymphatic disorders. The American Venous Forum and the American College of Phlebology have endorsed the Core Content. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  3. Compression therapies for chronic venous leg ulcers: interventions and adherence

    Directory of Open Access Journals (Sweden)

    Latz CA

    2015-01-01

    Full Text Available Christopher A Latz,1 Kellie R Brown,2 Ruth L Bush11Texas A&M Health Science Center College of Medicine, Bryan, TX, USA; 2Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Compression therapy has been the mainstay for the treatment of lower extremity edema, venous insufficiency, and particularly, venous ulcerative disease. Though modern surgical treatments exist, none are completely effective without good compressive options to allow for decreased swelling and better oxygenation of damaged tissues. This review article will describe the pathophysiology and presentation of lower extremity venous ulcerations, as well as current options for compression therapy. The benefits, along with the major pitfall of nonadherence, will also be discussed.Keywords: venous disease, chronic venous insufficiency, venous ulceration

  4. [Venous thrombosis associated with central venous catheter use in patients with cancer].

    Science.gov (United States)

    Iglesias Rey, Leticia; Fernández Pérez, Isaura; Barbagelata López, Cristina; Rivera Gallego, Alberto

    2015-01-01

    The use of central venous catheters for various applications (administration of chemotherapy, blood products and others) in patients with cancer is increasingly frequent. The association between thrombosis and catheter use has been fully established but aspects such as its causes, diagnosis, prophylaxis and treatment have not. We describe a case of thrombosis in a patient with cancer treated with chemotherapy who carried a central venous catheter. We also perform a review of the risk factors, the role of the prophylaxis and the treatment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

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

    Science.gov (United States)

    Shen, Tao; Baker, Keith

    2015-01-01

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

  6. An unusual cause of hydrocephalus: aqueductal developmental venous anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Yagmurlu, Banu; Fitoz, Suat; Atasoy, Cetin; Erden, ilhan [Ankara University School of Medicine, Department of Radiology, Ankara (Turkey); Deda, Gulhis; Unal, Ozlem [Ankara University School of Medicine, Division of Pediatric Neurology, Ankara (Turkey)

    2005-06-01

    Vascular malformations are infrequent causes of aqueductal stenoses, developmental venous anomaly (DVA) being the rarest among them. DVAs, also known as venous angiomas, are congenital in origin and characterized by dilatation of vessels in the superficial and deep venous system. Although they are usually clinically silent, they can be complicated by hemorrhage, seizures and neurologic deficits. Herein, we report MR imaging findings of a 7-year-old girl whose hydrocephalus was due to an abnormal vein coursing through the aqueduct. (orig.)

  7. Massive hydrothorax with malpositioned central venous catheter – Ultrasound detection

    Directory of Open Access Journals (Sweden)

    Neha Hasija

    2016-04-01

    Full Text Available Radioimaging is the gold standard for confirmation of the position of central venous catheter as well as its related complications. Use of ultrasound has been proven in guiding central venous cannulations, and it can also be used in detecting related complications. We report a case of a 2 year old child with hydrothorax causing desaturation due to malpositioned central venous catheter diagnosed by ultrasound in the delay for getting a radiograph.

  8. Influence of aspirin therapy in the ulcer associated with chronic venous insufficiency.

    Science.gov (United States)

    del Río Solá, Ma Lourdes; Antonio, Jose; Fajardo, González; Vaquero Puerta, Carlos

    2012-07-01

    To determine the effect of aspirin on ulcer healing rate in patients with chronic venous insufficiency, and to establish prognostic factors that influence ulcer evolution. Between 2001 and 2005, 78 patients with ulcerated lesions of diameter >2 cm and associated with chronic venous insufficiency were evaluated in our hospital. Of these, 51 patients (22 men, 29 women) with mean age of 60 years (range: 36-86) were included in a prospective randomized trial with a parallel control group. The treatment group received 300 mg of aspirin and the control group received no drug treatment; in both groups, healing was associated with standard compression therapy. During follow-up, held weekly in a blinded fashion, there was ulcer healing as well as cases of recurrence. Results were analyzed by intention-to-treat approach. Cure rate was estimated using Kaplan-Meier survival analysis, and the influence of prognostic factors was analyzed by applying the Cox proportional hazards model. In the presence of gradual compression therapy, healing occurred more rapidly in patients receiving aspirin versus the control subjects (12 weeks in the treated group vs. 22 weeks in the control group), with a 46% reduction in healing time. The main prognostic factor was estimated initial area of injury (P = 0.032). Age, sex, systemic therapy, and infection showed little relevance to evolution. The administration of aspirin daily dose of 300 mg shortens the healing time of ulcerated lesions in the chronic venous insufficiency (CVI). The main prognostic factor for healing of venous ulcerated lesions is the initial surface area of the ulcer. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  9. Blood flow vs. venous pressure effects on filtration coefficient in oleic acid-injured lung.

    Science.gov (United States)

    Anglade, D; Corboz, M; Menaouar, A; Parker, J C; Sanou, S; Bayat, S; Benchetrit, G; Grimbert, F A

    1998-03-01

    On the basis of changes in capillary filtration coefficient (Kfc) in 24 rabbit lungs, we determined whether elevations in pulmonary venous pressure (Ppv) or blood flow (BF) produced differences in filtration surface area in oleic acid-injured (OA) or control (Con) lungs. Lungs were cyclically ventilated and perfused under zone 3 conditions by using blood and 5% albumin with no pharmacological modulation of vascular tone. Pulmonary arterial, venous, and capillary pressures were measured by using arterial, venous, and double occlusion. Before and during each Kfc-measurement maneuver, microvascular/total vascular compliance was measured by using venous occlusion. Kfc was measured before and 30 min after injury, by using a Ppv elevation of 7 cmH2O or a BF elevation from 1 to 2 l . min-1 . 100 g-1 to obtain a similar double occlusion pressure. Pulmonary arterial pressure increased more with BF than with Ppv in both Con and OA lungs [29 +/- 2 vs. 19 +/- 0.7 (means +/- SE) cmH2O; P Kfc (200 +/- 40 vs. 83 +/- 14%, respectively; P < 0.01) and microvascular/total vascular compliance ratio (86 +/- 4 vs. 68 +/- 5%, respectively; P < 0.01) increased more with BF than with Ppv. In conclusion, for a given OA-induced increase in hydraulic conductivity, BF elevation increased filtration surface area more than did Ppv elevation. The steep pulmonary pressure profile induced by increased BF could result in the recruitment of injured capillaries and could also shift downstream the compression point of blind (zone 1) and open injured vessels (zone 2).

  10. 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.

  11. Pregnancy-related venous thromboembolism and risk of occult cancer

    DEFF Research Database (Denmark)

    Tarp Hansen, Anette; Veres, Katalin; Horváth-Puhó, Erzsébet

    2017-01-01

    The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected.An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk.......The cancer risk during the first year after a pregnancy-related venous thromboembolism episode is higher than expected.An aggressive search for cancer in women with pregnancy-related venous thromboembolism is probably not warranted, due to low absolute risk....

  12. Percutaneous transfemoral repositioning of malpositioned central venous catheters.

    Science.gov (United States)

    Hartnell, G G; Roizental, M

    1995-04-01

    Central venous catheters inserted by blind surgical placement may not advance into a satisfactory position and may require repositioning. Malpositioning via surgical insertion is common in patients in whom central venous catheters have previously been placed, as these patients are more likely to have central venous thrombosis and distortion of central venous anatomy. This is less of a problem when catheter placement is guided by imaging; however, even when insertion is satisfactory, central venous catheters may become displaced spontaneously after insertion (Fig. 1). Repositioning can be effected by direct manipulation using guidewires or tip-deflecting wires [1, 2], by manipulation via a transfemoral venous approach [3-5], and by injection of contrast material or saline [6]. Limitations of the direct approach include (1) the number and type of maneuvers that can be performed to effect repositioning when anatomy is distorted, (2) difficulty in accessing the catheter, and (3) the risk of introducing infection. Moreover, these patients are often immunosuppressed, and there is a risk of introducing infection by exposing and directly manipulating the venous catheter. Vigorous injection of contrast material or saline may be unsuccessful for the same reasons: It seldom exerts sufficient force to reposition large-caliber central venous catheters and may cause vessel damage or rupture if injection is made into a small or thrombosed vessel. We illustrate several alternative methods for catheter repositioning via a transfemoral venous approach.

  13. Tricuspid valve endocarditis following central venous cannulation: The increasing problem of catheter related infection

    Directory of Open Access Journals (Sweden)

    Suresh Babu Kale

    2013-01-01

    Full Text Available A central venous catheter (CVC is inserted for measurement of haemodynamic variables, delivery of nutritional supplements and drugs and access for haemodialysis and haemofiltration. Catheterization and maintenance are common practices and there is more to the technique than routine placement as evident when a procedure-related complication occurs. More than 15% of the patients who receive CVC placement have some complications and infectious endocarditis involving the tricuspid valve is a rare and serious complication with high morbidity and mortality. Overenthusiastic and deep insertion of the guide wire and forceful injection through the CVC may lead to injury of the tricuspid valve and predispose to bacterial deposition and endocarditis. We report a case of tricuspid valve endocarditis, probably secondary to injury of the anterior tricuspid leaflet by the guide wire or the CVC that required open heart surgery with vegetectomy and repair of the tricuspid valve.

  14. 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.

  15. Diagnosis and endovascular treatment of multiple cerebral venous and venous sinuses thrombosis

    International Nuclear Information System (INIS)

    Li Baomin; Zhang Ji; Yin Ling; Huang Xusheng; Jiang Jinli; Liu Jun; Lang Senyang; Zhou Dingbiao; Zhu Ke

    2000-01-01

    Objective: Eighty-five cases with multiple cerebral venous and venous sinuses thrombosis including the diagnosis and endovascular therapy were reported. Methods: The long T2 and short T1 signals in the related regions of multiple venous sinuses on MRI and prolonged blood circulation time of the brain with tortuous dilatation of vein in angiography were the important characteristics for the diagnosis. Of the 85 cases, the treatment procedures were consisted of injecting urokinase intermittently via common carotid artery and intra-sinus contact thrombolysis as well as warfarin intake orally. Results: Intracranial pressure of 80 cases reduced down between 230 and 300 mm H 2 O, and clinical deficits were markedly improved within 10 days. Re-angiography of 18 cases revealed recanalization partly in 5 cases and circulation time appeared near normal i 8 cases during one week after therapy. Conclusions: Combined intraarterial thrombolysis consecutively with general anticoagulation for the treatment of multiple thrombosis in cerebral venous sinuses may be one of the effective means

  16. 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.

  17. Pulmonary arterio-venous micro fistulae - Diagnostic

    International Nuclear Information System (INIS)

    Ebram, J.C.

    1989-01-01

    Four patients with pulmonary arterio-venous micro-fistulae - of which two were male (50%) - the ages varying from 10 to 43 (X sup(∼) = 22,7), were studied at the Cardiology Centre of the 6th Ward of Santa Casa da Misericordia Hospital in Rio de Janeiro. They were all basically suffering from Manson's Schistosomiasis, the hepato-splenic form in 3 cases (75%) and the Rendu Osler Weber disease with juvenile cirrhosis in 1 case (25%). All four of them had portal hypertension. The individual cases were clinically evaluate with X-rays, scintillographic and hemodynamic tests. (author)

  18. Congenital Retinal Macrovessel and the Association of Retinal Venous Malformations With Venous Malformations of the Brain.

    Science.gov (United States)

    Pichi, Francesco; Freund, K Bailey; Ciardella, Antonio; Morara, Mariachiara; Abboud, Emad B; Ghazi, Nicola; Dackiw, Christine; Choudhry, Netan; Souza, Eduardo Cunha; Cunha, Leonardo Provetti; Arevalo, J Fernando; Liu, T Y Alvin; Wenick, Adam; He, Lingmin; Villarreal, Guadalupe; Neri, Piergiorgio; Sarraf, David

    2018-04-01

    Congenital retinal macrovessel (CRM) is a rarely reported venous malformation of the retina that is associated with venous anomalies of the brain. To study the multimodal imaging findings of a series of eyes with congenital retinal macrovessel and describe the systemic associations. In this cross-sectional multicenter study, medical records were retrospectively reviewed from 7 different retina clinics worldwide over a 10-year period (2007-2017). Patients with CRM, defined as an abnormal, large, macular vessel with a vascular distribution above and below the horizontal raphe, were identified. Data were analyzed from December 2016 to August 2017. Clinical information and multimodal retinal imaging findings were collected and studied. Pertinent systemic information, including brain magnetic resonance imaging findings, was also noted if available. Of the 49 included patients, 32 (65%) were female, and the mean (SD) age at onset was 44.0 (20.9) years. A total of 49 eyes from 49 patients were studied. Macrovessel was unilateral in all patients. Color fundus photography illustrated a large aberrant dilated and tortuous retinal vein in all patients. Early-phase frames of fluorescein angiography further confirmed the venous nature of the macrovessel in 40 of 40 eyes. Optical coherence tomography angiography, available in 17 eyes (35%), displayed microvascular capillary abnormalities around the CRM, which were more evident in the deep capillary plexus. Of the 49 patients with CRM, 39 (80%) did not illustrate any evidence of ophthalmic complications. Ten patients (20%) presented with retinal complications, typically an incidental association with CRM. Twelve patients (24%) were noted to have venous malformations of the brain with associated magnetic resonance imaging. Of these, location of the venous anomaly in the brain was ipsilateral to the CRM in 10 patients (83%) and contralateral in 2 patients (17%), mainly located in the frontal lobe in 9 patients (75%). Our study has

  19. Venous pump of the calf: a study of venous and muscular pressures.

    Science.gov (United States)

    Alimi, Y S; Barthelemy, P; Juhan, C

    1994-11-01

    Little data are available concerning the relation between the muscular pumping mechanism and the variation of superficial and deep venous pressure during normal action of the calf pump; therefore we undertook this study to determine the pressure values in three compartments of the calf and in the deep and the superficial venous system and to establish correlation between muscular and venous pressure. Nine healthy young women with a mean age of 23 years (range 19 to 28 years) were examined. In the same calf, a muscular catheter was placed in the deep posterior compartment (DPC), in the superficial posterior compartment (SPC), and in the anterior tibial compartment (ATC), and a vascular catheter was placed in the popliteal vein and in the greater saphenous vein (GSV). The five lines of pressure were simultaneously recorded in the following situations: at rest, during Valsalva maneuver, foot flexion, and foot extension. The situation was studied with the patient in the following positions: decubitus, sitting, standing, and squatting. A final continuous recording was carried out after the patient had been walking for 5 minutes. Mean values with standard errors of muscular and venous pressure were established in each situation. At rest and during Valsalva maneuver, the muscular pressures did not vary, whereas venous pressures increased significantly when the patient was sitting and standing. On the other hand, squatting was associated with a rise in the muscular and vein pressures. Foot flexion entailed a significant increase in the ATC pressure and a rise in the GSV pressure, whereas foot extension caused the DPC pressure to rise without venous pressure modifications. Walking was associated with an alternating increase in the DPC, SPC, GSV and popliteal vein pressures when the foot was compressed to floor followed by a significant decrease when the foot pressure was released. The variations in the deep and superficial venous pressures when the patient is sitting and

  20. Developmental venous anomalies with capillary stain: a subgroup of symptomatic DVAs?

    NARCIS (Netherlands)

    Roccatagliata, Luca; van den Berg, René; Soderman, Michael; Boulin, Anne; Condette-Auliac, Stéphanie; Rodesch, Georges

    2012-01-01

    Intracranial developmental venous anomalies (DVAs) are considered benign vascular dispositions; they are asymptomatic in the vast majority of cases. They represent extreme variations of the venous drainage and may rarely be responsible for focal venous ischemia leading to neurological dysfunction.

  1. Altered Venous Function during Long-Duration Spaceflights

    Directory of Open Access Journals (Sweden)

    Jacques-Olivier Fortrat

    2017-09-01

    Full Text Available Aims: Venous adaptation to microgravity, associated with cardiovascular deconditioning, may contribute to orthostatic intolerance following spaceflight. The aim of this study was to analyze the main parameters of venous hemodynamics with long-duration spaceflight.Methods: Venous plethysmography was performed on 24 cosmonauts before, during, and after spaceflights aboard the International Space Station. Venous plethysmography assessed venous filling and emptying functions as well as microvascular filtration, in response to different levels of venous occlusion pressure. Calf volume was assessed using calf circumference measurements.Results: Calf volume decreased during spaceflight from 2.3 ± 0.3 to 1.7 ± 0.2 L (p < 0.001, and recovered after it (2.3 ± 0.3 L. Venous compliance, determined as the relationship between occlusion pressure and the change in venous volume, increased during spaceflight from 0.090 ± 0.005 to 0.120 ± 0.007 (p < 0.01 and recovered 8 days after landing (0.071 ± 0.005, arbitrary units. The index of venous emptying rate decreased during spaceflight from −0.004 ± 0.022 to −0.212 ± 0.033 (p < 0.001, arbitrary units. The index of vascular microfiltration increased during spaceflight from 6.1 ± 1.8 to 10.6 ± 7.9 (p < 0.05, arbitrary units.Conclusion: This study demonstrated that overall venous function is changed during spaceflight. In future, venous function should be considered when developing countermeasures to prevent cardiovascular deconditioning and orthostatic intolerance with long-duration spaceflight.

  2. Radiographic signs of non-venous placement of intended central venous catheters in children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Erin C. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-02-15

    Central venous catheters (CVCs) are commonly used in children, and inadvertent arterial or extravascular cannulation is rare but has potentially serious complications. To identify the radiographic signs of arterial placement of CVCs. We retrospectively reviewed seven cases of arterially malpositioned CVCs on chest radiograph. These cases were identified through departmental quality-assurance mechanisms and external consultation. Comparison of arterial cases was made with 127 age-matched chest radiographs with CVCs in normal, expected venous location. On each anteroposterior (AP) radiograph we measured the distance of the catheter tip from the right lateral border of the thoracic spine, and the angle of the vertical portion of the catheter relative to the midline. On each lateral radiograph we measured the angle of the vertical portion of each catheter relative to the anterior border of the thoracic spine. When bilateral subclavian catheters were present, the catheter tips were described as crossed, overlapping or uncrossed. On AP radiographs, arterially placed CVCs were more curved to the left, with catheter tip positions located farther to the left of midline than normal venous CVCs. When bilateral, properly placed venous catheters were present, all catheters crossed at the level of the superior vena cava (SVC). When one of the bilateral catheters was in arterial position, neither of the catheters crossed or the inter-catheter crossover distance was exaggerated. On lateral radiographs, there was a marked anterior angulation of the vertical portion of the catheter (mean angle 37 ± 15 standard deviation [SD] in arterial catheters versus 5.9 ± 8.3 SD in normally placed venous catheters). Useful radiographic signs suggestive of unintentional arterial misplacement of vascular catheters include leftward curvature of the vertical portion of the catheter, left-side catheter tip position, lack of catheter crossover on the frontal radiograph, as well as exaggerated

  3. Human cerebral venous outflow pathway depends on posture and central venous pressure

    Science.gov (United States)

    Gisolf, J; van Lieshout, J J; van Heusden, K; Pott, F; Stok, W J; Karemaker, J M

    2004-01-01

    Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position, but mainly through the vertebral plexus in the upright position. A Valsalva manoeuvre while standing completely re-opened the jugular veins. Results of ultrasound imaging of the right internal jugular vein cross-sectional area at the level of the laryngeal prominence in six healthy subjects, before and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R2 = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the primary pathway. The internal jugular veins are collapsed in the standing position and blood is shunted to an alternative venous pathway, but a marked increase in CVP while standing completely re-opens the jugular veins. PMID:15284348

  4. Thrombophilia in children with venous thromboembolic disease.

    Science.gov (United States)

    Revel-Vilk, Shoshana; Kenet, Gili

    2006-01-01

    Venous thromboembolic events (VTEs) in children are usually associated with underlying clinical conditions such as central venous line, cancer and cardiac diseases. The objective of this review is to present the importance of thrombophilia to the occurrence of childhood VTE. The reported prevalence of thrombophilia in children with VTE varies extremely between 10% and 78% in different registries. The variation in the reported prevalence most probably reflects differences in the clinical characteristics of the children studied and differences in study designs. The initial management of children with thrombophilia and VTE is similar to those individuals who do not have a specific inherited thrombophilic risk factor, except in the rare events of homozygous deficiencies of prothrombotic coagulation proteins. The impact of thrombophilic markers on long-term therapy and outcome of children with VTE has not been completely clarified. According to the current guidelines for thrombophilia, all children with VTE should be tested for a full panel of genetic and acquired prothrombotic traits. However, re-evaluation of co-morbid risk factors other than thrombophilic markers and careful consideration of the prognostic value of thrombophilic markers might help to change future attitude from the rigidity of current guidelines to more rational schemes.

  5. MRI and CT in cerebral venous thrombosis

    International Nuclear Information System (INIS)

    Surur, Alberto; Marangoni, Alberto; Devallis, Juan P.; Galvez, Vasco; Marchegiani, Silvio; Galletti, Cayetano; Martin, Juan J.

    2004-01-01

    Purpose: The veno-occlusive encephalic disease is a neurologic disorder of difficult clinic diagnostic almost always. This clinic situation presents a high morbi-mortality range without an early and precise diagnostic. With the use of Helical Computed Tomography (HCT) and Angio Magnetic Resonance Image (AMRI) the diagnosis has became more effective in the encephalic venous thrombosis. Methods: Fourteen patients with clinical suspicion on encephalic venous thrombosis using non-invasive techniques as HCT and AMRI were studied. Results: In all these cases we were able to arrive at the exact etiologic diagnostic using these techniques associated to the clinics findings, without needing the use of another invasive method like Angiography. Conclusion: The results were satisfactory for definitive diagnosis, without Angiography. When a patient has a high suspicion of veno-occlusive disease the neuro radiologic examination in the urgency is a very important fact and using HCT and AMRI as the first examinations techniques it is possible to obtain good results without most aggressive techniques. (author)

  6. Knowledge and practice of prophylaxis of deep venous thrombosis ...

    African Journals Online (AJOL)

    2015-09-03

    Sep 3, 2015 ... Kesieme, et al.: Knowledge and practice of prophylaxis of deep venous thrombosis: A survey. 171. Nigerian Journal of Clinical Practice • Mar-Apr 2016 • Vol 19 • Issue 2. Introduction. Venous thromboembolism (VTE) is an important but preventable cause of morbidity and mortality among surgical patients.

  7. Counteracting venous stasis during acute lower leg immobilization.

    NARCIS (Netherlands)

    Poelkens, F.; Thijssen, D.H.J.; Kersten, B.T.P.; Scheurwater, H.; Laarhoven, E.W. van; Hopman, M.T.E.

    2006-01-01

    AIM: During lower limb immobilization, patients are at risk to develop deep venous thrombosis. Recently, a water-pad was developed that should counteract venous stasis. The water-pad, located under the plaster, mobilizes water from the foot to the calf during weight bearing and, thereby, imitates

  8. Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Stylianos Kykalos

    2011-01-01

    Full Text Available Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy.

  9. Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism

    NARCIS (Netherlands)

    Weitz, Jeffrey I.; Lensing, Anthonie W. A.; Prins, Martin H.; Bauersachs, Rupert; Beyer-Westendorf, Jan; Bounameaux, Henri; Brighton, Timothy A.; Cohen, Alexander T.; Davidson, Bruce L.; Decousus, Hervé; Freitas, Maria C. S.; Holberg, Gerlind; Kakkar, Ajay K.; Haskell, Lloyd; van Bellen, Bonno; Pap, Akos F.; Berkowitz, Scott D.; Verhamme, Peter; Wells, Philip S.; Prandoni, Paolo; Bianchi, Alessandra; Brighton, Tim; Carroll, Patrick; Chong, Beng; Chunilal, Sanjeev; Coughlin, Paul; Curnow, Jennifer; Jackson, David; Tran, Huyen; Ward, Chris; Brodmann, Marianne; Kyrle, Paul; Marschang, Peter; Petkov, Ventzislav; Hainaut, Philippe; Jordens, Paul; Vandekerkhof, Jos; Wautrecht, Jean-Claude; Annichino-Bizzacchi, Joyce; Correa, Joao; Cukier, Alberto; Freire, Antonio; Pereira, Adamastor; Porto, Carmen; Sacilotto, Roberto; Vasconcelos Costa, Agenor; Della Siega, Anthony; Dolan, Sean; Le Gal, Gré goire; Middeldorp, Saskia

    2017-01-01

    BACKGROUND Although many patients with venous thromboembolism require extended treatment, it is uncertain whether it is better to use full- or lower-intensity anticoagulation therapy or aspirin. METHODS In this randomized, double-blind, phase 3 study, we assigned 3396 patients with venous

  10. Regular sports activities decrease the risk of venous thrombosis

    NARCIS (Netherlands)

    van Stralen, K. J.; le Cessie, S.; Rosendaal, F. R.; Doggen, C. J. M.

    2007-01-01

    BACKGROUND: Stasis of the blood has been postulated as a major cause of venous thrombosis. However, little is known about the effect of stimulating the blood flow in order to prevent venous thrombosis through, for example, sports activities. OBJECTIVES: In a large population-based case-control study

  11. 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

  12. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism

    NARCIS (Netherlands)

    Büller, Harry R; Décousus, Hervé; Grosso, Michael A; Mercuri, Michele; Middeldorp, Saskia; Prins, Martin H; Raskob, Gary E; Schellong, Sebastian M; Schwocho, Lee; Segers, Annelise; Shi, Minggao; Verhamme, Peter; Wells, Phil; Kamphuisen, P.W.

    2013-01-01

    BACKGROUND: Whether the oral factor Xa inhibitor edoxaban can be an alternative to warfarin in patients with venous thromboembolism is unclear. METHODS: In a randomized, double-blind, noninferiority study, we randomly assigned patients with acute venous thromboembolism, who had initially received

  13. Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism

    DEFF Research Database (Denmark)

    Büller, Harry R; Décousus, Hervé; Grosso, Michael A

    2013-01-01

    Whether the oral factor Xa inhibitor edoxaban can be an alternative to warfarin in patients with venous thromboembolism is unclear.......Whether the oral factor Xa inhibitor edoxaban can be an alternative to warfarin in patients with venous thromboembolism is unclear....

  14. Deep venous thrombosis like puerperium complication: two cases

    International Nuclear Information System (INIS)

    Martin Gomez, J.I.; Larena Iturbe, J.A.; Zuazo Ojeda, M.A.; Pena Sarnago, J.M.

    1994-01-01

    Deep venous thrombosis, especially that of the ovarian vein, is a rare, potentially fatal complication that can present during the puerperium, its clinical diagnosis is not easy, thus dangerously delaying specific treatment. Two cases are presented of deep venous thrombosis diagnosed on the basis of computerized tomography (CT) in puerperal patients with symptoms of postpartum pain and fever. (Author) 9 refs

  15. Mechanical thrombectomy: an alternative for treating cerebral venous sinus thrombosis.

    Science.gov (United States)

    Izura Gómez, Marta; Misis Del Campo, Maite; Puyalto de Pablo, Paloma; Castaño Duque, Carlos

    2018-01-01

    We report the use of mechanical venous thrombectomy in 2 cases of cerebral venous sinus thrombosis in which the usual first-choice treatment with systemic anticoagulants was contraindicated. Our aim is to present this treatment as an alternative to consider when anticoagulants therapy is too risky or is contraindicated in critically ill patients.

  16. Increased venous thrombosis incidence in pregnancies after in vitro fertilization

    DEFF Research Database (Denmark)

    Hansen, Anette Tarp; Kesmodel, U S; Juul, S

    2014-01-01

    STUDY QUESTION Is venous thrombosis risk increased in pregnancies after in vitro fertilization? SUMMARY ANSWER The venous thrombosis incidence was significantly increased in pregnancies after in vitro fertilization; especially in the first trimester and in the first 6 weeks post-partum. WHAT...... IS KNOWN ALREADY In vitro fertilization without pregnancy is not associated with increased venous thrombosis incidence. STUDY DESIGN, SIZE, DURATION This national register-based cohort study covered the period from 1995 to 2005. PARTICIPANTS/MATERIALS, SETTING, METHODS All Danish pregnancies conceived...... by in vitro fertilization (n = 18 787) were included. Venous thrombosis incidence rates in pregnancies after in vitro fertilization were compared with venous thrombosis incidence rates in reference pregnancies, by calculating incidence rate ratios. MAIN RESULTS AND THE ROLE OF CHANCE In total, 48 cases were...

  17. Determination of intestinal viability by Doppler ultrasonography in venous infarction.

    Science.gov (United States)

    Cooperman, M; Martin, E W; Carey, L C

    1980-01-01

    The accuracy of Doppler ultrasound in predicting the viability of ischemic intestine secondary to venous obstruction was assessed. Twenty loops of ischemic intestine were created in dogs by temporarily obstructing venous return from the bowel. Doppler arterial flow signals within the intestine quickly disappeared following venous occlusion. In ten segments, arterial signals promptly returned following release of venous occlusion. Nine of these ten segments were viable at reoperation 24 hours later. In ten segments, no arterial signals could be detected following release of venous occlusion, and only one segment proved to be viable. Doppler ultrasound findings were far more accurate in distinguishing between viable and nonviable intestine thatn were clinical guides to intestinal viability. PMID:7352777

  18. THE AZYGOS VENOUS SYSTEM AND ITS ANATOMICAL VARIATIONS

    Directory of Open Access Journals (Sweden)

    Madiki Sudhakara Rao

    2016-06-01

    Full Text Available AIMS AND OBJECTIVES Azygos veins are important cavocaval and portacaval junctions, which form a collateral circulation in caval vein occlusion and in portal hypertension, cirrhosis of liver. The unpaired azygos venous system consists of azygos vein, hemiazygos vein and accessory azygos vein. This system of veins, along with its mediastinal, bronchial and oesophageal tributaries drains most of the body wall of trunk, namely posterior abdominal and thoracic wall. Anatomical variations of this unpaired azygos venous system are clinically important. AIMS To study and report the occurrence of anatomical variations of the unpaired azygos venous system in the region of East Godavari District, Andhra Pradesh (India. METHODS The present study was carried out in the Department of Anatomy, KIMS & RF, Amalapuram and G.S.L. Medical College, Rajahmundry over a period of 2 years. The present study was conducted on 60 cadavers (irrespective of age and sex. The entire course of the azygos venous system in these 60 cadavers was carefully observed and documented. RESULTS Anatomical variations were present in 16.66% of cases, out of which three distinct types were identified. 6.6% exhibited two separate azygos venous systems with no communications, 5% with communication between the left brachiocephalic vein and the azygos vein and 5% presence of post-aortic venous channels. CONCLUSION Variations of azygos venous system may be wrongly dubbed as aneurysm, lymphadenopathy or other abnormalities while reporting a CT scan of mediastinum. Venous anomalies are also detected only during surgery. The most troublesome intraoperative hazard is haemorrhage, which is mainly of venous origin. To avoid such situations is to have an awareness and knowledge of the expected venous anomalies.

  19. Cerebrofacial venous metameric syndrome (CVMS) 3: Sturge-Weber syndrome with bilateral lymphatic/venous malformations of the mandible

    International Nuclear Information System (INIS)

    Ramli, N.; Sachet, M.; Bao, C.; Lasjaunias, P.

    2003-01-01

    We present a case of Sturge-Weber syndrome with a bilateral lymphatic/venous malformation of the mandible. Modern biology suggests an explanation for such a case. The classification of cerebrofacial venous metameric syndromes (CVMS) enables us to recognise this lesion as involving the most caudal of the cranial metamere (CVMS 3). (orig.)

  20. Venous, Arterialized-Venous, or Capillary Glucose Reference Measurements for the Accuracy Assessment of a Continuous Glucose Monitoring System

    NARCIS (Netherlands)

    Kropff, Jort; van Steen, Sigrid C.; deGraaff, Peter; Chan, Man W.; van Amstel, Rombout B. E.; DeVries, J. Hans

    2017-01-01

    Background: Different reference methods are used for the accuracy assessment of continuous glucose monitoring (CGM) systems. The effect of using venous, arterialized-venous, or capillary reference measurements on CGM accuracy is unclear. Methods: We evaluated 21 individuals with type 1 diabetes

  1. Systemic treatments for the prevention of venous thrombo-embolic events in paediatric cancer patients with tunnelled central venous catheters

    NARCIS (Netherlands)

    Schoot, Reineke A.; Kremer, Leontien C. M.; van de Wetering, Marianne D.; van Ommen, Cornelia H.

    2013-01-01

    Venous thrombo-embolic events (VTEs) occur in 2.2% to 14% of paediatric cancer patients and cause significant morbidity and mortality. The malignant disease itself, the cancer treatment and the presence of central venous catheters (CVCs) increase the risk of VTE. The primary objective of this review

  2. Penile venous surgery for treating erectile dysfunction: Past, present, and future perspectives with regard to new insights in venous anatomy

    Directory of Open Access Journals (Sweden)

    Cheng-Hsing Hsieh

    2016-06-01

    Full Text Available In the physiologic model of normal erectile function, a healthy veno-occlusive mechanism is essential to initiate and maintain a rigid erection. The surgical treatment of patients with venous leakage, which is synonymous with corporoveno-occlusive dysfunction (CVOD, was based on the decreased venous outflow during the erection process. The initial reports of short-term results were promising, but the long-term benefits of penile venous ligation surgery were limited. Most clinical guideline panels concluded that surgeries performed in an attempt to limit the venous outflow of the penis were not recommended. Consequently, this surgery was nearly abandoned in most medical societies worldwide. These unfavorable postoperative outcomes seemed attributable to the indispensable usage of electrocautery and insufficient venous management, based on conventional penile venous anatomy. Advances in better understanding of human penile venous anatomy has enabled the development of refined penile venous stripping surgery. The thorough stripping surgery is an even more radical procedure, which is an even more radical procedure, and seems to be a viable option for the treatment of CVOD, however, there is still a need for further study with well-defined diagnostic criteria, and standardized patient and partner outcome assessment.

  3. Preditores de injúria renal aguda em pacientes submetidos ao transplante ortotópico de fígado convencional sem desvio venovenoso Predictors of acute kidney injury in patients undergoing a conventional orthotopic liver transplant without veno-venous bypass

    Directory of Open Access Journals (Sweden)

    Olival Cirilo L. da Fonseca-Neto

    2011-06-01

    Full Text Available RADICAL: Injúria renal aguda é uma das complicações mais comuns do transplante ortotópico de fígado. A ausência de critério universal para sua definição nestas condições dificulta as comparações entre os estudos. A técnica convencional para o transplante consiste na excisão total da veia cava inferior retro-hepática durante a hepatectomia nativa. Controvérsias sobre o efeito da técnica convencional sem desvio venovenoso na função renal continuam. OBJETIVO: Estimar a incidência e os fatores de risco de injúria renal aguda entre os receptores de transplante ortotópico de fígado convencional sem desvio venovenoso. MÉTODOS: Foram avaliados 375 pacientes submetidos a transplante ortotópico de fígado. Foram analisadas as variáveis pré, intra e pós-operatórias em 153 pacientes submetidos a transplante ortotópico de fígado convencional sem desvio venovenoso. O critério para a injúria renal aguda foi valor da creatinina sérica > 1,5 mg/dl ou débito urinário BACKGROUND: Acute kidney injury is one of the most common complications of orthotopic liver transplantation. The absence of universal criteria for definition of these conditions make comparisons difficult between studies. The conventional technique for transplantation is the total excision of the inferior vena cava during liver retro-native hepatectomy. Controversies about the effect of the conventional technique without venovenous bypass on renal function remain. AIM: To estimate the incidence and risk of acute kidney injury factors among recipients of orthotopic liver transplantation without conventional venovenous bypass. METHODS: Was studied 375 patients undergoing orthotopic liver transplantation. Variables were analyzed in preoperative, intraoperative and postoperative complications in 153 patients undergoing orthotopic liver transplantation without conventional venovenous bypass. The criterion for acute kidney injury was serum creatinine > 1.5 mg/dl or

  4. Imaging Characteristics of Venous Parenchymal Abnormalities.

    Science.gov (United States)

    Arnoux, Audrey; Triquenot-Bagan, Aude; Andriuta, Daniela; Wallon, David; Guegan-Massardier, Evelyne; Leclercq, Claire; Martinaud, Olivier; Castier-Amouyel, Mélody; Godefroy, Olivier; Bugnicourt, Jean-Marc

    2017-12-01

    There are few published data on the patterns of parenchymal imaging abnormalities in a context of cerebral venous thrombosis (CVT). The objectives of the present study were to describe the patterns of parenchymal lesions associated with CVT and to determine the lesion sites. We included 44 consecutively hospitalized patients with CVT and parenchymal lesions on magnetic resonance imaging. The diagnosis of CVT had been confirmed by magnetic resonance imaging/magnetic resonance venography. Magnetic resonance imaging patterns for CVT were retrospectively analyzed with regard to the lesion's type, shape, and site. The most frequent stroke subtype was hemorrhagic ischemia (in 56.8% of cases), followed by intracerebral hematoma (in 22.72% of cases) and nonhemorrhagic ischemia (in 20.45% of cases). Although there were no significant differences between these 3 groups with regard to the clinical and radiological characteristics, we observed a nonsignificant trend ( P =0.08) toward a shorter time interval between hospital admission and magnetic resonance imaging for nonhemorrhagic stroke. The CVT parenchymal abnormalities were centered on 6 main foci and were related to the site of venous occlusion: (1) the inferior parietal lobule (n=20; 44.5%), associated mainly with occlusion of the transverse sinus (n=10) or pure cortical veins (n=10); (2) the inferior and posterior temporal regions (n=10; 22.75%), associated mainly with occlusion of the transverse sinus (n=9); (3) the parasagittal frontal region (n=6; 13.6%), associated mainly with occlusion of the superior sagittal sinus (n=4) or the transverse sinus (n=4); (4) the thalamus (n=5; 11.3%) associated with occlusion of the straight sinus (n=5); (5) the cerebellar hemisphere (n=2; 4.5%), associated in both cases with occlusion of the transverse sinus; and (6) the deep hemispheric regions (n=3; 6.8%), associated with occlusion of the superior sagittal sinus in all cases. Parenchymal lesions caused by CVT display specific

  5. 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

  6. Deep venous thrombosis associated with corporate air travel.

    Science.gov (United States)

    Dimberg, L A; Mundt, K A; Sulsky, S I; Liese, B H

    2001-01-01

    Deep venous thrombosis (DVT) is commonly seen among bedridden and postoperative patients. Its association with travel may also make DVT an occupational health risk to otherwise healthy business travelers. We estimated the incidence of and risk factors for DVT among 8,189 World Bank employees and a subset of 4,951 international business travelers. Occurrence of DVT between 1995 and 1998 was determined using 1) medical insurance claims; 2) Workers' Compensation claims; and 3) intra-office E-mail solicitation followed by interview. For each insurance claim case, 10 controls were randomly selected from among World Bank employees insured during the same month and year as the case's claim was filed, and case-control analyses were performed to identify potential predictors or risk factors for DVT. Thirty individuals filed claims for DVT of the legs (annual incidence rate: 0.9 per 1,000 employees); three of these claims were filed within 30 days after a travel mission. Two employees reported DVT as a Workers' Compensation injury, and five staff with verified DVT participated in interviews. After controlling for age and gender, no association with any travel-related covariate was seen. Results of analyses considering all thrombophlebitis and thromboembolism followed the same pattern. The average annual incidence of DVT occurring within 30 days of mission among traveling staff ranged from 0.10 per 1,000 to 0.25 per 1,000 travelers, depending on the case-finding method. No association between DVT and travel was observed after adjustment for gender and age. These results, however, are preliminary, and due to the rarity of DVT, based on small numbers.

  7. Primary prophylaxis of venous thromboembolism in children.

    Science.gov (United States)

    Cole, Catherine H

    2010-06-01

    Venous thromboembolism (VTE) is rare in children and young adolescents, and occurs predominantly in those with congenital heart disease in whom guidelines exist for VTE prophylaxis. For other paediatric patients, the rarity of the event makes writing an evidence-based clinical practice guideline difficult because each of the known risk factors contributes only a small increase in risk. Thrombophilia screening is controversial because few results assist with prediction of likely thrombosis and may not alter recommendations for prophylaxis. Recent publications highlight the importance of non-pharmacological prevention of VTE in children and adolescents undergoing surgery and the importance of liaison among surgeon, anaesthetist and haematologist. This annotation was written with the aim of collating current evidence for VTE prophylaxis and emphasising the need for further research in vulnerable subgroups.

  8. Bilateral Pneumothoraces Following Central Venous Cannulation

    Science.gov (United States)

    Pazos, F.; Masterson, K.; Inan, C.; Robert, J.; Walder, B.

    2009-01-01

    We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax. PMID:19901997

  9. Venous thromboembolism prophylaxis in plastic surgery

    DEFF Research Database (Denmark)

    Nielsen, Lea Juul; Matzen, Steen H

    2017-01-01

    BACKGROUND: Venous thromboembolism is a well-documented complication of surgery, including plastic surgery. However, few consensus guidelines on thromboembolism prophylaxis exist in plastic surgery and, thus, the different approaches in the public as well as the private clinics in Denmark were...... investigated using a web-based survey. METHODS: Forty-two clinics were contacted and 45% responded. RESULTS: The collected data reveals a lack of consensus in plastic surgery in Denmark, not only regarding the use of mechanical and chemical prophylaxis, but also which type of prophylaxis to apply, the duration...... of prophylaxis, and how to risk stratify the patients. CONCLUSION: The development of a guideline, based on plastic surgical data, using a validated risk assessment model, which combines the surgical risk with the patient related risk and recommends guidelines for mechanical as well as chemoprophylaxis...

  10. [The diagnostic scores for deep venous thrombosis].

    Science.gov (United States)

    Junod, A

    2015-08-26

    Seven diagnostic scores for the deep venous thrombosis (DVT) of lower limbs are analyzed and compared. Two features make this exer- cise difficult: the problem of distal DVT and of their proximal extension and the status of patients, whether out- or in-patients. The most popular score is the Wells score (1997), modi- fied in 2003. It includes one subjective ele- ment based on clinical judgment. The Primary Care score 12005), less known, has similar pro- perties, but uses only objective data. The pre- sent trend is to associate clinical scores with the dosage of D-Dimers to rule out with a good sensitivity the probability of TVP. For the upper limb DVT, the Constans score (2008) is available, which can also be coupled with D-Dimers testing (Kleinjan).

  11. Central venous stenosis among hemodialysis patients is often not associated with previous central venous catheters.

    Science.gov (United States)

    Kotoda, Atsushi; Akimoto, Tetsu; Kato, Maki; Kanazawa, Hidenori; Nakata, Manabu; Sugase, Taro; Ogura, Manabu; Ito, Chiharu; Sugimoto, Hideharu; Muto, Shigeaki; Kusano, Eiji

    2011-01-01

    It is widely assumed that central venous stenosis (CVS) is most commonly associated with previous central venous catheterization among the chronic hemodialysis (HD) patients. We evaluated the validity of this assumption in this retrospective study. The clinical records from 2,856 consecutive HD patients with vascular access failure during a 5-year period were reviewed, and a total of 26 patients with symptomatic CVS were identified. Combined with radiological findings, their clinical characteristics were examined. Only seven patients had a history of internal jugular dialysis catheterization. Diagnostic multidetector row computed tomography angiography showed that 7 of the 19 patients with no history of catheterization had left innominate vein stenosis due to extrinsic compression between the sternum and arch vessels. These patients had a shorter period from the time of creation of the vascular access to the initial referral (9.2 ± 7.6 months) than the rest of the patients (35.5 ± 18.6 months, p = 0.0017). Our findings suggest that cases without a history of central venous catheterization may not be rare among the HD patients with symptomatic CVS. However, those still need to be confirm by larger prospective studies of overall chronic HD patients with symptomatic CVS.

  12. Duplex correlation phlebography in venous mapping of the upper limbs for artery venous fistulas for hemodialysis

    International Nuclear Information System (INIS)

    Esperon Percovich, A.; Lopez Chapuis, D.; Velverdu, M.; Curi, J.; Sciuto, F.; Velverdu, M.; Curi, J.

    1995-01-01

    When clinical evaluation is not enough,the evaluation of the venous condition of the upper limbs for the realization of angio access for hemodialysis is classically based on phlebography,an invasive,risky method.the appear rance of non invasive techniques such as eco Doppler(duplex) makes it necessary to do research in order to determine the utility of the method and define its indications.The authors analyse 35 venous mappings of the upper limbs by phlebography and duplex and compare its results for the different venous regions.They come to the conclusion that duplex presented the best performance for the hum ero axillary subclavian region,detecting thrombosis with a sensitivity of 100% a specificity of 97% positive predictive value of 50% and negative predictive value of 100%.For superficial axis (radial and superficial ulnar,basilic and cephalic)there is low sensitivity for the determination of presence and permeability of the axis but 100% specificity.Duplex was not useful for the description of veins in order to determine utility for Avf.Finally,the authors make recommendations as regards indications of these para clinical tests [es

  13. The Role of Inflammation in Venous Thromboembolism

    Directory of Open Access Journals (Sweden)

    Brian R. Branchford

    2018-05-01

    Full Text Available Venous thromboembolism (VTE, comprising deep vein thrombosis (DVT, and pulmonary embolism (PE, is becoming increasingly recognized as a cause of morbidity and mortality in pediatrics, particularly among hospitalized children. Furthermore, evidence is accumulating that suggests the inflammatory response may be a cause, as well as consequence, of VTE, but current anticoagulation treatment regimens are not designed to inhibit inflammation. In fact, many established clinical VTE risk factors such as surgery, obesity, cystic fibrosis, sepsis, systemic infection, cancer, inflammatory bowel disease, and lupus likely modulate thrombosis through inflammatory mediators. Unlike other traumatic mechanisms of thrombosis involving vascular transection and subsequent exposure of subendothelial collagen and other procoagulant extracellular matrix materials, inflammation of the vessel wall may initiate thrombosis on an intact vein. Activation of endothelial cells, platelets, and leukocytes with subsequent formation of microparticles can trigger the coagulation system through the induction of tissue factor (TF. Identification of biomarkers to evaluate VTE risk could be of great use to the clinician caring for a patient with inflammatory disease to guide decisions regarding the risk:benefit ratio of various types of potential thromboprophylaxis strategies, or suggest a role for anti-inflammatory therapy. Unfortunately, no such validated inflammatory scoring system yet exists, though research in this area is ongoing. Elevation of C-reactive protein, IL-6, IL-8, and TNF-alpha during a response to systemic inflammation have been associated with increased VTE risk. Consequent platelet activation enhances the prothrombotic state, leading to VTE development, particularly in patients with other risk factors, most notably central venous catheters.

  14. [Association between venous thrombosis and dyslipidemia].

    Science.gov (United States)

    García Raso, Aránzazu; Ene, Gabriela; Miranda, Carolina; Vidal, Rosa; Mata, Raquel; Llamas Sillero, M Pilar

    2014-07-07

    Venous and arterial thrombosis, despite being historically considered as distinct conditions, share certain risk factors. Dyslipidemia is a clinical condition with a relatively high prevalence in the population and has been associated with an increased thrombotic risk. Lipids and lipoproteins modulate the expression and/or function of thrombotic, fibrinolytic and rheological factors. We have developed a descriptive, retrospective, comparative, cross-sectional study including a group of 313 patients with venous thromboembolism (VTE). We collected basic demographic data, cardiovascular risk factors and thrombotic complications. All patients were subjected to a lipid profile study with determination of total cholesterol, high density lipoprotein cholesterol (cHDL), low density lipoprotein cholesterol (cLDL) and triglycerides. The multivariable analysis showed that dyslipidemia was a risk factor for VTE (odds ratio [OR] 3.87, 95% confidence interval [95% CI] 2.72-5.56; P<.0001). Of a total of 313 patients included in the study, 31% (n=97) had a recurrent thrombotic event and 23% (n=72) developed post-thrombotic syndrome. cHDL levels below 35 mg/dl and cLDL levels higher than 180 mg/dl represented risk factors for the development of recurrent thrombosis, OR 3.12 (95% CI 1.35-7.74; P=.008) and OR 2.35 (95% CI 1.24-4.45; P=.008), respectively, and post-thrombotic syndrome, OR 3.44 (95% CI 1.43-8.83; P=.005) and OR 2.35 (95% CI 1.24-4.45; P=.008). Our study confirmed the association between dyslipidemia and VTE and showed a risk of thrombosis nearly 4 times higher in individuals with this disease. In addition, alterations in the lipid profile were also related to a higher prevalence of thrombotic complications, recurrence and post-thrombotic syndrome. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  15. Hepatic venous pressure gradients measured by duplex ultrasound

    International Nuclear Information System (INIS)

    Tasu, J.-P.; Rocher, L.; Peletier, G.; Kuoch, V.; Kulh, E.; Miquel, A.; Buffet, C.; Biery, M.

    2002-01-01

    AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r = 0.83, P -2 provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient > 12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r = 0.45,P = 0.01) and portal vein velocity (r = 0.40,P = 0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension. Tasu, J.-P. et al. (2002)

  16. Venous anomalies and abnormalities of the posterior fossa

    International Nuclear Information System (INIS)

    Goulao, A.; Alvarez, H.; Garcia Monaco, R.; Pruvost, P.; Lasjaunias, P.

    1990-01-01

    The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called 'venous angioma' are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVA). Posterior fossa DVA, like the supra-tentorial ones are classified according to their drainage into deep and superficial type. They are exclusively located in the cerebellum or tectum. In 4 cases DVA was an incidental finding, in 3 an associated cerebral venous malformation (CVM) was found and felt to be the cause of the symptoms and only in one (Trigeminal pain) was a link between both suspected. Cavernous venous malformation (CVM) were found in frequent association with DVA (27%). 4 cases were single and 2 multiple. 5 CVM were located in the brain stem and 3 in the cerebellum. The clinical and radiological files were reviewed and a direct relationship between symptoms and localization was found in all patients with CVM. In 2 cases venous dysplasia was found: 1 Sturge-Weber and 1 First branchial arch syndrome. Both posterior fossa venous abnormalities were incidental findings. (orig.)

  17. Cardiovascular Pressures with Venous Gas Embolism and Decompression

    Science.gov (United States)

    Butler, B. D.; Robinson, R.; Sutton, T.; Kemper, G. B.

    1995-01-01

    Venous gas embolism (VGE) is reported with decompression to a decreased ambient pressure. With severe decompression, or in cases where an intracardiac septal defect (patent foramen ovale) exists, the venous bubbles can become arterialized and cause neurological decompression illness. Incidence rates of patent foramen ovale in the general population range from 25-34% and yet aviators, astronauts, and deepsea divers who have decompression-induced venous bubbles do not demonstrate neurological symptoms at these high rates. This apparent disparity may be attributable to the normal pressure gradient across the atria of the heart that must be reversed for there to be flow potency. We evaluated the effects of: venous gas embolism (0.025, 0.05 and 0.15 ml/ kg min for 180 min.) hyperbaric decompression; and hypobaric decompression on the pressure gradient across the left and right atria in anesthetized dogs with intact atrial septa. Left ventricular end-diastolic pressure was used as a measure of left atrial pressure. In a total of 92 experimental evaluations in 22 dogs, there were no reported reversals in the mean pressure gradient across the atria; a total of 3 transient reversals occurred during the peak pressure gradient changes. The reasons that decompression-induced venous bubbles do not consistently cause serious symptoms of decompression illness may be that the amount of venous gas does not always cause sufficient pressure reversal across a patent foramen ovale to cause arterialization of the venous bubbles.

  18. Postoperative deep venous thrombosis in Japan. Incidence and prophylaxis

    International Nuclear Information System (INIS)

    Inada, K.; Shirai, N.; Hayashi, M.; Matsumoto, K.; Hirose, M.

    1983-01-01

    The incidence of postoperative deep venous thrombosis was investigated using the iodine-125-fibrinogen method in 256 patients undergoing major surgery. Deep venous thrombosis was found in 49 patients (15.3 percent), and nonfatal pulmonary embolism developed in one of seven patients in whom the thrombus extended to the popliteal vein. The same investigation was performed in 110 patients who wore a graduated compression stocking on one leg, with the other leg serving as a control. Deep venous thrombosis was found in 4 of 110 stockinged legs (3.6 percent) and in 16 of 110 control legs (14.5 percent). The incidence of deep venous thrombosis decreased significantly in patients who wore the stocking. An increase in femoral venous flow velocity was found in the stockinged legs by the Doppler method. The mean velocity of venous return by xenon-133 clearance was significantly greater in the stockinged legs than in the control legs. These findings were considered to support the efficacy of graduated compression stockings for the prevention of deep venous thrombosis

  19. Hepatic venous pressure gradients measured by duplex ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Tasu, J.-P.; Rocher, L.; Peletier, G.; Kuoch, V.; Kulh, E.; Miquel, A.; Buffet, C.; Biery, M

    2002-08-01

    AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r = 0.83, P < 0.0001) and with the Child-Pugh score (r = 0.63, P < 0.0001). An acceleration index cut-off value of 1 m.s{sup -2} provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient > 12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r = 0.45,P = 0.01) and portal vein velocity (r = 0.40,P = 0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension. Tasu, J.-P. et al. (2002)

  20. Eye Injuries

    Science.gov (United States)

    ... that you could lose your vision. Most eye injuries are preventable. If you play sports or work in certain jobs, you may need protection. The most common type of injury happens when something irritates the ...

  1. Ocular Injuries

    African Journals Online (AJOL)

    GB

    2015-04-02

    Apr 2, 2015 ... KEYWORDS: Bangers, eye injuries, holidays, Nigeria ... antibiotic and cycloplegic eye drops, antibiotic ointment at night and .... Adeoti C. O, Bello T. O., Ashaye A. O. Blinding ... Can fireworks-related injuries to children during ...

  2. ACL Injuries

    Science.gov (United States)

    ... while doing things like skiing, playing soccer or football, and jumping on a trampoline. When you injure ... severity of the injury, age, physical condition, medical history, and other injuries or illnesses. People who are ...

  3. Knee Injuries

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Knee Injuries KidsHealth / For Teens / Knee Injuries What's in ... can do to protect them. What's in a Knee? The knee is a joint , actually the largest ...

  4. Venous and Arterial Thromboses: Two Sides of the Same Coin?

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J

    2018-04-01

    Arterial and venous thromboses are sustained by development of intraluminal thrombi, respectively, within the venous and arterial systems. The composition and structure of arterial and venous thrombi have been historically considered as being very different. Arterial thrombi (conventionally defined as "white") have been traditionally proposed to be composed mainly of fibrin and platelet aggregates, whilst venous thrombi (conventionally defined as "red") have been proposed as mostly being enriched in fibrin and erythrocytes. This archaic dichotomy seems ever more questionable, since it barely reflects the pathophysiology of thrombus formation in vivo. Both types of thrombi are actually composed of a complex fibrin network but, importantly, also contain essentially the same blood-borne cells (i.e., red blood cells, leukocytes, and platelets), and it is only the relative content of these individual elements that differ between venous and arterial clots or, otherwise, between thrombi generated under different conditions of blood flow and shear stress. Convincing evidence now suggests that either white or red intracoronary thrombi may be present in patients with myocardial infarction and, even more importantly, red thrombi may be more prone to distal embolization during percutaneous coronary intervention than those with lower content of erythrocytes. Conversely, it is now accepted that components traditionally considered to be involved "only" in arterial thrombosis are also represented in venous thrombosis. Thus, platelets comprise important components of venous clots, although they may be present in lower amounts here than in arterial thrombi, and von Willebrand factor is also represented in both arterial and venous thrombi. Of importance, such evidence thus supports the concept that adjunctive treatment normally associated to prevention of arterial thrombosis (e.g., aspirin) may have a role also in prevention and treatment of venous thrombosis. Thieme Medical

  5. ENDOVASCULAR TREATMENT FOR DISORDERS OF THE VENOUS SYSTEM

    Directory of Open Access Journals (Sweden)

    A. G. Osiev

    2015-01-01

    Full Text Available The annual rate of deep vein thrombosis in general population is from 5 to 9 cases per 10 000, whereas for venous thromboembolism (deep vein thrombosis and pulmonary embolism taken together amounts to 14 cases per 10 000. To improve longterm results of therapy for thrombosis of deep veins of the lower extremities, it is important to restore venous function and outflow. Anticoagulant therapy with low weight or non-fractionated heparin preparations remains the most widely used method of management. However, total or partial thrombosis resolution under anticoagulant treatment is achieved only in 4 and 14% of cases, respectively. Thrombolysis allows for early resorption of the thrombus by means of a minimally invasive procedure with lower risk of complication. After the venous flow is restored, the aim of treatment is to prevent damage to the venous valves, venous hypertension and repeated thrombosis with development of the post-thrombotic syndrome. Compared to anticoagulation, systemic thrombolysis has the benefit of more rapid clot resorption and less damage to the venous valve. One of its serious limitations is a high bleeding risk related to higher doses of the drug administered through a peripheral vein catheter. Therefore, selective intra-clot administration of thombolytics (direct catheter thrombolysis has been suggested as an alternative. For more effective therapy with the use of lower doses of thrombolytics, the so called pharmaco-mechanical thrombectomy has been developed. Venous stenosis hindering the venous outflow is frequently seen after direct catheter or pharmaco-mechanical thrombolysis. Angioplasty with stent placement is recommended in the cases with residual venous abnormality after successful thrombolysis and thrombectomy. 

  6. Femoral vessel injury by a nonlethal weapon projectile.

    Science.gov (United States)

    Biagioni, Rodrigo Bruno; Miranda, Gustavo Cunha; Mota de Moraes, Leonardo; Nasser, Felipe; Burihan, Marcelo Calil; Ingrund, José Carlos

    2018-06-01

    Rubber projectiles are used as an alternative to metal bullets owing to their lower morbidity and mortality rate. There are few reports of vascular lesions of extremities caused by rubber projectiles in the literature. The authors report the case of a 37-year-old man who was the victim of a penetrating injury to the left thigh with a rubber projectile. He reported only pain at the site of the injury; pulses were decreased in the affected limb. After arteriography confirmed an injury to the superficial femoral artery, he underwent an arterial and venous femorofemoral bypass using a reversed contralateral saphenous vein.

  7. Femoral vessel injury by a nonlethal weapon projectile

    Directory of Open Access Journals (Sweden)

    Rodrigo Bruno Biagioni, MD

    2018-06-01

    Full Text Available Rubber projectiles are used as an alternative to metal bullets owing to their lower morbidity and mortality rate. There are few reports of vascular lesions of extremities caused by rubber projectiles in the literature. The authors report the case of a 37-year-old man who was the victim of a penetrating injury to the left thigh with a rubber projectile. He reported only pain at the site of the injury; pulses were decreased in the affected limb. After arteriography confirmed an injury to the superficial femoral artery, he underwent an arterial and venous femorofemoral bypass using a reversed contralateral saphenous vein. Keywords: Vascular trauma, Nonlethal projectile, Penetrating trauma

  8. Hamstring Injury

    Science.gov (United States)

    Hamstring injury Overview A hamstring injury occurs when you strain or pull one of your hamstring muscles — the group of three muscles that run along ... You may be more likely to get a hamstring injury if you play soccer, basketball, football, tennis ...

  9. Orienteering injuries

    OpenAIRE

    Folan, Jean M.

    1982-01-01

    At the Irish National Orienteering Championships in 1981 a survey of the injuries occurring over the two days of competition was carried out. Of 285 individual competitors there was a percentage injury rate of 5.26%. The article discusses the injuries and aspects of safety in orienteering.

  10. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  11. 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.

  12. Arterial versus venous lactate: a measure of sepsis in children.

    Science.gov (United States)

    Samaraweera, Sahan Asela; Gibbons, Berwyck; Gour, Anami; Sedgwick, Philip

    2017-08-01

    This study assessed the agreement between arterial and venous blood lactate and pH levels in children with sepsis. This retrospective, three-year study involved 60 PICU patients, with data collected from electronic or paper patient records. The inclusion criteria comprised of children (≤17 years old) with sepsis and those who had a venous blood gas taken first with an arterial blood gas taken after within one hour. The lactate and pH values measured through each method were analysed. There is close agreement between venous and arterial lactate up to 2 mmol/L. As this value increases, this agreement becomes poor. The limits of agreement (LOA) are too large (±1.90 mmol/L) to allow venous and arterial lactate to be used interchangeably. The mean difference and LOA between both methods would be much smaller if derived using lactate values under 2.0 mmol/L. There is close agreement between arterial and venous pH (MD = -0.056, LOA ± 0.121). However, due to extreme variations in pH readings during sepsis, pH alone is an inadequate marker. A venous lactate ≤2 mmol/L can be used as a surrogate for arterial lactate during early management of sepsis in children. However, if the value exceeds 2 mmol/L, an arterial sample must confirm the venous result. What is known: • In children with septic shock, a blood gas is an important test to show the presence of acidosis and high lactic acid. Hyperlactataemia on admission is an early predictor of outcome and is associated with a greater mortality risk. • An arterial sample is the standard for lactate measurement, however getting a sample may be challenging in the emergency department or a general paediatric ward. Venous samples are quicker and easier to obtain. Adult studies generally advise caution in replacing venous lactate values for the arterial standard, whilst paediatric studies are limited in this area. What is new: • This is the first study assessing the agreement between arterial and peripheral venous

  13. 'Chronic cerebrospinal venous insufficiency' in multiple sclerosis. Is multiple sclerosis a disease of the cerebrospinal venous outflow system?

    International Nuclear Information System (INIS)

    Wattjes, M.P.; Doepp, F.; Bendszus, M.; Fiehler, J.

    2011-01-01

    Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency (CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients. (orig.)

  14. Protocol for the realization of venous mapping by chronic venous insufficiency in lower limbs under sonographic guide

    International Nuclear Information System (INIS)

    Blanco Rojas, Diego Jose

    2013-01-01

    The current state of knowledge is reviewed with respect to the realization of lower limbs venous mapping. Venous mapping is obtained by the use of color and spectral Doppler ultrasound. Doppler ultrasound has provided a precise graphical representation of the superficial and deep venous systems. The performance of the venous mapping is considered essential for the correct handling of venous diseases. The anatomical and pathophysiological basic concepts are defined to realize the sonographic assessment of the veins of the lower limbs. The required technical aspects are revised for the realization of sonographic exploration of the patient with venous insufficiency. Sonographic findings are characterized to support the diagnostic of venous insufficiency of the lower limbs. The CEAP (clinical-etiologic-anatomic-pathophysiologic) classification is utilized to differentiate forms and degrees of severity of the disorder, and has allowed an interinstitutional comparison in clinical studies, the evaluation of treatment and monitoring of patients. A proposal is designed to perform reports that have served of guide surgical to vascular surgeons [es

  15. Posttraumatic venous gas in the liver - a case report and review of the current literature.

    Science.gov (United States)

    Fahrner, René; Rauchfuss, Falk; Scheuerlein, Hubert; Settmacher, Utz

    2018-03-02

    There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding. Furthermore, a blunt thoracic trauma with hemopneumothorax due to rib fractures was treated with a chest tube. No obvious abdominal pathology was seen. While in the operating theatre for the surgical revision of the cranial soft tissue lesions, a femoral venous catheter was inserted without any complications. A routine ultrasound of the abdomen six hours after the trauma revealed unclear hepatic gas formation. A contrast-enhanced computer tomography (CT) scan of the abdomen was performed, and the gas formation was found to be localized within the left hepatic vein. Afterwards, there was no specific treatment of the hepatic venous gas formation, as no alterations of liver function or liver enzymes were seen. The further course of the patient was uneventful regarding the gas formation in the liver, and another ultrasound two days later revealed no further gas in the liver. The placement of a femoral venous catheter is a risk factor for gas formation in liver veins. No further treatment is needed in cases with stable liver function. To rule out serious pathologies, diagnostic findings (e.g., ultrasound, CT), clinical history and underlying diseases need to be analyzed carefully after the detection of intrahepatic gas formation. With contrast-enhanced CT, the localization of the gas and its potential causes might be detectable.

  16. Partial anomalous pulmonary venous return in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Sung, Won-kyung; Au, Virginia; Rose, Anand

    2012-01-01

    Anomalous pulmonary venous return is an uncommon congenital malformation, and may be partial or total. Partial anomalous pulmonary venous return (PAPVR) is more common than total anomalous pulmonary venous return, and is often associated with other congenital cardiac anomalies. Whilst many patients with PAPVR remain asymptomatic, some may present in later age with symptoms related to left-to-right shunt, right heart failure and pulmonary hypertension. We report two cases of PAPVR detected on Computed Tomography Pulmonary Angiogram (CTPA) for the work up of pulmonary hypertension. The cases demonstrate that, although uncommon, partial anomalous pulmonary venous return can be a contributing factor to pulmonary hypertension and pulmonary veins should be carefully examined when reading a CTPA study.

  17. Splanchnic venous thrombosis driven by a constitutively activated ...

    African Journals Online (AJOL)

    Introduction: Splanchnic venous thrombosis (SVT) has varied etiology with Philadelphia-negative myeloproliferative neoplasms (MPNs) being the most frequent underlying prothrombotic factor. Hematological indices often remain within normal range because of portal hypertension and its sequelae, causing diagnostic ...

  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. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  19. Color-flow Doppler imaging in suspected extremity venous thrombosis

    International Nuclear Information System (INIS)

    Foley, W.D.; Middleton, W.D.; Lawson, T.L.; Hinson, G.W.; Puller, D.R.

    1987-01-01

    Color-flow Doppler imaging (CFDI) (Quanatum, 5 and 7.5 MHz, linear array) has been performed on 23 extremities (nine positive for venous thrombosis, 14 negative) with venographic correlation. CFDI criteria evaluated were venous color-flow respiratory variation, augmentation, compressibility, valve competence, and intraluminal echogenic filling defects. Both CFDI and venography were evaluated independently and prospectively. CFDI and venography agreed in all six cases of femoral vein thrombosis and eight of nine cases of popliteal vein thrombosis. CFDI was negative in one instance of recanalized popliteal vein thrombosis. Recanalized femoral vein thrombosis was documented in three patients by CFDI when the vein was nonopacified on conventional venography. CFDI provides a rapid and accurate assessment of the femoral popliteal venous system and can distinguish an occluded from a recanalized thrombus. Initial experience with auxiliary subclavian venous thrombus has produced equally accurate results

  20. [Venous thrombosis of atypical location in patients with cancer].

    Science.gov (United States)

    Campos Balea, Begoña; Sáenz de Miera Rodríguez, Andrea; Antolín Novoa, Silvia; Quindós Varela, María; Barón Duarte, Francisco; López López, Rafael

    2015-01-01

    Venous thromboembolism (VTE) is a complication that frequently occurs in patients with neoplastic diseases. Several models have therefore been developed to identify patient subgroups diagnosed with cancer who are at increased risk of developing VTE. The most common forms of thromboembolic episodes are deep vein thrombosis in the lower limbs and pulmonary thromboembolism. However, venous thrombosis is also diagnosed in atypical locations. There are few revisions of unusual cases of venous thrombosis. In most cases, VTE occurs in the upper limbs and in the presence of central venous catheters, pacemakers and defibrillators. We present the case of a patient diagnosed with breast cancer and treated with surgery, chemotherapy and radiation therapy who developed a thrombosis in the upper limbs (brachial and axillary). Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  1. Central venous oxygen saturation during hypovolaemic shock in humans

    DEFF Research Database (Denmark)

    Madsen, P; Iversen, H; Secher, N H

    1993-01-01

    We compared central venous oxygen saturation and central venous pressure (CVP) as indices of the effective blood volume during 50 degrees head-up tilt (anti-Trendelenburg's position) induced hypovolaemic shock in eight healthy subjects. Head-up tilt increased thoracic electrical impedance from 31...... (28-36) (median and range) to 34 (30-40) Ohm, mean arterial pressure (MAP) from 79 (70-88) to 86 (80-99) mmHg, heart rate (HR) from 67 (56-71) to 99 (78-119) beats min-1 (p ....05) but thereafter remained stable. In contrast, central venous oxygen saturation showed a linear decrease with time from 0.75 (0.69-0.78) at rest to 0.60 (0.49-0.67) (p measurement of central venous oxygen saturation...

  2. [The unnecessary application of central venous catheterization in surgical patients].

    Science.gov (United States)

    Uemura, Keiko; Inoue, Satoki; Kawaguchi, Masahiko

    2018-04-06

    Perioperative physicians occasionally encounter situations where central venous catheters placed preoperatively turn out to be unnecessary. The purpose of this retrospective study is to identify the unnecessary application of central venous catheter placement and determine the factors associated with the unnecessary application of central venous catheter placement. Using data from institutional perioperative central venous catheter surveillance, we analysed data from 1,141 patients who underwent central venous catheter placement. We reviewed the central venous catheter registry and medical charts and allocated registered patients into those with the proper or with unnecessary application of central venous catheter according to standard indications. Multivariate analysis was used to identify factors associated with the unnecessary application of central venous catheter placement. In 107 patients, representing 9.38% of the overall population, we identified the unnecessary application of central venous catheter placement. Multivariate analysis identified emergencies at night or on holidays (odds ratio [OR] 2.109, 95% confidence interval [95% CI] 1.021-4.359), low surgical risk (OR=1.729, 95% CI 1.038-2.881), short duration of anesthesia (OR=0.961/10min increase, 95% CI 0.945-0.979), and postoperative care outside of the intensive care unit (OR=2.197, 95% CI 1.402-3.441) all to be independently associated with the unnecessary application of catheterization. Complications related to central venous catheter placement when the procedure consequently turned out to be unnecessary were frequently observed (9/107) compared with when the procedure was necessary (40/1034) (p=0.032, OR=2.282, 95% CI 1.076-4.842). However, the subsequent multivariate logistic model did not hold this significant difference (p=0.0536, OR=2.115, 95% CI 0.988-4.526). More careful consideration for the application of central venous catheter is required in cases of emergency surgery at night or on

  3. Monstrous venous haemangioma tumor of the retroperitonial space - Diagnosis and diagnostic problems

    International Nuclear Information System (INIS)

    Leinung, S.; Wuerl, P.; Frey, A.; Schoenfelder, M.; Lotz, I.; Lochhaas, L.

    2000-01-01

    The preoperative diagnosis and its inherent problems are illustrated using a coincidentally diagnosed monstrous haemangioma tumor of the retroperitonial space in a twenty year old patient. With respect to our patient, X-ray, computer tomography and angiography all failed as diagnostic tools. Only the use of Doppler sonographic flow signals suggested the presence of a haemangioma. The morphology, prognosis and clinical significance of blood vessel tumors are multifaceted. The most important differential diagnoses to the venous haemangioma are the cavernous and the cappilliary haemangioma. The venous haemangioma distinguishes itself through the presence of blood vessel walls. Haemangiomas are common benign tumors. In the presence of highly developed muscular components, there exists a transition to angiomyomas and to leiomyomas. Venal haemangiomas are extremely rare in the demonstrated localisation of the retroperitoneal space. Here they can grow to monstrous preportions whilst remaining undetected. Thus the patient is under the potential danger of bleeding to death through trivial injuries. The therapy of choice reamins total surgical excision. (orig.) [de

  4. Pulmonary venous thrombosis secondary to radiofrequency ablation of the pulmonary veins

    Directory of Open Access Journals (Sweden)

    Raquel López-Reyes

    Full Text Available Background: Pulmonary Vein Thrombosis (PVT is a rare and underdiagnosed entity produced by local mechanical nature mechanisms, vascular torsion or direct injury to the vein. PVT has been described in clinical cases or small multicenter series mainly in relation to pulmonary vein stenosis, metastatic carcinoma, fibrosing mediastinitis, as an early surgical complication of lung transplantation lobectomy and radiofrequency ablation performed in patients with atrial fibrillation, although in some cases the cause is not known. Case: We report the case of a 57 years old male with history of atrial fibrillation treated by radiofrequency ablation who was admitted in our center because of a two-week history of consistent pleuritic pain in the left hemithorax and low-grade hemoptysis and a lung consolidation treated as a pneumonia with antibiotic but not responding to medical therapy. In view of the poor evolution of the patient, computed tomography angiography was performed with findings of PVT and secondary venous infarction and anticoagulation therapy was optimized. At the end, pulmonary resection was performed due to hemorrhagic recurrence. Conclusion: PVT remains a rare complication of radiofrequency ablation and other procedures involving pulmonary veins. Clinical suspicion and early diagnosis is crucial because is a potentially life-threatening entity. Keywords: Venous thrombosis, Atrial fibrilation, Radiofrequency ablation, Hemoptysis, Lung consolidation, Lung infarction, Lung resection surgery

  5. Open heart surgery for management of right auricular thrombus related to central venous catheterization.

    Science.gov (United States)

    Ribeiro, A F; Neto, I S; Maia, I; Dias, C

    2018-04-19

    Central venous catheters are widely used in critically ill patients; however, they are also associated with increased morbidity and mortality. The literature may underestimate the incidence of catheter-inducible right atrial thrombi that are asymptomatic but potentially life threatening. The recognized risk factors for its development include infections related to the catheter, endothelial injury secondary to mechanical and chemical damage induced by certain medications and infused fluids. The characteristics of the patient and the catheter, such as size, material, type, location and ease of insertion, as well as the duration of placement play an additional role. We report the case of a 38-year-old man, who developed an asymptomatic catheter-inducible right atrial thrombi requiring open heart surgery, after taking a central venous catheter for thirty-five days. The present case highlights existing limitations in making a correct and fast diagnosis, which should be anticipated in patients with multiple risk factors for thrombosis. Given the limited recommendations available, we consider that the most appropriate strategy should be individualized. Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Idiopathic versus secondary venous thromboembolism. Findings of the RIETE registry.

    Science.gov (United States)

    Pedrajas, J M; Garmendia, C; Portillo, J; Gabriel, F; Mainez, C; Yera, C; Monreal, M

    2014-10-01

    The Computerized Registry of Patients with Venous Thromboembolism (RIETE) is a prospective registry that consecutively includes patients diagnosed with venous thromboembolism. We compared the clinical presentation and response to anticoagulant treatment in patients with idiopathic venous thromboembolism (IVT) versus secondary venous thromboembolism (SVT, associated with a risk factor). We analyzed the differences in clinical characteristics, comorbidity, treatment and events during the first 3months after the diagnosis of venous thromboembolism in patients with IVT or SVT and according to their initial clinical presentation. A total of 39,921 patients with IVT (n=18,029; 45.1%) or SVT (n=21,892; 54.9%) were enrolled. The patients with IVT had a greater history of venous thromboembolism than those diagnosed with SVT (p<.001). The initial treatment was similar for the 2 groups, but more inferior vena cava filters were placed in the SVT group (p<.001). In the long term, low-molecular-weight heparin was used more often in the SVT group than in the IVT group. At 90days, bleeding, death and the recurrence of venous thromboembolism were significantly more frequent in the SVT group. The multivariate analysis confirmed that IVT was associated with fewer major (OR, 0.60; 95%CI, 0.50-0.61; p<.001) and fatal (OR, 0.41; 95%CI, 0.29-0.62; p<.001) bleedings, fewer relapses (OR, 0.58; 95%CI, 0.39-0.78; p<.001) and fewer fatal pulmonary embolisms (OR, 0.29; 95%CI, 0.12-0.52; p<.001). These differences were maintained in patients whose venous thromboembolism started with a pulmonary embolism or with deep vein thrombosis. IVT has a better prognosis than SVT at 90days of the diagnosis. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  7. ANKYLOSING SPONDYLITIS - AN ALARMING RISK OF VENOUS THROMBOEMBOLIC DISEASE

    OpenAIRE

    Dr. Darpanarayan Hazra; Dr. Shahid Mahdi; Dr. Amit Madan; Dr. Neeraj Bhalla

    2017-01-01

    Venous thrombo-embolic disease (VTE) is a potentially life threatening clinical event. Ankylosing spondylitis (AS) is a chronic inflammatory disease with a significantly increased risk of developing VTE. Management of acute proximal deep venous thrombosis (DVT) depends on the clinical status of the affected limb, extent of the thrombus and comorbidities of the patient. Semba and Dake introduced Catheter directed thrombolysis (CDT) to treat 21 patients of DVT in 1994. CDT is a life or limb sav...

  8. How to objectively assess jugular primary venous obstruction

    OpenAIRE

    Paolo Zamboni

    2014-01-01

    Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a ...

  9. Total anomalous systemic venous drainage in left heterotaxy syndrome.

    Science.gov (United States)

    Khandenahally, Ravindranath S; Deora, Surender; Math, Ravi S

    2013-04-01

    Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous drainage to the left-sided atrium with non-compaction of the left ventricle.

  10. Sustained compression and healing of chronic venous ulcers.

    OpenAIRE

    Blair, S. D.; Wright, D. D.; Backhouse, C. M.; Riddle, E.; McCollum, C. N.

    1988-01-01

    STUDY OBJECTIVE--Comparison of four layer bandage system with traditional adhesive plaster bandaging in terms of (a) compression achieved and (b) healing of venous ulcers. DESIGN--Part of larger randomised trial of five different dressings. SETTING--Outpatient venous ulcer clinic in university hospital. PATIENTS--(a) Pressure exerted by both bandage systems was measured in the same 20 patients. (b) Healing with the four layer bandage was assessed in 148 legs in 126 consecutive patients (mean ...

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ...

  12. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...

  13. 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. © The Author(s) 2015.

  14. Portal-venous gas unrelated to mesenteric ischemia

    International Nuclear Information System (INIS)

    Wiesner, Walter; Mortele, Koenraad J.; Ji, Hoon; Ros, Pablo R.; Glickman, Jonathan N.

    2002-01-01

    The aim of this study was to report on 8 patients with all different non-ischemic etiologies for portal-venous gas and to discuss this rare entity and its potentially misleading CT findings in context with a review of the literature. The CT examinations of eight patients who presented with intrahepatic portal-venous gas, unrelated to bowel ischemia or infarction, were reviewed and compared with their medical records with special emphasis on the pathogenesis and clinical impact of portal-venous gas caused by non-ischemic conditions. The etiologies for portal-venous gas included: abdominal trauma (n=1); large gastric cancer (n=1); prior gastroscopic biopsy (n=1); prior hemicolectomy (n=1); graft-vs-host reaction (n=1); large paracolic abscess (n=1); mesenteric recurrence of ovarian cancer superinfected with clostridium septicum (n=1); and sepsis with Pseudomonas aeruginosa (n=1). The clinical outcome of all patients was determined by their underlying disease and not negatively influenced by the presence of portal-venous gas. Although the presence of portal-venous gas usually raises the suspicion of bowel ischemia and/or intestinal necrosis, this CT finding may be related to a variety of non-ischemic etiologies and pathogeneses as well. The knowledge about these conditions may help to avoid misinterpretation of CT findings, inappropriate clinical uncertainty and unnecessary surgery in certain cases. (orig.)

  15. Visualization of coronary venous anatomy by cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Crean Andrew

    2009-08-01

    Full Text Available Abstract Background Coronary venous imaging with whole-heart cardiovascular magnetic resonance (CMR angiography has recently been described using developmental pulse sequences and intravascular contrast agents. However, the practical utility of coronary venous imaging will be for patients with heart failure in whom cardiac resynchronisation therapy (CRT is being considered. As such complementary information on ventricular function and myocardial viability will be required. The aim of this study was to determine if the coronary venous anatomy could be depicted as part of a comprehensive CMR protocol and using a standard extracellular contrast agent. Methods and Results Thirty-one 3D whole heart CMR studies, performed after intravenous administration of 0.05 mmol/kg gadolinium DTPA, were reviewed. The cardiac venous system was visualized in all patients. The lateral vein of the left ventricle was present in 74%, the anterior interventricular vein in 65%, and the posterior interventricular vein in 74% of patients. The mean maximum distance of demonstrable cardiac vein on the 3D images was 81.5 mm and was dependent on the quality of the 3D data set. Five patients showed evidence of myocardial infarction on late gadolinium enhancement (LGE images. Conclusion Coronary venous anatomy can be reliably demonstrated using a comprehensive CMR protocol and a standard extracellular contrast agent. The combination of coronary venous imaging, assessment of ventricular function and LGE may be useful in the management of patients with LV dysfunction being considered for CRT.

  16. Venous compression syndrome of internal jugular veins prevalence in patients with multiple sclerosis and chronic cerebro-spinal venous insufficiency.

    Science.gov (United States)

    Mandolesi, Sandro; Niglio, Tarcisio; Orsini, Augusto; De Sio, Simone; d'Alessandro, Alessandro; Mandolesi, Dimitri; Fedele, Francesco; d'Alessandro, Aldo

    2016-01-01

    Analysis of the incidence of Venous Compression Syndrome (VCS) with full block of the flow of the internal jugular veins (IJVs) in patients with Multiple Sclerosis and Chronic cerebro-spinal venous insufficiency. We included 769 patients with MS and CCSVI (299 males, 470 females) and 210 controls without ms and ccsvi (92 males, 118 females). each subject was investigated by echo-color-doppler (ecd). morphological and hemodynamic ecd data were recorded by a computerized mem-net maps of epidemiological national observatory on ccsvi and they were analyzed by mem-net clinical analysis programs. VCS of IJVs occurs in 240 subjects affected by CCSVI and MS (31% of total) and in 12 controls (6% of total). The differences between the two groups are statistical significant (X² = 36.64, pCerebro-Spinal Venous Insufficiency, Multiple Sclerosis, Venous Compression Syndrome.

  17. Adipsic diabetes insipidus and venous thromboembolism (VTE): recommendations for addressing its hypercoagulability.

    Science.gov (United States)

    Miljic, Dragana; Miljic, Predrag; Doknic, Mirjana; Pekic, Sandra; Stojanovic, Marko; Petakov, Milan; Popovic, Vera

    2014-01-01

    Adipsic diabetes insipidus (ADI) is a rare disorder. It can occur after transcranial surgery for craniopharyngeoma, suprasellar pituitary adenoma and anterior communicating artery aneurysm but also with head injury, toluene exposure and developmental disorders. It is often associated with significant hypothalamic dysfunction and complications like obesity, sleep apnea, thermoregulatory disorders, seizures and venous thromboembolism (VTE). Morbidity and mortality data have been reported as single case reports with only one large series suggesting increased risk for VTE in patients with ADI. Here we report a mini-series of four patients with ADI and VTE. Post-surgery immobilization, obesity, infection, with prolonged hospitalization, hemoconcentration and changes in coagulation which might be induced by inadequate hormone treatment in the postoperative period (high doses of glucocorticoids, sex steroids and DDAVP replacement) may all contribute to the pathogenesis of VTE. Thromboprophylactic treatment after pituitary surgery and during episodes of hypernatremia is therefore warranted.

  18. Comparison of oxidative/antioxidative status of penile corpus cavernosum blood and peripheral venous blood.

    Science.gov (United States)

    Yeni, E; Gulum, M; Selek, S; Erel, O; Unal, D; Verit, A; Savas, M

    2005-01-01

    The aim of the study is to determine and to compare the oxidative and antioxidative status of penile corpus cavernosum and peripheral venous blood. A total of 28 adult healthy males were included in the study. Whole blood was simultaneously withdrawn from penile corpus cavernosum and the cubital vein and their plasma separated. Total antioxidant capacity (TAC), vitamin C, total protein, albumin, uric acid, bilirubin and total peroxide (TP) levels of both plasma samples were measured and compared. While TAC, total protein, albumin, bilirubin and uric acid levels were higher, vitamin C levels were lower in cavernosal blood than that of peripheral blood. On the other hand, TP level was found to be higher in penile blood samples than that of peripheral blood. We thought that the normal erectile process of the penile cavernosal body leads to increased production of oxidants as in the mechanism of ischaemia-reperfusion; however, the increase of TAC can prevent development of oxidative injury.

  19. [Venous thromboembolism triggered by spinning in a young woman with thrombophilia].

    Science.gov (United States)

    Elikowski, Waldemar; Małek, Małgorzata; Montewska, Dominika; Kurosz, Jolanta; Wróblewski, Dariusz; Zawilska, Krystyna

    2011-01-01

    Although regular sports activities decrease the risk of venous thromboembolism (VTE), VTE cases have been observed among professional and amateur athletes practicing various disciplines. The authors describe a case of a 25-year-old-woman in whom calf pain, as popliteal vein thrombosis manifestation--preceding pulmonary embolism, occurred after she took up spinning, a popular form of indoor cycling. There was no history of leg injury. In hemostasis work up, factor V Leiden mutation and acquired low antithrombin activity-related to oral contraceptives use, were found. Strenuous exercise in an untrained woman might augment prothrombotic hemostasis profile. Vigorous cycling in standing position in the last phase of spinning, seems to be most unfavorable for patients with high VTE risk.

  20. Pitfalls of radioisotope diagnosis of deep venous thromboses with /sup 125/I-fibrinogen in traumatology

    Energy Technology Data Exchange (ETDEWEB)

    Novak, K.; Pestal, M. (Vyzkumny Ustav Traumatologicky, Brno (Czechoslovakia))

    1984-05-25

    Experience is described with the examination of deep venous thromboses of the lower extremities using /sup 125/I-fibrinogen. Intravenously administered labelled fibrinogen is taken up into the forming thrombus which may then be detected. Experience is presented with preparations of various makes. It was proved that in injured patients the biological half-life of /sup 125/I-fibrinogen is reduced to 50 hrs and less as against the standard half-life of 96.2 hrs. This is caused by fibrinogen losses owing to the injury, increased intensity of metabolic processes and the quality of the preparation being used. Injured patients should be examined using a highest quality preparation without denaturation damage to the labelled protein.

  1. Pitfalls of radioisotope diagnosis of deep venous thromboses with 125I-fibrinogen in traumatology

    International Nuclear Information System (INIS)

    Novak, K.; Pestal, M.

    1984-01-01

    Experience is described with the examination of deep venous thromboses of the lower extremities using 125 I-fibrinogen. Intravenously administered labelled fibrinogen is taken up into the forming thrombus which may then be detected. Experience is presented with preparations of various makes. It was proved that in injured patients the biological half-life of 125 I-fibrinogen is reduced to 50 hrs and less as against the standard half-life of 96.2 hrs. This is caused by fibrinogen losses owing to the injury, increased intensity of metabolic processes and the quality of the preparation being used. Injured patients should be examined using a highest quality preparation without denaturation damage to the labelled protein. (Ha)

  2. Pulmonary Venous Obstruction in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Chuang-Chi Liaw

    2015-01-01

    Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.

  3. Bilateral Pneumothoraces Following Central Venous Cannulation

    Directory of Open Access Journals (Sweden)

    F. Pazos

    2009-01-01

    Full Text Available We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax.

  4. Unilateral papilledema in cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Girish Baburao Kulkarni

    2017-01-01

    Full Text Available In the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster–Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis. The risk factors found on evaluation were Vitamin B12 deficiency and hyperhomocysteinemia. On optic fundus examination, she had swollen optic disc on the right side with normal fundus on the left side, confirmed with the orbital ultrasound B-scan and optic coherence tomography. Her magnetic resonance imaging showed features of raised intracranial pressure with thrombosis of the superior sagittal and bilateral lateral sinus thrombosis. She was treated with anticoagulation (heparin followed by oral anticoagulants, antiedema measures, and vitamin supplementation for hyperhomocysteinemia. She improved over time and was asymptomatic during follow-up. We discuss the possible mechanisms described in the literature for unilateral papilledema. This report highlights the need for carefully performing bilateral fundus examination so as not to miss the vision or life-threatening causes of a headache.

  5. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  6. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    International Nuclear Information System (INIS)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M.

    2016-01-01

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  7. Paragliding injuries.

    OpenAIRE

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-01-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during st...

  8. Paragliding injuries.

    Science.gov (United States)

    Krüger-Franke, M; Siebert, C H; Pförringer, W

    1991-06-01

    Regulations controlling the sport of paragliding were issued in April 1987 by the German Department of Transportation. The growing popularity of this sport has led to a steady increase in the number of associated injuries. This study presents the incidence, localization and degree of injuries associated with paragliding documented in Germany, Austria and Switzerland. The 283 injuries suffered by 218 paragliders were documented in the period 1987-1989: 181 occurred during landing, 28 during starting procedures and nine during flight. The mean patient age was 29.6 years. There were 34.9% spinal injuries, 13.4% upper extremity injuries and 41.3% lower limb injuries. Over half of these injuries were treated surgically and in 54 instances permanent disability remained. In paragliding the lower extremities are at greatest risk of injury during landing. Proper equipment, especially sturdy footwear, exact training in landing techniques as well as improved instruction in procedures during aborted or crash landings is required to reduce the frequency of these injuries.

  9. [Evaluation of the Charing Cross Venous Ulcer Questionnaire in patients with chronic venous ulcers in Uruguay].

    Science.gov (United States)

    Tafernaberry, Gabriela; Otero, Gabriela; Agorio, Caroline; Dapueto, Juan J

    2016-01-01

    Chronic venous ulcers (CVU) represent a frequent condition, with difficult therapeutic approaches, that impact on patients’ quality of life, and generate an economic burden to patients and health systems. To perform the cultural adaptation and initial evaluation of the Charing Cross Venous Ulcer Questionnaire (CCVUQ) for Uruguay, and to study the health-related quality of life (HRQL) of patients with CVU. The translated and culturally adapted version of the CCVUQ was applied to a convenience sample of 50 patients. In addition, the PROMIS Global Health Survey was included in the assessment. Both questionnaires showed good internal consistency (Cronbach alfa > 0.70). A statistically significant association was observed between the CCVUQ total scores, its subscales and both dimensions of the PROMIS: Global Physical (GPH) and Global Mental Health (GMH) (rho ≥ 0.40). The CCVUQ mean score was 54.9 ± 42 points while GPH and GMH mean scores were 37.9 ± 29 points, and 43.1 ± 35.1 points respectively. Simple linear regression showed that patients with higher income reported better emotional well-being, while in younger patients, ulcers had a higher impact on Emotional Status and Cosmetics. The translated and adapted version of the CCVUQ was easy to comprehend and apply, showing good psychometric properties. When used in association with the PROMIS Global Health Measure it provides complementary information. HRQL was severely affected in the study sample.

  10. Tapping but not massage enhances vasodilation and improves venous palpation of cutaneous veins.

    Science.gov (United States)

    Ichimura, Mika; Sasaki, Shinsuke; Mori, Masaharu; Ogino, Tetsuya

    2015-01-01

    This paper investigated whether tapping on the median cubital vein or massaging the forearm was more effective in obtaining better venous palpation for venipuncture. Forty healthy volunteers in their twenties were subjected to tapping (10 times in 5 sec) or massage (10 strokes in 20 sec from the wrist to the cubital fossa) under tourniquet inflation on the upper arm. Venous palpation was assessed using the venous palpation score (0-6, with 0 being impalpable). Three venous factors-venous depth, cross-sectional area, and elevation-were also measured using ultrasonography. The venous palpation score increased significantly by tapping but not by massage. Moreover, all 3 venous measurements changed significantly by tapping, while only the depth decreased significantly by massage. The three venous measurements correlated significantly with the venous palpation score, indicating that they are useful objective indicators for evaluating vasodilation. We suggest that tapping is an effective vasodilation technique.

  11. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

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    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. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

    International Nuclear Information System (INIS)

    Guo, Xin-bin; Fu, Zhenqiang; Song, Lai-jun; Guan, Sheng

    2013-01-01

    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 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

  13. A Factor Increasing Venous Contamination on Bolus Chase Three-dimensional Magnetic Resonance Imaging: Charcot Neuroarthropathy.

    Science.gov (United States)

    Çildağ, Mehmet B; Ertuğrul, Mustafa B; Köseoğlu, Ömer Fk; Armstrong, David G

    2018-01-01

    The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN). Bolus-chase three-dimensional magnetic resonance (MR) of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A), patients with diabetic foot ulcers (Group B) and patients with CN accompanying diabetic foot ulcers (Group C). Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Venous contamination following bolus chase MR was higher in patients with CN.

  14. A factor increasing venous contamination on bolus chase three-dimensional magnetic resonance imaging: Charcot neuroarthropathy

    Directory of Open Access Journals (Sweden)

    Mehmet B Cildag

    2018-01-01

    Full Text Available Background: The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN. Materials and Methods: Bolus-chase three-dimensional magnetic resonance (MR of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A, patients with diabetic foot ulcers (Group B and patients with CN accompanying diabetic foot ulcers (Group C. Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Results: Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Conclusion: Venous contamination following bolus chase MR was higher in patients with CN.

  15. Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-leg immobilization.

    Science.gov (United States)

    Testroote, Mark; Stigter, Willem A H; Janssen, Loes; Janzing, Heinrich M J

    2014-04-25

    Immobilization of the lower leg is associated with venous thromboembolism (VTE). Low molecular weight heparin (LMWH) is an anticoagulant treatment which might be used in adult patients with lower-leg immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-leg immobilization in an ambulant setting. For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched June 2013) and CENTRAL (2013, Issue 5). Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that described thromboprophylaxis by means of LMWH compared with no prophylaxis or placebo in adult patients with lower-leg immobilization. Immobilization was by means of a plaster cast or brace. Two authors independently assessed trial quality and extracted data. The review authors contacted the trial authors for additional information if required. Statistical analysis was carried out using Review Manager (RevMan 5). We included six RCTs fulfilling the above criteria with a total of 1490 patients. We found an incidence of VTE ranging from 4.3% to 40% in patients who had a leg injury that had been immobilized in a plaster cast or a brace for at least one week and who received no prophylaxis, or placebo. This number was significantly lower in patients who received daily subcutaneous injections of LMWH during immobilization (event rates ranging from 0% to 37%; odds ratio (OR) 0.49; fixed 95% confidence interval (CI) 0.34 to 0.72; with minimal evidence of heterogeneity with an I(2) of 20%, P = 0. 29). Comparable results were seen in the following subcategories: operated patients, conservatively treated patients, patients with fractures, patients with soft-tissue injuries, patients with proximal thrombosis, patients with

  16. Review of the cost of venous thromboembolism

    Science.gov (United States)

    Fernandez, Maria M; Hogue, Susan; Preblick, Ronald; Kwong, Winghan Jacqueline

    2015-01-01

    Background Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion Costs for VTE treatment are considerable and increasing faster than general inflation for medical care services, with hospitalization costs being the primary cost driver. Readmissions for VTE are generally more costly than the initial VTE admission. Further studies evaluating the economic impact of new

  17. Iliocaval Confluence Stenting for Chronic Venous Obstructions

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    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  18. Management of Orbital and Periorbital Venous Malformation

    Directory of Open Access Journals (Sweden)

    Lara A. Benoiton

    2017-05-01

    Full Text Available BackgroundTo review our management of common venous malformation (VM affecting the orbit and/or periorbital area.MethodsConsecutive patients with orbital and/or periorbital VM were identified from our vascular anomalies database. Demographic details of the patients, anatomic site(s affected, symptoms and signs, presence of a family history of VM, and types of treatment(s were collected, supplemented by chart review.ResultsA total of 24 patients’ age 1–68 (mean, 30 years with orbital and/or periorbital VM presented with cosmetic concerns (n = 17, 71%, distensibility (n = 15, 63%, pain (n = 9, 38%, diplopia (n = 4, 17%, and spontaneous thrombosis (n = 1, 8%. The VM caused globe dystopia (n = 13, 54%, enophthalmos (n = 6, 25%, proptosis (n = 3, 12%, exotropia (n = 3, 12%, and pseudoptosis with visual obstruction (n = 3, 13%. A total of 11 (46% patients were managed conservatively. 13 (54% patients underwent active treatment. Ethanol sclerotherapy (ES was performed in six patients with extensive facial VM associated with orbital/periorbital involvement, resulting in symptomatic improvement in five patients, one of whom developed skin necrosis and another patient developed reduced infraorbital nerve sensation. Surgery was performed for localized lesion (n = 3, 23%, for extensive lesions (n = 4, 31% and as an adjunct to ES (n = 6, 46% resulting in symptomatic improvement in all patients. One patient required correction of lower lid ectropion.ConclusionOrbital and/or periorbital VMs are heterogeneous, and management needs to be individualized. Surgery is used for localized lesions aiming for complete excision, as a debulking procedure for extensive orbital/periorbital VM when ES was not possible, or following ES for extensive facial VM with orbital and/or periorbital involvement.

  19. Whiplash injuries.

    Science.gov (United States)

    Malanga, Gerard; Peter, Jason

    2005-10-01

    Whiplash injuries are very common and usually are associated with rear-end collisions. However, a whiplash injury can be caused by any event that results in hyperextension and flexion of the cervical spine. These injuries are of serious concern to all consumers due to escalating cost of diagnosis, treatment, insurance, and litigation. Most acute whiplash injury cases respond well to conservative treatments, which result in resolution of symptoms usually within weeks to a few months after the injury occurred. Chronic whiplash injuries often are harder to diagnose and treat and often result in poor outcomes. Current research shows that various structures in the cervical spine receive nociceptive innervation and potentially may be the cause of chronic pain symptoms. One potential pain generator showing promise is the facet or zygapophyseal joints. Various researchers have proven that these joints are injured during whiplash injuries and that diagnosis and temporary pain relief can be obtained with facet joint injections. The initial evaluation of any patient should follow an organized and stepwise approach, and more serious causes of neck pain must first be ruled out through the history, physical examination, and diagnostic testing. Treatment regimens should be evidence-based, focusing on treatments that have proven to be effective in treating acute and chronic whiplash injuries.

  20. Ocular Injury

    Science.gov (United States)

    ... trauma can happen at home, school, play or sports. Most common injuries are scratches to the cornea or blunt trauma. Approved and tested eye and face protection is essential to prevent injuries. Sports such as hockey, baseball, racquet ball, squash, and ...

  1. Rowing Injuries

    DEFF Research Database (Denmark)

    Thornton, Jane S; Vinther, Anders; Wilson, Fiona

    2017-01-01

    understanding in pre-participation screening, training load, emerging concepts surrounding back and rib injury, and relative energy deficiency in sport. Through a better understanding of the nature of the sport and mechanisms of injury, physicians and other healthcare providers will be better equipped to treat...

  2. Trampoline injuries.

    Science.gov (United States)

    Nysted, M; Drogset, J O

    2006-12-01

    To describe the mechanism, location and types of injury for all patients treated for trampoline-associated injuries at St Olav's University Hospital, Trondheim, Norway, from March 2001to October 2004. Patients were identified from a National Injury Surveillance System. All patients were asked to complete a standard questionnaire at their first visit at the hospital. Most data were recorded prospectively, but data on the mechanism of injury, the number of participants on the trampoline at the time of injury, adult supervision and whether the activity occurred at school or in another organised setting were collected retrospectively. A total of 556 patients, 56% male and 44% female, were included. The mean age of patients was 11 (range 1-62) years. 77% of the injuries occurred on the body of the trampoline, including falls on to the mat, collisions with another jumper, falls on to the frame or the springs, and performing a somersault, whereas 22% of the people fell off the trampoline. In 74% of the cases, more than two people were on the trampoline, with as many as nine trampolinists noted at the time of injury. For children Trampolining can cause serious injuries, especially in the neck and elbow areas of young children. The use of a trampoline is a high-risk activity. However, a ban is not supported. The importance of having safety guidelines for the use of trampolines is emphasised.

  3. The Current Role of Venous Sampling in the Localization of Endocrine Disease

    International Nuclear Information System (INIS)

    Lau, Jeshen H. G.; Drake, William; Matson, Matthew

    2007-01-01

    Endocrine venous sampling plays a specific role in the diagnosis of endocrine disorders. In this article, we cover inferior petrosal sinus sampling, selective parathyroid venous sampling, hepatic venous sampling with arterial stimulation, adrenal venous sampling, and ovarian venous sampling. We review their indications and the scientific evidence justifying these indications in the diagnosis and management of Cushing's syndrome, hyperparathyroidism, pancreatic endocrine tumors, Conn's syndrome, primary hyperaldosteronism, pheochromocytomas, and androgen-secreting ovarian tumors. For each sampling technique, we compare its diagnostic accuracy with that of other imaging techniques and, where possible, look at how it impacts patient management. Finally, we incorporate venous sampling into diagnostic algorithms used at our institution

  4. Effect of hepatic venous sphincter contraction on transmission of central venous pressure to lobar and portal pressure.

    Science.gov (United States)

    Lautt, W W; Legare, D J; Greenway, C V

    1987-11-01

    In dogs anesthetized with pentobarbital, central vena caval pressure (CVP), portal venous pressure (PVP), and intrahepatic lobar venous pressure (proximal to the hepatic venous sphincters) were measured. The objective was to determine some characteristics of the intrahepatic vascular resistance sites (proximal and distal to the hepatic venous sphincters) including testing predictions made using a recent mathematical model of distensible hepatic venous resistance. The stimulus used was a brief rise in CVP produced by transient occlusion of the thoracic vena cava in control state and when vascular resistance was elevated by infusions of norepinephrine or histamine, or by nerve stimulation. The percent transmission of the downstream pressure rise to upstream sites past areas of vascular resistance was elevated. Even small increments in CVP are partially transmitted upstream. The data are incompatible with the vascular waterfall phenomenon which predicts that venous pressure increments are not transmitted upstream until a critical pressure is overcome and then further increments would be 100% transmitted. The hepatic sphincters show the following characteristics. First, small rises in CVP are transmitted less than large elevations; as the CVP rises, the sphincters passively distend and allow a greater percent transmission upstream, thus a large rise in CVP is more fully transmitted than a small rise in CVP. Second, the amount of pressure transmission upstream is determined by the vascular resistance across which the pressure is transmitted. As nerves, norepinephrine, or histamine cause the hepatic sphincters to contract, the percent transmission becomes less and the distensibility of the sphincters is reduced. Similar characteristics are shown for the "presinusoidal" vascular resistance and the hepatic venous sphincter resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency.

    Science.gov (United States)

    Ercan, Sabriye; Çetin, Cem; Yavuz, Turhan; Demir, Hilmi M; Atalay, Yurdagül B

    2018-05-01

    Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly ( p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.

  6. Iliofemoral and iliocaval interventions in deep venous thrombosis

    International Nuclear Information System (INIS)

    Haage, P.; Guenther, R.W.

    2005-01-01

    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 post-thrombotic 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.)

  7. Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers*

    Science.gov (United States)

    Januário, Virginia; de Ávila, Dione Augusto; Penetra, Maria Alice; Sampaio, Ana Luisa Bittencourt; Noronha Neta, Maria Isabel; Cassia, Flavia de Freire; Carneiro, Sueli

    2016-01-01

    BACKGROUND: Among the chronic leg ulcers, venous ulcers are the most common and constitute a major burden to public health. Despite all technology available, some patients do not respond to established treatments. In our study, carboxymethylcellulose was tested in the treatment of refractory chronic venous ulcers. OBJECTIVE: To evaluate the efficacy of carboxymethylcellulose 20% on the healing of chronic venous ulcers refractory to conventional treatments. METHODS: This is an analytical, pre-experimental study. Thirty patients were included with refractory venous ulcers, and applied dressings with carboxymethylcellulose 20% for 20 weeks. The analysis was based on measurement of the area of ulcers, performed at the first visit and after the end of the treatment. RESULTS: There was a reduction of 3.9 cm2 of lesion area (p=0.0001), corresponding to 38.8% (p=0.0001). There was no interruption of treatment and no increase in lesion area in any patient. CONCLUSIONS: Carboxymethylcellulose 20% represents a low cost and effective therapeutic alternative for the treatment of refractory chronic venous ulcers. However, controlled studies are necessary to prove its efficacy. PMID:26982773

  8. 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

  9. Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis.

    Science.gov (United States)

    Bever, Katherine M; Masha, Luke I; Sun, Fangui; Stern, Lauren; Havasi, Andrea; Berk, John L; Sanchorawala, Vaishali; Seldin, David C; Sloan, J Mark

    2016-01-01

    Patients with immunoglobulin light chain amyloidosis are at risk for both thrombotic and bleeding complications. While the hemostatic defects have been extensively studied, less is known about thrombotic complications in this disease. This retrospective study examined the frequency of venous thromboembolism in 929 patients with immunoglobulin light chain amyloidosis presenting to a single referral center, correlated risk of venous thromboembolism with clinical and laboratory factors, and examined complications of anticoagulation in this population. Sixty-five patients (7%) were documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60-11.55; P=0.0038) for serum albumin less than 3 g/dL compared to serum albumin greater than 4 g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism. Copyright© Ferrata Storti Foundation.

  10. Partial anomalous pulmonary venous return in Turner syndrome.

    Science.gov (United States)

    van den Hoven, Allard T; Chelu, Raluca G; Duijnhouwer, Anthonie L; Demulier, Laurent; Devos, Daniel; Nieman, Koen; Witsenburg, Maarten; van den Bosch, Annemien E; Loeys, Bart L; van Hagen, Iris M; Roos-Hesselink, Jolien W

    2017-10-01

    The aim of this study is to describe the prevalence, anatomy, associations and clinical impact of partial anomalous pulmonary venous return in patients with Turner syndrome. All Turner patients who presented at our Turner clinic, between January 2007 and October 2015 were included in this study and underwent ECG, echocardiography and advanced imaging such as cardiac magnetic resonance or computed tomography as part of their regular clinical workup. All imaging was re-evaluated and detailed anatomy was described. Partial anomalous pulmonary venous return was diagnosed in 24 (25%) out of 96 Turner patients included and 14 (58%) of these 24 partial anomalous pulmonary venous return had not been reported previously. Right atrial or ventricular dilatation was present in 11 (46%) of 24 partial anomalous pulmonary venous return patients. When studied with advanced imaging modalities and looked for with specific attention, PAPVR is found in 1 out of 4 Turner patients. Half of these patients had right atrial and/or ventricular dilatation. Evaluation of pulmonary venous return should be included in the standard protocol in all Turner patients. Copyright © 2017. Published by Elsevier B.V.

  11. 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.

  12. Venous Thromboembolism in Podiatric Foot and Ankle Surgery.

    Science.gov (United States)

    Matthews, Jemma H; Terrill, Alexander J; Barwick, Alex L; Butterworth, Paul A

    2018-01-01

    The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis. Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed. Venous thromboembolism within the first 30 days following surgery was recorded using the Australasian College of Podiatric Surgeons surgical audit tool. Logistic regression analyses were undertaken to determine the factors that influenced thromboprophylaxis. Of the 4238 patient records, 3677 records (87%) provided complete data (age range 2-94 years; mean ± SD, 49.1 ± 19.7 years; 2693 females). A total of 7 venous thromboembolic events (0.2% rate) were reported. Operative duration and age (OR 12.63, 95% CI 9.47 to 16.84, P < 0.01), postoperative immobilization (OR 6.94, 95% CI 3.95 to 12.20, P < 0.01), and a prior history of VTE (OR 3.41, 95% CI 1.01 to 11.04, P = 0.04) were the strongest predictors of thromboprophylaxis. Podiatric foot and ankle surgery is associated with a low rate of venous thromboembolism. This may be due in part to the thromboprophylaxis regime implemented by podiatric surgeons, which closely aligns with current evidence-based guidelines. Level II: Prospective cohort study.

  13. Intramedullary Venous Drainage System for Distal Fingertip Replantations.

    Science.gov (United States)

    Purisa, Husrev; Ozturk, Muhammed Besir; Kabakas, Fatih; Mersa, Berkan; Ozcelik, Ismail Bulent; Sezer, Ilker

    2017-08-01

    The number of venous anastomoses performed during fingertip replantation is one of the most important factors affecting the success of replantation. However, because vessel diameters decrease in the zone 1 level, vessel anastomoses, especially vein anastomoses, are technically difficult and, thus, cannot be performed in most cases. Alternative venous drainage methods are crucial when any reliable vein repair is not possible. In the literature, so many artery-only replantation techniques have been defined, such as arteriovenous anastomoses, forming an arteriovenous or venocutaneous fistula, manual milking and massage, puncturing, and external bleeding via a fishmouth incision and using a medical leech. It has been shown that, in distal fingertip replantations, the medullary cavity may also be a good way for venous return. In this study, we introduce an alternative intramedullary venous drainage system we developed to facilitate venous drainage in artery-only fingertip replantations. The results of 24 fingertip replantations distal to the nail fold by using this system are presented with a literature review.

  14. Venous damage prevention by defibrotide in vinorelbine-treated patients.

    Science.gov (United States)

    Mare, M; Maisano, R; Caristi, N; Adamo, V; Altavilla, G; Carboni, R; Munaò, S; La Torre, F

    2003-09-01

    The aim of our study was to evaluate the incidence of venous toxicity induced by vinorelbine administration in patients who received a preventive therapy with defibrotide. From July 1996 to July 2002 we treated 203 patients with vinorelbine, 51 with vinorelbine alone and 152 with vinorelbine in combination with other drugs via peripheral vein infusion. Of the 203 patients, 123 were male and 80 female with a median age of 67 years (range 18 to 82 years), and 118 were chemotherapy-naive. Defibrotide was delivered i.v. at a dose of 400 mg in 250 ml normal saline. After infusion of 125 ml over about 15 min, vinorelbine mixed with 10 ml normal saline was delivered as quick brief repeated pulses over 5 min through the plastic tube, followed by infusion of the remaining defibrotide. The specific Rittenberg scale was used to assess venous irritation episodes. Among a total of 1336 vinorelbine infusions, with a median of five infusions per patient, the incidence of venous irritation episodes graded according to Rittenberg scale was 1.1% (15), of which 0.6% (8) were grade 2 and 0.5% (7) grade 1. Globally, 15 patients (7.3%) developed venous toxicity after a median of 3 infusions (range 1-14), but no patient had more than one event. Our findings support the use of defibrotide as an effective, safe and low-cost means for preventing vinorelbine-related venous damage.

  15. Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis

    Science.gov (United States)

    Bever, Katherine M.; Masha, Luke I.; Sun, Fangui; Stern, Lauren; Havasi, Andrea; Berk, John L.; Sanchorawala, Vaishali; Seldin, David C.; Sloan, J. Mark

    2016-01-01

    Patients with immunoglobulin light chain amyloidosis are at risk for both thrombotic and bleeding complications. While the hemostatic defects have been extensively studied, less is known about thrombotic complications in this disease. This retrospective study examined the frequency of venous thromboembolism in 929 patients with immunoglobulin light chain amyloidosis presenting to a single referral center, correlated risk of venous thromboembolism with clinical and laboratory factors, and examined complications of anticoagulation in this population. Sixty-five patients (7%) were documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60–11.55; P=0.0038) for serum albumin less than 3 g/dL compared to serum albumin greater than 4 g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism. PMID:26452981

  16. A conservative approach to a thoracic duct injury caused by left subclavian vein catheterization

    OpenAIRE

    Vedran Premuzic; Ranko Smiljanic; Drazen Perkov

    2018-01-01

    Thoracic duct injury is a rare complication of left subclavian vein catheterization. A significant injury could lead to chylothorax, a condition with high mortality rate if not treated. It is diagnosed with lymphography or by laboratory tests of pleural fluid aspirate. A 51 year old Caucasian male with a history of unregulated hypertension presented to our Emergency department (ED) with anginous symptoms and increased serum creatinine level. After the placement of a temporary central venous c...

  17. Computer identification of symptomatic deep venous thrombosis associated with peripherally inserted venous catheters.

    Science.gov (United States)

    Evans, R Scott; Linford, Lorraine H; Sharp, Jamie H; White, Gayle; Lloyd, James F; Weaver, Lindell K

    2007-10-11

    Peripherally inserted central catheters (PICCs) are considered a safe method to provide long-term antibiotic therapy, chemotherapy and nutrition support. Deep venous thrombosis (DVT) is a complication that requires early PICC removal, may extend hospitalization and can result in pulmonary embolism. PICC insertion teams strive to understand risk factors and develop methods to prevent DVTs. However, they can only manage what they can measure. At LDS Hospital, identification of PICC associated DVTs was dependent on verbal notification or manual surveillance of more than a thousand free-text vascular reports. Accurate DVT rates were not known which hindered prevention. We describe the development of a computer application (PICC-DVT monitor) to identify PICC associated DVTs each day. A one-year evaluation of the monitor by the PICC team and a review of 445 random vascular reports found a positive predictive value of 98%, sensitivity of 94%, specificity of 100% and a PICC team associated DVT rate of 2.8%.

  18. Injury - kidney and ureter

    Science.gov (United States)

    ... kidney; Ureteral injury; Pre-renal failure - injury, Post-renal failure - injury; Kidney obstruction - injury Images Kidney anatomy Kidney - blood and urine flow References Molitoris BA. Acute kidney injury. In: Goldman ...

  19. Spinal Cord Injury 101

    Medline Plus

    Full Text Available menu Understanding Spinal Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  20. Repetitive Stress Injuries

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Repetitive Stress Injuries KidsHealth / For Teens / Repetitive Stress Injuries What's ... t had any problems since. What Are Repetitive Stress Injuries? Repetitive stress injuries (RSIs) are injuries that ...

  1. Pdgfrb-Cre targets lymphatic endothelial cells of both venous and non-venous origins.

    Science.gov (United States)

    Ulvmar, Maria H; Martinez-Corral, Ines; Stanczuk, Lukas; Mäkinen, Taija

    2016-06-01

    The Pdgfrb-Cre line has been used as a tool to specifically target pericytes and vascular smooth muscle cells. Recent studies showed additional targeting of cardiac and mesenteric lymphatic endothelial cells (LECs) by the Pdgfrb-Cre transgene. In the heart, this was suggested to provide evidence for a previously unknown nonvenous source of LECs originating from yolk sac (YS) hemogenic endothelium (HemEC). Here we show that Pdgfrb-Cre does not, however, target YS HemEC or YS-derived erythro-myeloid progenitors (EMPs). Instead, a high proportion of ECs in embryonic blood vessels of multiple organs, as well as venous-derived LECs were targeted. Assessment of temporal Cre activity using the R26-mTmG double reporter suggested recent occurrence of Pdgfrb-Cre recombination in both blood and lymphatic ECs. It thus cannot be excluded that Pdgfrb-Cre mediated targeting of LECs is due to de novo expression of the Pdgfrb-Cre transgene or their previously established venous endothelial origin. Importantly, Pdgfrb-Cre targeting of LECs does not provide evidence for YS HemEC origin of the lymphatic vasculature. Our results highlight the need for careful interpretation of lineage tracing using constitutive Cre lines that cannot discriminate active from historical expression. The early vascular targeting by the Pdgfrb-Cre also warrants consideration for its use in studies of mural cells. genesis 54:350-358, 2016. © 2016 The Authors. Genesis Published by Wiley Periodicals, Inc. © 2016 The Authors. Genesis Published by Wiley Periodicals, Inc.

  2. Preliminary Investigations Showing Venous Thromboembolism Recurrence in Patients with Residual Venous Obstruction in Singaporean Population.

    Science.gov (United States)

    Sule, Ashish Anil; Er, Chaozer; Chong, Claudia Y X; Chin, Han Xin; Chin, Tay Jam

    2017-12-01

    This study aims to determine the association of residual venous obstruction (RVO) with recurrent venous thromboembolism (VTE). A retrospective cohort study was conducted determining if RVO on ultrasonography is associated with recurrent VTE in a Singaporean population. The subjects were identified from the Vascular Diagnostic Laboratory patients' record of Tan Tock Seng Hospital (TTSH), Singapore between 2008 and 2013. All the patients included had RVO after 3 months of anticoagulation. Data such as age, gender, race, thrombus location, etiology, history of malignancy, thrombophilia screen, treatment duration, and follow-up were recorded for analysis. Statistical analysis was performed using Stata/SE 13.1 (StataCorp LLC). The study was approved by the National Healthcare Group Domain Specific Review Board (DSRB), Singapore. Out of the 34 patients who had RVO, 6 (17.6%) developed VTE recurrence. Patients were treated with anticoagulation for a mean time of 24.5 months. The mean follow-up time for VTE recurrence was 25.4 months. Out of the six patients who had VTE recurrence, one had common iliac vein involvement, four had superficial femoral vein and common femoral vein involvement, zero had popliteal vein involvement, and one had calf veins involvement. There was a significant association between thrombophilia ( p  = 0.0195) and malignancy ( p  = 0.020) at inclusion with the risk of recurrent VTE. The presence of RVO after 3 months of anticoagulation is likely to increase the risk of VTE recurrence. Larger studies with RVO are needed to evaluate if there is an increased risk of VTE recurrence in the Asian population.

  3. Review of the cost of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Fernandez MM

    2015-08-01

    Full Text Available Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent literature to provide updated cost estimates on VTE management. Methods: Literature search strategies were performed in PubMed, Embase, Cochrane Collaboration, Health Economic Evaluations Database, EconLit, and International Pharmaceutical Abstracts from 2003–2014. Additional studies were identified through searching bibliographies of related publications. Results: Eighteen studies were identified and are summarized in this review; of these, 13 reported data from the USA, four from Europe, and one from Canada. Three main cost estimations were identified: cost per VTE hospitalization or per VTE readmission; cost for VTE management, usually reported annually or during a specific period; and annual all-cause costs in patients with VTE, which included the treatment of complications and comorbidities. Cost estimates per VTE hospitalization were generally similar across the US studies, with a trend toward an increase over time. Cost per pulmonary embolism hospitalization increased from $5,198–$6,928 in 2000 to $8,764 in 2010. Readmission for recurrent VTE was generally more costly than the initial index event admission. Annual health plan payments for services related to VTE also increased from $10,804–$16,644 during the 1998–2004 period to an estimated average of $15,123 for a VTE event from 2008 to 2011. Lower costs for VTE hospitalizations and annualized all-cause costs were estimated in European countries and Canada. Conclusion: Costs for VTE treatment are

  4. Fecal impaction causing pelvic venous compression and edema

    Directory of Open Access Journals (Sweden)

    Sara Naramore

    2015-09-01

    Full Text Available Chronic constipation is a common condition which may result in fecal impaction. A 13-year-old male with chronic constipation and encopresis presented with fecal impaction for three weeks. The impaction caused abdominal pain, distension, encopresis, and decreased oral intake. He was found in severe distress with non-pitting edema of his feet and ankles along with perineal edema. The pedal edema worsened after receiving a fluid bolus, so concern arose for venous compression or a thrombus. A Duplex Ultrasound demonstrated changes in the venous waveforms of the bilateral external iliac and common femoral veins without thrombosis. Manual disimpaction and polyethylene glycol 3350 with electrolytes resolved the pedal and perineal edema. Four months later, he had soft bowel movements without recurrence of the edema. A repeat Duplex Ultrasound was normal. We present a child in whom severe fecal impaction caused pelvic venous compression resulting in bilateral pedal and perineal edema.

  5. New anticoagulants for the prevention and treatment of venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Simon J McRae

    2005-04-01

    Full Text Available Simon J McRae, Jeffrey S GinsbergDepartment of Medicine, McMaster University, Hamilton, ON, CanadaAbstract: Anticoagulant therapy is effective at preventing the development of venous thromboembolism in high-risk patients, and reduces morbidity and mortality in individuals with established thromboembolic disease. Vitamin K antagonists and heparins are currently the most commonly used anticoagulant drugs, but they have practical limitations. Therefore, new antithrombotic agents with predictable dose-responses (thereby decreasing the need for monitoring without compromising efficacy or safety, ideally available in an oral formulation and with a rapidly reversible anticoagulant effect, are needed. New drugs fulfilling some of the above criteria have been developed and have proven to be effective agents for the treatment and prevention of venous thromboembolism.Keywords: venous thromboembolism, anticoagulants, antithrombotic

  6. Venous thromboembolism: epidemiology and magnitude of the problem.

    Science.gov (United States)

    Goldhaber, Samuel Z

    2012-09-01

    Pulmonary embolism is the third most common cardiovascular disease after myocardial infarction and stroke. The death rate from pulmonary embolism exceeds the death rate from myocardial infarction, because myocardial infarction is much easier to detect and to treat. Among survivors of pulmonary embolism, chronic thromboembolic pulmonary hypertension occurs in 2-4 of every 100 patients. Post-thrombotic syndrome of the legs, characterized by chronic venous insufficiency, occurs in up to half of patients who suffer deep vein thrombosis or pulmonary embolism. We have effective pharmacological regimens using fixed low dose unfractionated or low molecular weight heparin to prevent venous thromboembolism among hospitalized patients. There remains the problem of low rates of utilization of pharmacological prophylaxis. The biggest change in our understanding of the epidemiology of venous thromboembolism is that we now believe that deep vein thrombosis and pulmonary embolism share similar risk factors and pathophysiology with atherothrombosis and coronary artery disease. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. The value of interventional therapy in acute deep venous thrombosis

    International Nuclear Information System (INIS)

    He Yaoqiang; Cao Ran; Luo Canhua; Lin Haibo; Chen Yanfang

    2004-01-01

    Objective: To discuss the clinical application in the treatment of acute deep venous thrombosis by the intervention from Share vein little cutting edges. Methods: To treat 8 patients who are with acute deep venous thrombosis by using Share vein little cutting edges enter road comprehensive intervene treatment, to press and dissolve the thrombus. Among the 8 cases, put the bracket of hip total vein in 3 cases. The others put Next cavity vein strain permanently. Result: The success rate is 100%. After the treatment, the thrombus and swelling of the crura had gone, basically the patients could get back to a normal activity. Conclusion: It is quite complicated and dangerous in the treatment of acute deep venous thrombosis by the interposition from Share vein little cutting edges. But the curative effect is remarkable and it could dissolve the thrombus completely. (authors)

  8. [An update on the treatment of venous insufficiency in pregnancy].

    Science.gov (United States)

    Rodríguez-Nora, B; Álvarez-Silvares, E

    Chronic venous insufficiency is a long-term pathological condition resulting from anatomical or functional alterations of the venous system. This leads to the appearance of symptoms and physical signs that affect a large part of the population and particularly pregnant women, due to the physiology of pregnancy. The few published studies on the use of pharmacological treatments of venous insufficiency in this group of the population, often makes the management of this condition difficult in routine clinical practice. A review is presented in this article, with all the latest updates in the treatment of this condition during pregnancy. There are numerous general, and some pharmacological, recommendations, that we can safely offer the pregnant patient. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Varicose Veins: Role of Mechanotransduction of Venous Hypertension

    Science.gov (United States)

    Atta, Hussein M.

    2012-01-01

    Varicose veins affect approximately one-third of the adult population and result in significant psychological, physical, and financial burden. Nevertheless, the molecular pathogenesis of varicose vein formation remains unidentified. Venous hypertension exerted on veins of the lower extremity is considered the principal factor in varicose vein formation. The role of mechanotransduction of the high venous pressure in the pathogenesis of varicose vein formation has not been adequately investigated despite a good progress in understanding the mechanomolecular mechanisms involved in transduction of high blood pressure in the arterial wall. Understanding the nature of the mechanical forces, the mechanosensors and mechanotransducers in the vein wall, and the downstream signaling pathways will provide new molecular targets for the prevention and treatment of varicose veins. This paper summarized the current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure and tries to relate this information to setting of venous hypertension in varicose veins. PMID:22489273

  10. Cortical venous thrombosis following exogenous androgen use for bodybuilding.

    Science.gov (United States)

    Sveinsson, Olafur; Herrman, Lars

    2013-02-05

    There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic-clonic seizure. At admission, he was drowsy, not fully orientated, had sensory inattention, pronation drift and a positive extensor response, all on the left side. The patient had been using anabolic steroids (dainabol 20 mg/day) for the last month for bodybuilding. CT angiography showed a right cortical venous thrombosis. Anticoagulation therapy was started with intravenous heparin for 11 days and oral anticoagulation (warfarin) thereafter. A control CT angiography 4 months later showed resolution of the thrombosis. He recovered fully.

  11. Badminton injuries.

    Science.gov (United States)

    Krøner, K; Schmidt, S A; Nielsen, A B; Yde, J; Jakobsen, B W; Møller-Madsen, B; Jensen, J

    1990-01-01

    In a one year period, from 1 January 1986 to 31 December 1986, 4303 patients with sports injuries were treated at Aarhus Amtssygehus and Aarhus Kommunehospital. The mean age was 21.6 years (range 7-72 years) and 2830 were men. Two hundred and seventeen badminton injuries occurred in 208 patients (136 men) with a mean age of 29.6 years (range 7-57 years), constituting 4.1 percent of all sport injuries in Aarhus. Joints and ligaments were injured in 58.5 percent of the patients, most frequently located in the lower limb and significantly more often among patients younger than 30 years of age. Muscle injury occurred in 19.8 percent of the patients. This type of injury was significantly more frequent among patients older than 30 years of age. Most injuries were minor. However, 6.8 percent of the patients were hospitalized and 30.9 percent received additional treatment by a physician. As the risk of injury varies with age, attempts to plan training individually and to institute prophylactic measures should be made. PMID:2078802

  12. Imaging diagnosis of venous malformation in head and neck

    International Nuclear Information System (INIS)

    Ha, Doo Hoe; Kim, Dong Ik; Suh, Jung Ho; Jung, Tae Sub

    1992-01-01

    The venous malformation in head and neck is a development vascular disease which arises from the arrest in the certain stage of vascular embryogenesis. However, the lesion extends along the fascia and has a tendency to recur after incomplete therapy. Retrospectively, the authors reviewed radiologic studies of 20 patients diagnosed as venous malformation during the last 5 years. The diagnosis was verified by histopathology (5 patients) and direct puncture angiography (15 patients). The radiologic studies included. CT with intravenous contrast injection (20 patients), RI angiography with 99mTc-pyrophosphate (6 patients), and direct puncture angiography (15 patients). Multiplicity of venous malformation was noted in 9 patients. On CT scan, the lesions had lobulated irregular shape, with heterogeneous appearance, showed delayed enhancing characteristics, and had the phleboliths (21 lesions). The venous malformations were located at the masticator space (including masseter muscle) (n = 12), retrobulbar space (n 6), submandibular space (n = 4), paravertebral space (n = 3) and so on. In two cases, the lesions were very extensive involving entire neck and parapharynx. On RI angiography using 99m Tc-pyrophosphate, all of the lesions showed persistent and delayed uptake. With direct puncture angiography the lesions could be classified as acinar pattern (n = 17) and mixed pattern (acinar and saccular) (n = 2). Venous connections were noted in 10 lesions. In conclusion, if a soft tissue mass on head and neck shows a heterogeneous attenuation density with or without calcified phlebolith on CT scan, RI angiography is recommended as a next diagnostic study. If it shows delayed persistent uptake, venous malformation can be suspected. Finally direct puncture angiography can verify the nature and extent of the lesion

  13. How to objectively assess jugular primary venous obstruction

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2014-12-01

    Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

  14. Repositioning of malpositioned or flipped central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Thalhammer, A.; Jacobi, V.; Balzer, J.; Vogl, T.J. [Institute for Diagnostic and Interventional Radiology, Central Radiology Clinic, J.W. Goethe University, Frankfurt am Main (Germany)

    2002-03-01

    Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach, replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation. (orig.)

  15. Calcification in the portal venous system demonstrated by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hadar, H; Sommer, R

    1983-08-01

    The CT appearance of calcification in the portal venous system in a patient with chronic alcoholic cirrhosis is presented. Reported cases of radiologically detectable calcification in the portal system are rare, and most of them have been associated with longstanding portal hypertension. We presume that with CT this diagnosis will be made more frequently. In the presence of calcification in the portal venous system, portal vein thrombosis is highly probable. This information is of obvious importance to the surgeon contemplating a portal decompressive shunt procedure.

  16. Endovascular therapy for chronic cerebrospinal venous insufficiency in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Marc A. Lazzaro

    2011-07-01

    Full Text Available Recent reports have emerged suggesting that multiple sclerosis (MS may be due to abnormal venous outflow from the central nervous system, termed Chronic Cerebrospinal Venous Insufficiency (CCSVI. These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment.

  17. Central Venous Disease in Hemodialysis Patients: An Update

    Energy Technology Data Exchange (ETDEWEB)

    Modabber, Milad, E-mail: mmodabber@gmail.com [McMaster University, Michael G. DeGroote School of Medicine (Canada); Kundu, Sanjoy [Scarborough Hospital and Scarborough Vascular Ultrasound, The Vein Institute of Toronto (Canada)

    2013-08-01

    Central venous occlusive disease (CVD) is a common concern among the hemodialysis patient population, with the potential to cause significant morbidity. Endovascular management of CVD, comprising percutaneous balloon angioplasty and bare-metal stenting, has been established as a safe alternative to open surgical treatment. However, these available treatments have poor long-term patency, requiring close surveillance and multiple repeat interventions. Recently, covered stents have been proposed and their efficacy assessed for the treatment of recalcitrant central venous stenosis and obstruction. Moreover, newly proposed algorithms for the surgical management of CVD warrant consideration. Here, we seek to provide an updated review of the current literature on the various treatment modalities for CVD.

  18. [Delayed (tension) pneumothorax after placement of a central venous catheter].

    Science.gov (United States)

    Tan, E C; van der Vliet, J A

    1999-09-11

    Laborious attempts at introducing a central venous catheter for parenteral nutrition in two women, aged 36 and 62 years, were followed by shortness of breath after 32 and 10 hours, respectively. This symptom was due to a (tension) pneumothorax not visible on earlier roentgenograms. Thoracic drainage led to recovery. In all patients with a central venous catheter an undetected delayed pneumothorax can be present. Urgent chest X-ray examination should be performed in all patients with acute respiratory symptoms. Patients undergoing elective intubation with positive pressure breathing should be examined carefully, since they are at risk of developing a late (tension) pneumothorax.

  19. Reduction mammoplasty as a treatment for symptomatic central venous stenosis

    Directory of Open Access Journals (Sweden)

    Denise Seok Fun Fok

    2018-03-01

    Full Text Available Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

  20. Central venous catheters: detection of catheter complications and therapeutical options

    International Nuclear Information System (INIS)

    Gebauer, B.; Beck, A.; Wagner, H.J.; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg

    2008-01-01

    For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary

  1. Symptomatic iliofemoral deep venous thrombosis treated with hybrid operative thrombectomy.

    Science.gov (United States)

    Rodríguez, Limael E; Aponte-Rivera, Francisco; Figueroa-Vicente, Ricardo; Bolanos-Avila, Guillermo E; Martínez-Trabal, Jorge L

    2015-10-01

    During the past 15 years, strategies that promote immediate and complete thrombus removal have gained popularity for the treatment of acute-onset iliofemoral deep venous thrombosis. In this case report, we describe a novel operative approach to venous thrombus removal known as hybrid operative thrombectomy. The technique employs a direct inguinal approach with concomitant retrograde advancement of a balloon catheter by femoral venotomy. Moreover, it provides effective thrombus removal through a single incision, with or without stent placement, and has the advantage of a completion venogram. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  2. Deep venous thrombus characterization: ultrasonography, elastography and scattering operator

    OpenAIRE

    Thibaud Berthomier; Ali Mansour; Luc Bressollette; Frédéric Le Roy; Dominique Mottier

    2017-01-01

    A thrombus or a blood clot is the result of blood coagulation which is a natural process to prevent bleeding. An inappropriate formation of a thrombus in a deep vein is known as Deep Venous Thrombosis (DVT). The main complication of a DVT is a Pulmonary Embolism (PE) which occurs when a thrombus breaks loose and travels to the lungs. DVT, PE, or both are also known as Venous thromboembolism (VTE). It affects an estimated 300,000–600,000 Individuals just in the United States per year and can c...

  3. 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...... were probable cases (1.7%) whereas for 449 (41.6%) the diagnosis could be excluded. The incidence rate was 1 per 1000 personyears. Out of the 632 cases 60% were DVT and 40% PE. 315 VT were considered idiopathic (49.8%), 311 were secondary (49.2%) and 15 were unclassifiable. 122 patients had cancer, 87...

  4. Central Venous Catheter-related Fungemia Caused by Rhodotorula glutinis.

    Science.gov (United States)

    Miglietta, Fabio; Letizia Faneschi, Maria; Braione, Adele; Palumbo, Claudio; Rizzo, Adriana; Lobreglio, Giambattista; Pizzolante, Maria

    2015-01-01

    Bloodstream infection due to Rhodotorula glutinis is extremely rare and mostly associated with underlying immunosuppression or cancer. Vascular access devices provide the necessary surfaces for biofilm formation and are currently responsible for a significant percentage of human infections. In this work, we describe a rare case of central venous catheter-related Rhodotorula glutinis fungemia in a female patient with acute myelogenous leukemia in remission. The timely removal of central venous catheter was an essential element for overcoming this CVC-related Rhodotorula fungemia.

  5. Maximal venous outflow velocity: an index for iliac vein obstruction.

    Science.gov (United States)

    Jones, T Matthew; Cassada, David C; Heidel, R Eric; Grandas, Oscar G; Stevens, Scott L; Freeman, Michael B; Edmondson, James D; Goldman, Mitchell H

    2012-11-01

    Leg swelling is a common cause for vascular surgical evaluation, and iliocaval obstruction due to May-Thurner syndrome (MTS) can be difficult to diagnose. Physical examination and planar radiographic imaging give anatomic information but may miss the fundamental pathophysiology of MTS. Similarly, duplex ultrasonographic examination of the legs gives little information about central impedance of venous return above the inguinal ligament. We have modified the technique of duplex ultrasonography to evaluate the flow characteristics of the leg after tourniquet-induced venous engorgement, with the objective of revealing iliocaval obstruction characteristic of MTS. Twelve patients with signs and symptoms of MTS were compared with healthy control subjects for duplex-derived maximal venous outflow velocity (MVOV) after tourniquet-induced venous engorgement of the leg. The data for healthy control subjects were obtained from a previous study of asymptomatic volunteers using the same MVOV maneuvers. The tourniquet-induced venous engorgement mimics that caused during vigorous exercise. A right-to-left ratio of MVOV was generated for patient comparisons. Patients with clinical evidence of MTS had a mean right-to-left MVOV ratio of 2.0, asymptomatic control subjects had a mean ratio of 1.3, and MTS patients who had undergone endovascular treatment had a poststent mean ratio of 1.2 (P = 0.011). Interestingly, computed tomography and magnetic resonance imaging results, when available, were interpreted as positive in only 53% of the patients with MTS according to both our MVOV criteria and confirmatory venography. After intervention, the right-to-left MVOV ratio in the MTS patients was found to be reduced similar to asymptomatic control subjects, indicating a relief of central venous obstruction by stenting the compressive MTS anatomy. Duplex-derived MVOV measurements are helpful for detection of iliocaval venous obstruction, such as MTS. Right-to-left MVOV ratios and

  6. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  7. Complications of an implantable venous access port: Prevention and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Tae Seok; Song, Myung Gyu [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Cha, In Ho [Dept. Radiology, Chungang University Hospital, Chungang University College of Medicine, Seoul (Korea, Republic of)

    2016-11-15

    Placement of an implantable venous access port (IVAP) is a popular procedure for repeated and intermittent chemotherapy in patients with malignancy. In this article, we present various IVAP related complications. In addition, we review the technical tips to prevent and manage the complications. It is important that the operator should keep the mechanism of the complications in mind, perform a careful procedure for prevention, and manage the complication properly and immediately in case of its development for safety and satisfaction of the patients Complications of an implantable venous access port: Prevention and treatment.

  8. Neonatal Hemoperitoneum Secondary to Hemorrhage from Omental Venous Malformation

    Directory of Open Access Journals (Sweden)

    So-Hyun Nam

    2015-12-01

    Full Text Available Hemoperitoneum in the neonate is uncommon. We report our experience with a neonate who suddenly developed hemoperitoneum in late gestation. Ascites with right pleural effusion initially suggested fetal hydrops. However, a decrease in hemoglobin with bloody ascites from the paracentesis gave the impression of hemoperitoneum. Ultrasonography and computed tomography showed no abnormality in the solid organs. Using 3-mm laparoscopic exploration, we found the omental mass and excised it. It was histologically confirmed as a venous malformation. Venous malformation of the omentum with significant bleeding requiring exploration is a very rare condition in the neonate, but it should be considered as a cause of neonatal hemoperitoneum.

  9. Risk of a venous thromboembolic episode due to caesarean section and BMI

    DEFF Research Database (Denmark)

    Colmorn, Lotte Berdiin; Ladelund, S; Rasmussen, S

    2014-01-01

    BMI significantly influences the risk of venous thromboembolism after emergency caesarean delivery compared with vaginal delivery.......BMI significantly influences the risk of venous thromboembolism after emergency caesarean delivery compared with vaginal delivery....

  10. Oral contraceptives and venous thromboembolism: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Edström, Birgitte; Kreiner, Svend

    2002-01-01

    Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare......Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare...

  11. Spinal injury

    Science.gov (United States)

    ... Dallas, TX: American Red Cross; 2016. Kaji AH, Newton EJ, Hockberger RS. Spinal injuries. In: Marx JA, ... member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

  12. Chilling injury

    African Journals Online (AJOL)

    ahar

    2013-12-18

    Dec 18, 2013 ... ROS avoidance genes play pivotal role in defense mechanism against chilling injury derived oxidative stress. ... Low temperature storage is a postharvest technology ..... crops is highly dependent on ethylene production and.

  13. Injury Statistics

    Science.gov (United States)

    ... Power Saws for 2001 05/15/2002 Nail Gun Related Injuries and Deaths Home Maintenance & Construction 05/ ... Information (FOIA) Inspector General No Fear Act Data USA.gov Report an Unsafe Product Contact Us: 800- ...

  14. Electrical injury

    Science.gov (United States)

    ... RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 134. Price LA, Loiacono LA. Electrical and lightning injury. In: Cameron JL, Cameron AM, eds. Current Surgical ...

  15. Ear Injury

    Science.gov (United States)

    ... of different injuries can affect the outer ear. Cauliflower ear (subperichondrial hematoma) A blunt blow to the ... to a deformed ear. This deformity, called a cauliflower ear, is common among wrestlers, boxers, and rugby ...

  16. Risk factors for venous port migration in a single institute in Taiwan

    OpenAIRE

    Fan, Wen-Chieh; Wu, Cheng-Han; Tsai, Ming-Ju; Tsai, Ying-Ming; Chang, Hsu-Liang; Hung, Jen-Yu; Chen, Pei-Huan; Yang, Chih-Jen

    2014-01-01

    Background An implantable port device provides an easily accessible central route for long-term chemotherapy. Venous catheter migration is one of the rare complications of venous port implantation. It can lead to side effects such as pain in the neck, shoulder, or ear, venous thrombosis, and even life-threatening neurologic problems. To date, there are few published studies that discuss such complications. Methods This retrospective study of venous port implantation in a single center, a Taiw...

  17. Duplex imaging of residual venous obstruction to guide duration of therapy for lower extremity deep venous thrombosis.

    Science.gov (United States)

    Stephenson, Elliot J P; Liem, Timothy K

    2015-07-01

    Clinical trials have shown that the presence of ultrasound-identified residual venous obstruction (RVO) on follow-up scanning may be associated with an elevated risk for recurrence, thus providing a potential tool to help determine the optimal duration of anticoagulant therapy. We performed a systematic review to evaluate the clinical utility of post-treatment duplex imaging in predicting venous thromboembolism (VTE) recurrence and in adjusting duration of anticoagulation. The Ovid MEDLINE Database, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects were queried for the terms residual thrombus or obstruction, duration of therapy, deep vein thrombosis, deep venous thrombosis, DVT, venous thromboembolism, VTE, antithrombotic therapy, and anticoagulation, and 228 studies were selected for review. Six studies determined the rate of VTE recurrence on the basis of the presence or absence of RVO. Findings on venous ultrasound scans frequently remained abnormal in 38% to 80% of patients, despite at least 3 months of therapeutic anticoagulation. In evaluating for VTE recurrence, the definition of RVO varied widely in the literature. Some studies have shown an association between RVO and VTE recurrence, whereas other studies have not. Overall, the presence of RVO is a mild risk factor for recurrence (odds ratio, 1.3-2.0), but only when surveillance imaging is performed soon after the index deep venous thrombosis (3 months). RVO is a mild risk factor for VTE recurrence. The presence or absence of ultrasound-identified RVO has a limited role in guiding the duration of therapeutic anticoagulation. Further research is needed to evaluate its utility relative to other known risk factors for VTE recurrence. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  18. Cold injuries.

    Science.gov (United States)

    Kruse, R J

    1995-01-01

    There are two categories of cold injury. The first is hypothermia, which is a systemic injury to cold, and the second is frostbite, which is a local injury. Throughout history, entire armies, from George Washington to the Germans on the Russian Front in World War II, have fallen prey to prolonged cold exposure. Cold injury is common and can occur in all seasons if ambient temperature is lower than the core body temperature. In the 1985 Boston Marathon, even though it was 76 degrees and sunny, there were 75 runners treated for hypothermia. In general, humans adapt poorly to cold exposure. Children are at particular risk because of their relatively greater surface area/body mass ratio, causing them to cool even more rapidly than adults. Because of this, the human's best defense against cold injury is to limit his/her exposure to cold and to dress appropriately. If cold injury has occurred and is mild, often simple passive rewarming such as dry blankets and a warm room are sufficient treatment.

  19. The effect of flight-related behaviour on the risk of venous thrombosis after air travel

    NARCIS (Netherlands)

    Schreijer, Anja J.M.; Cannegieter, Suzanne C.; Doggen, Catharina Jacoba Maria; Rosendaal, Frits R.

    2009-01-01

    In a case–control study including 11 033 participants (The Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study) on risk factors of venous thrombosis, we studied the effect of flight-related behaviour on the risk of venous thrombosis after air travel. Patients

  20. 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

  1. Frequency of venous thromboembolism events during acute inpatient rehabilitation in a comprehensive cancer centre

    Directory of Open Access Journals (Sweden)

    Amy H. Ng

    2017-09-01

    Conclusion: Cancer patients with low FIM transfer scores and lower extremity oedema are at higher risk of venous thromboembolism. Patients with these clinical findings at admission may require measures for more aggressive surveillance for the presence of venous thromboembolism. Patients with venous thromboembolism had an increased length of stay in rehabilitation, but ultimately did not have significant differences in FIM score changes.

  2. Sex differences in cerebral venous thrombosis: A systematic analysis of a shift over time

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; Middeldorp, Saskia; Stam, Jan; Coutinho, Jonathan M.

    2016-01-01

    In contemporary studies, cerebral venous thrombosis is three times more common in adult women than in men. To study the change in sex ratio over time in cerebral venous thrombosis. We systematically reviewed the literature. Any type of study with at least 40 patients with cerebral venous thrombosis

  3. Prevalence of venous sinus stenosis in Pseudotumor cerebri (PTC using digital subtraction angiography (DSA

    Directory of Open Access Journals (Sweden)

    Mohamed Hamdy Ibrahim

    2014-06-01

    Conclusion: Studying the intracranial venous system in patients with PTC is an important step in understanding the pathophysiology of the disease. Detection of venous sinus stenosis opens the way to a novel therapeutic option for refractory patients like venous sinus stenting.

  4. Ultrasonic Guided Insertion of Central Venous Catheter in Infants ...

    African Journals Online (AJOL)

    Background/Purpose: ultrasound is licensed for application of regional blocks and insertion of vascular access. We aimed to compare ultrasonic guided (USG) and anatomical landmark technique (ALT) for insertion of central venous catheter (CVC) as regard success rate and rate of complications in infants and children.

  5. Factor XI Antisense Oligonucleotide for Prevention of Venous Thrombosis

    NARCIS (Netherlands)

    Büller, Harry R.; Bethune, Claudette; Bhanot, Sanjay; Gailani, David; Monia, Brett P.; Raskob, Gary E.; Segers, Annelise; Verhamme, Peter; Weitz, Jeffrey I.; Weitz, Jeffrey; Prins, Martin; Beenen, Ludo; Otten, Hans-Martin; Roos, Yvo; Slagboom, Ton; Vandenbriele, Christophe; Vanassche, Thomas; Dani, Vidhi; Schulz, Dan; Shapiro, Cara; Kwoh, Katherine; Jung, Bill; Gawinek-Samelczak, Agata; Kaemmer, Christina; Angelov, S.; Stavrev, V.; Kinov, P.; Dessouki, E.; Abuzgaya, F.; Baurovskis, A.; Peredistijs, A.; Petronis, S.; Danilyak, V.; Driagin, V.; Kuropatkin, G.; Parfeev, S.; Safronov, A.; Ankin, M.; Korzh, M.; Olinichenko, G.; Polivoda, A.; Shevchenko, V.; Sulyma, V.

    2015-01-01

    Background Experimental data indicate that reducing factor XI levels attenuates thrombosis without causing bleeding, but the role of factor XI in the prevention of postoperative venous thrombosis in humans is unknown. FXI-ASO (ISIS 416858) is a second-generation antisense oligonucleotide that

  6. Causes and predictors of death in cerebral venous thrombosis

    NARCIS (Netherlands)

    Canhão, Patrícia; Ferro, José M.; Lindgren, Arne G.; Bousser, Marie-Germaine; Stam, Jan; Barinagarrementeria, Fernando

    2005-01-01

    Background and Purpose - The causes of death of patients with cerebral venous thrombosis (CVT) have not been systematically addressed in previous studies. We aimed to analyze the causes and predictors of death during the acute phase of CVT in the International Study on Cerebral Vein and Dural Sinus

  7. The surgical treatment of ilio-femoral venous obstruction.

    Science.gov (United States)

    Illuminati, G; Caliò, F G; D'Urso, A; Mancini, P; Papaspyropoulos, V; Ceccanei, G; Lorusso, R; Vietri, F

    2004-01-01

    A series of 9 patients of a mean age of 48 years, operated on for compression of the ilio-femoral venous axis is reported. The cause of obstruction was external compression in 3 cases, a retroperitoneal sarcoma in 1 case, and an infrarenal aortic aneurysm in 2. Two patients presented with a Cockett's syndrome, 3 with a chronic ilio-femoral thrombosis, and one with a post-traumatic segmentary stenosis. Treatment consisted in a resection/Dacron grafting of 2 infrarenal aortic aneurysms, one femoro-caval bypass graft, 2 transpositions of the right common iliac artery in the left hypogastric artery for Cockett's syndrome, 3 Palma's operations for chronic thrombosis, and one internal jugular vein interposition for segmentary stenosis. There were no postoperative deaths and no early thromboses of venous reconstructions performed. All the patients were relieved of symptoms during the follow-up period, whose mean length was 38 months. The cause of venous obstruction and the presence of symptoms which are resistant to medical treatment are the main indications to ilio-femoral venous revascularization. The choice of the optimal treatment in each single case yields satisfactory results.

  8. Risk Stratification for Bleeding Complications in Patients With Venous Thromboembolism

    DEFF Research Database (Denmark)

    Brown, Joshua D; Goodin, Amie J; Lip, Gregory Y H

    2018-01-01

    BACKGROUND: The Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile International Normalized Ratio (INR), Elderly, Drugs or alcohol use (HAS-BLED) score has strong predictive validity for major bleeding complications, but limited validation has been conducted in venous thromboem...

  9. The risk of venous thromboembolism in patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Peeters, P J H L; Bazelier, M T; Uitdehaag, B M J

    2014-01-01

    BACKGROUND: In patients with multiple sclerosis (MS), disability and autoinflammatory processes may result in an increased risk of venous thromboembolism (VTE) OBJECTIVE: To evaluate the risk of VTE associated with MS. METHODS: We conducted an observational-cohort study within the Clinical Practice...

  10. Prevention of venous pain and phlebitis caused by epirubicin hydrochloride.

    Science.gov (United States)

    Sugimoto, Masakazu; Matsui, Masateru; Harada, Masanori; Yamauchi, Yumiko; Moriyama, Nao; Andou, Kanae; Yamamoto, Makoto; Yamaoka, Hisayo; Ono, Chiemi; Ishikawa, Mami; Kamo, Nobuyuki; Ikeda, Tadashi; Yamaoka, Keiko

    2009-06-01

    Many patients complain of venous pain or develop phlebitis following treatment with epirubicin hydrochloride(EPI). To ensure effective and safe treatment with this drug, it is essential to deal with the adverse events associated with it appropriately. At our hospital, EPI was previously administered by drip infusion(diluted with 50mL of physiological saline)over 15 minutes after pretreatment(EPI main route). With this method of treatment, venous pain and phlebitis developed in 14 of 15 cases. In 3 of these 14 cases, the regimen was modified. Following this experience, EPI administration was switched to drip infusion from the fully-opened side tube used for pretreatment(EPI sub-route). Switching to this route resulted in a sharp decrease in the incidence of venous pain and phlebitis, to only 1 of 15 cases. Stimulation of vascular tunica intima by EPI has been considered a factor principally responsible for the venous pain and phlebitis seen after EPI therapy. To prevent these adverse reactions, it is necessary to modify the method of administration so that strong or long-term exposure of blood vessels to EPI can be reduced. The results of this study suggest that the EPI sub-route we devised is useful in achieving this goal.

  11. Compression therapy in patients with venous leg ulcers.

    Science.gov (United States)

    Dissemond, Joachim; Assenheimer, Bernd; Bültemann, Anke; Gerber, Veronika; Gretener, Silvia; Kohler-von Siebenthal, Elisabeth; Koller, Sonja; Kröger, Knut; Kurz, Peter; Läuchli, Severin; Münter, Christian; Panfil, Eva-Maria; Probst, Sebastian; Protz, Kerstin; Riepe, Gunnar; Strohal, Robert; Traber, Jürg; Partsch, Hugo

    2016-11-01

    Wund-D.A.CH. is the umbrella organization of the various wound care societies in German-speaking countries. The present consensus paper on practical aspects pertinent to compression therapy in patients with venous leg ulcers was developed by experts from Germany, Austria, and Switzerland. In Europe, venous leg ulcers rank among the most common causes of chronic wounds. Apart from conservative and interventional wound and vein treatment, compression therapy represents the basis of all other therapeutic strategies. To that end, there are currently a wide variety of materials and systems available. While especially short-stretch bandages or multicomponent systems should be used in the initial decongestion phase, ulcer stocking systems are recommended for the subsequent maintenance phase. Another - to date, far less common - alternative are adaptive Velcro bandage systems. Medical compression stockings have proven particularly beneficial in the prevention of ulcer recurrence. The large number of treatment options currently available enables therapists to develop therapeutic concepts geared towards their patients' individual needs and abilities, thus resulting in good acceptance and adherence. Compression therapy plays a crucial role in the treatment of patients with venous leg ulcers. In recent years, a number of different treatment options have become available, their use and application differing among German-speaking countries. The present expert consensus is therefore meant to outline concrete recommendations for routine implementation of compression therapy in patients with venous leg ulcers. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  12. Radiological evaluation of the chronic venous stasis syndrome

    International Nuclear Information System (INIS)

    Train, J.S.; Schanzer, H.; Peirce, E.C. II; Dan, S.J.; Mitty, H.A.

    1987-01-01

    Chronic venous stasis is an extremely complex clinical syndrome of pain and changes in the skin that can involve the superficial, deep, and perforating veins. This syndrome is commonly referred to as the postphlebitic syndrome, implying that thrombophlebitis is its sole etiology. To test this hypothesis, the authors performed ascending venography on 51 limbs of patients with the chromic venous stasis syndrome and demonstrated that 32 had no radiological evidence of recent or old thrombophlebitis. Instead, they had normal-appearing veins, suggesting primary incompetence of the deep and/or perforating venous valves rather than thrombophlebitis as the etiology. Since various operations have recently been proposed to correct or bypass malfunctioning valves, precise demonstration of pathological change is required to choose the appropriate procedure and to evaluate results. Descending venograms were combined with the ascending studies in 42 limbs for this purpose. In addition to outlining the abnormalities responsible for chronic venous stasis syndrome in individual cases, interesting conclusions regarding the syndrome itself were reached

  13. Ultrasonography of Skin Changes in Legs with Chronic Venous Disease.

    Science.gov (United States)

    Caggiati, A

    2016-10-01

    In daily practice, ultrasonography (US) is used only to designate the location and pattern of venous lesions. Skin US is not performed between routine venous investigations. Skin morphology is evaluated by the same probes used for routine Duplex evaluation of superficial veins. US findings from evident skin lesions are comparatively evaluated with those from the surrounding apparently normal skin and from the contralateral leg. Inflammation and dermal edema can be found in the apparently normal skin of C2 legs. Swollen legs show thickening of the subcutaneous layer as a result of diffuse soaking or anechoic cavities, with or without dermal edema. Chronic hypodermitis is characterized by inflammatory edema in initial phases, and by liposclerosis in advanced cases. Recrudescence of inflammation provokes focal rarefactions of the subcutaneous layer, possibly related to ulcer opening. In legs with venous disorders, sonography refines clinical evaluation of the skin and may reveal changes not highlighted by inspection. Some of these changes could require further investigation because they have not yet been explained or described. Skin sonography should improve knowledge of the natural history of skin changes, as well as contribute to a better grading of venous diseases severity In particular, US evidence of cutaneous and subcutaneous changes in C2 legs should be considered to stratify the treatment in C2 legs, by identifying those in which varicose veins are not simply a cosmetic problem. Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  14. 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

  15. Is there a role for thrombolytic therapy in venous thromboembolism?

    NARCIS (Netherlands)

    Sanson, B. J.; Büller, H.

    1999-01-01

    Theoretically, thrombolytic therapy would appear to offer benefits over standard heparin therapy in the treatment of venous thromboembolism based on the more rapid resolution of thrombus. In this paper, the results of clinical trials performed with thrombolytic agents in the initial treatment of

  16. Delivery of Compression Therapy for Venous Leg Ulcers

    DEFF Research Database (Denmark)

    Zarchi, Kian; Jemec, Gregor B E

    2014-01-01

    adequate subbandage pressure when treating patients with venous leg ulcers and the factors that predict the ability to achieve optimal pressure. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional study from March 1, 2011, through March 31, 2012, in home care centers in 2 Danish...

  17. Partial anomalous pulmonary venous return in Turner syndrome

    NARCIS (Netherlands)

    Hoven, A.T. van den; Chelu, R.G.; Duijnhouwer, A.L.; Demulier, L.; Devos, D.; Nieman, K.; Witsenburg, M.; Bosch, A.E. van den; Loeys, B.L.; Hagen, I.M. van; Roos-Hesselink, J.W.

    2017-01-01

    PURPOSE: The aim of this study is to describe the prevalence, anatomy, associations and clinical impact of partial anomalous pulmonary venous return in patients with Turner syndrome. METHODS AND RESULTS: All Turner patients who presented at our Turner clinic, between January 2007 and October 2015

  18. Partial abnormal pulmonary venous return in Turner syndrome

    NARCIS (Netherlands)

    van Wassenaer, A. G.; Lubbers, L. J.; Losekoot, G.

    1988-01-01

    Three cases of partial anomalous pulmonary venous return, in one case combined with coarctation of the aorta and in another with discrete subaortic stenosis, are described in patients with Turner syndrome. In two of them the right and left superior pulmonary veins drained into the right superior

  19. An unusual case of repeated venous air embolism during awake ...

    African Journals Online (AJOL)

    Keywords: awake craniotomy, burr hole, deep brain stimulation, neurosurgery, venous air embolism. Introduction ... surgery started with the right burr hole and after the dura mater was opened, the ... opened. The patient was initially comfortable but then developed ... The surgery for the insertion of DBS on the left side was.

  20. Risk of Cerebral Venous Thrombosis in Obese Women

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; Arnold, Marcel; Middeldorp, Saskia; Broeg-Morvay, Anne; Silvis, Suzanne M.; Heldner, Mirjam R.; Meisterernst, Julia; Nemeth, Banne; Meulendijks, Eva R.; Stam, Jan; Cannegieter, Suzanne C.; Coutinho, Jonathan M.

    2016-01-01

    Obesity is a risk factor for deep vein thrombosis of the leg and pulmonary embolism. To date, however, whether obesity is associated with adult cerebral venous thrombosis (CVT) has not been assessed. To assess whether obesity is a risk factor for CVT. A case-control study was performed in

  1. Diagnosing thoracic venous aneurysm: A contemporary imaging perspective

    Directory of Open Access Journals (Sweden)

    Rohit Aggarwal

    2017-01-01

    Full Text Available Thoracic venous aneurysms are a rare clinical entity and contrast-enhanced computed tomography has been the cornerstone of their diagnosis. We are reporting a rare case of isolated left brachiocephalic vein aneurysm, which was surgically managed, highlighting the role of dynamic contrast-enhanced magnetic resonance imaging as a definitive diagnostic modality in this patient.

  2. Development of Needle Insertion Manipulator for Central Venous Catheterization

    Science.gov (United States)

    Kobayashi, Yo; Hong, Jaesung; Hamano, Ryutaro; Hashizume, Makoto; Okada, Kaoru; Fujie, Masakatsu G.

    Central venous catheterization is a procedure, which a doctor insert a catheter into the patient’s vein for transfusion. Since there are risks of bleeding from arterial puncture or pneumothorax from pleural puncture. Physicians are strictly required to make needle reach up into the vein and to stop the needle in the middle of vein. We proposed a robot system for assisting the venous puncture, which can relieve the difficulties in conventional procedure, and the risks of complication. This paper reports the design structuring and experimental results of needle insertion manipulator. First, we investigated the relationship between insertion force and angle into the vein. The results indicated that the judgment of perforation using the reaction force is possible in case where the needling angle is from 10 to 20 degree. The experiment to evaluate accuracy of the robot also revealed that it has beyond 0.5 mm accuracy. We also evaluated the positioning accuracy in the ultrasound images. The results displays that the accuracy is beyond 1.0 mm and it has enough for venous puncture. We also carried out the venous puncture experiment to the phantom and confirm our manipulator realized to make needle reach up into the vein.

  3. 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 ...

  4. Reduction in central venous pressure enhances erythropoietin synthesis

    DEFF Research Database (Denmark)

    Montero, D.; Rauber, S.; Gøtze, Jens Peter

    2016-01-01

    AIMS: Erythropoiesis is a tightly controlled biological event, but its regulation under non-hypoxic conditions, however, remains unresolved. We examined whether acute changes in central venous blood pressure (CVP) elicited by whole-body tilting affect erythropoietin (EPO) concentration according...

  5. Serious Complication of Central Venous Catheterization Due to Hemothorax: Hemothorax

    Directory of Open Access Journals (Sweden)

    Ümmügülsüm Gaygısız

    2017-12-01

    Full Text Available Central venous catheterization may cause life-threatening complications including pneumothorax and hemothorax. We report a case of multiple trauma complicated with an incidence of hemothorax due to a misplaced central venous catheter. Firstly, the tip of the guide-wire was ruptured in subcutaneous tissue and, secondly, the catheter came out of the vessel and caused hemothorax. During left subclavian catheterization, in this 47-years-old male patient, we could not advance the guide wire forward easily in the first attempt and tried to draw it back. In the second attempt, we inserted a new catheter without any difficulty. The blood gas analyses through the catheter for verification of location revealed its venous nature. After the catheterization, 500 mL hemorrhagic fluid was drained through the ipsilateral chest tube. Control chest X-ray showed that the catheter was in the left hemithorax and a piece of the guide wire was present below the left clavicle. Thorax computerized tomography showed that the catheter entered the thoracic cavity and extended to the paramediastinal region. An emergency surgery was performed to remove the piece of the guide wire and the catheter extending out of the vessel. A common method to check the intravenous insertion of a central catheter into a vein is to verify that the easily drawn blood has the nature of venous blood. This method, however, does not exclude the extravascular placement of the catheter in the presence of ipsilateral hemothorax.

  6. Chlamydia pneumoniae, systemic inflammation and the risk of venous thrombosis.

    NARCIS (Netherlands)

    Maraha, B.; Peeters, M.F.; Aken, B.E. van; Heijer, M. den

    2002-01-01

    Inflammatory mediators are involved in activation of the coagulation system, and elevated plasma concentrations of IL-6 and IL-8 are associated with an increased risk of venous thrombosis. Using serologic and molecular biologic tests, we investigated in a case-control study on patients with

  7. Involvement of pterygoid venous plexus in patulous eustachian tube symptoms.

    Science.gov (United States)

    Oshima, Takeshi; Ogura, Masaki; Kikuchi, Toshiaki; Hori, Yoko; Mugikura, Shunji; Higano, Shuichi; Takahashi, Shoki; Kawase, Tetsuaki; Kobayashi, Toshimitsu

    2007-07-01

    The pterygoid venous plexus (PVP) is an important factor in the mechanism of eustachian tube (ET) closure under conditions that can cause increased venous pressure in the head, such as during neck compression and postural change from the sitting/standing to the recumbent position. The symptoms of patulous ET are usually improved by neck compression or postural change (from sitting/standing to recumbent position). Venous congestion around the ET and/or gravitational change may be involved in the changing degree of symptoms, but its mechanism is not understood. This study investigated whether the PVP is involved. The dimensions of soft tissues surrounding ET were measured on magnetic resonance images before and after neck compression. The lateral pterygoid muscle became enlarged after neck compression. Simultaneously, the volume of venous plexus observed between the medial pterygoid muscle and tensor veli palatini muscle was increased. Such enlargement was probably due to blood pooling in the PVP, resulting in protrusion of the ET anterior wall to the luminal side, and decreased ET patency.

  8. The benefit of pharmacological venous thromboprophylaxis in foot ...

    African Journals Online (AJOL)

    The risks and benefits of pharmacological thromboprophylaxis are well documented in respect of total joint arthroplasty and hip fractures, but little is understood about the incidence of venous thromboembolism (VTE) or the potential risks and benefits of chemoprophylaxis in foot and ankle surgery. Objective. To determine ...

  9. Clinical Features and Patterns of Imaging in Cerebral Venous Sinus ...

    African Journals Online (AJOL)

    Background: Cerebral venous sinus thrombosis (CVST) is an uncommon neurological deficit. It shows a wide range of clinical manifestations that may mimic many other neurological disorders and lead to misdiagnosis. Imaging plays a key role in the diagnosis. Objective: To evaluate the clinical characteristics and patterns ...

  10. Managing Inadvertent Arterial Catheterization During Central Venous Access Procedures

    International Nuclear Information System (INIS)

    Nicholson, Tony; Ettles, Duncan; Robinson, Graham

    2004-01-01

    Purpose: Approximately 200,000 central venous catheterizations are carried out annually in the National Health Service in the United Kingdom. Inadvertent arterial puncture occurs in up to 3.7%. Significant morbidity and death has been reported. We report on our experience in the endovascular treatment of this iatrogenic complication. Methods: Retrospective analysis was carried out of 9 cases referred for endovascular treatment of inadvertent arterial puncture during central venous catheterization over a 5 year period. Results: It was not possible to obtain accurate figures on the numbers of central venous catheterizations carried out during the time period. Five patients were referred with carotid or subclavian pseudoaneurysms and hemothorax following inadvertent arterial catheter insertion and subsequent removal. These patients all underwent percutaneous balloon tamponade and/or stent-graft insertion. More recently 4 patients were referred with the catheter still in situ and were successfully treated with a percutaneous closure device. Conclusion: If inadvertent arterial catheterization during central venous access procedures is recognized and catheters removed, sequelae can be treated percutaneously. However, once the complication is recognized it is better to leave the catheter in situ and seal the artery percutaneously with a closure device

  11. An unusual case of intrahepatic portosystemic venous shunt

    African Journals Online (AJOL)

    vena cava (IVC) (most common). Intrahepatic portosystemic venous shunts are rare vascular anomalies that may be detected in asymptomatic patients, given the recent advances in radiological imaging techniques. Accurate shunt evaluation and classification can be performed with ultrasound and multi-detector computed.

  12. Pure and diluted contrast medium in the evaluation of portal venous system with digital subtraction angiography

    International Nuclear Information System (INIS)

    Gattoni, F.; Baldini, V.; Pozzato, C.; Nessi, R.; Raiteri, R.; Uscenghi, C.; Opocher, E.; Santambrogio, R.

    1990-01-01

    We report the results of intra-arterial digital subtraction angiography (DSA) in 100 patients with portal hypertension. The portal venous system was evaluated; all patients underwent angiography of the celiac and superior mesenteric arteries before surgery. Forty-four of them were also examined after Warren splenorenal shunts. Therefore, a total of 144 exams was evaluated. The authors always employed low-osmolality ionic and non-ionic contrast media (iodine concentration: 300-350 mg/ml). In 70 cases pure contrast medium was injected (20/25 ml): in the extant 74 cases it was diluted with an equal volume of saline solution (osmolality and iodine concentration reduced by 50%). Intra-arterial DSA always visualized portal venous system, collateral circulation, shunt location and postoperative changes. The mayor advantage of intra-arterial DSA is the smaller amount of contrast medium injected, so that local and systemic side effects are rare. According to our experience, it is best to dilute the contrast medium and inject the same amount as in conventional angiography, at the same rate. Other well-known advantages of intra-arterial DSA are quicker execution, less injury to arteries using smaller caliber catheters, and low cost. The major disadvantage of intra-arterial DSA, as it appeared also in our study, is the field size of the intensifier, which in our case was limited to 6-9 inches. This is an insufficient coverage for the whole portal system to be studied, and some contrast medium injections become therefore necessary. An average of 3 injections were given to each patient. This problem reduces the advantage of less contrast medium per injection. At any rate, even though intra-arterial DSA exhibits this limitation, it can nevertheless yield important information in the pre- and postoperative evaluation of patients with portal hypertension

  13. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  14. Cerebral Venous-Sinus Thrombosis: A Case Series Analysis

    Directory of Open Access Journals (Sweden)

    Nahid Ashjazadeh

    2011-09-01

    Full Text Available Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16% were women and 37 (29.83% were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51% women took oral contraceptive pills. Twenty of 57 women (35.08% took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%. High mortality and morbidity rates (14.51% and 35.48%, respectively were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001 and evidence of hemorrhage in primary CT scan (P=0.005. Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it

  15. Fingertip Reconstruction Using Free Toe Tissue Transfer Without Venous Anastomosis

    Directory of Open Access Journals (Sweden)

    Won Young Yoon

    2012-09-01

    Full Text Available BackgroundThis study was designed to introduce the feasibility of toe tissue transfer without venous outflow for fingertip reconstruction.MethodsFive cases of fingertip defects were treated successfully with this method. Four cases were traumatic fingertip defects, and one case was a hook-nail deformity. The lateral pulp of a great toe or medioinferior portion of a second toe was used as the donor site. An arterial pedicle was dissected only within the digit and anastomosis was performed within 2 cm around the defect margin. The digital nerve was repaired simultaneously. No additional dissection of the dorsal or volar pulp vein was performed in either the donor or recipient sites. Other surgical procedures were performed following conventional techniques. Postoperative venous congestion was monitored with pulp temperature, color, and degree of tissue oxygen saturation. Venous congestion was decompressed with a needle-puncture method intermittently, but did not require continuous external bleeding for salvage.ResultsVenous congestion was observed in all the flaps, but improved within 3 or 4 days postoperatively. The flap size was from 1.5×1.5 cm2 to 2.0×3.0 cm2. The mean surgical time was 2 hours and 20 minutes. A needle puncture was carried out every 2 hours during the first postoperative day, and then every 4 hours thereafter. The amount of blood loss during each puncture procedure was less than 0.2 mL. In the long-term follow-up, no flap atrophy was observed.ConclusionsWhen used properly, the free toe tissue transfer without venous anastomosis method can be a treatment option for small defects on the fingertip area.

  16. Sustained compression and healing of chronic venous ulcers.

    Science.gov (United States)

    Blair, S. D.; Wright, D. D.; Backhouse, C. M.; Riddle, E.; McCollum, C. N.

    1988-01-01

    STUDY OBJECTIVE--Comparison of four layer bandage system with traditional adhesive plaster bandaging in terms of (a) compression achieved and (b) healing of venous ulcers. DESIGN--Part of larger randomised trial of five different dressings. SETTING--Outpatient venous ulcer clinic in university hospital. PATIENTS--(a) Pressure exerted by both bandage systems was measured in the same 20 patients. (b) Healing with the four layer bandage was assessed in 148 legs in 126 consecutive patients (mean age 71 (SE 2); range 30-96) with chronic venous ulcers that had resisted treatment with traditional bandaging for a mean of 27.2 (SE 8) months. INTERVENTIONS--(a) Four layer bandage system or traditional adhesive plaster bandaging for pressure studies; (b) four layer bandaging applied weekly for studies of healing. END POINTS--(a) Comparison of pressures achieved at the ankle for up to one week; (b) complete healing within 12 weeks. MEASUREMENTS AND MAIN RESULTS--(a) Four layer bandage produced higher initial pressures at the ankle of 42.5 (SE 1) mm Hg compared with 29.8 (1.8) for the adhesive plaster (p less than 0.001; 95% confidence interval 18.5 to 6.9). Pressure was maintained for one week with the four layer bandage but fell to 10.4 (3.5) mm Hg at 24 hours with adhesive plaster bandaging. (b) After weekly bandaging with the four layer bandage 110 of 48 venous ulcers had healed completely within 12 (mean 6.3 (0.4)) weeks. CONCLUSION--Sustained compression of over 40 mm Hg achieved with a multilayer bandage results in rapid healing of chronic venous ulcers that have failed to heal in many months of compression at lower pressures with more conventional bandages. PMID:3144330

  17. Emulsifiers' composition modulates venous irritation of the nanoemulsions as a lipophilic and venous irritant drug delivery system.

    Science.gov (United States)

    Mao, Chengwen; Wan, Jiangling; Chen, Huabing; Xu, Huibi; Yang, Xiangliang

    2009-01-01

    In this study, a nanoemulsion (NE) system was investigated for intravenous delivery of lipophilic and venous irritant drugs. NEs were prepared to deliver diallyl trisulfide (DT) for systemic therapy of bacterial and fungal infection, egg phospholipid was chosen as the main emulsifier, and two co-emulsifiers were also incorporated, including Poloxamer 188 (P188) and Solutol HS 15 (S15). Soybean oil was used as the dispersed phases, forming stable DT NEs with small particle sizes. The venous irritation of DT NEs was evaluated by in vitro human umbilical cord endothelial cells (CRL 1730) compatibility model with the intracellular adenosine triphosphate (ATP) and guanosine triphosphate (GTP) concentrations as the indices. The intracellular ATP and GTP reduction changed with the incorporation of a variety of co-emulsifiers, which varied in a free DT concentration-dependent manner. It was deduced that the free DT concentrations of NEs containing co-emulsifiers were determined by the partition coefficient of DT between oil and surfactant buffer solution. In conclusion, NE was an appropriate delivery system for lipophilic and venous irritant drug, and optimization of the composition of emulsifiers was an effective method to alleviate the venous irritation of DT NEs.

  18. Validation of a novel venous duplex ultrasound objective structured assessment of technical skills for the assessment of venous reflux.

    Science.gov (United States)

    Jaffer, Usman; Normahani, Pasha; Lackenby, Kimberly; Aslam, Mohammed; Standfield, Nigel J

    2015-01-01

    Duplex ultrasound measurement of reflux time is central to the diagnosis of venous incompetence. We have developed an assessment tool for Duplex measurement of venous reflux for both simulator and patient-based training. A novel assessment tool, Venous Duplex Ultrasound Assessment of Technical Skills (V-DUOSATS), was developed. A modified DUOSATS was used for simulator training. Participants of varying skill level were invited to viewed an instructional video and were allowed ample time to familiarize with the Duplex equipment. Attempts made by the participants were recorded and independently assessed by 3 expert assessors and 5 novice assessors using the modified V-DUOSATS. "Global" assessment was also done by expert assessors on a 4-point Likert scale. Content, construct, and concurrent validities as well as reliability were evaluated. Content and construct validity as well as reliability were demonstrated. Receiver operator characteristic analysis-established cut points of 19/22 and 21/30 were most appropriate for simulator and patient-based assessment, respectively. We have validated a novel assessment tool for Duplex venous reflux measurement. Further work is required to establish transference validity of simulator training to improve skill in scanning patients. We have developed and validated V-DUOSATS for simulator training. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  20. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M. [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B.; Draf, W. [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S. [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G. [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  1. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    Energy Technology Data Exchange (ETDEWEB)

    Brors, D [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Schaefers, M [Dept. of Neurology, University Hospital Wuerzburg (Germany); Schick, B; Draf, W [Dept. of Ear, Nose and Throat Diseases, Head, Neck and Facial Plastic Surgery, Klinikum Fulda (Germany); Dazert, S [Univ. Hospital Wuerzburg (Germany). Dept. of Oto-Rhino-Laryngology, Head- and Neck-Surgery; Kahle, G [Department of Radiology, Hospital Fulda (Germany)

    2001-02-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  2. Sigmoid and transverse sinus thrombosis after closed head injury presenting with unilateral hearing loss

    International Nuclear Information System (INIS)

    Brors, D.; Schaefers, M.; Schick, B.; Draf, W.; Dazert, S.

    2001-01-01

    Sinus thrombosis has rarely been associated with closed head injury; more often, thrombosis of the sigmoid or transverse sinus is caused by otogenic inflammations or tumours, or occurs during pregnancy. Symptoms are frequently vague, while untreated thrombus progression may be fatal due to venous congestion and infarction. We report a 32-year-old man presenting with right hearing loss, tinnitus and headache 2 days after a closed head injury. Neurological examination showed no additional abnormality. The EEG showed focal bifrontal slowing. CT revealed a fracture of the occipital bone. MRI and MRA demonstrated complete thrombosis of the right sigmoid and transverse sinuses. After 2 weeks of intravenous heparin therapy followed by warfarin, the patient's hearing improved and MRI and MRA showed complete recanalisation of the sigmoid and transverse sinuses. Venous sinus thrombosis can be an undetected sequel to head injury. Appropriate imaging studies should be carried out to enable therapy to be started as soon as possible. (orig.)

  3. The natural history of postoperative venous thromboemboli in gynecologic oncology: a prospective study of 382 patients

    International Nuclear Information System (INIS)

    Clarke-Pearson, D.L.; Synan, I.S.; Colemen, R.E.; Hinshaw, W.; Creasman, W.T.

    1984-01-01

    Three hundred eighty-two patients who underwent major operations for gynecologic malignancy were studied prospectively to determine the natural history of postoperative venous thromboemboli. Iodine 125-labeled fibrinogen leg counting, to diagnose deep venous thrombosis, was performed daily. Sixty-three patients (17%) developed postoperative venous thromboembolic complications. Deep venous thrombosis initially arose in the calf veins in 52 patients. Twenty-seven percent of these thrombi lysed spontaneously. Four percent of thrombi in the calf veins progressed to deep venous thrombosis in the femoral vein, and 4% resulted in pulmonary emboli. Nine other patients developed proximal deep venous thrombosis without prior thrombosis in the calf veins. One patient with proximal deep venous thrombosis also had a pulmonary embolus. Two patients with no evidence of deep venous thrombosis on prospective 125 I-labeled fibrinogen leg counting developed pulmonary emboli, including one fatal pulmonary embolus that was found at autopsy to have arisen from the internal iliac veins. Fifty percent of all venous thromboemboli were detected within 48 hours of operation, although two patients developed significant deep venous thrombosis and pulmonary emboli after discharge from the hospital. These results add important information to our understanding of this disease process, and raise issues related to appropriate treatment and prophylaxis of venous thromboembolism in patients after gynecologic operations

  4. Comparison between capillary, venous and arterial levels of protein S100B in patients with severe brain pathology

    DEFF Research Database (Denmark)

    Astrand, Ramona; Romner, Bertil; Reinstrup, Peter

    2012-01-01

    of the study was to investigate the relation between capillary, venous and arterial measurements of protein S100B, primarily by determining whether capillary S100B differ from venous and if capillary S100B can predict venous S100B levels, and secondarily, if arterial S100B samples can substitute venous samples...... in severely brain-injured patients....

  5. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...

  6. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW ...

  8. Dealing with Sports Injuries

    Science.gov (United States)

    ... Videos for Educators Search English Español Dealing With Sports Injuries KidsHealth / For Teens / Dealing With Sports Injuries ... a long way toward preventing injuries. Types of Sports Injuries Common reasons why teens get injured playing ...

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ... Animated Spinal Cord Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal ...

  10. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 David ...

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Topic Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 Adult Injuries Spinal Cord Injury 101 ...

  12. Use if a soecuak sokubt ub reverse syrak artery flap to reduce venous congestion and flap necrosis

    International Nuclear Information System (INIS)

    Masood, T.; Ahmed, R.; Obaidullah, M.

    2016-01-01

    Background: Distally based sural fascio-cutaneous flap is a commonly performed plastic surgery procedure for the coverage of distal third of leg, ankle and foot defects. However congestion is the main complication of this flap which results into partial or complete loss of the flap. We devised a special splint to reduce this complication and retrospectively reviewed its effect on this complication between two groups. Methods: This retrospective study was carried out at Northwest General hospital between 1995 and 2012. Group-A included 30 patients who were managed without the splint between 1995 and 2005 and group B comprised of 35 patients were treated with the splint between 2006 and 2012. Complications like venous congestion, epidermolysis, and partial and complete flap failure were documented. Data were analyzed by SPSS.16.5 software. Chi- square test was used for data analysis. P value less than 0.05 was considered as the level of significance. Results: Total 65 patients were operated. Age of the patients ranged from 7 to 60 years. Road traffic accident and spoke wheel injury was the main cause of soft tissue loss in our patients. In group A 12 patients suffered from venous congestion. Out of 12, three patients had epidermolysis while partial flap necrosis occurred in 9 patients. Only 3 patients had venous congestion in group B. Two patients suffered from epidermolysis and one had partial flap necrosis. None of patient suffered from complete flap loss in both groups. Conclusion: Reverse sural artery flap continues to be a versatile flap for distal lower extremity reconstruction. By using a special splint to reduce pressure on the pedicle site as a modification, flap complication rate can be decreased significantly. (author)

  13. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  14. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    International Nuclear Information System (INIS)

    Koo, Kevin S.H.; Dowd, Christopher F.; Hess, Christopher P.; Mathes, Erin F.; Frieden, Ilona J.; Rosbe, Kristina W.; Hoffman, William Y.

    2015-01-01

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  15. Endovascular stent-support angioplasty for cerebral venous sinus stenosis

    Directory of Open Access Journals (Sweden)

    Xin-feng LI

    2011-06-01

    Full Text Available Objective To investigate the pathophysiological features of cerebral venous sinus stenosis,and the modus and therapeutic effect of stent-support angioplasty.Methods The clinical data of 36 patients with cerebral venous sinus stenosis,admitted to Neurosurgical Department of General Hospital of PLA from Dec.2001 to Jun.2010,were retrospectively analyzed.Of the 36 cases,10 were males and 26 females,aged from 14 to 57 years with a mean of 37.8 years,and the disease course ranged from 4 days to 9 years.The main clinical manifestations included headache,vomiting,optical visual blurring,and limb weakness with anesthesia in some patients.The diagnosis of all patients was confirmed by digital subtraction angiography,and the results showed that the local stenosis located in right transverse-sigmoid sinus in 21 cases,left transverse-sigmoid sinus in 12 cases,and on both sides in 3 cases.All patients received thrombolytic therapy via carotid artery or a microcatheter inserted in the venous sinus,followed by stent angioplasty of venous sinus.Meanwhile,general anticoagulant and antiplatelet therapy were essential.Results All the 36 patients were successively treated with balloon dilatation and stent angioplasty of venous sinus with exception of 3 cases,who failed because of the circuitous jugular foramen preventing the insertion of the stent.The successful rate was 91.7%.The cerebrospinal fluid pressure of the patients was lowered from 374.7±82.9mmH2O before operation to 230.3±48.1mmH2O after operation.Thirty-three patients were followed-up for 1 month to 8 years by brain angiography and examinations in the outpatient clinic.Among them 32 showed persistent relief of clinical symptoms.The remaining patient presented severe headache and optical visual blurring 1 month after stent implantation,however the symptoms were alleviated obviously after thrombolytic therapy via the carotid artery with adequate anticoagulation.Conclusions Stent angioplasty of venous

  16. Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

    International Nuclear Information System (INIS)

    Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.; Siegel, Randall L.; Biswal, Rajiv; Gribbin, Christopher E.; Tokarz, Robert

    2000-01-01

    Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. A combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically significant

  17. Injuries of the Portal Vein in Patients With Blunt Abdominal Trauma

    Science.gov (United States)

    Kremer, B.; Lloyd, D. M.; Meyer-Pannwitt, U.

    1993-01-01

    Between January 1987 and September 1991, 68 severely traumatized patients underwent emergency laparotomy because of blunt abdominal trauma. Intraoperatively, 54.4% of the patients had a major injury to one organ, 23.5% had injuries to two organs, 16.2% had injuries to three organs and 5.9% to four or more organs. Additionally, in 11.8% of these cases (n = 8) a major vascular injury (portal vein n = 5, vena cava n = 2, mesenteric root n = 1) was found. Injuries to the portal vein were always associated with complete rupture of the pancreas, requiring distal pancreatic resection in four cases and a duodenum preserving resection of the head of the pancreas in one. In two of these patients the portal vein had to be reconstructed with a Goretex prosthetic graft. Mortality was 14.7% for the whole group (n = 68) and 0% for patients with additional portal venous injuries. PMID:8489966

  18. Injuries of the Portal Vein in Patients With Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    D. Henne-Bruns

    1993-01-01

    four or more organs. Additionally, in 11.8% of these cases (n = 8 a major vascular injury (portal vein n = 5, vena cava n = 2, mesenteric root n = 1 was found. Injuries to the portal vein were always associated with complete rupture of the pancreas, requiring distal pancreatic resection in four cases and a duodenum preserving resection of the head of the pancreas in one. In two of these patients the portal vein had to be reconstructed with a Goretex prosthetic graft. Mortality was 14.7% for the whole group (n = 68 and 0% for patients with additional portal venous injuries.

  19. Penetrating Obturator Artery Injury after Gunshot Wounds: A Successful Multidisciplinary Trauma Team Approach to a Potentially Lethal Injury.

    Science.gov (United States)

    Maraqa, Tareq I; Shin, Ji-Sun J; Diallo, Ismael; Sachwani-Daswani, Gul R; Mercer, Leo C

    2017-11-17

    Obturator artery injury (OAI) from pelvic gunshot wounds (GSW) is a rarely reported condition. Hemorrhages from pelvic trauma (PT) are mostly venous. Arterial hemorrhages represent about 10-20% of PTs. When arterial hemorrhages from PT occur, they are a severe and deadly complication often causing significant hemodynamic instability and eventual shock. A  23-year-old male presented to our emergency service via a private vehicle with multiple gunshot wounds to both thighs and to the lower back, resulted in rectal and obturator artery (OA) injuries. The patient underwent a successful coil-embolization of the right OA. Given the density of structures within the pelvis, patients who sustain gunshot wounds to the pelvic region are at high risk for injury to the small bowel, sigmoid colon, rectum, bladder, and/or vascular structures. While bleeding is the major cause of early mortality in PT, rectal injuries carry the highest mortality due to visceral injuries. A high clinical index of suspicion is needed to diagnose an iliac artery injury or injury to its branches. Prompt computed tomographic angiogram (CTA) and embolization of the OA is the best method to control and stop the bleeding and improve the mortality outcome. Clinicians caring for patients presenting with pelvic gunshot wounds should pay attention to the delayed presentation of internal hemorrhage from the OAs. A multidisciplinary team approach is crucial in the successful management of penetrating injuries to the obturator artery.

  20. Fingertip Injuries

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Fingertip Injury Email to a friend * required fields ...

  1. Musculoskeletal injuries

    International Nuclear Information System (INIS)

    Gigirey, V

    2012-01-01

    This presentation is about musculoskeletal injuries and the diagnosis of osseous tumors. The use of the radiology, bone scintigraphy, computed tomography and magnetic resonance contribute to detect the localization of the osseous lesions as well as the density (lytic, sclerotic, mixed) and the benign and malignant tumors.

  2. Iliac Vein Interrogation Augments Venous Ulcer Healing in Patients Who Have Failed Standard Compression Therapy along with Pathological Venous Closure.

    Science.gov (United States)

    Mousa, Albeir Y; Broce, Mike; Yacoub, Michael; AbuRahma, Ali F

    2016-07-01

    Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. We conducted a systematic retrospective analysis of a consecutive series of patients who presented with CEAP (clinical, etiological, anatomical, and pathophysiological) 6 venous disease. All patients had great saphenous vein ablation, compressive treatment, wound care (including Unna boot compression), and perforator closure using ablation therapy. Iliac vein stenosis was defined as ≥50% stenosis in cross-sectional surface area on intravascular ultrasound. Primary outcomes include time of venous ulcer healing and/or measurable change in the Venous Clinical Severity Score. Twenty-two patients with CEAP 6 venous disease met the inclusion criteria (active ulcers >1.5 cm in diameter). The average age and body mass index were 62.2 ± 9.2 years and 41.7 ± 16.7, respectively. The majority were female (72.7%) with common comorbidities, such as hyperlipidemia (54.5%), hypertension (36.4%), and diabetes mellitus (27.3%). Twenty-nine ulcers with an average diameter of 3.4 ± 1.9 cm and a depth of 2.2 ± 0.5 mm were treated. The majority of the ulcers occurred on the left limb (n = 17, 58.6%). Average perforator venous reflux was 3.6 ± 0.8 sec, while common femoral reflux was 1.8 ± 1.6. The majority (n = 19, 64.5%) of the perforator veins were located at the base of the ulcer, while the remainder (n = 10, 34.5%) were within 2 cm from the base. Of the 13 patients who underwent IVI, 8 patients (61.5%) had stenosis >50% that was corrected with iliac vein angioplasty and stenting (IVAS). There was a strong trend toward shorter healing time in the IVI group (7.9 ± 9.5 weeks) than for patients in the no iliac vein interrogation (NIVI) group (20.2 ± 15

  3. Minimal Invasive Approach for Lips Venous Lake Treatment by 980 nm Diode Laser with Emphasis on the Aesthetic Results. А Clinical Series

    Directory of Open Access Journals (Sweden)

    Voynov Parvan P.

    2016-06-01

    Full Text Available Introduction: A venous lake (VL is a vascular lesion with common occurrence in many patients, manifested as a dark blue-to-violet compressible papule, caused by dilation of venules. The main reasons for the treatment of VL are aesthetic. The haemorrhaging episodes or impairment of oral normal functions are also under considerations. Treatment of lip VL includes surgical excision, selective photocoagulation, cryotherapy, sclerotherapy and electrodessication. The high-intensity diode laser is an option. The 980 nm diode laser is selectively absorbed by haemoglobin and selectively destroys blood vessels, minimising injury to the surrounding healthy skin.

  4. Diagnosis of suspected venous thromboembolic disease in pregnancy

    International Nuclear Information System (INIS)

    Scarsbrook, A.F.; Evans, A.L.; Owen, A.R.; Gleeson, F.V.

    2006-01-01

    Venous thromboembolic disease is a leading cause of maternal mortality during pregnancy. Early and accurate radiological diagnosis is essential as anticoagulation is not without risk and clinical diagnosis is unreliable. Although the disorder is potentially treatable, unnecessary treatment should be avoided. Most of the diagnostic imaging techniques involve ionizing radiation which exposes both the mother and fetus to finite radiation risks. There is a relative lack of evidence in the literature to guide clinicians and radiologists on the most appropriate method of assessing this group of patients. This article will review the role of imaging of suspected venous thromboembolic disease in pregnant patients, highlight contentious issues such as radiation risk, intravenous contrast use in pregnancy and discuss the published guidelines, as well as suggesting an appropriate imaging algorithm based on the available evidence

  5. Magnetic resonance imaging of anomalous pulmonary venous connections

    International Nuclear Information System (INIS)

    Choe, Yeon Hyeon; Lee, Heung Jae; Kim, Hak Soo; Ko, Jae Kon; Kim, Ji Eun; Han, Jae Jin

    1994-01-01

    We evaluated the capability of MR in the diagnosis of anomalous pulmonary venous connection (APVC). The patient group consisted of 11 total APVC and 8 partial APVC diagnosed with MR. Echocardiography was performed in all cases, cardiac angiography in 12 cases and operation in 12 cases. We compared MR findings with those of operation, echocardiography and cardiac angiography. In surgically proven 12 cases, diagnostic accuracy of preoperative MR, echocardiography and cardiac angiography was 100%, 67%, and 63%, respectively. In the remaining cases, MR findings well correlated with those of echocardiography or cardiac angiography. Stenosis of common pulmonary vein or superior vena cava was identified in 4 cases. In one patient, MR duplicated associated cortriatriatum clearly. MR is an effective modally in depicting anomalous pulmonary venous connections

  6. Rivaroxaban or Aspirin for Extended Treatment of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Weitz, Jeffrey I; Lensing, Anthonie W A; Prins, Martin H

    2017-01-01

    BACKGROUND: Although many patients with venous thromboembolism require extended treatment, it is uncertain whether it is better to use full- or lower-intensity anticoagulation therapy or aspirin. METHODS: In this randomized, double-blind, phase 3 study, we assigned 3396 patients with venous...... thromboembolism to receive either once-daily rivaroxaban (at doses of 20 mg or 10 mg) or 100 mg of aspirin. All the study patients had completed 6 to 12 months of anticoagulation therapy and were in equipoise regarding the need for continued anticoagulation. Study drugs were administered for up to 12 months...... in 17 of 1107 patients (1.5%) receiving 20 mg of rivaroxaban and in 13 of 1127 patients (1.2%) receiving 10 mg of rivaroxaban, as compared with 50 of 1131 patients (4.4%) receiving aspirin (hazard ratio for 20 mg of rivaroxaban vs. aspirin, 0.34; 95% confidence interval [CI], 0.20 to 0.59; hazard ratio...

  7. Radioisotopic phlebography in investigating venous diseases of lower limbs

    International Nuclear Information System (INIS)

    San-Galli, F.; Vendaud-Busquet, M.; Philippe, J.C; Leccia, F.; Beylot, C.; Ducassous, D.

    1984-01-01

    The aim of this study is to analyse the interest of isotope phlebography in diagnosis of deep thrombosis and of chronic venous disease in the lower extremity as well as its value in relation to contrast venography. Out of 30 patients, 17 underwent both examinations. With contrast venography as a means of testing, radioisotope phlebography has a sensitivity of 71%, a specificity of 100%, an accuracy of 88%. Thirteen patients only had isotope phlebography. Results were confirmed everybody by clinical developments. The main interest of isotope phlebography is the diagnosis of femoral and iliac thromboses with a sensitivity and specificity of 100% at this point. In chronic venous disease isotope phlebography only shows indirect signs but gives information on the permeability of deep veins, wich is enough to make a therapeutic decision [fr

  8. Radioisotopic phlebography in investigating venous diseases of lower limbs

    Energy Technology Data Exchange (ETDEWEB)

    San-Galli, F.; Vendaud-Busquet, M.; Philippe, J.C; Leccia, F.; Beylot, C.; Ducassous, D. (Hopital du Haut-Leveque, 33 - Pessac (France))

    1984-10-01

    The aim of this study is to analyse the interest of isotope phlebography in diagnosis of deep thrombosis and of chronic venous disease in the lower extremity as well as its value in relation to contrast venography. Out of 30 patients, 17 underwent both examinations. With contrast venography as a means of testing, radioisotope phlebography has a sensitivity of 71%, a specificity of 100%, an accuracy of 88%. Thirteen patients only had isotope phlebography. Results were confirmed everybody by clinical developments. The main interest of isotope phlebography is the diagnosis of femoral and iliac thromboses with a sensitivity and specificity of 100% at this point. In chronic venous disease isotope phlebography only shows indirect signs but gives information on the permeability of deep veins, which is enough to make a therapeutic decision.

  9. Management of Cavoatrial Deep Venous Thrombosis: Incorporating New Strategies

    Science.gov (United States)

    Zayed, Mohamed A.; De Silva, Gayan S.; Ramaswamy, Raja S.; Sanchez, Luis A.

    2017-01-01

    Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years. Each therapeutic modality requires operator expertise and a coordinated care paradigm to facilitate successful outcomes. Open surgical thrombectomy is alternatively reserved for specific patient conditions, including intolerance of anticoagulation, failed catheter-based interventions, or acute emergencies. PMID:28265127

  10. Involvement of systemic venous congestion in heart failure.

    Science.gov (United States)

    Rubio Gracia, J; Sánchez Marteles, M; Pérez Calvo, J I

    2017-04-01

    Systemic venous congestion has gained significant importance in the interpretation of the pathophysiology of acute heart failure, especially in the development of renal function impairment during exacerbations. In this study, we review the concept, clinical characterisation and identification of venous congestion. We update current knowledge on its importance in the pathophysiology of acute heart failure and its involvement in the prognosis. We pay special attention to the relationship between abdominal congestion, the pulmonary interstitium as filtering membrane, inflammatory phenomena and renal function impairment in acute heart failure. Lastly, we review decongestion as a new therapeutic objective and the measures available for its assessment. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  11. Deep venous thrombosis of the upper extremity. A review

    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....... Treatment modalities and strategies: the treatment modalities include anticoagulation therapy, catheter-directed thrombolysis, surgical decompression, percutaneous transluminal angioplasty and stenting and they may be combined. However, the optimal treatment and timing of treatment remains controversial...

  12. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  13. Venous thromboprophylaxis in general surgery ward admissions: strategies for improvement.

    Science.gov (United States)

    Galante, Mariana; Languasco, Agustín; Gotta, Daniel; Bell, Soledad; Lancelotti, Tomás; Knaze, Viktoria; Saubidet, Cristián Lopez; Grand, Beatriz; Milberg, Matías

    2012-12-01

    To estimate the adherence to institutional venous thromboprophylaxis clinical practice guidelines (CPGs) in general surgery patients and to assess the effectiveness of a multi-strategy improvement intervention. A prospective before-after study. Two teaching hospitals located in the city of Buenos Aires, Argentina. Prescriptions belonging to patients admitted to the general surgery wards were evaluated. A multi-strategy intervention that included (i) simplification of institutional CPGs for venous thromboprophylaxis using a single drug at a single dose, based on the American College of Chest Physicians recommendations, (ii) distribution of pocket cards with an algorithm for the implementation of new recommendations to both, physicians and nurses, working in the general surgery units, (iii) educational talks, (iv) paper-based reminders and (v) audit and feedback. The adherence of the venous thromboprophylaxis prescription to the institutional recommendations. The prescriptions of 100 admitted patients before and 90 after the intervention were included in the analysis. The initial rate of adherence was 31%. After the intervention this rate rose to 71.1% (P< 0.001). The major improvement observed was the reduction in omitted prophylaxis in patients at risk of venous thromboembolism from 45 to 13.3% (P< 0.001). In the adjusted model, prescribing compliance with CPGs was five times more likely during the second stage than during the first stage (OR = 5.60, 95% CI = 2.92-10.74). Simple and economical interventions such as those described in this study can improve general surgeons compliance with the institutional and international guidelines, thus assuring patient safety and quality of health care.

  14. Association of Traditional Cardiovascular Risk Factors with Venous Thromboembolism

    DEFF Research Database (Denmark)

    Mahmoodi, Bakhtawar K; Cushman, Mary; Næss, Inger Anne

    2017-01-01

    Background: Much controversy surrounds the association of traditional cardiovascular disease risk factors with venous thromboembolism (VTE). Methods: We performed an individual level random-effect meta-analysis including 9 prospective studies with measured baseline cardiovascular disease risk...... factors and validated VTE events. Definitions were harmonized across studies. Traditional cardiovascular disease risk factors were modeled categorically and continuously using restricted cubic splines. Estimates were obtained for overall VTE, provoked VTE (ie, VTE occurring in the presence of 1 or more...

  15. Pinch grafting for chronic venous leg ulcers in general practice

    OpenAIRE

    Steele, Keith

    1985-01-01

    Twenty-five patients with chronic venous leg ulcers were treated in general practice by pinch grafting. Fifteen of the ulcers (60%) were completely healed one year after grafting. Prior to grafting 19 patients (76%) complained of daily pain in the ulcer. These patients experienced complete relief from pain after grafting. Pinch grafting is a simple, safe and effective therapy when applied in a domiciliary environment.

  16. Chronic venous leg ulcers – role of topical zinc

    Directory of Open Access Journals (Sweden)

    Maher SF

    2015-06-01

    Full Text Available Sara F Maher Physical Therapy Program, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA Abstract: Topical zinc has been used in the treatment of wounds for over 3,000 years, and is reported to have antiseptic, astringent, anti-inflammatory, antimicrobial, and wound healing properties. Fourteen studies were identified and reviewed, to assess the efficacy of this treatment modality as either a bandage or skin protectant in the treatment of venous ulcers. The authors of three studies reported improved healing time or success rate in wounds treated with zinc-based products. However, the authors of one study attributed the faster healing rate mainly to the extra compression (that improved venous blood return, delivered by the non-elastic paste bandage, and not by the zinc oxide alone. The quality of evidence is fair, as 50% of the studies were conducted prior to 2000 and 50% of the studies utilized fewer than 45 patients randomized to two or more groups. Other treatments have been reported to be more cost-effective than zinc, including hydrocolloids, four-layer compression systems, and CircAid Thera-boots. Finally, zinc was reported to be less comfortable, less easy to use, and caused increased pain, in comparison to other products on the market. This literature review, therefore, demonstrated that current evidence is insufficient to determine the effectiveness of zinc-based products in the treatment of venous wounds. Future research is needed focusing on larger, high-quality trials with an emphasis on quality of life issues and cost-effectiveness of treatment. Keywords: chronic wounds, leg ulcers, venous insufficiency, topical zinc

  17. [Complications associated to central venous catheters in hematology patients].

    Science.gov (United States)

    García-Gabás, Carmen; Castillo-Ayala, Ana; Hinojo-Marín, Begoña; Muriel-Abajo, M Ángeles; Gómez-Gutiérrez, Isabel; de Mena-Arenas, Ana M; Rodríguez-Gonzalo, Ana; Chao-Lozano, Cristina; García-Menéndez, Carmen; Madroñero-Agreda, M Antonia

    2015-01-01

    To discover the incidence of central venous catheters (tunnelled, subcutaneous and PICC) in patients with onco-hematological conditions, hospitalized in the Hematology or Transplantations of Hematopoietic Stem Cells Units, in two tertiary care hospitals. A cross-sectional, descriptive study form was developed in order to gather sociodemographic, clinical data as well as complications and follow-up of the care protocol. Each catheter was assigned a correlative identification number. Information was collected on 366 catheters: 185 in the University Hospital Ramón y Cajal (HURYC), 80 tunnelled, 40 subcutaneous venous access and 65 PICC, and 181 in the University Hospital Gregorio Marañón (HUGM), 101 tunnelled and 80 subcutaneous venous access. Major complications in the tunnellized were infections (13.7% in HURYC vs. 6.8% in HUGM - p<0.001) and occlusions (at least once in 3.8% vs. 21.8%). In subcutaneous venous access, infections were confirmed in 5% in HURYC vs. 1.2% in HUGM. There were occlusions at least once in 10% in HUGM and no other significant complications were detected. Regarding PICC, information was only collected in HURYC, where complications were phlebitis 10.8%, thrombosis 7.7%, confirmed or suspected infection 4.6%, occlusion at least once 7.7%. Differences between hospitals with regard to major complications, infection and occlusion may be related to different care protocol. We need to stress the high incidence of phlebitis and thrombosis in PICC catheters, compared with data of lower incidence of other papers. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Venous and autonomic function in formerly pre-eclamptic women and BMI-matched controls.

    Science.gov (United States)

    Heidema, Wieteke M; van Drongelen, Joris; Spaanderman, Marc E A; Scholten, Ralph R

    2018-03-25

    Pre-pregnancy reduced plasma volume increases the risk on subsequent pre-eclamptic pregnancy. Reduced plasma volume is thought to reflect venous reserve capacity, especially when venous vasculature is constricted and sympathetic tone is elevated. As obesity might affect these variables and also relates to pre-eclampsia, increased body weight may underlie these observations. We hypothesized that the relationship between reduced venous reserve and preeclampsia is independent of body mass index (BMI). We compared the non-pregnant venous reserve capacity in 30 formerly pre-eclamptic women, equally divided in 3 BMI-classes (BMI 19.5-24.9, BMI 25-29.9, BMI ≥30) to 30 controls. Cases and controls were matched for BMI, age and parity. The venous reserve capacity was quantified by assessing plasma volume and venous compliance. The autonomic nervous system regulating the venous capacitance was evaluated with heart rate variability analysis in resting supine position and during positive head-up tilt (HUT). Formerly pre-eclamptic women had in supine position lower plasma volume than controls (1339 ± 79 vs 1547 ± 139 ml/m 2 (pBMI-matched controls, reduced venous reserve capacity. This is reflected by lower plasma volume and venous compliance, the autonomic balance is shifted towards sympathetic dominance and lower baroreceptor sensitivity. This suggests that not BMI, but underlying reduced venous reserve relates to pre-eclampsia. This article is protected by copyright. All rights reserved.

  19. Cranial dural arteriovenous shunts. Part 4. Clinical presentation of the shunts with leptomeningeal venous drainage.

    Science.gov (United States)

    Baltsavias, Gerasimos; Spiessberger, Alex; Hothorn, Torsten; Valavanis, Anton

    2015-04-01

    Cranial dural arteriovenous fistulae have been classified into high- and low-risk lesions mainly based on the pattern of venous drainage. Those with leptomeningeal venous drainage carry a higher risk of an aggressive clinical presentation. Recently, it has been proposed that the clinical presentation should be considered as an additional independent factor determining the clinical course of these lesions. However, dural shunts with leptomeningeal venous drainage include a very wide spectrum of inhomogeneous lesions. In the current study, we correlated the clinical presentation of 107 consecutive patients harboring cranial dural arteriovenous shunts with leptomeningeal venous drainage, with their distinct anatomic and angiographic features categorized into eight groups based on the "DES" (Directness and Exclusivity of leptomeningeal venous drainage and features of venous Strain) concept. We found that among these groups, there are significant angioarchitectural differences, which are reflected by considerable differences in clinical presentation. Leptomeningeal venous drainage of dural sinus shunts that is neither direct nor exclusive and without venous strain manifested only benign symptoms (aggressive presentation 0%). On the other end of the spectrum, the bridging vein shunts with direct and exclusive leptomeningeal venous drainage and venous strain are expected to present aggressive symptoms almost always and most likely with bleeding (aggressive presentation 91.5%). Important aspects of the above correlations are discussed. Therefore, the consideration of leptomeningeal venous drainage alone, for prediction of the clinical presentation of these shunts appears insufficient. Angiographic analysis based on the above concept, offers the possibility to distinguish the higher- from the lower-risk types of leptomeningeal venous drainage. In this context, consideration of the clinical presentation as an additional independent factor for the prediction of their clinical

  20. Venous thromboembolism and coffee: critical review and meta-analysis.

    Science.gov (United States)

    Lippi, Giuseppe; Mattiuzzi, Camilla; Franchini, Massimo

    2015-07-01

    Among the various risk factors of venous thromboembolism (VTE), nutrients seem to play a significant role in the pathogenesis of this condition. This study aimed to clarify the relationship between coffee intake and venous thrombosis, and we performed a critical review of clinical studies that have been published so far. An electronic search was carried out in Medline, Scopus and ISI Web of Science with the keywords "coffee" AND "venous thromboembolism" OR "deep vein thrombosis" OR "pulmonary embolism" in "Title/Abstract/Keywords", with no language and date restriction. According to our criteria, three studies (two prospective and one case-control) were finally selected (inter-study heterogeneity: 78%; P<0.001). Cumulative data suggests that a modest intake of coffee (i.e., 1-4 cups/day) may be associated with an 11% increased risk of VTE compared to abstainers, whereas a larger intake (i.e., ≥5 coffee/day) may be associated with a 25% decreased risk. Our analysis of published data seemingly confirm the existence of a U-shape relationship between coffee intake and VTE, thus exhibiting a trend that overlaps with that previously reported for cardiovascular disease (CVD).

  1. Femoral venous catheters: a safe alternative for delivering parenteral alimentation.

    Science.gov (United States)

    Friedman, B; Kanter, G; Titus, D

    1994-04-01

    Femoral vein catheterization is an alternative method of obtaining central venous access. Placement of femoral venous catheters (FVCs) is possible in the majority of patients, suitable for most indications, and associated with a low complication rate during insertion. We wished to determine the incidence of infections or other complications resulting when parenteral nutrition was delivered through FVCs. Fifty-two patients were followed from a hospital-wide population including patients in the critical care units. Triple-lumen catheters were placed by using the sterile Seldinger technique, and sites were examined daily for inflammation. Bacteriologic surveillance was accomplished by submitting the catheter tip for semiquantitative cultures. If catheter line sepsis was suspected, blood samples for cultures were drawn through the catheter and peripherally. The rate of occurrence of colonized catheters was 9.6% (five of 52), and catheter sepsis was found in one case (1.9%). Other than inflammation at six (11.5%) of 52 catheter sites, noninfectious complications of FVCs were not found. On the basis of these findings, we consider FVC-delivered parenteral alimentation a safe and effective alternative to other forms of central venous access.

  2. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

    International Nuclear Information System (INIS)

    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho

    2010-01-01

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate

  3. Diagnosis of deep venous thrombosis by radioisotopic phlebography

    International Nuclear Information System (INIS)

    Araujo, Antonio Luiz de

    1993-01-01

    The author studied 20 patients with deep venous thrombosis of members (one of them attacked on both arms), from various etiologies, by mean radioisotopic phlebography, in the Vascular Diseases, Radiology and Nuclear Medicine Services of Army Central Hospital (Rio de Janeiro, Brazil) from january 1988 to june 1990. The years old was 18 to 72. The cause most frequency of deep venous thrombosis was idiopathic (seven cases 33.3%). The presence of clot by radionuclide marker in all cases, 16 observations (76.2%) in the lower members and five in the upper extremities (23.9%); 17 cases (85%) also were a conventional venography and his images were confirmed. The diagnostic of deep venous thrombosis from 99m T c MAA (macro aggregate of albumin tagged with technetium) should always de complemented by pulmonary mapping, tracking possible silent emboli. Permit as well repetitions evolutionary until daily and using in patients with history of allergy to radiologic contrast because has not complication. (author)

  4. Secondary venous aneurysm following intravenous drug abuse: A case report

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    Marković Miroslav

    2016-01-01

    Full Text Available Introduction. Venous aneurysm (VA is a rare condition that can be presented in both superficial and deep venous system. Secondary VAs as well as pseudoaneurysms are usually caused by external spontaneous or iatrogenic trauma. They are often misdiagnosed and inadequately treated. Complications include thrombosis, phlebitis, eventual pulmonary embolism and rupture. Case report. We presented a case of secondary VA of the great saphenous vein developed in a young addict following chronic intravenous drug application in the groin region. Aneurysm required urgent surgical treatment due to bleeding complication as it was previously misdiagnosed for hematoma (or abscess and punctuated by a general surgeon. Complete resection of VA with successful preservation of continuity of the great saphenous vein was performed. Postoperative course was uneventful. Regular venous flow through the great saphenous vein was confirmed on control ultrasound examination. Conclusion. VAs are uncommon, among them secondary VA being extremely rare. In cases with a significant diameter or threatening complications surgical treatment is recommended. [Projekat Ministarstva nauke Republike Srbije, br. ON175008 i br. III41007

  5. Combination of phlebography and sanguinous measurement of venous blood pressure

    International Nuclear Information System (INIS)

    Weber, J.

    1988-01-01

    Phlebographic visualisation offers the highest spatial resolution of all imaging methods both in respect of veins of the leg and pelvis and of the abdomen. Phlebography offers optimal conditions for assessing morphological changes at the veins and in their direct neighbourhood. No quantitative information is available via phlebography if haemodynamics are disturbed; qualitative information is yielded merely to a restricted extent (by assessing flow velocity and collaterals). Direct sanguinous measurement of venous blood pressure is particularly suitable for the quantitative and qualitative assessment of disturbed haemodynamic conditions; in this respect it stands out among the function tests based on the employment of apparatures. If it is combined with phlebography, it is possible not only to optimise the diagnostic yield in the hands of one investigator, but also to reduce the invasiveness of both methods to one single puncture, since the puncture needle is at the same time also an instrument to measure the pressure. The article points out the possibilities and limitations of combining a) ascending phlebography of the leg and pelvis with peripheral venous pressure measurement (phlebodynamometry) and b) visualisation of the veins of the pelvis and vena cava inferior with central sanguinous venous pressure measurement (CP). Indicatious and technical execution are described. (orig.) [de

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

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    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. Sagittal venous sinus thrombosis after cesarean section: a case report

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    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  8. A Predictive Framework to Elucidate Venous Stenosis: CFD & Shape Optimization.

    Science.gov (United States)

    Javid Mahmoudzadeh Akherat, S M; Cassel, Kevin; Boghosian, Michael; Hammes, Mary; Coe, Fredric

    2017-07-01

    The surgical creation of vascular accesses for renal failure patients provides an abnormally high flow rate conduit in the patient's upper arm vasculature that facilitates the hemodialysis treatment. These vascular accesses, however, are very often associated with complications that lead to access failure and thrombotic incidents, mainly due to excessive neointimal hyperplasia (NH) and subsequently stenosis. Development of a framework to monitor and predict the evolution of the venous system post access creation can greatly contribute to maintaining access patency. Computational fluid dynamics (CFD) has been exploited to inspect the non-homeostatic wall shear stress (WSS) distribution that is speculated to trigger NH in the patient cohort under investigation. Thereafter, CFD in liaison with a gradient-free shape optimization method has been employed to analyze the deformation modes of the venous system enduring non-physiological hemodynamics. It is observed that the optimally evolved shapes and their corresponding hemodynamics strive to restore the homeostatic state of the venous system to a normal, pre-surgery condition. It is concluded that a CFD-shape optimization coupling that seeks to regulate the WSS back to a well-defined physiological WSS target range can accurately predict the mode of patient-specific access failure.

  9. Fingertip Replantation With Palmar Venous Anastomoses in Children.

    Science.gov (United States)

    Wen, Gen; Xu, Jia; Chai, Yi-Min

    2017-06-01

    Fingertip amputation in children is difficult to manage using microsurgical replantation techniques and many salvage procedures have failed owing to the nonavailability of suitable veins for anastomosis in the fingertip. This study reviewed our experience of pediatric fingertip replantation involving palmar venous anastomoses and evaluated the clinical outcomes. From October 2008 to May 2013, 21 pediatric fingertips that had been completely amputated at or distal to the distal interphalangeal joint of the finger, or at or distal to the interphalangeal joint of the thumb were managed using complete replantation. One artery was anastomosed for revascularization with or without nerve repair, and a palmar venous anastomosis was performed to reestablish the outflow system. Twenty (95.2%) of the 21 fingertips survived. One replant involving an avulsion amputation of the left little finger failed, and the patient underwent stump cap-plasty. Excellent restoration of finger motion, pinch strength, and appearance was observed during the mean 39.9-month (range, 18-65 months) follow-up. The mean regained static 2-point discrimination sensation was 3.8 mm (range, 3.2-4.2 mm). All of the children and their families were satisfied with the surgical outcomes. Successful palmar venous anastomosis appears to promote the survival of replanted fingertips in children. Given that the procedure may simplify postoperative care, minimize complications, and achieve a high survival rate, it should be attempted if the technical expertise is available.

  10. Central venous catheter-related bloodstream infections in cancer patients

    International Nuclear Information System (INIS)

    Butt, T.; Afzal, R.K.; Ahmad, R.N.; Hussain, I.; Anwar, M.

    2004-01-01

    Objective: To determine the frequency of central venous catheter-related bloodstream infections (CR-BSI) in cancer patients and the antimicrobial susceptibility pattern of the isolates. Subjects and Methods: Cancer patients requiring short or long-term central venous catheterization at the time of admission or thereafter were included. Catheter tips on removal were cultured quantitatively; specimens of blood and pus were cultured qualitatively. Isolates were identified and antimicrobial susceptibility testing was performed by standard techniques. Results: Eighty-nine patients were included in the study. The frequency of CR-BSI was 17%. Out of the 19 organisms isolated, 10 (53%) were Gram-positive cocci, 8 (42%) were Gram-negative rods and 1 (5%) was a fungus. Coagulase negative staphylococci (27%) were the predominant pathogens. Among the staphylococci, 46% of the isolates were methicillin-resistant. All Gram-positive isolates were susceptive to glycopeptides. Gram-negative rods were resistant to most of the commonly used antimicrobial groups. Conclusion: Central venous catheter is an important source of bloodstream infections in cancer patients. Most of the infections are caused by Gram-positive cocci. Rigorous infection control measures and continuous surveillance is required to curb the frequency of these infections. (author)

  11. Deep venous thrombosis after orthopedic surgery in adult cancer patients.

    Science.gov (United States)

    Lin, P P; Graham, D; Hann, L E; Boland, P J; Healey, J H

    1998-05-01

    Patients with cancer and patients undergoing major orthopedic procedures are two groups at risk of deep venous thrombosis (DVT). The objective was to determine the rate of venous thromboembolic disease in patients with a malignant neoplasm and major orthopaedic surgery of the lower limb. The study included 169 patients. All patients were given knee-high intermittent pneumatic compression devices for prophylaxis. Postoperative surveillance for thrombosis was performed on all patients with venous duplex doppler ultrasonography. Proximal DVT occurred in 24 of 169 patients (14.2%). One patient (0.6%) developed a symptomatic, nonfatal pulmonary embolus (PE). The development of DVT was not associated with age, sex, type of surgery, type of neoplasm, location, or pathologic fracture. The addition of anticoagulant medication such as warfarin did not significantly reduce the rate of DVT in a subset of 54 patients. In three patients, the DVT occurred only in the contralateral limb, and in four patients, there were bilateral DVTs. When intermittent compression boots were used for prophylaxis in conjunction with ultrasound screening, the risk of proximal DVT was substantial (14.2%), but the rate of symptomatic PE was low (0.6%).

  12. The Need of Slanted Side Holes for Venous Cannulae

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    Joong Yull Park

    2012-01-01

    Full Text Available Well-designed cannulae must allow good flow rate and minimize nonphysiologic load. Venous cannulae generally have side holes to prevent the rupture of blood vessel during perfusion. Optimizing side hole angle will yield more efficient and safe venous cannulae. A numerical modeling was used to study the effect of the angle (0°–45° and number (0–12 of side holes on the performance of cannulae. By only slanting the side holes, it increases the flow rate up to 6% (in our models. In addition, it was found that increasing the number of side holes reduces the shear rate up to 12% (in our models. A new parameter called “penetration depth” was introduced to describe the interfering effect of stream jets from side holes, and the result showed that the 45°-slanted side holes caused minimum interfering for the flow in cannula. Our quantitative hemodynamic analysis study provides important guidelines for venous cannulae design.

  13. Radiologic Placement of Tunneled Central Venous Catheters in Pediatric Patients

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    Kim, Eun Ji; Song, Soon Young; Cho, On Koo; Koh, Byung Hee; Kim, Yong Soo; Jeong, Woo Kyoung; Lee, Yong Ho [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    We evaluated the technical success and complication rates associated with the radiological placement of tunneled central venous catheters in pediatric patients. Between May 1, 2005 and March 31, 2008, a total of 46 tunneled central venous catheters were placed in 34 children (M:F = 22:12; mean age, 9.9 years [9 months to 16.8 years]). All procedures were performed under ultrasonographic and fluoroscopic guidance. Follow-up data were obtained through the retrospective review of the medical records. We used the Kaplan-Meier survival method for the evaluation of survival rate of the catheters. All procedures were technically successful. The observed periprocedural complications included hematoma formation in three patients. The mean catheter life was 189.3 days (total, 8710 days; range, 7-810). Catheters were removed due to death (n=9), the end of treatment (n=8), catheter sepsis (n=4), malfunction (n=8), and accidental removal (n=4). The rate of catheter sepsis and malfunction was 0.459 and 0.919 for every 1000 catheter days, respectively. The expected mean catheter life was 479.6 days as per the Kaplan- Meier analysis. The results suggest that the radiologic placement of a tunneled central venous catheter is an effective technique with a high technical success rate and low complication rate.

  14. Low molecular weight heparin for prevention of venous thromboembolism in patients with lower-limb immobilization.

    Science.gov (United States)

    Zee, Aniek Ag; van Lieshout, Kelly; van der Heide, Maaike; Janssen, Loes; Janzing, Heinrich Mj

    2017-08-06

    Immobilization of the lower limb is a risk factor for venous thromboembolism (VTE). Low molecular weight heparins (LMWHs) are anticoagulants, which might be used in adult patients with lower-limb immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-limb immobilization in an ambulatory setting. For this update, the Cochrane Vascular Information Specialist searched the Specialised Register, CENTRAL, and three trials registers (April 2017). Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that described thromboprophylaxis by means of LMWH compared with no prophylaxis or placebo in adult patients with lower-limb immobilization. Immobilization was by means of a plaster cast or brace. Two review authors independently selected trials, assessed risk of bias and extracted data. The review authors contacted the trial authors for additional information if required. Statistical analysis was carried out using Review Manager 5. We included eight RCTs that fulfilled our criteria, with a total of 3680 participants. The quality of evidence, according GRADE, varied by outcome and ranged from low to moderate. We found an incidence of DVT ranging from 4.3% to 40% in patients who had a leg injury that had been immobilized in a plaster cast or a brace for at least one week, and who received no prophylaxis, or placebo. This number was significantly lower in patients who received daily subcutaneous injections of LMWH during immobilization, with event rates ranging from 0% to 37% (odds ratio (OR) 0.45, 95% confidence interval (CI) 0.33 to 0.61; with minimal evidence of heterogeneity: I² = 26%, P = 0.23; seven studies; 1676 participants, moderate-quality evidence). Comparable results were seen in the following groups of participants: patients with below

  15. Cerebral venous sinus thrombosis on MRI: A case series analysis

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    Sanjay M Khaladkar

    2014-01-01

    Full Text Available Background: Cerebral venous sinus thrombosis (CVST is a rare form of stroke seen in young and middle aged group, especially in women due to thrombus of dural venous sinuses and can cause acute neurological deterioration with increased morbidity and mortality if not diagnosed in early stage. Neurological deficit occurs due to focal or diffuse cerebral edema and venous non-hemorrhagic or hemorrhagic infarct. Aim and Objectives: To assess/evaluate the role of Magnetic Resonance Imaging (MRI and Magnetic Resonance Venography (MRV as an imaging modality for early diagnosis of CVST and to study patterns of venous thrombosis, in detecting changes in brain parenchyma and residual effects of CVST using MRI. Materials and Methods: Retrospective descriptive analysis of 40 patients of CVST diagnosed on MRI brain and MRV was done. Results: 29/40 (72.5% were males and 11/40 (27.5% were females. Most of the patients were in the age group of 21-40 years (23/40-57.5%. Most of the patients 16/40 (40% presented within 7 days. No definite cause of CVST was found in 24 (60% patients in spite of detailed history. In 36/40 (90% of cases major sinuses were involved, deep venous system were involved in 7/40 (17.5% cases, superficial cortical vein was involved in 1/40 (2.5% cases. Analysis of stage of thrombus (acute, subacute, chronic was done based on its appearance on T1 and T2WI. 31/40 (77.5% patients showed complete absence of flow on MRV, while 9/40 (22.5% cases showed partial flow on MR venogram. Brain parenchyma was normal in 20/40 (50% patients while 6/40 (15% cases had non-hemorrhagic infarct and 14/40 (35% patients presented with hemorrhagic infarct. Conclusion: Our study concluded that MRI brain with MRV is sensitive in diagnosing both direct signs (evidence of thrombus inside the affected veins and indirect signs (parenchymal changes of CVST and their follow up.

  16. A survey of current practice of vascular surgeons in venous disease management.

    Science.gov (United States)

    Bush, Ruth L; Gloviczki, Peter

    2013-01-01

    Acute venous thromboembolism and chronic venous diseases are common conditions that affect a large proportion of the United States population. The diagnosis of venous disease has improved, and the treatment options have rapidly evolved over the past decade. To date, it is unclear to what extent vascular surgeons have become involved in the modern management of venous disorders. This survey was undertaken to explore the current interest and practice of vascular surgeons in the contemporary care of venous disease. A survey was administered via a web-based platform to active and candidate members of the Society for Vascular Surgery (SVS). The survey included 30 questions investigating the characteristics of venous surgeons and scope of venous practice. Open-ended questions were also included for commentary. A total of 1879 surveys were sent to SVS members nationwide, and 385 members participated (response rate of 20.5%). The participants were mostly men (89.6%) with 37.7% practicing in an academic setting and 59.2% in private practice. The respondents treated superficial veins (92.9%) and deep veins (85.8%) in clinical practice, with 89.9% having their own vascular laboratory. A wide spectrum of interventions for superficial (91.9%), deep (85.8%), and perforator veins (52.7% endovenous, 19.4% subfascial endoscopic perforator surgery) are being performed by respondents. Only 26.2% had learned endovenous thermal ablation in their training program; however, over 96% of those performing venous interventions utilized this technique. Overall, the majority (85.5%) devoted 50% or less of practice to venous disorders. Respondents indicated that limitations to expansion of vein practices mainly involved challenges with third party payers, local competition, and existing large volumes of arterial interventions needing to be performed. Despite the widespread incorporation of venous disease into current vascular practices, 66.1% are not members of the American Venous Forum (AVF

  17. Cystourethrographic findings of the lower urinary tract injury

    International Nuclear Information System (INIS)

    Bae, H. S.; Bae, W. K.; Cho, O. K.

    1981-01-01

    During the period of 4 years from July, 1976 to June 1980 the radiological and clinical evaluation had been made on 102 patients suffered from lower urinary tract injuries which were confirmed by the radiological examination and operation. The results were as follows: 1. Age distribution of the total 102 patients (87 males and 15 females) was broad from 4 to 72 years. And most of the patient were in the age group of 20 to 49 years. 2. The most common cause of injury was traffic accident (67.6%), next blunt trauma, saddle injury, fall down respectively. 3. 46 patients of bladder injury were as follows: intraperitoneal rupture in 17, extraperitoneal rupture in 12, and contusion in 14. 4. 74 patients of urethral injury were as follows: membranous portion in 37, bulbous portion in 31, prostatic portion in 3, and penile portion in 2. Most of the cases showed extravasation of contrast media. 12 cases showed extravasation with venous intravasation. 5. Contusion or extraperitoneal rupture of the bladder, membranous urethral injury, and concommitent bladder and urethral ruptures were frequently associated with pelvic bone fracture. Intraperitoneal ruptures of the bladder and solitary ruptures of the bulbous urethra were infrequently associated with pelvic bone fracture. 6. Late sequelae of the lower urinary tract injury were stricture, fistula and stone formation

  18. Isolated Subclavian Vein Injury: A Rare and High Mortality Case

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    Sahin Iscan

    2013-01-01

    Full Text Available Isolated subclavian vein injuries are rarely seen without concomitant arterial injury, bone fracture, damage to brachial plexus, and thoracal traumas. Our case was brought to the emergency service 6 hours after he had been shot at the shoulder with a firearm. After detection of extravasation from the left axillary and subclavian vein on arteriographic and venographic examinations, he was operated on. An autogenous saphenous vein graft was interposed between subclavian and axillary veins. Cardiac arrest developed twice because of hypovolemia, which was resolved with medical therapy. Subclavian vein injuries have a more mortal course when compared with the injuries to the subclavian arteries. Its most important reason is excessive blood loss and air embolism because of delayed arrival to hospital. As is the case in all vascular injuries, angiography is the most important diagnostic examination. If the general health state of the patient permits, arteriography and venography should be performed in patients potentially exposed to vascular injuries. In patients with extreme blood loss and deteriorated health state, direct surgical exploration of the injury site, containment of the bleeding, and venous repair are life-saving approaches.

  19. Circulating endothelial cells in patients with venous thromboembolism and myeloproliferative neoplasms.

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    Cláudia Torres

    Full Text Available BACKGROUND: Circulating endothelial cells (CEC may be a biomarker of vascular injury and pro-thrombotic tendency, while circulating endothelial progenitor cells (CEP may be an indicator for angiogenesis and vascular remodelling. However, there is not a universally accepted standardized protocol to identify and quantify these cells and its clinical relevancy remains to be established. OBJECTIVES: To quantify CEC and CEP in patients with venous thromboembolism (VTE and with myeloproliferative neoplasms (MPN, to characterize the CEC for the expression of activation (CD54, CD62E and procoagulant (CD142 markers and to investigate whether they correlate with other clinical and laboratory data. PATIENTS AND METHODS: Sixteen patients with VTE, 17 patients with MPN and 20 healthy individuals were studied. The CEC and CEP were quantified and characterized in the blood using flow cytometry, and the demographic, clinical and laboratory data were obtained from hospital records. RESULTS: We found the CEC counts were higher in both patient groups as compared to controls, whereas increased numbers of CEP were found only in patients with MPN. In addition, all disease groups had higher numbers of CD62E+ CEC as compared to controls, whereas only patients with VTE had increased numbers of CD142+ and CD54+ CEC. Moreover, the numbers of total and CD62+ CEC correlated positively with the white blood cells (WBC counts in both groups of patients, while the numbers of CEP correlated positively with the WBC counts only in patients with MPN. In addition, in patients with VTE a positive correlation was found between the numbers of CD54+ CEC and the antithrombin levels, as well as between the CD142+ CEC counts and the number of thrombotic events. CONCLUSIONS: Our study suggests that CEC counts may reveal endothelial injury in patients with VTE and MPN and that CEC may express different activation-related phenotypes depending on the disease status.

  20. Thrombocytosis in splenic trauma: In-hospital course and association with venous thromboembolism.

    Science.gov (United States)

    Chia, Tze L; Chesney, Tyler R; Isa, David; Mnatzakanian, Gevork; Colak, Errol; Belmont, Caio; Hirpara, Dhruvin; Veigas, Precilla V; Acuna, Sergio A; Rizoli, Sandro; Rezende-Neto, Joao

    2017-01-01

    Thrombocytosis is common following elective splenectomy and major trauma. However, little is known about the in-hospital course of platelet count (PC) and incidence of thrombocytosis after splenic trauma. Extreme thrombocytosis (PC>1000×10 9 ) is associated with increased risk of venous thromboembolism (VTE) in primary thrombocytosis leading to the use of acetylsalicylic acid (ASA) for risk reduction, but the need for this agent in splenic trauma is undefined. Retrospective cohort study of all patients with splenic trauma between April 1, 2010 and March 31, 2014. The in-hospital course of PC was assessed based on splenic injury management type. The association of management type with thrombocytosis was evaluated using a multivariable logistic regression model adjusting for potential confounders. The association of thrombocytosis, extreme thrombocytosis, and ASA use for the outcome of VTE was explored. 156 patients were eligible, PC initially increased in all patients with the highest peak after total splenectomy. The incidence of thrombocytosis was 41.0% (64/156). Thrombocytosis was more likely following splenectomy compared with spleen preserving strategies independent of length of stay, injury grade, ISS, age and transfusion (OR 7.58, 95% CI: 2.26-25.45). Splenectomy was associated with extreme thrombocytosis (OR 10.39, 95% CI: 3.59-30.07). Thrombocytosis in splenic trauma is more likely after splenectomy than with spleen preserving strategies. Splenectomy is associated with extreme thrombocytosis. There was insufficient data in our study to determine the use of ASA as primary prevention of VTE after splenic trauma. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. 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.

  2. Pulmonary venous thrombosis secondary to radiofrequency ablation of the pulmonary veins.

    Science.gov (United States)

    López-Reyes, Raquel; García-Ortega, Alberto; Torrents, Ana; Feced, Laura; Calvillo, Pilar; Libreros-Niño, Eugenia Alejandra; Escrivá-Peiró, Juan; Nauffal, Dolores

    2018-01-01

    Pulmonary Vein Thrombosis (PVT) is a rare and underdiagnosed entity produced by local mechanical nature mechanisms, vascular torsion or direct injury to the vein. PVT has been described in clinical cases or small multicenter series mainly in relation to pulmonary vein stenosis, metastatic carcinoma, fibrosing mediastinitis, as an early surgical complication of lung transplantation lobectomy and radiofrequency ablation performed in patients with atrial fibrillation, although in some cases the cause is not known. We report the case of a 57 years old male with history of atrial fibrillation treated by radiofrequency ablation who was admitted in our center because of a two-week history of consistent pleuritic pain in the left hemithorax and low-grade hemoptysis and a lung consolidation treated as a pneumonia with antibiotic but not responding to medical therapy. In view of the poor evolution of the patient, computed tomography angiography was performed with findings of PVT and secondary venous infarction and anticoagulation therapy was optimized. At the end, pulmonary resection was performed due to hemorrhagic recurrence. PVT remains a rare complication of radiofrequency ablation and other procedures involving pulmonary veins. Clinical suspicion and early diagnosis is crucial because is a potentially life-threatening entity.

  3. Anatomical features of venous outflow from rat’s reproductive organs

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    N. A. Nikitin

    2012-01-01

    Full Text Available The venous drainage from reproductive organs of rats is described; new data on peculiarities of the venous drainage are obtained.Objects of study were adult Wistar white rats (20 animals. The animals have passed precision dissection of vessels in order to study anatomic peculiarities of venous drainage from the left spermary in male rats and internal genital organs in female rats in norm. It has been shown that the venous drainage from the left spermary follows the spermatic vein entering into the pampiniform plexus system, which continues into the single venous trunk, which, in its turn, divides into the ascending and descending veins. The descending vein runs into the common left iliac vein, while the ascending vein runs into the renal vein. The venous drainage from female reproductive organs follows through the uterine vein, which, taking the tubal and spermatic veins, runs from the left into the left renal vein and from the right into the caudal vena cava.

  4. Diagnosis of venous disorders; A challenge for the radiologist. Die radiologische Diagnostik von Venenerkrankungen; Eine Herausforderung

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    Minar, E. (Abt. Angiologie, Universitaetsklinik fuer Innere Medizin 2, Vienna (Austria))

    1993-09-01

    Limited accuracy in the clinic diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutric management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous sytem also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insuffficiency the deep venous system should assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforrating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system. (orig.)

  5. Mesenteric venous thrombosis after prolonged air travel-a case report

    Directory of Open Access Journals (Sweden)

    Joaquín Salas-Coronas

    2014-07-01

    Full Text Available We present a case of acute mesenteric venous thrombosis after a long distance flight in a traveller presenting with abdominal pain, diarrhoea and vomiting within 48 h of prolonged immobility situation. Venous thrombosis in the lower limbs and venous thromboembolism has been clearly associated with prolonged air travel (economy class syndrome. Thrombosis was diagnosed by computed tomography of the abdomen, and after starting anticoagulant therapy with acenocumarol, symptoms yielded completely in a few weeks. The study of thrombophilia was negative, although the existence of two first-degree relatives (mother and grandmother with a history of venous thrombosis with a history of venous thrombosis makes it likely a situation of inherited thrombophilia. Although exceptional, mesenteric venous thrombosis should be considered in travellers with acute abdominal pain after prolonged air travel when there are thrombophilic conditions.

  6. Active hemorrhage and vascular injuries in splenic trauma: utility of the arterial phase in multidetector CT.

    Science.gov (United States)

    Uyeda, Jennifer W; LeBedis, Christina A; Penn, David R; Soto, Jorge A; Anderson, Stephan W

    2014-01-01

    To determine whether the addition of arterial phase computed tomography (CT) to the standard combination of portal venous and delayed phase imaging increases sensitivity in the diagnosis of active hemorrhage and/or contained vascular injuries in patients with splenic trauma. The institutional review board approved this HIPAA-compliant retrospective study; the requirement to obtain informed consent was waived. The study included all patients aged 15 years and older who sustained a splenic injury from blunt or penetrating trauma and who underwent CT in the arterial and portal venous phases of image acquisition during a 74-month period (September 2005 to November 2011). CT scans were reviewed by three radiologists, and a consensus interpretation was made to classify the splenic injuries according to the American Association for the Surgery of Trauma splenic injury scale. One radiologist independently recorded the presence of contained vascular injuries or active hemorrhage and the phase or phases at which these lesions were seen. Clinical outcome was assessed by reviewing medical records. The relationship between imaging findings and clinical management was assessed with the Fisher exact test. One hundred forty-seven patients met the inclusion criteria; 32 patients (22%) had active hemorrhage and 22 (15%) had several contained vascular injuries. In 13 of the 22 patients with contained injuries, the vascular lesion was visualized only at the arterial phase of image acquisition; the other nine contained vascular injuries were seen at all phases. Surgery or embolization was performed in 11 of the 22 patients with contained vascular injury. The arterial phase of image acquisition improves detection of traumatic contained splenic vascular injuries and should be considered to optimize detection of splenic injuries in trauma with CT. ©RSNA, 2013.

  7. Near-infrared vascular imaging in peripheral venous and arterial access

    OpenAIRE

    Cuper, N.J.

    2012-01-01

    Venous and arterial access are among the most widespread medical procedures performed in children. Especially in young children venous and arterial access can be problematic due to tiny blood vessels that are difficult to localize beneath a layer of baby fat. This thesis describes the development and clinical evaluation of the VascuLuminator, a guidance tool for peripheral venous and arterial access by visualizing blood vessels underneath the skin with near-infrared light. In a third to a fif...

  8. Wedge and subselective pulmonary angiography in pulmonary hypertension secondary to venous obstruction

    International Nuclear Information System (INIS)

    Bowen, J.S.; Bookstein, J.J.; Johnson, A.D.; Peterson, K.L.; Moser, K.M.

    1985-01-01

    Pulmonary wedge or subselective angiography provided key diagnostic information in two cases of pulmonary hypertension secondary to pulmonary venous obstruction. Whereas conventional pulmonary angiograms and ventilation-perfusion lung scans were interpreted as showing embolism, plain radiographs demonstrated Kerley B lines, suggesting venous obstruction. Subselective or wedge angiography of nonopacified arteries verified their anatomical patency and also revealed venous stenoses, collaterals, and atrophy indicative of obstruction

  9. Scintigraphy and venous sampling in endocrine adrenal diseases. Clinical results in 85 patients

    International Nuclear Information System (INIS)

    Feltrin, G.P.; Maffessanti, M.; Miotto, D.; Mantero, F.; Macri, G.; Romani, S.

    1979-01-01

    The results obtained by adrenal scanning and venous sampling in 85 patients affected by various forms of adrenal pathology are reported and discussed. Pheochromocytoma rarely needs venous catheterization and blood sampling, since arteriography is almost always capable to visualize it. Scintigraphy alone is generally accurate enough to distinguish between bilateral hyperplasia and tumors in Cushing's and adrenogenital syndromes (100% of personal observations); only a tumoral situation benefits by venous catheterization. Blood samples and venography must be preceded by scintigraphy in Conn's syndrome

  10. Use of the direct puncture technique in management of capillaro-venous malformations: case report

    Directory of Open Access Journals (Sweden)

    Tyagi Isha

    2002-03-01

    Full Text Available Abstract Background Preoperative devascularization of the capillaro-venous malformations located in the aero-digestive tract is important for surgeons, to minimize blood loss during surgical excision of malformations. Case presentation Here we present two cases of capillaro-venous malformation in which we could successfully achieve preoperative devascularization, by directly injecting n-butyl cyano acrylate into the capillaro-venous bed. This technique is relatively easy, safe and cheap, and can be carried out immediately before surgery.

  11. Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis

    OpenAIRE

    Huan, An-shi; Regmi, Subhash; Gu, Jia-xiang; Liu, Hong-jun; Zhang, Wen-zhong

    2016-01-01

    Purpose The purpose of this study was to report our experience of fingertip replantation without venous anastomosis using alternate method to counter post-operative venous congestion. Methods 30 Patients (18 men and 12 women) with 30 fingertip amputations (Tamai zone I) were treated with artery-only anastomosis fingertip replantation between March 2010 and July 2014. Postoperative venous outflow was maintained by allowing bleeding through wound gaps combined with topical (12500u:250mlNS) and ...

  12. Central venous catheter-related thrombosis in senile male patients: New risk factors and predictors.

    Science.gov (United States)

    Liu, Gao; Fu, Zhi-Qing; Zhu, Ping; Li, Shi-Jun

    2015-06-01

    Central venous catheterization (CVC)-related venous thrombosis is a common but serious clinical complication, thus prevention and treatment on this problem should be extensively investigated. In this research, we aimed to investigate the incidence rate of CVC-related venous thrombosis in senile patients and give a further discussion on the related risk factors and predictors. A total of 324 hospitalized senile male patients subjected to CVC were selected. Retrospective investigation and analysis were conducted on age, underlying diseases, clinical medications, catheterization position and side, catheter retention time, and incidence of CVC-related venous thrombosis complications. Basic laboratory test results during catheterization and thrombogenesis were also collected and analyzed. Among the 324 patients, 20 cases (6.17%) of CVC-related venous thrombosis were diagnoseds. The incidence rate of CVC-related venous thrombosis in subclavian vein catheterization was significantly lower than that in femoral vein catheterization (Pcatheterization (Pcatheterization and internal jugular vein catheterization (Pvenous thrombosis history (Pvenous thrombosis in senile male patients. Subclavian vein catheterization was the most appropriate choice among senile patients to decrease the incidence of CVC-related venous thrombosis. Previous venous thrombosis history, high lactate dehydrogenase level, low HDL level, and low albumin level were important risk factors in predicting CVC-related venous thrombosis.

  13. Complication of venous thrombosis of the lower extremities with pulmonary embolism

    International Nuclear Information System (INIS)

    Suzuki, Teruyasu; Morita, Rikushi

    1993-01-01

    We studied the relationship between the complication of the pulmonary embolism and the localization of the venous thrombus in the lower extremities using Tc-99m macroaggregated albumin (MAA) venography. Tc-99m MAA venography clearly demonstrated most of the deep and superficial veins from the leg to the pelvis and the abdomen. The incidence of venous thrombosis was highest in the pelvic veins (28.8%), and second in the superficial leg veins (10.9%). The complication of pulmonary embolism was highest in the pelvic venous thrombosis (20.4%), and second in the femoral venous thrombosis (16.0%). (author)

  14. Complication of venous thrombosis of the lower extremities with pulmonary embolism; Approach by radionuclide studies

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Teruyasu; Morita, Rikushi (Shiga Medical School, Otsu (Japan))

    1993-07-01

    We studied the relationship between the complication of the pulmonary embolism and the localization of the venous thrombus in the lower extremities using Tc-99m macroaggregated albumin (MAA) venography. Tc-99m MAA venography clearly demonstrated most of the deep and superficial veins from the leg to the pelvis and the abdomen. The incidence of venous thrombosis was highest in the pelvic veins (28.8%), and second in the superficial leg veins (10.9%). The complication of pulmonary embolism was highest in the pelvic venous thrombosis (20.4%), and second in the femoral venous thrombosis (16.0%). (author).

  15. Heterotopic bone formation (myositis ossificans) and lower-extremity swelling mimicking deep-venous disease

    International Nuclear Information System (INIS)

    Orzel, J.A.; Rudd, T.G.; Nelp, W.B.

    1984-01-01

    A quadriplegic patient with a swollen leg was suspected of having deep-venous thrombosis, and was studied with radionuclide venography (RNV) and contrast venography. Focal narrowing of the femoral vein, seen on RNV, was due to extrinsic compression. Although soft-tissue radiographs were normal, Tc-99m diphosphonate imaging established the diagnosis of early heterotopic bone formation (myositis ossificans), which was responsible for the venous compression. Clinically this inflammatory process can mimic deep-venous thrombosis, and should be considered in evaluating patients at risk for both heterotopic bone formation and deep-venous thrombosis

  16. ORBITAL INJURIES

    Directory of Open Access Journals (Sweden)

    Andrej Kansky

    2002-12-01

    Full Text Available Background. Orbit is involved in 40% of all facial fractures. There is considerable variety in severity, ranging from simple nondisplaced to complex comminuted fractures. Complex comminuted fractures (up to 20% are responsible for the majority of complications and unfavorable results. Orbital fractures are classified as internal orbital fractures, zygomatico-orbital fractures, naso-orbito-ethmoidal fractures and combined fractures. The ophtalmic sequelae of midfacial fractures are usually edema and ecchymosis of the soft tissues, subconjuctival hemorrhage, diplopia, iritis, retinal edema, ptosis, enophthalmos, ocular muscle paresis, mechanical restriction of ocular movement and nasolacrimal disturbances. More severe injuries such as optic nerve trauma and retinal detachments have also been reported. Within the wide range of orbital fractures small group of complex fractures causes most of the sequelae. Therefore identification of severe injuries and adequate treatment is of major importance. The introduction of craniofacial techniques made possible a wide exposure even of large orbital wall defects and their reconstruction by bone grafts. In spite of significant progress, repair of complex orbital wall defects remains a problem even for the experienced surgeons.Results. In 1999 121 facial injuries were treated at our department (Clinical Centre Ljubljana Dept. Of Maxillofacial and Oral Surgery. Orbit was involved in 65% of cases. Isolated inner orbital fractures presented 4% of all fractures. 17 (14% complex cases were treated, 5 of them being NOE, 5 orbital (frame and inner walls, 3 zygomatico-orbital, 2 FNO and 2 maxillo-orbital fractures.Conclusions. Final result of the surgical treatment depends on severity of maxillofacial trauma. Complex comminuted fractures are responsable for most of the unfavorable results and ocular function is often permanently damaged (up to 75% in these fractures.

  17. Multiple versus single lumen umbilical venous catheters for newborn infants.

    Science.gov (United States)

    Kabra, N S; Kumar, M; Shah, S S

    2005-07-20

    Multiple lumen umbilical venous catheters (ML-UVCs) instead of single lumen UVCs (SL-UVCs) may decrease the need for additional venous lines. Although it seems self-evident that ML-UVCs would reduce the need of additional venous lines, the rates of associated complications might be different. To compare the effectiveness and the safety of ML-UVCs versus SL-UVCs in terms of need of additional vascular access, rates of complications, morbidity and mortality in newborn infants. Randomized and quasi-randomized trials were identified by searching the MEDLINE (1966 - February 2005), EMBASE (1980- February 2005), CINAHL (1982 - February 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 4, 2004) and Science Direct (subject area: medicine, journal and abstract database; 1967 to February 2005). Literature search also included a manual search of the abstracts of scientific meetings published in Pediatric Research (1990-2004). Additional citations were sought using references in articles retrieved from searches. Subject experts were contacted to identify the unpublished and ongoing studies. Randomized and quasi-randomized controlled clinical trials comparing safety and efficacy of multiple versus single lumen umbilical venous catheter in neonates (both term and preterm) who were in need of umbilical venous catheter insertion for vascular access in first four weeks of life. Each review author performed data extraction independently and differences were resolved by discussion. The following outcomes were determined: total number of additional peripheral intravenous lines per baby in first week and first four weeks of life, total number of additional percutaneously and surgically placed central venous lines per baby in first four weeks of life, and other safety and efficacy measures. The treatment effect estimators used were RR, RD, and WMD when appropriate along with their 95% CI. If RD was statistically significant, then number

  18. Analysis of the association between periportal low attenuation, as seen on CT, after blunt abdominal trauma, and elevated central venous pressure

    International Nuclear Information System (INIS)

    Lee, Jae Hung; Lee, Hyeon Kyeong; Lee, Chae Kyeong; Ku, Kwan Min; Lee, Sung Woo; Kim, Miu Woon; Ahn, Woo Sub; Yoon, Ji Young

    1999-01-01

    To assess the causes of periportal low attenuation, as seen on CT, in patients with blunt abdominal trauma. From among 812 patients who underwent abdominal CT after blunt abdominal trauma, we retrospectively analysed the findings in 124 with evidence of periportal low attenuation. Among these, hepatic injury was noted in only 87. The presence or absence, and extent of hepatic injury, and of periportal low attenuation, as seen on CT, were carefully evaluated. In each case, the ratio of the transverse diameter of the inferior vena cava(IVC) to the aorta at the level of the right adrenal gland provided an indirect measurement of central venous pressure ; for control purposes, the ratio was also obtained in 21 non-traumatic patients with no abnormal abdominal CT findings. Of the 87 patients with hepatic injury, 46 showed no periportal low attenuation, and average value of the ratio between the IVC and aorta was 1.16±0.12, while the remaining 41 patients showed periportal low attenuation with a ratio of 1.51±0.21(p<0.05). In the 37 patients with periportal low attenuation but no evidence of concomitant hepatic injury, the average ratio was 1.52±0.25, while in 21 non-traumatic patients it was 1.15±0.16. For resuscitation, all patients had received 0.5-5.0 litre of IV fluid therapy before CT, and at the time of CT, were normotensive. Rapidly elevated central venous pressure following massive IV infusion therapy in patients with blunt abdominal trauma can be one of the causes of periportal low attenuation, as seen on CT

  19. Analysis of the association between periportal low attenuation, as seen on CT, after blunt abdominal trauma, and elevated central venous pressure

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Hung; Lee, Hyeon Kyeong; Lee, Chae Kyeong; Ku, Kwan Min; Lee, Sung Woo; Kim, Miu Woon; Ahn, Woo Sub [Dongguk Univ. College of Medicine, Pohang (Korea, Republic of); Yoon, Ji Young [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To assess the causes of periportal low attenuation, as seen on CT, in patients with blunt abdominal trauma. From among 812 patients who underwent abdominal CT after blunt abdominal trauma, we retrospectively analysed the findings in 124 with evidence of periportal low attenuation. Among these, hepatic injury was noted in only 87. The presence or absence, and extent of hepatic injury, and of periportal low attenuation, as seen on CT, were carefully evaluated. In each case, the ratio of the transverse diameter of the inferior vena cava(IVC) to the aorta at the level of the right adrenal gland provided an indirect measurement of central venous pressure ; for control purposes, the ratio was also obtained in 21 non-traumatic patients with no abnormal abdominal CT findings. Of the 87 patients with hepatic injury, 46 showed no periportal low attenuation, and average value of the ratio between the IVC and aorta was 1.16{+-}0.12, while the remaining 41 patients showed periportal low attenuation with a ratio of 1.51{+-}0.21(p<0.05). In the 37 patients with periportal low attenuation but no evidence of concomitant hepatic injury, the average ratio was 1.52{+-}0.25, while in 21 non-traumatic patients it was 1.15{+-}0.16. For resuscitation, all patients had received 0.5-5.0 litre of IV fluid therapy before CT, and at the time of CT, were normotensive. Rapidly elevated central venous pressure following massive IV infusion therapy in patients with blunt abdominal trauma can be one of the causes of periportal low attenuation, as seen on CT.

  20. Multicenter assessment of venous reflux by duplex ultrasound.

    Science.gov (United States)

    Lurie, Fedor; Comerota, Anthony; Eklof, Bo; Kistner, Robert L; Labropoulos, Nicos; Lohr, Joann; Marston, William; Meissner, Mark; Moneta, Gregory; Neglén, Peter; Neuhardt, Diana; Padberg, Frank; Welsh, Harold J

    2012-02-01

    This prospective multicenter investigation was conducted to define the repeatability of duplex-based identification of venous reflux and the relative effect of key parameters on the reproducibility of the test. Repeatability was studied by having the same technologist perform duplicate tests, at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position. Reproducibility was examined by having two different technologists perform the test at the same time of the day, using the same reflux-provoking maneuver and with the patient in the same position. Facilitated reproducibility was studied by having two different technologists examine the same patients immediately after an educational intervention. Limits of agreement between two duplex scans were studied by changing three elements of the test: time of the day (morning vs afternoon), patient's position (standing vs supine), and reflux initiation (manual vs automatic compression-decompression). The study enrolled 17 healthy volunteers and 57 patients with primary chronic venous disease. Repeatability of reflux time measurements in deep veins did not significantly differ with the time of day, the patient's position, or the reflux-provoking maneuver. Reflux measurements in the superficial veins were more repeatable (P ultrasound detection of venous reflux. Reports should include information on the time of the test, the patient's position, and the provoking maneuver used. Adopting a uniform cut point of 0.5 second for pathologic reflux can significantly improve the reliability of reflux detection. Implementation of a standard protocol should elevate the minimal standard for agreement between repeated tests from the current 70% to at least 80% and with more rigid standardization, to 90%. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  1. Pain and efficacy of local anesthetics for central venous access

    Directory of Open Access Journals (Sweden)

    William C Culp Jr

    2008-11-01

    Full Text Available William C Culp Jr1, Mohammed Yousaf2, Benjamin Lowry1, Timothy C McCowan3, William C Culp21Division of Cardiothoracic Anesthesiology, Scott and White Hospital, The Texas A&M University College of Medicine, Temple, TX, USA; 2Division of Interventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 3Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USAPurpose: To compare pain during injection and efficacy of analgesia of local anesthetics during central venous line placement.Methods: Sixty-two patients were studied in a randomized, double-blinded prospective fashion. Patients received 1% lidocaine (L, buffered 1% lidocaine (LB, or 2% chloroprocaine (CP injected around the internal jugular vein for procedural analgesia for central venous access. Patients reported pain via a standard linear visual analog scale, with 0 representing no pain and 10 being the worst pain imaginable.Results: Overall patient perception of pain was better with CP and L than LB with mean scores of CP 2.4, L 2.6, LB 4.2. Pain with injection mean scores were CP 2.1, L 2.5, LB 3.2. Pain with catheter placement scores were CP 2.5, L 1.7, LB 3.4. Operator assessment of overall pain values were CP 1.9, L 2.2, LB 3.4. LB consistently scored the worst, though compared with CP, this only reached statistical significance in overall patient pain and pain at catheter insertion compared with L.Conclusion: Though chloroprocaine scored better than lidocaine in 3 of 4 parameters, this trend did not achieve statistical significance. Adding sodium bicarbonate to lidocaine isn’t justified in routine practice, nor is routine replacement of lidocaine with chloroprocaine.Keywords: local anesthesia, analgesia, central venous access, lidocaine, chloroprocaine

  2. Thai venous stroke prognostic score: TV-SPSS.

    Science.gov (United States)

    Poungvarin, Niphon; Prayoonwiwat, Naraporn; Ratanakorn, Disya; Towanabut, Somchai; Tantirittisak, Tassanee; Suwanwela, Nijasri; Phanthumchinda, Kamman; Tiamkoa, Somsak; Chankrachang, Siwaporn; Nidhinandana, Samart; Laptikultham, Somsak; Limsoontarakul, Sansern; Udomphanthuruk, Suthipol

    2009-11-01

    Prognosis of cerebral venous sinus thrombosis (CVST) has never been studied in Thailand. A simple prognostic score to predict poor prognosis of CVST has also never been reported. The authors are aiming to establish a simple and reliable prognostic score for this condition. The medical records of CVST patients from eight neurological training centers in Thailand who received between April 1993 and September 2005 were reviewed as part of this retrospective study. Clinical features included headache, seizure, stroke risk factors, Glasgow coma scale (GCS), blood pressure on arrival, papilledema, hemiparesis, meningeal irritation sign, location of occluded venous sinuses, hemorrhagic infarction, cerebrospinal fluid opening pressure, treatment options, length of stay, and other complications were analyzed to determine the outcome using modified Rankin scale (mRS). Poor prognosis (defined as mRS of 3-6) was determined on the discharge date. One hundred ninety four patients' records, 127 females (65.5%) and mean age of 36.6 +/- 14.4 years, were analyzed Fifty-one patients (26.3%) were in the poor outcome group (mRS 3-6). Overall mortality was 8.4%. Univariate analysis and then multivariate analysis using SPSS version 11.5 revealed only four statistically significant predictors influencing outcome of CVST They were underlying malignancy, low GCS, presence of hemorrhagic infarction (for poor outcome), and involvement of lateral sinus (for good outcome). Thai venous stroke prognostic score (TV-SPSS) was derived from these four factors using a multiple logistic model. A simple and pragmatic prognostic score for CVST outcome has been developed with high sensitivity (93%), yet low specificity (33%). The next study should focus on the validation of this score in other prospective populations.

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

    International Nuclear Information System (INIS)

    Schubiger, P.A.; Haeberli, A.; Gallino, A.; Straub, P.W.

    1989-09-01

    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 α 2 -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

  4. Automatic Control of Veno-Venous Extracorporeal Lung Assist.

    Science.gov (United States)

    Kopp, Ruedger; Bensberg, Ralf; Stollenwerk, Andre; Arens, Jutta; Grottke, Oliver; Walter, Marian; Rossaint, Rolf

    2016-10-01

    Veno-venous extracorporeal lung assist (ECLA) can provide sufficient gas exchange even in most severe cases of acute respiratory distress syndrome. Commercially available systems are manually controlled, although an automatically controlled ECLA could allow individualized and continuous adaption to clinical requirements. Therefore, we developed a demonstrator with an integrated control algorithm to keep continuously measured peripheral oxygen saturation and partial pressure of carbon dioxide constant by automatically adjusting extracorporeal blood and gas flow. The "SmartECLA" system was tested in six animal experiments with increasing pulmonary hypoventilation and hypoxic inspiratory gas mixture to simulate progressive acute respiratory failure. During a cumulative evaluation time of 32 h for all experiments, automatic ECLA control resulted in a peripheral oxygen saturation ≥90% for 98% of the time with the lowest value of 82% for 15 s. Partial pressure of venous carbon dioxide was between 40 and 49 mm Hg for 97% of the time with no value 49 mm Hg. With decreasing inspiratory oxygen concentration, extracorporeal oxygen uptake increased from 68 ± 25 to 154 ± 34 mL/min (P < 0.05), and reducing respiratory rate resulted in increasing extracorporeal carbon dioxide elimination from 71 ± 37 to 92 ± 37 mL/min (P < 0.05). The "SmartECLA" demonstrator allowed reliable automatic control of the extracorporeal circuit. Proof of concept could be demonstrated for this novel automatically controlled veno-venous ECLA circuit. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  5. Pulmonary embolism in a wounded with mine blast injury against the background of anticoagulant prophylaxis (case report

    Directory of Open Access Journals (Sweden)

    K. N. Nikolaev

    2015-01-01

    Full Text Available Venous thrombosis and pulmonary embolism in healthy military are rare. Fighting surgical trauma is the trigger of a cascade of defense reactions of the body and the blood coagulation system, leading to stop bleeding. Hemostatic disorders, shifting the equilibrium toward hypercoagulable state, the emergence of the risk factors associated with the injury, lead to uncontrolled thrombosis with subsequent development of venous thromboembolic complications. We present the case of the left pulmonary artery thromboembolism in 41 year old wounded with a gunshot fracture of the right femur, obtained by blowing an unknown explosive device. Medical assistance was provided in three stages of evacuation. In order to stabilize a femur fracture the external fixation device was used. According coagulogram thrombinemia persisted for more than 30 days. Prevention of thrombosis carried LMWH (Clexane, with 9 days after injury. 31 day angiography was performed computer, identified thrombus by 70% ceiling clearance left pulmonary artery; by ultrasound scanning of the veins of the lower limbs was diagnosed asymptomatic thrombosis of the right iliofemoral. Against the background of complex treatment for 67 hours after the injury occurred recanalization. This case shows that the injured limb wound clinical symptoms of the disease symptoms negate venous thrombosis, which becomes the only manifestation of pulmonary embolism. Prevention of venous thromboembolic events, as well as monitoring of its effectiveness, should be carried out at all stages of the evacuation of the wounded and for the entire period of the presence of risk factors for their development.

  6. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... About Media Donate Spinal Cord Injury Medical Expert Videos ... Home Kim Eberhardt Muir, MS Coping with a New Injury Robin Dorman, PsyD Sex and Fertility After Spinal Cord Injury Diane M. ...

  7. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... spinal cord injury? play_arrow What kind of surgery is common after a spinal cord injury? play_ ... How soon after a spinal cord injury should surgery be performed? play_arrow Is it common to ...

  8. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... L Sarah Harrison, OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury ... a spinal cord injury important? play_arrow What role does “compression” play in a spinal cord injury? ...

  9. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences ...

  10. Radiotherapy injuries in children

    International Nuclear Information System (INIS)

    Kalifa, G.; Bennet, J.; Couanet, D.; Masselot, J.

    1985-01-01

    Side effects of radiotherapy in pediatrics are reviewed including bone injuries and radio-induced bone tumors; nervous system injuries with emphasis on hypothalamus, pituitary gland, brain and spinal cord; lung, digestive system and urinary tract injuries [fr

  11. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury ... Jennifer Piatt, PhD David Chen, MD Read Bio Medical Director, Spinal Cord Injury Rehabilitation Program, Rehabilitation Institute ...

  12. Facial Sports Injuries

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Facial Sports Injuries Facial Sports Injuries Patient Health Information News ... should receive immediate medical attention. Prevention Of Facial Sports Injuries The best way to treat facial sports ...

  13. Spinal Cord Injury 101

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    Full Text Available ... Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics Spinal Cord Injury 101 ... arrow What is the “Spinal Cord Injury Model Systems” program? play_arrow What are the most promising ...

  14. Spinal Cord Injury 101

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    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD David Chen, MD Read Bio Medical ...

  15. Preventing Knee Injuries

    Science.gov (United States)

    ... Our Newsletter Donate Blog Skip breadcrumb navigation Preventing Knee Injuries Knee injuries in children and adolescent athletes ... this PDF Share this page: WHAT ARE COMMON KNEE INJURIES? Pain Syndromes One of the most common ...

  16. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  17. Spinal Cord Injury 101

    Medline Plus

    Full Text Available ... Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ... a spinal cord injury? play_arrow Why are high-dose steroids often used right after an injury? ...

  18. Multiple Cranial Nerve Palsy Due to Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Esra Eruyar

    2017-04-01

    Full Text Available Cerebral venous thrombosis (CVT is a rare clinical condition between cerebrovasculer diases. The most common findings are headache, seizure and focal neurological deficit. Multiple cranial nerve palsy due to CVT is rarely seen and it is not clear pathology. A pathology that could explain the lack of cranial nerve imaging is carrying suspected diagnosis but the disease is known to provide early diagnosis and treatment. We want to emphasize with this case multipl cranial nerve palsy due to CVT is seen rarely and good response to treatment.

  19. Pregnancy predispose to higher incidence of venous thromboembolism

    DEFF Research Database (Denmark)

    Andersen, Anita Sylvest; Bergholt, Thomas; Salvig, Jannie Dalby

    2015-01-01

    Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality despite the possibility to prevent and treat the disorder. The hypercoagulability of normal pregnancy predispose to an approximately six-fold higher incidence of VTE in pregnancy. Identification of risk pregnancies...... and start of prophylaxis is essential, as is early diagnosis of VTE to prevent progression and pulmonary embolism. For anticoagulant treatment and prophylaxis in pregnancy, low molecular weight heparin is the drug of choice and prophylaxis, if indicated, should initiate as soon as pregnancy is confirmed....

  20. Spontaneous migration of central venous catheter tip following extubation

    Directory of Open Access Journals (Sweden)

    Balaji Prabaharan

    2014-01-01

    Full Text Available Migration of the tip of central venous catheters is not an uncommon event and the mechanism for this is not clear. Increased intrathoracic pressure due to coughing, sneezing or weight lifting, changing the body position or physical movements such as abduction or adduction of the arms is thought to be the cause of such migration. We present here a case of a patient with a port catheter tip that migrated from the left subclavian to the superior vene cava following extubation.