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Sample records for splanchnic vein thrombosis

  1. CAUSES OF ADULT SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA

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    Valerio De Stefano

    2011-12-01

    Full Text Available The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS, extrahepatic portal vein obstruction (EHPVO, and mesenteric vein thrombosis. Risk factors can be local or systemic. A local precipitating factor is rare in BCS, while it is common in  patients with portal vein thrombosis. Chronic myeloproliferative neoplasms (MPN are the leading systemic cause of splanchnic vein thrombosis, and are diagnosed in half BCS patients and one-third of EHPVO patients; the molecular marker JAK2 V617F is detectable in a large majority of patients with overt MPN and up to 40% of patients without overt MPN. Inherited thrombophilia is present in at least one-third of patients, and the factor V Leiden or the prothrombin G20210A mutations are the most common mutations found in BCS or EHPVO patients, respectively. Multiple factors are present in approximately one-third of patients with BCS and two- thirds of patients with portal vein thrombosis. In a few patient series from the Southern Mediterranean area the high prevalence of MPN and thrombophilia as underlying cause of BCS is confirmed, although the data should be considered preliminary. Peculiar risk factors present in the area are Behcet’s disease and hydatidosis; moreover, the presence of membraneous webs, typically found in Asian patients, can be found in a significant portion of cases.

  2. CAUSES OF ADULT SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA

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    Laura Betti

    2011-01-01

    Full Text Available

    The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS, extrahepatic portal vein obstruction (EHPVO, and mesenteric vein thrombosis.

    Risk factors can be local or systemic. A local precipitating factor is rare in BCS, while it is common in  patients with portal vein thrombosis. Chronic myeloproliferative neoplasms (MPN are the leading systemic cause of splanchnic vein thrombosis, and are diagnosed in half BCS patients and one-third of EHPVO patients; the molecular marker JAK2 V617F is detectable in a large majority of patients with overt MPN and up to 40% of patients without overt MPN. Inherited thrombophilia is present in at least one-third of patients, and the factor V Leiden or the prothrombin G20210A mutations are the most common mutations found in BCS or EHPVO patients, respectively. Multiple factors are present in approximately one-third of patients with BCS and two- thirds of patients with portal vein thrombosis.

    In a few patient series from the Southern Mediterranean area the high prevalence of MPN and thrombophilia as underlying cause of BCS is confirmed, although the data should be considered preliminary. Peculiar risk factors present in the area are Behcet’s disease and hydatidosis; moreover, the presence of membraneous webs, typically found in Asian patients, can be found in a significant portion of cases.

  3. SPLANCHNIC VEIN THROMBOSIS IN THE MEDITERRANEAN AREA IN CHILDREN

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    Hanaa El-Karaksy

    2011-07-01

    Full Text Available Abdominal venous thrombosis may present as splanchnic venous thrombosis (SVT (occlusion of portal, splenic, superior or inferior mesenteric veins or Budd- Chiari Syndrome (BCS (thrombosis of inferior vena cava and/or hepatic veins. The aim of this review is to report the scanty data available for splanchnic vein thrombosis in the South Mediterranean area. In one Egyptian study, the possible circumstantial risk factors for portal vein thrombosis were found in 30% of cases:  19% neonatal sepsis, 8.7% umbilical catheterization, 6% severe gastroenteritis and dehydration. Another Egyptian study concluded that hereditary thrombophilia was common in children with PVT (62.5%, the commonest being factor V Leiden mutation (FVL (30%. Concurrence of more than one hereditary thrombophilia was not uncommon (12.5%. The first international publication on hepatic veno-occlusive disease (VOD in Egypt was in 1965 in children who rapidly develop abdominal distention with ascites and hepatomegaly. This disease was more frequent in malnourished children coming from rural areas; infusions given at home may contain noxious substances that were hepatotoxic and Infections might play a role. VOD of childhood is rarely seen nowadays. Data from South Mediterranean area are deficient and this may be attributable to reporting in local medical journals that are difficult to access. Medical societies concerned with this topic could help distribute this information.

  4. Clinical approach to splanchnic vein thrombosis: risk factors and treatment.

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    Riva, Nicoletta; Donadini, Marco P; Dentali, Francesco; Squizzato, Alessandro; Ageno, Walter

    2012-10-01

    Splanchnic vein thrombosis (SVT) is an unusual manifestation of venous thromboembolism which involves one or more abdominal veins (portal, splenic, mesenteric and supra-hepatic veins). SVT may be associated with different underlying disorders, either local (abdominal cancer, liver cirrhosis, intra-abdominal inflammation or surgery) or systemic (hormonal treatment, thrombophilic conditions). In the last decades, myeloproliferative neoplasm (MPN) emerged as the leading systemic cause of SVT. JAK2 mutation, even in the absence of known MPN, showed a strong association with the development of SVT, and SVT was suggested to be the first clinical manifestation of MPN. Recently, an association between SVT, in particular supra-hepatic vein thrombosis, and paroxysmal nocturnal hemoglobinuria has also been reported. SVT occurs with heterogeneous clinical presentations, ranging from incidentally detected events to extensive thrombosis associated with overt gastrointestinal bleeding, thus representing a clinical challenge for treatment decisions. In the absence of major contraindications, anticoagulant therapy is generally recommended for all patients presenting with acute symptomatic SVT, but there is no consensus about the use of anticoagulant drugs in chronic or incidentally detected SVT. High quality evidence on the acute and long-term management is substantially lacking and the risk to benefit-ratio of anticoagulant therapy in SVT still needs to be better assessed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Splanchnic Vein Thrombosis - an Uncommon Complication after Laparoscopic Sleeve Gastrectomy

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    Tanja Carli

    2016-04-01

    Full Text Available Background: Laparoscopic sleeve gastrectomy (LSG is an innovative and relatively safe surgical approach for weight reduction in morbidly obese people. Splanchnic vein thrombosis (SVT is an extremely rare complication of LSG and, if not recognized, carries a high mortality rate. This paper highlights a potentially lethal condition of SVT after LSG. Case Report: A 37-year-old morbidly obese woman was referred to our institution for LSG. Three weeks after the intervention, she was readmitted with abdominal pain, vomiting, nausea, diarrhea, and fever with positive family anamnesis to viral disease. Abdominal X-ray as well as utrasonography were both normal, and no X-ray contrast medium leakage was observed. One week later, she was readmitted with septic condition. An abdominal computed tomography scan diagnosed lienal vein thrombosis along its whole length and partial thrombosis of the superior mesenteric vein. Conclusion: SVT presents very heterogeneously, which makes it extremely challenging to diagnose and to make an appropriate treatment decision. With regard to the high prevalence of obesity and the increasing frequency of LSG, prompt diagnosis and management are crucial.

  6. Splanchnic vein thrombosis and variceal rebleeding in patients with cirrhosis.

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    Amitrano, Lucio; Guardascione, Maria A; Scaglione, Mariano; Menchise, Antonella; Martino, Rossana; Manguso, Francesco; Lanza, Alfonso G; Lampasi, Filippo

    2012-12-01

    Splanchnic vein thrombosis (SVT) affects the short-term prognosis of acute variceal bleeding in cirrhotic patients. This study evaluated whether SVT also affects the rebleeding rate of patients included in a program of secondary prophylaxis after variceal bleeding. A total of 387 patients with variceal bleeding were included from January 2001 to December 2010. Band ligation was carried out every 3-4 weeks. Follow-up included endoscopy at 1, 3, and every 6 months, Echo-Doppler, and biochemical examination every 6 months. From 2005, patients with SVT received anticoagulation with enoxaparin 200 UI/kg/day for at least 6 months. The therapy was started after variceal eradication. SVT was diagnosed in 41 patients at variceal bleeding, in eight before and in 18 patients during the follow-up. Variceal eradication was achieved in 89.2 and 86.6% in no-SVT and SVT patients. Rebleeding occurred in 9.5 and 11.9% of no-SVT and SVT patients at 12 months. Varices relapsed more frequently in SVT than in no-SVT patients (25.4 vs. 14.67%, P=0.03). The rates of variceal rebleeding and relapse were similar in patients who received or did not receive anticoagulation, but mortality was significantly lower in patients who received anticoagulation. SVT favors the relapse of esophageal varices, but rebleeding can be effectively prevented by standard scheduled band ligations. Anticoagulation does not prevent variceal relapse. The improvement in the survival of patients treated with anticoagulation needs to be confirmed in future studies.

  7. Baseline characteristics and management of patients with splanchnic vein thrombosis: Results of an international registry

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    Ageno, W.; Riva, N.; Schulman, S.; Bang, S.-M.; Sartori, M.T.; Grandone, E.; Beyer, J.; Pasca, S.; Di Minno, D.; Duce, R.; Malato, A.; Santoro, R.; Poli, D.; Verhamme, P.; Passamonti, S.; Kamphuisen, P.; Alatri, A.; Becattini, C.; Bucherini, E.; Piana, A.; De Stefano, V.; Vidili, G.; Bazzan, M.; Di Nisio, M.; Dentali, F.; Martinelli, I.; Barillari, G.; Poggio, R.; Colaizzo, D.; Vaccarino, A.

    2012-01-01

    Background Splanchnic vein thrombosis (SVT) is a challenging disease. The aim of this international registry was to describe the characteristics of a large cohort of patients with SVT and their management in clinical practice. Patients and Methods Consecutive patients with objectively diagnosed SVT

  8. Antithrombotic Treatment of Splanchnic Vein Thrombosis : Results of an International Registry

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    Ageno, Walter; Riva, Nicoletta; Bang, Soo-Mee; Sartori, Maria Teresa; Grandone, Elvira; Beyer-Westendorf, Jan; Barillari, Giovanni; Di Minno, Matteo N. D.; Duce, Rita; Malato, Alessandra; Santoro, Rita; Poli, Daniela; Verhamme, Peter; Martinelli, Ida; Kamphuisen, Pieter W.; Alatri, Adriano; Oh, Doyeun; Amico, Elbio D.; Schulman, Sam; Dentali, Francesco

    2012-01-01

    Background: Treatment of splanchnic vein thrombosis (SVT) is a clinical challenge due to heterogeneity of clinical presentations, increased bleeding risk and lack of evidences from clinical trials. We carried out an international registry aimed to describe current treatment strategies and factors

  9. Splanchnic vein thrombosis in myeloproliferative neoplasms: pathophysiology and molecular mechanisms of disease

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    How, Joan; Zhou, Amy; Oh, Stephen T.

    2016-01-01

    Myeloproliferative neoplasms (MPNs) are the most common underlying prothrombotic disorder found in patients with splanchnic vein thrombosis (SVT). Clinical risk factors for MPN-associated SVTs include younger age, female sex, concomitant hypercoagulable disorders, and the JAK2 V617F mutation. These risk factors are distinct from those associated with arterial or deep venous thrombosis (DVT) in MPN patients, suggesting disparate disease mechanisms. The pathophysiology of SVT is thought to derive from local interactions between activated blood cells and the unique splanchnic endothelial environment. Other mutations commonly found in MPNs, including CALR and MPL, are rare in MPN-associated SVT. The purpose of this article is to review the clinical and molecular risk factors for MPN-associated SVT, with particular focus on the possible mechanisms of SVT formation in MPN patients. PMID:28246554

  10. Genetic variation in thrombin-activatable fibrinolysis inhibitor (TAFI) is associated with the risk of splanchnic vein thrombosis

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    de Bruijne, Emile L. E.; Darwish Murad, Sarwa; de Maat, Moniek P. M.; Tanck, Michael W. T.; Haagsma, Elizabeth B.; van Hoek, Bart; Rosendaal, Frits R.; Janssen, Harry L. A.; Leebeek, Frank W. G.

    2007-01-01

    Splanchnic vein thrombosis (SVT) has been associated with a hypercoagulable state. Thrombin-activatable fibrinolysis inhibitor (TAFI) may contribute to a hypercoagulable state, and therefore we were interested in the role of TAFI in SVT. Since the disease is frequently associated with liver

  11. Genetic variation in thrombin-activatable fibrinolysis inhibitor (TAR) is associated with the risk of splanchnic vein thrombosis

    NARCIS (Netherlands)

    de Bruijne, Emile L. E.; Murad, Sarwa Darwish; de Maat, Moniek P. M.; Tanck, Michael W. T.; Haagsma, Elizabeth B.; van Hoeks, Bart; Rosendaal, Frits R.; Janssen, Harry L. A.; Leebeek, Frank W. G.

    Splanchnic vein thrombosis (SVT) has been associated with a hypercoagulable state. Thrombin-activatable fibrinolysis inhibitor (TAFI) may contribute to a hypercoagulable state, and therefore we were interested in the role of TAR in SVT. Since the disease is frequently associated with liver

  12. Clonal populations of hematopoietic cells with paroxysmal nocturnal hemoglobinuria phenotype in patients with splanchnic vein thrombosis.

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    Ageno, Walter; Dentali, Francesco; De Stefano, Valerio; Barco, Stefano; Lerede, Teresa; Bazzan, Mario; Piana, Antonietta; Santoro, Rita; Duce, Rita; Poli, Daniela; Martinelli, Ida; Siragusa, Sergio; Barillari, Giovanni; Cattaneo, Marco; Vidili, Gianpaolo; Carpenedo, Monica; Rancan, Elena; Giaretta, Ilaria; Tosetto, Alberto

    2014-06-01

    Splanchnic vein thrombosis (SVT) is a serious complication in patients with paroxysmal nocturnal hemoglobinuria (PNH). Mutant PNH clones can be associated with an increased risk of SVT even in the absence of overt disease, but their prevalence in non-selected SVT patients remains unknown. Patients with objective diagnosis of SVT and without known PNH were tested for the presence of PNH clone using high-sensitivity flow cytometric analysis. A total of 202 SVT patients were eligible, 58.4% were males, mean age was 54.6years (range 17-94), site of thrombosis was portal in 103 patients, mesenteric in 67, splenic in 37, and supra-hepatic in 10. SVT was associated with JAK2 V6167F in 28 of 126 (22.2%) screened patients, liver cirrhosis in 15.3% patients, recent surgery in 10.9%, and myeloproliferative neoplasm in 10.6%, whereas in 34.6% of patients neither permanent nor transient risk factors were detected. None of the patients had a clearly demonstrable PNH clone, but in two patients (0.99%, 95% CI 0.17-3.91) we observed very small PNH clones (size 0.014% and 0.16%) confirmed in two independent samples. One patient had portal vein thrombosis and no associated risk factors, the second had superior mesenteric vein thrombosis and inflammatory bowel disease. Very small PNH clones can be detected in patients with SVT and no clinical manifestations of disease. Future studies are needed to explore the potential role of this finding in the pathogenesis of SVT. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies

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    Xu, Wenda; Qi, Xingshun; Chen, Jiang; Su, Chunping; Guo, Xiaozhong

    2015-01-01

    Splanchnic vein thrombosis (SVT) may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes o...

  14. Predictive factors of splanchnic vein thrombosis in acute pancreatitis: A 6-year single-center experience.

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    Toqué, Laurence; Hamy, Antoine; Hamel, Jean-Francois; Cesbron, Elodie; Hulo, Pauline; Robert, Solen; Aube, Christophe; Lermite, Emilie; Venara, Aurélien

    2015-12-01

    Splanchnic vein thrombosis (SVT) is a potentially severe complication of pancreatitis. The aim of this single-center, retrospective cohort study was to investigate the incidence of SVT and to determine the connected risk factors. All consecutive patients with acute pancreatitis (AP) managed in our hospital were included. The primary outcome was the occurrence of SVT and data was collected in accordance with Ranson's criteria. A total of 318 patients were included, of whom 124 (39.0%) were women. Biliary lithiasis was the main cause of pancreatitis (n = 156, 49.1%). A total of 19 (6.0%) SVT were identified. In univariate analysis, alcohol intake, smoking and male gender were associated with SVT (P = 0.005, 0.003 and 0.007, respectively). Biological parameters significantly associated with thrombosis were lactate dehydrogenase (LDH) 75% was a protective factor against thrombosis (OR 0.148, P = 0.019). Leukocytes >10 × 10(9)/L (OR 6.397, P = 0.034), hyperglycemia (≥ 10 mmol/L) (OR 6.845, P = 0.023), LDH SVT. Alcohol intake, male gender and smoking should focus the physician's attention on the risk of SVT. When further associated with certain biological parameters, the physicians should consider therapeutic anticoagulation to prevent SVT. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  15. Outcomes during anticoagulation in patients with symptomatic vs. incidental splanchnic vein thrombosis.

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    Tufano, Antonella; Ageno, Walter; Di Micco, Pierpaolo; Niglio, Alferio; Rosa, Vladimir; Ballaz, Aitor; Braester, Andrei; Rubio, Carmen Mª; Isern, Virginia; Imbalzano, Egidio; Monreal, Manuel

    2018-02-27

    Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT. In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71-5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47-2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14-8.17) and anaemia (HR: 4.11; 95%CI: 1.45-11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68-10.1) were associated with at increased risk for major bleeding. The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Selective testing for calreticulin gene mutations in patients with splanchnic vein thrombosis: A prospective cohort study.

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    Poisson, Johanne; Plessier, Aurélie; Kiladjian, Jean-Jacques; Turon, Fanny; Cassinat, Bruno; Andreoli, Annalisa; De Raucourt, Emmanuelle; Goria, Odile; Zekrini, Kamal; Bureau, Christophe; Lorre, Florence; Cervantes, Francisco; Colomer, Dolors; Durand, François; Garcia-Pagan, Juan-Carlos; Casadevall, Nicole; Valla, Dominique-Charles; Rautou, Pierre-Emmanuel; Marzac, Christophe

    2017-09-01

    Myeloproliferative neoplasms (MPN) are the leading cause of splanchnic vein thrombosis (SVT). Janus kinase 2 gene (JAK2) V617F mutations are found in 80 to 90% of patients with SVT and MPN. Mutations of the calreticulin (CALR) gene have also been reported. However, as their prevalence ranges from 0 to 2%, the utility of routine testing is questionable. This study aimed to identify a group of patients with SVT at high risk of harboring CALR mutations and thus requiring this genetic testing. CALR, JAK2 V617F and thrombopoietin receptor gene (MPL) mutations were analysed in a test cohort that included 312 patients with SVT. Criteria to identify patients at high risk of CALR mutations in this test cohort was used and evaluated in a validation cohort that included 209 patients with SVT. In the test cohort, 59 patients had JAK2 V617F , five had CALR and none had MPL mutations. Patients with CALR mutations had higher spleen height and platelet count than patients without these mutations. All patients with CALR mutations had a spleen height ⩾16cm and platelet count >200×10 9 /L. These criteria had a positive predictive value of 56% (5/9) and a negative predictive value of 100% (0/233) for the identification of CALR mutations. In the validation cohort, these criteria had a positive predictive value of 33% (2/6) and a negative predictive value of 99% (1/96). CALR mutations should be tested in patients with SVT, a spleen height ⩾16cm, platelet count >200×10 9 /L, and no JAK2 V617F . This strategy avoids 96% of unnecessary CALR mutations testing. Lay summary: Mutations of the CALR gene are detected in 0 to 2% of patients with SVT, thus the utility of systematic CALR mutation testing to diagnose MPN is questionable. This study demonstrates that CALR mutations testing can be restricted to patients with SVT, a spleen height ⩾16cm, a platelet count >200×10 9 /L, and no JAK2 V617F . This strategy avoids 96% of unnecessary CALR mutations testing. Copyright © 2017 European

  17. Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies.

    Science.gov (United States)

    Xu, Wenda; Qi, Xingshun; Chen, Jiang; Su, Chunping; Guo, Xiaozhong

    2015-01-01

    Splanchnic vein thrombosis (SVT) may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes of pancreatitis, location of SVT, and regions where the studies were performed. After the review of 714 studies, 44 studies fulfilled the inclusion criteria. Meta-analyses showed a pooled prevalence of SVT of 13.6% in pancreatitis. According to the stage of pancreatitis, the pooled prevalence of SVT was 16.6% and 11.6% in patients with acute and chronic pancreatitis, respectively. According to the causes of pancreatitis, the pooled prevalence of SVT was 12.2% and 14.6% in patients with hereditary and autoimmune pancreatitis. According to the location of SVT, the pooled prevalence of portal vein, splenic vein, and mesenteric vein thrombosis was 6.2%, 11.2%, and 2.7% in pancreatitis. The prevalence of SVT in pancreatitis was 16.9%, 11.5%, and 8.5% in Europe, America, and Asia, respectively.

  18. Prevalence of Splanchnic Vein Thrombosis in Pancreatitis: A Systematic Review and Meta-Analysis of Observational Studies

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    Wenda Xu

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT may be negatively associated with the prognosis of pancreatitis. We performed a systematic review and meta-analysis of literatures to explore the prevalence of SVT in pancreatitis. All observational studies regarding the prevalence of SVT in pancreatitis were identified via PubMed and EMBASE databases. The prevalence of SVT was pooled in the total of patients with pancreatitis. And it was also pooled in the subgroup analyses according to the stage and causes of pancreatitis, location of SVT, and regions where the studies were performed. After the review of 714 studies, 44 studies fulfilled the inclusion criteria. Meta-analyses showed a pooled prevalence of SVT of 13.6% in pancreatitis. According to the stage of pancreatitis, the pooled prevalence of SVT was 16.6% and 11.6% in patients with acute and chronic pancreatitis, respectively. According to the causes of pancreatitis, the pooled prevalence of SVT was 12.2% and 14.6% in patients with hereditary and autoimmune pancreatitis. According to the location of SVT, the pooled prevalence of portal vein, splenic vein, and mesenteric vein thrombosis was 6.2%, 11.2%, and 2.7% in pancreatitis. The prevalence of SVT in pancreatitis was 16.9%, 11.5%, and 8.5% in Europe, America, and Asia, respectively.

  19. Recurrent Thrombotic Events after Discontinuation of Vitamin K Antagonist Treatment for Splanchnic Vein Thrombosis: A Multicenter Retrospective Cohort Study

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    Nicoletta Riva

    2015-01-01

    Full Text Available It is generally recommended that patients with splanchnic vein thrombosis (SVT should receive a minimum of 3 months of anticoagulant treatment. However, little information is available on the long-term risk of recurrent thrombotic events. The aim of this study was to evaluate the risk of venous and arterial thrombosis after discontinuation of vitamin K antagonist (VKA in SVT patients. Retrospective information from a cohort of SVT patients treated with VKA and followed by 37 Italian Anticoagulation Clinics, up to June 2013, was collected. Only patients who discontinued VKA and did not receive any other anticoagulant drug were enrolled in this study. Thrombotic events during follow-up were centrally adjudicated. Ninety patients were included: 33 unprovoked SVT, 27 SVT secondary to transient risk factors, and 30 with permanent risk factors. During a median follow-up of 1.6 years, 6 venous and 1 arterial thrombosis were documented, for an incidence of 3.3/100 patient-years (pt-y. The recurrence rate was highest in the first year after VKA discontinuation (8.2/100’pt-y and in patients with permanent risk factors (10.2/100’pt-y. Liver cirrhosis significantly increased the risk of recurrence. In conclusion, the rate of recurrent vascular complications after SVT is not negligible, at least in some patient subgroups.

  20. High frequency of endothelial colony forming cells marks a non-active myeloproliferative neoplasm with high risk of splanchnic vein thrombosis.

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    Vittorio Rosti

    Full Text Available Increased mobilization of circulating endothelial progenitor cells may represent a new biological hallmark of myeloproliferative neoplasms. We measured circulating endothelial colony forming cells (ECFCs in 106 patients with primary myelofibrosis, fibrotic stage, 49 with prefibrotic myelofibrosis, 59 with essential thrombocythemia or polycythemia vera, and 43 normal controls. Levels of ECFC frequency for patient's characteristics were estimated by using logistic regression in univariate and multivariate setting. The sensitivity, specificity, likelihood ratios, and positive predictive value of increased ECFC frequency were calculated for the significantly associated characteristics. Increased frequency of ECFCs resulted independently associated with history of splanchnic vein thrombosis (adjusted odds ratio = 6.61, 95% CI = 2.54-17.16, and a summary measure of non-active disease, i.e. hemoglobin of 13.8 g/dL or lower, white blood cells count of 7.8×10(9/L or lower, and platelet count of 400×10(9/L or lower (adjusted odds ratio = 4.43, 95% CI = 1.45-13.49 Thirteen patients with splanchnic vein thrombosis non associated with myeloproliferative neoplasms were recruited as controls. We excluded a causal role of splanchnic vein thrombosis in ECFCs increase, since no control had elevated ECFCs. We concluded that increased frequency of ECFCs represents the biological hallmark of a non-active myeloproliferative neoplasm with high risk of splanchnic vein thrombosis. The recognition of this disease category copes with the phenotypic mimicry of myeloproliferative neoplasms. Due to inherent performance limitations of ECFCs assay, there is an urgent need to arrive to an acceptable standardization of ECFC assessment.

  1. Deep Vein Thrombosis

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    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  2. Imaging Diagnosis of Splanchnic Venous Thrombosis

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    S. Rajesh

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT is a broad term that includes Budd-Chiari syndrome and occlusion of veins that constitute the portal venous system. Due to the common risk factors involved in the pathogenesis of these clinically distinct disorders, concurrent involvement of two different regions is quite common. In acute and subacute SVT, the symptoms may overlap with a variety of other abdominal emergencies while in chronic SVT, the extent of portal hypertension and its attendant complications determine the clinical course. As a result, clinical diagnosis is often difficult and is frequently reliant on imaging. Tremendous improvements in vascular imaging in recent years have ensured that this once rare entity is being increasingly detected. Treatment of acute SVT requires immediate anticoagulation. Transcatheter thrombolysis or transjugular intrahepatic portosystemic shunt is used in the event of clinical deterioration. In cases with peritonitis, immediate laparotomy and bowel resection may be required for irreversible bowel ischemia. In chronic SVT, the underlying cause should be identified and treated. The imaging manifestations of the clinical syndromes resulting from SVT are comprehensively discussed here along with a brief review of the relevant clinical features and therapeutic approach.

  3. Portal Vein Thrombosis

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    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  4. What Is Deep Vein Thrombosis?

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    ... To Health Topics / Deep Vein Thrombosis Deep Vein Thrombosis Leer en español What Is Deep vein thrombosis ( ... life-threatening problems if not treated. Deep Vein Thrombosis Only about half of the people who have ...

  5. The clinical significance of JAK2V617F mutation for Philadelphia-negative chronic myeloproliferative neoplasms in patients with splanchnic vein thrombosis.

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    Yonal, Ipek; Pinarbası, Binnur; Hindilerden, Fehmi; Hancer, Veysel Sabri; Nalcaci, Meliha; Kaymakoglu, Sabahattin; Diz-Kucukkaya, Reyhan

    2012-10-01

    Polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF), collectively known as Philadelphia-negative (Ph-negative) chronic myeloproliferative neoplasms (MPNs), MPNs represent the most common causes of splanchnic vein thrombosis (SVT), including Budd-Chiari syndrome (BCS) and portal vein thrombosis (PVT). The JAK2V617F mutation has been demonstrated in most of the Ph-negative chronic MPNs. The study objective was to assess the diagnostic value of JAK2V617F mutation in patients with SVT in a group of 68 patients with SVT (42 PVT,19 BCS, 7 combined PVT and BCS). By DNA-melting curve analysis, the JAK2V617F mutation was detected in 42.1 % of BCS, 38.1 % of PVT and 71.4 % of combined PVT and BCS groups. Thirteen of 15 (86.6 %) SVT patients with overt MPN and 16 of 53 (30.1 %) SVT patients without overt MPN (patients with either normal blood counts or cytopenias), including 6 of 16 with BCS (37.5 %), 7 of 33 with PVT (21.2 %) and 3 of 4 with combined BCS and PVT (75 %) possessed JAK2V617F mutation. A substantial proportion of patients with SVT were recognized as carriers of the JAK2V617F mutation despite the absence of overt signs of MPN. Receiver Operating Characteristic (ROC) curve analysis determined a platelet count of 190,000 mm(3) (area under the curve; AUC = 0.724, p = 0.002) and a white blood cell (WBC) count of 8,150 mm(3) (AUC = 0.76, p = 0.001) as the best cut-off values for the highest sensitivity and specificity ratios of the JAK2V617F mutation in patients with SVT. A significant positive correlation existed between the JAK2V617F mutational status of SVT patients and the WBC and platelet counts. Our results imply that JAK2V617F mutation screening should be an initial test for MPN in patients with SVT.

  6. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  7. 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 ...

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

    African Journals Online (AJOL)

    Abstract. 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 ...

  9. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  10. Mesenteric vein thrombosis: CT identification

    International Nuclear Information System (INIS)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-01-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis

  11. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  12. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    ABSTRACT. BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously ...

  13. Portal vein thrombosis.

    Science.gov (United States)

    Chawla, Yogesh K; Bodh, Vijay

    2015-03-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion.

  14. Portal Vein Thrombosis

    Science.gov (United States)

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  15. Deep Cerebral Vein Thrombosis: A Clinical Masquerader

    OpenAIRE

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-01-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially ...

  16. PAI-1 4G-4G, MTHFR 677TT, V Leiden 506Q, and Prothrombin 20210A in Splanchnic Vein Thrombosis: Analysis of Individual Patient Data From Three Prospective Studies.

    Science.gov (United States)

    Pasta, Linda; Pasta, Francesca; D'Amico, Mario

    2016-03-01

    There are no univocal opinions on the role of genetic thrombophilia on splanchnic vein thrombosis (SVT). We defined genetic thrombophilia the presence of one of these thrombophilic genetic factors (THRGFs): PAI-1 4G-4G, MTHFR 677TT, V Leiden 506Q, and prothrombin 20210A. To evaluate the frequencies of these THRGFs in SVT patients, we analyzed individual data of 482 Caucasian patients, recruited from 2000 to 2014 in three prospective studies. SVT was defined as the presence of thrombosis of portal (PVT), mesenteric (MVT), splenic (SPVT), cava (CT), and hepatic vein (Budd Chiari syndrome, BCS). Pre-hepatic SVT (pre-HSVT) was defined as PVT with or without MVT/SPVT, without BCS. Post-hepatic SVT (post-HSVT) was BCS with or without PVT/MVT/SPVT. We compared 350 patients with liver cirrhosis (LC), 47 hepatocellular carcinoma (HCC), 37 myeloproliferative neoplasm (MPN), 38 associated disease (AD), 10 without any associated disease (WAD), vs 150 healthy controls (HC); 437 patients showed pre-HSVT and 45 post-HSVT. Thrombophilia was present in 294/482 (60.9%) patients: 189/350 LC (54.0%), 31/47 (66.0%) HCC, 29/39 (74.4%) MPN, 35/38 AD (92.1%), and 10/10 (100%) WAD, and 54/150 (36.0%) in HC. In the total group, we found 175 PAI-1 4G-4G, 130 MTHFR 677TT, 42V Leiden 506Q, and 27 prothrombin 20210A; 75 patients showed presence of >1 TRHGF; the more frequent association was PAI-1 4G-4G/MTHFR 677TT, in 36 patients. PAI-1 4G-4G and MTHFR 677TT were significantly more frequent in patients with SVT (P values 4G-4G and MTHFR 677TT distributions deviated significantly from that expected from a population in Hardy-Weinberg equilibrium. Thrombophilia was significantly less frequent in patients with pre-HSVT (250/437, 57.2%) than in patients with post-HSVT (44/45, 97.8%). Our study shows the significant prevalence of PAI-1 4G-4G and MTHFR 677TT in SVT, mainly in post-HSVT.

  17. Superficial vein thrombosis and deep vein thrombosis – a comparison

    OpenAIRE

    Krasiński, Zbigniew; Aniukiewicz, Krzysztof; Krasińska, Aleksandra; Krasińska, Beata; Gabriel, Marcin

    2017-01-01

    Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without...

  18. [Management of superficial vein thrombosis].

    Science.gov (United States)

    Frappé, Paul; Bertoletti, Laurent; Moulin, Nathalie; Décousus, Hervé

    2015-02-01

    Recent epidemiological studies have highlighted the potential severity of superficial vein thrombosis of the lower limbs (SVT). Diagnosis is based on clinical and Doppler ultrasonography evaluation, and define its therapeutic management. If SVT is associated with objectively confirmed deep vein thrombosis or pulmonary embolism, curative anticoagulation is indicated. If SVT is isolated and measured over 5 cm long, prophylactic dosage of fondaparinux may be provided for 45 days.

  19. Deep Cerebral Vein Thrombosis: A Clinical Masquerader.

    Science.gov (United States)

    Kumar, Prabhat; Sasmal, Gargi; Mahto, Subodh Kumar; Gupta, Shreya; Gupta, Harish

    2017-04-01

    Cerebral Vein Thrombosis (CVT) is an uncommon cause of stroke. Thrombosis can occur in superficial veins, deep venous system or cortical veins of brain. The term Deep Cerebral Vein Thrombosis (DCVT) is used for thrombosis of internal cerebral vein, vein of Galen and basal vein of Rosenthal. Only 10% cases of CVT are because of thrombosis of deep cerebral vein. The diagnosis of DCVT is often missed because of its heterogenous presentation. Herein, we present a case of DCVT which was initially treated as meningoencephalitis. A timely advised brain imaging helped in making the diagnosis and patient recovered completely after institution of anticoagulation.

  20. Mesenteric vein thrombosis following laparoscopic appendectomy

    OpenAIRE

    Jamie Harris; Brian Blackwood; Srikumar Pillai; Bill Chiu

    2014-01-01

    Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscop...

  1. Management of superficial vein thrombosis.

    Science.gov (United States)

    Cosmi, B

    2015-07-01

    Superficial vein thrombosis (SVT) is less well studied than deep vein thrombosis (DVT), because it has been considered to be a minor, self-limiting disease that is easily diagnosed on clinical grounds and that requires only symptomatic relief. The most frequently involved sites of the superficial vein system are the lower limbs, especially the saphenous veins, mostly in relation to varicosities. Lower-limb SVT shares the same risk factors as DVT; it can propagate into the deep veins, and have a complicated course with pulmonary embolism. Clinical diagnosis may not be accurate, and ultrasonography is currently indicated for both confirmation and evaluation of SVT extension. Treatment aims are symptom relief and prevention of venous thromboembolism (VTE) in relation to the thrombotic burden. SVT of the long saphenous vein within 3 cm of the saphenofemoral junction (SFJ) is considered to be equivalent to a DVT, and thus deserving of therapeutic anticoagulation. Less severe forms of lower-limb SVT not involving the SFJ have been included in randomized clinical trials of surgery, compression hosiery, non-steroidal anti-inflammatory drugs, unfractionated heparin, and low molecular weight heparins, with inconclusive results. The largest randomized clinical trial available, on 3004 patients with lower-limb SVT not involving the SFJ, showed that fondaparinux 2.5 mg once daily for 6 weeks is more effective than placebo in reducing the risk of the composite of death from any cause and symptomatic VTE (0.9% versus 5.9%). Further studies are needed to define the optimal management strategies for SVT of the lower limbs and other sites, such as the upper limbs. © 2015 International Society on Thrombosis and Haemostasis.

  2. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  3. Mesenteric vein thrombosis following laparoscopic appendectomy

    Directory of Open Access Journals (Sweden)

    Jamie Harris

    2014-11-01

    Full Text Available Mesenteric vein thrombosis is an uncommon complication following laparoscopic surgery. A review of the literature has shown that there is a higher incidence of thrombosis following laparoscopic bariatric procedures, including the gastric sleeve procedure and roux-en-y gastric bypass surgery. Additionally, pylephlebitis, thrombosis of portal or mesenteric veins, has been described following perforated appendicitis. However no report has described mesenteric vein thrombosis following laparoscopy for nonperforated appendicitis in the pediatric population. The cause of this thrombosis is hypothesized to be secondary to venous stasis secondary to insufflation during laparoscopy.

  4. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  5. Deep vein thrombosis and pulmonary embolism

    NARCIS (Netherlands)

    Di Nisio, Marcello; van Es, Nick; Büller, Harry R.

    2016-01-01

    Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep vein thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer

  6. Superficial vein thrombosis and deep vein thrombosis – a comparison

    Directory of Open Access Journals (Sweden)

    Zbigniew Krasiński

    2017-09-01

    Full Text Available Although superficial vein thrombosis is commonly considered a rather minor condition, a number of studies indicate that its consequences can be much more severe. Since the introduction of Doppler ultrasonography to common diagnosis of venous diseases, the approach to threats associated with superficial vein thrombosis has changed, mainly in the context of venous thromboembolism. Superficial thrombosis in varicose veins must be differentiated from that occurring in patients without varicosities. In the former case, superficial vein thrombosis is usually caused by haemodynamic disorders (slower flow, while in the latter, it is caused by thrombophilia or inflammation, but it can also be a prodromal sign of cancer. Ultrasonography enables one to distinguish deep vein thrombosis caused by superficial vein thrombosis progression (by extension through perforator veins or the great/small saphenous vein ostium into the deep venous system from deep vein thrombosis occurring at a certain distance from the site of superficial vein thrombosis. The authors emphasise that due to the possibility of concomitant deep vein thrombosis or pulmonary embolism, our attitude to the diagnostic process, potential complications and treatment of superficial vein thrombosis should be changed.

  7. A complicated case of deep vein thrombosis

    OpenAIRE

    Cerutti, Elena; Colagrande, Paola; Provera, Edoardo; Giusti, Massimo

    2011-01-01

    We report a case of a patient with deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) associated to portal vein thrombosis (PVT), complicated by hospital-acquired pneumonia (HAP). The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas), acquired conditions (neoplasms, antiphospholipid syndrome) or genetically determined situations (thrombophilia). PVT of the sovrahepatic vein...

  8. A current approach to superficial vein thrombosis.

    Science.gov (United States)

    Ellis, Martin H; Fajer, Simone

    2013-02-01

    Superficial vein thrombosis (SVT) is an entity commonly encountered in practice. While the clinical diagnosis is reasonably straightforward, care must be taken to exclude concurrent thrombosis of the deep veins, and the possibility of the presence of occult systemic illness such as malignancy should be considered. Recent studies of the epidemiology of SVT demonstrate a high incidence of concurrent deep vein thrombosis emphasizing the need for surveying the deep veins using compression ultrasonography. Treatment decisions are may now be based upon the results of randomized clinical trials and should include a period of anticoagulation using fondaparinux or a low molecular weight heparin. The appropriate doses and duration of therapy are not fully established, and the cost-effectiveness of these drugs for the treatment of SVT needs further evaluation. © 2012 John Wiley & Sons A/S.

  9. Acute mesenteric vein thrombosis: factors associated with evolution to chronic mesenteric vein thrombosis.

    Science.gov (United States)

    Vietti Violi, Naïk; Fournier, Nicolas; Duran, Rafael; Schmidt, Sabine; Bize, Pierre; Guiu, Boris; Denys, Alban

    2014-07-01

    Acute mesenteric venous thrombosis signs at MDCT are well described, but the literature lacks studies assessing their evolution. We aimed to describe the radiologic evolution of isolated acute mesenteric venous thrombosis and associated prognostic factors. Patients with isolated acute mesenteric venous thrombosis with follow-up for a minimum of 1 month with MDCT were selected. Images at the acute phase and on follow-up were reviewed in consensus reading. For acute mesenteric venous thrombosis, we searched for low-attenuated intraluminal filling defect. For chronic mesenteric venous thrombosis, we searched for vessel stenosis or occlusion associated with collateral mesenteric veins. Treatment, thrombosis risk factor, symptoms, location, and length and diameter of mesenteric venous thrombosis were reported and correlated with evolution over time. Twenty patients (nine women and 11 men; mean age, 52 years) were selected. Four patients recovered without radiologic sequelae, and 16 developed chronic mesenteric venous thrombosis signs. Anticoagulation did not influence recovery (p = 1). Patients with recovery compared with patients with chronic mesenteric venous thrombosis showed more frequent central lesions (p = 0.03). At diagnosis, the thrombosed segment was shorter and larger in the complete radiologic recovery group compared with the chronic mesenteric venous thrombosis signs group: mean length (± SD) 6.25 ± 3.21 cm and 12.81 ± 5.96 cm, respectively (p = 0.01); mean transverse diameter 1.82 ± 0.42 cm and 1.12 ± 0.34 cm, respectively (p = 0.01). Mesenteric fat infiltration at diagnosis was more frequent in the chronic mesenteric venous thrombosis signs group than in the complete recovery group (p = 0.03). Most cases of acute mesenteric venous thrombosis evolve toward the chronic form with vein stenosis or occlusion and development of collateral veins. Location, length of mesenteric venous thrombosis, transverse diameter of the vein, and mesenteric fat

  10. Superficial vein thrombosis with hemorrhagic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Yu-wei CONG

    2016-01-01

    Full Text Available Background Cerebral superficial vein thrombosis was rare and often misdiagnosed or missed for its various etiological factors, and complicated and nonspecific clinical manifestations. This paper reported one case of superficial vein thrombosis in right fronto-parietal lobe with hemorrhagic infarction. The anatomy of superficial vein, pathophysiological points, diagnosis and treatment of superficial vein thrombosis were reviewed to help to reduce missed diagnosis or misdiagnosis. Methods and Results A 18-year-old male patient had suffered from progressive headache for 4 years and weakness of left limbs for 2 d. Head MRI showed circular space-occupying lesion in right fronto-parietal lobe. Magnetic resonance venography (MRV examination showed the front two-thirds of the superior sagittal sinus was not clear. The lesions were removed and decompressive craniectomy was conducted, showing the brain tissue was pale, partly yellow or dark red, and superficial venous engorgement. Histological observation showed pial superficial vein thrombosis and subpial encephalomalacia, and multifocal hemorrhage of cerebral cortex and local parenchymal hemorrhage. A large number of "grid cells" and vascular "cuff" phenomenan were visible in surrounding tissue, and the parenchymal blood vessel proliferation was obvious. Left hand activity of the patient was obviously limited after the operation. Conclusions Clinical diagnosis of superficial vein thrombosis with hemorrhagic infarction is difficult, and brain imaging and serological examination can provide certain help. Much attention should be paid to the multidisciplinary diagnosis and treatment to reduce misdiagnosis or missed diagnosis, and gather clinical experience. DOI: 10.3969/j.issn.1672-6731.2016.01.007

  11. Cerebral and Sinus Vein Thrombosis

    Science.gov (United States)

    ... Thrombosis Stephan Moll , Beth Waldron Download PDF https://doi.org/10.1161/CIRCULATIONAHA.113.008018 Circulation. 2014; 130: ... e68-e70 , originally published August 18, 2014 https://doi.org/10.1161/CIRCULATIONAHA.113.008018 Citation Manager Formats ...

  12. Venous Thromboembolic Events After Cerebral Vein Thrombosis

    NARCIS (Netherlands)

    Miranda, Bruno; Ferro, José M.; Canhão, Patrícia; Stam, Jan; Bousser, Marie-Germaine; Barinagarrementeria, Fernando; Scoditti, Umberto

    2010-01-01

    Background and Purpose-After cerebral vein and dural sinus thrombosis (CVT), there is an increased risk of further venous thromboembolic events (VTEs). Time to a second cerebral or systemic venous thrombotic event and risk factors for recurrence have not been investigated in large prospective

  13. Portal vein thrombosis following laparoscopic gastric plication

    Science.gov (United States)

    Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery. PMID:27652795

  14. Portal vein thrombosis complicating appendicitis | Ayantunde | West ...

    African Journals Online (AJOL)

    Appendicitis is still the most common acute surgical abdomen all over the world and its complications may be grave. We report an adult case of acute appendicitis complicated by Portal Vein Thrombosis (PVT) and ascending portomesenteric phlebitis treated successfully with antibiotics and anticoagulation with no residual ...

  15. Portal vein thrombosis following laparoscopic gastric plication

    OpenAIRE

    Som, R; Rikabi, S; Chang, A; Durkin, N; Ramar, S

    2017-01-01

    Portal vein thrombosis (PVT) following laparoscopic surgery including Roux-en-Y bypass, sleeve gastrectomy and Nissen’s fundoplication is a rare but recognised complication. Laparoscopic gastric plication in a new procedure that is popular in some parts of the world. We report a case of a patient suffering PVT as a complication of this surgery.

  16. Portal vein thrombosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    von Köckritz, Leona; De Gottardi, Andrea; Trebicka, Jonel

    2017-01-01

    Portal vein thrombosis (PVT) is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare, but can be life-threatening. However, different aspects of clinical relevance, diagnosis and management of PVT are still areas of uncertainty...

  17. Puzzles in practice: splenic vein thrombosis.

    Science.gov (United States)

    McIntyre, Brittany; Marsh, Melanie; Walden, Jeffrey

    2016-06-01

    This report details a 58-year-old gentleman who presented to his outpatient primary care physician's clinic several times over four weeks for ongoing epigastric pain radiating into his left flank, dry heaving, and constipation. He was presumed to have gastritis at each visit and prescribed escalating doses of proton pump inhibitors. Due to the unrelenting pain, he eventually was admitted to the hospital and diagnosed with splenic vein thrombosis after computed tomography imaging of the abdomen. Our literature search revealed that pancreatic pathology is overwhelmingly the contributing factor to splenic vein thrombosis. Our patient had prominent collateral vasculature, suggesting that his splenic vein thrombosis was chronic in nature and likely the cause of his ongoing abdominal pain. Splenic vein thrombosis is an uncommon cause of abdominal pain, but one that should be included in the treating physician's differential diagnoses when abdominal pain is ongoing despite medical therapy. Although he had no evidence of initial findings on radiography, our patient was eventually diagnosed with biopsy-proven pancreatic cancer. Our case report demonstrates how patients presenting with persistent or worsening abdominal pain despite the use of proton pump inhibitors or other acid reducing agents and potential 'red flag' findings such as decreased appetite and weight loss should be worked up for other potential sources of abdominal pathology.

  18. Lower extremity dep vein thrombosis in children

    International Nuclear Information System (INIS)

    Perlmutt, L.; Fellows, K.E.; Harvard Medical School, Boston, MA

    1983-01-01

    Of 113 leg venograms performed in patients of all ages between 1969 and 1982, 68 were in children 16 years old or less. The patients were all studied on a tilt table (method of Rabinov and Paulin) in a head-up, 40-50 0 incline without tourniquets, supporting their weight on the unaffected leg. Among the 68 venograms, 12 (18%) were positive for deep vein thrombosis. The clinical settings for thrombosis in children were post-catheterization (two patients), post surgery (two), tumor/tumor therapy (three), drug abuse (one), and idiopathic (three). There were no long-term clinical sequelae in five patients. Pulmonary infarction occurred in three, and three patients required either long-term anticoagulation or IVC clipping. Clinical diagnosis is no more accurate for the diagnosis of deep vein thrombosis in children than it is in adults. Venography is the best method for making an accurate diagnosis and directing subsequent therapy.(orig.)

  19. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review

    NARCIS (Netherlands)

    Wichers, Iris M.; Di Nisio, Marcello; Büller, Harry R.; Middeldorp, Saskia

    2005-01-01

    The aim of this systematic review was to summarize the evidence from randomized controlled trials (RCT) concerning the efficacy and safety of medical or surgical treatments of superficial vein thrombosis (SVT) for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE). A

  20. Isolated thrombosis of the external jugular vein.

    Science.gov (United States)

    Colomina, M J; Godet, C; Bagó, J; Pellisé, F; Puig, O; Villanueva, C

    2000-08-01

    Thrombosis of the external jugular vein (EJV) is an infrequent clinical condition that has been associated with central venous catheterization, head and neck infections, intravenous drug abuse, and compression at the affected site. The authors report a case of thrombotic obstruction of the EJV in the late postoperative period after laparoscopic anterior lumbar interbody fusion. A 40-year-old morbidly obese woman with a depressive syndrome was diagnosed with L5-S1 discopathy and was submitted to laparoscopic anterior isthmic fusion. The operation lasted approximately 6 hours, during which the patient remained in a supine decubitus and Trendelenburg position. The left radial artery, peripheral veins, and right internal jugular vein were canalized. The internal jugular vein catheter was electively withdrawn 24 hours after the intervention. The postoperative period was satisfactory, and the patient was started on prophylaxis with low-molecular-weight heparin. She sat up and began walking at 24 hours and was discharged to her home 4 days after the procedure. Eight days after discharge she returned, experiencing right cervical pain. Palpation revealed a painful induration and erythematous area under the anterior edge of the sternocleidomastoid muscle. Results of otoscopy and laryngoscopy were normal. Cervical echo-Doppler disclosed an image consistent with EJV thrombosis. The most frequent causes of jugular vein thrombosis are mentioned above. A higher incidence has been described after upper abdomen and pelvic surgery; other contributing factors are age, obesity, and associated illness. There are few references in the literature to position-induced EJV thrombosis in the late postoperative period. The authors' patient presented signs and symptoms of EJV thrombosis (probably because of various factors), which was confirmed by echo-Doppler study and treated with 10 days of calcic heparin.

  1. Animal Model of Acute Deep Vein Thrombosis

    International Nuclear Information System (INIS)

    Roy, Sumit; Laerum, Frode; Brosstad, Frank; Kvernebo, Knut; Sakariassen, Kjell S.

    1998-01-01

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

  2. Portal, superior mesenteric and splenic vein thrombosis secondary to hyperhomocysteinemia with pernicious anemia: a case report.

    Science.gov (United States)

    Venkatesh, Prashanth; Shaikh, Nissar; Malmstrom, Mohammad F; Kumar, Vajjala R; Nour, Bakr

    2014-08-25

    Acute portomesenteric vein thrombosis is an uncommon but serious condition with potential sequelae, such as small-bowel gangrene and end-stage hepatic failure. It is known to be caused by various pro-thrombotic states, including hyperhomocysteinemia. We describe what is, to the best of our knowledge, the first reported case of concomitant thrombosis of portal, superior mesenteric and splenic veins due to hyperhomocysteinemia secondary to pernicious anemia and no other risk factors. A 60-year-old Indian man presented with epigastric pain, diarrhea and vomiting. An abdominal imaging scan showed that he had concomitant pernicious anemia and concomitant portal, superior mesenteric and splenic vein thrombosis. A work-up for the patient's hypercoagulable state revealed hyperhomocysteinemia, an undetectable vitamin B12 level and pernicious anemia with no other thrombophilic state. He developed infarction with perforation of the small bowel and subsequent septic shock with multi-organ dysfunction syndrome, and he ultimately died due to progressive hepatic failure. This report demonstrates that pernicious anemia, on its own, can lead to hyperhomocysteinemia significant enough to lead to lethal multiple splanchnic vein thrombosis. Our case also underscores the need to (1) consider portomesenteric thrombosis in the differential diagnosis of epigastric abdominal pain, (2) perform a complete thrombotic work-up to elucidate metabolic abnormalities that could be contributing to a pro-thrombotic state and (3) initiate aggressive measures, including early consideration of multi-visceral transplantation, in order to avoid decompensation and a significant adverse outcome.

  3. Superior mesenteric vein thrombosis complicating appendicular masses

    International Nuclear Information System (INIS)

    Echitibi, Salma S.; Bashir, Masoud O.; Ahmad, Misba U.

    2003-01-01

    Mesenteric vein thrombosis (MVT) is rare. Its diagnosis is usually difficult and delayed. We report two patients who developed MVT as a complication of an appendicular mass. One of them had appendectomy and developed fever 10 days postoperatively. The other was treated conservatively. An abdominal computerized tomography(CT) scan with intravenous contrast was helpful in diagnosing superior MVT in both patients, which were not suspected. Intravenous contrast should be used when performing CT of an appendicular mass. Special interest should be directed at studying the superior mesenteric vein. Early diagnosis of our patients helped to start early medical treatment with anticoagulation. (author)

  4. [Idiopathic thrombosis of the renal vein].

    Science.gov (United States)

    Ignjatović, I; Ilić, M; Marković, N; Stamenić, T

    1995-01-01

    Renal vein thrombosis (TVR) is not a common disease especially when is not associated with renal parenchymal nephropathy. TVR has no characteristic symptoms, so it is often late recognised. The main procedures for diagnosis of TVR are: echotomography, CT and phlebography. All these procedures, although very informative, have certain limits in the clinical use. Therapy of TVR trombolytic, anticoagulant or surgical: thrombectomy or nephrectomy. In cases where the underlying parenchymal disease exists, aggresive therapeutic approach is not recommended, but in acute idiopathic TVR immediate recanalisation of the renal vein is the most effective.

  5. Deep Vein Thrombosis (DVT) / Pulmonary Embolism (PE) - Blood Clot Forming in a Vein

    Science.gov (United States)

    ... Recommend on Facebook Tweet Share Compartir Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often underdiagnosed and serious, but preventable medical conditions. Deep vein thrombosis (DVT) is a medical condition that occurs when ...

  6. Thrombosis of the Abdominal Veins in Childhood

    Directory of Open Access Journals (Sweden)

    Riten Kumar

    2017-09-01

    Full Text Available Abdominal venous thrombosis is a rare form of venous thromboembolic disease in children. While mortality rates are low, a significant proportion of affected children may suffer long-term morbidity. Additionally, given the infrequency of these thrombi, there is lack of stringent research data and evidence-based treatment guidelines. Nonetheless, pediatric hematologists and other subspecialists are likely to encounter these problems in practice. This review is therefore intended to provide a useful guide on the clinical diagnosis and management of children with these rare forms of venous thromboembolic disease. Herein, we will thus appraise the current knowledge regarding major forms of abdominal venous thrombosis in children. The discussion will focus on the epidemiology, presentation, diagnosis, management, and outcomes of (1 inferior vena cava, (2 portal, (3 mesenteric, (4 hepatic, and (5 renal vein thrombosis.

  7. Deep Vein Thrombosis after Coronary Angiography

    Directory of Open Access Journals (Sweden)

    Vivek Singh Guleria

    2015-01-01

    Full Text Available Deep vein thrombosis (DVT is a rare but potentially serious complication of coronary angiography (CAG, incidence being just 0.05%. Only a few clinical cases of DVT after diagnostic transfemoral catheterization have been reported. Here, we describe the case of a 54-year-old woman who developed significant DVT after CAG without venous thromboembolism (VTE and, which was treated with anticoagulants.

  8. Brucellosis associated with deep vein thrombosis.

    Science.gov (United States)

    Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah

    2014-11-19

    Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

  9. Brucellosis associated with deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Ilir Tolaj

    2014-11-01

    Full Text Available Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.

  10. Superior mesenteric vein thrombosis: a case report

    International Nuclear Information System (INIS)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de; Marchiori, Edson; Universidade Federal, Rio de Janeiro, RJ; Santos, Alair Augusto S.M.

    1995-01-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs

  11. Deep vein thrombosis: diagnosis, treatment, and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Stewart, W.P.; Youngswick, F.D.

    Deep vein thrombosis (DVT) is a dangerous complication that may present after elective foot surgery. Because of the frequency with which DVT occurs in the elderly patient, as well as in the podiatric surgical population, the podiatrist should be acquainted with this entity. A review of the diagnosis, treatment, prevention, and the role of podiatry in the management of DVT is discussed in this paper.

  12. Diagnosis and treatment of superficial vein thrombosis.

    Science.gov (United States)

    Bauersachs, R M

    2013-08-01

    Superficial vein thrombosis (SVT) is a common disease, characterized by an inflammatory-thrombotic process in a superficial vein. Typical clinical findings are pain and a warm, tender, reddish cord along the vein. Until recently, no reliable epidemiological data were available. The incidence is estimated to be higher than that of deep-vein thrombosis (DVT) (1/1000). SVT shares many risk factors with DVT, but affects twice as many women than men and frequently occurs in varicose veins. Clinically, SVT extension is commonly underestimated, and patients may have asymptomatic DVT. Therefore, ultrasound assessment and exclusion of DVT is essential. Risk factors for concomitant DVT are recent hospitalization, immobilization, autoimmune disorders, age > 75 years, prior VTE, cancer and SVT in non-varicose veins. Even though most patients with isolated SVT (without concomitant DVT or PE) are commonly treated with anticoagulation for a median of 15 days, about 8% experience symptomatic thromboembolic complications within three months. Risk factors for occurrence of complications are male gender, history of VTE, cancer, SVT in a non-varicose vein or SVT involving the sapheno-femoral junction (SFJ). As evidence supporting treatment of isolated SVT was sparse and of poor quality, the large, randomized, double-blind, placebo-controlled CALISTO trial was initiated assessing the effect of fondaparinux on symptomatic outcomes in isolated SVT. This study showed that, compared with placebo, 2.5 mg fondaparinux given for 45 days reduced the risk of symptomatic thromboembolic complications by 85% without increasing bleeding. Based on CALISTO and other observational studies, evidence-based recommendations can be made for the majority of SVT patients. Further studies can now be performed in higher risk patients to address unresolved issues.

  13. Gonadal vein tumor thrombosis due to renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Hamidreza Haghighatkhah

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC had a tendency to extend into the renal vein and inferior vena cava, while extension into the gonadal vein has been rarely reported. Gonadal vein tumor thrombosis appears as an enhancing filling defect within the dilated gonadal vein anterior to the psoas muscle and shows an enhancement pattern identical to that of the original tumor. The possibility of gonadal vein thrombosis should be kept in mind when looking at an imaging study of patients with RCC

  14. A superior mesenteric vein thrombosis associated with in vitro fertilization.

    Science.gov (United States)

    Dorais, Jessie; Jones, Kirtly; Hammoud, Ahmad; Gibson, Mark; Johnstone, Erica; Peterson, C Matthew

    2011-02-01

    To describe a case of superior mesenteric vein thrombosis associated with IVF. Case report. University teaching hospital. A 33-year-old female developed progressive abdominal pain several days after ET in her first IVF cycle. A computed tomography scan 12 days after ET showed a superior mesenteric vein thrombosis. Therapeutic anticoagulation. Resolution of the superior mesenteric vein thrombosis with therapeutic anticoagulation. Early diagnosis and treatment of a superior mesenteric vein thrombosis associated with IVF led to a favorable outcome. Endocrine alterations consequent to controlled ovarian hyperstimulation for IVF place patients at risk for thromboembolic events. Thromboembolic events may occur during an IVF cycle in the absence of overt ovarian hyperstimulation, an inherited thrombophilia, or pregnancy. Early diagnosis and treatment of superior mesenteric vein thrombosis can lead to a favorable outcome. Treatment guidelines for superior mesenteric vein thrombosis in setting of IVF are discussed. Published by Elsevier Inc.

  15. Association between superficial vein thrombosis and deep vein thrombosis of the lower extremities.

    Science.gov (United States)

    Binder, Barbara; Lackner, Helmut Karl; Salmhofer, Wolfgang; Kroemer, Susanne; Custovic, Jasmina; Hofmann-Wellenhof, Rainer

    2009-07-01

    To evaluate the occurrence of deep vein thrombosis (DVT) in patients with superficial vein thrombosis (SVT). A prospective study in patients with sonographically proven SVT. Outpatient department of the Department of Dermatology, Medical University of Graz. Patients Forty-six consecutive patients with superficial vein thrombosis were enrolled. Intervention Every patient underwent color-coded duplex sonography of both lower extremities at the beginning of the study. Important risk factors (eg, history of thromboembolic events, recent immobilization, active malignant disease, and the use of oral contraceptives) were investigated. In 24% of our patients, a concomitant, mostly asymptomatic DVT was found. In 73% of these patients, the DVT occurred in the affected leg, in 9% in the contralateral leg, and in 18% in both legs. The calf muscle veins were most commonly involved. In all patients with DVT, the SVT was located on the lower leg and the D-dimer findings were positive. Superficial vein thrombosis is not a life-threatening disease, but the risk of concomitant DVT cannot be ignored. Color-coded duplex sonography should be performed in patients with SVT to rule out DVT.

  16. A complicated case of deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Elena Cerutti

    2011-03-01

    Full Text Available We report a case of a patient with deep vein thrombosis (DVT and pulmonary thromboembolism (PTE associated to portal vein thrombosis (PVT, complicated by hospital-acquired pneumonia (HAP. The pathogenesis of DVT is multifactorial; among risk factors we can list: transitory situations (surgical interventions, infectious diseases with fever, traumas, acquired conditions (neoplasms, antiphospholipid syndrome or genetically determined situations (thrombophilia. PVT of the sovrahepatic veins is responsible for 5-10% of portal hypertension cases in adults and can be associated to local or systemic infections. PVT is present in 10% of patients with cirrhosis and often associated to cancers. It can also complicate a surgery abdominal intervention. HAP is defined as pneumonia that appears for the first time within 48 h of hospital admission. In Internal Medicine Departments the incidence is 7-10 cases/1.000 of hospital admissions, with an important impact in terms of both mortality and morbility. An early diagnosis, together with a correct identification of microbiologic agents in cause, allows a suitable antibiotic therapy with consequent improvement of clinical prognosis and a meaningful reduction of mortality. Main risk factors are: age, hospital and department. An important variable to be considered is the onset of pneumonia. The later is the onset of HAP (5 or more days from the admission to hospital, the more often is associated to multidrug resistant (MRD microorganisms, poorly responsive to antibiotic.

  17. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  18. Recurrence of superficial vein thrombosis in patients with varicose veins.

    Science.gov (United States)

    Karathanos, Christos; Spanos, Konstantinos; Saleptsis, Vassileios; Tsezou, Aspasia; Kyriakou, Despina; Giannoukas, Athanasios D

    2016-08-01

    To investigate which factors other than history of superficial vein thrombosis (SVT) are associated with recurrent spontaneous SVT episodes in patients with varicose veins (VVs). Patients with a history of spontaneous SVT and VVs were followed up for a mean period of 55 months. Demographics, comorbidities, and thrombophilia screening test were analyzed. Patients were grouped according to the clinical-etiology-anatomy-pathophysiology classification. A multiple logistic regression analysis with the forward likelihood ratio method was undertaken. Thirteen patients out of 97 had a recurrence SVT episode during the follow-up period. All those patients were identified to have a thrombophilia defect. Protein C and S, antithrombin, and plasminogen deficiencies were more frequently present in patients without recurrence. Gene mutations were present in 38% in the nonrecurrence group and 77% in the recurrence group. After logistic regression analysis, patients with dislipidemia and mutation in prothrombin G20210A (FII) had an increased risk for recurrence by 5.4-fold and 4.6-fold, respectively. No deep vein thrombosis or pulmonary embolism occurred. Dislipidemia and gene mutations of F II are associated with SVT recurrence in patients with VVs. A selection of patients may benefit from anticoagulation in the short term and from VVs intervention in the long term. © The Author(s) 2015.

  19. Endovascular Treatment of Deep Vein Thrombosis.

    Science.gov (United States)

    Javier, Julian J

    2014-10-01

    Venous thromboembolism (VTE) is associated with substantial morbidity and mortality. Conventional treatment with anticoagulation therapy may undertreat the condition. Patients with VTE are at risk for recurrence with increasing time passage. Endovascular approaches exist for treating VTE, including deep vein thrombosis, but it is unclear which patients are appropriate candidates for endovascular versus medical approaches. Many new endovascular technologies are in development, and new oral anticoagulants are also on the market. Clinicians must be mindful of these new products and use them appropriately to better manage VTE. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Deep vein thrombosis chemoprophylaxis in plastic surgery.

    Science.gov (United States)

    Gold, Alan

    2013-07-01

    The practice of plastic surgery is a unique mixture of art and science, and both must be carefully balanced to provide the best possible care for patients. To do that, clinicians should be practicing evidence-based medicine. This article discusses the prevalence and risks associated with deep vein thrombosis and the reasons and options for its possible chemoprophylaxis. Until evidence-based medicine best-practice recommendations can be developed, it would be prudent for clinicians to empirically select and consistently apply a risk stratification system and prophylaxis regimen of their choice for the benefit of their patients. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. JAK2V617F: Is It Sufficient as a Single Player in Splanchnic Venous Thrombosis?

    Directory of Open Access Journals (Sweden)

    Pratibha Dhiman

    2015-01-01

    Full Text Available Splanchnic venous thrombosis (SVT includes thrombosis of the hepatic, portal, and mesenteric venous system. Myeloproliferative neoplasms (MPNs are important factors of SVT in adults. Addition of JAK2V617F mutation in WHO criteria for diagnosis of MPNs has made this test a useful tool for diagnosis. JAK2 is an intracytoplasmic tyrosine kinase that plays a critical role in signal transduction from multiple hematopoietic factor receptors. The mutation is found frequently in patients with SVT; many such patients have no other manifestations of an MPN. Although the correlation of JAK2V617F mutation with thrombotic risk in MPNs has been shown in many studies, the impact of presence of additional thrombophilic factors in these cases is yet not known. As the management of MPNs remains highly dependent on the patient’s thrombotic risk, it is important to assess the thrombotic risk factors in detail. Here, we report two cases of JAK2V617F positive MPN who also had other thrombophilic conditions and presented with recurrent thrombosis.

  2. The association of the JAK2 46/1 haplotype with non-splanchnic venous thrombosis.

    Science.gov (United States)

    Zerjavic, Katja; Zagradisnik, Boris; Lokar, Lidija; Krasevac, Marjana G; Vokac, Nadja K

    2013-08-01

    The inherited JAK2 46/1 haplotype is strongly associated with the development of myeloproliferative neoplasms (MPNs), and its increased frequency has also been reported in splanchnic venous thrombosis (SVT). In the present study, the role of the JAK2 46/1 haplotype in non-splanchnic venous thrombosis (non-SVT) was investigated. We genotyped 438 patients with non-SVT, 226 patients with MPNs and 459 healthy controls for three single nucleotide polymorphisms (SNPs) which tag the JAK2 46/1 haplotype (rs12342421 G>C, rs12343867 T>C and rs10974944 C>G). We found statistically significant association of the rs12342421 GC+CC genotypes (OR=1.40; p=0.023) and the rs12343867 TC+CC genotypes (OR=1.83; p=7.02 x 10(-5)) with non-SVT. We also found that the CC haplotype of these two SNPs was associated with an increased risk of the disease (OR=1.68; p=0.009). Stratification analysis indicated that the observed association of the JAK2 46/1 haplotype with non-SVT was probably largely free of confounding effect of thrombophilic risk factors. In addition, we established a strong association of SNPs rs12342421 and rs10974944 and their CG haplotype with MPNs and with JAK2 V617F-positive MPNs. This study provides statistical evidence that SNPs rs12342421 and rs12343867 are associated with an increased risk of non-SVT. Consistently, haplotypes of the SNPs were also associated with non-SVT risk, suggesting that inherited genetic variation in the JAK2 gene may play a role in the pathogenesis of non-SVT. Furthermore, the reported associations of the JAK2 46/1 haplotype with MPNs as well as with the occurrence of the JAK2 V617F mutation in MPNs were confirmed. © 2013.

  3. Deep Vein Thrombosis: Symptoms, Diagnosis, Treatment and Latest NIH Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Deep Vein Thrombosis Deep Vein Thrombosis: Symptoms, Diagnosis, Treatment and Latest NIH Research Past ... Symptoms The signs and symptoms of deep vein thrombosis (DVT) may be related to DVT itself or ...

  4. Acute partial Budd-Chiari syndrome and portal vein thrombosis in cytomegalovirus primary infection: a case report

    Directory of Open Access Journals (Sweden)

    Morard Isabelle

    2006-03-01

    Full Text Available Abstract Background Splanchnic vein thrombosis may complicate inherited thrombotic disorders. Acute cytomegalovirus infection is a rare cause of acquired venous thrombosis in the portal or mesenteric territory, but has never been described extending into a main hepatic vein. Case presentation A 36-year-old immunocompetent woman presented with acute primary cytomegalovirus infection in association with extensive thrombosis in the portal and splenic vein. In addition, a fresh thrombus was evident in the right hepatic vein. A thorough evaluation for a hypercoagulable state was negative. The clinical course, biological evolution, radiological and histological findings were consistent with cytomegalovirus hepatitis complicated by a partial acute Budd-Chiari syndrome and portal thrombosis. Therapeutic anticoagulation was associated with a slow clinical improvement and partial vascular recanalization. Conclusion We described in details a new association between cytomegalovirus infection and acute venous thrombosis both in the portal vein and in the right hepatic vein, realizing a partial Budd-Chiari syndrome. One should be aware that this rare thrombotic event may be complicated by partial venous outflow block.

  5. Portal vein thrombosis after splenectomy for beta-thalassemia major

    International Nuclear Information System (INIS)

    Al-Hawsawi, Zakaria M.; Tarawah, Ahmed M.; Hassan, Ruhul Amin A.; Haouimi, Ammar S.

    2004-01-01

    Portal vein thrombosis is a recognized complication after splenectomy for beta-thalassemia major due to the chronic hypercoagulable state which has been recognized to exist in childhood thalassemia and contribute to thromboembolic events. We reporting one patient with beta-thalassemia major developed portal vein thrombosis following splenectomy. (author)

  6. Ovarian vein thrombosis | Jenayah | Pan African Medical Journal

    African Journals Online (AJOL)

    Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the postpartum patients, with anticoagulation therapy being the current recommendation. Key words: Ovarian vein thrombosis, postpartum, ...

  7. Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia ...

    African Journals Online (AJOL)

    Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia. Emmanuel K Srofenyoh, Ali Samba, Enyonam Y Kwawukume. Abstract. Deep vein thrombosis (DVT) can cause severe morbidity in the puerperium and, less commonly, during pregnancy. A woman who developed DVT as a result of thrombophilia was ...

  8. HIV Associated Deep Vein Thrombosis: Case Reports from Jos ...

    African Journals Online (AJOL)

    Deep vein thrombosis (DVT) has been reported to be 2-10 times commoner in HIV infected patients than in the general population. We report two cases of extensive unilateral deep vein thrombosis involving the lower limb in HIV infected patients on highly active antiretroviral therapy (HAART). Doppler ultrasound in the two ...

  9. Ovarian vein thrombosis – a rare but important complication of ...

    African Journals Online (AJOL)

    When associated with parturition, ovarian vein thrombosis usually becomes apparent within the first week after delivery,[4] with significant clinical symptoms often mimicking appendicitis.[5]. The morbidity of ovarian vein thrombosis arises from complications such as sepsis, extension of the thrombus to the inferior vena cava ...

  10. The management of mesenteric vein thrombosis: a single institution's experience.

    Science.gov (United States)

    Yanar, Fatih; Ağcaoğlu, Orhan; Gök, Ali Fuat Kaan; Sarıcı, Inanç Samil; Ozçınar, Beyza; Aksakal, Nihat; Aksoy, Murat; Ozkurt, Enver; Kurtoğlu, Mehmet

    2013-05-01

    Mesenteric vein thrombosis occurs rarely and is responsible for approximately 5-15% of all cases of acute mesenteric ischemia. The aim of this report was to discuss the management of mesenteric vein thrombosis based on our experience with 34 patients. In the present study, 34 patients who were admitted to our emergency surgery department between January 2007 and January 2010 with a diagnosis of acute mesenteric vein thrombosis were assessed retrospectively. Patients with peritoneal signs first underwent diagnostic laparoscopy to rule out perforation or bowel gangrene. We performed a second-look laparoscopy within 72 hours of the first operation. All patients were administered 100 mg/kg of the anticoagulant enoxaparin twice daily. In the 6th and 12th months of follow up, CT angiography was performed to evaluate recanalization of the veins. CT angiography revealed superior mesenteric vein thrombosis in 25 (73%) patients, portal vein thrombosis in 24 (70%) patients, and splenic vein thrombosis in 12 (35%) patients. Eleven patients with peritoneal signs underwent diagnostic laparoscopy; eight of the patients underwent small bowel resection, anastomosis, and trocar insertion. During second-look laparoscopy, small bowel ischemia was found in two patients and re-resection was performed. Early diagnosis with CT angiography, surgical and non-surgical blood flow restoration, proper anticoagulation, and supportive intensive care are the cornerstones of successful treatment of mesenteric vein thrombosis.

  11. On the dragnosis of deep vein thrombosis

    International Nuclear Information System (INIS)

    Olsson, C.-G.

    1979-01-01

    Clinical and laboratory diagnostic methods were studied in 301 consecutive patients with suspected deep vein thrombosis (DVT). Unexpectedly, phlebography (the reference method) was found to cause DVT in estimated 48 % of patients without initial DVT. Using a new type of contrast medium, however, no thrombotic complications were found. - Neither clinical examination nor plethysmography were found to give reliable results. Using a modified technique for radioisotope detection, high sensitivity to DVT was found with the 125 I-fibrinogen uptake test (within 2 days) and a newly developed 99 Tcsup(m)-plasmin test (within one hour). Since both tests showed low specificity, they are reliable as screening tests to exclude DVT, but not as independent diagnostic methods. (author)

  12. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

    Directory of Open Access Journals (Sweden)

    Asli Bostanci

    2015-01-01

    Full Text Available Internal jugular vein thrombosis (IJVT is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications.

  13. Two cases of jugular vein thrombosis in severely burned patients

    Directory of Open Access Journals (Sweden)

    Cen H

    2013-07-01

    Full Text Available Hanghui Cen, Xiaojie HeDepartment of Burn, The Second Affiliated Hospital, Zhejiang University Medical College, Hangzhou, People’s Republic of ChinaAbstract: Here we present two cases of jugular vein thrombosis in burn patients, with diagnosis, risk factor analysis, and treatment approaches. Severely burned patients have high risk of deep vein thrombosis occurrence due to multiple surgeries. The deep vein catheter should be carefully performed. Once deep vein thrombosis is detected, a wide ultrasonography helps to find other thrombosis sites. During the acute phase, low molecular weight heparin can be used. Upon long-term anti-thrombosis treatment, combined use of herbal medicine during rehabilitation is helpful.Keywords: burn, heparin, combined treatment

  14. Ovarian vein thrombosis | Jenayah | Pan African Medical Journal

    African Journals Online (AJOL)

    ... surgery, pelvic inflammatory disease, or malignancy. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the postpartum patients, with anticoagulation therapy being the current recommendation.

  15. Ovarian vein thrombosis – a rare but important complication of ...

    African Journals Online (AJOL)

    This case study highlights the clinical importance of ovarian vein thrombosis in the context of pelvic surgery for benign gynaecological conditions and the role of imaging, particularly computed tomography with reformatting, in confirming the diagnosis.

  16. Plantar vein thrombosis: a rare cause of plantar foot pain

    Energy Technology Data Exchange (ETDEWEB)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G. [Beth Israel Deaconess Medical Center, Department of Radiology, Boston, MA (United States); Challies, Tracy [Beth Israel Deaconess Medical Center, Department of Pathology, Boston, MA (United States)

    2008-03-15

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  17. Plantar vein thrombosis: a rare cause of plantar foot pain

    International Nuclear Information System (INIS)

    Siegal, Daniel S.; Wu, Jim S.; Brennan, Darren D.; Hochman, Mary G.; Challies, Tracy

    2008-01-01

    Plantar vein thrombosis is a rare condition, with only a handful of cases reported in the literature. The cause is unknown; however, the disease has been attributed to prior surgery, trauma, and paraneoplastic conditions. We present a case of a 32-year-old female runner with plantar vein thrombosis diagnosed on contrast-enhanced MRI and confirmed on ultrasound. The symptoms resolved with conservative treatment and evaluation revealed the presence of a prothrombin gene mutation and use of oral contraceptive pills. To our knowledge, this is the first case of plantar vein thrombosis diagnosed initially by MRI. Moreover, this case suggests that plantar vein thrombosis should be considered in patients with hypercoagulable states and plantar foot pain. (orig.)

  18. Extrahepatic portal vein thrombosis : aetiology and determinants of survival

    NARCIS (Netherlands)

    Janssen, HLA; Haagsma, EB; van Uum, SHM; van Nieuwkerk, CMJ; Adang, RP; Chamuleau, RAFM; van Hattum, J; Vleggaar, FP; Hansen, BE; Rosendaal, FR; van Hoek, B

    2001-01-01

    Background-Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with, EPVT may be associated with these concurrent medical conditions or with

  19. Extrahepatic portal vein thrombosis: aetiology and determinants of survival

    NARCIS (Netherlands)

    H.L.A. Janssen (Harry); B.E. Hansen (Bettina); B. van Hoek (Bart); F.R. Rosendaal (Frits); E.B. Haagsma (Els); S.H. van Uum; C.M. van Nieuwkerk; R.P.R. Adang (Rob); R.A. Chamuleau; J. van Hattum (Jan); F.P. Vleggaar (Frank); A.D. Wijnhoud (Annemarie)

    2001-01-01

    textabstractBACKGROUND: Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with EPVT may be associated with these concurrent medical

  20. Portal vein thrombosis; risk factors, clinical presentation and treatment

    DEFF Research Database (Denmark)

    Sogaard, Kirstine K; Astrup, Lone B; Vilstrup, Hendrik

    2007-01-01

    BACKGROUND: Portal vein thrombosis (PVT) is increasingly frequently being diagnosed, but systematic descriptions of the natural history and clinical handling of the condition are sparse. The aim of this retrospective study was to describe risk factors, clinical presentation, complications...

  1. Postpartum Ovarian Vein Thrombosis: Two Cases and Review of Literature

    Directory of Open Access Journals (Sweden)

    Amos A. Akinbiyi

    2009-01-01

    Conclusion. Ovarian vein thrombosis is rare, but could present late, and difficult to diagnose, hence, should be considered as a differential diagnosis in a postpartum woman with fever and tender pelvic mass.

  2. Adult adrenal haemorrhage: an unrecognised complication of renal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Loke, T.K.L. E-mail: lokekl@ha.org.hk

    2001-07-01

    There are many predisposing factors for neonatal adrenal haemorrhage but the causative factors are different in adults. Several cases of neonatal adrenal haemorrhage have been reported in association with renal vein thrombosis. This complication has not been documented in the adults. The presence of an adrenal mass in the setting of renal vein thrombosis should raise the possibility of adrenal haemorrhage even though this is extremely uncommon in adults.

  3. Superficial vein thrombosis in non-varicose veins of the lower limbs and thrombophilia.

    Science.gov (United States)

    Lucchi, Gabriella; Bilancini, Salvino; Tucci, Sandro; Lucchi, Massimo

    2017-01-01

    Objectives Superficial vein thrombosis in non-varicose veins of the lower limbs is rather frequent and may be underestimated. This study aims to evaluate the prevalence of inherited or acquired thrombophilia in a sample of outpatients with the disease. Method An observational study was conducted on 73 consecutive superficial vein thrombosis patients tested for inherited or acquired thrombophilia. Results Sixty of 73 patients with superficial vein thrombosis completed the testing protocol, while 13 dropped out; 46 of 60 patients were found to have a thrombophilia (76.6%). The types detected were: factor V Leiden (31/60, i.e. 51.6%), prothrombin mutation (2/60, i.e. 3.3%), MTHFR mutation (23/60, i.e. 38.3%), antiphospholipid antibodies (5/60, i.e. 8.3%), protein C deficit (1/60, i.e. 1.6%), protein S deficit (1/60, i.e. 1.6%), and antithrombin deficit (0/60, i.e. 0%). Conclusions Among patients with superficial vein thrombosis in non-varicose veins, testing demonstrated a high prevalence of thrombophilia. The most common form proved to be factor V Leiden. As thrombophilia was found to be a major cause of superficial vein thrombosis in non-varicose veins, the authors recommend that patients with superficial vein thrombosis in non-varicose veins be investigated for thrombophilia.

  4. A retrospective analysis of patients treated for superficial vein thrombosis

    NARCIS (Netherlands)

    Wichers, I. M.; Haighton, M.; Büller, H. R.; Middeldorp, S.

    2008-01-01

    Introduction: The absolute risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) as well as extension and/or recurrence in superficial vein thrombosis (SVT) of the leg is considerable and underestimated. We retrospectively evaluated therapeutic management, thrombophilic risk factors and

  5. Detection of deep vein thrombosis with I-123 plasminogen

    International Nuclear Information System (INIS)

    Smal, F.; Schonne, E.; Mahieu, P.; Verhas, M.; Schoutens, A.

    1982-01-01

    An experience with I-123 plasminogen used to investigate patients with clinically suspected deep vein thrombosis is reported. The test is efficient, not invasive and produces no discomfort on the contrary to venography. The test is not sensitive to heparine therapy since 5 thrombosis were detected in patients under heparine. Certain false positive results such as those due to Erysipelas can be foreseen by careful clinical investigation. False negative cases were due to very old thrombi or superficial thrombosis without clinical consequences

  6. Cerebral Vein Thrombosis Post Cabg Precipitated by Malposition of ...

    African Journals Online (AJOL)

    CASE DETAILS: In this case report, we described the clinical and radiological findings of a patient who developed cerebral vein thrombosis post coronary artery bypass grafting secondary undiagnosed protein C and S deficiency which was precipitated by malposition of subclavian central catheter into internal jugular vein.

  7. Thrombolysis for acute upper extremity deep vein thrombosis

    DEFF Research Database (Denmark)

    Feinberg, Joshua; Nielsen, Emil Eik; Jakobsen, Janus C

    2017-01-01

    BACKGROUND: About 5% to 10% of all deep vein thromboses occur in the upper extremities. Serious complications of upper extremity deep vein thrombosis, such as post-thrombotic syndrome and pulmonary embolism, may in theory be avoided using thrombolysis. No systematic review has assessed the effect...

  8. Early Diagnosis of Posttraumatic Deep Vein Thrombosis - A Review ...

    African Journals Online (AJOL)

    OBJECTIVE: The importance of early diagnosis and treatment of deep vein thrombosis in patients with fractures of long bones. INTRODUCTION: Associated injury to deep-veins in limb fractures presents a serious pathology. It results not only to localized venous occlusion but also to death from pulmonary embolism.

  9. Upper extremity deep vein thrombosis after elbow trauma: a case ...

    African Journals Online (AJOL)

    ... K antagonists was conducted and evaluation by Doppler ultrasonography realized 18 months after trauma showed recanalization of basilica and humeral veins and thrombosis of axillary and subclavian veins. Management of occupational activity was prescribed including eviction of heavy loads handling and repetitive ...

  10. Deep vein thrombosis as a paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Klačar Marija

    2014-01-01

    Full Text Available Introduction: Several conditions represent the risk factor for deep vein thrombosis (DVT but sometimes it occurs with no apparent reason. DVT usually involve lower extremities. It can be a component of paraneoplastic syndrome, and occasionally it is the first manifestation of malignancy. Case report: Fifty-five years old male reported to his general practitioner with history of painless right leg swelling of three weeks duration. He denied leg trauma or any other hardship. The patient had a long history of hypertension and took his medications irregularly. Family history was positive for cardiovascular diseases but negative for metabolic diseases or malignancies. He was a smoker and physically active. Physical examination revealed right calf swelling without skin discoloration, distention of superficial veins or trophic changes. Pulses of magistral arteries of the leg were symmetrical, Homans' sign was positive on the right leg. The rest of the physical examination was normal, except for the blood pressure. He was referred to vascular surgeon with the clinical diagnosis of femoro- popliteal phlebothrombosis of the right leg. Vascular surgeon performed the Color duplex scan of the lower extremities which confirmed the diagnosis. The patient was treated with low-molecular-weight heparin. The swelling significantly subsided after two weeks of therapy, but then patient fell and fractured left ramus of ischial bone. X-ray examination of pelvis revealed both fracture line and osteoblastic deposits in pelvis and the fracture was pronounced pathological. In order to localize the primary tumor, subsequent tests included chest X-ray, abdominal and pelvic ultrasound and digitorectal examination of prostate were performed. The results of all of the above mentioned examinations were within normal ranges, including routine blood tests. Skeletal scintigraphy revealed multiple secondary deposits in pelvic bones, vertebral column and ribs. Tumor markers' values

  11. Risk factors and outcome of splanchnic venous thrombosis in patients with necrotizing acute pancreatitis.

    Science.gov (United States)

    Zhou, Jing; Ke, Lu; Tong, Zhihui; Li, Gang; Li, Weiqin; Li, Ning; Li, Jieshou

    2015-01-01

    Splanchnic venous thrombosis (SVT) is considered a rare but important complication in patients with acute pancreatitis (AP) and literatures regarding this topic were sparse. The aim of the present study was to investigate the risk factors of SVT in necrotizing acute pancreatitis (NAP) and assess the prognosis of these patients. Both univariate and multivariate logistic regression analyses were applied using 15 indices including age, gender, Acute Physiology and Chronic Health Evaluation II scores (APACHE II), CRP (C - reactive protein) levels, etc to explore potential risk factors for the development of SVT in NAP patients. Moreover, clinical outcome measures such as mortality, organ failure and length of hospital and ICU stay were also compared between NAP patients with or without SVT. According to the statistical results, only intra-abdominal pressure (IAP) was proved to be an independent risk factor for SVT (OR, 1.283; 95% CI, 1.091-1.509,P=0.003). In addition, Balthazar's CT score and occurrence of IPN (infected pancreatic necrosis) also reached statistical significance (P=0.040 and 0.047, respectively), but the 95% confidence interval shown in the multivariate logistic regression suggested that the observed ORs are not significant (1.326;95% CI 0.984-1.787 and 2.61;95 CI 0.972-7.352, respectively), which indicates weaker association between the two parameters and SVT. Regarding the clinical outcomes, patients with SVT showed higher mortality, longer hospital and intensive care unit duration, higher rates of a variety of complications and more utilization of invasive interventions. IAP is an independent risk factor for the development of SVT in patients with NAP, while Balthazar's CT score and occurrence of IPN are also associated with SVT, although not as strong as IAP. Moreover, occurrence of SVT relates with extremely poor prognosis in NAP patients, evidenced by increased mortality, morbidity and need for invasive interventions. Copyright © 2014 Elsevier

  12. Patterns in the management of superficial vein thrombosis.

    Science.gov (United States)

    Karathanos, Christos; Spanos, Konstantinos; Lachanas, Vasileios; Athanasoulas, Athanasios; Giannoukas, Athanasios D

    2017-04-01

    Objective To highlight current practice patterns in management of superficial vein thrombosis. Methods An electronic survey was conducted using the mailing lists of the Mediterranean League of Angiology and Vascular Surgery and European Venous Forum regarding superficial vein thrombosis diagnosis, investigation, and treatment. Results The response rate was 41% (175/430) and the majority of the participants were vascular surgeons practicing in a hospital. More experienced physicians considered superficial vein thrombosis as a medical issue of moderate seriousness and performed duplex ultrasound for confirmation of diagnosis. Elastic stockings were recommended by 87% of the physicians, while 57% prescribed nonsteroidal anti-inflammatory drugs. Eighty six percent advised anticoagulation, although a large disparity was shown regarding regime, dose, and duration. Thrombophilia test was regularly suggested by 19% of the physicians. Ligation of the saphenofemoral junction was the treatment of choice by those who suggested intervention in the acute phase of superficial vein thrombosis. Conclusions A great disparity exists in the management of superficial vein thrombosis. Current guidelines have not been adopted by physicians; more focused training is needed for those involved in the management of venous diseases.

  13. Clinically silent deep vein thrombosis in patients with superficial thrombophlebitis and varicose veins at legs.

    Science.gov (United States)

    Jerkic, Zoran; Karic, Alen; Karic, Amela

    2009-01-01

    Although superficial thrombophlebitis is a common disorder until recently it was considered as benign disorder. Also it is associated with varicose vein at legs and it was treated effectively with conservative methods, walking and non-steroid anti-inflammatory drugs. Aims of our investigation were: determine frequency of clinically silent deep vein thrombosis at legs in patient with and without superficial thrombophlebitis, determine correlation between superficial thrombophlebitis and deep vein thrombosis regardless of localization of superficial thrombophlebitis in superficial veins of legs and determine adequacy and safety vein phlebography in early diagnosis clinically silent deep vein thrombosis in patients with superficial thrombophlebitis. Using flebography in prospective study was evaluated incidence of clinically silent deep vein thrombosis in 92 patients with varicose veins at legs. By phlebograpy in patients with varicose veins at legs and superficial thrombophlebitis at legs and without clinical signs of DVT at legs of the 49 patients we detected DVT in 12 patients (24, 48%), in three male and nine female. We detected localization of DVT in ilijacofemoral junction in 4,08% patients, although localization of DVT in femoropopliteal region was observed in 6, 12% patients and localization in crural region was in 14.28% patients. Localization of DVT at legs was detected in iliac vein in 16.66% patients, in femoral vein in 25% patients, popliteal vein 8.33% patients, anterior tibial vein 16.66%, posterior tibial vein in 25% and crural veins 8.33% patients. Also we deduced significant difference between two group of patients (chi2 = 10, 76). Such result proves thesis that in most patients with superficial thrombophlebitis and varicose veins is possibility of developing of DVT.

  14. Pulmonary Septic Emboli due to Azygos Vein Septic Thrombosis

    Directory of Open Access Journals (Sweden)

    Ginius Pradhan

    2013-01-01

    Full Text Available The triad of extrapulmonary infection, contiguous septic vein thrombosis, and septic pulmonary embolism is a rare complex but associated with significant morbidity and mortality. Septic azygos vein thrombosis is extremely rare and potentially serious since it may also cause pulmonary emboli and sudden death. We report a case of a 32-year-old woman with history of IV drug abuse who presented with epidural abscess and methicillin-resistant S. aureus (MRSA bacteremia. Later she developed signs of septic pulmonary embolism secondary to septic azygos vein thrombosis. With early diagnosis, appropriate antimicrobial therapy, and control of the infectious source, resolution of the illness can be expected for most patients with avoidance of potential complications.

  15. A Rare Complication of Acute Appendicitis: Superior Mesenteric Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hendra Koncoro

    2016-12-01

    Full Text Available Superior mesenteric vein (SMV thrombosis caused by acute appendicitis is quite rare nowadays. These conditions occurs secondary to infection in the region drained by the portal venous system. In this case, we report a successfully treated case of SMV thrombosis and liver abscess associated with appendicitis with antibiotics and anticoagulant.Early diagnosis and prompt treatment are basic to a favorable clinical course.

  16. Evaluation of apoptosis in varicose vein disease complicated by superficial vein thrombosis.

    Science.gov (United States)

    Filis, Konstantinos; Kavantzas, Nikolaos; Dalainas, Ilias; Galyfos, George; Karanikola, Evridiki; Toutouzas, Konstantinos; Tsioufis, Constantinos; Sigala, Fragiska

    2014-07-01

    The factors contributing to superficial vein thrombosis (SVT) in patients with varicose vein disease are unclear. Differences in vein wall apoptotic activity could be associated with the pathogenesis of SVT. The aim of the study is to address the role of the programmed cell death in the vein wall by comparing varicose veins with history of SVT to uncomplicated varicose veins. Vein segments from the proximal part of the great saphenous vein (GSV), the distal part of the vein and from a varicose tributary, from 16 patients with varicose vein disease and one episode of SVT, were evaluated for the immunohistochemical expression of pro-apoptotic (Bax, p53, Caspase 3, BCL-6, BCL-xs), anti-apoptotic (BCL-xl and BCL-2) and proliferation (Ki-67) markers. The results of this study were compared to the results from the evaluation of 19 patients suffering from uncomplicated varicose vein disease and 10 healthy GSVs as controls. Overall, there was increased apoptosis in the distal part of GSV compared to the proximal part documented by increased expression of Bax (p veins and patients with a history of SVT showed significant differences among the three different anatomic locations. In the proximal GSV, only BCL-xs was higher in patients with SVT (p = 0.029). In the tributaries, Bax, BCL-xl and Ki-67 were higher in patients with SVT (p thrombosis group compared to uncomplicated veins (p vein wall in SVT shows increased pro-apoptotic activity compared to uncomplicated disease and normal veins. Whether increased vein wall cell apoptosis is a causative factor for SVT in varicose veins disease or a repairing mechanism of the thrombosis itself needs further research.

  17. Case report: Limb-threatening femoral vein thrombosis in a healthy carpet fitter: Carpet fitter's thrombosis.

    Science.gov (United States)

    Rothnie, Alex; Aga, Sarah; Vijayaragahavan, Santhosh; Nyamekye, Isaac

    2016-07-01

    To report a case of femoral vein thrombosis in a carpet fitter and to highlight this as an occupational hazard. Case presentation and literature review. An otherwise fit 21-year-old carpet fitter with no past medical history presented with acute thrombosis of his left common femoral, superficial femoral and great saphenous veins. Attempted catheter directed thrombolysis was unsuccessful. Due to severe pain and the threat of venous gangrene he was treated by emergency surgical thrombectomy with excision of chronic venous scarring and vein-patch repair that led to resolution of his symptoms. Deep vein thrombosis is typically associated with factors such as increasing age and prolonged periods of immobility; however, certain 'active' occupations can increase its risk. Crouched and cramped working conditions including repetitive active movement with flexed hips and knees can predispose to increased risk of venous thromboembolism. © The Author(s) 2015.

  18. [Diagnostic strategy in patients with clinically suspected deep vein thrombosis

    DEFF Research Database (Denmark)

    Mantoni, Margit Yvonne; Kristensen, M.; Brogaard, M.H.

    2008-01-01

    INTRODUCTION: The standard method for diagnosing deep vein thrombosis (DVT) involves determination of D-dimer and ultrasound scanning. In an attempt to reduce the number of ultrasound examinations we have supplemented this with a clinical probability estimate for DVT (DVT-score) over one year...

  19. Deep Vein Thrombosis: Risk Factors and Prevention in Surgical ...

    African Journals Online (AJOL)

    BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously by many ...

  20. Evaluation of clinical model for deep vein thrombosis: a cheap ...

    African Journals Online (AJOL)

    Background: Deep vein thrombosis is an important cause of morbidity and mortality worldwide. The clinical features are non-specific and the clinical diagnosis is unreliable. The objective testing for the correct diagnosis is not usually available in most developing countries and the expertise are not readily available couple ...

  1. Effect of Helicobacter pylori infection on deep vein thrombosis seen ...

    African Journals Online (AJOL)

    Objective: To investigate the role of homocysteine metabolism due to Helicobacter pylori infection on the development of deep vein thrombosis (DVT) in patients with Behcet's disease (BD). Design: Prospective clinical study. Setting: Teaching hospital. Subject: Fifty-five patients with BD divided into groups, with DVT and ...

  2. Extrahepatic portal vein thrombosis: aetiology and determinants of survival

    NARCIS (Netherlands)

    Janssen, H. L.; Wijnhoud, A.; Haagsma, E. B.; van Uum, S. H.; van Nieuwkerk, C. M.; Adang, R. P.; Chamuleau, R. A.; van Hattum, J.; Vleggaar, F. P.; Hansen, B. E.; Rosendaal, F. R.; van Hoek, B.

    2001-01-01

    Malignancy, hypercoagulability, and conditions leading to decreased portal flow have been reported to contribute to the aetiology of extrahepatic portal vein thrombosis (EPVT). Mortality of patients with EPVT may be associated with these concurrent medical conditions or with manifestations of portal

  3. Clinical Management of Acute Portal/Mesenteric Vein Thrombosis

    Science.gov (United States)

    Lang, Sven A.; Loss, Martin; Wohlgemuth, Walter A.; Schlitt, Hans J.

    2014-01-01

    Background Acute thrombosis of the portal vein (PV) and/or the mesenteric vein (MV) is a rare but potentially life-threatening disease. A multitude of risk factors for acute portal vein thrombosis (PVT)/mesenteric vein thrombosis (MVT) have been identified, including liver cirrhosis, malignancy, coagulation disorders, intra-abdominal infection/inflammation, and postoperative condition. Methods This article analyses the treatment options for acute PVT/MVT. Results Initially, the clinical management should identify patients with an intra-abdominal focus requiring immediate surgical intervention (e.g. bowel ischaemia). Subsequently, emphasis is placed on the recanalization of the PV/MV or at least the prevention of thrombus extension to avoid long-term complications of portal hypertension. Several therapeutic options are currently available, including anticoagulation therapy, local/systemic thrombolysis, interventional or surgical thrombectomy, and a combination of these procedures. Due to the lack of prospective randomized studies, a comparison between these therapeutic approaches regarding the efficacy of PV/MV recanalization is difficult, if not impossible. Conclusion In patients with acute PVT/MVT, an individualized treatment based on the clinical presentation, the underlying disease, the extent of the thrombosis, and the patients' comorbidities is mandatory. Therefore, these patients should be considered for an interdisciplinary therapy in specialized centres with the option to utilise all therapeutic approaches currently available. PMID:26285602

  4. effect of helicobacter pylori infection on deep vein thrombosis seen ...

    African Journals Online (AJOL)

    hi-tech

    Objective: To investigate the role of homocysteine metabolism due to Helicobacter pylori infection on the development of deep vein thrombosis (DVT) in patients with Behcet's disease (BD). Design: Prospective clinical study. Setting: Teaching hospital. Subject: Fifty-five patients with BD divided into groups, with DVT and ...

  5. Peripherally inserted central catheters and upper extremity deep vein thrombosis

    International Nuclear Information System (INIS)

    Ong, B.; Gibbs, H.; Catchpole, I.; Hetherington, R.; Harper, J.

    2006-01-01

    The purpose of the study was to determine the incidence and risk factors for venous thrombosis in patients with a peripherally inserted central catheter (PICC). A retrospective study of all upper extremity venous duplex scans was carried out in the Vascular Medicine department from year 2000 to 2002 inclusive. A chart review of positive scans was undertaken to identify possible thrombotic risk factors. Of 317 upper extremity venous duplex scans carried out, 115, or 32%, were positive for upper extremity deep vein thrombosis. Three main risk factors were identified - presence of a central line, malignancy and administration of chemotherapy. PICC were the most common central line present. Symptomatic thrombosis occurred in 7% of PICC inserted for chemotherapy compared with 1% of PICC inserted for other reasons. Ten per cent of the patients receiving chemotherapy through a PICC developed a thrombosis. The post-thrombotic syndrome was infrequent following upper extremity deep vein thrombosis. Patients receiving chemotherapy through a PICC are at increased risk of thrombosis. There may be a role for prophylactic low-dose anticoagulation in these high-risk patients

  6. Superficial vein thrombosis: a current approach to management.

    Science.gov (United States)

    Scott, Gemma; Mahdi, Ali Jassem; Alikhan, Raza

    2015-03-01

    Superficial vein thrombosis (SVT) was considered to be a benign and self-limiting condition. However, it is now appreciated that a significant proportion of those presenting with SVT will have concomitant deep vein thrombosis or pulmonary embolism, or are at significant risk of developing deep venous thromboembolism. Potential therapeutic options include topical preparations, compression therapy (stockings, bandages), medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or anticoagulants (therapeutic or prophylactic doses) and surgery, ligation or stripping, of superficial veins. The treatment of choice is therapeutic/intermediate dose low molecular weight heparin or prophylactic dose fondaparinux administered for 4-6 weeks. The cost-effectiveness of treatment is a concern and more targeted therapy is required. © 2014 John Wiley & Sons Ltd.

  7. Acute superior mesenteric vein thrombosis associated with abdominal trauma

    Science.gov (United States)

    Lim, Kyoung Hoon; Jang, Jihoon; Yoon, Hye Young; Park, Jinyoung

    2017-01-01

    Abstract Rationale: Acute mesenteric vein thrombosis (MVT) is defined as new-onset thrombosis of the mesenteric vein without evidence of collateralization, finally resulting in extensive intestinal infarction. MVT may be idiopathic or be caused by conditions responsible for thrombophilia and acquired risk factors. To date, there have been few reports of MVT after trauma. Herein we describe our experiences treating three patients with MVT. Patient concerns: Case 1 was a 44-year-old man with transverse colon mesenteric hematoma after blunt abdominal trauma. Case 2 was a 55-year-old man with jejunal transection after a traffic accident. Case 3 was a 26-year-old man presented with multiple abdominal stab bowel injury. Diagnoses: A 1-week follow-up abdominal computed tomography scan showed superior mesenteric vein thrombosis in all of three patients. Interventions: All patients were treated with anticoagulant for 3 or 6 months. Outcomes: MVTs were completely resolved without any complications. Lessons: If early diagnosis and treatment could be available, anticoagulation alone might be adequate for the treatment of SMVT associated with trauma. Early anticoagulation in patients with acute SMVT may avoid the grave prognosis observed in patients with arterial thrombosis. PMID:29382004

  8. Diagnostic and therapeutic aspects of deep vein thrombosis

    International Nuclear Information System (INIS)

    Lagerstedt, C.

    1992-01-01

    51 out-patients presenting with calf-vein thrombosis were randomized to treatment with heparin for five days or heparin with subsequent warfarin for three months. Among 23 patients in the warfarin-group no recurrence occurred, whereas 8 of the 28 patients (29%) in the non-warfarin group had recurrent thrombo-embolism during the first 90 days. It is concluded that patients with symptomatic calf-vein thrombi should be treated with both heparin and oral anticoagulation. In a prospective study of X-ray contrast media, post-phlebographic reactions occurred in 7 of 19 patients (37%) investigated with a high-osmolality contrast medium metrizoate whereas no such reaction occurred among 24 patients investigated with a low-osmolality contrast medium iohexol. Thus, low-osmolatily contrast media should preferably be used at phlebography. 396 out-patients with suspected venous thrombosis were investigated with the 99m Tc-plasmin test, physical examination and phlebography. The plasmin test has a high sensitivity (95%) but a low specificity (47%), and was frequently abnormal when clinical signs of inflammation were present. Clinical signs could not accurately predict if thrombosis was present, although subpopulations of patients with high or low probability of venous thrombosis could be identified. 112 patients with suspected DVT were investigated with thermography. Both sensitivity and specificity were low (77% and 66% respectively) and thermography therefore seems not to be useful in the diagnosis of symptomatic venous thrombosis. Long-term sequelae after a first episode of venous thrombosis are mostly mild as long as 6 years after the diagnosis. Venous function correlated to the extension of the thrombus but no to subjective symptoms. Clinical signs at diagnosis could not predict the late outcome. During the six years of follow-up, 28% of the patients had recurrent thrombosis. (158 refs.) (au)

  9. Management Strategy for Patients With Chronic Subclavian Vein Thrombosis.

    Science.gov (United States)

    Keir, Graham; Marshall, M Blair

    2017-02-01

    We performed a systematic review to determine best practice for the management of patients with chronic or subacute subclavian vein thrombosis. This condition is best managed with surgical excision of the first rib followed by long-term anticoagulation. Interventional techniques aimed at restoring patency are ineffective beyond 2 weeks postthrombosis. Additional therapeutic options should be made based on the severity of symptoms as well as vein status. Patients with milder symptoms are given decompression surgery followed by anticoagulation whereas patients with more severe symptoms are considered for either a jugular vein transposition or saphenous patch based on the vein characteristics. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Acute Appendicitis Complicating into Portal and Superior Mesenteric Vein Thrombosis.

    Science.gov (United States)

    Yousaf, Adnan; Ahmed, Mushtaq; Aurangzeb, Mahmud

    2016-06-01

    This case report describes a young man who presented with 9-day history of sudden-onset epigastric and right-sided lower abdominal pain. He was tachycardiac with temperature of 102°F. Tenderness was present in the peri-umbilical area and right iliac fossa. Investigations revealed a raised total leucocyte count (predominantly neutrophilic). Triphasic CTscan abdomen found thrombosis of right portal vein and its hepatic tributaries alongwith superior mesenteric vein (SMV) and its tributaries. Co-existent fluid in right hemipelvis abutting the cecum and appendiceal tip was suggestive of acute appendicitis. He was resuscitated with fluids and analgesics and started on intravenous metronidazole and ceftriaxone. Anticoagulation with subcutaneous heparin was commenced and eventually switched over to warfarin. Appendicectomy was not performed as the patient responded to conservative treatment. Appendicitis is associated with multiple complications but secondary venous thrombosis has rarely been reported with it.

  11. Adventitial cystic disease of the common femoral vein presenting as deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Young-Kyun Kim

    2016-07-01

    Full Text Available Adventitial cystic disease of the common femoral vein is a rare condition. We herein report the case of a 50-year-old woman who presented with painless swelling in her left lower leg that resembled deep vein thrombosis. She underwent femoral exploration and excision of the cystic wall. The presentation, investigation, treatment, and pathology of this condition are discussed with a literature review.

  12. Deep Vein Thrombosis as Initial Manifestation of Whipple Disease

    Directory of Open Access Journals (Sweden)

    Mônica Souza de Miranda Henriques

    2016-11-01

    Full Text Available Introduction: Wipple disease (WD is a rare chronic disease caused by the bacillus Tropheryma whipplei. Constitutive, rheumatologic, gastrointestinal, cardiac, cerebral, lymphatic, cutaneous, and ophthalmological signs are possible systemic symptoms. However, thrombotic manifestations are rarely described as “stroke-like syndrome” or arterial thrombosis. Diagnosis is based on clinical manifestations and pathological examination. Laboratory findings may include anemia, leukocytosis, and thrombocytosis. Objective: We report a case of venous thrombosis as initial manifestation of WD. Case Report: We describe the case of a 53-year-old male with iliofemoral vein thrombosis followed by intermittent diarrhea, loss of appetite, abdominal distension, and bloating. A mild malnutrition state with a weight loss of 13 kg, pallor (+/4 +, presence of lower-limb edema (+/4 +, and hypertympanic distended abdomen occurred. Laboratory tests on admission revealed anemia, positive inflammatory activity tests, and normal coagulation. Endoscopic examination showed villous edema with white dotted infiltrates in the second duodenal portion and intestinal lymphangiectasia in the terminal ileum. Pathological examination revealed numerous macrophages with positive periodic acid-Schiff inclusions. Venous Doppler ultrasound showed extensive deep thrombosis on the left lower limb and recanalization of the femoral vein in the right lower limb. The patient was treated with ceftriaxone and enoxaparin sodium, which led to an improvement of gastrointestinal and thrombosis symptoms. Comments: Hypercoagulability, endothelial damage, vasculitis, and blood stasis are present in T. whipplei infection, which are associated with the activation of inflammatory mechanisms as well as procoagulant and thromboembolic events. WD should be part of the differential diagnosis of diseases that cause venous thrombosis of unknown origin.

  13. Isolated cortical vein thrombosis: systematic review of case reports and case series

    NARCIS (Netherlands)

    Coutinho, Jonathan M.; Gerritsma, Jorn J.; Zuurbier, Susanna M.; Stam, Jan

    2014-01-01

    Isolated cortical vein thrombosis is a distinct subtype of cerebral venous and sinus thrombosis. Because of the rarity of isolated cortical vein thrombosis, limited knowledge on its clinical and radiological manifestations is available. We performed a systematic review of published data. Isolated

  14. Isolated cortical vein thrombosis associated with prothrombin gene mutation.

    Science.gov (United States)

    Giraldo, Elias A; Arora, Rohan; Koenigsberg, Robert A

    2014-04-01

    Isolated cortical vein thrombosis (ICVT) accounts for less than 1% of strokes. We report a 47-year-old female patient who had a frontal hemorrhage with headache associated with contralateral hemiparesis and hemisensory deficit on presentation. This hemorrhagic stroke was localized in a nonarterial territory, and it was caused by ipsilateral and isolated thrombosis of the vein of Labbe found on catheter angiogram that demonstrated a filling defect of the vein of Labbe at its connection with the transverse sinus. There were no filling defects in the superficial middle cerebral veins. Our patient had a family history of cardiovascular disease, stroke, and factor V Leiden mutation and cigarette smoking as stroke risk factors. Complete prothrombotic state laboratory workup revealed a heterozygous prothrombin G20210 A gene mutation. The patient's hospital course was uneventful. Neurologic exam was normal at stroke clinic follow-up 6 weeks later. To our knowledge, this is the first report of an ICVT associated with prothrombin gene mutation. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Diagnostic efficacy of impedance plethysmography for clinically suspected deep-vein thrombosis. A randomized trial

    NARCIS (Netherlands)

    Hull, R. D.; Hirsh, J.; Carter, C. J.; Jay, R. M.; Ockelford, P. A.; Buller, H. R.; Turpie, A. G.; Powers, P.; Kinch, D.; Dodd, P. E.

    1985-01-01

    Impedance plethysmography is an accurate noninvasive method to test for proximal vein thrombosis, but it is insensitive to calf-vein thrombi. We randomly assigned patients on referral with clinically suspected deep-vein thrombosis and normal impedance plethysmographic findings to either serial

  16. Rational classification of portal vein thrombosis and its clinical significance.

    Directory of Open Access Journals (Sweden)

    Jingqin Ma

    Full Text Available Portal vein thrombosis (PVT is commonly classified into acute (symptom duration <60 days and absence of portal carvernoma and portal hypertension and chronic types. However, the rationality of this classification has received little attention. In this study, 60 patients (40 men and 20 women with PVT were examined using contrast-enhanced computed tomography (CT. The percentage of vein occlusion, including portal vein (PV and superior mesenteric vein (SMV, was measured on CT image. Of 60 patients, 17 (28.3% met the criterion of acute PVT. Symptoms occurred more frequently in patients with superior mesenteric vein thrombosis (SMVT compared to those without SMVT (p<0.001. However, there was no significant difference in PV occlusion between patients with and without symptoms. The frequency of cavernous transformation was significantly higher in patients with complete PVT than those with partial PVT (p<0.001. Complications of portal hypertension were significantly associated with cirrhosis (p<0.001 rather than with the severity of PVT and presence of cavernoma. These results suggest that the severity of PVT is only associated with the formation of portal cavernoma but unrelated to the onset of symptoms and the development of portal hypertension. We classified PVT into complete and partial types, and each was subclassified into with and without portal cavernoma. In conclusion, neither symptom duration nor cavernous transformation can clearly distinguish between acute and chronic PVT. The new classification system can determine the pathological alterations of PVT, patency of portal vein and outcome of treatment in a longitudinal study.

  17. Risk factors for upper limb deep vein thrombosis associated with the use of central vein catheter in cancer patients

    NARCIS (Netherlands)

    Verso, Melina; Agnelli, Giancarlo; Kamphuisen, Pieter W.; Ageno, Walter; Bazzan, Mario; Lazzaro, Antonio; Paoletti, Francesco; Paciaroni, Maurizio; Mosca, Stefano; Bertoglio, Sergio

    2008-01-01

    Deep vein thrombosis of upper limb is a common complication of CVC in patients with cancer. In these patients the risk factors for CVC-related thrombosis are not completely defined. The purpose of this study was to identify the risk factors for CVC-related thrombosis in patients included in a

  18. Spontaneous Internal Jugular Vein Thrombosis: A Case Report

    Directory of Open Access Journals (Sweden)

    Mustafa Serinken

    2010-12-01

    Full Text Available Internal jugular vein thrombosis (IJVT is an elusive vascular disease that is rarely seen, with potentially lethal complications such as sepsis and pulmonary embolism. Spontaneous IJVT is considered when no apparent predisposing cause of thrombosis is present. A previously healthy, 31-year-old woman presented to the university-based emergency department because of painless swelling in the right anterior side of her neck. Physical examination revealed a painless, soft and immobile mass in the right anterior side of her neck beneath the sternocleidomastoid muscle, without hyperemia or local heat. On ultrasonographic examination, a hyperechogenic mass was visualized around the thoracic entrance of the right internal jugular vein, which was suggestive of a thrombus. The patient was administered intravenous antibiotic and low-molecular-weight heparin followed by oral coumadin as anticoagulant therapy. Her complaints were relieved within 5 days. She was completely well after 6 months. Venous thrombosis generally results from impaired blood flow locally or systemically that leads to activation of coagulation. Primary care physicians should sustain a high index of suspicion in patients who present with undiagnosed swelling in the neck, or other signs and symptoms attributed to IJVT.

  19. Inferior mesenteric vein thrombosis in Crohn`s disease: CT diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Coralnick, J.R.; Budin, J.A.; Sedarat, A. [Hackensack Medical Center, NJ (United States)

    1996-01-01

    Mesenteric vein thrombosis has been described in association with such risk factors as coagulation disorders, postoperative dehydration, sepsis, and trauma. CT and ultrasound have greatly facilitated early diagnosis, and the features of superior mesenteric and portal vein thrombosis are well recognized. We present a case of inferior mesenteric vein thrombosis in a patient with Crohn`s disease. To our knowledge, this entity has not been reported in the radiologic literature. 7 refs., 2 figs.

  20. Nephrotic syndrome complicated with portal, splenic, and superior mesenteric vein thrombosis

    Directory of Open Access Journals (Sweden)

    Bong Soo Park

    2014-09-01

    Full Text Available Thromboembolism is a major complication of nephrotic syndrome. Renal vein thrombosis and deep vein thrombosis are relatively common, especially in membranous nephropathy. However, the incidence of portal vein and superior mesenteric vein (SMV thrombosis in patients with nephrotic syndrome is very rare. To date, several cases of portal vein thrombosis treated by anticoagulation therapy, not by thrombolytic therapy, have been reported as a complication of nephrotic syndrome. Here, we report a case of portal, splenic, and SMV thrombosis in a patient with a relapsed steroid dependent minimal change disease who was treated successfully with anticoagulation and thrombolytic therapy using urokinase. Radiologic findings and his clinical conditions gradually improved. Six months later, a complete remission of the nephrotic syndrome was observed and the follow-up computed tomography scan showed the disappearance of all portal vein, splenic vein, and SMV thrombi.

  1. Extensive deep vein thrombosis following prolonged gaming ('gamer's thrombosis'): a case report.

    Science.gov (United States)

    Chang, Hsien-Cheng Leon; Burbridge, Hayley; Wong, Conroy

    2013-10-08

    The average time spent playing video games is increasing. Prolonged immobility associated with gaming may therefore be an important risk factor for venous thromboembolism. We report a case of deep vein thrombosis associated with prolonged playing of PlayStation® games. A 31-year-old Caucasian man, an exterior painter, presented with a three-day history of left leg pain and swelling after playing PlayStation® games for almost eight hours a day for four consecutive days. Doppler ultrasound of the left leg confirmed extensive left leg deep venous thrombosis requiring thrombolysis and anticoagulation. Video gaming should be considered a risk factor for venous thromboembolism. Further studies are needed to estimate the degree of risk associated with prolonged periods of playing video games, and education for preventing venous thrombosis should be provided to gamers.

  2. Neutrophil extracellular trap (NET) impact on deep vein thrombosis.

    Science.gov (United States)

    Fuchs, Tobias A; Brill, Alexander; Wagner, Denisa D

    2012-08-01

    Deep vein thrombosis (DVT) is a major health problem that requires improved prophylaxis and treatment. Inflammatory conditions such as infection, cancer, and autoimmune diseases are risk factors for DVT. We and others have recently shown that extracellular DNA fibers produced in inflammation and known as neutrophil extracellular traps (NETs) contribute to experimental DVT. NETs stimulate thrombus formation and coagulation and are abundant in thrombi in animal models of DVT. It appears that, in addition to fibrin and von Willebrand factor, NETs represent a third thrombus scaffold. Here, we review how NETs stimulate thrombosis and discuss known and potential interactions of NETs with endothelium, platelets, red blood cells, and coagulation factors and how NETs could influence thrombolysis. We propose that drugs that inhibit NET formation or facilitate NET degradation may prevent or treat DVT.

  3. Sport-Related Portal Vein Thrombosis: An Unusual Complication.

    Science.gov (United States)

    Dumic, Igor; Tankosic, Nikola; Stojkovic Lalosevic, Milica; Alempijevic, Tamara

    2017-01-01

    Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.

  4. Sport-Related Portal Vein Thrombosis: An Unusual Complication

    Directory of Open Access Journals (Sweden)

    Igor Dumic

    2017-01-01

    Full Text Available Portal vein thrombosis (PVT is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.

  5. Spontaneous thrombosis of primary external jugular veins aneurysms

    Directory of Open Access Journals (Sweden)

    Sergio Gianesini

    2013-09-01

    Full Text Available External jugular vein (EJV aneurysms represent a rare condition whose origin, evolution and consequent best therapeutic options still need further investigations. We present herein two peculiar clinical cases. In the first one, an EJV aneurysm developed around a malformed valve which embedded a spontaneous thrombosis. Transverse cutaneous nerve compression by the aneurysmatic mass was identified. In the second case, a recurring thrombosed EJV aneu - rysm was found pinched among the platysma muscle and the superficial layer of the cervical fascia. A pertinent literature review is also presented in order to interpret the findings herein never previously described.

  6. Progression of Thrombus in Portal Vein, Superior Mesenteric Vein, and Splenic Vein Even on Anticoagulation in a Patient with Ascending Colonic Malignancy with Liver Metastasis: Portal Vein Thrombosis versus Portal Vein Tumor Thrombosis.

    Science.gov (United States)

    Sule, Ashish; Borja, Annamarie; Chin, Tay Jam

    2016-12-01

    Portal vein thrombosis (PVT) in a setting of liver metastasis is not easy to treat as it may be portal vein tumor thrombus (PVTT). A 77-year-old male patient was diagnosed as ascending colon carcinoma, underwent right hemicolectomy in 1991 with a recurrence in July 2009. In August 2009, he underwent computed tomography (CT) scan of the abdomen which showed evidence of superior mesenteric vein thrombosis with no liver metastasis. He was started with anticoagulation and decision was to treat long term. He was admitted with mesenteric artery ischemic symptoms in February 2012 on anticoagulation. CT scan abdomen and pelvis in February 2012 showed tumor thrombus involving the superior mesenteric vein, portal vein, and splenic vein with hepatic metastasis. His tumor marker chorioembryonic antigen was 34 µg/L. He was continued on anticoagulation. A repeat CT scan abdomen after 2 years (in January 2014) showed, increase in size of hepatic metastasis, extensive thrombus involving the superior mesenteric vein, portal vein, and splenic vein with collaterals. Mesentery was congested due to extensive superior mesenteric vein thrombus. He finally succumbed in June 2014. It is very important to differentiate PVT from PVTT as the prognosis is different. PVTT progresses despite of long-term anticoagulation with poor prognosis.

  7. [Management of deep-vein thrombosis: A 2015 update].

    Science.gov (United States)

    Messas, E; Wahl, D; Pernod, G

    2016-02-01

    Deep vein thrombosis (DVT) is a frequent and multifactor disease, with two major complications, post thrombotic syndrome and pulmonary embolism. Both transient (surgery, plaster immobilization, bed rest/hospitalization) and chronic/persistent (age, cancer, clinical or biological thrombophilia…) risk factors modulate treatment duration. Diagnostic management relies on clinical evaluations, probability followed by laboratory tests or imaging. So far, compression ultrasound is the diagnostic test of choice to make a positive diagnosis of DVT. Anticoagulants at therapeutic dose for at least 3 months constitute the cornerstones of proximal (i.e. involving popliteal or more proximal veins) DVT therapeutic management. The arrival of new oral anticoagulants should optimize ambulatory management of DVT. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Mesenteric vein thrombosis after percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

    Energy Technology Data Exchange (ETDEWEB)

    Luska, G.; Langer, H.E.; Le Blanc, S.

    1984-07-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. 1 fig.

  9. Mesenteric vein thrombosis after percitaneous transhepatic portal vein catheterisation for the localisation of an insulinoma

    International Nuclear Information System (INIS)

    Luska, G.; Langer, H.E.; Le Blanc, S.; Medizinische Hochschule Hannover

    1984-01-01

    The authors report on a fatal mesenteric vein thrombosis following an uncomplicated percutaneous transhepatic portal vein catheterisation for the localisation of an insulinoma. Several hours after the procedure the patient developed an acute abdomen. An emergency laparotomy revealed a haemorrhagic infarct of the ileum. The resected specimen showed an acute phlebitis with fresh thrombus. The cause of the phlebothrombosis was thought to be intimal damage from high osmolar contrast medium. There was no evidence of damage due to the catheder, either on the phlebogram or pathologically. (orig.) [de

  10. [Spontaneous dissolution of isolated superior mesenteric vein thrombosis in acute pancreatitis].

    Science.gov (United States)

    Na, Byung Soo; John, Byung Min; Kim, Ki Bum; Lee, Je Soo; Jo, Hyun Woo; Seock, Chang Hyeon; Kim, Dong Hui; Lee, Ki Sung

    2011-01-01

    Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year- old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.

  11. Management of superficial vein thrombosis and thrombophlebitis: status and expert opinion document.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Agus, G; Georgiev, M; Errichi, B M; Marinucci, R; Errichi, S; Filippini, A; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Cipollone, G; Lania, M; Gizzi, G; Ippolito, E; Bavera, P; Fano, F; Dugall, M; Adovasio, R; Gallione, L; Del Boccio, G; Cornelli, U; Steigerwalt, R; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M; Di Ciano, L; Simeone, E; Collevecchio, G; Grossi, M G; Di Giambattista, F; Carestia, F; Zukowski, A

    2007-01-01

    Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants. It is better to avoid bed rest and reduced mobility. Topical analgesia with nonsteroidal, anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area controls symptoms. Hirudoid cream (heparinoid) shortens the duration of signs/symptoms. Locally acting anticoagulants/antithrombotics (Viatromb, Lipohep, spray Na-heparin) have positive effects on pain and on the reduction in thrombus size. Intravenous catheters should be changed every 24 to 48 hours (depending on venous flow and clinical parameters) to prevent superficial vein thrombosis/superficial thrombophlebitis and removed in case of events. Low molecular weight heparin prophylaxis and nitroglycerin patches distal to peripheral lines may reduce the incidence of superficial vein thrombosis/superficial thrombophlebitis in patients with vein catheters. In case of superficial vein thrombosis/superficial thrombophlebitis, vein lines should be removed. In neoplastic diseases and hematological disorders, anticoagulants may be necessary. Exercise reduces pain and the possibility of deep vein thrombosis. Only in cases in which pain is very severe is bed rest necessary. Deep vein thrombosis prophylaxis should be established in patients with reduced mobility. Antibiotics usually do not have a place in superficial vein thrombosis/superficial thrombophlebitis unless there are documented infections. Prevention of superficial vein thrombosis should be considered on the basis of patient's history and clinical evaluation.

  12. Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis: A Single Center Experience in Japan.

    Science.gov (United States)

    Shirasugi, Nozomu; Horiguchi, Sadaaki; Shirato, Hiroyuki; Kawakami, Toshimitsu; Ono, Hisako; Yabuki, Shiho; Jojima, Kumiko; Niimi, Masanori

    2016-01-01

    Prevalence of asymptomatic deep vein thrombosis (DVT) in patients with primary varicose veins remains unclear. Here, we conducted a retrospective study to clarify the incidence of asymptomatic DVT in patients with varicose veins, especially focusing on those with superficial thrombophlebitis (STP). Among 431 patients with primary varicose veins with saphenous vein incompetence, 20 (4.64%) had asymptomatic DVT. The presence of STP was a significant risk factor for asymptomatic DVT as 10 of the 24 (41.7%) patients with STP had asymptomatic DVT, and all cases having calf muscle vein thrombosis. In contrast, of the patients with primary varicose veins without STP only 2.46% had asymptomatic DVT. In patients with primary varicose veins with STP, significant risk factors for DVT were being over C3 on the clinical, etiological, anatomical, and pathophysiological (CEAP) classification. (This article is a translation of Jpn J Phlebol 2014; 25: 13-19.).

  13. Fondaparinux for the treatment of superficial-vein thrombosis in the legs

    NARCIS (Netherlands)

    Decousus, Hervé; Prandoni, Paolo; Mismetti, Patrick; Bauersachs, Rupert M.; Boda, Zoltán; Brenner, Benjamin; Laporte, Silvy; Matyas, Lajos; Middeldorp, Saskia; Sokurenko, German; Leizorovicz, Alain; Décousus, H.; Leizorovicz, A.; Bauersachs, R.; Brenner, B.; Laporte, S.; Mismetti, P.; Prandoni, P.; Richard-Lordereau, I.; Boda, Z.; Matyas, L.; Sokurenko, G.; Schulman, S.; Cucherat, M.; Ford, I.; Monreal, M.; Becker, F.; Bost, V.; Girard, P.; Constans, J.; Gauthier, E.; Seymour, L.; Froloshki, B.; Stober, P.; Borthwick, L.; Jaques, D.; Trelfa, A.; Allende-Echevarrietta, P.; Kensit, S.; Kovacs, I.; Laursen, E.; Dramov, A.; Chlumsky, J.; Maasalu, K.; Quere, I.; Kiskinis, D.; Hoffman, R.; Piovella, F.; Krievins, D.; Oszkinis, G.; Stvrtinova, V.; Lozano Sanchez, F.; Mazzolai, L.; Myschalov, V.; Popovich, V.; Baluev, M.; Burov, Y.; Mikulskaya, E.; Chirkova, V.; Shvalb, P.; Kalinin, R.; Kachinskiy, A.; Apartsin, K.; Shulikovskaya, I.; Chizhova, E.; Subbotin, Y.; Shulgina, L.; Ignatenko, P.; Antropova, N.; Solomatin, A.; Nosko, V.; Zhukov, B.; Melnikov, M.; Zubareva, N.; Gusev, V.; Mineev, D.; Plechev, V.; Oleynik, B.; Khafizov, A.; Barbarash, O.; Lonchakova, I.; Berns, S.; Dubrovskiy, A.; Mikhaylov, D.; Mosin, S.; Chumakov, A.; Smirnov, G.; Krasavin, V.; Suplotova, L.; Ivanov, E.; Klushina, T.; Chernyatina, M.; Belikov, L.; Gladchenko, M.; Khmelniker, S.; Peshkov, A.; Shanigin, A.; Voskanyan, Y.; Golubov, E.; Shnukov, R.; Esipenko, V.; Neverko, I.; Ivanov, A.; Lenskaya, L.; Hvashevskiy, A.; Kotelnikov, M.; Apurin, S.; Zonova, E.; Nimaev, V.; Rogalev, K.; Butorin, S.; Sabelnikov, V.; Prokopets, A.; Nikiforov, Y.; Chernyakov, A.; Kon, E.; Guskova, A.; Katelnitskiy, I.; Belentsov, S.; Rodoman, G.; Ershova, O.; Soroka, V.; Mátyás, L.; Szentesi, S.; Simon, G.; Hajdu, L.; Varga, M.; Mogán, I.; Darabos, G.; Simó, G.; Ungár, D.; Bende, B.; Nyíri, B.; Rázsó, K.; Oláh, Zs; Halmos, F.; Gergely, M.; Somogyi, Z.; Kollár, L.; Menyhei, G.; Benkö, L.; Szentpéteri, I.; Simon, J.; Szegedi, J.; Murányi, A.; Frank, J.; Schoenen, B.; Grossgloss, T.; Mueller-Buehl, U.; Eggeling, T.; Eggeling, S.; Mietaschk, A.; von Bilderling, P.; Kurzbach, J.; Pfister, R.; Buechner, L.; Schoen, N.; Schoen, B.; Kaehler, W.; Schnieder, H.-G.; Enderle, J.; Muenter, K.-C.; Schulte-Huermann, D.; Ruetten, A.; Ante, D.; von Nettelbladt, E. Freiherr; Zollman, C.; Kamphausen, U.; Keilhau, D.-A.; Brado, B.; Pourhassan, S.; Boss, S.; Noppeney, T.; Betzl, G.; Herman, G.; Tsantilas, D.; Gudz, I.; Voloshyna, M.; Syerna, A.; Nikulnikov, P.; Danylets, A.; Guch, A.; Skupyy, O.; Tatarin, A.; Kravchenko, I.; Shtutin, O.; Rodin, Y.; Konovalova, K.; Sergeev, O.; Socolov, A.; Harbarlak, S.; Mylytsya, M.; Mylytsya, K.; Grigorjeva, M.; Shershneva, O.; Myshalov, V.; Chernyak, V.; Nykonenko, O.; Velygotskyy, M.; Bobrov, O.; Sofronkov, N.; Feshchenko, Y.; Kobza, I.; Rusyn, V.; Guenneguez, H.; Ouvry, P.; Di Maio, A.; Diamand, J.-M.; Quéré, I.; Brisot, D.; Martin, M.; Bressollette, L.; Louis, P.; Boveda, S.; Delsart, D.; Faisse, P.; Elias, A.; Aquilanti, S.; Gris, J.-C.; Jurus, C.; Quémeneur, T.; Leandri, C.; Saby, J.-C.; Lance, G.; Giannoukas, A.; Saleptsis, V.; Koutsias, S.; Saratzis, N.; Giannopoulos, A.; Katsamouris, A.; Kostas, T.; Tsetis, D.; Lazarides, M.; Filis, K.; Gerasimidis, T.; Papacharalambous, G.; Tsoupanos, S.; Gedins, M.; Kisis, K.; Zelobovskis, J.; Nokikovs, N.; Smolakova, V.; Zvirgzdins, V.; Ivanova, P.; Udris, I.; Bugán, V.; Komová, J.; Dzupina, A.; Horvát, P.; Bojdova, E.; Lasan, I.; Lasanová, Z.; Jascur, J.; Vacula, I.; Dostálová, K.; Andreozzi, G.; Camporese, G.; Verlato, F.; Davì, G.; Lessiani, G.; Pesavento, R.; Minotto, I.; Siragusa, S.; Parisi, R.; Imberti, D.; Prisco, D.; Lozano Vilardell, P.; Merino, O.; Acín García, F.; Cañibano, C.; Marinello Roura, J.; Alvarez Fernández, J.; Trujillo Santos, J.; Blanes Mompo, J.; Giménez Gaibar, A.; Izquierdo Lamoca, L.; Moreno Palomares, J.; Sánchez Gutiérrez, A.; Martínez Fernández, S.; Vaquero, C.; Muñoz Alvarez, D.; Cairols Castellote, M.; Grozdinski, L.; Gabriel, M.; Slowiński, M.; Dorobisz, A.; Milnerowicz, A.; Jawień, A.; Dereziński, T.; Strugala, C.; Jirka, V.; Skalicka, L.; Hirmerova, J.; Krcova, E.; Stanek, F.; Krivankova, M.; Kaha, E.; Aru, A.; Kamphuisen, P.; Gaastra, M.; Gerdes, V.; Damsté, H. Sinninghe; ten Cate, H.; Valentijn, R.; Jeanneret, C.; Banyai, M.; Hayoz, D.; Kalka, C.; Willenberg, T.; Lugassy, G.; Lishner, M.; Hussein, O.

    2010-01-01

    The efficacy and safety of anticoagulant treatment for patients with acute, symptomatic superficial-vein thrombosis in the legs, but without concomitant deep-vein thrombosis or symptomatic pulmonary embolism at presentation, have not been established. In a randomized, double-blind trial, we assigned

  14. Endovenous saphenous vein ablation in patients with acute isolated superficial-vein thrombosis.

    Science.gov (United States)

    Gradman, Wayne S

    2015-04-01

    The possible benefits of endovenous saphenous ablation (EVSA) as initial treatment in patients presenting with isolated superficial-vein thrombosis (SVT) and saphenous vein reflux include: (1) definitive treatment of the underlying pathology and (2) elimination of the saphenous vein as a path for pulmonary emboli, which (3) may eliminate the need for anticoagulation. In a ten-year review of 115 limbs presenting with acute isolated SVT, 72 limbs (71 patients) with saphenous reflux were given a choice of two treatments following an explanation of the risks and benefits of each. Group I limbs (n = 41) were treated with office EVSA using radiofrequency or laser with or without thrombophlebectomy if performed within 45 days of diagnosis. Post-treatment anticoagulants were not given. Group II limbs (n = 31) were treated with compression hose and repeat Duplex within one week, with added anticoagulants if SVT extended into the thigh. In group I, mean interval from diagnosis to treatment was 13.7 days. One calf deep vein thrombosis was noted. In group II no complications were noted. In late follow-up of group II patients, 12/29 underwent EVSA more than 45 days after initial presentation. The safety and efficacy of EVSA and thrombophlebectomy appear indistinguishable from conservative measures and may be offered as initial treatment to patients presenting with SVT and saphenous reflux. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Great saphenous vein stump thrombosis after harvesting for coronary artery bypass graft surgery.

    Science.gov (United States)

    Labropoulos, N; Bishawi, M; Gasparis, A; Tassiopoulos, A; Gupta, S

    2014-05-01

    To determine the rate of superficial venous thrombosis in patients undergoing great saphenous vein (GSV) harvesting for coronary artery bypass surgery (CABG). Post-CABG patients with suspected lower-extremity thrombosis underwent duplex scanning. Thrombus in the saphenofemoral junction stump was noted, and thrombus extension and associated complications collected. Out of 2335 patients who underwent CABG in five years, 98 patients presented with signs and symptoms of lower-extremity thrombosis. Thrombosis was present in 19 (19.4%) of these patients, 15 of which had a thrombus in the GSV. Five patients had significant signs and symptoms of pulmonary embolism (PE). On objective diagnostic imaging, three of them had a PE. Patients undergoing great saphenous vein harvesting for CABG are at an increased risk of developing superficial vein thrombosis especially at the saphenous stump. Given the increased risk of deep vein thrombosis and PE, further studies investigating this topic are warranted.

  16. Intra-Arterial Thrombolysis for Deep Vein Thrombosis of the Lower Extremity: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Moo Sang; Roh, Byung Suk [Dept. of Radiology, Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2011-09-15

    If the appropriate catheterization of the affected vein was not possible because of a narrowed or thrombus-filled venous lumen, successful treatment gets into trouble during catheter directed regional thrombolysis for treatment of deep vein thrombosis. In this situation, intra-arterial thrombolysis can be considered as an alternative treatment, but to the best of our knowledge, only two reports have been described. We present here cases of successful intra-arterial thrombolysis in patients with deep vein thrombosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  18. Inflammatory pseudotumor causing deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

    LENUS (Irish Health Repository)

    Memon, Adeel Rasool

    2013-01-01

    Metal-on-metal hip resurfacings have recently been associated with a variety of complications resulting from adverse reaction to metal debris. We report a case of extensive soft tissue necrosis associated with a huge pelvic mass causing extensive deep vein thrombosis of the lower limb secondary to mechanical compression of the iliac vein. This is a rare and unusual cause of deep vein thrombosis after metal-on-metal hip resurfacing arthroplasty.

  19. Deep Vein Thrombosis Prophylaxis: State of the Art.

    Science.gov (United States)

    Lieberman, Jay R

    2018-03-21

    The selection of a prophylaxis regimen to prevent symptomatic pulmonary embolism and deep vein thrombosis is a balance between efficacy and safety. The latest American Academy of Orthopaedic Surgeons guideline recommended that either chemoprophylaxis or mechanical prophylaxis be used after total joint arthroplasty but did not recommend specific agents. However, the latest evidence-based American College of Chest Physicians guideline recommended a variety of chemoprophylaxis and mechanical agents for a minimum of 10 to 14 days after total joint arthroplasty. Risk stratification is the key to the selection of the appropriate prophylaxis regimen for the individual patient, but the optimal risk stratification protocol still needs to be developed. Copyright © 2018. Published by Elsevier Inc.

  20. Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment

    Science.gov (United States)

    Ponziani, Francesca R; Zocco, Maria A; Campanale, Chiara; Rinninella, Emanuele; Tortora, Annalisa; Maurizio, Luca Di; Bombardieri, Giuseppe; Cristofaro, Raimondo De; Gaetano, Anna M De; Landolfi, Raffaele; Gasbarrini, Antonio

    2010-01-01

    Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient’s outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients’ future prognoses. PMID:20066733

  1. Superior Mesenteric Vein Thrombosis Secondary to Oral Contraceptive Use

    Directory of Open Access Journals (Sweden)

    Heather Stewart

    2012-01-01

    Full Text Available Superior mesenteric vein thrombosis (SMVT is a rare yet frequently fatal cause of intestinal ischemia. Despite its severe consequences, SMVT often presents with nonspecific symptoms such as nausea, vomiting, and abdominal pain. It can occur with or without gastrointestinal bleeding, and symptoms may be present for hours to weeks. Physical exam can vary from a benign to an acute abdomen. The are no specific diagnostic laboratory studies for the presence of MVT, and it can be an incidental finding of computed tomography or ultrasound. Patients at risk for MVT include those with a history of a hypercoagulable state or secondary cases such as sepsis, gastrointestinal malignancy, liver disease, pancreatic pathology, abdominal surgery and medications. The authors present a case of a patient presenting with acute abdominal pain and ultimately a SMVT secondary to oral contraceptives by exclusion.

  2. The history and historical treatments of deep vein thrombosis.

    Science.gov (United States)

    Galanaud, J-P; Laroche, J-P; Righini, M

    2013-03-01

    Deep vein thrombosis (DVT) is a common disease. However, unlike that of varicose veins, which have been depicted since antiquity in art and literature, its description was more recent in the history of medicine. The first well-documented case of DVT was reported during the Middle Ages: in 1271, Raoul developed a unilateral edema in the ankle, which then extended to the leg. The number of reported DVT cases steadily increased thereafter, particularly in pregnant and postpartum women. During the first half of the 20th century, well before the discovery of anticoagulants, many therapeutic approaches were used, and arose from the pathologic hypotheses that prevailed at their time. Despite the development of anticoagulants, and the fact that they were thought to dramatically decrease DVT mortality, numerous complementary treatments have also been developed during the last 50 years: they include vena cava clips and surgical thrombectomy, and are intended to decrease mortality or to prevent late complications. Most of these treatments have now been abandoned, or even forgotten. In this review, we recall also the discovery and the use of vitamin K antagonists and heparin, which have constituted the mainstay of treatment for decades. We also bring some perspective to historical aspects of this disease and its treatment, notably regarding elastic compression and early mobilization, but also abandoned and complementary treatments. In these times of change regarding DVT treatment, mainly marked by the arrival of new oral anticoagulants, efforts of physicians through the ages to treat this common disease provide a beautiful example of the history of knowledge. © 2013 International Society on Thrombosis and Haemostasis.

  3. MANAGEMENT OF PORTAL VEIN THROMBOSIS IN CIRRHOTIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Maria Anna Guardascione

    2009-11-01

    Full Text Available

    Portal vein thrombosis (PVT not associated with hepatocellular carcinoma is considered a frequent complication of liver cirrhosis but, unlike PVT occurring in non-cirrhotic patients, very few data are available on its natural history and management.  The reduced portal blood flow velocity is the main determinant of PVT but, as in other venous thromboses, multiple factors local and systemic, inherited or acquired often can concur with. PVT has a variety of clinical presentations ranging from asymptomatic to life-threatening diseases like gastroesophageal bleeding or acute intestinal ischemia. It is usually diagnosed by Doppler ultrasound but computed tomography and magnetic resonance imaging are useful to study the extent of thrombosis and the involvement of the abdominal organs. The risk of bleeding mainly determined by the presence of gastroesophageal varices and clotting alterations causes concern for the treatment of PVT in cirrhotic patients. To date, anticoagulant therapy seems to be indicated only in patients awaiting liver transplantation. This review focuses on the definition of the subgroups of patients with cirrhosis that might benefit from treatment of PVT and examines the pros and cons of the available treatments in terms of efficacy, monitoring and safety, providing also perspectives for future studies.

  4. [Management of mesenteric ischemia and mesenteric vein thrombosis].

    Science.gov (United States)

    Hoffmann, M; Keck, T

    2014-07-01

    Acute mesenteric ischemia is secondary to acute embolic disease or thrombosis of the superior mesenteric artery. Further pathologies that manifest themselves with the same clinical presentation are thrombosis of the superior mesenteric vein and non-occlusive disease. The patients are admitted to the emergency room with an acute abdomen. Most patients are more than 70 years old. Known risk factors for mesenteric ischemia are cardiac diseases as atrial fibrillation, aneurysms of the aorta and the visceral arteries, occlusive arterial diseases, tumorigenic compression of the vessel and several diseases that result in a reduction of the flow and intravascular volume in the superior mesenteric artery. The golden standard in the diagnosis of acute mesenteric ischemia is CT-angiography of the abdominal vessels with 3 D reconstruction. The therapy is different and dependent from the underlying pathology. A statistically significantly elevated mortality of more than 95% is associated with a delay of surgical or interventional therapy of more than 12 hours after the initial symptoms and non-occlusive mesenteric ischemia. Because of the advanced age of the patients and the co-morbidities a non-surgical interventional re-canalisation of the superior mesenteric vessels is recommended. A laparotomy is necessary in all patients with peritonitis and/or bowel necrosis or perforation. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Pulmonary vein tumor thrombosis and left atrial extension in lung carcinoma.

    Science.gov (United States)

    Koo, B C; Woldenberg, L S; Kim, K T

    1984-10-01

    A case of lung carcinoma extending into left atrium through a pulmonary vein and mimicking left atrial myxoma is presented. The localized enlargement of a pulmonary vein is seen as a possible CT sign of pulmonary vein tumor thrombosis. Computed tomography (CT) and echocardiography are complementary in the correct diagnosis of this condition.

  6. Health-related quality of life after deep vein thrombosis

    DEFF Research Database (Denmark)

    Utne, Kristin Kornelia; Tavoly, Mazdak; Wik, Hilde Skuterud

    2016-01-01

    BACKGROUND: Health-related quality of life (HRQoL) is known to be impaired in patients who develop post-thrombotic syndrome (PTS) following deep vein thrombosis (DVT). However, there is limited knowledge of the long-term HRQoL after DVT compared to controls without DVT. The objectives of this study...... were to evaluate long-term HRQoL following DVT and to compare that with age and sex matched control group and to population norms as well as to investigate possible predictors for reduced HRQoL. METHODS: HRQoL was evaluated in 254 patients with confirmed DVT using the generic EQ-5D and the diseases...... specific VEINES-QOL/Sym questionnaire, whereas PTS was assessed by the Villalta scale. Patients were asked to give the EQ-5D questionnaire to two friends of same age- (±5 years) and sex (buddy controls). RESULTS: Patients scored significantly lower on all dimensions of EQ-5D compared to controls. EQ-5D...

  7. Hepatic Veins and Inferior Vena Cava Thrombosis in a Child Treated by Transjugular Intrahepatic Portosystemic Shunt

    International Nuclear Information System (INIS)

    Carnevale, Francisco Cesar; Santos, Aline Cristine Barbosa; Tannuri, Uenis; Cerri, Giovanni Guido

    2010-01-01

    We report the case of a 9-year-old boy with portal hypertension, due to Budd-Chiari syndrome, and retrohepatic inferior vena cava thrombosis, submitted to a transjugular intrahepatic portosystemic shunt (TIPS) by connecting the suprahepatic segment of the inferior vena cava directly to the portal vein. After 3 months, the withdrawal of anticoagulants promoted the thrombosis of the TIPS. At TIPS revision, thrombosis of the TIPS and the main portal vein and clots at the splenic and the superior mesenteric veins were found. Successful angiography treatment was performed by thrombolysis and balloon angioplasty of a severe stenosis at the distal edge of the stent.

  8. Superficial siderosis of the central nervous system due to bilateral jugular vein thrombosis.

    Science.gov (United States)

    Yavagal, Dileep R; Geng, Deqing; Akar, Serra; Buonanno, Ferdinando; Kesari, Santosh

    2010-10-01

    To describe a novel cause of meningeal siderosis due to intermittent subarachnoid bleeding caused by chronic bilateral jugular vein thrombosis. Case report and review of literature. A 51-year-old man with a distant history of cervical injury who presented with transient aphasia in the setting of progressive cognitive decline. Neurological examination, magnetic resonance imaging, lumbar puncture, and angiogram. The patient had intermittent subarachnoid bleeding resulting from extensive venous collaterals in the neck and cervical spine due to chronic bilateral jugular vein thrombosis. Unexplained neurological deterioration and history of cervical trauma warrants diagnostic consideration of superficial siderosis and jugular vein thrombosis.

  9. Vein mechanism simulation study for deep vein thrombosis early diagnosis using cfd

    Science.gov (United States)

    Ibrahim, Nabilah; Aziz, Nur Shazilah Abd; Manap, Abreeza Noorlina Abd

    2017-04-01

    Using a Computational Fluid Dynamics (CFD) technique, this work focus on the analysis of pressure, velocity, and vorticity of blood flow along the popliteal vein. Since the study of early stage of Deep Vein Thrombosis (DVT) becomes essential to prevent the pulmonary embolism (PE), those three parameters are analysed to assess the effect of different opening between two valves of a normal popliteal vein. When only one valve is simulated, the result of pressure shows that the highest and lowest velocities are 15.45 cm/s and 0.73 cm/s, respectively. From the visualization of observed data, however, the different size of orifice between the first and second valves influencing the velocity and vorticity of the blood flow. The rotational motion of blood particle at the same region increases the probability of blood accumulating which is associated with the development of thrombus. Thus, a series of experiment has been conducted by changing the size of valve orifice for the first and second valves along the vein distribution. The result of the CFD simulation shows a significant variation in blood flow in terms of velocity and vorticity.

  10. Postoperative Massive Pulmonary Embolism Due to Superficial Vein Thrombosis of the Upper Limb.

    Science.gov (United States)

    Cascella, Marco; Viscardi, Daniela; Bifulco, Francesca; Cuomo, Arturo

    2016-04-01

    It is well known that deep vein thrombosis of the upper extremities is linked to high morbidity/mortality, resulting in 12-20% of all documented pulmonary embolism; however, there are few data about thromboembolism originating from a vein and/or a branch of a superficial vein of the upper extremities. Pulmonary embolism secondary to upper limb superficial vein thrombosis (not combined with upper extremities deep vein thrombosis) is a very rare clinical manifestation with few cases reported in the literature. We report a rare case of thrombophlebitis in departure from a superficial branch of the cephalic vein of the right arm, complicated by cardiac arrest secondary to a massive pulmonary embolism in a patient who underwent major surgery for ovarian cancer. We discuss on the numerous thrombotic risk factors, triggering a cascade of reactions and resulting in a potential fatal clinical manifestation.

  11. Pulmonary embolism caused by ovarian vein thrombosis during cesarean section: a case report.

    Science.gov (United States)

    Oda, Yutaka; Fujita, Michie; Motohisa, Chika; Nakata, Shinichi; Shimada, Motoko; Komatsu, Ryushi

    2018-01-01

    Ovarian vein thrombosis is a rare complication of pregnancy. The representative complaints of patients with ovarian vein thrombosis are abdominal pain and fever. In some cases, however, fatal pulmonary embolism may develop. We report a case of pulmonary embolism presenting with severe hypotension and loss of consciousness during cesarean section possibly caused by ovarian vein thrombosis. A 25-year-old woman at 38 weeks 4 days of gestation was scheduled for repeat cesarean section. Her past history was unremarkable, and the progress of her pregnancy was uneventful. She did not experience any symptoms indicative of deep vein thrombosis. Cesarean section was performed under spinal anesthesia, and a healthy newborn was delivered. After removal of the placenta, she suddenly developed dyspnea, hypotension, and loss of consciousness with decreased peripheral oxygen saturation. Blood pressure, heart rate, and oxygen saturation recovered after tracheal intubation and mechanical ventilation with oxygen. Postoperative computed tomography revealed no abnormality in the brain or in the pulmonary artery, but a dilated right ovarian vein with thrombi, extending up to the inferior vena cava, was found. A diagnosis of pulmonary embolism caused by ovarian vein thrombosis was made, and heparin was administered. The tracheal tube was removed on the first postoperative day. Her postoperative course was uneventful, and she was discharged with no complications. Fatal pulmonary embolism might be caused by ovarian vein thrombosis during cesarean section. Careful and continuous observation of the patient after delivery and prompt treatment are important.

  12. Combined jugular and subclavian vein thrombosis following assisted reproductive technology--new observation.

    Science.gov (United States)

    Salomon, Ophira; Schiby, Ginette; Heiman, Zehava; Avivi, Kamila; Sigal, Carol; Levran, David; Dor, Jeushua; Itzchak, Yacov

    2009-08-01

    To study the predilection of jugular and subclavian vein thrombosis in patients going through assisted reproductive technology (ART). This technology puts women at high risk of developing the ovarian hyperstimulation syndrome (OHSS) and thrombotic events. Study cases. Large Academic Medical Center. Five women who developed jugular and subclavian vein thrombosis following ART were included in the study. The deep vein thrombosis was demonstrated by ultrasound Doppler or computerized tomography angiography. All women were interviewed and data obtained from outpatient and hospital medical charts. Magnetic resonance imaging and complete thrombophilic profile workup was performed in each woman. Open biopsy from the lesions was taken from one of the women. Correlation between mechanical branchial cysts filled with fluid during OHSS and jugular and subclavian vein thrombosis. Five women developed jugular and subclavian vein thrombosis following ART. They were found to harbor clusters of rudimentary branchial cysts filled with fluid at the time of OHSS, which compressed the jugular and subclavian veins at their junction at the base of the neck. Four patients (80%) were found to be carriers of factor V Leiden. Predilection of jugular and subclavian vein thrombosis early in pregnancy is the result of mechanical compression mediated by rudimentary branchial cysts filled with fluid during OHSS, particularly in subjects who are carriers of factor V Leiden.

  13. DEEP VEIN THROMBOSIS IN PATIENT WITH VON WILLEBRAND DISEASE

    Directory of Open Access Journals (Sweden)

    V. A. Elykomov

    2016-01-01

    Full Text Available Objective: to identify the possible factors of thrombogenic risk and ways of its prevention in patients with von Willebrand disease.Case description. Patient X., 42 years old, who suffers from von Willebrand disease type 3 with 5-years of age. Asked on reception to the traumatologist in the polyclinic of the Regional Hospital with pain in the left hip joint. Recommended planned operative treatment in the Altai Regional Clinical Hospital. Preoperative preparation included the infusion of concentrate of von Willebrand factor and coagulation factor VIII. Operation – cement total arthroplasty of the left hip joint. In the postoperative period analgesic treatment, elastic compression of the lower extremities, iron supplements, also conducted infusion of concentrate of von Willebrand factor and coagulation factor VIII for 20 days and thromboprophylactic with dabigatran. On the 3rd day after the operation the patient revealed deep vein thrombosis of the femoral segment (floating clot.Results. The patient was operated for emergency indications in the Department of endovascular surgery – installation of venous cava filter “Volan”. Dabigatran is cancelled, appointed clexane for 3 months. In our clinical example the patient lacked risk factors of pulmonary embolism as obesity, age, smoking, prolonged immobilization, estrogen therapy. Overdose of factor VIII were not observed – the level of factor did not exceed 135 % on transfusions. At the same time, the patient was found polymorphisms in the genes ITGA2, FGB, MTHFR, MTR – heterozygote, MTRR – mutant homozygote, which may indicate the genetic factors of thrombogenic risk. Also a significant risk factor was massive surgical intervention (total hip replacement. Despite preventive measures (elastic compression, thromboprophylactic dabigatran, early activation we cannot to avoid thrombotic complications.Conclusion. This article presents a case demonstrating a thrombotic complication in patients

  14. Can deep vein thrombosis be predicted after varicose vein operation in women in rural areas?

    Directory of Open Access Journals (Sweden)

    Marcin Warot

    2014-09-01

    Full Text Available [b]Introduction[/b]. Chronic venous disease is a group of symptoms caused by functional and structural defects of the venous vessels. One of the most common aspects of this disease is the occurrence of varicose veins. There are many ways of prevention and treatment of varicose veins, but in Poland the leading one is still surgery. As in every medical procedure there is the possibility of some complications. One of them is deep vein thrombosis (DVT. The diagnosis of DVT can be difficult, especially when access to a specialist is limited, such as in case of rural patients. [b]The aim of the study.[/b] The aim of the study was estimation of the influence of LMWH primary prophylaxis on the formation of postoperative DVT, as well as sensitivity and specificity of clinical examination and D-dimer value in diagnosis of postoperative DVT in women. [b]Materials and methods[/b]. The study was conducted in a group of 93 women operated on in the Department of General, Vascular Surgery and Angiology at the Karol Marcinkowski University of Medical Sciences in Poznań, Poland. The patients had undergone a varicose vein operation and were randomly divided into two groups: A – 48 women receiving LMWH during two days of the perioperative period, B – 45 women receiving LMWH during seven days of the perioperative period. [b]Results[/b]. There was no significant difference in the postoperative DVT complications in both groups. The value of D-dimer > 0.987 mcg/ml and swelling > 1.5 cm of shin (in comparison to the preoperative period plays a significant role in diagnosis of DVT. [b]Conclusions[/b]. The extended primary prophylaxis with LMWH does not affect the amount or quality of thrombotic complications after varicose vein operation. If the DVT occurs, the evaluation of the D – dimer and careful clinical examination can be a useful method for its diagnosis.

  15. Right iliac vein thrombosis mimicking acute appendicitis in pregnancy: a case report.

    Science.gov (United States)

    Aroke, Desmond; Kadia, Benjamin Momo; Dimala, Christian Akem; Bechem, Ndemazie Nkafu; Ngek, Larry Tangie; Choukem, Simeon Pierre

    2017-01-03

    Right iliac vein thrombosis is uncommon in pregnancy. Nonetheless, when it does occur, its presentation could be very unspecific with important diagnostic challenges and this could have negative therapeutic consequences especially in a resource limited setting. The historical, clinical and laboratory data of a 30 year old G2P1001 woman of African ethnicity at 11 weeks of gestation pointed towards a right iliac vein thrombosis missed for an acute appendicitis with subsequent appendectomy and failure to cure. Following the diagnosis of right iliac vein thrombosis post-appendectomy, the patient was started on low molecular weight heparin and the clinical progress thereafter was favourable. Pelvic vein thrombosis should be considered a differential diagnosis of intractable lower abdominal pain in early pregnancy. A high index of suspicion could lead to early diagnosis, prompt management and a favourable prognosis even in a low-income setting.

  16. JAK2 V617F mutation, mesenteric vein thrombosis, and myeloproliferative disorders.

    Science.gov (United States)

    Owens, Christopher D

    2010-07-01

    Mesenteric vein thrombosis is a rare disorder that is often the first manifestation of a systemic condition such as a hypercoagulable state or cancer. In particular, myeloproliferative disorders can present as mesenteric vein thrombosis even in the setting of relatively normal peripheral blood counts. A recent novel mutation in the Janus activated kinase 2 gene involving a gain-of-function substitute of valine to phenylalanine at position 617 (JAK2 V617F) has been discovered to be prevalent in patients with mesenteric vein thrombosis and myeloproliferative disorders. This article reports a patient who presented with mesenteric vein thrombosis and relatively normal peripheral blood counts. He was diagnosed with essential thrombocythemia after he tested positive for the JAK2 V617F mutation. Copyright (c) 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  17. Primary venous insufficiency increases risk of deep vein thrombosis.

    Science.gov (United States)

    Shaydakov, Maxim E; Comerota, Anthony J; Lurie, Fedor

    2016-04-01

    Varicose veins have been recognized as a risk factor for deep vein thrombosis (DVT). However, venous reflux has not carried the same correlation. This study evaluated the association between primary valvular reflux and DVT. We performed a nested case-control study with enrollment of outpatients presenting to the vascular laboratory with signs and symptoms of DVT. All patients had a complete bilateral venous duplex examination evaluating for DVT and superficial and deep venous valvular reflux. Eighty-seven patients with confirmed DVT on venous duplex were selected for the study group. The control group was randomly selected from the same cohort in a 4:1 ratio matched by age and gender (n = 348). Groups were compared for the prevalence of deep and superficial reflux. DVT outpatients were 4.7-times more likely to have primary valvular reflux than symptomatic controls (65.5% vs 29.0%; 95% confidence interval [CI], 2.8-7.7; P superficial reflux was 4.6-times more prevalent (43.7% vs 14.4%; odds ratio, 4.62; 95% CI, 2.75-7.77; P superficial reflux than non-DVT patients (13.8% vs 6.6%, 95% CI, 1.08-4.75; P = .044). The prevalence of primary valvular reflux in patients with DVT is significantly higher than expected. Reflux may be considered as a novel risk factor for DVT. Two-thirds of patients with DVT have pre-existent primary chronic venous disease, which is likely to contribute to post-thrombotic morbidity. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  18. Association of Oesophageal Varices and Splanchnic Vein Thromboses in Patients with JAK2-Positive Myeloproliferative Neoplasms: Presentation of Two Cases and Data from a Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Cornelia S. Link

    2013-06-01

    Full Text Available Background: Oesophageal varices and gastrointestinal bleeding are common complications of liver cirrhosis. More rarely, oesophageal varices occur in patients with non-cirrhotic portal hypertension that results from thromboses of portal or splanchnic veins. Case Report: We describe 2 young men who initially presented with varices as a result of portal vein thromboses. In the clinical follow-up, both were tested positive for a JAK2 mutation and consequently diagnosed with myeloproliferative neoplasms (MPNs. In an attempt to characterise the frequency of gastrointestinal complications in patients with JAK2-positive MPNs, we retrospectively analysed all known affected patients from our clinic for the diagnosis of portal vein thromboses and oesophageal varices. Strikingly, 48% of those who had received an oesophagogastroduodenoscopy had detectable oesophageal or gastric varices, and 82% of those suffered from portal or splanchnic vein thromboses. Conclusion: While the association between JAK2, myeloproliferative disease and thrombotic events is well established, patients with idiopathic oesophageal varices are not regularly tested for JAK2 mutations. However, the occurrence of oesophageal varices may be the first presenting symptom of a MPN with a JAK2 mutation, and affected patients may profit from a close haematological monitoring to assure the early detection of developing MPN.

  19. A Pitfall in the Diagnosis of Bilateral Deep Vein Thrombosis in a Young Man.

    Science.gov (United States)

    Adachi, Yusuke; Sakakura, Kenichi; Okochi, Tomohisa; Mase, Takaaki; Matsumoto, Mitsunari; Wada, Hiroshi; Fujita, Hideo; Momomura, Shin-Ichi

    2018-03-30

    A 32-year-old man with a history of bronchial asthma was referred for low back pain and bilateral femur pain. Vascular sonography revealed bilateral deep vein thrombosis (DVT) from the femoral veins to the popliteal veins. Computed tomography revealed hypoplasia of the inferior vena cava (IVC) and dilated lumbar veins, ascending lumbar veins, and azygos vein as collaterals. There was no evidence of malignant neoplasm. The results of the thrombophilia tests were within normal limits. Hypoplasia of the IVC is a rare cause of DVT. This anomaly should be considered as a cause of bilateral and proximal DVT, in particular, in young patients without major risk factors.

  20. Spontaneous thrombosis of a vein of Galen aneurysmal malformation: possible effects of contrast media

    International Nuclear Information System (INIS)

    Konus, Oe.L.; Ilgit, E.T.; Oezdemir, A.; Oenal, B.

    2000-01-01

    A 5-year-old boy with macrocephaly and mental retardation was referred for radiologic evaluation. After cranial CT and MR imaging, the diagnosis of mural type vein of Galen aneurysmal malformation was established by angiography. Two weeks later, preembolization angiography revealed complete thrombosis of the malformation. Although it is a very rare event, vein of Galen aneurysmal malformation may spontaneously thrombose following diagnostic angiography. Possible effects of contrast media on thrombosis were discussed. (orig.)

  1. Superficial Dorsal Vein Injury/Thrombosis Presenting as False Penile Fracture Requiring Dorsal Venous Ligation

    Directory of Open Access Journals (Sweden)

    Arash Rafiei, MD

    2014-12-01

    Conclusion: Early exploration of patients with suspected penile fracture provides excellent results with maintenance of erectile function. Also, in the setting of dorsal vein thrombosis, ligation preserves the integrity of the penile tissues and avoids unnecessary complications from conservative management. Rafiei A, Hakky TS, Martinez D, Parker J, and Carrion R. Superficial dorsal vein injury/thrombosis presenting as false penile fracture requiring dorsal venous ligation. Sex Med 2014;2:182–185.

  2. Azygos vein thrombosis secondary to a peripherally inserted central catheter (PICC).

    Science.gov (United States)

    Sherif, Moayid M; Hall, Rebecca; Schauer, Cameron K M W

    2015-07-20

    This case illustrates a rare complication of a peripherally inserted central catheter (PICC). PICCs are associated with a significantly increased risk of upper extremity deep vein thrombosis; however, there are currently no case reports of isolated thrombosis of the azygos vein secondary to a PICC. With the well-documented increase in the use of PICCs for venous access we remind clinicians to consider this rare complication.

  3. Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

    Science.gov (United States)

    Le, Trong Binh; Lee, Taeg Ki; Park, Keun-Myoung; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu

    2018-04-25

    To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P VIH should be considered a potential cause. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

  4. Duplex scanning in the diagnosis of acute deep vein thrombosis of the lower extremity

    NARCIS (Netherlands)

    van Ramshorst, B.; Legemate, D. A.; Verzijlbergen, J. F.; Hoeneveld, H.; Eikelboom, B. C.; de Valois, J. C.; Meuwissen, O. J.

    1991-01-01

    In a prospective study the value of duplex scanning in the diagnosis of acute femoro-popliteal thrombosis was compared to conventional contrast venography (CV) as a gold standard. A total of 126 legs in 117 patients suspected of having deep vein thrombosis (DVT) or pulmonary embolism (PE) were

  5. Prognosis of cerebral vein thrombosis presenting as isolated headache: Early vs. late diagnosis

    NARCIS (Netherlands)

    Gameiro, Joana; Ferro, José M.; Canhão, Patricia; Stam, Jan; Barinagarrementeria, Fernando; Lindgren, Arne

    2012-01-01

    Objective: To analyse the outcome of cerebral venous thrombosis (CVT) patients presenting with isolated headache, specifically to compare isolated headache patients with early vs. late CVT diagnosis. Method: In the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) database we

  6. Asymptomatic deep vein thrombosis and superficial vein thrombosis in ambulatory cancer patients: impact on short-term survival.

    Science.gov (United States)

    Gary, T; Belaj, K; Steidl, K; Pichler, M; Eisner, F; Stöger, H; Hafner, F; Froehlich, H; Samonigg, H; Pilger, E; Brodmann, M

    2012-10-09

    Asymptomatic venous thrombotic events (VTEs) are possible findings in ambulatory cancer patients. Data regarding the incidence and clinical impact of asymptomatic VTEs are conflicting. We therefore conducted a study to evaluate the occurrence of asymptomatic VTEs of the lower limbs in ambulatory cancer patients to further evaluate the association of these asymptomatic VTEs on survival during a 9-month follow-up period. In our prospective cohort, we included 150 consecutive ambulatory cancer patients who were free of any clinical symptoms for VTEs. Compression ultrasound to detect deep vein thrombosis (DVT) and superficial venous thrombosis (SVT) of the lower limbs was performed by a vascular specialist in all patients at baseline. In case of pathological findings the patients were treated with low molecular weight heparin (LMWH) because of current established guidelines. The occurrence of death was investigated during a 9-month follow-up period. A total of 27 (18%) patients with VTEs were detected, which included 13 patients (8.7%) with a SVT and 16 patients (10.7%) showing a DVT. Two patients had both, a SVT and a DVT as well. During the 9-month follow-up period the occurrence of a VTE at baseline was associated with a 2.4-fold increased risk for death (HR 2.4 (1.2-5.3); P=0.03). Asymptomatic VTEs of the lower limbs in ambulatory cancer patients are frequently occurring concomitant features and are associated with poor survival during a 9-month follow-up period despite anticoagulation with LMWH.

  7. Asymptomatic deep vein thrombosis and superficial vein thrombosis in ambulatory cancer patients: impact on short-term survival

    Science.gov (United States)

    Gary, T; Belaj, K; Steidl, K; Pichler, M; Eisner, F; Stöger, H; Hafner, F; Froehlich, H; Samonigg, H; Pilger, E; Brodmann, M

    2012-01-01

    Background: Asymptomatic venous thrombotic events (VTEs) are possible findings in ambulatory cancer patients. Data regarding the incidence and clinical impact of asymptomatic VTEs are conflicting. We therefore conducted a study to evaluate the occurrence of asymptomatic VTEs of the lower limbs in ambulatory cancer patients to further evaluate the association of these asymptomatic VTEs on survival during a 9-month follow-up period. Methods: In our prospective cohort, we included 150 consecutive ambulatory cancer patients who were free of any clinical symptoms for VTEs. Compression ultrasound to detect deep vein thrombosis (DVT) and superficial venous thrombosis (SVT) of the lower limbs was performed by a vascular specialist in all patients at baseline. In case of pathological findings the patients were treated with low molecular weight heparin (LMWH) because of current established guidelines. The occurrence of death was investigated during a 9-month follow-up period. Results: A total of 27 (18%) patients with VTEs were detected, which included 13 patients (8.7%) with a SVT and 16 patients (10.7%) showing a DVT. Two patients had both, a SVT and a DVT as well. During the 9-month follow-up period the occurrence of a VTE at baseline was associated with a 2.4-fold increased risk for death (HR 2.4 (1.2–5.3); P=0.03). Conclusion: Asymptomatic VTEs of the lower limbs in ambulatory cancer patients are frequently occurring concomitant features and are associated with poor survival during a 9-month follow-up period despite anticoagulation with LMWH. PMID:22968652

  8. Seasonal variation in the superficial vein thrombosis frequency.

    Science.gov (United States)

    Frappé, Paul; Bertoletti, Laurent; Presles, Emilie; Buchmuller-Cordier, Andréa; Merah, Adel; Le Hello, Claire; Peycelon, Déborah; Tardy, Bernard; Décousus, Hervé

    2015-12-01

    A seasonal variation of venous thromboembolic disease frequency is subject to discussion, and has been recently suggested for superficial vein thrombosis (SVT) in a small retrospective study. Our aim was to search for a seasonal variation of SVT frequency according to the data of larger studies. We analyzed the data of three French prospective multicenter studies with different designs which have included patients with SVT (STENOX, POST, and STEPH studies). Seasonal variation of SVT frequency was evaluated by comparing the observed seasonal frequency of SVT to a theoretical frequency of 25% for each season. The analysis included 1395 patients and 4.75 seasonal cycles. The difference to a theoretical frequency of 25% was statistically significant in one study (POST, p = 0.044). The higher risk difference was -6.1% (95% CI -11.7–−0.5) in summer in STENOX, +7.1% (95% CI +2.7-+11.5) in winter in POST and 4.2% (95% CI -5.2-+13.7) in spring in STEPH, corresponding to a relative risk of 0.80, 1.40 and 1.20, respectively. A seasonal variation was found in only one study which has the weakest methodology to warrant completeness. Variation pattern was

  9. Renal vein thrombosis mimicking urinary calculus: a dilemma of diagnosis.

    Science.gov (United States)

    Wang, Yimin; Chen, Shanwen; Wang, Wei; Liu, Jianyong; Jin, Baiye

    2015-07-02

    Renal vein thrombosis (RVT) with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified RVT. A 38-year-old woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. She underwent extracorporeal shock wave lithotripsy that failed, leading to the recommendation that percutaneous lithotomy was necessary to remove the renal calculus. In preoperative view of the unusual shape of the calculus without hydronephrosis, noncontrast computed tomography was taken and demonstrated left ureteric calculus. However computed tomography angiography revealed, to our surprise, a calcified RVT that was initially thought to be a urinary calculus. This case shows that a calcified RVT might mimic a urinary calculus on conventional ultrasonography and ureteric calculus on noncontrast computed tomography. Subsequent computed tomography angiography disclosed that a calcified RVT caused the imaging findings, thus creating a potentially dangerous clinical pitfall. Hence, it is suggested that the possibility of a RVT needs to be considered in the differential diagnosis whenever one detects an uncommon shape for a urinary calculus.

  10. Small bowel varices secondary to chronic superior mesenteric vein thrombosis in a patient with heterozygous Factor V Leiden mutation: a case report.

    Science.gov (United States)

    Garcia, Maria C; Ahlenstiel, Golo; Mahajan, Hema; van der Poorten, David

    2015-10-01

    Bleeding ectopic small bowel varices pose a clinical dilemma for the physician, given their diagnostic obscurity and the lack of evidence-based medicine to guide therapy. They often occur in the context of portal hypertension, secondary to either liver disease or extrahepatic causes. Rarely is their presence associated with chronic superior mesenteric vein thrombosis and hereditary coagulopathies. A 74-year-old white woman, with a heterozygous Factor V Leiden mutation and no underlying liver disease or portal hypertension, presented over the course of 13 months for recurrent episodes of melena and per rectal bleeding. An initial endoscopy showed a clean-based chronic gastric ulcer, while colonoscopies showed multiple, non-bleeding angioectasias which were treated with argon plasma coagulation. Subsequent video capsule endoscopy and double balloon enteroscopy revealed red wale marks overlying engorged submucosal veins in her distal ileum, consistent with ectopic varices. A chronic superior mesenteric vein thrombus, found via computed tomography venogram, was the cause of the ileal varices. She underwent curative surgical resection of the affected bowel, with no re-bleeding episodes 17 months post-surgery, despite needing lifelong anticoagulation for recurrent venous thromboembolisms. Clinicians should consider ectopic varices in patients who present with obscure gastrointestinal bleeding, even in the absence of portal hypertension or liver disease. In those with a known thrombophilia, patients should be screened for splanchnic thrombosis, which may precipitate ectopic varices.

  11. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A [Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis (United States)

    2014-02-15

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  12. Balloon occlusion retrograde transvenous obliteration of gastric varices in two-cirrhotic patients with portal vein thrombosis

    International Nuclear Information System (INIS)

    Borhei, Peyman; Kim, Seung Kwon; Zukerman, Darryl A

    2014-01-01

    This report describes two non-cirrhotic patients with portal vein thrombosis who underwent successful balloon occlusion retrograde transvenous obliteration (BRTO) of gastric varices with a satisfactory response and no complications. One patient was a 35-year-old female with a history of Crohn's disease, status post-total abdominal colectomy, and portal vein and mesenteric vein thrombosis. The other patient was a 51-year-old female with necrotizing pancreatitis, portal vein thrombosis, and gastric varices. The BRTO procedure was a useful treatment for gastric varices in non-cirrhotic patients with portal vein thrombosis in the presence of a gastrorenal shunt.

  13. The risk of venous thrombosis in individuals with a history of superficial vein thrombosis and acquired venous thrombotic risk factors.

    Science.gov (United States)

    Roach, Rachel E J; Lijfering, Willem M; van Hylckama Vlieg, Astrid; Helmerhorst, Frans M; Rosendaal, Frits R; Cannegieter, Suzanne C

    2013-12-19

    Superficial vein thrombosis (SVT) increases the risk of venous thrombosis fourfold to sixfold. As most individuals with SVT do not develop venous thrombosis, additional risk factors may explain the risk of developing a venous thrombosis. In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study, we assessed the risk of venous thrombosis in individuals with previous SVT and a mild thrombotic risk factor (smoking or overweight/obesity), a strong risk factor (surgery, hospitalization, plaster cast immobilization, or malignancy), or a reproductive factor in women (oral contraception, postmenopausal hormone therapy, or pregnancy/puerperium). Individuals with previous SVT alone had a 5.5-fold (95% confidence interval [CI], 4.4-6.8) increased risk of venous thrombosis. This was 9.3 (95% CI, 7.2-12.1) combined with a mild thrombotic risk factor, 31.4 (95% CI, 14.6-67.5) with a strong risk factor, and 34.9 (95% CI, 19.1-63.8) in women with a reproductive risk factor. The highest separate risk estimates were found for SVT with surgery (42.5; 95% CI, 10.2-177.6), hospitalization (49.8; 95% CI, 11.9-209.2), or oral contraception (43.0; 95% CI, 15.5-119.3 in women). In conclusion, the risk of venous thrombosis is markedly increased in individuals with previous SVT who have an acquired thrombotic risk factor.

  14. Simultaneous thrombosis of superior mesenteric artery and superior mesenteric vein following chemotherapy: MDCT findings.

    Science.gov (United States)

    Olgun, Deniz Cebi; Bakan, Selim; Samanci, Cesur; Tutar, Onur; Demiryas, Suleyman; Korkmazer, Bora; Kantarci, Fatih

    2014-02-01

    A case of acute mesenteric ischemia due to thrombosis of superior mesenteric artery and vein in a 44-year-old woman following chemotherapy for invasive laryngeal carcinoma was diagnosed on a multi-detector CT scan. Although the link between malignancy and thromboembolism is widely recognized in patients with cancer, chemotherapy further elevates the risk of thrombosis. Acute mesenteric ischemia associated or not associated with chemotherapy rarely occurs in patients with cancer. Moreover, co-occurrence of superior mesenteric artery and superior mesenteric vein thrombosis is reported for the first time.

  15. Paroxysmal Nocturnal Haemoglobinuria Type III Presenting as Portal and Mesenteric Vein Thrombosis in a Young Girl.

    Science.gov (United States)

    Sarwar, Shahzad; Chaudhry, Monazza; Ali, Natasha

    2016-11-01

    Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired, life-threatening haematological disorder. It is characterised by complement induced haemolytic anaemia, thrombosis and impaired bone marrow function. Thrombosis most commonly occurs in the hepatic, portal, superior mesenteric and cerebral veins. A22-year female, previously diagnosed with severe aplastic anaemia treated with anti-lymphocyte globulin (ALG) and cyclosporine, had become transfusion independent for more than 10 years. She presented with abdominal pain and vomiting, initially diagnosed with portal and superior mesenteric vein thrombosis. Immunophenotyping by flow cytometry revealed a diagnosis of paroxysmal nocturnal haemoglobinuria type III. She was treated with vitmamin K anatagonist and platelet transfusion.

  16. Neutrophil histone modification by peptidylarginine deiminase 4 is critical for deep vein thrombosis in mice.

    Science.gov (United States)

    Martinod, Kimberly; Demers, Melanie; Fuchs, Tobias A; Wong, Siu Ling; Brill, Alexander; Gallant, Maureen; Hu, Jing; Wang, Yanming; Wagner, Denisa D

    2013-05-21

    Deep vein thrombosis and pulmonary embolism are major health problems associated with high mortality. Recently, DNA-based neutrophil extracellular traps (NETs) resulting from the release of decondensed chromatin, were found to be part of the thrombus scaffold and to promote coagulation. However, the significance of nuclear decondensation and NET generation in thrombosis is largely unknown. To address this, we adopted a stenosis model of deep vein thrombosis and analyzed venous thrombi in peptidylarginine deiminase 4 (PAD4)-deficient mice that cannot citrullinate histones, a process required for chromatin decondensation and NET formation. Intriguingly, less than 10% of PAD4(-/-) mice produced a thrombus 48 h after inferior vena cava stenosis whereas 90% of wild-type mice did. Neutrophils were abundantly present in thrombi formed in both groups, whereas extracellular citrullinated histones were seen only in thrombi from wild-type mice. Bone marrow chimera experiments indicated that PAD4 in hematopoietic cells was the source of the prothrombotic effect in deep vein thrombosis. Thrombosis could be rescued by infusion of wild-type neutrophils, suggesting that neutrophil PAD4 was important and sufficient. Endothelial activation and platelet aggregation were normal in PAD4(-/-) mice, as was hemostatic potential determined by bleeding time and platelet plug formation after venous injury. Our results show that PAD4-mediated chromatin decondensation in the neutrophil is crucial for pathological venous thrombosis and present neutrophil activation and PAD4 as potential drug targets for deep vein thrombosis.

  17. Mesenteric vein thrombosis caused by secondary polycythaemia from AndroGel.

    Science.gov (United States)

    Katz, Heather; Popov, Eugene; Bray, Natasha; Berman, Barry

    2014-10-21

    Mesenteric vein thrombosis is a rare but potentially lethal cause of abdominal pain. It is usually caused by prothrombotic states that can either be hereditary or acquired. Testosterone supplementation causes an acquired prothrombotic state by promoting erythropoeisis thus causing a secondary polycythaemia. We report a case of a 59-year-old man with a history of chronic obstructive pulmonary disease (COPD) stage III, who presented with abdominal pain. Evaluation revealed an elevated haemoglobin and haematocrit, a superior mesenteric vein thrombosis on CT and a negative Janus kinase 2 mutation. The patient is currently being treated with 6 months of anticoagulation with rivaroxiban. Although a well-known side effect of testosterone is thrombosis, the present case is used to document in the literature the first case of mesenteric vein thrombosis due to secondary polycythaemia from Androgel in the setting of COPD. 2014 BMJ Publishing Group Ltd.

  18. Painful swollen leg – think beyond deep vein thrombosis or Baker's cyst

    Directory of Open Access Journals (Sweden)

    Babu Vinayagam

    2008-01-01

    Full Text Available Abstract Background The diagnosis of deep vein thrombosis of leg is very common in clinical practice. Not infrequently a range of pathologies are diagnosed after excluding a thrombosis, often after a period of anticoagulation. Case presentation This is a report of three patients who presented with a painful swollen leg and were initially treated as a deep vein thrombosis or a baker's cyst, but later diagnosed as a pleomorphic sarcoma, a malignant giant cell tumor of the muscle and a myxoid liposarcoma. A brief review of such similar reports and the relevant literature is presented. Conclusion A painful swollen leg is a common clinical scenario and though rare, tumors must be thought of without any delay, in a duplex negative, low risk deep vein thrombosis situation.

  19. Septic thrombosis of the portal vein due to peripancreatic ligamental abscess

    Energy Technology Data Exchange (ETDEWEB)

    Wakisaka, M.; Mori, H.; Kiyosue, H. [Dept. of Radiology, Oita Medical Univ. (Japan); Kamegawa, T. [Dept. of Surgery, Nankai Hospital (Japan); Uragami, S. [Dept. of Internal Medicine, Nankai Hospital, Saiki (Japan)

    1999-02-01

    Septic thrombus formation of both the main portal vein and its intrahepatic branches were observed on CT in a patient with peripancreatic abscess. The septic thrombosis of portal vein (STPV) extended from the level of porta hepatis into the intrahepatic branches, but the portal vein and superior mesenteric vein at the level of pancreatic head were preserved with no evidence of thrombosis angiographically. The gas-containing abscess near the head of the pancreas extended toward the hepatic hilum and surrounded the portal vein and its branches on CT. It was concluded that these thrombi of portal vein branches at porta hepatis and intrahepatic branches were caused by extensions of peripancreatic abscess via the hepatoduodenal ligament and ligamentum teres. Computed tomography was useful in depicting the ligamentous spread of peripancreatic abscess resulting in STPV. (orig.) (orig.) With 2 figs., 6 refs.

  20. Septic thrombosis of the portal vein due to peripancreatic ligamental abscess

    International Nuclear Information System (INIS)

    Wakisaka, M.; Mori, H.; Kiyosue, H.; Kamegawa, T.; Uragami, S.

    1999-01-01

    Septic thrombus formation of both the main portal vein and its intrahepatic branches were observed on CT in a patient with peripancreatic abscess. The septic thrombosis of portal vein (STPV) extended from the level of porta hepatis into the intrahepatic branches, but the portal vein and superior mesenteric vein at the level of pancreatic head were preserved with no evidence of thrombosis angiographically. The gas-containing abscess near the head of the pancreas extended toward the hepatic hilum and surrounded the portal vein and its branches on CT. It was concluded that these thrombi of portal vein branches at porta hepatis and intrahepatic branches were caused by extensions of peripancreatic abscess via the hepatoduodenal ligament and ligamentum teres. Computed tomography was useful in depicting the ligamentous spread of peripancreatic abscess resulting in STPV. (orig.) (orig.)

  1. Accurate diagnosis of iliac vein thrombosis in pregnancy with magnetic resonance direct thrombus imaging (MRDTI).

    Science.gov (United States)

    Dronkers, Charlotte E A; Srámek, Alexandr; Huisman, Menno V; Klok, Frederikus A

    2016-12-13

    A pregnant woman aged 29 years, G1P0 at 21 weeks of gestation of a dichorionic diamniotic twin, presented with suspected deep vein thrombosis (DVT) of the left leg. Repeated (compression) ultrasonography was not diagnostic for DVT but showed reduced flow over the left external iliac vein, common femoral vein and superficial femoral vein. In pursue of a definite diagnosis, magnetic resonance direct thrombus imaging was performed showing a clear high signal in the left common iliac vein which is diagnostic for acute thrombosis in this venous segment. Phase contrast venography supported this diagnosis, showing no flow in the left common iliac vein. Treatment with anticoagulants was started. 6 months after the diagnosis, the patient is doing well and does not report signs of post-thrombotic syndrome. 2016 BMJ Publishing Group Ltd.

  2. Catheter directed thrombolysis for deep vein thrombosis during the first trimester of pregnancy: two case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kum Rae; Park, Won Kyu; Kim, Jae Woon; Kwun, Woo Hyung; Suh, Bo Yang [College of Medicine, Yeungnam University, Daegu (Korea, Republic of); Park, Kyeong Seok [Yeungnam University, Medical Center, Daegu (Korea, Republic of)

    2008-02-15

    Anticoagulation with heparin has been the standard management therapy of deep vein thrombosis during pregnancy. Pregnancy is generally considered as a contraindication for thrombolysis. However, anticoagulation therapy alone does not protect the limbs from post-thrombotic syndrome and venous valve insufficiency. Catheter-directed thrombolysis, combined with angioplasty and stenting, can remove the thrombus and restore patency of the veins, resulting in prevention of post-thrombotic syndrome and valve insufficiency. We report successful catheter-directed thrombolysis and stenting in two early gestation patients with a deep vein thrombosis of the left lower extremity.

  3. Catheter directed thrombolysis for deep vein thrombosis during the first trimester of pregnancy: two case report

    International Nuclear Information System (INIS)

    Kim, Kum Rae; Park, Won Kyu; Kim, Jae Woon; Kwun, Woo Hyung; Suh, Bo Yang; Park, Kyeong Seok

    2008-01-01

    Anticoagulation with heparin has been the standard management therapy of deep vein thrombosis during pregnancy. Pregnancy is generally considered as a contraindication for thrombolysis. However, anticoagulation therapy alone does not protect the limbs from post-thrombotic syndrome and venous valve insufficiency. Catheter-directed thrombolysis, combined with angioplasty and stenting, can remove the thrombus and restore patency of the veins, resulting in prevention of post-thrombotic syndrome and valve insufficiency. We report successful catheter-directed thrombolysis and stenting in two early gestation patients with a deep vein thrombosis of the left lower extremity

  4. Prevalence of deep vein thrombosis in patients with paraplegia caused by traumas

    Directory of Open Access Journals (Sweden)

    Nelson Mesquita Junior

    2013-12-01

    Full Text Available BACKGROUND: Deep vein thrombosis is a common disease among people who are immobilized. Immobility is inherent to paraplegia and leads to venous stasis, which is one of the factors covered by Virchow's triad describing its development. Trauma is the primary cause of paraplegia and is currently increasing at a rate of 4% per year. OBJECTIVE: To determine the prevalence of deep vein thrombosis in paraplegic patients whose paraplegia was caused by traumas, using color Doppler ultrasonography for diagnosis. METHODS: This was a cross-sectional observational study of 30 trauma-induced paraplegia patients, selected after analysis of medical records at the neurosurgery department of a University Hospital in Curitiba, Brazil, and by a proactive survey of associations that care for the physically disabled. The prevalence of deep vein thrombosis was analyzed using 95% confidence intervals. RESULTS: Spinal cord trauma was the cause of paraplegia in 29 patients. The most common cause of trauma was gunshot wounding, reported by 17 patients. Deep vein thrombosis was diagnosed by color Doppler ultrasonography in 14 patients in the sample. The most often affected vein was the posterior tibial, in 11 patients. The left lower limb was involved three times more often than the right. Edema was observed in 25 individuals, cyanosis in 14, ulcers in 8 and localized increase in temperature in 13. CONCLUSIONS: Deep vein thrombosis was prevalent, occurring in 46.7% of the patients.

  5. [Routine screening of splenic or portal vein thrombosis after splenectomy].

    Science.gov (United States)

    Bouvier, A; Gout, M; Audia, S; Chalumeau, C; Rat, P; Deballon, O

    2017-01-01

    Portal and/or splenic vein thrombosis (PSVT) is common after splenectomy. It can be a life-threatening complication, with a risk of bowel ischemia and portal hypertension. An early diagnosis allows an effective medical treatment and prevents life-threatening complications. There is no consensus regarding the benefit of systematic screening of patients after splenectomy for PSVT. We started in January 2012 a routine screening of PSVT after elective splenectomy. The aim of this study was to assess this policy. Since January 2012, all patients undergoing an elective splenectomy had an abdominal CT-scan on postoperative-day 7. Demographic data, pathology, type of surgery, platelet counts before and after surgery, outcome, results of medical imaging, and management of PSVT and its results were recorded. Over 3 years, 52 patients underwent an elective splenectomy. All of them had a CT-scan at postoperative-day 7. A PSVT was found in 11 patients (21.2 %). They were all asymptomatic. Lymphoma and splenomegaly were the main factors associated with PSVT in the univariate analysis. All patients with PSVT were treated with anticoagulation and no complication of PSVT occurred. The follow-up CT confirmed the efficacy of anticoagulation therapy in all patients. Routine screening of PSVT after elective splenectomy is warranted because it allows to start anticoagulant therapy and avoid further life-threatening complications. The incidence of PSVT is particularly high among patients operated on for lymphoma or with splenomegaly. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  6. Factors associated with the development of superficial vein thrombosis in patients with varicose veins.

    Science.gov (United States)

    Karathanos, Christos; Exarchou, Maria; Tsezou, Aspasia; Kyriakou, Despina; Wittens, Cees; Giannoukas, Athanasios

    2013-07-01

    Superficial vein thrombosis (SVT) is a common and controversial clinical entity. Recent studies have demonstrated that SVT should be seen as a venous thromboembolism (VTE). The objective of this study was to investigate the prevalence of thrombophilia defects and to estimate the role of age, sex and body mass index (BMI) in patients with varicose veins (VVs) and SVT. A total of 230 patients with VVs, 128 with, and 102 without SVT underwent thrombophilia testing included factor V Leiden, prothrombin G20210A, methylenetetrahydrofolate reductase and plasminogen activator inhibitor- 1 mutations, protein C, protein S (PS), anti-thrombin III and plasminogen deficiencies and levels of A2 antiplasmin, activate protein C resistance and lupus anticoagulant. According to Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification patients were categorized in two subgroups: moderate disease (C2,3) and severe disease (C4,5,6). Age and body mass index were also assessed. The prevalence of thrombophilia defects was significantly higher in patients with moderate disease and SVT (p=0.002). In the C2,3 group, SVT was associated with PS deficiency (p=0.018), obesity (p<0.001), male gender (p=0.047) and age (p<0.001). There were no significant differences in patients with severe disease. Age, male sex, obesity and PS deficiency are factors associated with SVT development among patients with VVs having moderate disease (C2,3). Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Treatment of postoperative main portal vein and superior mesenteric vein thrombosis with balloon angioplasty and/or stent placement.

    Science.gov (United States)

    Cao, Guangshao; Ko, Gi-Young; Sung, Kyu-Bo; Yoon, Hyun-Ki; Gwon, Dong Il; Kim, Jin-Hyoung

    2013-06-01

    Thrombolysis and mechanical thrombectomy have been used to treat postoperative main portal vein and superior mesenteric vein thrombosis. To evaluate the safety and efficacy of balloon angioplasty and/or stent placement without thrombolysis or thrombectomy for treating such thromboses. Fourteen patients with postoperative main portal vein or superior mesenteric vein thrombosis underwent percutaneous transhepatic balloon angioplasty and/or stent placement without thrombolysis or thrombectomy. The rates of technical and clinical success, major complications, and recurrence were evaluated retrospectively. Initial technical success was achieved in 13 of the 14 patients (93%). After the procedures, these 13 patients showed brisk portal inflow, without a significant amount of residual thrombus in the stented lumen or embolism. One patient was considered to be a technical failure despite showing a brisk portal inflow because 50% stenosis and partial residual thrombus remained in the stented lumen. Initial clinical success was achieved in 13 patients. One patient with technical success died of acute respiratory distress syndrome 8 days after the procedure, whereas one patient with technical failure achieved clinical success. One patient experienced acute rethrombosis 8 days after the procedure. During the median follow-up period of 16.3 months, rethrombosis occurred in six patients (43%), including one patient with acute rethrombosis. Balloon angioplasty and/or stent placement without thrombolysis or thrombectomy may be a safe and effective treatment modality for postoperative main portal vein and superior mesenteric vein thrombosis. © 2013 The Foundation Acta Radiologica.

  8. Spontaneously reversible portal vein thrombosis complicating acute pancreatits - computed tomographic findings; Computertomographische Verlaufsbeobachtungen der spontanen Rueckbildung von Portalvenenthrombosen bei akuter Pankreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, J.; Lorenz, F.; Vlahovic, J. [Klinikum Niederberg Velbert (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie; Kirchner, E.M. [Klinikum Duisburg (Germany). Klinik fuer Innere Medizin

    2008-07-01

    Portal vein thrombosis complicating acute pancreatitis is more often diagnosed today due to the improved imaging techniques (computed tomography, ultrasound, nmr). Nevertheless the outcome of recent portal vein thrombosis is ill-known. We report on the computed tomographic findings and clinical course of portal vein thrombosis in two patients suffering from acute pancreatitis. Both patients showed spontaneous recanalization of the thrombosis. (orig.)

  9. Increased risk of venous thrombosis in persons with clinically diagnosed superficial vein thrombosis: results from the MEGA study.

    Science.gov (United States)

    van Langevelde, Kirsten; Lijfering, Willem M; Rosendaal, Frits R; Cannegieter, Suzanne C

    2011-10-13

    Superficial vein thrombosis (SVT) is regarded a self-limiting disorder, although the authors of recent studies showed that ultrasonographically diagnosed SVT is a precursor for venous thrombosis. We aimed to determine whether the same holds true for clinically diagnosed SVT and to what extent it is associated with thrombophilia in a population-based case-control study (ie, Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis). We found that a history of clinical SVT was associated with a 6.3-fold (95% confidence interval [CI] 5.0-8.0) increased risk of deep-vein thrombosis and a 3.9-fold (95% CI 3.0-5.1) increased risk of pulmonary embolism. Blood group non-O and factor V Leiden showed a small increase in SVT risk in controls, with odds ratios of 1.3 (95% CI 0.9-2.0) and 1.5 (95% CI 0.7-3.3), respectively. In conclusion, clinically diagnosed SVT was a risk factor for venous thrombosis. Given that thrombophilia was only weakly associated with SVT, it is likely that other factors (varicosis, obesity, stasis) also play a role in its etiology.

  10. ABDUCENS NERVE PALSY AND THROMBOSIS OF THE CEREBRAL VEINS AND SINUSES - A DIAGNOSTIC PITFALL

    Directory of Open Access Journals (Sweden)

    Alexandra J. Tzoukeva

    2012-12-01

    Full Text Available Thrombosis of the cerebral veins and sinuses is an infrequent cerebrovascular disorder. Because the highly variable symptoms, recent neuroimaging plays a key role in the diagnosis. Abducens nerve palsy as a focal neurological deficit is a rare clinical manifestation in these patients. We present two cases with sudden onset of diplopia and headache. Case 1: A 3-year old girl with B cell lymphoblastic leukemia developed bilateral abducens deficit and bilateral optic disc edema after treatment including L-asparaginase. Thrombosis of the right jugular vein, sagittal and right sigmoid sinuses was visualized on magnetic resonance imaging (MRI and magnetic resonance venography (MRV. Symptoms gradually resolved after treatment with enoxiparine and MRV demonstrated recanalization.Case 2: A 75-year old female with medical history of arterial hypertension presented with headache and sudden left abduction deficit. Computerized tomography (CT scan was normal. MRI and MRV revealed aging brain and disruption of venous flow at the left internal jugular vein, suspecting thrombosis. Extracranial colour duplex sonography and CT angiography proved haemodinamic equivalent of left internal jugular vein thrombosis due to sclerotic pathology of aortic arch.Our first case illustrates the role of improved neuroimaging techniques as the best method for diagnosis of cerebral veins and sinuses thrombosis, presenting with abducens nerve palsy. With second case the potential neuroimaging pitfalls concerning the accurate diagnosis of these cerebrovascular disorders with neuro-ophthalmologic manifestation are discussed.

  11. Lower Extremity Deep Vein Thrombosis among Intensive Care ...

    African Journals Online (AJOL)

    Introduction. Deep Venous Thrombosis (DVT) is a common preventable health problem associated with high mortality worldwide. The factors that predispose to venous thrombosis were initially described by Virchow in 18561 and include stasis, vascular damage and hypercoagulability. The risk for DVT has been reported.

  12. A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male

    Directory of Open Access Journals (Sweden)

    Javier Corral

    2016-01-01

    Full Text Available We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.

  13. Frequency of superficial and deep vein thrombosis in patients with variations of superficial veins of lower extremities.

    Science.gov (United States)

    Lovic, Svetlana; Delic, Jasmin; Ljuca, Farid; Mujanovic, Emir; Custendil-Delic, Sunita; Zabic, Aida; Suljkanovic-Mahmutovic, Ahida

    2012-01-01

    Anatomical variations of veins often play a crucial role in formation of thrombotic changes in superficial and deep veins of lower extremities. THE AIM of this study was to determine the frequency of the dominant type of the lower extremity superficial veins, and to determine the eventual influence of such variations to the formation of superficial and deep vein thrombosis (DVT). The sample used in this study consisted of 180 patients subjected to ascedent contrast phlebography of lower extremities. The total sample was divided into following groups: patients with and without variations of the lower extremity superficial veins. Dominant type of the superficial veins (without variation) consisted of 97 patients (53.89%), while the rest of 83 patients showed some kind of anatomical variation (46.11%). The most frequent variation was the duplicated form ofv. saphena magna in 53.85%, while this procentage in women was 57.89%. Most frequent variations of duplicated v. saphena magna were: simple duplicated form, closed loop form, branching form and combined form. Topographical variation of saphenopopliteal junction besides fossa poplitea in the group of men showed procentage of 53.85%, while in the group of women that value accounted 63.16%. The percentage of varicose veins was more frequent in men and women without variations, but deep vein DVT showed higher frequency in patients with anatomical variations of superficial veins of lower extremities.

  14. Phlebitis, pulmonary emboli and presidential politics: Richard M. Nixon's complicated deep vein thrombosis.

    Science.gov (United States)

    Pascarella, Luigi; Pappas, Theodore N

    2013-02-01

    In September of 1974, Richard Nixon resigned the Presidency of the United States during an impeachment investigation concerning the Watergate Affair. One month after his resignation, the former President had an exacerbation of his chronic deep vein thrombosis. He also received a Presidential pardon from Gerald Ford on the same day that his recurrent deep vein thrombosis was diagnosed. The political, legal, and medical events that unfolded in the fall of 1974 are the substance of this report. Presidents often receive medical care that stretches the ordinary as a result of their position and the importance of their actions. The events surrounding Richard Nixon's care for deep vein thrombosis and its complications were not unusual for Presidential health care but were closely intertwined with the legal proceedings during the prosecution of the Watergate defendants.

  15. The use of infrared thermal imaging in the diagnosis of deep vein thrombosis

    Science.gov (United States)

    Kacmaz, Seydi; Ercelebi, Ergun; Zengin, Suat; Cindoruk, Sener

    2017-11-01

    The diagnosis of Deep Vein Thrombosis is of vital importance, especially in emergency situations where there is a lack of time and the patient's condition is critical. Late diagnosis causes cost increase, long waiting time, and improper treatment. Today, with the rapidly developing technology, the cost of thermal cameras is gradually decreasing day by day. Studies have shown that many diseases are associated with heat. As a result, infrared images are thought to be a tool for diagnosing various diseases. In this study, it has been shown that infrared thermal imaging can be used as a pre-screening test in the diagnosis of Deep Vein Thrombosis with the developed computer aided software. In addition, a sample combination is shown for applications that utilize emergency services to perform diagnosis and treatment of Deep Vein Thrombosis as soon as possible.

  16. Clinical and radiographic presentation of superior mesenteric vein thrombosis in Crohn's disease: a single center experience.

    Science.gov (United States)

    Kopylov, Uri; Amitai, Marianne M; Lubetsky, Aharon; Eliakim, Rami; Chowers, Yehuda; Ben-Horin, Shomron

    2012-06-01

    Mesenteric vein thrombosis (MVT) is a rare and frequently underdiagnosed complication of Crohn's disease (CD). This study describes the clinical and radiological characteristics of CD /patients with superior mesenteric vein thrombosis (MVT) diagnosed by CT/MRI. The database of Crohn's disease patients treated in Sheba Medical Center between 2005-2010 was searched for MVT diagnosis. Imaging studies of identified patients were retrieved and reviewed by an experienced abdominal radiologist. MVT was defined by superior mesenteric vein obliteration and/or thrombus in the vessel lumen on abdominal imaging. The clinical and radiologic data of these patients were collected from the medical records. MVT was demonstrated in 6/460 CD patients. Five patients had stricturing disease, and one patient had a combined fistulizing and stricturing disease phenotype. All patients had small bowel disease, but 3/6 also had colonic involvement. No patient had a prior thromboembolic history or demonstrable hypercoagulability. One patient had an acute SMV thrombus demonstrable on CT scanning, the remaining patients showed an obliteration of superior mesenteric vein. Two patients received anticoagulation upon diagnosis of thrombosis. No subsequent thromboembolic events were recorded. The incidence of mesenteric vein thrombosis is likely to be underestimated in patients with Crohn's disease. Both CT and MRI imaging demonstrate the extent of enteric disease and coincident SMV thrombosis. In our cohort, thrombosis was associated with stricturing disease of the small bowel. The clinical impact of SMV thrombosis and whether anticoagulation is mandatory for all of these patients remains to be determined. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  17. Fondaparinux for the treatment of superficial-vein thrombosis in the legs.

    Science.gov (United States)

    Decousus, Hervé; Prandoni, Paolo; Mismetti, Patrick; Bauersachs, Rupert M; Boda, Zoltán; Brenner, Benjamin; Laporte, Silvy; Matyas, Lajos; Middeldorp, Saskia; Sokurenko, German; Leizorovicz, Alain

    2010-09-23

    The efficacy and safety of anticoagulant treatment for patients with acute, symptomatic superficial-vein thrombosis in the legs, but without concomitant deep-vein thrombosis or symptomatic pulmonary embolism at presentation, have not been established. In a randomized, double-blind trial, we assigned 3002 patients to receive either fondaparinux, administered subcutaneously at a dose of 2.5 mg once daily, or placebo for 45 days. The primary efficacy outcome was a composite of death from any cause or symptomatic pulmonary embolism, symptomatic deep-vein thrombosis, or symptomatic extension to the saphenofemoral junction or symptomatic recurrence of superficial-vein thrombosis at day 47. The main safety outcome was major bleeding. The patients were followed until day 77. The primary efficacy outcome occurred in 13 of 1502 patients (0.9%) in the fondaparinux group and 88 of 1500 patients (5.9%) in the placebo group (relative risk reduction with fondaparinux, 85%; 95% confidence interval [CI], 74 to 92; Pvein thrombosis was 85% lower in the fondaparinux group than in the placebo group (0.2% vs. 1.3%; 95% CI, 50 to 95; Pvein thrombosis. Major bleeding occurred in one patient in each group. The incidence of serious adverse events was 0.7% with fondaparinux and 1.1% with placebo. Fondaparinux at a dose of 2.5 mg once a day for 45 days was effective in the treatment of patients with acute, symptomatic superficial-vein thrombosis of the legs and did not have serious side effects. (Funded by GlaxoSmithKline; ClinicalTrials.gov number, NCT00443053.)

  18. Diagnosis and management of deep vein thrombosis of the upper extremity: a review

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, Henk J.; Reekers, Jim A. [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Koopman, Maria M.W. [Department of Vascular Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Beek, Edwin J.R. van [Unit of Academic Radiology, Floor C, Royal Hallamshire Hospital, Glossop Road, S10 2JF, Sheffield (United Kingdom)

    2004-07-01

    Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background, the imaging modalities that may be employed, treatment options and outcome of patients with upper extremity thrombosis. (orig.)

  19. Diagnosis and management of deep vein thrombosis of the upper extremity: a review

    International Nuclear Information System (INIS)

    Baarslag, Henk J.; Reekers, Jim A.; Koopman, Maria M.W.; Beek, Edwin J.R. van

    2004-01-01

    Deep vein thrombosis of the upper extremity is an increasing clinical problem due to the use of long-term indwelling catheters for chemotherapy or long-term feeding. The clinical diagnosis is difficult to make, and various imaging modalities have been used for this purpose. The use of (interventional) radiological procedures has been advancing in recent years. This review describes the clinical background, the imaging modalities that may be employed, treatment options and outcome of patients with upper extremity thrombosis. (orig.)

  20. The color Doppler ultrasonography in in the diagnosis of deep vein thrombosis

    International Nuclear Information System (INIS)

    Ameneiro Perez, Santiago; Alvarez Sanchez, Jose A.; Rodriguez Villalonga, Luis; Borras Migues, Marisela; Quinnones Castro, Mayda

    2004-01-01

    The paper was aimed at evaluating the accuracy of color Doppler ultrasonography, a noninvasive method, in the diagnosis of deep vein thrombosis of the lower limbs, comparing it to the results of the cruel and costly diagnostic g olden rule , that is, phlebography. Methods: Color Doppler ultrasonography served to assess 102 patients clinically suspected of deep vein thrombosis of the lower limbs, taking into account the following criteria: vein compressibility, echographic images, color, Vein Doppler signal modulation after several maneuvers and distal compression. Sensitivity, specificity, positive and negative predictive values and diagnostic efficacy were estimated for each criteria, taking the phlebography as a reference. Results: Total or partial lack of vein compressibility combined with the vein flow evaluation is the ultrasonographic criterion that reveals higher degree of sensitivity, specificity and efficacy (0,98; 0,95 and 0,97 respectively. Color Doppler ultrasonography is a highly effective noninvasive diagnostic method that detects deep vein thrombosis in proximal areas of the lower limbs

  1. Medical management of acute superficial vein thrombosis of the saphenous vein.

    Science.gov (United States)

    Scovell, Sherry D; Ergul, Emel A; Conrad, Mark F

    2018-01-01

    Acute superficial vein thrombosis (SVT) of the axial veins, such as the great saphenous vein (GSV), is a common clinical condition that carries with it significant risk of propagation of thrombus, recurrence, and, most concerning, subsequent venous thromboembolism (VTE). Conservative therapy with nonsteroidal anti-inflammatory medication and heat does not prevent extension of thrombus or protect against recurrent or future VTE in patients with extensive SVT (thrombotic segment of at least 5 cm in length). To prevent future thromboembolic events, anticoagulation has become the treatment of choice for extensive acute SVT in the GSV. In spite of this, the dose and duration of anticoagulation in the treatment of SVT vary widely. This review summarizes the evidence from large prospective, randomized clinical trials on the treatment of SVT with anticoagulation (vs placebo or different doses and durations of anticoagulation) with respect to the outcome measures of thrombus extension, SVT recurrence, and future VTE. A systematic search was performed using the MEDLINE database to identify all prospective, randomized controlled trials of treatment with anticoagulation in patients with SVT in the GSV. Six prospective, randomized trials were identified that met the inclusion criteria and were reviewed in detail. Treatment of acute SVT was most commonly managed in an outpatient setting using either low-molecular-weight heparin (LMWH) in four studies or, alternatively, a factor Xa inhibitor in one large multicenter trial. LMWH was associated with a lower rate of thrombus extension and subsequent recurrence, especially when an intermediate dose (defined as a dose between prophylactic and therapeutic doses) was used for a period of 30 days. The full effect of treatment with LMWH on the risk of subsequent VTE remains unclear, as do the optimal dose and duration of this drug. Prophylactic doses of fondaparinux, a factor Xa inhibitor, were found to be beneficial in reducing the

  2. Obesity is an independent risk factor for pre-transplant portal vein thrombosis in liver recipients

    Directory of Open Access Journals (Sweden)

    Ayala Rosa

    2012-08-01

    Full Text Available Abstract Background Portal vein thrombosis is a frequent complication in end-stage cirrhosis with a considerable peri-operative risk for liver transplant candidates. We aimed to characterize the pre-transplant portal vein thrombosis in a cohort of liver transplant recipients, and to identify independent risk factors for this complication. Methods 380 consecutive primary orthotopic liver transplants were performed in the Digestive Surgery Department of “12 de Octubre” Hospital (Madrid, Spain, between January 2001 and December 2006. The main risk factors considered were smoking, obesity, metabolic disorders, previous immobility, surgery or trauma, nephrotic syndrome, associated tumor, inflammatory disease, neoplasm myeloprolipherative. Furthermore we have reported genetic thrombophilia results for 271 recipients. Results Sixty-two (16.3% patients developed pre-transplant portal vein thrombosis and its presence had no impact in the overall survival of liver recipients. Obesity was the only independent risk factor for pre-transplant portal vein thrombosis. Conclusion We recommend close control of cardiovascular factors in patients with liver cirrhosis in order to avoid associated thrombosis.

  3. The natural history of pelvic vein thrombosis on magnetic resonance venography after vaginal delivery.

    Science.gov (United States)

    Khalil, Hisham; Avruch, Leonard; Olivier, Andre; Walker, Mark; Rodger, Marc

    2012-04-01

    Venous thromboembolism constitutes the leading cause of direct maternal mortality in the developed world. To date, there are no studies using magnetic resonance venography (MRV) to delineate the incidence and natural history of intraluminal filling defects in the postpartum period in patients with low thrombosis risk. This was a prospective cohort study of women at low thrombosis risk postvaginal delivery undergoing MRV in the early postpartum period. In 30 eligible and consenting participants, independently adjudicated MRV, conducted on a median of postpartum day 1, identified definite thrombosis in 30% (95% confidence interval [CI], 13.6-46.4%) of study participants. All episodes of definite thrombosis were identified in the iliac and ovarian veins. Probable thrombosis was identified in an additional 27% of study participants (95% CI, 10.3-41.7%), and possible thrombosis in an additional 10% (95% CI, 0-20.7%). In this group of low-risk postpartum patients, we identified a high prevalence of definite pelvic vein intraluminal filling defects of uncertain clinical significance. This study suggests that some degree of pelvic vein intraluminal filling defect may be a normal finding after uncomplicated vaginal delivery. Copyright © 2012 Mosby, Inc. All rights reserved.

  4. A rare case of renal vein thrombosis secondary to Klebsiella pneumoniae pyelonephritis

    Directory of Open Access Journals (Sweden)

    Kelly L Lurz

    2018-01-01

    Full Text Available Renal vein thrombosis (RVT is most often an implication of nephrotic syndrome. Pyelonephritis has been associated at a much lower rate, with the incidence of Klebsiella pneumoniae causation being extremely rare. In our case, a 35-year-old female patient presented with right-sided K. pneumoniae-positive acute pyelonephritis complicated by perinephric abscess and renal vein thrombosis. She was successfully treated with anticoagulation and extended antibiotic therapy. The possibility of RVT in patients with K. pneumoniae-induced pyelonephritis warrants consideration.

  5. Macronodular hepatic tuberculosis associated with portal vein thrombosis and portal hypertension

    International Nuclear Information System (INIS)

    Venkatesh, S.K.; Tan, L.K.A.; Siew, E.P.Y.; Putti, T.C.

    2005-01-01

    Tuberculosis (TB) of the liver is usually associated with miliary spread. Macronodular TB of the liver is rare. A case of macronodular TB of the liver in a 31-year-old woman causing portal vein thrombosis and portal hypertension is presented. Ultrasound and CT appearances are described. There was coexistent ileo-caecal TB with extensive mesenteric and retroperitoneal lymphadenopathy. Macronodular TB should be considered in the differential diagnosis when a patient presents with multiple calcified masses in the liver with portal vein thrombosis and portal hypertension. Copyright (2005) Blackwell Science Pty Ltd

  6. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis

    International Nuclear Information System (INIS)

    Bercu, Zachary L.; Sheth, Sachin B.; Noor, Amir; Lookstein, Robert A.; Fischman, Aaron M.; Nowakowski, F. Scott; Kim, Edward; Patel, Rahul S.

    2015-01-01

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation

  7. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis.

    Science.gov (United States)

    Bercu, Zachary L; Sheth, Sachin B; Noor, Amir; Lookstein, Robert A; Fischman, Aaron M; Nowakowski, F Scott; Kim, Edward; Patel, Rahul S

    2015-10-01

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  8. Percutaneous Mesocaval Shunt Creation in a Patient with Chronic Portal and Superior Mesenteric Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Bercu, Zachary L., E-mail: zachary.bercu@mountsinai.org; Sheth, Sachin B., E-mail: sachinsheth@gmail.com [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States); Noor, Amir, E-mail: amir.noor@gmail.com [The George Washington University School of Medicine and Health Sciences (United States); Lookstein, Robert A., E-mail: robert.lookstein@mountsinai.org; Fischman, Aaron M., E-mail: aaron.fischman@mountsinai.org; Nowakowski, F. Scott, E-mail: scott.nowakowski@mountsinai.org; Kim, Edward, E-mail: edward.kim@mountsinai.org; Patel, Rahul S., E-mail: rahul.patel@mountsinai.org [Icahn School of Medicine at Mount Sinai, Division of Interventional Radiology (United States)

    2015-10-15

    The creation of a transjugular intrahepatic portosystemic shunt (TIPS) is a critical procedure for the treatment of recurrent variceal bleeding and refractory ascites in the setting of portal hypertension. Chronic portal vein thrombosis remains a relative contraindication to conventional TIPS and options are limited in this scenario. Presented is a novel technique for management of refractory ascites in a patient with hepatitis C cirrhosis and chronic portal and superior mesenteric vein thrombosis secondary to schistosomiasis and lupus anticoagulant utilizing fluoroscopically guided percutaneous mesocaval shunt creation.

  9. Malignant peritoneal mesothelioma associated with deep vein thrombosis following radiotherapy for seminoma of the testis

    International Nuclear Information System (INIS)

    Sato, Fuminori; Yamazaki, Hajime; Ataka, Ken; Mashima, Ichiro; Suzuki, Kenta; Takahashi, Toru; Umezu, Hajime; Gejyo, Fumitake

    2000-01-01

    A 52-year-old man developed malignant peritoneal mesothelioma 17 years after radiotherapy for seminoma of the testis. Although asbestos exposure is considered to be the major risk factor for the development of malignant mesothelioma, prior therapeutic radiation has also been postulated as a causative factor. The unexplained appearance of ascites or pleural effusion within a previously irradiated area should be considered suggestive of malignant mesothelioma in any long-term survivor of cancer. In addition, the patient suffered a deep vein thrombosis four years before the diagnosis of mesothelioma. Deep vein thrombosis is a common complication of malignant disease, and is often the first clue to occult malignancy. (author)

  10. Malignant peritoneal mesothelioma associated with deep vein thrombosis following radiotherapy for seminoma of the testis

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Fuminori; Yamazaki, Hajime; Ataka, Ken; Mashima, Ichiro; Suzuki, Kenta; Takahashi, Toru; Umezu, Hajime; Gejyo, Fumitake [Niigata Univ. (Japan). School of Medicine

    2000-11-01

    A 52-year-old man developed malignant peritoneal mesothelioma 17 years after radiotherapy for seminoma of the testis. Although asbestos exposure is considered to be the major risk factor for the development of malignant mesothelioma, prior therapeutic radiation has also been postulated as a causative factor. The unexplained appearance of ascites or pleural effusion within a previously irradiated area should be considered suggestive of malignant mesothelioma in any long-term survivor of cancer. In addition, the patient suffered a deep vein thrombosis four years before the diagnosis of mesothelioma. Deep vein thrombosis is a common complication of malignant disease, and is often the first clue to occult malignancy. (author)

  11. Endovascular Therapy Is Effective for Leriche Syndrome with Deep Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Tasuku Higashihara

    2015-01-01

    Full Text Available A 65-year-old man presented to our hospital due to intermittent claudication and swelling in his left leg. He had Leriche syndrome and deep vein thrombosis. We performed endovascular therapy (EVT for Leriche syndrome, and a temporary filter was inserted in the inferior vena cava. He received anticoagulation therapy for deep vein thrombosis. The stenotic lesion in the terminal aorta was stented with an excellent postprocedural angiographic result and dramatic clinical improvement after EVT. This case suggests that EVT can be a treatment for Leriche syndrome.

  12. An unusual case of fistula formation and thrombosis between arteriovenous graft and a native vein

    Directory of Open Access Journals (Sweden)

    Young Sub Kim

    2016-03-01

    Full Text Available Arteriovenous graft for hemodialysis vascular access is a widely used technique with many advantages. However, it has crucial complications with graft thrombosis and infection. We recently experienced an unusual case of arteriovenous graft complication involving graft thrombosis related to fistula formation between the graft and the natural vein with infection. We diagnosed this condition using Doppler ultrasound and computed tomography angiography. Successful surgical treatment including partial graft excision and creation of a secondary arteriovenous fistula using an inadvertently dilated cephalic vein was performed. The dialysis unit staff should keep this condition in mind and try to prevent this complication.

  13. Super-mesenteric-vein-expia-thrombosis, the clinical sequelae can be quite atrocious.

    Science.gov (United States)

    Lole Harris, Benjamin Howell; Walsh, Jason Leo; Nazir, Sarfraz A

    2016-11-01

    Superior mesenteric vein (SMV) thrombosis is a rare, potentially life-threatening complication of intra-abdominal infection. Here we present a case of massive SMV thrombosis secondary to appendicitis in a 13-year-old boy. He presented with vague abdominal pain and associated symptoms, persistently elevated serum inflammatory markers and a pyrexia of unknown origin. Sonography proved inconclusive, and a definitive diagnosis was made by abdominal contrast-enhanced computed tomography. He was treated with antibiotics and anticoagulation before interval elective laparoscopic appendectomy. The non-specific nature of the presenting symptoms makes SMV thrombosis an important differential to consider when dealing with such patients.

  14. Is the prevalence of the factor V Leiden mutation in patients with pulmonary embolism and deep vein thrombosis really different?

    NARCIS (Netherlands)

    Turkstra, F.; Karemaker, R.; Kuijer, P. M.; Prins, M. H.; Büller, H. R.

    1999-01-01

    Previous investigations have suggested a lower prevalence of the factor V Leiden mutation in patients with pulmonary embolism, as compared to patients with deep leg vein thrombosis. We studied unselected patients with pulmonary embolism, in whom we also assessed the presence of deep vein thrombosis

  15. Portal vein thrombosis after cesarean section in a patient on prolonged bed rest due to threatened preterm labor.

    Science.gov (United States)

    Hibi, Arata; Mogi, Kazumasa

    2018-03-01

    Portal vein thrombosis is a rare but life-threatening complication during pregnancy and postpartum period. Color Doppler ultrasound is useful for prompt diagnosis. Although the risk of complications should be considered, successful pregnancy with comorbid portal vein thrombosis is possible with appropriate anticoagulation therapy and close monitoring.

  16. A case report of minimal change nephrotic syndrome complicated with portal, splenic and superior mesenteric vein thrombosis.

    Science.gov (United States)

    Wang, Jun; Fan, QiuLing; Chen, Ying; Dong, Xuezhu; Zhang, YuXia; Feng, JiangMin; Ma, JianFei; Wang, LiNing

    2012-06-01

    Venous thrombosis is common in nephrotic syndrome, but portal vein thrombosis has a relatively low incidence in patients with nephrotic syndrome. We describe here a case of an 18-year old male student with newly diagnosed nephrotic syndrome that was complicated with portal, splenic and superior mesenteric vein thrombosis. In the presence of newly diagnosed nephrotic syndrome of minimal change disease, thrombus formation can occur and should be noted, particularly when it occurs, in rare sites. The recognition in nephrotic syndrome complicated with portal, splenic and superior mesenteric vein thrombosis should be emphasized.

  17. Catheter-directed thrombolysis with transjugular access in portal vein thrombosis secondary to pancreatitis

    International Nuclear Information System (INIS)

    Aytekin, Cueneyt; Boyvat, Fatih; Kurt, Aydin; Yologlu, Zeynel; Coskun, Mehmet

    2001-01-01

    A case of portal vein thrombosis (PVT) secondary to pancreatitis is presented. Patient was treated with catheter-directed thrombolysis using urokinase solution. Because the percutaneous transhepatic approach is associated with higher risk of hemorrhage we used the catheter-directed thrombolysis via the transjugular intrahepatic access to restore the patency of the thrombosed portal vein. This case shows that catheter-directed thrombolysis with transjugular approach can be effectively used in the treatment of PVT

  18. [Management of patients with varicose veins presenting with a history of deep venous thrombosis].

    Science.gov (United States)

    Battino, A; Battino, J

    1989-01-01

    The notion of a history of deep venous thrombosis in patients with varicose veins has often been at the origin of a contemplative attitude toward this pathology. What used to be an act of vigilance has now become plain negligence, if not a therapeutic error. Indeed, the difficulty in diagnosing an acute episode explains the many false positive results obtained; moreover, the variability of the evolution of true venous thrombosis should no longer cause one to adopt a monolithic attitude. In this indication, noninvasive investigating procedures allow distinguishing quite different situations occurring in these patients. In a substantial number of cases, no deep vein circulatory abnormality can be found. Treatment should address primary varicose veins. For those patients with deep venous thrombosis sequelae, such studies allow us to differentiate between occlusion/restriction states from devalvulation, and to detect the precise location of such sequelae, as well as their impact on circulatory function. When occlusion is found, varicose veins, which may be supplementary veins, are left untouched. When devalvulation occurs as an isolated phenomenon, superficial vein insufficiency is of primary importance. Treatment is the more complete that deep reflux will promote relapse through all existing leakage points. If, regardless of this treatment, deep reflux causes significant disturbances, surgical revalvulation should be recommended. More complex cases combining persisting occlusion with devalvulation call for a graded attitude. Noninvasive investigating procedures coupled with phlebography allow us to assess the part played by the various anomalies in causing the disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Superficial vein thrombosis in patients with varicose veins: role of thrombophilia factors, age and body mass.

    Science.gov (United States)

    Karathanos, Ch; Sfyroeras, G; Drakou, A; Roussas, N; Exarchou, M; Kyriakou, D; Giannoukas, A D

    2012-03-01

    To investigate the association of various risk factors including thrombophilia defects, in patients with varicose veins (VVs) and history of episodes of superficial vein thrombosis (SVT). Two hundred and thirty patients with primary VVs were included in this prospective study. A total of 128 (43 men, age 56 ± 13) had an acute episode or a previous history of SVT, while 102 patients (27 men, age 48 ± 12) did not. Coagulation profile investigation included serum levels of protein C (PC), protein S (PS), anti-thrombin III (AT III), plasminogen (Plg), A(2) antiplasmin (A(2)Apl) and activated protein C resistance (APCR). This was performed at least 3 months after the SVT episode to ensure that the results were not altered. Age and body mass index (BMI) were also assessed. PC deficiency was detected in 3/128 (2.3%), PS deficiency in 19/128 (14.8%), AT III deficiency in 29/128 (22.7%), Plg deficiency in 9/128 (7%), A(2)Apl excess in 3/128 (2.3%) and APCR in 9/128 (7%) patients with SVT and 0/102 (0%), 3/102 (2.9%), 15/102 (14.7%), 6/102 (5.8%), 0/102 (0%) and 1/102 (0.9%) in the control group, respectively. BMI greater than 30 kg m(-2) was associated with SVT. In logistic regression analysis SVT was associated with PS deficiency (odds ratio (OR) 6.7, p = 0.004, 95% confidence interval (CI) 1.83-24.53), obesity (OR 3.5, p = 0.003, 95% CI 1.53-8.05) and age (OR 1.038, p = 0.001, 95% CI 1.01-1.06). Obesity, age and PS deficiency were found as factors associated with SVT episodes in patients with VVs. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  20. How to Spot and Prevent Deep Vein Thrombosis

    Science.gov (United States)

    ... May Help More People After Stroke Transplant Reverses Sickle Cell Disease Avoiding Anemia When Blood Cells Bend Wise Choices Clues of a Clot Seek treatment if you have these symptoms. They may signal a deep vein clot or ...

  1. Rivaroxaban for the treatment of saphenous vein graft thrombosis.

    Science.gov (United States)

    Marmagkiolis, Konstantinos; Cilingiroglu, Mehmet

    2016-01-01

    Thrombus formafigtion plays a significant role in disease of saphenous vein bypass grafts. Use of oral anticoagulants has not been tested in treatment of thrombotic occlusion of saphenous vein graft (SVG) disease. Here we describe the use of the novel oral anticoagulant rivaroxaban in the treatment of occlusive SVG disease with intraluminal thrombus, leading to successful recanalization. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Mesenteric vein thrombosis associated with Klinefelters syndrome--a case report.

    Science.gov (United States)

    Murray, F E

    1988-01-01

    A case of mesenteric vein thrombosis presenting as gastrointestinal hemorrhage in a patient with Klinefelter's syndrome is reported, an association not previously described. The diagnosis was made preoperatively and was confirmed by angiography. The patient underwent a small bowel resection and made an uneventful recovery. A possible association between Klinefelter's syndrome and a hypercoagulable state, previously suggested elsewhere, is emphasized.

  3. Variable effects of radiological contrast media on thrombus growth in a rabbit jugular vein thrombosis model

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; Biemond, B. J.; Sturk, A.; Hoek, J.; ten Cate, J. W.

    1991-01-01

    We studied the effect of an ionic high osmolar contrast medium (Ioxitalamate), an ionic low osmolar contrast medium (Ioxaglate) and various nonionic low osmolar contrast media (Iopamidol, Iopromide and Iohexol) on thrombus growth in a rabbit jugular vein thrombosis model. Thrombus growth was

  4. Deep-vein thrombosis and the incidence of subsequent symptomatic cancer

    NARCIS (Netherlands)

    Prandoni, P.; Lensing, A. W.; Büller, H. R.; Cogo, A.; Prins, M. H.; Cattelan, A. M.; Cuppini, S.; Noventa, F.; ten Cate, J. W.

    1992-01-01

    In contrast to the established relation between overt cancer and subsequent venous thromboembolism, it is unclear whether symptomatic deep-vein thrombosis is associated with a risk of subsequent overt malignant disease. Two hundred sixty consecutive patients with symptomatic, venographically proved

  5. Refractory Pulmonary Edema Caused by Late Pulmonary Vein Thrombosis After Lung Transplantation: A Rare Adverse Event.

    Science.gov (United States)

    Denton, Eve J; Rischin, Adam; McGiffin, David; Williams, Trevor J; Paraskeva, Miranda A; Westall, Glen P; Snell, Greg

    2016-09-01

    After lung transplantation, pulmonary vein thrombosis is a rare, potentially life-threatening adverse event arising at the pulmonary venous anastomosis that typically occurs early and presents as graft failure and hemodynamic compromise with an associated mortality of up to 40%. The incidence, presentation, outcomes, and treatment of late pulmonary vein thrombosis remain poorly defined. Management options include anticoagulant agents for asymptomatic clots, and thrombolytic agents or surgical thrombectomy for hemodynamically significant clots. We present a rare case highlighting a delayed presentation of pulmonary vein thrombosis occurring longer than 2 weeks after lung transplantation and manifesting clinically as graft failure secondary to refractory pulmonary edema. The patient was treated successfully with surgical thrombectomy and remains well. We recommend a high index of suspicion of pulmonary vein thrombosis when graft failure after lung transplantation occurs and is not responsive to conventional therapy, and consideration of investigation with transesophageal echocardiography or computed tomography with venous phase contrast in such patients even more than 2 weeks after lung transplantation. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Bilateral upper-extremity deep vein thrombosis following central cord syndrome

    OpenAIRE

    Onmez, Hilal; Cingoz, Havva Turac; Kucuksen, Sami; Anliacık, Emel; Yaşar, Ozan; Yilmaz, Halim; Salli, Ali

    2013-01-01

    Deep vein thrombosis (DVT) is a common complication following spinal cord injury (SCI). Although DVT of the upper extremity is much less common than DVT of the lower extremities, the risk of pulmonary embolism following upper-extremity DVT should not be disregarded.

  7. Multimodality imaging in the diagnosis of deep vein thrombosis and popliteal pseudoaneurysm complicating a sessile osteochondroma

    Energy Technology Data Exchange (ETDEWEB)

    Christensen, Jared D.; Monu, Johnny U.V. [University of Rochester School of Medicine and Dentistry, Department of Imaging Sciences, 601 Elmwood Ave., Box 648, Rochester, NY (United States)

    2008-08-15

    Synergistic use of ultrasonography, radiography, multidetector CT (MDCT) and MRI enabled a prompt and accurate diagnosis of a nonocclusive popliteal vein thrombus (deep venous thrombosis, DVT) and a pseudoaneurysm complicating a sessile osteochondroma in an 11-year-old boy who presented in the emergency department with sudden-onset nontraumatic pain in the posterior aspect of the knee. (orig.)

  8. Management of Nonneoplastic Portal Vein Thrombosis in the Setting of Liver Transplantation : A Systematic Review

    NARCIS (Netherlands)

    Rodriguez-Castro, Kryssia I.; Porte, Robert J.; Nadal, Elena; Germani, Giacomo; Burra, Patrizia; Senzolo, Marco

    2012-01-01

    Background. Nonneoplastic portal vein thrombosis (PVT) is frequent in patients with cirrhosis who undergo liver transplantation (LT); however, data on its impact on outcome and strategies of management are sparse. Methods. A systematic review of the literature was performed by analyzing studies that

  9. Mesenteric vein thrombosis associated with primary cytomegalovirus infection : a case report

    NARCIS (Netherlands)

    Lijfering, Willem M.; Sprenger, Herman G.; van Son, Willem J.; van der Meer, Jan

    In the past few years several studies have supported an interplay between cytomegalovirus infections and a prothrombotic state. We describe a case of primary cytomegalovirus infection in an immunocompetent adult that was complicated with mesenteric vein thrombosis. Transient protein C deficiency,

  10. GI ischemia in patients with portal vein thrombosis: A prospective cohort study

    NARCIS (Netherlands)

    J. Harki (Jihan); E.P.C. Plompen (Elisabeth); D. van Noord (Désirée); J.W. Hoekstra; E.J. Kuipers (Ernst); H.L.A. Janssen (Harry); E.T.T.L. Tjwa (Eric)

    2016-01-01

    textabstractBackground and Aims GI ischemia is a concerning adverse event of portal vein thrombosis (PVT). Minimally invasive techniques, such as visible light spectroscopy (VLS), have greatly improved the ability to diagnose GI ischemia. The aim of this study was to assess the clinical presentation

  11. Detection of superior mesenteric vein thrombosis by real time and Doppler sonography

    International Nuclear Information System (INIS)

    Mildenberger, P.; Schild, H.; Jenny, E.

    1988-01-01

    Superior mesenteric vein thrombosis after splenectomy is very rare. In the case described of a patient presenting with acute abdominal pain the diagnosis was made primarily by real-time and Doppler ultrasonography. This reduced the time elapsing before it was recognized that angiography and subsequent thrombectomy were indicated. (orig.) [de

  12. Pathogenesis and treatment of Budd-Chiari syndrome combined with portal vein thrombosis

    NARCIS (Netherlands)

    Murad, SD; Valla, DC; de Groen, PC; Zeitoun, G; Haagsma, EB; Kuipers, EJ; Janssen, HLA

    OBJECTIVES: Combined Budd-Chiari syndrome and Portal Vein Thrombosis (BCS-PVT) is a challenging clinical condition with as yet unknown outcome. The aim of the present study was to investigate etiology, treatment options, and prognosis of patients with BCS-PVT. METHODS: Patients diagnosed with

  13. Interventional treatment for symptomatic acute-subacute portal and superior mesenteric vein thrombosis.

    Science.gov (United States)

    Liu, Feng-Yong; Wang, Mao-Qiang; Fan, Qing-Sheng; Duan, Feng; Wang, Zhi-Jun; Song, Peng

    2009-10-28

    To summarize our methods and experience with interventional treatment for symptomatic acute-subacute portal vein and superior mesenteric vein thrombosis (PV-SMV) thrombosis. Forty-six patients (30 males, 16 females, aged 17-68 years) with symptomatic acute-subacute portal and superior mesenteric vein thrombosis were accurately diagnosed with Doppler ultrasound scans, computed tomography and magnetic resonance imaging. They were treated with interventional therapy, including direct thrombolysis (26 cases through a transjugular intrahepatic portosystemic shunt; 6 through percutaneous transhepatic portal vein cannulation) and indirect thrombolysis (10 through the femoral artery to superior mesenteric artery catheterization; 4 through the radial artery to superior mesenteric artery catheterization). The blood reperfusion of PV-SMV was achieved completely or partially in 34 patients 3-13 d after thrombolysis. In 11 patients there was no PV-SMV blood reperfusion but the number of collateral vessels increased significantly. Symptoms in these 45 patients were improved dramatically without severe operational complications. In 1 patient, the thrombi did not respond to the interventional treatment and resulted in intestinal necrosis, which required surgical treatment. In 3 patients with interventional treatment, thrombi re-formed 1, 3 and 4 mo after treatment. In these 3 patients, indirect PV-SMV thrombolysis was performed again and was successful. Interventional treatment, including direct or indirect PV-SMV thrombolysis, is a safe and effective method for patients with symptomatic acute-subacute PV-SMV thrombosis.

  14. Superficial dorsal penile vein thrombosis: a little-known complication of subinguinal varicocelectomy.

    Science.gov (United States)

    Arango, Octavio; Lorente, José A; Nohales, Gloria; Rijo, Enrique; Bielsa, Oscar

    2011-01-01

    To describe the symptomatology, diagnosis and treatment of superficial thrombosis of the dorsal penile vein - the most common complication of subinguinal varicocelectomy - and analyse the possible mechanisms involved in the development of the condition. The clinical records of 326 patients who underwent varicocele repair during the last 10 years was reviewed. The technique used was subinguinal varicocelectomy with arterial preservation. A mini-Doppler probe was used during surgery for artery identification. We report on the postoperative complications of varicocelectomy, with special attention to superficial dorsal penile vein thrombosis, and provide a detailed description of the anatomy of the superficial venous system of the penis. Complications usually associated with varicocele surgery occurred in less than 1% of patients. However, the most common complication in our series was superficial dorsal penile vein thrombosis, which occurred in 2.1% of patients. The use of the mini-Doppler probe allowed us to identify and preserve the arteries in all 326 patients. Subinguinal varicocelectomy with intra-operative use of a mini-Doppler probe is a rapid and safe technique. The outcomes and complications are similar to those reported for subinguinal microscopic varicocelectomy. Superficial dorsal penile vein thrombosis is a benign self-limited condition whose association with subinguinal varicocelectomy has not been previously reported. © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

  15. Thrombosis of a Superior Mesenteric Vein Aneurysm: Transarterial Thrombolysis and Transhepatic Aspiration Thrombectomy

    International Nuclear Information System (INIS)

    Hechelhammer, L.; Crook, D.W.; Widmer, U.; Wildermuth, S.; Pfammatter, T.

    2004-01-01

    We report the case of a 31-year-old woman presenting with abdominal pain due to acute thrombosis of a superior and inferior mesenteric vein aneurysm, which was treated by a combination of arterial thrombolysis and transhepatic thrombus aspiration. At the last follow-up CT, 21 months following this procedure, there was no evidence of rethrombosis, and the patient continues to do well under oral anticoagulation. The literature regarding these uncommon mesenteric vein aneurysms without portal vein involvement, as well as their treatment options, is reviewed

  16. Comparison of Efficacy Compressive Stockings with Heparin in Prevention of Deep Vein Thrombosis in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Nastaran Majdi-Nasab

    2013-04-01

    Full Text Available Background: The present study is carried out to make a comparison between two pharmacological (heparin and physical (compression stockings in the prevention of deep vein thrombosis in lower limb of the patients suffered from acute stroke. Materials and Methods: In this investigation as a clinical trial, the effectiveness of the above methods on 100 patients with the stroke was compared in two groups of 50 persons. Results: Three patients in physical group and two patients in pharmacological group got deep vein thrombosis that showed no significant difference between two groups.Conclusion: In spite of no significant relationship and due to less incurrence of thrombosis in heparin group, it is more reasonable to use pharmacological methods.

  17. Isolated superficial sylvian vein thrombosis with long cord sign: case report and review of the literature.

    Science.gov (United States)

    Kitamura, Yohei; Hara, Koichi; Tsunematsu, Kenichiro

    2014-01-01

    Isolated cortical vein thrombosis (ICVT) is extremely rare. Only single case or small series of ICVT have been reported; clinical details are still uncertain. We report a case of isolated superficial sylvian vein thrombosis with exceedingly long cord sign. A 14-year-old female with severe sudden onset headache visited our hospital. Fluid attenuated inversion recovery and echo-planar T2(*) susceptibility-weighted imaging (T2(*)SW) showed a long cord sign on the surface of the sylvian fissure. The patency of dural sinuses and deep cerebral veins were confirmed by magnetic resonance venography (MRV), and diagnosis of ICVT was made. She recovered completely without anticoagulant agents. To clarify the clinical characteristics of ICVT, we reviewed 51 ICVT cases in the literature. In many cases, T2(*)SW was the most useful examination to diagnose ICVT. In contrast with general cerebral venous thrombosis, MRV and conventional angiography were either supporting or useless. Anastomotic cortical veins were involved frequently; symptoms of gyri around the veins were common. It also suggested that ICVTs of the silent area might have been overlooked because of nonspecific symptoms, and more patients with ICVT may exist. In cases involving patients with nonspecific symptoms, the possibility of ICVT should be considered.

  18. Spontaneous bilateral subclavian vein thrombosis in a 40-year-old man: A case report.

    Science.gov (United States)

    Huang, Chun-Yen; Wu, Yen-Hung; Yeh, I-Jeng; Chen, Yun-Yi; Kung, Fung-Ya

    2018-04-01

    Paget-Schroetter syndrome (PSS) is an uncommon condition that refers to primary (spontaneous) thrombosis of the deep veins that drain the upper extremities because of anatomical anomalies or repetitive strenuous arm activity. Bilateral spontaneous upper extremity deep-vein thrombosis (UEDVT) is an extremely rare phenomenon in adults, which may be misdiagnosed by physicians in acute settings. A 40-year-old man presented to our emergency department because of progressive left upper arm swelling for 1 day. He denied fever, chest pain, dyspnea, trauma, or any other systemic disease before. The swollen left arm also had no local heat or redness with normal radius pulsation. He was a laborer who lifted heavy objects. Blood examination included tests for complete blood count, renal function, liver function, blood coagulation profile, cardiac enzyme levels, and D-dimer level. Results showed that the white blood cell count, renal and liver functions, and cardiac enzyme levels were all within their normal ranges, except for the elevated D-dimer level (1.93 mg/L). Chest radiography and electrocardiography were performed with nonspecific findings. Subsequently, computed tomographic angiography was recommended for the suspected deep-vein thrombosis. The report showed venous thrombosis involving the bilateral subclavian and internal jugular veins. Heparin and enoxaparin were prescribed for this patient, with loading and maintenance doses. He was then admitted to our cardiovascular ward for further treatment. The patient was discharged 9 days later in a stable condition. Emergency physicians should consider the rare condition of UEDVT when a healthy patient presents with acute arm swelling. Patient history taking should be thorough, especially concerning the risk factors of secondary causes and possible frequent vigorous heavy lifting and overhead motion. Without secondary risk factors, primary upper deep-vein thrombosis might be suspected. Further laboratory tests and imaging

  19. Pre-transplant portal vein thrombosis is an independent risk factor for graft loss due to hepatic artery thrombosis in liver transplant recipients

    NARCIS (Netherlands)

    Stine, Jonathan G.; Pelletier, Shawn J.; Schmitt, Timothy M.; Porte, Robert J.; Northup, Patrick G.

    Background: Hepatic artery thrombosis is an uncommon but catastrophic complication following liver transplantation. We hypothesize that recipients with portal vein thrombosis are at increased risk. Methods: Data on all liver transplants in the U.S. during the MELD era through September 2014 were

  20. Prevalence of deep vein thrombosis and pulmonary embolism in patients with superficial vein thrombosis: a systematic review and meta-analysis.

    Science.gov (United States)

    Di Minno, M N D; Ambrosino, P; Ambrosini, F; Tremoli, E; Di Minno, G; Dentali, F

    2016-05-01

    Essentials The association of superficial vein thrombosis (SVT) with venous thromboembolism (VTE) is variable. We performed a meta-analysis to assess the prevalence of concomitant VTE in patients with SVT. Deep vein thrombosis was found in 18.1%, and pulmonary embolism in 6.9%, of SVT patients. Screening for VTE may be worthy in some SVT patients to plan adequate anticoagulant treatment. Background Some studies have suggested that patients with superficial vein thrombosis (SVT) have a non-negligible risk of concomitant deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis. Unfortunately, the available data on this association are widely variable. Objectives To perform a systematic review and meta-analysis of the literature in order to evaluate the prevalence of concomitant DVT/PE in patients with SVT of the lower limbs. Methods Studies reporting on the presence of DVT/PE in SVT patients were systematically searched for in the PubMed, Web of Science, Scopus and EMBASE databases. The weighted mean prevalence (WMP) of DVT and PE was calculated by use of the random effect model. Results Twenty-one studies (4358 patients) evaluated the prevalence of DVT and 11 studies (2484 patients) evaluated the prevalence of PE in patients with SVT. The WMP of DVT at SVT diagnosis was 18.1% (95%CI: 13.9%, 23.3%) and the WMP of PE was 6.9% (95%CI: 3.9%, 11.8%). Heterogeneity among the studies was substantial. Selection of studies including outpatients only gave similar results (WMP of DVT, 18.2%, 95% CI 12.2-26.3%; and WMP of PE, 8.2%, 95% CI 3.3-18.9%). Younger age, female gender, recent trauma and pregnancy were inversely associated with the presence of DVT/PE in SVT patients. Conclusions The results of our large meta-analysis suggest that the prevalence of DVT and PE in patients presenting with SVT is not negligible. Screening for a major thromboembolic event may be worthwhile in some SVT patients, in order to allow adequate anticoagulant treatment

  1. Long-term risk of venous thromboembolism recurrence after isolated superficial vein thrombosis.

    Science.gov (United States)

    Galanaud, J-P; Sevestre, M-A; Pernod, G; Kahn, S R; Genty, C; Terrisse, H; Brisot, D; Gillet, J-L; Quéré, I; Bosson, J-L

    2017-06-01

    Essentials Long-term risk of recurrence of isolated superficial vein thrombosis (SVT) is under-studied. We analyzed data from a cohort of first SVT and proximal deep vein thrombosis (DVT) without cancer. The risk of recurrence as DVT or pulmonary embolism is twice lower in SVT patients. However, overall risk of recurrence is similar between SVT and proximal DVT patients. Click to hear Dr Decousus' perspective on superficial vein thrombosis SUMMARY: Background Isolated superficial vein thrombosis (iSVT) (without concomitant deep vein thrombosis [DVT] or pulmonary embolism [PE]) is a frequent event, but available data on long-term outcomes are scarce and retrospective. Therefore, we aimed to determine prospectively the risk and type of venous thromboembolism (VTE) recurrence after iSVT and compare them with those of proximal DVT. Methods Using data from the prospective, multicenter, observational, OPTIMEV study, we assessed, at 3 years and after anticoagulants were stopped, the incidence and the type of VTE recurrence (iSVT/DVT/PE) of patients with a first objectively confirmed iSVT without cancer (n = 285), and compared these with those of patients with a first proximal DVT without cancer (n = 262). Results As compared with proximal DVT patients, iSVT patients had a similar overall incidence of VTE recurrence (5.4% per patient-year [PY] versus 6.5% per PY, adjusted hazard ratio [aHR] 0.9, 95% confidence interval [CI] 0.5-1.6), but iSVT recurred six times more often as iSVT (2.7% versus 0.6%, aHR 5.9, 95% CI 1.3-27.1) and 2.5 times less often as deep-VTE events (2.5% versus 5.9%, aHR 0.4, 95% CI 0.2-0.9). Varicose vein status did not influence the risk or the type of VTE recurrence. Saphenian junction involvement by iSVT was not associated with a higher risk of recurrence (5.2% per PY versus 5.4% per PY), but was associated with recurrence exclusively as deep-VTE events. Conclusion In patients with a first iSVT without cancer, after stopping anticoagulants, the

  2. Prevalence of Deep Vein Thrombosis and Associated Factors in ...

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    increased risk in male patients older than 40 and in those. 8 with cancer. Risk factors for DVT are multifactorial and can be ... of DVT and associated risk factors in medical patients admitted to the UTH with aim of advocating and ... Collateral non-varicose superficial veins. 1. Active cancer or cancer treated within 6 months. 1.

  3. Superficial venous thrombosis: role of inherited deficiency of natural anticoagulants in extension to deep veins.

    Science.gov (United States)

    Milio, G; Siragusa, S; Malato, A; Grimaudo, S; Pinto, A

    2009-08-01

    Superficial venous thrombosis (SVT) has been considered for a long time a limited clinical condition of low importance, but this approach has changed in recent years, when several studies demonstrated that extension to deep veins occurs in 7.3 to 44% of patients, with high prevalence of pulmonary embolism. The aim of this study was to evaluate the prevalence of inherited deficiency of natural coagulation inhibitors in patients suffering from SVT in both normal and varicose veins, and to understand their role in extension to deep veins. The study included 83 patients with SVT, without clinically obvious risk factors. Ultrasound examination was performed, and deficiencies of Protein C, Protein S and Antithrombin (AT) were investigated. In the patients where SVT occurred in normal veins, coagulation inhibitor deficiencies were 6.45% in the absence of extension and 62.5% in patients with extension to deep veins. In the patients with varicose vein SVT, the presence of these factors was less evident, but their prevalence was considerably higher in those with extension to deep veins (36.3%) than in non-extension (6.06%). Present data confirm the role of inherited thrombophilic states related to inhibitor deficiency, considering them as risk factors for SVT in normal veins. Furthermore, an association has been found between their presence and the progression of SVT to deep veins.

  4. Internal Jugular and Subclavian Vein Thrombosis in a Case of Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Hiroto Moriwaki

    2017-01-01

    Full Text Available Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT. DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin. Laboratory tests showed a white blood cell count of 5,800/mm3 and an elevated serum C-reactive protein of 4.51 mg/dL. Computed tomography (CT of the neck revealed a vascular filling defect in the left internal jugular vein to left subclavian vein region, with the venous lumina completely occluded with dense soft tissue. On the basis of the findings, we made the diagnosis of thrombosis of the left internal jugular and left subclavian veins. The patient was begun on treatment with oral rivaroxaban, but the left shoulder pain worsened. She was then admitted to the hospital and treated by balloon thrombectomy and thrombolytic therapy, which led to improvement of the left subclavian venous occlusion. Histopathologic examination of the removed thrombus revealed adenocarcinoma cells, indicating hematogenous dissemination of malignant cells.

  5. Acute superior mesenteric vein thrombosis associated with abdominal trauma: A rare case report and literature review.

    Science.gov (United States)

    Lim, Kyoung Hoon; Jang, Jihoon; Yoon, Hye Young; Park, Jinyoung

    2017-11-01

    Acute mesenteric vein thrombosis (MVT) is defined as new-onset thrombosis of the mesenteric vein without evidence of collateralization, finally resulting in extensive intestinal infarction. MVT may be idiopathic or be caused by conditions responsible for thrombophilia and acquired risk factors. To date, there have been few reports of MVT after trauma. Herein we describe our experiences treating three patients with MVT. Case 1 was a 44-year-old man with transverse colon mesenteric hematoma after blunt abdominal trauma. Case 2 was a 55-year-old man with jejunal transection after a traffic accident. Case 3 was a 26-year-old man presented with multiple abdominal stab bowel injury. A 1-week follow-up abdominal computed tomography scan showed superior mesenteric vein thrombosis in all of three patients. All patients were treated with anticoagulant for 3 or 6 months. MVTs were completely resolved without any complications. If early diagnosis and treatment could be available, anticoagulation alone might be adequate for the treatment of SMVT associated with trauma. Early anticoagulation in patients with acute SMVT may avoid the grave prognosis observed in patients with arterial thrombosis. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  6. Deep vein thrombosis of the lower limb secondary to lumbar discal hernia compression: a rarity? Review of the literature.

    Science.gov (United States)

    Di Cello, P; Izzo, S; Pugliese, F; Di Poce, I; Orsini, A; Izzo, L; Mazzone, G; Biancucci, F; Sinaimeri, G; Valabrega, S; Almansour, M; Izzo, P

    2016-01-01

    This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4- L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous discal hernia can cause venous thrombosis.

  7. Superior ophthalmic vein thrombosis developed after orbital cellulitis.

    Science.gov (United States)

    Cumurcu, Tongabay; Demirel, Soner; Keser, Sinem; Bulut, Taner; Cavdar, Mufide; Doğan, Metin; Saraç, Kaya

    2013-03-01

    A 65-year-old female patient presented with eye pain, swelling and blurred vision in the left eye. Routine biochemistry and microbiological analyzes were conducted. Orbital tomography (CT), magnetic resonance imaging (MRI) findings, and cerebral angiography were performed. Orbital cellulitis due to a complication of ethmoidal sinusitis was diagnosed with thrombosis of the SOV in the patient. Systemic broad-spectrum antibiotic and anticoagulant therapy was started on the patient. The patient's symptoms were recorded at the end of two weeks of the treatment.

  8. CT diagnosis of acute mesenteric vein thrombosis with bowel infarction

    International Nuclear Information System (INIS)

    Sommer, A.; Jaschke, W.; Georgi, M.

    1994-01-01

    Imaging methods provide an important diagnostic basis to clarify mesenteric ischemia. Angiography is the definitive method of investigation in such cases. Other noninvasive methods such as ultrasonography, computed tomography, and magnetic resonance imaging must still prove their importance. We describe three cases of unspezific abdominal pain where the CT shows a mesenteric venous thrombosis with an infarcted bowel. The venous infarcted bowel is clearly demonstrated by CT when other signs for MTV such as ascites, bowel wall thickening, bowel dilatation, and pneumatosis intestinalis are present. CT seems to be a good procedure in order to identify unspecific abdominal pain as being caused by a vascular insufficiency. (orig.) [de

  9. MRI of portal vein and superior mesenteric venous thrombosis with intestinal ischemia

    International Nuclear Information System (INIS)

    Mo Youfa; Zhang Xuelin; Zhang Lijuan; Li Xiangliang; Hu Basheng

    2007-01-01

    Objective: To discuss the diagnostic value of MRI for portal vein (PV) and superior mesenteric venous (SMV) thrombosis. Methods: Twelve patients with portal vein and superior mesenteric venous thrombosis proved by operation and pathology were examined with T 1 WI, T 2 WI, T 2 -weighted fat suppression imaging, MR angiography (MRA) and Gd-DTPA enhanced dynamic MRI. Results: Signals in PV and SMV were detected on T 1 WI and T 2 WI in 12 cases; 3 acute thrombus presented hypo- or isointense on T 1 WI and hyperintense on T 2 WI. Hyperintense on T 1 WI and T 2 WI were showed in 8 subacute thrombus; 1 chronic thrombus presented heterogenous intense on T 1 WI and hypointense on T 2 WI. No enhancement within PV and SMV was found on Gd-DTPA enhanced images. Bowel dilatation was found in 10 cases, bowel hemorrhage in 6, bowel wall thickening in 12, intestinal pneumatosis in 3, ascites in 12, cavernous transformation of the portal vein in 3, hepatic perfusion disorder in 6. Conclusion: MRI is an important and sensitive imaging method for the diagnosis and location of portal vein and superior mesenteric venous thrombosis with intestinal ischemia. (authors)

  10. Superficial dorsal vein injury/thrombosis presenting as false penile fracture requiring dorsal venous ligation.

    Science.gov (United States)

    Rafiei, Arash; Hakky, Tariq S; Martinez, Daniel; Parker, Justin; Carrion, Rafael

    2014-12-01

    Conditions mimicking penile fracture are extremely rare and have been seldom described. To describe a patient with false penile fracture who presented with superficial dorsal vein injury/thrombosis managed with ligation. A 33-year-old male presented with penile swelling and ecchymosis after intercourse. A penile ultrasound demonstrated a thrombosed superficial dorsal vein but also questionable fracture of the tunica albuginea. As the thrombus was expanding, he was emergently taken to the operating room for exploration and required only dorsal venous ligation. Postoperatively, patient's Sexual Health Inventory for Men score was 23, and he had no issues with erections or sexual intercourse. Early exploration of patients with suspected penile fracture provides excellent results with maintenance of erectile function. Also, in the setting of dorsal vein thrombosis, ligation preserves the integrity of the penile tissues and avoids unnecessary complications from conservative management. Rafiei A, Hakky TS, Martinez D, Parker J, and Carrion R. Superficial dorsal vein injury/thrombosis presenting as false penile fracture requiring dorsal venous ligation.

  11. Tumoural portal vein thrombosis. Enhancement with MnDPDP

    International Nuclear Information System (INIS)

    Marti-Bonmati, L.; Lonjedo, E.; Mathieu, D.; Coffin, C.; Poyatos, C.; Anglade, M.C.

    1997-01-01

    Purpose: Intrahepatic thrombus is usually associated with either cirrhosis or hepatocellular carcinoma (HCC). Most HCCs enhance after the administration of MnDPDP (Teslascan). Our objective was to analyze the enhancement characteristics of tumour portal vein thrombi. Material and Methods: Thrombi affecting the main or segmental portal veins (17 cases) and the suprahepatic inferior vena cava (1 case) were retrospectively selected from a series of 128 patients studied with MR imaging before and after the administration of MnDPDP. Enhancement was assessed qualitatively and quantitatively. Results: All tumour thrombi enhanced after MnDPDP administration. The enhancement was more conspicuous in the GRE images. On the quantitative evaluation, the portal thrombus enhancement was greater for GRE images than SE images. Portal thrombi enhanced more than the liver and the HCCs. There was a significant difference between the enhancement of the HCCs and the thrombi with both MR imaging techniques. (orig./AJ)

  12. Deep vein thrombosis and/or pulmonary embolism concurrent with superficial vein thrombosis of the legs: cross-sectional single center study of prevalence and risk factors.

    Science.gov (United States)

    Hirmerova, J; Seidlerova, J; Subrt, I

    2013-08-01

    The aim of this paper was to assess the prevalence of concurrent deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in the patients with superficial vein thrombosis (SVT) of the legs and to find factors significantly and independently associated with coincident DVT/PE. In the setting of a tertiary referral hospital, patients with SVT, attending vascular clinic, underwent physical examination, laboratory testing and leg vein ultrasound (in the case of clinically suspected PE also perfusion/ventilation lung scan or/and helical CT pulmonary angiography). In statistical analysis, we used unpaired t-test, non-parametric Wilcoxon rank sum test, stepwise logistic regression and multivariable logistic regression model. We examined 138 patients (age 61.4 ± 13.9 years, 36.2% men), with ST mostly on varicose veins (89.9%). The prevalence of concurrent DVT/PE was 34.1%. Neither the clinical manifestation nor SVT localization differed significantly between the group with isolated SVT and that with coincident DVT/PE. Of all the assessed patients characteristics (age and sex, BMI, history of SVT, DVT or PE, hypercoagulable states, cardiovascular risk factors) only two factors were significantly and independently associated with the presence of concurrent DVT/PE. Log BMI was significantly higher in the patients with isolated SVT. Factor V Leiden (FVL) was proved as an independent risk factor for concomitant DVT/PE with odds ratio 2,531 (95% CI 1,064-6,016). The prevalence of concurrent DVT/PE in patients with SVT, referred to hospital vascular clinic was 34.1%. Lower BMI (log BMI, respectively) and the presence of FVL were significantly and independently associated with concurrent DVT/PE. Our results should be further investigated in a larger prospective study.

  13. Acute pancreatitis complicated with deep vein thrombosis and pulmonary embolism: a case report.

    Science.gov (United States)

    Herath, H M M T B; Kulatunga, Aruna

    2016-06-23

    Acute pancreatitis is an acute inflammatory process of the pancreas that can trigger a systemic inflammatory response. Pulmonary embolism refers to obstruction of the pulmonary artery or one of its branches by material (usually a thrombus) that originated elsewhere in the body. Extensive lower limb deep vein thrombosis with pulmonary embolism is a rare complication of acute pancreatitis that has been described in a few case reports. Deep vein thrombosis and hypercoagulable states in pancreatitis are thought to be due to release of pancreatic proteolytic enzymes from a cyst that is connected to the pancreatic duct and penetrates into a vessel. Proteolytic damage or inflammation of the vessels may also play a significant part. Acute pancreatitis also causes a systemic inflammatory response that has effects on an endothelium-dependent relaxing response for acetylcholine. A 38-year-old Sri Lankan man presented with acute pancreatitis and later he developed progressive abdominal distention with bilateral ankle edema. A contrast-enhanced computed tomographic scan showed two pancreatic pseudocysts and deep vein thrombosis in both lower limbs, as well as a pulmonary embolism involving the right lower lobe pulmonary artery and the left segmental pulmonary arteries. One of the pseudocysts in the head of the pancreas was compressing the inferior vena cava without direct communication. The patient's thrombophilia screen result was negative. He was started on subcutaneous enoxaparin 1 mg/kg twice daily and warfarin to achieve a target international normalized ratio of 2-3. Deep vein thrombosis with pulmonary embolism is a rare but life-threatening complication of acute pancreatitis. Once diagnosed, early treatment with intravenous heparin or thrombolysis is effective. Patients with severe acute pancreatitis may be at risk of deep vein thrombosis due to immobilization and other mechanisms, but anticoagulation as prophylaxis is often not used. However, it may be considered on a

  14. Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases

    Directory of Open Access Journals (Sweden)

    M.R. Ramesh Babu

    2013-01-01

    Full Text Available Deep vein thrombosis (DVT is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.

  15. Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases.

    Science.gov (United States)

    Babu, M R Ramesh; Ramesh, C; Thirumurugan, K; Prasad, G Arun

    2013-04-01

    Deep vein thrombosis (DVT) is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.

  16. Incidence of deep vein thrombosis and thrombosis of the portal-mesenteric axis after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Alsina, Ena; Ruiz-Tovar, Jaime; Alpera, Maria Remedios; Ruiz-García, Jose Gregorio; Lopez-Perez, Manuel Enrique; Ramon-Sanchez, Jose Francisco; Ardoy, Francisco

    2014-09-01

    Venous thromboembolism is the most common postoperative medical complication after bariatric surgery. Mortality associated with thromboembolic processes can reach up to 50%-75%. The aim of this study was to determine the incidence of deep vein thrombosis (DVT) and portal-splenic-mesenteric vein thrombosis (PSMVT) in our population undergoing laparoscopic sleeve gastrectomy (LSG) as the bariatric technique, with an anti-thromboembolic dosage scheme of 0.5 mg/kg/day 12 hours preoperatively and maintained during 30 days postoperatively. A prospective observational study was performed, including 100 consecutive patients undergoing LSG between October 2007 and September 2013. To determine the incidence of DVT and PSMVT, all patients undergo contrast-enhanced abdominal computed tomography (CT) and Doppler ultrasonography (US) of both lower limbs on the third postoperative month, whether they were asymptomatic or symptomatic. Contrast-enhanced CT showed 1 case of PSMVT (1%). Two patients presented DVT in the right leg (2%). All the cases were asymptomatic. The incidence of PSMVT and DVT after LSG with a prophylactic low-molecular-weight heparin dose of 0.5 mg/kg/day and maintained during 30 days postoperatively is 1% and 2%, respectively. According to these results, a postoperative screening with Doppler US and/or contrast-enhanced CT seems to be unnecessary.

  17. A NEWBORN CASE WITH RENAL VEIN THROMBOSIS DUE TO DOUBLE MUTATIONS OF FACTOR V LEIDEN AND MTHFR

    Directory of Open Access Journals (Sweden)

    HAKAN ALTIN (Pediyatrik kardiyoloji uzman doktoru1. isim; sENOL CiTLi (Tibbi genetik uzman doktoru2. isim; AHMET AKCAY (Yenidogan uzman doktoru3. isim

    2015-06-01

    Full Text Available Newborns are more susceptible to thrombosis than adults due to their lower amount of anticoagulant and fibrinolytic system proteins. Incidence of thrombosis rises with presence of the predisposing factors such as hypoxia , infection, dehydration, polycytemia, infants of diabetic mothers, intravenous catheter use, and prothrombotic genetic disorders. Renal vein thrombosis can lead to potentially serious health problems and clinically present with hematuria, renal failure, thrombocytopenia, hypertension, oliguria and palpable mass in the abdomen. Although renal vein thrombosis is a rare disease of newborn its incidence has been increased in recent years. In this article we presented a newborn case with meconium aspiration syndrome and renal vein thrombosis with presence of the genetic predisposing factors as Factor V Leiden and MTHFR gene mutations. [J Contemp Med 2015; 5(2.000: 135-139

  18. Localized superficial femoral vein thrombosis coupled with iatrogenic arteriovenous fistulas presenting as pulmonary emboli.

    Science.gov (United States)

    De Santis, F; Zywica, M; Mani, G; Martini, G

    2012-06-01

    'Localized' femoral vein thrombosis (FVT) is a relatively rare condition usually associated with traumas, external compression or iatrogenic etiologies and the consequence can be pulmonary embolism. This is the case of a 46-year-old woman who presented with pulmonary emboli secondary to 'localized' superficial FVT, coupled with post-puncture arteriovenous fistulas (AVFs), two days after trans-femoral vein radio-frequency cardiac ablation. After placing a temporary IVC-filter, the AVFs were sutured directly while the residual FVT was treated conservatively. Close local monitoring and adequate medical and surgical management are mandatory to avoid possible dangerous complications, also in apparently 'low-risk' iatrogenic AVFs.

  19. A case of deep vein thrombosis with postthrombotic syndrome cured by homoeopathic therapy

    Directory of Open Access Journals (Sweden)

    Gyandas G Wadhwani

    2015-01-01

    Full Text Available A 46-year-old woman consulted for right-sided deep vein thrombosis in external iliac, common femoral, superficial femoral and popliteal veins with extension along with postthrombotic syndrome. After homoeopathic consultation, she was prescribed Argentum nitricum in ascending LM potencies. Symptomatic relief was reported within 2 weeks of treatment, and gradually the quality of life improved after simultaneous reduction in pain due to other complaints of sciatica and osteoarthrosis. Venous Doppler studies repeated a year later showed complete resolution of the medical condition with homoeopathic drug therapy alone. The physical examination also revealed a reduction in limb circumference.

  20. [A case of adenosquamous carcinoma of the sigmoid colon with inferior mesenteric vein thrombosis].

    Science.gov (United States)

    Otsuka, Ryota; Maruyama, Takashi; Tanaka, Hajime; Matsuzaki, Hiroshi; Natsume, Toshiyuki; Miyazaki, Akinari; Sato, Yayoi; Sazuka, Tetsutaro; Yamamoto, Yuji; Yoshioka, Takafumi; Kanada, Yoko; Yanagihara, Akitoshi; Yokoyama, Masaya; Kobayashi, Hiroshi; Shimizu, Shinichiro

    2014-11-01

    A 63-year-old man who had been admitted to another institute with sepsis and renal failure was referred to our hospital after computed tomography (CT) findings showed thickening of the walls in the sigmoid colon and a defect in contrast enhancement in the portal and inferior mesenteric veins. Emergency sigmoid colon resection with D2 lymphadenectomy was performed after detection of perforation due to sigmoid colon cancer. The histopathological diagnosis was adenosquamous carcinoma, pSS, int, INF b, ly1, v0, pN2, pStage IIIband inferior mesenteric vein thrombosis. He was discharged on day 12, and we administered anticoagulant warfarin therapy.

  1. Peroneal artery-vein index as a potential factor of thrombosis occurrence in free osteocutaneous fibula flap.

    Science.gov (United States)

    Dziemianczyk-Pakiela, Dorota; Groth, Dawid; Toloczko-Iwaniuk, Natalia; Rybak, Jozef S; Piotrowski, Leszek; Lukasiewicz, Adam; Borys, Jan; Ettl, Tobias

    2016-09-01

    Despite high popularity and great success rates of free osteocutaneous fibula flaps, the flap failure caused by vascular thrombosis is still a challenging problem. The authors present their evaluation of a potential thrombosis risk factor - a peroneal artery-vein index. The authors evaluated the diameters of peroneal vessels and peroneal artery-vein indexes based on the computed tomography angiographies in 10 patients who underwent a mandible reconstruction with a free fibula flap and compared the results with clinical outcome. In one case the flap was lost, because of thrombosis in the donor vein. This patient presented superficial varicose veins of both lower extremities. Peroneal vein diameters in this patient ranged from 5,05 mm to 6,68 mm and were higher than in patients without complications. The peroneal artery-vein index in the patient with thrombosis ranged from 0,37 to 0,50 with median 0,40 and was lower than in patients without complications. High disproportion between peroneal artery and concomitant veins might be a potential risk factor of the occurrence of venal thrombosis. Detailed perioperative examination of peroneal veins in patients with varicosities should be considered. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Detection of deep vein thrombosis with impedance plethysmography and real-time compression ultrasonography in hospitalized patients

    NARCIS (Netherlands)

    Heijboer, H.; Cogo, A.; Büller, H. R.; Prandoni, P.; ten Cate, J. W.

    1992-01-01

    Serial testing with impedance plethysmography or compression ultrasonography has been demonstrated to be feasible and accurate for the detection of deep vein thrombosis (DVT) in symptomatic outpatients, and these techniques are replacing contrast venography in this patient category. Limited data,

  3. Studies of the incidence of post-operative deep-vein thrombosis in Sudan, using 125I-fibrinogen

    International Nuclear Information System (INIS)

    Hassan, M.A.

    1974-01-01

    Sudanese patients undergoing surgery in Khartoum Civil Hospital were investigated for evidence of post-operative deep vein thrombosis by means of the 125 I-fibrinogen test. An analysis of the results obtained in an initial series of 100 patients undergoing various operations including prostatectomy (transvesical or retropubic), vagotomy and drainage, cholocystectomy, various operations on the urinary bladder, various operations on the hip, splenectomy, herniorrhaphy, nephrectomy and haemorrhoidectomy revealed an incidence of post-operative deep vein thrombosis of 12.0%. There was no significant variation of incidence with age or sex. A subsequent analysis of the results obtained in 104 patients undergoing prostatectomy (transvesical or retropubic) revealed an incidence of deep vein thrombosis of 9.6%. These values differ markedly from the incidences of 21-47% reported in Sweden and UK. It is suggested that the indicence of post-operative deep vein thrombosis is lower in Sudan than in European countries

  4. Prevention of deep vein thrombosis after hip replacement: randomised comparison between unfractionated heparin and low molecular weight heparin

    NARCIS (Netherlands)

    Leyvraz, P. F.; Bachmann, F.; Hoek, J.; Büller, H. R.; Postel, M.; Samama, M.; Vandenbroek, M. D.

    1991-01-01

    To evaluate the efficacy and safety of two subcutaneous prophylactic regimens for postoperative deep vein thrombosis after total hip replacement. Prospective open randomised multicentre trial. 28 European departments of orthopaedic surgery. All patients had bilateral phlebography 10 days after

  5. Gastrointestinal Variant of Lemierre Syndrome: Fusobacterium nucleatum Bacteremia-Associated Hepatic Vein Thrombosis: a Case Report and Literature Review.

    Science.gov (United States)

    Zheng, Lin; Giri, Badri

    2016-01-01

    Fusobacterium nucleatum is a gram-negative bacillius commonly found in oropharynx and is traditionally associated with Lemierre syndrome, which is characterized by history of recent oropharyngeal infection, internal jugular vein thrombosis, and isolation of anaerobic pathogens, mainly Fuosobacterium necrophorum. However, recent evidence indicated that F. nucleatum is also a normal resident of human gut. Less than a dozen of case reports had linked F. nucleatum to gastrointestinal variant of Lemierre syndrome with portal vein thrombosis. However, F. nucleatum bacteremia-associated hepatic vein thrombosis is very rare. We report a case of a 73-year-old man who had hepatic vein thrombosis associated with F. nucleatum bacteremia, most likely from subclinical primary infection affecting the lower gastrointestinal tract. The underlying pathophysiology and treatment options are discussed here. With rapid increase in reporting of Lemierre syndrome, this case deserves particular attention from clinicians.

  6. Predictors of a Positive Duplex Scan in Patients with a Clinical Presentation Compatible with Deep Vein Thrombosis or Cellulitis

    Directory of Open Access Journals (Sweden)

    Curtis E Rabuka

    2003-01-01

    Full Text Available BACKGROUND: Deep vein thrombosis (DVT and cellulitis are common conditions whose symptoms lead patients to seek medical attention in the emergency department (ED. Distinguishing between these two conditions quickly and accurately is important.

  7. Case report of deep vein thrombosis caused by artificial urinary sphincter reservoir compressing right external iliac vein

    Directory of Open Access Journals (Sweden)

    Marcus J Yip

    2015-01-01

    Full Text Available Artificial urinary sphincters (AUSs are commonly used after radical prostatectomy for those who are incontinent of urine. However, they are associated with complications, the most common being reservoir uprising or migration. We present a unique case of occlusive external iliac and femoral vein obstruction by the AUS reservoir causing thrombosis. Deflation of the reservoir and anticoagulation has, thus far, not been successful at decreasing thrombus burden. We present this case as a rare, but significant surgical complication; explore the risk factors that may have contributed, and other potential endovascular therapies to address this previously unreported AUS complication.

  8. EVALUATION OF AVERAGE DIAMETER OF LOWER EXTREMITY VEINS IN ACUTE AND CHRONIC THROMBOSIS AND COMPARISON WITH NORMAL PERSONS BY DOPPLER SONOGRAPHY

    Directory of Open Access Journals (Sweden)

    H. Sharifian F. Gharekhanloo

    2003-07-01

    Full Text Available The goal of this study was to define the normal range of diameter in the deep vein of the lower limb and to compare this range with diameter of the veins with acute thrombosis and of veins with chronic thrombosis by using color doppler sonography. The study was cross sectional. The vein diameter and vein to artery ratio in different levels were measured and the following results were obtained. In patients with acute thrombosis the vein diameter and vein to artery ratio were more than normal range and this difference had statistical significance so we can reliably predict acute thrombosis if the vein diameter is upper than a suggested level. In chronic thrombosis, however, the vein diameter is not a good diagnostic factor and so we can not rely on it.

  9. Portal vein thrombosis in pregnancy caused by hepatocellular carcinoma: A rare case report

    Directory of Open Access Journals (Sweden)

    Nasrin Jalilian

    2014-03-01

    Full Text Available Background: Portal Vein Thrombosis (PVT during pregnancy is very rare. Its most common underlying causes are myeloproliferative disorders, pancreatitis, hepatocellular carcinoma and hereditary deficiency of natural anticoagulants (thrombophilia. Hepatocellular Carcinoma (HCC is one of the most common gastrointestinal malignancies which is caused by toxins, alcohol and hepatitis viruses. Viral hepatitis is the cause of one-third of this carcinoma in China and Asia. Case Report: We reported a case of Portal Vein Thrombosis (PVT in a 31-year-old pregnant woman with an otherwise normal liver function, no risk factors, no hepatitis and no history of thrombophilia. Report of ultrasonography, CT scan and elevated alpha-fetoprotein test, indicated hepatocellular carcinoma and metastases was found in the bone and lungs. Conclusion: This case is very rare in pregnancy so diagnosis and decision to termination of pregnancy is important.

  10. [Sinus pericranii associated to spontaneous thrombosis of the ophthalmic vein: neuroimaging studies].

    Science.gov (United States)

    Murias, E; Villota, E; Saiz, A; Gil, A; Calleja, S

    2009-01-01

    Sinus pericranii is an abnormal venous communication between the intracranial dural sinuses and epicranial venous dilatations. The periorbital location is uncommon; spontaneous partial thromboses of the subcutaneous varices have been reported in association with local signs and symptoms; however, to our knowledge there are no reports of sinus pericranii associated to thrombosis in the ophthalmic vein. Sinus pericranii is related to arteriovenous and lymphatic-venous malformations. We present the case of a patient with a generalized and diffuse disorder of venous drainage that affected the right cerebral hemisphere who presented at the emergency department with ophthalmologic signs and symptoms after thrombosis of the superior ophthalmic vein and who had three sinus pericranii located in the frontal, parietal, and occipital areas.

  11. Controversies in venous thromboembolism: to treat or not to treat superficial vein thrombosis.

    Science.gov (United States)

    Beyer-Westendorf, Jan

    2017-12-08

    The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions. However, several recent observational and interventional studies provide better insight into the optimal treatment of patients with SVT who are at different risks for thromboembolic complications. This educational review summarizes the available evidence and aims to provide practical guidance based on a clinical decision pathway. © 2016 by The American Society of Hematology. All rights reserved.

  12. Management of a patient with small-area burns, severe sepsis and superficial vein thrombosis.

    Science.gov (United States)

    Shao, H; Luo, R; Wang, X; Pan, X; Chen, G

    2015-02-01

    Sepsis is frequently seen in severely burned patients, however it is not common in those with small-area burns. We present a case of a 22-year-old man suffering from a hot crush injury to his left hand dorsum covering 1% of his total body surface area. The patient developed severe sepsis and superficial vein thrombosis, probably due to wound infection. Culture of the wound secretion indicated Corynebacterium striatum. Following intensive topical and systemic treatment the severe sepsis was controlled. The local wound was repaired by the abdominal skin pedicle flap which had taken well by day 27 post admission. A topical superficial vein thrombosis, unintentionally found 42 days after admission, was partially excised. This case demonstrates that when treating severe sepsis in patients with small-area burns, the timely recognition and diagnosis along with active systemic support, play a vital role in successful management. None of the authors have any financial interest to declare.

  13. Liver Abscess and Portal Vein Thrombosis Due to Ileal Diverticulitis Mediated by Barium Fluoroscopy.

    Science.gov (United States)

    Kubo, Haremaru; Asai, Genki; Haraguchi, Kou; Shibahara, Yu; Kihara, Toshihiro; Yamakawa, Genta; Kira, Fumitaka; Higashi, Hisato; Morishita, Shinji; Fujie, Hajime; Matsumoto, Masao; Shimura, Wahei

    2017-12-01

    We report a case of liver abscess and portal vein thrombosis, which occurred due to diverticulitis at the terminal ileum in a 59-year-old man. The patient underwent a barium fluoroscopic examination 1 month before presenting to our hospital. He also showed liver dysfunction due to thrombosis at the superior mesenteric and portal veins. His inflammation gradually subsided after the initiation of treatment, but the recovery was not sufficient. Thus, surgery was performed. The patient condition improved after surgery and he was discharged. Barium examinations are relatively safe, but can sometimes cause severe adverse effects in patients with certain risk factors, and an appropriate diagnosis and treatment are necessary when symptoms appear.

  14. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii. © The Author(s) 2014.

  15. Headache Could Be Finding of Sinus Vein Thrombosis in Behcets Patients

    OpenAIRE

    Halil Sen

    2014-01-01

    Globally Behcet%u2019s disease (BD) is most frequently seen in Turkey and takes its name from the Turkish dermatologist Hulusi Behcet. Basic findings of the disease are the triad of genital ulcers, oral ulcers and uveitis. Neurological involvement in BD appears an average of 5 years after the beginning of disease, or the first appearance of the disease may be neurological findings. Sinus vein thrombosis (SVT) is among neurological involvements observed in BD. However diagnosis of SVT is diffi...

  16. Portomesenteric Vein Thrombosis, Bowel Gangrene, and Bilateral Pulmonary Artery Embolism Two Weeks after Laparoscopic Sleeve Gastrectomy

    OpenAIRE

    Darcy, David G.; Charafeddine, Ali H.; Choi, Jenny; Camacho, Diego

    2015-01-01

    Sleeve gastrectomy and gastric bypass surgery are popular and effective options for weight loss surgery. Portomesenteric vein thrombosis (PMVT) is a documented but rare complication of bariatric surgery. Proper surgical technique, careful postoperative prophylaxis, and early mobilization are essential to prevent this event. The diagnosis of PMVT in the postoperative period requires a high index of suspicion and early directed intervention to prevent a possibly fatal outcome. We present a case...

  17. Superior mesenteric vein thrombosis: a case report; Trombose da veia mesenterica superior: relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Costa Praxedes, Marcia da; Malheiros, Noemia Reis; Machado, Dianne Melo; Carvalho, Ana Alice Vidal de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia]|[Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Santos, Alair Augusto S.M. [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Inst. Biomedico

    1995-09-01

    A case of superior mesenteric mesenteric vein thrombosis diagnosed by computed tomography in 29 year-old man with abdominal pain, without any predisposing pathologic disorders is reported. This patient had a chronic evolution, had not resulting in mesenteric infarction. He was treated conservatively with anticoagulant therapy and recanalization of the involved vessels was demonstrated by another computed tomography. The patient is asymptomatic now. (author). 8 refs., 3 figs.

  18. Small bowel stricture as a late sequela of superior mesenteric vein thrombosis.

    Science.gov (United States)

    Paraskeva, Panoraia; Akoh, Jacob A

    2015-01-01

    The increasing frequency of use of CT in patients with acute abdomen is likely to improve the diagnosis of rarely occurring conditions/causes such as superior mesenteric vein thrombosis (MVT). Despite its severe consequences, MVT often presents with nonspecific clinical features. AD, a 64-year-old man was an emergency admission with vague abdominal discomfort of two weeks duration, acute upper abdominal pain, loose stools, fresh rectal bleeding and vomiting. A contrast enhanced abdominal CT showed thrombosis of the proximal portal vein and the entire length of the superior mesenteric vein (SMV) with small bowel ischaemia extending from the terminal ileum to the mid jejunal loops. Tests for paroxysmal nocturnal haemoglobinuria and Janus kinase 2 mutation yielded negative results. AD was readmitted seven months later with small bowel obstruction requiring segmental small bowel resection with end-to-end anastomosis. Abdominal CT had shown complete resolution of MVT but a small bowel stricture. Thrombosis limited to mesenteric veins results in earlier and more frequent development of infarction compared to portal combined with mesenteric venous thrombosis. Most patients may be successfully treated with anti-coagulation therapy alone. However, surgery may be required to deal with intestinal infarction or late sequela of MVT. This case demonstrates that MVT can be reversed by effective anticoagulation. However, the price paid for a mild to moderate effect on the bowel may be significant stricture later on. Patients escaping early bowel resection due to massive MVT leading to bowel infarction may still require resection later due to stricture. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Imaging diagnosis of portal vein thrombosis following splenectomy in 23 patients with hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Yamashita, Kohsuke; Takayasu, Kenichi; Muramatsu, Yukio; Moriyama, Noriyuki; Yamada, Tatsuya; Makuuchi, Masatoshi; Hasegawa, Hiroshi

    1988-01-01

    During the past two years, the postoperative development of portal vein thrombosis (PVT) following splenectomy with simultaneous or subsequent hepatectomy for hepatocellular carcinoma was detected in 3 of 23 patients (13 %) utilizing ultrasound and/or computed tomography. These 3 patients were clinically asymptomatic. Two of these patients were treated medically with urokinase, and aspirin or dipyridamole, with documented resolution of the PVT by ultrasound. (author)

  20. Catheter-Directed Thrombolysis of Deep Vein Thrombosis in a Patient with Churg-Strauss Syndrome: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jun Beom; Kim, See Hyung; Choi, Jin Soo; Kim, Young Hwan [Dongsan Hospital, Keimyung University, Daegu (Korea, Republic of)

    2010-10-15

    Vasculitis by Churg-Strauss Syndrome (CSS) is an uncommon disease characterized by the inflammation of blood vessel walls and can involve many organs. The clinical manifestations and courses of vasculitis are highly variable. Deep vein thrombosis has rarely been reported in vasculitis by CSS. We report a case of deep vein thrombosis associated with CSS that was successfully treated by catheter-directed thrombolysis.

  1. Catheter-Directed Thrombolysis of Deep Vein Thrombosis in a Patient with Churg-Strauss Syndrome: A Case Report

    International Nuclear Information System (INIS)

    Park, Jun Beom; Kim, See Hyung; Choi, Jin Soo; Kim, Young Hwan

    2010-01-01

    Vasculitis by Churg-Strauss Syndrome (CSS) is an uncommon disease characterized by the inflammation of blood vessel walls and can involve many organs. The clinical manifestations and courses of vasculitis are highly variable. Deep vein thrombosis has rarely been reported in vasculitis by CSS. We report a case of deep vein thrombosis associated with CSS that was successfully treated by catheter-directed thrombolysis

  2. A clinical score to rule out the concomitant presence of deep vein thrombosis in patients presenting with superficial vein thrombosis: The ICARO study.

    Science.gov (United States)

    Pomero, F; Di Minno, M N D; Tamburini Premunian, E; Malato, A; Pasca, S; Barillari, G; Fenoglio, L; Siragusa, S; Di Minno, G; Ageno, W; Dentali, F

    2015-11-01

    Superficial vein thrombosis (SVT) is commonly encountered in clinical practice. Recent studies have suggested that the concomitant presence of deep vein thrombosis (DVT) or pulmonary embolism (PE) at the time of SVT diagnosis is not uncommon, thus increasing the interest on this disease. Whether this coexistence is predicted by specific risk factors remains unknown. To evaluate potential risk factors for DVT coexistence in patients presenting with acute objectively diagnosed SVT of the lower limbs and to develop a simple score entirely based on clinical variables to define the pre-test probability of DVT in these patients. A multicenter, retrospective cohort study on SVT patients was conducted. Information was collected on clinical signs and on risk factors for venous thrombosis. 494 patients (mean age 56.3 ± 17.9 years, 64.2% women) were included. Concomitant DVT was found in 16.0% of patients. After multivariate analysis, we identified 5 independent variables that were used to develop the ICARO score: active malignancy (1.5 points), limb edema (1.5 points), rope-like sign (-1 point), age ≥ 50 years (1 point), unprovoked SVT (-1 point). The prevalence of concomitant DVT was 1.1% in the low-probability category (< 0 points), 12.0% in the intermediate-probability category (0 to 1 points), and 32.3% in the high probability category (≥ 1.5 points). The concomitant presence of major DVT is not negligible in patients with SVT. Our prediction score entirely based on simple clinical variables may be useful in assessing the risk of concomitant DVT in these patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The response of thrombosis in the portal vein or hepatic vein in hepatocellular carcinoma to radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Bong Kyung; Kim, Jae Chul [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2016-09-15

    The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.

  4. Mesenteric vein thrombosis following impregnation via in vitro fertilization-embryo transfer.

    Science.gov (United States)

    Hirata, Masaaki; Yano, Hiroko; Taji, Tomoe; Shirakata, Yoshiharu

    2017-10-27

    Pregnancy is an acquired hypercoagulable state. Most patients with thrombosis that develops during pregnancy present with deep vein leg thrombosis and/or pulmonary embolism, whereas the development of mesenteric vein thrombosis (MVT) in pregnant patients is rare. We report a case of MVT in a 34-year-old woman who had achieved pregnancy via in vitro fertilization-embryo transfer (IVF-ET). At 7 wk of gestation, the patient was referred to us due to abdominal pain accompanied by vomiting and hematochezia, and she was diagnosed with superior MVT. Following resection of the gangrenous portion of the small intestine, anticoagulation therapy with unfractionated heparin and thrombolysis therapy via a catheter placed in the superior mesenteric artery were performed, and the patient underwent an artificial abortion. Oral estrogen had been administered for hormone replacement as part of the IVF-ET procedure, and additional precipitating factors related to thrombosis were not found. Pregnancy itself, in addition to the administered estrogen, may have caused MVT in this case. We believe that MVT should be included in the differential diagnosis of a pregnant patient who presents with an acute abdomen.

  5. High risk of deep vein thrombosis associated with peripherally inserted central catheters in lymphoma

    Science.gov (United States)

    Li, Chao-Feng; Wang, Yu; Liu, Pan-Pan; Bi, Xi-Wen; Sun, Peng; Lin, Tong-Yu; Jiang, Wen-Qi; Li, Zhi-Ming

    2016-01-01

    Peripherally inserted central venous catheters (PICCs) are widely used in cancer patients. Although PICC is a convenient tool, its use is associated with an obvious increase in the incidence of venous thrombosis. The risk factors for deep vein thrombosis associated with the use of PICCs in cancer patients are largely unexplored. This study aimed to investigate the incidence of PICC-associated thrombosis in lymphoma compared with its incidences in other types of cancer. A total of 8028 adult cancer patients inserted with PICC between June 2007 and June 2015 were included in this study. A total of 249 of the 8028 included patients (3.1%) inserted with PICC developed upper extremity deep vein thrombosis (PICC-UEDVT). Patients with lymphoma were more likely to have PICC-UEDVT than those with other types of malignancies (7.1% vs. 2.80%; P PICC (OR: 3.849, 95% CI: 2.334–6.347). Patients with lymphoma may be more predisposed to developing PICC-UEDVT than those with other types of malignancies. Identifying the mechanism underlying the relationship between PICC-UEDVT and lymphoma requires further study. PMID:27078849

  6. The diagnostic management of upper extremity deep vein thrombosis: A review of the literature.

    Science.gov (United States)

    Kraaijpoel, Noémie; van Es, Nick; Porreca, Ettore; Büller, Harry R; Di Nisio, Marcello

    2017-08-01

    Upper extremity deep vein thrombosis (UEDVT) accounts for 4% to 10% of all cases of deep vein thrombosis. UEDVT may present with localized pain, erythema, and swelling of the arm, but may also be detected incidentally by diagnostic imaging tests performed for other reasons. Prompt and accurate diagnosis is crucial to prevent pulmonary embolism and long-term complications as the post-thrombotic syndrome of the arm. Unlike the diagnostic management of deep vein thrombosis (DVT) of the lower extremities, which is well established, the work-up of patients with clinically suspected UEDVT remains uncertain with limited evidence from studies of small size and poor methodological quality. Currently, only one prospective study evaluated the use of an algorithm, similar to the one used for DVT of the lower extremities, for the diagnostic workup of clinically suspected UEDVT. The algorithm combined clinical probability assessment, D-dimer testing and ultrasonography and appeared to safely and effectively exclude UEDVT. However, before recommending its use in routine clinical practice, external validation of this strategy and improvements of the efficiency are needed, especially in high-risk subgroups in whom the performance of the algorithm appeared to be suboptimal, such as hospitalized or cancer patients. In this review, we critically assess the accuracy and efficacy of current diagnostic tools and provide clinical guidance for the diagnostic management of clinically suspected UEDVT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Clinical relevance of symptomatic superficial-vein thrombosis extension: lessons from the CALISTO study.

    Science.gov (United States)

    Leizorovicz, Alain; Becker, François; Buchmüller, Andrea; Quéré, Isabelle; Prandoni, Paolo; Decousus, Hervé

    2013-09-05

    The clinical relevance of symptomatic extension of spontaneous, acute, symptomatic, lower-limb superficial-vein thrombosis (SVT) is debated. We performed a post hoc analysis of a double-blind trial comparing fondaparinux with placebo. The main study outcome was SVT extension by day 77, whether to ≤ 3 cm or > 3 cm from the sapheno-femoral junction (SFJ). All events were objectively confirmed and validated by an adjudication committee. With placebo (n = 1500), symptomatic SVT extension to ≤ 3 cm or > 3 cm from the SFJ occurred in 54 (3.6%) and 56 (3.7%) patients, respectively, inducing comparable medical resource consumption (eg, anticoagulant drugs and SFJ ligation); subsequent deep-vein thrombosis or pulmonary embolism occurred in 9.3% (5/54) and 8.9% (5/56) of patients, respectively. Fondaparinux was associated with lower incidences of SVT extension to ≤ 3 cm (0.3%; 5/1502; P 3 cm (0.8%; 12/1502; P vein thrombosis or pulmonary embolism was observed in fondaparinux patients. Thus, symptomatic extensions are common SVT complications and, whether or not reaching the SFJ, are associated with a significant risk of venous thromboembolic complications and medical resource consumption, all reduced by fondaparinux.

  8. Magnetic resonance portal venography: use of fast-acquisition true FISP imaging in the detection of portal vein thrombosis

    International Nuclear Information System (INIS)

    Smith, C.S.; Sheehy, N.; Mceniff, N.; Keogan, M.T.

    2007-01-01

    Aim: To determine the accuracy of true fast imaging with steady-state precession (true FISP) in the diagnosis of portal vein thrombosis in patients with cirrhosis and compare it to contrast-enhanced three-dimensional (3D) magnetic resonance (MR) angiography, the reference standard. Materials and methods: Twenty-four consecutive patients with suspected portal venous thrombosis underwent contrast-enhanced 3D MR angiography and true FISP imaging of the portal vein. All patients had undergone at least one other imaging study, either computed tomography, (CT) or ultrasound. Both sets of MR images were evaluated for patency of the portal venous system and for image quality. Results: Portal vein thrombosis was diagnosed in six of the 24 patients. Four patients with portal vein thrombosis were accurately diagnosed on the true FISP sequence. This sequence also accurately diagnosed the patency of the portal vein in 17 patients. However, the results were inconclusive in three patients. The image quality of the true FISP sequence of the three inconclusive patients was graded as either poor or fair. Of these three patients, contrast-enhanced 3D MR angiography confirmed portal vein thrombosis in two patients and portal vein stenosis in one patient. True FISP imaging had a sensitivity of 67% and a specificity of 100% for the diagnosis of portal vein thrombosis. Conclusion: The results of the present study show that the true FISP sequence is useful in diagnosing portal vein thrombosis. It could be employed as an adjunct to contrast-enhanced MR angiography in the severely debilitated patient where respiratory motion may degrade the images or in patients where the use of intravenous contrast medium is not possible due to poor venous access

  9. CMS reimbursement reform and the incidence of hospital-acquired pulmonary embolism or deep vein thrombosis.

    Science.gov (United States)

    Gidwani, Risha; Bhattacharya, Jay

    2015-05-01

    In October 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for the marginal cost of treating certain preventable hospital-acquired conditions. This study evaluates whether CMS's refusal to pay for hospital-acquired pulmonary embolism (PE) or deep vein thrombosis (DVT) resulted in a lower incidence of these conditions. We employ difference-in-differences modeling using 2007-2009 data from the Nationwide Inpatient Sample, an all-payer database of inpatient discharges in the U.S. Discharges between 1 January 2007 and 30 September 2008 were considered "before payment reform;" discharges between 1 October 2008 and 31 December 2009 were considered "after payment reform." Hierarchical regression models were fit to account for clustering of observations within hospitals. The "before payment reform" and "after payment reform" incidences of PE or DVT among 65-69-year-old Medicare recipients were compared with three different control groups of: a) 60-64-year-old non-Medicare patients; b) 65-69-year-old non-Medicare patients; and c) 65-69-year-old privately insured patients. Hospital reimbursements for the control groups were not affected by payment reform. CMS payment reform for hospital-based reimbursement of patients with hip and knee replacement surgeries. The outcome was the incidence proportion of hip and knee replacement surgery admissions that developed pulmonary embolism or deep vein thrombosis. At baseline, pulmonary embolism or deep vein thrombosis were present in 0.81% of all hip or knee replacement surgeries for Medicare patients aged 65-69 years old. CMS payment reform resulted in a 35% lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis in these patients (p = 0.015). Results were robust to sensitivity analyses. CMS's refusal to pay for hospital-acquired conditions resulted in a lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis after hip or knee replacement surgery

  10. Clinical risk factors to predict deep venous thrombosis post-endovenous laser ablation of saphenous veins.

    Science.gov (United States)

    Chi, Y-W; Woods, T C

    2014-04-01

    Endovenous laser ablation of saphenous veins is an alternative in treating symptomatic varicose veins. Deep venous thrombosis (DVT) has been reported in up to 7.7% of patients undergoing such procedure. We sought to establish clinical risk factors that predict DVT post-endovenous laser ablation. Patients who underwent endovenous laser ablation were prospectively followed. Clinical data and post-interventional duplex ultrasound were analysed. A P value 66 (P = 0.007), female gender (P = 0.048) and prior history of superficial thrombophlebitis (SVT) (P = 0.002) were associated with increased risk of DVT postprocedure. Age >66, female gender and history of SVT were significant predictors of DVT post-endovenous laser ablation of saphenous veins.

  11. An Unexpectedly High Rate of Thrombophilia Disorders in Patients with Superficial Vein Thrombosis of the Lower Extremities

    DEFF Research Database (Denmark)

    Sobreira, Marcone Lima; Rogatto, Silvia Regina; Dos Santos, Rodrigo Mattos

    2017-01-01

    BACKGROUND: Superficial vein thrombosis (SVT) is a common venous condition. Recent studies have shown that SVT is associated with high frequency of thromboembolic complications: from 22-37% for deep venous thrombosis and up to 33% for pulmonary embolism. Our goal was to assess the prevalence...... deficiency, presence of lupus anticoagulant, as well as anticardiolipin antibody titers. Patients aged less than 18 years, with confirmed deep vein thrombosis, and pregnant women were excluded. RESULTS: 95.5% were Caucasian, and 62.1% were female gender. Age ranged from 21-88 years. Molecular testing showed...

  12. A new computerized impedance plethysmograph: accuracy in the detection of proximal deep-vein thrombosis in symptomatic outpatients

    NARCIS (Netherlands)

    Prandoni, P.; Lensing, A. W.; Huisman, M. V.; Jonker, J. J.; Vigo, M.; Borm, J. J.; Büller, H. R.; Sing, A. K.; Carta, M.; ten Cate, J. W.

    1991-01-01

    Because of the lack of specificity of the clinical diagnosis it is appropriate in patients with clinically suspected deep-vein thrombosis to apply an objective test before starting anticoagulant treatment. Impedance plethysmography is a highly accurate technique for the detection of proximal-vein

  13. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound.

    Science.gov (United States)

    Su, Li-ya; Guo, Fa-jin; Xu, Guang; Han, Xiu-jie; Sun, Chang-kun; Zhang, Zheng; Jing, Qing-hong

    2013-12-01

    Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT). This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma. A retrospective case series of 35 ICMVT (M:F, 21:14; mean age (64.5 ± 10.6) years) and 23 gastrocnemius hematoma (M:F, 16:7; mean age (75.4 ± 11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012. Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein, great saphenous vein, calf muscles, skin, and soft tissue were examined. ICMVT hypoechoic signals were characterized by long, tube-like masses on longitudinal sections and oval masses on transverse sections, with apparent muscle thrombosis boundaries, distal and proximal venous connections, and, often, lower limb DVT. Gastrocnemius hematoma hypoechoic signals were characterized by large volumes, enhanced posterior hematoma echo, hyperechoic muscle boundaries, no hematoma blood flow, and no DVT, and clear differences in trauma/exercise- and oral anticoagulant-induced hematomas were readily apparent. According to the measurement, the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0, whereas in gastrocnemius hematoma patients the ratio was more than 2.0. Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas. Partial muscle fibers in the hematoma due to muscle fractures were apparent. High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  14. Deep vein thrombosis of the lower limb secondary to lumbar discal hernia compression: a rarity? Review of the literature

    OpenAIRE

    DI CELLO, P.; IZZO, S.; PUGLIESE, F.; DI POCE, I.; ORSINI, A.; IZZO, L.; MAZZONE, G.; BIANCUCCI, F.; SINAIMERI, G.; VALABREGA, S.; ALMANSOUR, M.; IZZO, P.

    2016-01-01

    This case report is about a 70-years-old female patient, suffering from discal hernia, with compression of the iliac vein, that led to the formation of deep vein thrombosis of the lower limbs. The angio-CT scan revealed the starting point of the L4–L5 compression where a voluminous discal hernia caused deep vein thrombosis, with the involvement the femoro-popliteal venous axis. Blood samples and PET-CT scans excluded other possible etiologic factors. This case demonstrates how a voluminous di...

  15. Idiopathic thrombosis of the superficial scrotal veins (Mondor's disease) during the postoperative period of an umbilical herniorraphy.

    Science.gov (United States)

    Méndez Rubio, Santiago; Menéndez Sánchez, Pablo; Platas Sancho, Arturo; González Cajigal, Beatriz; Salinas Casado, Jesús; Sanz Migueláñez, Juan Luis

    2012-12-01

    Mondor's disease is a superficial thrombophlebitis and usually occurs in the anterior and lateral chest. The scrotal vein thrombosis is a fairly rare disease. Thirty-four year old male who consulted for inguinal tumor and pain in the postoperative period of an umbilical hernia repair, which resulted in a subsequent scrotal vein thrombosis treated conservatively. It was resolved with conservative treatment, with recanalization of the scrotal veins. Mondor's disease is a rare entity, related to multiple etiological factors. The diagnosis is made easily with Doppler ultrasound and most resolve with conservative treatment.

  16. Clinical course of patients with symptomatic isolated superficial vein thrombosis: the ICARO follow-up study.

    Science.gov (United States)

    Barco, S; Pomero, F; Di Minno, M N D; Tamborini Permunian, E; Malato, A; Pasca, S; Barillari, G; Fenoglio, L; Siragusa, S; Di Minno, G; Ageno, W; Dentali, F

    2017-11-01

    Essentials Late sequelae of isolated superficial vein thrombosis (iSVT) have rarely been investigated. We studied 411 consecutive outpatients with acute iSVT with a median follow-up of three years. Male sex and cancer are risk factors for future deep vein thrombosis or pulmonary embolism. Patients without cancer appear to be at a negligible risk for death. Background Studies of long-term thromboembolic complications and death following acute isolated superficial vein thrombosis (iSVT) of the lower extremities are scarce. Objectives To investigate the course of iSVT in the setting of an observational multicenter study. Methods We collected longitudinal data of 411 consecutive outpatients with acute, symptomatic, objectively diagnosed iSVT who were previously included in the cross-sectional ICARO study. Four patients followed for vein thrombosis (DVT) or pulmonary embolism (PE) were excluded from the present analysis. The primary outcome was symptomatic DVT or PE. The safety outcomes were major bleeding and all-cause death. Results The median follow-up time was 1026 days (interquartile range 610-1796). Symptomatic DVT/PE occurred in 52 (12.9%) patients, giving annualized rates of 1.3% (95% confidence interval [CI] 0.3-3.9%) on anticoagulant treatment and 4.4% (95% CI 3.2-5.8%) off anticoagulant treatment. Male sex (adjusted hazard ratio [HR] 2.03 [95% CI 1.16-3.54]) and active solid cancer (adjusted HR 3.14 [95% CI 1.11-8.93]) were associated with future DVT/PE, whereas prior DVT/PE failed to show significance, most likely because of bias resulting from prolonged anticoagulant treatment. Three major bleeding events occurred on treatment, giving an annualized rate of 1.4% (95 CI 0.3-4.0%). Death was recorded in 16 patients (annualized rate: 1.1% [95% CI 0.6-1.7%]), and was attributable to cancer (n = 8), PE (n = 1), cardiovascular events (n = 3), or other causes (n = 4). Conclusions The long-term risk of DVT/PE after anticoagulant discontinuation for acute iSVT is

  17. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome: An Observational Study.

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-11-01

    Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes.All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed.Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS.Lower-extremity vein thrombosis

  18. Clinical and Ultrasonographic Evaluation of Lower-extremity Vein Thrombosis in Behcet Syndrome

    Science.gov (United States)

    Seyahi, Emire; Cakmak, Osman Serdal; Tutar, Burcin; Arslan, Caner; Dikici, Atilla Suleyman; Sut, Necdet; Kantarci, Fatih; Tuzun, Hasan; Melikoglu, Melike; Yazici, Hasan

    2015-01-01

    Abstract Vascular involvement can be seen in up to 40% of patients with Behcet syndrome (BS), the lower-extremity vein thrombosis (LEVT) being the most common type. The aim of the current study was to compare venous Doppler findings and clinical features between BS patients with LEVT and control patients diagnosed as having LEVT due to other causes. All consecutive 78 patients (71 men, 7 women; mean age 38.6 ± 10.3 years) with LEVT due to BS and 50 control patients (29 men, 21 women; mean age 42.0 ± 12.5 years) who had LEVT due to other causes, or idiopathic, were studied with the help of a Doppler ultrasonography after a detailed clinical examination. Patterns of venous disease were identified by cluster analyses. Clinical features of chronic venous disease were assessed using 2 classification systems. Venous claudication was also assessed. Patients with BS were more likely to be men, had significantly earlier age of onset of thrombosis, and were treated mainly with immunosuppressives and less frequently with anticoagulants. Furthermore, they had significantly more bilateral involvement, less complete recanalization, and more frequent collateral formation. While control patients had a disorganized pattern of venous involvement, BS patients had a contiguous and symmetric pattern, involving all deep and superficial veins of the lower extremities, with less affinity for crural veins. Clinical assessment, as measured by the 2 classification systems, also indicated a more severe disease among the BS patients. In line, 51% of the BS patients suffered from severe post-thrombotic syndrome (PTS) and 32% from venous claudication, whereas these were present in 8% and 12%, respectively, among the controls. Among BS patients, a longer duration of thrombosis, bilateral femoral vein involvement, and using no anticoagulation along with immunosuppressive treatment when first diagnosed were found to be associated independently with severe PTS. Lower-extremity vein

  19. [Recent advances in the treatment of superficial vein thrombosis and extracranial carotid artery stenosis].

    Science.gov (United States)

    Bauersachs, R M; Kuhlencordt, P J

    2011-02-01

    Superficial vein thrombosis (SVT) occurs at least as frequent as deep vein thrombosis (DVT), and shares common risk factors with venous thromboembolism. The CALISTO trial was the first to provide specific recommendations for the pharmacologic treatment of SVT. Before treatment is initiated, an accompanying DVT must be excluded and the proximal extension of the SVT assessed. If the proximal extension of the thrombus is closer than 3 cm towards the deep vein system, it should be treated like DVT. Under certain conditions treatment with fondaparinux is indicated in acute symptomatic SVT. Furthermore, compression treatment is recommended. Extracranial carotid artery stenosis can be treated by either surgical thrombarterectomy or catheter based endovascular stent implantation. Trials comparing the two methods have not provided conclusive results on whether the two strategies are equally safe and effective. Considering the latest data from RCTs, careful patient selection (symptoms, comorbidities, age, anatomy, re-stenosis) including individual interdisciplinary discussion appears of ample importance. To date no information is available on whether patients with asymptomatic high grade carotid stenosis receiving "best medical therapy" should be considered for revascularisation in general or only in selected circumstances. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Results of post-laparoscopic cholecystectomy duplex scan without deep vein thrombosis prophylaxis prior to surgery

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Pakaneh

    2012-11-01

    Full Text Available  Abstract Backgrounds: There are controversies among surgeons about prophylaxis of deep vein thrombosis (DVT in laparoscopic cholecystectomy. The aim of this study was the assessment of patients’ condition after laparoscopic cholecystectomy without any prophylactic measure. Methods: 100 cases of laparoscopic cholecystectomy without DVT prophylaxis were followed by duplex scanning in the first postoperative day and by physical examination and patient history at the first to second postoperative week however no clinical sign was found for DVT. Results: Only one case of partially thrombosis (1% was found by duplex scanning which was managed conservatively. Conclusion: Laparoscopic cholecystectomy may consider as a low-risk procedure and routine prophylaxis may not be justified in the absence of other risk factor. 

  1. Management of Anticoagulation for Portal Vein Thrombosis in Individuals with Cirrhosis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Geneviève Huard

    2012-01-01

    Full Text Available Non-neoplastic portal vein thrombosis (PVT is an increasingly recognized complication of liver cirrhosis. It is often diagnosed fortuitously and can be either partial or complete. The clinical significance of PVT is not obvious except in some situations such as when patients are on the waiting list for liver transplantation. The only known therapy is anticoagulation which has been shown to permit the disappearance of thrombosis and to prevent further extension. Anticoagulation is a challenging therapy in individuals with liver cirrhosis because of the well-recognized coagulation abnormalities observed in that setting and because of the increased risk of bleeding, especially from gastrointestinal tract caused by portal hypertension. We herein review the current knowledge on that topic in order to highlight the advantages and disadvantages of the currently proposed therapeutic attitudes in face of the diagnosis of PVT in individuals with cirrhosis.

  2. Spontaneous acute superficial vein thrombosis of the legs: do we really need to treat?

    Science.gov (United States)

    Décousus, H; Bertoletti, L; Frappé, P

    2015-06-01

    Spontaneous acute superficial vein thrombosis (SVT) of the leg is now generally recognized as an integral component of venous thromboembolic disease with potentially severe consequences. However, the relatively low grades of some current international recommendations and uncertainty regarding the cost-effectiveness of available therapies may prompt questioning of the real need to treat patients with SVT and explain the persisting heterogeneity of their management in practise. Yet several studies have consistently shown high rates of thromboembolic complications associated with SVT, whether at first presentation or during follow-up. The CALISTO trial established for the first time the clinical benefit of a well-defined anticoagulant regimen for the prevention of serious thromboembolic complications in SVT patients, and we believe that patients such as those included in this trial should receive this regimen as tested. However, several areas of uncertainty remain for categories of SVT patients not evaluated in CALISTO. © 2015 International Society on Thrombosis and Haemostasis.

  3. The Compartment Syndrome Associated with Deep Vein Thrombosis due to Rattlesnake Bite: A Case Report

    Directory of Open Access Journals (Sweden)

    Radu Ciprian Tincu

    2017-08-01

    Full Text Available Background: Snakebite is a health issue specific to some parts of the world, especially in the tropical area, where it produces many victims. The main clinical damage caused by snake bite involves hemotoxic, neurotoxic and myotoxic reactions. It is also established that the importance of systemic impairment varies according to individual factors and are related to organ dysfunction, shock or hypotension. We report the case of a young woman suffering from snakebite who developed deep vein thrombosis and compartment syndrome. Case Report: We present the case of a 32-year-old Romanian woman who was injured by her own Crotalinae snake (also known as pit viper or rattlesnake on her left forearm. When admitted to our Emergency Department, she was conscious with a Glasgow coma scale of 12/15, somnolent, febrile, suffering of headache, tachypnea; the marks of the snakebite were located in the distal part of the anterior left forearm; she had pain and bleeding at the bite site and swelling of the left upper limb with lymphangitis up to the axilla. She experienced fasciotomy-requiring compartment syndrome of the upper limb and required unfractionated heparin and closed monitored using activated partial thromboplastin time evolution due micro-thrombosis in the brachial vein. Local improvement was achieved in the next 4 days with progressive diminish of local tenderness and swelling. Conclusion: Limb deep vein thrombosis might be induced by snakebite, despite pro-hemorrhagic general condition induced by the envenomation. High index of clinical suspicion is needed for early diagnosis and timely management which can improve survival of these patients

  4. Occult Amebic Liver Abscess as Cause of Extensive Inferior Vena Cava and Hepatic Vein Thrombosis.

    Science.gov (United States)

    Martin, Leslie; Burute, Nishigandha; Haider, Ehsan; Serrano, Pablo E; O'Shea, Timothy; Siegal, Deborah

    2017-10-01

    The most common extraintestinal complication of Entamoeba histolytica is amebic liver abscess (ALA). Hepatic vein and inferior vena cava (IVC) thrombosis are rare but well-documented complications of ALA, typically attributed to mechanical compression and inflammation associated with a large abscess. We present a case of a previously healthy 43-year-old Canadian man presenting with constitutional symptoms and right upper quadrant abdominal pain. He was found to have thrombophlebitis of the IVC, accessory right hepatic vein, and bilateral iliac veins. Extensive investigations for thrombophilia were negative. Magnetic resonance imaging of the liver demonstrated a 3.2-cm focal area of parenchymal abnormality that was reported as presumptive hepatocellular carcinoma, and a 1.9-cm lesion in the caudate lobe with diffusion restriction and peripheral rim enhancement. Despite multiple biopsy attempts, a histopathological diagnosis was not achieved. Abdominal pain and fever 4 months later prompted repeat ultrasound demonstrating a 10.4- × 12.0-cm rim-enhancing fluid attenuation lesion felt to represent a liver abscess. Thick dark "chocolate brown" drainage from the lesion and positive serology for E. histolytica confirmed the diagnosis of ALA acquired from a previous trip to Cuba. The patient was started on treatment with metronidazole and paromomycin and repeat abdominal ultrasound demonstrated resolution of the abscess. This case is the first to demonstrate extensive IVC thrombosis secondary to a relatively small occult ALA and emphasizes the thrombogenic potential of ALA. Amebic infection should be considered as a rare cause of IVC thrombosis in the correct clinical context.

  5. Traumatic deep vein thrombosis in a soccer player: A case study

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-10-01

    Full Text Available Abstract A 42 year-old male former semi-professional soccer player sustained a right lower extremity popliteal contusion during a soccer game. He was clinically diagnosed with a possible traumatic deep vein thrombosis (DVT, and sent for confirmatory tests. A duplex doppler ultrasound was positive for DVT, and the patient was admitted to hospital for anticoagulation (unfractionated heparin, warfarin. Upon discharge from hospital the patient continued oral warfarin anticoagulation (six months, and the use of compression stockings (nine months. He followed up with his family doctor at regular intervals for serial coagulation measurements, and ultrasound examinations. The patient's only identified major thrombotic risk factor was the traumatic injury. One year after the initial deep vein thrombosis (DVT the patient returned to contact sport, however he continued to have intermittent symptoms of right lower leg pain and right knee effusion. Athletes can develop vascular injuries in a variety of contact and non-contact sports. Trauma is one of the most common causes of lower extremity deep vein thrombosis (DVT, however athletic injuries involving lower extremity traumatic DVT are seldom reported. This diagnosis and the associated risk factors must be considered during the initial physical examination. The primary method of radiological diagnosis of lower extremity DVT is a complete bilateral duplex sonography, which can be augmented by other methods such as evidence-based risk factor analysis. Antithrombotic medication is the current standard of treatment for DVT. Acute thrombolytic treatment has demonstrated an improved therapeutic efficacy, and a decrease in post-DVT symptoms. There is a lack of scientific literature concerning the return to sport protocol following a DVT event. Athletic individuals who desire to return to sport after a DVT need to be fully informed about their treatment and risk of reoccurrence, so that appropriate decisions can be

  6. Deep vein thrombosis of the lower limbs: A retrospective analysis of doppler ultrasound findings

    Directory of Open Access Journals (Sweden)

    Sanjay M Khaladkar

    2014-01-01

    Full Text Available Background: Deep venous thrombosis (DVT of lower limbs is one of the most common cause for the majority of deaths caused by pulmonary embolism. Many medical and surgical disorders are complicated by DVT. Most venous thrombi are clinically silent. B-mode and color Doppler imaging is needed for early diagnosis of DVT to prevent complications and sequalae of DVT. Aim and Objectives: The objectives of the following study were to evaluate the role of Doppler as an imaging modality in diagnosing DVT of lower limbs, to study the spectrum of findings on Doppler ultrasound in patients with DVT. Materials and Methods: Retrospective descriptive analysis of 78 patients of DVT diagnosed on Doppler. Results: Nearly 74% of the patients were males and 26% were females with majority belonging to fifth decade (26%. 75 (96.1% cases showed unilateral while 3 (3.9% cases showed bilateral lower limb involvement. In our study, predominant distribution of thrombus was found to be in above knee region with 69/78 (88.5% patients having thrombus in the superficial femoral vein. Popliteal vein was involved in 54/78 (69.2% patients. Complete thrombosis was observed in 54/78 (69% cases, while partial thrombosis was observed in 24/78 (31% cases. Subacute stage was seen in 42 cases (53.8%, acute stage in 23 cases (29.5% while chronic stage in 13 cases (16.7%. 71 cases (91% had multiple contiguous segmental involvement, whereas 7 cases (9% had isolated vein involvement. Conclusion: Color Doppler is useful in diagnosing DVT in symptomatic and at risk patients and provides a non-invasive method of investigation. It is also helpful in evaluating the site, extent and stage of thrombus.

  7. Extended-Duration Treatment of Superficial Vein Thrombosis of the Lower Limbs with Tinzaparin.

    Science.gov (United States)

    Nikolakopoulos, Konstantinos M; Kakkos, Stavros K; Papageorgopoulou, Chrysanthi P; Tsolakis, Ioannis A

    2018-03-01

    To identify risk factors for recurrent thromboembolic events (RTEs) and define the optimum duration of treatment with tinzaparin in patients with superficial vein thrombosis (SVT) of the lower limbs. A total of 147 consecutive patients with significant SVT were treated with subcutaneously administered tinzaparin. The composite primary endpoint of the study was RTE, deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) at 120 days. Patients were stratified into group A, where patients received a variable dose of tinzaparin for up to 60 days (n=98), and a subsequent group B-ext, where patients received a standardized intermediate dose of tinzaparin (n=49) for 90 days. RTEs occurred in 15/147 patients (10.2%), including recurrent SVT (n=10), DVT (n=4) and fatal PE (n=1). RTEs were less frequent in group B-ext (0% vs. 15.3% for group A, P=0.004), a difference that remained significant at the one-year follow-up. Clinically extensive SVT was an independent predictor for RTEs (hazard ratio, 5.94; 95% confidence interval, 2.05-17.23; P=0.001, Cox regression). Predictors or DVT or PE in group A included clinically extensive SVT (P=0.004), absence of local pain (P=0.023) and the ultrasound findings of superficial axial vein thrombosis (any, P=0.006 or isolated, P=0.036) and multiple thrombosed superficial venous sites (P<0.001). An extended three-month regimen of tinzaparin in patients with SVT of the lower limbs is more effective than a shorter course and may be desirable in patients with risk factors.

  8. Epidemiology, diagnosis, treatment and management of superficial-vein thrombosis of the legs.

    Science.gov (United States)

    Decousus, Hervé; Frappé, Paul; Accassat, Sandrine; Bertoletti, Laurent; Buchmuller, Andrea; Seffert, Benjamin; Merah, Adel; Becker, François; Queré, Isabelle; Leizorovicz, Alain

    2012-09-01

    Recent data on lower-limb superficial-vein thrombosis (SVT) may substantially impact its clinical management. Particularly, the clear confirmation that SVT is closely linked to deep-vein thrombosis (DVT) or pulmonary embolism (PE) highlights the potential severity of the disease. DVT or PE is diagnosed in 20-30% of SVT patients. Moreover, clinically relevant symptomatic thromboembolic events complicate isolated SVT (without concomitant DVT or PE at diagnosis) in 4-8% of patients. For the first time, an anticoagulant treatment, once-daily 2.5 mg fondaparinux for 45 days, was demonstrated to be effective and safe for preventing these symptomatic thromboembolic events in patients with lower-limb isolated SVT in the randomized, placebo-controlled CALISTO study. More recent data from another randomized trial support these findings. New recommendations on the management of SVT patients, including complete ultrasonography examination of the legs and, in patients with isolated SVT, prescription of once-daily 2.5 mg fondaparinux subcutaneously for 45 days on top of symptomatic treatments, may be proposed, wherever the cost of fondaparinux is acceptable. Superficial-vein thrombosis (SVT) of the lower limbs has long been regarded as a benign, self-limiting disease, expected to resolve spontaneously and rapidly, and requiring only symptomatic treatments [1,2]. However, the perception of this disease is now changing with the recent publication of data indicating its potential severity [3] and showing for the first time the benefit of a therapeutic strategy based on the administration of an anticoagulant treatment [4]. The overall management of this frequent disease therefore needs to be reconsidered. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Nuclear medicine in the management of renal vein thrombosis post renal transplantation - a case study

    International Nuclear Information System (INIS)

    Waran, L.; Unger, S.

    2005-01-01

    Renal scintigraphy allows the assessment of both perfusion and function of the transplanted kidney. Treatment of renal dysfunction depends on its cause. Nuclear medicine plays an important role in determining the cause of renal dysfunction, thereby providing appropriate intervention. Renal vein thrombosis (RVT) is a rare occurrence (1-2%) in renal transplants, and constitutes a surgical emergency. Early detection of RVT is critical in order to prevent infarction and subsequent loss of the graft. A 43-year-old woman with end stage renal disease as a result of diabetic nephropathy underwent transplantation of a living-related-donor kidney. The patient underwent a post operative Tc-MAG, scan that demonstrated good perfusion to the graft. Three days post-transplantation, the patient complained of acute pain and swelling. Creatinine increased from 0.13 to 0.16. and urine output decreased. The m Tc-MAG, scan revealed dramatic deterioration, with absent perfusion to the kidney. Immediate allograft exploration was performed in theatre and RVT was revealed, followed by thrombectomy. A follow-up renal scan performed the next day demonstrated a viable kidney with improved but patchy perfusion throughout, indicating patchy cortical infarction as well as acute tubular necrosis. On day 19. the patient again complained of severe pain over the graft, and the 99 mTc-MAG, scan again revealed absent perfusion, this time with residual function. Further surgical exploration confirmed re-thrombosis of the renal vein, and subsequent genetic analysis revealed that the patient had a rare mutation of her clotting Factor V gene, leading to an increased thrombogenic tendency. Following full anticoagulation, the patient was finally discharged on day 58. This case illustrates a rare case of renal allograft infarction secondary to renal vein thrombosis. The ability of nuclear medicine to provide immediate functional information helped confirm the diagnosis, and salvage the kidney

  10. External jugular vein thrombosis secondary to deep tissue neck massage

    Directory of Open Access Journals (Sweden)

    Sneha Raju, HBSc

    2017-09-01

    Full Text Available An 85-year-old man presented with an acute asymptomatic lateral neck mass in the context of deep tissue neck massages during the past year. He was referred to vascular surgery after an ultrasound examination of the neck revealed a thrombus in the external jugular vein. His past medical history and comorbidities were noncontributory. A multidisciplinary team of vascular surgeons and hematologists did not recommend any anticoagulation, given that the patient did not have any risk factors for thrombosis as well as normal D-dimer levels. The patient was maintained on his previous dose of aspirin (81 mg daily.

  11. Portomesenteric Vein Thrombosis, Bowel Gangrene, and Bilateral Pulmonary Artery Embolism Two Weeks after Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    David G. Darcy

    2015-01-01

    Full Text Available Sleeve gastrectomy and gastric bypass surgery are popular and effective options for weight loss surgery. Portomesenteric vein thrombosis (PMVT is a documented but rare complication of bariatric surgery. Proper surgical technique, careful postoperative prophylaxis, and early mobilization are essential to prevent this event. The diagnosis of PMVT in the postoperative period requires a high index of suspicion and early directed intervention to prevent a possibly fatal outcome. We present a case of PMVT complicated by small bowel ischemia resulting in gangrene that necessitated resection.

  12. Lupus anticoagulant is significantly associated with inflammatory reactions in patients with suspected deep vein thrombosis

    DEFF Research Database (Denmark)

    Sidelmann, Johannes Jakobsen; Sjøland, Jonas A.; Gram, Jørgen

    2007-01-01

    OBJECTIVE: Lupus anticoagulant (LA) and antiphospholipid antibodies (aPL) are suggested as risk factors for development of deep vein thrombosis (DVT) among patients without systemic lupus erythematosus (SLE). Other conditions, e.g. inflammation, are reported to induce LA and it is uncertain whether...... the association between LA and DVT is causal. In this study the associations between aPL, LA and inflammation were investigated in 170 consecutive patients without SLE, but with a tentative diagnosis of DVT. MATERIAL AND METHODS: DVT was diagnosed in 64 patients. LA was determined according to the criteria...

  13. Transesophageal Echocardiographically-Confirmed Pulmonary Vein Thrombosis in Association with Posterior Circulation Infarction.

    LENUS (Irish Health Repository)

    Kinsella, Justin A

    2010-01-01

    Pulmonary venous thromboembolism has only been identified as a cause of stroke with pulmonary arteriovenous malformations\\/fistulae, pulmonary neoplasia, transplantation or lobectomy, and following percutaneous radiofrequency ablation of pulmonary vein ostia in patients with atrial fibrillation. A 59-year-old man presented with a posterior circulation ischemic stroke. \\'Unheralded\\' pulmonary vein thrombosis was identified on transesophageal echocardiography as the likely etiology. He had no further cerebrovascular events after intensifying antithrombotic therapy. Twenty-eight months after initial presentation, he was diagnosed with metastatic pancreatic adenocarcinoma and died 3 months later. This report illustrates the importance of doing transesophageal echocardiography in presumed \\'cardioembolic\\' stroke, and that potential \\'pulmonary venous thromboembolic\\' stroke may occur in patients without traditional risk factors for venous thromboembolism. Consideration should be given to screening such patients for occult malignancy.

  14. Incidence and risk factors of superficial and deep vein thrombosis associated with peripherally inserted central catheters in children.

    Science.gov (United States)

    Menéndez, J J; Verdú, C; Calderón, B; Gómez-Zamora, A; Schüffelmann, C; de la Cruz, J J; de la Oliva, P

    2016-11-01

    Essentials Pediatric studies on peripherally inserted central catheter (PICC)-related thrombosis are scarce. This study analyzes incidence and risk factors for PICC-related venous thrombosis in children. PICC-related thrombosis is a common, and nearly always, asymptomatic complication. Echo-guided insertion and a catheter to vein ratio thrombosis is associated with the use of peripherally inserted central catheters (PICCs). Few pediatric studies have focused on this issue. Objectives To determine the incidence and risk factors for PICC-related superficial vein thrombosis (SVT) and deep vein thrombosis (DVT) in children. Patients/methods An observational follow-up cohort study was conducted at a single hospital between June 2012 and June 2015. All patients receiving a PICC were enrolled and followed up, with weekly Doppler ultrasound examination of the catheterized limb until PICC removal. Patient, procedural and follow-up data were analyzed. Results In the study period, 265 PICCs were inserted (median age of patients 6.5 years, interquartile range [IQR] 2.4-13 years; median weight 20 kg, IQR 11-38 kg; 54% males; 67.9% chronically ill), and patients were followed up for a total of 9743 days. The median indwelling time was 21 days (IQR 12-37 days). During follow-up, 88 (33.2% of insertions) PICC-related thromboses (incidence rate [IR] 9.03 per 1000 catheter-days) were diagnosed, 66 (24.9%) as isolated SVT, seven (2.6%) as isolated DVT, and 15 (5.7%) as SVT with associated DVT (IR 6.78, 0.71 and 1.54 per 1000 catheter-days, respectively). Only 9.9% of patients with SVT and 18.2% of those with DVT were symptomatic. The main risk factors for PICC-related SVT and DVT were a catheter/vein ratio of > 0.33 and thrombosis of the catheterized superficial vein, respectively. Conclusions PICC-related thrombosis is a common and nearly always asymptomatic complication in children, the SVT rate being approximately three times higher than the DVT rate. Optimal vein and catheter

  15. Genetic polymorphism of NOS3 with susceptibility to deep vein thrombosis after orthopedic surgery: a case-control study in Chinese Han population.

    Directory of Open Access Journals (Sweden)

    Jizheng Qin

    Full Text Available Deep vein thrombosis is one of the common complications of orthopedic surgery. Studies indicated that genetic factors played a considerable role in the pathogenesis of deep vein thrombosis. Endothelial nitric oxide synthase which encoded by nitric oxide synthase 3 (NOS3, can generate nitric oxide in endothelial cells. As a predominant regulator for vascular homeostasis, nitric oxide might be involved in the pathogenesis of thrombosis. It had been proved that the NOS3 polymorphism (rs1799983 was associated with the development of cardiovascular diseases. Our objective was to evaluate the association between the NOS3 polymorphism (rs1799983 and deep vein thrombosis after orthopedic surgery in Chinese Han population. The polymorphism was genotyped in 224 subjects with deep vein thrombosis after orthopedic surgery and 580 controls. Allele and genotype frequencies were compared between subjects with deep vein thrombosis and control subjects. The allele and genotype frequencies of the NOS3 polymorphism (rs1799983 were significantly different between subjects with deep vein thrombosis and control subjects. There were also significant differences when the subjects were stratified by gender, surgery type and hypertension status. These findings suggested that the NOS3 polymorphism (rs1799983 was associated with susceptibility to the deep vein thrombosis after orthopedic surgery in Chinese Han population, and NOS3 might play a role in the development of deep vein thrombosis after orthopedic surgery.

  16. Relationship between Cerebral Vein Thrombosis and Non-Anticardiolipin Antiphospholipid Antibodies

    Directory of Open Access Journals (Sweden)

    M Saadatnia

    2004-04-01

    Full Text Available Background: Anticardiolipin antibody(aCLhas been recognized as a marker for increased risk of Cerebral Vein Thrombosis (CVT. However, there are only rare reports on CVT associated with other antibodies against different phospholipids such as phosphatidyl inositol, phosphatidyl serine, phosphatidic acid and beta 2 glycoprotein I. In this study, we studied the presence of these antiphospholipid antibodies (aPL, demographic and clinical characteristics in 30 patients with CVT. Methods: After diagnosis of CVT in 30 patients with MRI, we measured the titer of aCL and aPL (IgM and IgG in all cases. The titers of IgG and IgM type of aPL and aCL were estimated in the sera. Results: Anticardiolipin antibody was solely detected in 20% (n=6 and aCL and other aPL in 23.3% ( n=7 of patients, indicating one patient positive for other aPL but not for aCL (non-aCL. Although the aPL positive group did not differ from the aPL-negative group from the stand point of clinical and demographic characteristics, yet seizure, infarct, superficial veins and sinus involvement and the use of OCP were seen more frequently in aPL-positive group Conclusion: Our findings suggest that in addition to aCL, other antiphospholipid antibodies may be an associated condition that plays a role in the pathogenesis of CVT. The presence of aPL in CVT patients is probably associated with more superficial sinus or veins involvement and as a result death rate was lower in aPL- positive group. Further investigations are necessary to establish this hypothesis. Keywords: Cerebral Vein Thrombosis, antiphospholipid antibody, anticardiolipin

  17. Diagnosis of deep vein thrombosis using multi-detector helical CT

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Masashi; Minamiguchi, Hiroki; Sahara, Shinya [Wakayama Medical Coll. (Japan)] [and others

    2002-11-01

    The purpose of this study was to evaluate the usefulness of multi-detector helical CT (MDHCT) with contrast medium in the diagnosis of deep vein thrombosis (DVT). The bilateral veins of the dorsal pedis in 45 patients (12 men, 33 women; average age, 64 years) under clinical suspicion of DVT were first punctured using 22-G needles. Then CT scanning from the level of the foot to the inferior vena cava was started 20 sec after the initial injection of 200 mL of dilute contrast medium (50 mL nonionic iodinated contrast medium of 300 mgI/mL and 150 mL saline) at a rate of 5 mL/sec. Two patients were excluded because of unsuccessful venous puncture. The average scanning time in 43 patients was 38.5{+-}7.9 seconds. Images of veins from the foot to the inferior vena cava were clearly demonstrated in each case. MDHCT showed DVT in 32 cases and patent deep vein in 11 cases. Simultaneous venography of the lower extremity in 18 patients clearly visualized DVT at the same level detected by contrast MDHCT. MDHCT for the diagnosis of DVT has the advantages of wider scanning rage, shorter scanning time, and finer Z-axis resolution than the other diagnostic modalities. (author)

  18. Multi-channel photon migration study in visible Chinese human muscle for optical detection of deep vein thrombosis

    Science.gov (United States)

    Sun, Yunlong; Li, Ting

    2016-03-01

    Deep vein thrombosis (DVT) always induced venous thrombosis. Most cases of venous thrombosis were induced by deep vein thrombosis (DVT), with high incidence rate of >60% in >60 years old people. Near-infrared spectroscopy (NIRS) were reported recently to be an intriguing and potential technique in detecting DVT in clinics. However, the photon transport is still unclear, which is crucial for the image reconstruction of the updated development called as NIRS-based DVT imager. Here we employed the Monte Carlo simulation software for 3D voxelized media (MCVM) and the Visible Chinese Human (VCH) model, which segmentation is finest in the world, to simulate multi-channel photon migration in calf muscle. And the image reconstruction of DVT hemodynamic distribution was achieved. This study, for the first time, provides the most realistic 3-D multichannel photon migration for NIRS study on DVT, and explored the image reconstruction for furtherly developing a NIRS-based DVT imager.

  19. [Jugular vein thrombosis and Lemierre's syndrome--severe complications of oropharyngeal infections].

    Science.gov (United States)

    Maier, W; Lohnstein, P U; Schipper, J; Boedeker, C

    2010-09-01

    Acute oral or pharyngeal infections usually heal under adequate therapy within a few days. Therefore severe regionary or systemic complications are not regularly seen. We report on 3 patients in whom during or after apparent recovery from a pharyngeal or perioral infection a one-sided painful swelling of the neck associated with fever and leucocytosis developed. Color Doppler sonography (CDS) revealed unilateral thrombosis of the internal jugular vein (IJV) in all cases, whereupon we initiated high-dosed parenteral antibiotic therapy and therapeutic heparinisation. Furthermore, we drained detectable abscess formations. Nonetheless, in one patient fever attacks occurred postoperatively, accompanied by septic-embolic lung infiltrates, corresponding to Lemierre's syndrome. In all cases, we achieved clinical recovery and remission of infection. The course was significantly prolonged in the patient with pulmonary involvement and in this patient no reperfusion of the IJV was achieved. Even today serious complications may occur unexpectedly in presumed everyday oral or pharyngeal infections. CDS is a suitable procedure to disclose a jugular vein thrombosis (JVT) promptly and non-invasively. Parenteral antibiotic therapy for at least 10 days is usually the therapy of choice for JVT; additional full-heparinisation is controversially discussed in the professional literature. Septic pulmonary embolism following pharyngeal infection and JVT, as described by Lemierre, was associated with a high rate of mortality in the pre-antibiotic era, and even today may be fatal in spite of appropriate and maximal therapy. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Collet-Sicard syndrome: a rare but important presentation of internal jugular vein thrombosis.

    Science.gov (United States)

    Neo, Shermyn; Lee, Kim En

    2017-01-01

    We describe a rare neurological presentation of internal jugular vein thrombosis induced by central venous catheter placement in a patient with cancer. A 71-year-old man gave a 3-week history of dysphagia and dysarthria with left-sided neck pain and headache. He was receiving chemotherapy for appendiceal adenocarcinoma. On examination, he had left 9th-12th cranial neuropathies, manifesting as voice hoarseness, decreased palatal movement, absent gag reflex, weakness of scapular elevation and left-sided tongue wasting. CT scan of neck showed the left subclavian central venous catheter tip was in the left internal jugular vein. Skull base MRI showed thrombus within the left jugular foramen extending intracranially. We diagnosed Collet-Sicard syndrome secondary to thrombosis in the sigmoid-jugular venous complex. His headache and neck pain resolved 2 days after removing the catheter and starting anticoagulation. Collet-Sicard syndrome is an unusual syndrome of lower cranial nerve palsies, often signifying disease at the skull base, including malignancy, trauma or vascular causes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Trombose da veia de Galeno: relato de caso Galen vein thrombosis: case report

    Directory of Open Access Journals (Sweden)

    Marcio Chaves Pedro Marques

    2003-06-01

    Full Text Available A trombose venosa cerebral (TVC é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas. A trombose da veia de Galeno (TVG é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente de 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC.Cerebral venous thrombosis (CVT is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic. Galen vein thrombosis (GVT is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

  2. Differences in clinical presentation of deep vein thrombosis in men and women.

    Science.gov (United States)

    Andreou, E Roseann; Koru-Sengul, T; Linkins, L; Bates, S M; Ginsberg, J S; Kearon, C

    2008-10-01

    As assessment of clinical pretest probability is the first step in the diagnostic evaluation of deep vein thrombosis (DVT), it is important to know if the clinical features of DVT are the same in men and women. To compare the prevalence and clinical characteristics of DVT, and the accuracy of clinical pretest probability assessment, between men and women with suspected DVT. A retrospective analysis of individual patient data from three prospective studies by our group that evaluated diagnostic tests for a suspected first episode of DVT. Clinical characteristics, clinical pretest probability for DVT, and prevalence and extent of DVT was assessed in a total of 1838 outpatients. The overall prevalence of DVT was higher in men than in women (14.4% vs. 9.4%) (P = 0.001). The prevalence of DVT was higher in men than in women who were categorized as having a clinical pretest probability that was low (6.9% vs. 3.5%; P = 0.025) or moderate (16.9% vs. 8.7%; P = 0.04), but similar in patients in the high category (40.2% vs. 44.0%; P = 0.6). In patients diagnosed with DVT, swelling of the entire leg occurred more often (41.5% vs. 15.7%; P women than in men. In outpatients with suspected DVT, the overall prevalence of thrombosis and the prevalence of thrombosis in those with a low or a moderate clinical pretest probability were higher in men than in women.

  3. Physical Characterization of Mouse Deep Vein Thrombosis Derived Microparticles by Differential Filtration with Nanopore Filters

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    Antonio Peramo

    2011-12-01

    Full Text Available With the objective of making advancements in the area of pro-thrombotic microparticle characterization in cardiovascular biology, we present a novel method to separate blood circulating microparticles using a membrane-based, nanopore filtration system. In this qualitative study, electron microscopy observations of these pro-thrombotic mouse microparticles, as well as mouse platelets and leukocytes obtained using a mouse inferior vena cava ligation model of deep-vein thrombosis are presented. In particular, we present mouse microparticle morphology and microstructure using SEM and TEM indicating that they appear to be mostly spherical with diameters in the 100 to 350 nm range. The nanopore filtration technique presented is focused on the development of novel methodologies to isolate and characterize blood circulating microparticles that can be used in conjunction with other methodologies. We believe that determination of microparticle size and structure is a critical step for the development of reliable assays with clinical or research application in thrombosis and it will contribute to the field of nanomedicine in thrombosis.

  4. Endovascular Treatment for Iliac Vein Compression Syndrome: a Comparison between the Presence and Absence of Secondary Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lou, Wen Sheng; Gu, Jian Ping; He, Xu; Chen, Liang; Su, Hao Bo; Chen, Guo Ping; Song, Jing Hua; Wang, Tao [Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing (China)

    2009-04-15

    To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective

  5. Does low protein concentration of tissue-type plasminogen activator predict a low risk of spontaneous deep vein thrombosis?

    DEFF Research Database (Denmark)

    Gram, J; Sidelmann, Johannes Jakobsen; Jespersen, J

    1995-01-01

    Many reports have demonstrated an abnormal fibrinolysis in a subset of patients with deep vein thrombosis. We have studied systemic global fibrinolytic activity and protein concentrations of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) in plasma of 25...... young patients with a previous instance of spontaneous deep vein thrombosis documented by phlebography and in 50 healthy controls. The two populations were comparable with respect to a number of base-line variables (age, height, weight, etc.), while the patients had significantly lower fibrinolytic...

  6. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data meta-analysis

    Science.gov (United States)

    Zuithoff, N P A; Kearon, C; Anderson, D R; ten Cate-Hoek, A J; Elf, J L; Bates, S M; Hoes, A W; Kraaijenhagen, R A; Oudega, R; Schutgens, R E G; Stevens, S M; Woller, S C; Wells, P S; Moons, K G M

    2014-01-01

    Objective To assess the accuracy of the Wells rule for excluding deep vein thrombosis and whether this accuracy applies to different subgroups of patients. Design Meta-analysis of individual patient data. Data sources Authors of 13 studies (n=10 002) provided their datasets, and these individual patient data were merged into one dataset. Eligibility criteria Studies were eligible if they enrolled consecutive outpatients with suspected deep vein thrombosis, scored all variables of the Wells rule, and performed an appropriate reference standard. Main outcome measures Multilevel logistic regression models, including an interaction term for each subgroup, were used to estimate differences in predicted probabilities of deep vein thrombosis by the Wells rule. In addition, D-dimer testing was added to assess differences in the ability to exclude deep vein thrombosis using an unlikely score on the Wells rule combined with a negative D-dimer test result. Results Overall, increasing scores on the Wells rule were associated with an increasing probability of having deep vein thrombosis. Estimated probabilities were almost twofold higher in patients with cancer, in patients with suspected recurrent events, and (to a lesser extent) in males. An unlikely score on the Wells rule (≤1) combined with a negative D-dimer test result was associated with an extremely low probability of deep vein thrombosis (1.2%, 95% confidence interval 0.7% to 1.8%). This combination occurred in 29% (95% confidence interval 20% to 40%) of patients. These findings were consistent in subgroups defined by type of D-dimer assay (quantitative or qualitative), sex, and care setting (primary or hospital care). For patients with cancer, the combination of an unlikely score on the Wells rule and a negative D-dimer test result occurred in only 9% of patients and was associated with a 2.2% probability of deep vein thrombosis being present. In patients with suspected recurrent events, only the modified Wells

  7. Superficial vein thrombosis and recurrent venous thromboembolism: a pooled analysis of two observational studies.

    Science.gov (United States)

    Galanaud, J P; Bosson, J L; Genty, C; Presles, E; Cucherat, M; Sevestre, M A; Quere, I; Decousus, H; Leizorovicz, A

    2012-06-01

    The management strategies for symptomatic isolated superficial vein thrombosis (SVT) (without concomitant deep vein thrombosis [DVT] or pulmonary embolism [PE]) have yet to achieve widespread consensus. Concerns have been raised regarding the usefulness of prescribing anticoagulant treatments to all patients with isolated SVT. Determining the isolated SVT subgroups who have the highest risks of venous thromboembolism (VTE) recurrence (composite of DVT, PE, and new SVT) may facilitate the identification of patients who are likely to benefit from anticoagulant treatment. We performed a pooled analysis on individual data from two observational, multicenter, prospective studies, to determine predictors for VTE recurrence and their impact in an unselected population of symptomatic isolated SVT patients. One thousand and seventy-four cases of symptomatic isolated SVT were followed up at 3 months. VTE recurrence was observed in 3.9% of the patients; 16.2% of the patients did not receive anticoagulants, and 0.6% experienced a VTE recurrence. Cancer, personal history of VTE and saphenofemoral/popliteal involvement significantly increased the risk of subsequent VTE or DVT/PE in univariate analyses. Only male sex significantly increased the risk of VTE or DVT/PE recurrence in multivariate analyses. Twelve percent of the patients had cancer or saphenofemoral junction involvement, and were at higher risk of DVT/PE recurrence than patients without those characteristics (4.7% vs. 1.9%, P= 0.06). In patients with symptomatic SVT, only male sex significantly and independently increased the risk of VTE recurrence. Cancer or saphenofemoral junction involvement defined a population at high risk for deep VTE recurrence. Some SVTs might be safely managed without anticoagulants. © 2012 International Society on Thrombosis and Haemostasis.

  8. Giant cavernous hemangioma coexistent with diffuse hepatic hemangiomatosis presenting as portal vein thrombosis and hepatic lobar atrophy

    Directory of Open Access Journals (Sweden)

    Bo Reum Yoo

    2014-01-01

    Full Text Available

    A combination of giant hepatic hemangioma and diffuse hemangiomatosis is extremely rare in adults. Even when they are large, hemangiomas are soft and rarely compress adjacent structures. A 78-year-old man presented with abdominal pain and distension. Ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a large expansile mass replacing the medial segment and caudate lobe with diffusely scattered nodules in the entire liver. The large hilar mass contained a central nonenhancing area and had a mass effect, leading to left portal vein occlusion. The image findings also revealed two unprecedented findings: left lateral segmental atrophy of the liver and recent portomesenteric vein thrombosis. The hepatic lesions were confirmed with hemangiomas by ultrasonography-guided biopsy. We diagnosed intrahepatic portal vein obstruction caused by a mass effect of giant hepatic hemangioma coexistent with diffuse hemangiomatosis, resulting in hepatic segmental atrophy and extrahepatic portal vein thrombosis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-05-15

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

  10. Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Arkadopoulos Nikolaos

    2011-12-01

    Full Text Available Abstract Background Ovarian vein thrombosis (OVT is a rare, but serious condition that affects mostly postpartum women. A high index of suspicion is required in order to diagnose this unusual cause of abdominal pain. Case presentation A 19-year-old woman at three days postpartum was admitted to our hospital because of severe right lower quandrant abdominal pain and fever 38.5'C. Physical examination revealed an acutely ill patient and right lower quadrant tenderness with positive rebound and Giordano signs. The patient underwent appendectomy which proved to be negative for acute appendicitis. Postoperatively fever and pain persisted and abdominal CT-scan with intravenous contrast agent demonstrated a thrombosed right ovarian vein. The patient was initiated on low-molecular weight heparin (LMWH and antibiotic treatment and a month later a new abdominal CT-scan showed a patent right ovarian vein. Discussion Pathophysiologically, OVT is explained by Virchow's triad, because pregnancy is associated with a hypercoagulable state, venous stasis due to compression of the inferior vena cava by the uterus and endothelial trauma during delivery or from local inflammation. Common symptoms and signs of OVT include lower abdomen or flank pain, fever and leukocytosis usually within the first ten days after delivery. The reported incidence of OVT ranges 0,05-0,18% of pregnancies and in most cases the right ovarian vein is the one affected. Anticoagulation and antibiotics is the mainstay of treatment of OVT. Complications of OVT include sepsis, extension of the thrombus to the inferior vena cava and renal veins, and pulmonary embolism. The incidence of pulmonary embolism is reported to be 13.2% and represents the main source of mortality due to OVT. Conclusions OVT is a rare condition, usually in the postpartum period. A high index of suspicion is required for the prompt diagnosis and management especially in cases that mimic acute abdomen.

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

    International Nuclear Information System (INIS)

    Kwon, S.H.; Oh, J.H.; Seo, T.-S.; Ahn, H.J.; Park, H.C.

    2009-01-01

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

  12. A single hospital study on portal vein thrombosis in cirrhotic patients - clinical characteristics & risk factors

    Directory of Open Access Journals (Sweden)

    Huisong Chen

    2014-01-01

    Full Text Available Background & objectives: Discrepancies exist in the reported prevalence of portal vein thrombosis (PVT, and its clinical characteristics and sites of occurrence need to be elucidated. The risk factors for PVT are also poorly understood. This single centre study was undertaken to determine the clinical characteristics, sites of occurrence, and risk factors associated with PVT in patients with liver cirrhosis. Methods: Hospitalized cirrhotic patients (N = 162 were segregated into the PVT and non-PVT groups. Indices possibly associated with PVT were measured and PVT was detected by both Doppler ultrasonography and computed tomography portal angiography. The portal vein diameter and flow velocity and splenic thickness were measured by ultrasonography. Results: PVT was found in 40 patients (24.7%; in 34 PVT patients (85%, the liver cirrhosis resulted from hepatitis B virus infections. Most (90% patients were Child-Pugh classes B and C, with similar distribution between the groups. PVT was seen in 20 patients in the portal and superior mesenteric veins; ascites, abdominal pain, gastrointestinal bleeding, and jaundice were common findings in PVT patients. Haemoglobin levels and blood platelet counts (BPCs were significantly lower and splenic thickness was greater in PVT than in non-PVT patients (P<0.01. There was a significant positive correlation between BPCs and platelet aggregation rates (R = 0.533, P<0.01. Interpretation & conclusions: The occurrence of PVT was 24.7 per cent, primarily in post-hepatitis B liver cirrhosis patients. PVT occurred mainly in the portal vein trunk and superior mesenteric vein. Different PVT sites may account for the differing clinical presentations. The lower levels of haemoglobin and BPCs as well as splenic thickening were associated with PVT. Splenic thickening may be a risk factor for PVT.

  13. The non-compressibility ratio for accurate diagnosis of lower extremity deep vein thrombosis

    Directory of Open Access Journals (Sweden)

    Caecilia Marliana

    2014-08-01

    Full Text Available Background Accurate identification of patients with deep vein thrombosis (DVT is critical, as untreated cases can be fatal. It is well established that the specificity of the clinical signs and symptoms of DVT is low. Therefore, clinicians rely on additional tests to make this diagnosis. There are three modalities for DVT diagnosis; clinical scoring, laboratory investigations, and radiology. The objective of this study was to determine the correlation of plasma D-dimer concentration with the ultrasonographic non-compressibility ratio in patients with DVT in the lower extremities. Methods This research was a cross-sectional observational study. The sample comprised 25 subjects over 30 years of age with clinically diagnosed DVT in the lower extremities. In all subjects, D-dimer determination using latex enhanced turbidimetric test was performed, as well as ultrasonographic non-compressibility ratio assessment of the lower extremities. Data were analyzed using Pearson’s correlation at significance level of 0.05. Results Mean plasma D-dimer concentration was 2953.00 ± 2054.44 mg/L. The highest mean non-compressibility ratio (59.96 ± 35.98% was found in the superficial femoral vein and the lowest mean non-compressibility ratio (42.68 ± 33.71% in the common femoral vein. There was a moderately significant correlation between plasma D-dimer level and non-compressibility ratio in the popliteal vein (r=0.582; p=0.037. In the other veins of the lower extremities, no significant correlation was found. Conclusion The sonographic non-compressibility ratio is an objective test for quick and accurate diagnosis of lower extremity DVT and for evaluation of DVT severity.

  14. 5-HT causes splanchnic venodilation.

    Science.gov (United States)

    Seitz, Bridget M; Orer, Hakan S; Krieger-Burke, Teresa; Darios, Emma S; Thompson, Janice M; Fink, Gregory D; Watts, Stephanie W

    2017-09-01

    Serotonin [5-hydroxytryptamine (5-HT)] causes relaxation of the isolated superior mesenteric vein, a splanchnic blood vessel, through activation of the 5-HT 7 receptor. As part of studies designed to identify the mechanism(s) through which chronic (≥24 h) infusion of 5-HT lowers blood pressure, we tested the hypothesis that 5-HT causes in vitro and in vivo splanchnic venodilation that is 5-HT 7 receptor dependent. In tissue baths for measurement of isometric contraction, the portal vein and abdominal inferior vena cava relaxed to 5-HT and the 5-HT 1/7 receptor agonist 5-carboxamidotryptamine; relaxation was abolished by the 5-HT 7 receptor antagonist SB-269970. Western blot analyses showed that the abdominal inferior vena cava and portal vein express 5-HT 7 receptor protein. In contrast, the thoracic vena cava, outside the splanchnic circulation, did not relax to serotonergic agonists and exhibited minimal expression of the 5-HT 7 receptor. Male Sprague-Dawley rats with chronically implanted radiotelemetry transmitters underwent repeated ultrasound imaging of abdominal vessels. After baseline imaging, minipumps containing vehicle (saline) or 5-HT (25 μg·kg -1 ·min -1 ) were implanted. Twenty-four hours later, venous diameters were increased in rats with 5-HT-infusion (percent increase from baseline: superior mesenteric vein, 17.5 ± 1.9; portal vein, 17.7 ± 1.8; and abdominal inferior vena cava, 46.9 ± 8.0) while arterial pressure was decreased (~13 mmHg). Measures returned to baseline after infusion termination. In a separate group of animals, treatment with SB-269970 (3 mg/kg iv) prevented the splanchnic venodilation and fall in blood pressure during 24 h of 5-HT infusion. Thus, 5-HT causes 5-HT 7 receptor-dependent splanchnic venous dilation associated with a fall in blood pressure. NEW & NOTEWORTHY This research is noteworthy because it combines and links, through the 5-HT 7 receptor, an in vitro observation (venorelaxation) with in vivo events

  15. Transjugular approach for radiofrequency ablation of permanent junctional reciprocal tachycardia in a newborn with bilateral femoral vein thrombosis.

    Science.gov (United States)

    Gülgün, Mustafa; Karagöz, Tevfik; Aykan, Hakan Hayrettin; Ertuğrul, İlker

    2015-03-01

    Although radiofrequency ablation is the first line therapy in some children with supraventricular tachycardia, its application in small children is still limited. Herein, we presented a premature newborn diagnosed as multidrug-resistant permanent junctional reciprocal tachycardia, and treated by radiofrequency ablation via the jugular vein approach because of bilateral femoral vein thrombosis. We think that when there is limited vascular access, the transjugular route for radiofrequency ablation might be considered as an alternative treatment in newborns with multidrug-resistant supraventricular tachycardia.

  16. Pregnancy in the Setting of Asymptomatic Non-Cirrhotic Chronic Portal Vein Thrombosis Complicated by Pre-Eclampsia

    Directory of Open Access Journals (Sweden)

    Işık Üstüner

    2013-01-01

    Full Text Available Portal vein thrombosis (PVT can be chronic or acute in nature; it is characterized by a thrombus formation in the main portal vein and/or its right or left branches. Herein, we present a 36-year-old woman with asymptomatic noncirrhotic chronic PVT who developed preeclampsia in the later stage of pregnancy. This report will emphasize the clinical differential diagnosis, outcome, and management of pregnancies complicated by noncirrhotic PVT.

  17. Splenic vein thrombosis and pancreatic fistula after minimally invasive distal pancreatectomy.

    Science.gov (United States)

    Kang, C M; Chung, Y E; Jung, M J; Hwang, H K; Choi, S H; Lee, W J

    2014-01-01

    This study aimed to investigate the clinical relevance of splenic vein thrombosis (SVT) in the splenic vein remnant following minimally invasive distal pancreatosplenectomy (DPS). Medical records of patients who underwent laparoscopic or robotic distal pancreatectomy (DP) with or without splenectomy between January 2006 and August 2012 were reviewed. Rates of SVT and clinically relevant postoperative pancreatic fistula (POPF) were compared in a group of patients undergoing DPS and a group having spleen-preserving DP. Seventy-nine patients had minimally invasive DP, of whom 38 (48 per cent) developed SVT in the splenic vein remnant. DPS was associated with POPF (P = 0.001) and SVT (P SVT length was closely related to the amount of peripancreatic fluid collection (P = 0.025) and POPF (P = 0.045). In a comparison of splenic vessel-sacrificing, spleen-preserving DP and DPS, postoperative platelet count was significantly higher in the DPS group (P SVT (P = 0.092) and POPF (P = 0.065) tended to be associated with DPS, suggesting that SVT may be related to both splenectomy and POPF. Minimally invasive DPS is associated with SVT and POPF. Preservation of the spleen should be considered when treating patients with benign and borderline malignant tumours of the distal pancreas. © 2013 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  18. Transcatheter thrombolysis via the small saphenous vein for deep venous thrombosis of lower limb

    International Nuclear Information System (INIS)

    Jiang Zhongming; Xu Qinghua

    2010-01-01

    Objective: To discuss the clinical value of transcatheter thrombolysis via the small saphenous vein for the treatment of deep venous thrombosis (DVT) of lower extremity. Methods: Angiography of the diseased lower limb was performed in 14 patients with suspected DVT of lower limb. When the diagnosis was confirmed, the catheter-directed thrombolosis via the small saphenous vein was carried out through continuous infusion of urokinase with a micro-pump. The clinical symptoms were observed and the therapeutic results were analyzed. Results: Of 14 cases with lower extremity DVT, central type DVT was seen in 8 and mixed type in 6. The total success rate of thrombolysis was 71.4%. Trunk re-canalization as well as increased collateral circulation was seen in 10 patients. Alleviation of pain, subsidence of swelling and restoring to normal labor were obtained in 12 patients. Significant subsidence of edema was achieved in the remaining 2 patients and the patients were able to do some household works. Conclusion: The catheter-directed thrombolysis via the small saphenous vein is a safe and effective treatment for lower extremity DVT. (J Intervent Radiol, 2010, 19 : 944-946)(authors)

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Giant Splenorenal Shunt in a Young Patient with Autoimmune Hepatitis/Primary Biliary Cholangitis Overlap Syndrome and Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    F. Chegai

    2017-01-01

    Full Text Available We present a case of giant Splenorenal Shunt (SRS associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident. SRS was located among the spleen hilum and the left kidney with a maximum diameter of 3.25 cm and was associated with dilatation of left renal vein and inferior vena cava. After a multidisciplinary evaluation the patient was put on the Regional Liver Transplant waiting list and liver transplantation was performed successfully. Although portal vein thrombosis and SRS are common occurrences in cirrhotic patients, the impact in the natural history of the disease is still unclear. Careful management and accurate imaging protocols are essential in the evaluation of those patients.

  1. Percutaneous transhepatic portal vein catheterisation in the diagnosis of hormone-producing tumors in the splanchnic area

    International Nuclear Information System (INIS)

    Luska, G.; Zick, R.; Otten, G.; Mitzkat, H.J.; Medizinische Hochschule Hannover; Medizinische Hochschule Hannover

    1981-01-01

    During 1980, percutaneous transhepatic portal vein catheterisation was carried out in eight patients with suspected hormone-producing tumours in an attempt to localise these. Seven patients with hyperinsulinism were suspected of having an insulinoma and one a gastrinoma. There were no complications following the catheterisation, and difficulties were reduced by the use of a special catheter. The blood samples were examined by radio-immunological methods for insulin or gastrin. On the basis of localised rise in hormone level, it was possible to diagnose three insulinomas and one gastrinoma in the pancreas. The betacell tumours were removed by enucleation or segmental resection, the gastrinoma by a Whipple's operation. Three patients showed an insulin gradient and sub-total pancreatectomies were performed. In one patient there was no definite abnormality in the insulin level and an operation has so far not been performed. Our experience indicates that this technique is difficult, but is nevertheless a reliable method for localising hormone-producing tumours and surgery should not be carried out without it. (orig.) [de

  2. CLINICAL MANIFESTATIONS, RADIOLOGICAL FINDINGS AND OUTCOME IN CEREBRAL VEIN AND DURAL SINUS THROMBOSIS: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Thota

    2015-09-01

    Full Text Available Cerebral vein and dural sinus thrombosis (CVT is a type of cerebrovascular disease marked by thrombosis of blood in cerebral veins, or dural sinuses, and, in rare cases, cortical veins. CVT is now a days a disease that is easy to diagnose with MRI provide d the clinician suspect CVT in patients. Before CT and MRI evolution, CVT was considered as a disorder of infectious origin. Between November 2012 and December 2013, 50 patients with CVT in the neurology at the Sri Venkateswara Institute of Medical Science s (SVIMS, Tirupati, confirmed with radioimaging, were included and studied. The mean age of the patients was 27.67±9.1 years. Most of the patients were in the third decade of life; majority were women (70%. CVT. Procoagulant state is found to be major ri sk factor with majority belonging to postpartum state (32% followed by dehydration (30%. Postpartum in combination with dehydration constituted the major risk factor because of local ritual belief that water should not be taken by the postpartum mother f or initial few days after delivery, found to be a modifiable risk factor. Superior sagittal sinus is the commonest sinus involved (58% with transverse sinus being the second most common sinus involved and most (64% of the patients with CVT had involvemen t of more than 1 venous sinus and site of thrombosis didn’t show any correlation with presenting features. MRV brain detected CVT in all the 50 patients in the study but in 28% of the patients no evidence of CVT was found on CT brain plain and contrast sug gesting the sensitivity of MRV over the CT. 70% of the patients had complete functional recovery at the end of hospital stay where as 6% of the patients died. Early diagnosis and prompt institution of anticoagulation irrespective, antioedema measures and a ntiepileptic drugs brings down the mortality and morbidity in patients with CVT. Decompressive craniectomy is an effective procedure decreasing morbidity and mortality and should be

  3. Safety of Pregnancy After Cerebral Venous Thrombosis: Results of the ISCVT (International Study on Cerebral Vein and Dural Sinus Thrombosis)-2 PREGNANCY Study.

    Science.gov (United States)

    Aguiar de Sousa, Diana; Canhão, Patrícia; Crassard, Isabelle; Coutinho, Jonathan; Arauz, Antonio; Conforto, Adriana; Béjot, Yannick; Giroud, Maurice; Ferro, José M

    2017-11-01

    Pregnancy is associated with increased risk of venous thrombotic events, including cerebral venous thrombosis. We aimed to study the complications and outcome of subsequent pregnancies in women with previous cerebral venous thrombosis. Follow-up study of women with acute cerebral venous thrombosis at childbearing age included in a previously described cohort (International Study of Cerebral Vein and Dural Sinus Thrombosis). Patients were interviewed by local neurologists to assess rate of venous thrombotic events, pregnancy outcomes, and antithrombotic prophylaxis during subsequent pregnancies. A total of 119 women were included, with a median follow-up of 14 years. Eighty-two new pregnancies occurred in 47 women. In 83% (68 of 82), some form of antithrombotic prophylaxis was given during at least 1 trimester of pregnancy or puerperium. Venous thrombotic events occurred in 3 pregnancies, including 1 recurrent cerebral venous thrombosis. Two of the 3 women were on prophylactic low-molecular-weight heparin at the time of the event. Outcomes of pregnancies were 51 full-term newborns, 9 preterm births, 2 stillbirths, and 20 abortions (14 spontaneous). In women with prior cerebral venous thrombosis, recurrent venous thrombotic events during subsequent pregnancies are infrequent. © 2017 American Heart Association, Inc.

  4. A new technique for complete portal vein and superior mesenteric vein thrombosis in a liver transplant recipient.

    Science.gov (United States)

    Song, Sanghyun; Kwon, Choon Hyuck David; Shin, Milljae; Kim, Tae-Seok; Lee, Sanghoon; Moon, Hyung Hwan; Park, Jae Berm; Kim, Sung Joo; Joh, Jae-Won; Lee, Suk-Koo

    2014-02-01

    We describe a deceased-donor liver transplant recipient with grade 3 complete portal vein and superior mesenteric vein thromboses, which was successfully managed with an extensive thrombectomy through the venotomy site of superior mesenteric vein. In this case report, we suggest our method as an option for grade 3 portal vein thromboses, and discuss other options available for recipients with portal vein thromboses.

  5. Age-adjusted D-dimer cut-off in the diagnostic strategy for deep vein thrombosis

    DEFF Research Database (Denmark)

    Nybo, Mads; Hvas, Anne-Mette

    2017-01-01

    Background. Studies have indicated that use of an age-adjusted D-dimer cut-off value for patients above 50 years increases utility of the diagnostic strategy for pulmonary embolism. Evidence for the same approach regarding diagnosis of deep vein thrombosis (DVT) is, however, unclear. Materials...

  6. Magnetic resonance venography in consecutive patients with suspected deep vein thrombosis of the upper extremity: Initial experience

    NARCIS (Netherlands)

    Baarslag, H. J.; van Beek, E. J. R.; Reekers, J. A.

    2004-01-01

    Purpose: To assess the feasibility and accuracy of two magnetic resonance (MR) venography methods in a consecutive series of patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Material and Methods: Consecutive in- and outpatients who were referred for imaging of suspected

  7. Detection of superior mesenteric vein thrombosis by real time and Doppler sonography. [comparison with CT and radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Mildenberger, P.; Schild, H.; Jenny, E.

    1988-08-01

    Superior mesenteric vein thrombosis after splenectomy is very rare. In the case described of a patient presenting with acute abdominal pain the diagnosis was made primarily by real-time and Doppler ultrasonography. This reduced the time elapsing before it was recognized that angiography and subsequent thrombectomy were indicated.

  8. Subcutaneous heparin compared with continuous intravenous heparin administration in the initial treatment of deep vein thrombosis. A meta-analysis

    NARCIS (Netherlands)

    Hommes, D. W.; Bura, A.; Mazzolai, L.; Büller, H. R.; ten Cate, J. W.

    1992-01-01

    To quantitatively assess the efficacy and safety of published randomized trials comparing subcutaneous heparin with continuous intravenous heparin for the initial treatment of deep vein thrombosis. Studies published between January 1986 and April 1991 were identified through computer searches of the

  9. Pneumatic sequential-compression boots compared with aspirin prophylaxis of deep-vein thrombosis after total knee arthroplasty.

    Science.gov (United States)

    Haas, S B; Insall, J N; Scuderi, G R; Windsor, R E; Ghelman, B

    1990-01-01

    This prospective, randomized study was undertaken to compare the effectiveness of pneumatic sequential-compression boots with that of aspirin in preventing deep-vein thrombosis after total knee arthroplasty. Patients were randomly assigned to one of two prophylactic regimens: compression boots or aspirin. One hundred and nineteen patients completed the study. Seventy-two patients had unilateral arthroplasty and forty-seven, one-stage bilateral arthroplasty. In the unilateral group, the incidence of deep-vein thrombosis was 22 per cent for the patients who used compression boots compared with 47 per cent for those who received aspirin (p less than 0.03). In the bilateral group, the incidence of deep-vein thrombosis was 48 per cent for the patients who used compression boots compared with 68 per cent for those who received aspirin (p less than 0.20). The results confirm the effectiveness of compression boots in the treatment of patients who have had unilateral total knee arthroplasty. Despite the use of compression boots, however, patients who had bilateral arthroplasty were at greater risk for the development of deep-vein thrombosis.

  10. Era of liver transplantation: combined anatomic splenectomy and anticoagulant therapy in prevention of portal vein thrombosis after splenectomy.

    Science.gov (United States)

    Hongwei, Chen; Zhang, Liang; Maoping, Li; Yong, Zhang; Chengyou, Du; Dewei, Li

    2015-01-01

    Portal vein thrombosis (PVT) is a common complication following splenectomy in patients with liver cirrhosis and portal hypertension, which also brings difficulties to future possible liver transplantation. This paper retrospectively analyzes the preventive effect of combined anatomic splenectomy and early anticoagulant therapy on post-splenectomy portal vein thrombosis in patients with portal hypertension. We retrospectively analyzed 136 patients who underwent splenectomy at our hospital between January 2010 and December 2013 due to liver cirrhosis and portal hypertension. Patient conditions, such as coagulation function, splenic and portal vein thrombosis, intra-abdominal hemorrhage, pancreatic leakage and intra-abdominal infections, are observed postoperatively. Despite the presence of liver cirrhosis and portal hypertension in patients, early postoperative anticoagulant therapy has no significant impact on coagulation function and intra-abdominal hemorrhage of these patients (p > 0.05). Anatomic splenectomy can reduce the occurrence of complications such as postoperative bleeding, pancreatic leakage and intra-abdominal infections (p splenectomy and early postoperative anticoagulant therapy can reduce post-splenectomy portal vein thrombosis in patients with portal hypertension, and is conducive to the future liver transplantation therapy may be needed by the patients.

  11. The application of comprehensive nursing measures in interventional therapy for deep vein thrombosis of lower extremities

    International Nuclear Information System (INIS)

    Huang Linfen; Guo Yanxue; Nan Yi; Pan Xiaohui

    2009-01-01

    Objective: To discuss the effective nursing measures in interventional therapy for deep vein thrombosis (DVT) of lower extremities in order to improve the successful rate of the procedure and to decrease the occurrence of complications. Methods: Comprehensive nursing measures, including general nursing care, specific nursing care and emergency nursing care, were employed in 63 DVT patients receiving interventional therapy. Clinical response and complications were observed. Results: After the treatment, the disorder was cured in 31 cases, while excellent result was seen in 26 cases and obvious improvement in 6 cases. During the procedure, bleeding at puncture site occurred in 16 cases, pulmonary embolism in 2 cases and cerebral hemorrhage in one case. No death occurred. Conclusion: Comprehensive nursing measures can effectively prevent or reduce the occurrence of complications, decrease the mortality rate. Therefore, Comprehensive nursing measures are the most helpful nursing care for DVT patients receiving interventional therapy. (authors)

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

    Science.gov (United States)

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

    2016-07-01

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

  13. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

    Science.gov (United States)

    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Resveratrol Reduces the Incidence of Portal Vein System Thrombosis after Splenectomy in a Rat Fibrosis Model

    Science.gov (United States)

    Xu, Meng; Xue, Wanli; Ma, Zhenhua; Bai, Jigang

    2016-01-01

    Purpose. To investigate the preventive effect of resveratrol (RES) on the formation of portal vein system thrombosis (PVST) in a rat fibrosis model. Methods. A total of 64 male SD rats, weighing 200–300 g, were divided into five groups: Sham operation, Splenectomy I, Splenectomy II, RES, and low molecular weight heparin (LMWH), with the former two groups as nonfibrosis controls. Blood samples were subjected to biochemical assays. Platelet apoptosis was measured by flow cytometry. All rats were euthanized for PVST detection one week after operation. Results. No PVST occurred in nonfibrosis controls. Compared to Splenectomy II, the incidences of PVST in RES and LMWH groups were significantly decreased (both p Splenectomy II (all p splenectomy in cirrhotic rat. Regulation of platelet function and induction of platelet apoptosis might be the underlying mechanisms. PMID:27433290

  15. Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

    Directory of Open Access Journals (Sweden)

    R Kreidy

    2009-07-01

    Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

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

    Directory of Open Access Journals (Sweden)

    Levi Kitchen

    2016-06-01

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

  17. A rare complication of Ramsey Hunt Syndrome: Sınus vein thrombosis

    Directory of Open Access Journals (Sweden)

    Ramiz Ahmedov

    2011-03-01

    Full Text Available Ramsay-Hunt Syndrome (RHS is a rare affection characterized by peripheral facial paralysis (PFP, skin eruption in the auricular canal and cochleovestibular symptoms. It is produced by varicella-zoster virus(VZV reactivation at the geniculate ganglia. In elderly and immunocompromised individuals, the virus may reactivate to produce shingles (zoster. After zoster resolves, many elderly patients experience postherpetic neuralgia. Uncommonly, VZV can spread to large cerebral arteries to cause a spectrum of large-vessel vascular damage, ranging from vasculopathy to vasculitis, with stroke. In immunocompromised individuals, especially those with cancer or acquired immunodeficiency syndrome, deeper tissue penetration of the virus may occur (as compared with immunocompetent individuals, with resultant myelitis, small-vessel vasculopathy, ventriculitis, and meningoencephalitis. The polymerase chain reaction (PCR analysis of cerebrospinal fluid remains the mainstay for diagnosing the neurologic complications of VZV during life. We report a case of Ramsay Hunt syndrome complicated with cerebral venous thrombosis. Patient received treatment with acyclovir and anticoagulation. Early treatment with acyclovir therapy and anticoagulation could improve the recovery rate of facial nerve palsy and sinus vein thrombosis

  18. Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: 3 Case Reports and a Literature Review

    Science.gov (United States)

    Muneer, Mohammed; Abdelrahman, Husham; El-Menyar, Ayman; Zarour, Ahmad; Awad, Ahmed; Dhaheri, Mahmood Al; Al-Thani, Hassan

    2016-01-01

    Case series Patient: Male, 27 • Female, 46 • Male, 46 Final Diagnosis: — Symptoms: Vague abdominal pain • severe nausea • vomiting • fever and diffuse abdominal tendernes Medication: — Clinical Procedure: — Specialty: — Objective: Rare co-existance of disease or pathology Background: Porto-mesenteric venous thrombosis (PMVT) is an infrequent but severe surgical complication developing in patients who underwent laparoscopic bariatric surgery (sleeve gastrectomy). Herein, we describe the clinical presentation, management, and outcome of 3 rare cases of PMVT after laparoscopic sleeve gastrectomy (LSG), successfully treated at our center. Case Report: All patients developed PMVT post-LSG and presented with diffused abdominal pain, nausea, and vomiting. Computed tomography (CT) of the abdomen confirmed the diagnosis of portal vein thrombosis. Two patients were treated conservatively with anticoagulation and thrombolytic therapy and the third patient required operative intervention with bowel resection. Conclusions: PMVT is a rare presentation after LSG, which requires early diagnosis and management. Conservative management through anticoagulants and thrombolytic therapy is quite effective and, if indicated, should always be considered as the primary treatment option. PMID:27068354

  19. Isolated gastrocnemius and soleal vein thrombosis: should these patients receive therapeutic anticoagulation?

    Science.gov (United States)

    Lautz, Timothy B; Abbas, Farah; Walsh, Sarah J Novis; Chow, Christopher; Amaranto, Daniel J; Wang, Edward; Blackburn, Donna; Pearce, William H; Kibbe, Melina R

    2010-04-01

    To determine the incidence of isolated gastrocnemius and soleal vein thrombosis (IGSVT) and the effect of anticoagulation on venous thromboembolism (VTE) events in patients with IGSVT. Although IGSVT is diagnosed with increasing frequency, the clinical significance and optimal management remains unknown. Vascular laboratory studies from April 2002 to April 2007 were retrospectively reviewed to identify patients with IGSVT. Medical records were reviewed for demographic data, risk factors, treatment modalities, and VTE events. Univariate and multivariate analysis were performed. Of 38,426 lower extremity venous duplex studies, 406 patients with IGSVT were included in this study. Mean follow-up was 7.5 +/- 11 months. The overall incidence of VTE among the entire cohort was 18.7%, which included 3.9% pulmonary embolism and 16.3% deep venous thrombosis, with 1.5% of patients having both pulmonary embolism and deep venous thrombosis. However, the incidence of VTE was 30% (36/119) and 27% (13/48) in patients who received no or prophylactic anticoagulation, respectively, but only 12% in patients treated with therapeutic anticoagulation (23/188; P = 0.0003). Multivariate analysis identified lack of therapeutic anticoagulation (P = 0.017) and history of VTE (P = 0.011) as independent predictors of subsequent VTE development. The rate of IGSVT resolution during follow up was 61.2% with therapeutic anticoagulation, but only 40.0% and 41.0% with prophylactic or no anticoagulation, respectively (P = 0.003). IGSVT is associated with a clinically significant rate of VTE which is dramatically reduced with therapeutic anticoagulation. These data warrant further investigation, taking into account the risks and benefits of anticoagulation.

  20. Selective Thrombolysis in Acute Deep Vein Thrombosis: Evaluation of Adjuvant Therapy In Vivo

    International Nuclear Information System (INIS)

    Roy, Sumit; Brosstad, Frank; Sakariassen, Kjell S.

    1999-01-01

    Purpose: To evaluate in a porcine model of acute deep vein thrombosis (DVT) the efficacy of dalteparin and antithrombin with respect to heparin for local adjuvant therapy during selective thrombolysis, and the utility of nitroglycerin and iloprost as heparin supplements. Methods: DVT was induced in both hind limbs using a previously described technique (n = 20). Thirty minutes later, the animal was heparinized (2500 IU IV), and bilateral sequestrated thrombolysis was performed using 8 mg alteplase: both external iliac veins were endoluminally occluded with Swan-Ganz catheters, and a multi-sideport infusion wire coaxially introduced through each catheter and advanced into the ipsilateral popliteal vein. In the control limbs, tissue plasminogen activator (tPA) 8 mg was injected as 0.8-ml boluses at 3-min intervals for 2 hr as a 0.25-mg/ml solution containing heparin 50 IU/ml (n 20). On the contralateral side, heparin was substituted with either dalteparin 50 IU/ml (n = 5) or antithrombin 12.5 IU/ml (n = 5), or supplemented with either nitroglycerin 0.075 mg/ml (n = 5) or iloprost (150 ng/ml) (n = 5). Blood samples were taken at predetermined intervals to measure the activated partial thromboplastin time (aPTT), prothrombin time (PT), and fibrinogen concentration. At autopsy, the thrombus mass in the iliofemoral veins was measured, and the extent of residual thrombosis in the venous tributaries graded at four sites. Results: Bilateral thrombolysis was successfully completed in all animals. The median thrombus mass in the iliofemoral veins after thrombolysis was 0.48 g (range 0.06-1.58 g), 0.95 g (0.59-1.29 g), 0.74 g (0.52-0.96 g), and 0.29 g (0.0-0.77 g) for dalteparin, antithrombin, iloprost, and nitroglycerin respectively, as compared with 0.53 g (0.18-0.88 g) (p = 0.69), 0.97 g (0.46-1.15 g) (p = 0.69), 0.53 g (0.48-1.10 g) (p = 0.69), and 0.18 g (0.13-1.04 g) (p = 0.5) for the respective controls. Likewise, the severity of residual thrombosis in the venous

  1. Use of scintigraphy and cine-angio-scintigraphy to diagnose thrombosis of the superficial intracranial vein sinuses

    International Nuclear Information System (INIS)

    Bernard, M.H.; Rousseaux, P.; Scherpereel, B.; Guyot, J.F.; Morel, M.; Valeyre, J.

    14 cases of venous thrombosis of the large superficial ultracranial sinus were studied. The isotopic examinations were performed by two methods: standard brain scintigraphy ( 111 In-DTPA) and brain cine-angio-scintigraphy (sup(99m)Tc-pertechnetate). The data supplied by both these explorations are analysed. The thrombosis is seen directly in cine-angio-scintigraphy taken with dorsal incidence: the isotopic sinusogram appears clearly from the data accumulated over the first minute following injection. Uni- or bilateral vein softening upstream from the thrombosis is revealed by a maximum pathological uptake in the later stages of standard scintigraphy. A prognostic idea of how the venous thrombosis will develop may even emerge. However a single normal isotopic exploration does not allow elimination of the diagnosis [fr

  2. Endovascular Treatment of Left Iliofemoral Deep Vein Thrombosis Using Urokinase Thrombolysis and Adjunctive Aspiration Thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Sang Hyun; Lee, Do Yun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    To evaluate the efficacy of adjunctive aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis (DVT). 24 patients (9 males and 15 females; mean age, 53 years), treated by aspiration thrombectomy were enrolled in this study. The day after undergoing urokinase (UK) thrombolysis, any residual thrombus over a long segment was treated by aspiration thrombectomy using a 12 Fr long sheath. Residual short-segment (< 10 cm) iliac vein thrombus and/or stenosis were treated with a stent. The evaluation of venous patency was conducted by color Doppler ultrasonography, venography and/or computed tomography. The technical and clinical success rates were 100% and 92%, respectively. Twenty-three patients were treated by UK thrombolysis and iliac stent. The overall patency rate at 1, 2 and 3 years was 85%, 82% and 81%, respectively. Over the course of the follow-up period, occlusion was observed in 4 cases (1 acute and 3 chronic cases). Periprocedural complication occurred in 4 cases (17%) in the form of a minimal hematoma or pain on the puncture site as well as a case of pulmonary embolism at one month after treatment. The adjunctive aspiration thrombectomy with conventional thrombolysis and stent placement can be an effective and safe method in the treatment of left iliofemoral DVT

  3. Ultrasonography for suspected deep vein thrombosis: how useful is single-point augmentation?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Freeman Hospital, Newcastle upon Tyne (United Kingdom)], E-mail: andrewmcqueen7@hotmail.com; Elliott, S.T. [Department of Radiology, Freeman Hospital, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)

    2009-02-15

    Aims: To assess the role of single-point augmentation of spectral Doppler flow in the diagnosis of acute deep vein thrombosis (DVT). Secondary objectives included identifying the augmentation response in non-DVT diagnoses. Methods: Patients attending the ultrasound departments of two hospitals for investigation of suspected acute DVT during an 8-month period were recruited to the study group. Spectral Doppler assessment of the superficial femoral vein was recorded during Valsalva and calf compression manoeuvres in the asymptomatic and symptomatic legs. The Doppler waveforms from the symptomatic limb were characterized as 'normal' or 'abnormal' by the operator. Standard compression ultrasonography of the symptomatic leg was then performed with the presence of DVT or an alternative diagnosis documented. Results: One hundred and sixty-seven patients underwent ultrasound examinations using the study methodology. Nine patients were subsequently excluded due to bilateral DVT or inability to tolerate calf compression. The mean age of the remaining 158 patients was 65.4 years with 28 DVTs identified (18% of patients). Calf compression elicited a normal response in 118/130 of non-DVT examinations (specificity 91%) and an abnormal response in 18/28 DVT examinations (sensitivity 64%). Diminished or absent augmentation was identified in alternative diagnoses that included haematoma and Baker's cyst. Conclusions: This study demonstrates that single-point augmentation has a low sensitivity in suspected lower-limb DVT, and that the majority of undetected DVTs are isolated to the calf veins. An abnormal augmentation response is a poor predictor of lower-limb DVT as alternative diagnoses can produce diminished or reduced augmentation. Therefore, single-point augmentation does not add to the standard compression ultrasound examination for suspected DVT and should not be routinely performed.

  4. Ultrasonography for suspected deep vein thrombosis: how useful is single-point augmentation?

    International Nuclear Information System (INIS)

    McQueen, A.S.; Elliott, S.T.; Keir, M.J.

    2009-01-01

    Aims: To assess the role of single-point augmentation of spectral Doppler flow in the diagnosis of acute deep vein thrombosis (DVT). Secondary objectives included identifying the augmentation response in non-DVT diagnoses. Methods: Patients attending the ultrasound departments of two hospitals for investigation of suspected acute DVT during an 8-month period were recruited to the study group. Spectral Doppler assessment of the superficial femoral vein was recorded during Valsalva and calf compression manoeuvres in the asymptomatic and symptomatic legs. The Doppler waveforms from the symptomatic limb were characterized as 'normal' or 'abnormal' by the operator. Standard compression ultrasonography of the symptomatic leg was then performed with the presence of DVT or an alternative diagnosis documented. Results: One hundred and sixty-seven patients underwent ultrasound examinations using the study methodology. Nine patients were subsequently excluded due to bilateral DVT or inability to tolerate calf compression. The mean age of the remaining 158 patients was 65.4 years with 28 DVTs identified (18% of patients). Calf compression elicited a normal response in 118/130 of non-DVT examinations (specificity 91%) and an abnormal response in 18/28 DVT examinations (sensitivity 64%). Diminished or absent augmentation was identified in alternative diagnoses that included haematoma and Baker's cyst. Conclusions: This study demonstrates that single-point augmentation has a low sensitivity in suspected lower-limb DVT, and that the majority of undetected DVTs are isolated to the calf veins. An abnormal augmentation response is a poor predictor of lower-limb DVT as alternative diagnoses can produce diminished or reduced augmentation. Therefore, single-point augmentation does not add to the standard compression ultrasound examination for suspected DVT and should not be routinely performed

  5. High risk of cerebral-vein thrombosis in carriers of a prothrombin-gene mutation and in users of oral contraceptives.

    Science.gov (United States)

    Martinelli, I; Sacchi, E; Landi, G; Taioli, E; Duca, F; Mannucci, P M

    1998-06-18

    Idiopathic cerebral-vein thrombosis can cause serious neurologic disability. We evaluated risk factors for this disorder, including genetic risk factors (mutations in the genes encoding factor V and prothrombin) and nongenetic risk factors (such as the use of oral contraceptive agents). We compared the prevalence of these risk factors in 40 patients with cerebral-vein thrombosis, 80 patients with deep-vein thrombosis of the lower extremities, and 120 healthy controls. The G1691A mutation in the factor V gene and the G20210A prothrombin-gene mutation, which are established genetic risk factors for venous thrombosis, were studied. We also assessed the use of oral contraceptives and other risk factors for thrombosis. The prevalence of the prothrombin-gene mutation was higher in patients with cerebral-vein thrombosis (20 percent) than in healthy controls (3 percent; odds ratio, 10.2; 95 percent confidence interval, 2.3 to 31.0) and was similar to that in patients with deep-vein thrombosis (18 percent). Similar results were obtained for the mutation in the factor V gene. The use of oral contraceptives was more frequent among women with cerebral-vein thrombosis (96 percent) than among controls (32 percent; odds ratio, 22.1; 95 percent confidence interval, 5.9 to 84.2) and among those with deep-vein thrombosis (61 percent; odds ratio, 4.4; 95 percent confidence interval, 1.1 to 17.8). For women who were taking oral contraceptives and who also had the prothrombin-gene mutation (seven patients with cerebral-vein thrombosis but only one control), the odds ratio for cerebral-vein thrombosis rose to 149.3 (95 percent confidence interval, 31.0 to 711.0). Mutations in the prothrombin gene and the factor V gene are associated with cerebral-vein thrombosis. The use of oral contraceptives is also strongly and independently associated with the disorder. The presence of both the prothrombin-gene mutation and oral-contraceptive use raises the risk of cerebral-vein thrombosis further.

  6. Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass: a 36-case series.

    Science.gov (United States)

    El Lakis, Mustapha A; Pozzi, Agostino; Chamieh, Jad; Safadi, Bassem

    2017-03-01

    Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood. We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis. Articles discussing laparoscopic gastric banding were excluded. A total of 14 articles reporting on 36 cases were found. We analyzed the pooled data from these case reports and series with emphasis on number of reported patients, demographics, time of diagnosis, risk factors, symptoms, management, complications, and sequelae. Portomesenteric vein thrombosis is not uncommon following laparoscopic bariatric surgery and appears to occur more after laparoscopic sleeve gastrectomy. Bariatric surgeons should have a high index of suspicion for early detection and treatment of this potentially lethal complication. Obese patients at high risk for venous thrombosis should be screened for genetic predisposition for hypercoagulable state and should be considered for extended thromboprophylaxis postoperatively.

  7. Clinical analysis of patients with autoimmune disease complicated by mesenteric vein thrombosis: a retrospective study in a hospital.

    Science.gov (United States)

    Luo, Wen; Li, Mingwei; Luo, Jing; He, Yueming

    2012-05-01

    To analyze the clinical characteristics of patients with mesenteric venous thrombosis related to autoimmune disease (AID). Retrospective study of 5 AID patients with mesenteric vein thrombosis in a single hospital. All 5 patients were female with an average age of 57.6 years. At the clinical visit all patients had clinical manifestations with signs of mesenteric blood vessel involvement and a significant increase of inflammatory markers. Surgical exploration identified peritonitis in all 5 cases - 2 cases of intestinal stenosis with mucosal ulcers and 3 cases of intestinal necrosis complicated by perforation. All 5 patients underwent partial bowel resection. Pathological examination confirmed chronic inflammation and vasculitis of intestinal connective tissue, combined with the formation of mesenteric vein thrombosis. Mesenteric vein thrombosis is a serious complication of AID. AID patients with digestive tract symptoms should be screened by abdominal imaging. In addition to early hormonal therapy and immunosuppressant treatment of the primary disease, surgical treatment should be performed as soon as possible if the disease progresses.

  8. Superficial and deep vein thrombosis associated with congenital absence of the infrahepatic inferior vena cava in a young male patient.

    Science.gov (United States)

    O'Connor, Donal B; O'Brien, Noel; Khani, Tahir; Sheehan, Stephen

    2011-07-01

    Congenital absence of the inferior vena cava (AIVC) is a rare vascular anomaly that may be associated with deep vein thrombosis (DVT). It is underreported and may be present in up to 5% of young patients with DVT. We report a unique case of simultaneous thrombosis of both superficial and deep veins in a patient with AIVC. A 20-year-old man presented with a 2-week history of a swollen, painful, left lower limb. On examination, the left leg and thigh were found to be swollen and varicosities were present along the lower abdominal wall. Ultrasound showed extensive superficial and deep venous thrombosis of the entire left lower limb. Computed tomography venogram revealed an infrahepatic AIVC with lower limb drainage through enlarged intrathoracic continuations of the azygous and hemiazygous veins. The patient was put on oral anticoagulant therapy and was well at 6-month follow-up. The hypothesis for DVT in patients with AIVC is that venous drainage of the lower limbs is inadequate, leading to venous stasis and thrombosis. All young patients presenting with idiopathic DVT should be investigated for inferior vena cava anomalies with computed tomography if ultrasound does not visualize the inferior vena cava. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of Deep Vein Thrombosis with Multidetector Row CT after Orthopedic Arthroplasty: a Prospective Study for Comparison with Doppler Sonography

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    Byun, Sung Su; Kim, Youn Jeong; Chun, Yong Sun; Kim, Won Hong [Inha University, College of Medicine, Incheon (Korea, Republic of); Kim, Jeong Ho; Park, Chul Hi [Gachon University, Gil Medical Center, Incheon (Korea, Republic of)

    2008-02-15

    This prospective study evaluated the ability of indirect 16-row multidetector CT venography, in comparison with Doppler sonography, to detect deep vein thrombosis after total hip or knee replacement. Sixty-two patients had undergone orthopedic replacement surgery on a total of 30 hip joints and 54 knee joints. The CT venography (scan delay time: 180 seconds; slice thickness/increment: 2/1.5 mm) and Doppler sonography were performed 8 to 40 days after surgery. We measured the z-axis length of the beam hardening artifact that degraded the image quality so that the presence of deep vein thrombosis couldn't be evaluated on the axial CT images. The incidence and location of deep vein thrombosis was analyzed. The diagnostic performance of the CT venograms was evaluated and compared with that of Doppler sonography as a standard of reference. The z-axis length (mean{+-}standard deviation) of the beam hardening artifact was 4.5{+-}0.8 cm in the arthroplastic knees and 3.9{+-}2.9 cm in the arthroplastic hips. Deep vein thrombosis (DVT) was found in the popliteal or calf veins on Doppler sonography in 30 (48%) of the 62 patients. The CT venography has a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 90%, 97%, 96%, 91% and 94%, respectively. The ability of CT venography to detect DVT was comparable to that of Doppler sonography despite of beam hardening artifact. Therefore, CT venography is feasible to use as an alternative modality for evaluating postarthroplasty patients.

  10. Splenic Artery Embolization for the Treatment of Gastric Variceal Bleeding Secondary to Splenic Vein Thrombosis Complicated by Necrotizing Pancreatitis: Report of a Case

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    Hee Joon Kim

    2016-01-01

    Full Text Available Splenic vein thrombosis is a relatively common finding in pancreatitis. Gastric variceal bleeding is a life-threatening complication of splenic vein thrombosis, resulting from increased blood flow to short gastric vein. Traditionally, splenectomy is considered the treatment of choice. However, surgery in necrotizing pancreatitis is dangerous, because of severe inflammation, adhesion, and bleeding tendency. In the Warshaw operation, gastric variceal bleeding is rare, even though splenic vein is resected. Because the splenic artery is also resected, blood flow to short gastric vein is not increased problematically. Herein, we report a case of gastric variceal bleeding secondary to splenic vein thrombosis complicated by necrotizing pancreatitis successfully treated with splenic artery embolization. Splenic artery embolization could be the best treatment option for gastric variceal bleeding when splenectomy is difficult such as in case associated with severe acute pancreatitis or associated with severe adhesion or in patients with high operation risk.

  11. Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis

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    Tony Zitek, MD

    2016-03-01

    Full Text Available Introduction: Two-point compression ultrasound is purportedly a simple and accurate means to diagnose proximal lower extremity deep vein thrombosis (DVT, but the pitfalls of this technique have not been fully elucidated. The objective of this study is to determine the accuracy of emergency medicine resident-performed two-point compression ultrasound, and to determine what technical errors are commonly made by novice ultrasonographers using this technique. Methods: This was a prospective diagnostic test assessment of a convenience sample of adult emergency department (ED patients suspected of having a lower extremity DVT. After brief training on the technique, residents performed two-point compression ultrasounds on enrolled patients. Subsequently a radiology department ultrasound was performed and used as the gold standard. Residents were instructed to save videos of their ultrasounds for technical analysis. Results: Overall, 288 two-point compression ultrasound studies were performed. There were 28 cases that were deemed to be positive for DVT by radiology ultrasound. Among these 28, 16 were identified by the residents with two-point compression. Among the 260 cases deemed to be negative for DVT by radiology ultrasound, 10 were thought to be positive by the residents using two-point compression. This led to a sensitivity of 57.1% (95% CI [38.8-75.5] and a specificity of 96.1% (95% CI [93.8-98.5] for resident-performed two-point compression ultrasound. This corresponds to a positive predictive value of 61.5% (95% CI [42.8-80.2] and a negative predictive value of 95.4% (95% CI [92.9-98.0]. The positive likelihood ratio is 14.9 (95% CI [7.5-29.5] and the negative likelihood ratio is 0.45 (95% CI [0.29-0.68]. Video analysis revealed that in four cases the resident did not identify a DVT because the thrombus was isolated to the superior femoral vein (SFV, which is not evaluated by two-point compression. Moreover, the video analysis revealed that the

  12. Portal vein thrombosis in cirrhosis is not associated with intestinal barrier disruption or increased platelet aggregability.

    Science.gov (United States)

    Wosiewicz, Piotr; Żorniak, Michał; Hartleb, Marek; Barański, Kamil; Hartleb, Maciej; Onyszczuk, Magdalena; Pilch-Kowalczyk, Joanna; Kyrcz-Krzemień, Sławomira

    2016-12-01

    Portal vein thrombosis (PVT) is a common complication of cirrhosis, but its pathogenesis is unclear. We tested the hypotheses that PVT is the result of platelet hyperactivity or intestinal barrier disruption. This study included 49 patients with cirrhosis (15 females) of mixed etiology. Based on spiral computed-tomography, the patients were divided into two groups: with PVT (n=16) and without PVT (n=33). Serum biomarkers of intestinal barrier integrity were endotoxins and zonulin, and platelet activity was assessed with multiple electrode aggregometry. The levels of endotoxin (43.5±18.3ng/ml vs. 36.9±7.5ng/ml; P=0.19) and zonulin (56.3±31.1ng/ml vs. 69.3±63.1ng/ml; P=0.69) were not different between the patients with and without PVT. Moreover, endotoxin and zonulin did not correlate with the coagulation and platelet parameters. The platelet aggregability measured with the TRAP and the ADP tests was decreased in PVT patients. In the logistic regression analysis the PVT incidence was related to the levels of D-dimer and bilirubin as well as the TRAP test results. Patients with PVT presented with significantly higher levels of D-dimer (4.45±2.59 vs. 3.03±2.97mg/l; P<0.05) and prothrombin levels (175±98.8μg/ml vs. 115±72.9μg/ml; P<0.05) than patients without thrombosis. PVT could be excluded with a 90% negative predictive value when the D-dimer level was below 1.82mg/l. Endotoxemia and platelet activity are not determinants of PVT in patients with cirrhosis. The D-dimer measurement has diagnostic significance for PVT in patients with liver cirrhosis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Efficacy and safety of rotating pigtail catheter: lower extremity deep vein thrombosis of may-thurner syndrome

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    Kim, Yoon Kyung; Kang, Byung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Gang, Sung Gown [College of Medicine, Ewha Womans Univ., Seoul (Korea, Republic of)

    2004-07-01

    The purpose of this study was to evaluate the efficacy and safety of mechanical fragmentation of iliofemoral deep vein thromboses (DVTs) with a rotating pigtail catheter followed by aspiration thrombectomy. Ten patients (eight females, two males, 56.8 +/- 21.37 years) with iliofemoral DVT underwent treatment for a total of ten affected limbs. Approximately 5-10 min after infusing 400,000-700,000 IU urokinase (UK) into the thrombosed deep veins, the thromboses were fragmented by the mechanical action of the rotating pigtail catheter tip. Following their fragmentation, the fragmented thromboses were aspirated. After completion of the above procedure, a stent was inserted if iliac vein stenosis was demonstrated. We evaluated the total procedure time, volume of thrombolytic agent (urokinase), valvular injury, symptom-free time interval and success rate (primary patency rate). In all 10 patients, the iliofemoral deep vein thrombosis was successfully fragmented and aspirated using the combination method of a rotating pigtail catheter and aspiration thrombectomy (clinical and technical success rate, 100%). The thromboses were declotted by means of a rotating pigtail catheter with an average treatment time of 5.7 minutes. The average duration of the total intervention was 108 min. The mean primary patency was approximately 4 months with no recurrence. The total UK dose was 890,000 IU on average. There were no major complications, such as pulmonary embolism or cerebral hemorrhage, while performing the thrombus-fragmentation procedure using the rotating pigtail catheter. The combination method of a rotating pigtail catheter and aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis was found to be rapid, safe and effective for accomplishing recanalization in all cases without complication. Therefore, this procedure constitutes a potential treatment option in patients presenting with iliofemoral vein thrombosis.

  14. Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence

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    Meaghan S. Dendy, MD

    2017-09-01

    Conclusions. We present, to our knowledge, the first 2 reports of transplantation after successfully downstaging infiltrative disease with portal vein tumoral thrombosis, which traditionally poses as a relative contraindication for resection or transplantation.

  15. Diffusion-Weighted MRI of Malignant versus Benign Portal Vein Thrombosis

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    Ahn, Jhii-Hyun; Yu, Jeong-Sik; Cho, Eun-Suk; Chung, Jae-Joon; Kim, Joo Hee; Kim, Ki Whang [Department of Radiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 06273 (Korea, Republic of)

    2016-11-01

    To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40–85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm{sup 2} at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10{sup -3} mm{sup 2}/sec and 0.92 ± 0.25 × 10{sup -3} mm{sup 2}/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10{sup -3} mm{sup 2}/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9–98.9%) and a sensitivity of 22.2% (95% CI: 6.4–47.6%), respectively. Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.

  16. Diffusion-weighted MRI of malignant versus benign portal vein thrombosis

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    Ahn, Jhii Hyun; Yu, Jeong Sik; Cho, Eun Suk; Chung, Jae Joon; Kim, Joo Hee; Kim, Ki Whang [Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul(Korea, Republic of)

    2016-07-15

    To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40-85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm2 at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis. The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10(-3) mm{sup 2}/sec and 0.92 ± 0.25 × 10(-3) mm{sup 2}/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10(-3) mm{sup 2}/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9-98.9%) and a sensitivity of 22.2% (95% CI: 6.4-47.6%), respectively. Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.

  17. A STUDY ON AETIOLOGICAL CAUSES AND CLINICAL MANIFESTATIONS OF PORTAL VEIN THROMBOSIS

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    Radhakrishnan Natarajan

    2017-12-01

    Full Text Available BACKGROUND Portal Vein Thrombosis (PVT has become an increasingly recognisable disorder during evaluation of cases of abdominal pain with usage of widespread imaging techniques. VT can result due to various clinical conditions like chronic liver disease, infections, malignancies and hypercoagulable states. The aim of the study is to observe the clinical presentation and to do the aetiological workup of cases of PVT in a tertiary care centre. MATERIALS AND METHODS The study is a cross-sectional observational study done on patients having PVT who presented to Institute of Medical Gastroenterology, MMC and RGGGH, during the period of January 2016-July 2017 were taken up for the study. The clinical presentation of the above patients was observed and their aetiological workup were done. RESULTS Totally, 45 cases were taken into study. 27 were males and 18 were females. Clinical presentation- The main symptoms were abdominal distension (18 patients, 51%, abdominal pain (10 patients, 27%, pain associated with diarrhoea and vomiting (5 patients, 14%, pain with nausea and anorexia (3 patients, 8%. Aetiological workup showed chronic liver disease (24 patients, 54%, prothrombotic states (9 patients, 20%, local factors, prothrombotic risks and idiopathic causes (12 patients, 26%. Detection of PVT were done mostly by portal vein Doppler (32 patients, 72% and computed tomography (13 patients, 27%. CONCLUSION Higher incidence of PVT were seen among patients with chronic liver disease. Prothrombotic states like myeloproliferative disorders and coagulation defects were the next common causes detected. PVT presenting as plain abdominal pain, pain associated with nausea, vomiting and diarrhoea were seen in patients as well thereby suggesting that PVT is an important differential diagnosis in patients presenting as abdominal pain with a negative workup for common causes. With the help of widespread and improved imaging techniques, earlier diagnosis of PVT can be

  18. Is the fibrotic parietal thickening a reliable parameter for diagnosing previous asymptomatic deep vein thrombosis?

    Science.gov (United States)

    Quarto, Gennaro; Genovese, Giuseppe; Apperti, Marco; Amato, Bruno; Benassai, Giacomo; Furino, Ermenegildo

    2015-01-01

    Research of a starting point to debate about the possibility of identifying a unique sign of previous DVT. A retrospective study involving 202 outpatients with venous insufficiency of the lower limbs (CEAP classes C 4/6), classified according to the affected venous district. Patients positive for deep vein thrombosis (DVT) were subjected to Compression Ultra Sound test (CUS test) with measurement of the wall thickness at the point of formation of the thrombus and at fixed points of common femoral and popliteal veins used also in the patients with negative history of DVT RESULTS: Among total group, only 19 patients (9.40%) had an history of DVT. No one of them had a superficial incontinence. The measurement of wall thickness in positive DVT history patients (group A) resulted in an average value of 1.10 mm (s.d=0.06), while the average value obtained in negative DVT history (group B) was 0.55 mm (s.d.= 0.20). However, in 13 patients wall thickness was > 1mm (mean: 1.04 mm). The difference between the averages of group A and B was statistically significant (p 1 mm. Can the wall thickening more than 1 mm be considered an indicator of previous DVT? Can it be considered a "marker" for thrombophilia status? The usefulness of a sign of previous DVT (even if asymptomatic), detected during a routine Doppler ultrasound check of lower limbs, could be a warning bell to investigate thrombophilia status. Chronic Venous Insufficiency, Duplex ultrasound, Hypercoagulability, Post-thrombotic Syndrome, Venous Thromboembolism.

  19. Treatment of lower extremity superficial vein thrombosis with low molecular weight heparin.

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    Dzupina, A; Wald, M; Lee, B B; Stvrtinova, V

    2016-01-01

    The aim of our study was to ascertain the efficacy of low-molecular-weight heparin (LMWH) in the treatment of patients with SVT. A group of 336 outpatients with clinical diagnosis of SVT was evaluated in this prospective study. At the beginning of the study all patients were examined by clinical investigation, laboratory tests and duplex ultrasound investigation (examination). All patients included into the study were treated with LMWH. Clinical and ultrasound evaluation was carried out on days 10, 30 and 90 of the follow-up. This clinical study of SVT treatment with LMWH was organized in 18 outpatient departments in the Slovak Republic. After 10 days of treatment with LMWH in full therapeutic dosage, an improvement in the clinical symptoms was demonstrated in 93 % of patients; a complete resolution of clinical symptoms was demonstrated in 4 % of patients. On day 30 (after 10 days of LMWH treatment in full therapeutic dosage and further treatment in halved therapeutic dosage up to 20 days) a complete resolution of clinical symptoms was observed in 59 % (n = 189) of patients. Patients were further clinically evaluated on day 90, after two months of no anticoagulation treatment. The clinical evaluation revealed a complete resolution of symptoms in 88 % (n = 283) of patients and improvement in symptoms in 11.6 % (n = 34). Two patients developed pulmonary embolization; extension of SVT was seen in one patient and SVT recurrence in two patients. Superficial vein thrombosis can propagate into the deep veins with the risk of pulmonary embolism. The results indicate that current ambulatory treatment regimen using LMWH in the treatment of SVT is effective and safe (Fig. 4, Ref. 30).

  20. Comparative Study of Compression Bandages with Absolute Bed Rest versus Ambulation inTreatment of Acute Proximal Deep Vein Thrombosis

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    Pramook Mutirangura; Khamin Chinsakchai; Supaporn Tunpornpituk; Chumpol Wongwanit; Chanean Ruangsetakit

    2016-01-01

    Background: In general, many patients with acute proximal deep vein thrombosis (DVT) are treated with heparin and oral anticoagulant. Many physicians have been taught to admit these patients to absolute bed rest for the first 24-48 hours due to the fear of dislodging clots that may lead to fatal pulmonary embolism (PE). Objective: The aim of this study is to compare the differences among the changing circumference of affected limb, the severity of pain, and the incidence of sympto...

  1. Prothrombotic Fibrin Clot Phenotype in Patients with Deep Vein Thrombosis and Pulmonary Embolism: A New Risk Factor for Recurrence

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    Anetta Undas

    2017-01-01

    Full Text Available Prothrombotic fibrin clot phenotype, involving faster formation of dense meshwork composed of thinner and highly branched fibers that are relatively resistant to plasmin-induced lysis, has been reported in patients with not only myocardial infarction or stroke, but also venous thromboembolism (VTE, encompassing deep vein thrombosis (DVT, and/or pulmonary embolism (PE. Prothrombotic fibrin clot phenotype, in particular prolonged clot lysis time, is considered a novel risk factor for VTE as well as venous thrombosis at unusual location, for example, cerebral sinus venous thrombosis, retinal vein obstruction, and Budd-Chiari syndrome. Growing evidence from observational studies indicates that abnormal fibrin clot properties can predict recurrent DVT and PE and they are involved in serious complications of VTE, for example, thromboembolic pulmonary hypertension and postthrombotic syndrome. The purpose of this article is to review our current understanding of the role of fibrin clot structure and function in venous thrombosis with emphasis on clinical issues ranging from prognosis to therapy.

  2. [Thrombosis of the portal, upper mesenteric, and splenic veins in a patient with thrombophilia (a clinical case report)].

    Science.gov (United States)

    Shklyaev, A E; Malakhova, I G; Bessonov, A G; Utkin, I Yu

    Currently there are several dozens of hereditarily associated thrombophilias and acquired states known to condition the development of a thrombus. Thrombosis of visceral veins appears to be a considerably less often encountered event than thrombosis in the system of visceral arteries. Presented herein in the article is a clinical case report concerning subacute thrombosis of the portal, upper mesenteric and splenic veins, having developed on the background of mutations of 7 genes of the system of haemostasis in a young adult patient. Timely comprehensive examination with determining polymorphism of the haemostasis system genes made it possible to verify the aetiology of the disease in the patient, while multispiral computed tomography contributed favourably to specifying the extension of thrombosis. Due to the developed segmental necrosis of the small intestine the patient was subjected to resection of the necrotised portion of the small intestine followed by establishing an entero-enteric anastomosis. In the postoperative period adequate anticoagulant therapy was adjusted in order to prevent relapse of thrombogenesis.

  3. SUPERIOR MESENTERIC VEIN THROMBOSIS AND CYTOMEGALOVIRUS: A DIAGNOSTIC DILEMMA. A CASE REPORT AND REVIEW OF THE LITERATURE.

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    Vincenzo Davide Palumbo

    2014-04-01

    Full Text Available Superior mesenteric vein thrombosis (SMVT is a rare condition, usually caused by infections, intra-abdominal inflammatory diseases, portal hypertension, hypercoagulable states, or contraceptive therapy. Due to its vague symptomatology, SMVT is often diagnosed only after an abdominal contrast-enhanced computed tomography (CT scan. In this article, we present a case of SMVT in a patient with a history of contraceptive drug use and a recent cytomegalovirus infection. A 36-year-old female was admitted to our department with the clinical symptoms of an acute appendicitis. The patient was a smoker and had been using hormonal contraceptives for over a year. Surgery was deemed the best course of action. Before the operation, blood tests showed a mild lymphocytosis and altered liver enzyme levels, while coagulation values were normal. A contrast-enhanced CT scan revealed a complete superior mesenteric vein thrombosis without signs of bowel ischemia. Anticoagulants were immediately administered. A thrombophilia panel did not highlight any noteworthy elements. Cytomegalovirus (CMV tests resulted positive. Since CMV is a rare, but potentially significant cause or precipitating factor for thrombosis in immunocompetent hosts, all patients with an unexplained fever and seemingly spontaneous thrombosis should be screened for CMV infection.

  4. Unusual deep vein thrombosis sites: magnetic resonance venography in patients with negative compression ultrasound and symptomatic pulmonary embolism.

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    Gary, T; Steidl, K; Belaj, K; Hafner, F; Froehlich, H; Deutschmann, H; Pilger, E; Brodmann, M

    2014-02-01

    To evaluate the clinical characteristics of patients with pulmonary embolism (PE), negative compression ultrasound (CUS) of the lower limbs and detection of unusual deep vein thrombosis (DVT) sites by means of magnetic resonance (MR) venography. A retrospective data analysis of PE patients hospitalized at our institution from April 2009 to 2011. From April 2009 to 2011, a total of 762 PE patients were treated at our institution. In 169 of these patients CUS for DVT was negative. In these patients MR venography was performed for further evaluation. We found venous thrombosis at unusual sites in 12 of these patients. Due to free floating thrombus masses and fear of life-threatening PE progression we inserted an inferior vena cava filter in three of these 12 patients. The leading venous thromboembolism risk factor in our patients was immobilization (5 patients, 41.7%). We conclude that especially in patients with PE and negative CUS of the lower limbs a thrombosis of the pelvic veins should be considered in case of symptoms for venous thrombosis in this area. Further diagnostic work-up with MR venography should be scheduled in these patients especially in patients with risk factor immobilization as therapeutic consequences might occur.

  5. To determine the frequency of Factor V Leiden in cases of Deep Vein Thrombosis and Healthy controls.

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    Saeed, Anjum; Sumreen; Kashif, Muhammad Ali

    2015-01-01

    To determine the frequency of Factor V Leiden in cases of Deep Vein Thrombosis and Healthy controls. This case control study was performed in Armed Forces Institute of Pathology Rawalpindi, From 21(st) March to 25(th) September 2013. One hundred patients with diagnostic evidence of Deep vein thrombosis on Doppler ultrasound/Magnetic resonance imaging (MRI) scan were included in the study through non probability convenient sampling and compared with 100 matched healthy controls. DNA was extracted from the blood sample by kit method. In order to identify Factor V Leiden mutation, the polymerase chain reaction (PCR) method was utilized combined with the Amplification refractory mutation system. Data was analyzed using statistical package for social sciences (SPSS) version 17. In 100 patients of Deep Vein Thrombosis (DVT), frequency of Factor V Leiden (FVL) was 13% and it is was 2% in healthy control group. A significant association was found between FVL and DVT with odds ratio of 7.32 and with P value (P = 0.003). FVL was found to be highly prevalent among patients of DVT, Signifying strong association between the two.

  6. Cerebral Vein Thrombosis:Screening of Acquired and Hereditary Thrombophilic Risk Factors

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    Sarraf Payam

    2009-10-01

    Full Text Available Cerebral vein thrombosis (CVT is an infrequent condition with a large variety of causes that can lead to serious disabilities. However, in 20% to 35% of cases, no cause is found. In this study we evaluated the hereditary (P & C Proteins, antithrombin, mutation of prothrombin G20210A and factor V Leiden, other risk factors (hyperhomocycteinemia, factor VIII, ACL-ab, APL-ab, and OCP and clinical manifestations among a population of Iranian patients with CVT. 18 women and 10 men aged 16 to 50 years with CVT were screened for inherited and acquired coagulation risk factors. No one had an abnormal ACL-ab, APL-ab or antithrombin III deficiency. One had prothrombin G20210A mutation (heterozygot (3.6%. Hyperhomocycteinemia was observed in 5 patients (17.9%. APC-R was decreased in 3 (10.7%. 2 had positive factor V Leiden mutation (heterozygot (7.1%. 17 had an increased of factor VIII (60.7. PS and PC deficiencies were each detected in two cases (7.1%. Conclusion: Our study suggests that screening for inherited thrombophilia may be an integral part in the diagnostic workup and duration of treatment in patients with CVT.

  7. Deep vein thrombosis prophylaxis: a comprehensive approach for total hip and total knee arthroplasty patient populations.

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    Miric, A; Lombardi, P; Sculco, T P

    2000-04-01

    One of the most catastrophic complications after total joint arthroplasty is a fatal pulmonary embolism. Thromboembolic disease is particularly a problem in lower extremity joint arthroplasty secondary to the development of deep vein thrombosis (DVT) and proximal propagation of the thrombus. The environment created during total hip and knee arthroplasty fulfills the criteria for DVT formation: vessel wall damage, venous stasis, and a hypercoagulable state. Evidence that suggests the insult and primary event in thrombogenesis occurs during surgery. Until recently, however, the main thrust of DVT prophylaxis has concentrated on the immediate postoperative period. A more global approach to patient care during the 6-week period beginning with surgery may result in more effective DVT prophylaxis. Operative interventions that have proven to be effective include hypotensive epidural anesthesia and intravenous administration of heparin. Postoperative pharmaceutical interventions range from standard doses of aspirin or warfarin to recently studied dosing regimens of low-molecular-weight heparins, antiplatelet agents, and antithrombotic agents. Mechanical prophylaxis has also proved to be a valuable adjunct in DVT prophylaxis during these periods. It is hoped that a more comprehensive approach incorporating several of the aforementioned treatments into a strategy that encompasses the intraoperative and early and late postoperative periods will maximize the effectiveness of DVT prophylaxis.

  8. Deep Vein Thrombosis, Raynaud's Phenomenon, and Prinzmetal Angina in a Patient with Glanzmann Thrombasthenia

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    Alan Nurden

    2012-01-01

    Full Text Available Patients with Glanzmann thrombasthenia fail to form large platelet thrombi due to mutations that affect the biosynthesis and/or function of the αIIbβ3 integrin. The result is a moderate to severe bleeding syndrome. We now report unusual vascular behaviour in a 55-year-old woman with classic type I disease (with no platelet αIIbβ3 expression and a homozygous ITGA2B missense mutation (E324K affecting the terminal β-propeller domain of αIIb. While exhibiting classic bleeding symptoms as a child, in later life this woman first developed deep vein thrombosis after a long air flight then showed vascular problems characteristic of Raynaud’s phenomenon, and finally this year she presented with chest pains suggestive of coronary heart disease. Yet while coronary angiography first showed a stenosis, this was not seen on a second examination when she was diagnosed with coronary spastic angina and Prinzmetal phenomenon. It is significant that the absence of platelet aggregation with physiologic agonists had not prevented any of the above cardiovascular or vascular diseases.

  9. Deep vein thrombosis of the upper extremity: intra- and interobserver study of digital subtraction venography

    Energy Technology Data Exchange (ETDEWEB)

    Baarslag, Henk J.; Delden, Otto M. van; Bakker, Ad J.; Reekers, Jim A. [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Beek, Edwin J.R. van [Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Section of Academic Radiology, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF (United Kingdom); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2003-02-01

    Our objective was to assess the inter-observer and intra-observer agreement in the interpretation of digital subtraction venography (DSV) in patients with suspected deep vein thrombosis of the upper extremity (DVTUE). Prospectively, 62 consecutive DSV studies in 54 patients with clinically suspected DVTUE were included. Hard copies were presented without demographic data or original report. All venograms were read twice, at 3-month intervals, by an interventional vascular radiologist (observer 1) and an experienced general radiologist (observer 2). Consensus reading took place in the presence of a third experienced interventional radiologist. Inter-observer and intra-observer agreement were assessed using kappa statistics. Initial reading in 62 venograms showed an inter-observer agreement of 71% (kappa 0.48). The inter-observer agreement of the second reading was 83% (kappa 0.71). The agreement with the consensus report ranged from 76 to 94%. The intra-observer agreement for the first and second observer was 94% (kappa 0.89) and 76% (kappa 0.56), respectively (p<0.01). Digital subtraction venography has moderate to excellent intra- and inter-observer agreement, suggesting that digital subtraction venography is reliable for the diagnosis of DVTUE. (orig.)

  10. Resveratrol Reduces the Incidence of Portal Vein System Thrombosis after Splenectomy in a Rat Fibrosis Model

    Directory of Open Access Journals (Sweden)

    Meng Xu

    2016-01-01

    Full Text Available Purpose. To investigate the preventive effect of resveratrol (RES on the formation of portal vein system thrombosis (PVST in a rat fibrosis model. Methods. A total of 64 male SD rats, weighing 200–300 g, were divided into five groups: Sham operation, Splenectomy I, Splenectomy II, RES, and low molecular weight heparin (LMWH, with the former two groups as nonfibrosis controls. Blood samples were subjected to biochemical assays. Platelet apoptosis was measured by flow cytometry. All rats were euthanized for PVST detection one week after operation. Results. No PVST occurred in nonfibrosis controls. Compared to Splenectomy II, the incidences of PVST in RES and LMWH groups were significantly decreased (both p<0.05. Two rats in LMWH group died before euthanasia due to intra-abdominal hemorrhage. In RES group, significant decreases in platelet aggregation, platelet radical oxygen species (ROS production, and increase in platelet nitric oxide (NO synthesis and platelet apoptosis were observed when compared with Splenectomy II (all p<0.001, while in LMWH group only significant decrease in platelet aggregation was observed. Conclusion. Prophylactic application of RES could safely reduce the incidence of PVST after splenectomy in cirrhotic rat. Regulation of platelet function and induction of platelet apoptosis might be the underlying mechanisms.

  11. Coagulation disorders in the patients with deep vein thrombosis of lower extremity

    Directory of Open Access Journals (Sweden)

    Milić Dragan J.

    2003-01-01

    Full Text Available PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration. PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states in the patients with deep vein thrombosis (DVT of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT partial thromboplastin time (PTT, fibrinogen (Fib, alpha 2 antiplasmin (A-2 AP, D-dimer (DD, antithrombin III (AT III and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.

  12. Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

    Science.gov (United States)

    Gatot, D.; Mardia, A. I.

    2018-03-01

    Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

  13. Headache Could Be Finding of Sinus Vein Thrombosis in Behcets Patients

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    Halil Sen

    2014-08-01

    Full Text Available Globally Behcet%u2019s disease (BD is most frequently seen in Turkey and takes its name from the Turkish dermatologist Hulusi Behcet. Basic findings of the disease are the triad of genital ulcers, oral ulcers and uveitis. Neurological involvement in BD appears an average of 5 years after the beginning of disease, or the first appearance of the disease may be neurological findings. Sinus vein thrombosis (SVT is among neurological involvements observed in BD. However diagnosis of SVT is difficult and it is a situation that may cause disability or mortality. Our case was a 24-year old female patient with diagnosed SVT who had a diagnosis of BD from 5 years. In spite of the patient frequently applying to health services, SVT diagnosis was delayed until 15 days after the initial symptoms. BD can cause SVT and SVT may cause disability or mortality but SVT may be diagnosed late, just as in our case. Therefore we present this case to increase awareness of this disease.

  14. Thrombolytic Therapy for Cerebral Vein Thrombosis in Antiphospholipid Syndrome Secondary to Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Mehrzad Hajialilo

    2012-03-01

    Full Text Available A 20-year-old woman was admitted to a Gynecology Hospital in her 6th month of pregnancy for high blood pressure and tonic-clonic seizure. Primary diagnosis was eclampsia, and for that reason she underwent cesarean section. She also had headache on frontal and parietal areas without nausea or vomiting. There was not a focal neurological sign. Rheumatology consultation was requested. Sys-temic lupus erythematosus and secondary antiphospholipid (APS was confirmed. The patient had headache that continued several days after cesarean section, therefore, brain magnetic resonance im-aging (MRI and magnetic resonance venography (MRV were performed, and cerebral vein thrombosis was documented. Distal segment of right lateral sinus and sigmoid sinus were not ap-peared in brain MRV. Abnormal hypersignal intensity of right lateral sinus/coronal T2 was detected. Thrombolytic therapy with 20 mg tissue plasminogen activator on right sigmoid and transverse sinus was performed by an interventional neurologist. After this procedure, the patient's headache healed and she was discharged in a good condition.

  15. Treatment of deep vein thrombosis and pulmonary embolism: The present state of the art

    Directory of Open Access Journals (Sweden)

    Johannes eThaler

    2015-07-01

    Full Text Available AbstractVenous thromboembolism (VTE, a disease entity comprising deep vein thrombosis (DVT and pulmonary embolism (PE, is a frequent and potentially life-threatening event. To date different agents are available for the effective treatment of acute VTE and the prevention of recurrence. For several years the standard of care was the subcutaneous application of a low molecular weight heparin (LMWH or fondaparinux, followed by a vitamin K antagonist (VKA. The so-called direct oral anticoagulants (DOACs were introduced rather recently in clinical practice for the treatment of VTE. DOACs seem to have a favourable risk-benefit profile compared to VKAs. Moreover, DOACs significantly simplify VTE treatment, because they are administered in fixed doses and no routine monitoring is needed.Patients with objectively diagnosed DVT or PE should receive therapeutic anticoagulation for a minimum of 3 months. Whether a patient ought to receive extended treatment needs to be evaluated on an individual basis, depending mainly on risk factors determined by characteristics of the thrombotic event and patient-related factors. In specific patients groups (e.g. pregnant women, cancer patients and elderly patients treatment of VTE is more challenging than in the general population and additional issues need to be considered in those patients.The aim of this review is to give an overview of the currently available treatment modalities of acute VTE and secondary prophylaxis. In particular, specific aspects regarding the initiation of VTE treatment, duration of anticoagulation and specific patient groups will be discussed.

  16. [Usefulness of clinical prediction rules for ruling out deep vein thrombosis in a hospital emergency department].

    Science.gov (United States)

    Rosa-Jiménez, Francisco; Rosa-Jiménez, Ascensión; Lozano-Rodríguez, Aquiles; Santoro-Martínez, María Del Carmen; Duro-López, María Del Carmen; Carreras-Álvarez de Cienfuegos, Amelia

    2015-01-01

    To compare the efficacy of the most familiar clinical prediction rules in combination with D-dimer testing to rule out a diagnosis of deep vein thrombosis (DVT) in a hospital emergency department. Retrospective cross-sectional analysis of the case records of all patients attending a hospital emergency department with suspected lower-limb DVT between 1998 and 2002. Ten clinical prediction scores were calculated and D-dimer levels were available for all patients. The gold standard was ultrasound diagnosis of DVT by an independent radiologist who was blinded to clinical records. For each prediction rule, we analyzed the effectiveness of the prediction strategy defined by "low clinical probability and negative D-dimer level" against the ultrasound diagnosis. A total of 861 case records were reviewed and 577 cases were selected; the mean (SD) age was 66.7 (14.2) years. DVT was diagnosed in 145 patients (25.1%). Only the Wells clinical prediction rule and 4 other models had a false negative rate under 2%. The Wells criteria and the score published by Johanning and colleagues identified higher percentages of cases (15.6% and 11.6%, respectively). This study shows that several clinical prediction rules can be safely used in the emergency department, although none of them have proven more effective than the Wells criteria.

  17. Deep vein thrombosis, an unreported first manifestation of polyglandular autoimmune syndrome type III

    Directory of Open Access Journals (Sweden)

    M Horsey

    2016-07-01

    Full Text Available A 71-year-old woman with severe right lower leg pain, edema and erythema was presented to the Emergency Department and was found to have an extensive deep vein thrombosis (DVT confirmed by ultrasound. She underwent an extensive evaluation due to her prior history of malignancy and new hypercoagulable state, but no evidence of recurrent disease was detected. Further investigation revealed pernicious anemia (PA, confirmed by the presence of a macrocytic anemia (MCV=115.8fL/red cell, Hgb=9.0g/dL, decreased serum B12 levels (56pg/mL, with resultant increased methylmalonic acid (5303nmol/L and hyperhomocysteinemia (131μmol/L, the presumed etiology of the DVT. The patient also suffered from autoimmune thyroid disease (AITD, and both antithyroglobulin and anti-intrinsic factor antibodies were detected. She responded briskly to anticoagulation with heparin and coumadin and treatment of PA with intramuscular vitamin B12 injections. Our case suggests that a DVT secondary to hyperhomocystenemia may represent the first sign of polyglandular autoimmune syndrome III-B (PAS III-B, defined as the coexistent autoimmune conditions AITD and PA. It is important to recognize this clinical entity, as patients may not only require acute treatment with vitamin B12 supplementation and prolonged anticoagulation, as in this patient, but may also harbor other autoimmune diseases.

  18. Low Molecular Weight Heparin in Portal Vein Thrombosis of Cirrhotic Patients: Only Therapeutic Purposes?

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    Raffaele Licinio

    2014-01-01

    Full Text Available Cirrhosis has always been regarded as hemorrhagic coagulopathy caused by the reduction in the hepatic synthesis of procoagulant proteins. However, with the progression of liver disease, the cirrhotic patient undergoes a high rate of thrombotic phenomena in the portal venous system. Although the progression of liver failure produces a reduction in the synthesis of anticoagulant molecules, a test able to detect the patients with hemostatic balance shifting towards hypercoagulability has not yet been elaborated. The need of treatment and/or prophylaxis of cirrhotic patients is demonstrated by the increased mortality, the risk of bleeding from esophageal varices, and the mortality of liver transplantation, when portal vein thrombosis (PVT occurs even if current guidelines do not give indications about PVT treatment in cirrhosis. In view of the general feeling that the majority of cirrhotic patients at an advanced stage may be in a procoagulant condition (suggested by the sharp increase in the prevalence of PVT, it is presumable that a prophylaxis of this population could be of benefit. The safety and the efficacy of prophylaxis and treatment with enoxaparin in patients with cirrhosis demonstrated by a single paper suggest this option only in controlled trials and, currently, there are no sufficient evidences for a recommendation in the clinical practice.

  19. [News in the work-up of deep vein thrombosis (DVT)].

    Science.gov (United States)

    Wautrecht, J-C

    2015-09-01

    Deep vein thrombosis (DVT) is a component of venous thromboembolism (VTE), the other being pulmonary embolism (PE). Its incidence is 1 to 2/1.000/year and nearly 1/100/year after 80 years. The major complication of DVT is PE which occurs in about 1/3 of cases, is often asymptomatic but can be fatal. Another common complication, occurring in 20-50 % of cases is the post-thrombotic syndrome (PTS) which is likely to alter the quality of life. Several issues remain unanswered when considering DVT. The optimal management of distal DVT versus proximal DVT is not well codified. The diagnostic approach to DVT is essential : it is based on the estimation of clinical probability, the possible use of D-dimer test and compression ultrasonography. The new direct oral anticoagulants (NOACs) have been proven effective in the phase 3 studies but when to use them and which to choose in the real life ? Wearing compression stockings to prevent the SPT is recommended: what is the definition of compression stockings and is there some evidence of their efficacy ? The purpose of this article is to provide some useful information to primary care physicians to address a DVT.

  20. Prevention of deep vein thrombosis after total knee arthroplasty. Coumadin versus pneumatic calf compression.

    Science.gov (United States)

    Hodge, W A

    1991-10-01

    The rate of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) without prophylaxis has been reported as high as 84%. Coumadin anticoagulation and pneumatic calf compression (PCC) boots are two current therapies that have been thought to be effective in reducing this high rate of DVT. To investigate these two methods, a nonrandomized prospective study was designed. The first group involved treating 48 consecutive knee arthroplasties with a regimen of coumadin anticoagulation. The second group involved 81 consecutive knee arthroplasties treated with sequential PCC boots. Bilateral lower extremity venography was performed between the eighth and tenth hospital postoperative days. The overall incidence of DVT in the coumadin group was 33%, with 29% having calf thrombi and 6% having thigh thrombi. The overall incidence of DVT in the boot group was 31%, with 27% having calf thrombi and 6% having thigh thrombi. In both groups, there were no treatment-related complications. Cost analysis of the administration of each type of therapy showed coumadin to be approximately 50% more expensive than PCC boots. Although coumadin and PCC boot therapy are safe and effective in reducing the incidence of DVT after TKA, there are economic factors that make the latter a more favorable option.

  1. Relative Risk of Deep Vein Thrombosis in Very Elderly Patients Compared With Elderly Patients.

    Science.gov (United States)

    Yayan, Josef; Bals, Robert

    2016-01-01

    Deep vein thrombosis (DVT) and pulmonary embolism are major causes of morbidity and mortality in patients during hospitalization; previous studies have proposed that an advanced age of more than 60 years is a risk factor for these conditions. This study analyzes the relative risk of DVT in very elderly patients older than 90 years of age compared with elderly patients aged 80 to 89 years. The study was performed at the Department of Internal Medicine, University Hospital of Saarland, Homburg/Saar, Germany, between 2004 and 2012. After completing ultrasound examinations, 20 (64.52%, 12 [60%] female patients, mean age 91.8 ± 1.83 years) of the 31 patients in the study group and 132 (62.26%, 87 [65.91%] female patients, mean age 83.84 ± 2.66 years) of the 212 patients in the control group were diagnosed with DVT. An increased relative risk of DVT was not discovered in the very elderly patients (relative risk, 1.04; P = .80). © The Author(s) 2014.

  2. Role of blood transfusion product type and amount in deep vein thrombosis after cardiac surgery.

    Science.gov (United States)

    Ghazi, Lama; Schwann, Thomas A; Engoren, Milo C; Habib, Robert H

    2015-12-01

    Postoperative deep vein thrombosis (DVT) is associated with significant morbidity. Even with maximal thromboprophylaxis, postoperative DVT is present in 10% of cardiac surgery patients, and is linked to receiving transfusion. We hypothesized that the incidence of DVT varies with the transfused blood product type, and increases with transfusion dose. 139/1070 cardiac surgery patients have DVT despite maximal chemo and mechanical prophylaxis. DVTs were detected via serial perioperative duplex venous scans (DVS). Red blood cells (RBC), platelets (PLT), plasma (FFP) and cryoprecipitate transfusion data were collected. Transfusion was used in 506(47%) patients: RBC [468(44%); 4.0 ± 4.2u]; FFP [155(14.5%); 3.5 ± 2.3 u]; PLT [185(17.3%); 2.2 ± 1.3 u] and Cryoprecipitate [51(4.8%); 1.3 ± 0.6 u]. Isolated RBC transfusion accounted for 92.6% patients receiving one product, and their DVT rate was increased considerably compared to no transfusion (16.7% versus 7.3%; Pproduct transfusions; particularly when both RBC and FFP are used (25%-40%). Relative to no RBC (n=602), multivariate logistic regression analysis identified a significant RBC-DVT dose dependent relation (Pfashion that is exacerbated when accompanied with FFP. Postoperative screening diagnostic DVS are warranted in this transfused, high risk for DVT population to facilitate timely therapeutic intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Glucose-induced thermogenesis in splanchnic and leg tissues in man

    DEFF Research Database (Denmark)

    Simonsen, L; Ryge, C; Bülow, J

    1995-01-01

    and lactate were taken from an artery, a hepatic vein and a femoral vein. Blood flow in the splanchnic region was measured by constant infusion of Indocyanine Green. Leg blood flow was measured by venous occlusion strain-gauge plethysmography. Oxygen uptake and carbon dioxide output in the splanchnic and leg...

  4. An Autopsy Case of Acute Massive Hematochezia Caused by Superior Mesenteric Vein Thrombosis: A First Report in Forensic Medicine.

    Science.gov (United States)

    Watanabe, Mayumi; Unuma, Kana; Makino, Yohsuke; Noritake, Kanako; Yamada, Atsushi; Iwase, Hirotaro; Uemura, Koichi

    2016-01-01

    Superior mesenteric vein thrombosis (SMVT) is an uncommon cause of intestinal ischemia and massive gastrointestinal bleeding. This report describes a man with alcoholic liver cirrhosis, who died of massive hematochezia due to SMVT. A medicolegal autopsy disclosed a thrombus at the superior mesenteric vein and hemorrhagic infarction of the bowel wall, an area also within the territory of the superior mesenteric vein. Liver cirrhosis, an enlarged spleen, and esophageal varices without rupture were also observed, but ulcers and variceal bleeding were not. Other organs showed no significant findings. His blood alcohol level was 0.14% w/v. Thus, this man died from severe hematochezia associated with SMVT due to liver cirrhosis and alcohol dehydration, which can lead to coagulopathy and rapid progress of thrombus formation. This is the first report on an alternate cause for massive gastrointestinal hemorrhage with a cirrhotic patient in a forensic autopsy. © 2015 American Academy of Forensic Sciences.

  5. Time course and the recanalization rate of superficial vein thrombosis treated with low-molecular-weight heparin.

    Science.gov (United States)

    Spirkoska, Ana; Jezovnik, Mateja Kaja; Poredos, Pavel

    2015-04-01

    The aim of this study was to follow the thrombus progression and regression in superficial veins of lower limbs in patients with superficial vein thrombosis (SVT) treated with low-molecular-weight heparin. Patients (n = 68) with a first symptomatic SVT of the lower limbs received 2 different dosages of dalteparin. The primary outcome was a change in the diameter and length of thrombus in the affected veins. The regression of thrombus was not significantly different between the groups (P = .19). The reduction in the length of thrombus as well as thrombus diameter was significantly greater in females. At the end of the observation period, the length of thrombus in the distal part was more reduced than in the proximal segments. It seems that the dosage of anticoagulant drug does not have a significant impact on thrombus resolution. © The Author(s) 2014.

  6. Thrombosis of the dorsal vein of the penis (Mondor′s Disease: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Syed Sajjad Nazir

    2010-01-01

    Full Text Available Superficial thrombophlebitis of the dorsal vein of the penis (penile Mondor′s Disease is an important clinical diagnosis that every family practitioner should be able to recognize. Dorsal vein thrombosis is a rare disease with pain and induration of the dorsal part of the penis. The possible causes comprise traumatism, neoplasms, excessive sexual activity, or abstinence. The differential diagnosis must be established with Sclerotizing lymphangitis and peyronies disease and doppler ultrasound is the imaging diagnostic technique of choice. Proper diagnosis and consequent reassurance can help to dissipate the anxiety typically experienced by the patients with this disease. We describe the symptoms, diagnosis, and treatment of the superficial thrombophlebitis of the dorsal vein of the penis.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-15

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

  8. Superficial venous thrombosis: prevalence of common genetic risk factors and their role on spreading to deep veins.

    Science.gov (United States)

    Milio, Glauco; Siragusa, Sergio; Minà, Chiara; Amato, Corrado; Corrado, Egle; Grimaudo, Stefania; Novo, Salvatore

    2008-01-01

    Superficial venous thrombosis (SVT) has been considered for a long time a limited clinical condition with a low importance, but this approach has changed in recent years, when several studies demonstrated spreading to deep veins occurring from 7.3 to 44%, with high prevalence of pulmonary embolism. To evaluate the prevalence of genetic risk factors for VTE in patients suffering from SVT on both normal and varicose vein, and to understand their role on spreading to deep veins, we studied 107 patients with SVT, without other risk factors. Ultrasound examination was performed, and the presence of FV Leiden, Prothrombin G20210A mutation, and MTHFR C677T mutation was researched. In the patients where SVT occurred in normal veins, the presence of FV Leiden was 26.3% of the non-spreading and 60% of the spreading to deep veins SVT; Prothrombin mutation was found in 7.9% of the former case and in 20% of the latter; MTHFR C677T mutation was found respectively in 23.7% and 40%. In the patients with SVT on varicose veins, the presence of these factors was less evident (6.7%, 4.4% and 6.7% respectively), but their prevalence was considerably higher (35.7%, 7.4% and 21.4% respectively) in SVT spreading to deep veins than in non-spreading. Our data demonstrate the high prevalence of these mutations, especially FV Leiden and associations, in patients with SVT on normal veins and their role in the progression to deep vein system.

  9. A comparison of real-time compression ultrasonography with impedance plethysmography for the diagnosis of deep-vein thrombosis in symptomatic outpatients

    NARCIS (Netherlands)

    Heijboer, H.; Büller, H. R.; Lensing, A. W.; Turpie, A. G.; Colly, L. P.; ten Cate, J. W.

    1993-01-01

    Impedance plethysmography performed serially over a one-week period has been shown to be an effective diagnostic strategy for patients with clinically suspected acute deep-vein thrombosis. Compression ultrasonography has a high sensitivity and specificity for the detection of proximal-vein

  10. Annual diagnosis rate of superficial vein thrombosis of the lower limbs: the STEPH community-based study.

    Science.gov (United States)

    Frappé, P; Buchmuller-Cordier, A; Bertoletti, L; Bonithon-Kopp, C; Couzan, S; Lafond, P; Leizorovicz, A; Merah, A; Presles, E; Preynat, P; Tardy, B; Décousus, H

    2014-06-01

    The incidence of superficial vein thrombosis (SVT) in the general adult population remains unknown. To assess the annual diagnosis rate of symptomatic, objectively confirmed lower limb SVT, associated or not with concomitant deep vein thrombosis and/or symptomatic pulmonary embolism. We conducted, from November 14, 2011, to November 13, 2012, a multicenter, community-based study in the Saint-Etienne urban area, France, representing a population of 265 687 adult residents (according to the 2009 census). All 248 general practitioners located within the area were asked to refer any patient with clinically suspected lower limb acute SVT to a vascular physician for systematic compression ultrasonography. All 28 vascular physicians located within the area participated in the study. The annual diagnosis rate, with the corresponding 95% confidence interval (CI), was calculated as the number of patients with symptomatic, objectively confirmed SVT divided by the number of person-years at risk defined by population data of the area. All venous thromboembolic events were validated by an independent central adjudication committee. Overall, 171 patients with symptomatic, confirmed SVT were reported. The annual diagnosis rate was 0.64& (95% CI, 0.55%-0.74&), was higher in women, and increased with advancing age regardless of gender [corrected]. Concomitant deep vein thrombosis (20 proximal) was observed in 42 patients (24.6% [95% CI, 18.3%-31.7%]), and concomitant symptomatic pulmonary embolism was observed in eight patients (4.7% [95% CI, 2.0%-9.0%]). This first community-based study showed that symptomatic SVT with confirmed diagnosis is a relatively common disease frequently associated with thromboembolic events in the deep venous system. © 2014 International Society on Thrombosis and Haemostasis.

  11. Comparing study with two venous approaches of antegrade catheterization for thrombolysis in acute iliofemoral deep vein thrombosis

    International Nuclear Information System (INIS)

    Su Haobo; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Chen Guoping; Song Jinhua; Wang Tao

    2008-01-01

    Objective: To evaluate the clinical effectiveness of catheterization via the great saphenous vein for thrombolysis in acute iliofemoral deep vein thrombosis (IFVT). Methods: Patients with documented acute iliofemoral deep vein thrombosis were divided into two groups. Patients in group A received CDT with venous access through the ipsilateral great saphenous vein. The patients in group B received CDT via the ipsilateral popliteal vein. Clinical efficacy was evaluated by measuring the circumferences between the normal and affected limbs before and after treatment; the venous patency score, the rate of patency improvement based on venographic results; and the clinical results including the limbs edema reduction rate, the mean punctuation duration and complications; were all compared between the two groups. Results: The total effective rates between group A and group B showed no significant difference (95.2% vs 96%, P = 0.549); including the limbs edema reduction rates(86.6 ± 20.0% vs 85.7 ± 14.6%, P=0.868), likewise, the rates of venous patency improvement(57.9 ± 19.4% vs 57.7 ± 19.3%, P=0.968). The mean punctuation duration of group A was remarkable less than that of group B (7.3 minutes vs 16.7 minutes, P<0.05). The incidence of complications at the site of insertion in group A was lower than that in group B (P<0.05). Conclusions: The great saphenous vein is a new alternative access site for antegrade catheterization in catheter-directed thrombolysis for treatment of acute IFVT; more convenient and safe than popliteal venous approach. (authors)

  12. Comparative value of noninvasive testing for diagnosis and surveillance of deep vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Comerota, A.J.; Katz, M.L.; Grossi, R.J.; White, J.V.; Czeredarczuk, M.; Bowman, G.; DeSai, S.; Vujic, I.

    1988-01-01

    This is a prospective analysis of 351 patients in two distinct groups undergoing ascending phlebography, impedance plethysmography (IPG), and/or phleborheography (PRG) within the same 24-hour period. One hundred twenty patients also had a /sup 125/I-fibrinogen uptake test (RFUT). The two patient groups consisted of the following: those patients evaluated because of suspicion of deep vein thrombosis (DVT) (diagnostic) and those patients at high risk for postoperative DVT (total joint replacement) who had routine noninvasive testing and ascending phlebography (surveillance). The overall sensitivities for IPG and PRG were significantly better in the diagnosis group (71% (69 of 97 patients) and 78% (82 of 105), respectively) compared with the surveillance group (20% (14 of 71) and 27% (17 of 63), respectively) (p less than 0.0001). The sensitivities for IPG and PRG detecting proximal (A/K) thrombi was 83% (68 of 82 patients) and 92% (79 of 86) in the diagnosis group compared with 32% (11 of 34) and 33% (9 of 27) in the surveillance group (p less than 0.0001). Although there was no difference in overall incidence of DVT between the diagnosis group (56%, 118 of 212 patients) and the surveillance group (55%, 76 of 139), the results can be explained by the difference in A/K thrombi (84% (99 of 118) and 47% (36 of 76)) (p less than 0.001) and occlusive A/K thrombi (84% (58 of 69) and 23% (7 of 31)) (p less than 0.0001), respectively. Of the patients with A/K thrombi, 97% (67 of 69) in the diagnosis group had hemodynamically detectable thrombi compared with only 48% (12 of 25) in the surveillance group (p less than 0.001). Combining the RFUT with the noninvasive studies for surveillance significantly improved the sensitivity for both A/K and distal thrombi.

  13. Ageing, deep vein thrombosis and male gender predict poor outcome after acute Achilles tendon rupture.

    Science.gov (United States)

    Arverud, E Domeij-; Anundsson, P; Hardell, E; Barreng, G; Edman, G; Latifi, A; Labruto, F; Ackermann, P W

    2016-12-01

    Patients with an acute Achilles tendon rupture (ATR) take a long time to heal, have a high incidence of deep vein thrombosis (DVT) and widely variable functional outcomes. This variation in outcome may be explained by a lack of knowledge of adverse factors, and a subsequent shortage of appropriate interventions. A total of 111 patients (95 men, 16 women; mean age 40.3, standard deviation 8.4) with an acute total ATR were prospectively assessed. At one year post-operatively a uniform outcome score, Achilles Combined Outcome Score (ACOS), was obtained by combining three validated, independent, outcome measures: Achilles tendon Total Rupture Score, heel-rise height test, and limb symmetry heel-rise height. Predictors of ACOS included treatment; gender; age; smoking; body mass index; time to surgery; physical activity level pre- and post-injury; symptoms; quality of life and incidence of DVT. There were three independent variables that correlated significantly with the dichotomised outcome score (ACOS), while there was no correlation with other factors. An age of less than 40 years old was the strongest independent predictor of a good outcome one year after ATR (odds ratio (OR) 0.20, 95% confidence interval (CI) 0.08 to 0.51), followed by female gender (OR) 4.18, 95% CI 1.01 to 17.24). Notably, patients who did not have a DVT while immobilised post-operatively had a better outcome (OR 0.31, 95% CI 0.12 to 0.80). Over the age of 40 years, male gender and having a DVT while immobilised are independent negative predictors of outcome in patients with an acute ATR. Cite this article: Bone Joint J 2016;98-B:1635-41. ©2016 The British Editorial Society of Bone & Joint Surgery.

  14. Portal vein thrombosis before and after transjugular intrahepatic portosystemic shunt placement: An observational study (STROBE compliant).

    Science.gov (United States)

    Wan, Yue-Meng; Li, Yu-Hua; Wu, Hua-Mei; Xu, Zhi-Yuan; Xu, Ying; Yang, Li-Hong; Wu, Xi-Nan; Yang, Jin-Hui

    2017-11-01

    Portal vein thrombosis (PVT) is common in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS). This study had 3-fold aims: to assess risk factors for PVT; to determine the efficacy of anticoagulant therapy; to investigate the impact of PVT on clinical outcomes in TIPS-treated cirrhosis.Between June 2012 and February 2016, 126 TIPS-treated patients with cirrhosis were enrolled and studied prospectively. Enrolled patients were screened for PVT before TIPS and at 3, 6, 12, and 24 months post-TIPS. All patients received warfarin (1.5-3.0 mg/day) or aspirin (100 mg/day) or clopidogrel (75 mg/day) post-TIPS. Results of patients with and without PVT (baseline and de novo) were compared.White blood cell (WBC) counts (odds ratio (OR): 0.430, 95% confidence interval (CI): 0.251-0.739, P = .002) and Child-Turcotte-Pugh (CTP) score (OR: 2.377, 95% CI: 1.045-5.409, P = .039) were significant baseline predictors for PVT in TIPS-treated patients with cirrhosis. Warfarin resulted in markedly greater rates of complete recanalization than aspirin or clopidogrel (P < .05) in patients with PVT. Patients with PVT had markedly higher 2-year cumulative rates of variceal rebleeding, shunt dysfunction, hepatic encephalopathy, and hepatocellular carcinoma, and prominently lower overall survival than those without PVT (P < .05).In TIPS-treated patients with cirrhosis, lower WBC count and higher CTP score were independent baseline predictors for PVT; patients with PVT had worse clinical outcomes than those without; warfarin may be more effective in recanalizing PVT than aspirin or clopidogrel.

  15. Comparative value of noninvasive testing for diagnosis and surveillance of deep vein thrombosis

    International Nuclear Information System (INIS)

    Comerota, A.J.; Katz, M.L.; Grossi, R.J.; White, J.V.; Czeredarczuk, M.; Bowman, G.; DeSai, S.; Vujic, I.

    1988-01-01

    This is a prospective analysis of 351 patients in two distinct groups undergoing ascending phlebography, impedance plethysmography (IPG), and/or phleborheography (PRG) within the same 24-hour period. One hundred twenty patients also had a 125 I-fibrinogen uptake test (RFUT). The two patient groups consisted of the following: those patients evaluated because of suspicion of deep vein thrombosis (DVT) (diagnostic) and those patients at high risk for postoperative DVT (total joint replacement) who had routine noninvasive testing and ascending phlebography (surveillance). The overall sensitivities for IPG and PRG were significantly better in the diagnosis group (71% [69 of 97 patients] and 78% [82 of 105], respectively) compared with the surveillance group (20% [14 of 71] and 27% [17 of 63], respectively) (p less than 0.0001). The sensitivities for IPG and PRG detecting proximal (A/K) thrombi was 83% (68 of 82 patients) and 92% (79 of 86) in the diagnosis group compared with 32% (11 of 34) and 33% (9 of 27) in the surveillance group (p less than 0.0001). Although there was no difference in overall incidence of DVT between the diagnosis group (56%, 118 of 212 patients) and the surveillance group (55%, 76 of 139), the results can be explained by the difference in A/K thrombi (84% [99 of 118] and 47% [36 of 76]) (p less than 0.001) and occlusive A/K thrombi (84% [58 of 69] and 23% [7 of 31]) (p less than 0.0001), respectively. Of the patients with A/K thrombi, 97% (67 of 69) in the diagnosis group had hemodynamically detectable thrombi compared with only 48% (12 of 25) in the surveillance group (p less than 0.001). Combining the RFUT with the noninvasive studies for surveillance significantly improved the sensitivity for both A/K and distal thrombi

  16. Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Edeline, Julien [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Inserm UMR991, Rennes (France); Crouzet, Laurence; Pracht, Marc; Boucher, Eveline [Centre Eugene Marquis, Medical Oncology Department, Rennes (France); Campillo-Gimenez, Boris [Centre Eugene Marquis, Clinical Research Department, Rennes (France); Rolland, Yan; Rohou, Tanguy [Centre Eugene Marquis, Imaging Department, Rennes (France); Guillygomarc' h, Anne [CHU Pontchaillou, Hepatology Department, Rennes (France); Boudjema, Karim [CHU Pontchaillou, Hepatobiliary Surgery, Rennes (France); Lenoir, Laurence [Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France); Adhoute, Xavier [Hopital Saint-Joseph, Hepato-Gastroenterology Department, Marseille (France); Clement, Bruno [Inserm UMR991, Rennes (France); Blanc, Jean-Frederic [Hopital Saint-Andre, Hepato-Gastroenterology Department, Bordeaux (France); Garin, Etienne [Inserm UMR991, Rennes (France); Centre Eugene Marquis, Nuclear Medicine Department, Rennes (France)

    2016-04-15

    Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or {sup 90}Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population. We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model. A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39-0.97] (p = 0.037) and 0.40 (95 % CI 0.19-0.82) (p = 0.013), respectively. SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials. (orig.)

  17. Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis.

    Science.gov (United States)

    Edeline, Julien; Crouzet, Laurence; Campillo-Gimenez, Boris; Rolland, Yan; Pracht, Marc; Guillygomarc'h, Anne; Boudjema, Karim; Lenoir, Laurence; Adhoute, Xavier; Rohou, Tanguy; Boucher, Eveline; Clément, Bruno; Blanc, Jean-Frédéric; Garin, Etienne

    2016-04-01

    Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or (90)Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population. We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model. A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39-0.97] (p = 0.037) and 0.40 (95 % CI 0.19-0.82) (p = 0.013), respectively. SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials.

  18. [Cost-effectiveness of the deep vein thrombosis diagnosis process in primary care].

    Science.gov (United States)

    Fuentes Camps, Eva; Luis del Val García, José; Bellmunt Montoya, Sergi; Hmimina Hmimina, Sara; Gómez Jabalera, Efren; Muñoz Pérez, Miguel Ángel

    2016-04-01

    To analyse the cost effectiveness of the application of diagnostic algorithms in patients with a first episode of suspected deep vein thrombosis (DVT) in Primary Care compared with systematic referral to specialised centres. Observational, cross-sectional, analytical study. Patients from hospital emergency rooms referred from Primary Care to complete clinical evaluation and diagnosis. A total of 138 patients with symptoms of a first episode of DVT were recruited; 22 were excluded (no Primary Care report, symptoms for more than 30 days, anticoagulant treatment, and previous DVT). Of the 116 patients finally included, 61% women and the mean age was 71 years. Variables from the Wells and Oudega clinical probability scales, D-dimer (portable and hospital), Doppler ultrasound, and direct costs generated by the three algorithms analysed: all patients were referred systematically, referral according to Wells and Oudega scale. DVT was confirmed in 18.9%. The two clinical probability scales showed a sensitivity of 100% (95% CI: 85.1 to 100) and a specificity of about 40%. With the application of the scales, one third of all referrals to hospital emergency rooms could have been avoided (P<.001). The diagnostic cost could have been reduced by € 8,620 according to Oudega and € 9,741 according to Wells, per 100 patients visited. The application of diagnostic algorithms when a DVT is suspected could lead to better diagnostic management by physicians, and a more cost effective process. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  19. Usefulness of clinical predictors for preoperative screening of deep vein thrombosis in hip fractures.

    Science.gov (United States)

    Luksameearunothai, Kitchai; Sa-Ngasoongsong, Paphon; Kulachote, Noratep; Thamyongkit, Sorawut; Fuangfa, Praman; Chanplakorn, Pongsthorn; Woratanarat, Patarawan; Suphachatwong, Chanyut

    2017-05-22

    Recent studies showed that preoperative deep vein thrombosis (DVT) was common after hip fracture (HF), and preoperative DVT screening has been recommended for preventing the fatal DVT-related complications, especially in elderly HF patients with high surgical risk. However, to our knowledge, no previous studies have demonstrated the correlation between the clinical risk predictors and preoperative DVT. Therefore, this study aimed to correlate those clinical predictors related to DVT risk assessment with the incidence of preoperative DVT. A prospective study was conducted, between July 2015 and June 2016, in 92 HF patients. All patients were evaluated for the DVT-related risk, as patients' characteristics, clinical signs, D-dimer, DVT risk assessment score (Wells score and Caprini score), and then underwent doppler ultrasonography preoperatively. The incidence of preoperative DVT was correlated with each clinical risk predictor, and then significant factors were calculated for diagnostic accuracy. The average patients' age was 78 ± 10 years. Sixty-eight patients (74%) were female. The incidence of preoperative DVT was 16.3% (n = 15). The median time from injury to doppler ultrasonography was 2 days (range 0-150 days). DVT group showed a significantly higher in Wells score and Caprini score compared to the non-DVT group (p preoperative DVT in elderly HFs. Those with Caprini score ≥ 12 should be screened with doppler ultrasonography preoperatively. Those with Wells score 0-1 had low risk for preoperative DVT, so the surgery could perform without delay.

  20. Clinical and laboratory predictors of deep vein thrombosis after acute stroke.

    Science.gov (United States)

    Balogun, Ibrahim O; Roberts, Lara N; Patel, Raj; Pathansali, Rohan; Kalra, Lalit; Arya, Roopen

    2016-06-01

    Deep vein thrombosis (DVT) is a common complication of acute stroke, but the new incidence in the era of improved specialist input in stroke care is yet unknown. The models for VTE diagnosis is well established, but prediction models to target at-risk patients for pharmacological prophylaxis is lacking and requires further research, particularly in the aftermath of acute stroke. To predict DVT after acute stroke using markers of haemostatic activation and stroke severity scores. We examined the clinical utility of laboratory factors such as thrombin generation, D-dimer, fibrinogen alongside clinical factors (National Institute of Health Stroke Scale and Barthel Index) in the prediction of asymptomatic DVT, among 92 consecutively admitted patients. One in five patients (19.6%) had objectively confirmed DVT (6 proximal, 12 distal). Thrombolytic therapy did not protect against DVT, with 21% (6/29) of patients treated with r-tPA went on to develop DVT. Thrombin generation and fibrinogen had no clinical utility, but D-dimer at baseline and week 2 had high clinical potential in the prediction of asymptomatic DVT (2425ng/mL versus 1010ng/mL; p=0.001) and (2240 Vs 970ng/mL; pstroke severity, and are functionally less able, with lower Barthel index (p=0.05), and high National Institute of Health Stroke Score (p=0.07). Thrombolytic therapy and specialist stroke intervention does not protect against DVT risk. D-dimer concentration within 48h of acute stroke is independently associated with development of DVT. This observation would require confirmation in a large study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Comparison of Systemic Thrombolysis Versus Indirect Thrombolysis via the Superior Mesenteric Artery in Patients with Acute Portal Vein Thrombosis.

    Science.gov (United States)

    Liu, Kun; Li, Wen-Dong; Du, Xiao-Long; Li, Cheng-Long; Li, Xiao-Qiang

    2017-02-01

    The aim of this study was to evaluate the safety and efficacy of indirect thrombolysis via the superior mesenteric artery (SMA) in patients with acute portal vein thrombosis. Over 10 years, we studied the safety and efficacy of indirect thrombolysis via the SMA in 34 patients with acute portal vein thrombosis. Eighteen patients were categorized as the systemic thrombolysis (ST) group and 16 as the catheter thrombolysis (CT) group. The ST group was administered low-molecular-weight heparin, and patients in the CT group received catheter thrombolysis. Clinical data, such as comorbidities, laboratory test results, therapeutic methods, and prognosis, were recorded. All the patients underwent a routine clinical follow-up that was performed by inpatient examinations or outpatient visits at a mean follow-up time of 34 months. The thrombus score was significantly higher in the ST group (3.67 ± 1.19) than in the CT group (2.38 ± 0.62) after 2 weeks of treatment (P thrombosis compared with systemic thrombolysis. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. An Unexpectedly High Rate of Thrombophilia Disorders in Patients with Superficial Vein Thrombosis of the Lower Extremities.

    Science.gov (United States)

    Sobreira, Marcone Lima; Rogatto, Silvia Regina; Dos Santos, Rodrigo Mattos; Santos, Izolete Thomazini; Ferrari, Iracema Carvalho; Yoshida, Winston Bonetti

    2017-08-01

    Superficial vein thrombosis (SVT) is a common venous condition. Recent studies have shown that SVT is associated with high frequency of thromboembolic complications: from 22-37% for deep venous thrombosis and up to 33% for pulmonary embolism. Our goal was to assess the prevalence of major hereditary and acquired thrombophilic factors in patients with SVT. Sixty-six patients presenting with primary SVT underwent evaluation for thrombophilia: molecular testing for the factor V Leiden and factor II G20210 A (prothrombin) mutations, protein C, protein S, antithrombin deficiency, presence of lupus anticoagulant, as well as anticardiolipin antibody titers. Patients aged less than 18 years, with confirmed deep vein thrombosis, and pregnant women were excluded. 95.5% were Caucasian, and 62.1% were female gender. Age ranged from 21-88 years. Molecular testing showed that 34.2% of patients were heterozygous for factor V Leiden, 23.6% were heterozygous for the factor II mutation, 7.8% had antithrombin deficiency, 2.6% had protein S deficiency, and 2.1% had protein C deficiency. Our study showed that hereditary and acquired thrombophilias are higher than previously expected and reported. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Predictive factors for concurrent deep-vein thrombosis and symptomatic venous thromboembolic recurrence in case of superficial venous thrombosis. The OPTIMEV study.

    Science.gov (United States)

    Galanaud, Jean-Philippe; Genty, Celine; Sevestre, Marie-Antoinette; Brisot, Dominique; Lausecker, Michel; Gillet, Jean-Luc; Rolland, Carole; Righini, Marc; Leftheriotis, Georges; Bosson, Jean-Luc; Quere, Isabelle

    2011-01-01

    Superficial venous thrombosis (SVT) prognosis is debated and its management is highly variable. It was the objective of this study to assess predictive risk factors for concurrent deep-vein thrombosis (DVT) at presentation and for three-month adverse outcome. Using data from the prospective multicentre OPTIMEV study, we analysed SVT predictive factors associated with concurrent DVT and three-month adverse outcome. Out of 788 SVT included, 227 (28.8%) exhibited a concurrent DVT at presentation. Age >75years (odds ratio [OR]=2.9 [1.5-5.9]), active cancer (OR=2.6 [1.3-5.2]), inpatient status (OR=2.3 [1.2-4.4]) and SVT on non-varicose veins (OR=1.8 [1.1-2.7]) were significantly and independently associated with an increased risk of concurrent DVT. 39.4% of SVT on non-varicose veins presented a concurrent DVT. However, varicose vein status did not influence the three-month prognosis as rates of death, symptomatic venous thromboembolic (VTE) recurrence and major bleeding were equivalent in both non-varicose and varicose SVTs (1.4% vs. 1.1%; 3.4% vs. 2.8%; 0.7% vs. 0.3%). Only male gender (OR=3.5 [1.1-11.3]) and inpatient status (OR=4.5 [1.3-15.3]) were independent predictive factors for symptomatic VTE recurrence but the number of events was low (n=15, 3.0%). Three-month numbers of deaths (n=6, 1.2%) and of major bleedings (n=2, 0.4%) were even lower, precluding any relevant interpretation. In conclusion, SVT on non-varicose veins and some classical risk factors for DVT were predictive factors for concurrent DVT at presentation. As SVT remains mostly a clinical diagnosis, these data may help selecting patients deserving an ultrasound examination or needing anticoagulation while waiting for diagnostic tests. Larger studies are needed to evaluate predictive factors for adverse outcome.

  4. Statins improve the resolution of established murine venous thrombosis: reductions in thrombus burden and vein wall scarring.

    Directory of Open Access Journals (Sweden)

    Chase W Kessinger

    Full Text Available Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT will develop the post-thrombotic syndrome (PTS. Improving the long-term outcome of DVT patients at risk for PTS will therefore require new approaches. Here we investigate the effects of statins--lipid-lowering agents with anti-thrombotic and anti-inflammatory properties--in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice. Treatment of mice with daily atorvastatin or rosuvastatin significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi compared similarly to the therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1, tissue factor, neutrophils, myeloperoxidase, neutrophil extracellular traps (NETs, and macrophages, and these effects were most notable in the earlier timepoints after DVT formation. In addition, statins reduced DVT-induced vein wall scarring by 50% durably up to day 21 in stasis VT, as shown by polarized light microscopy of picrosirius red-stained vein wall collagen. The overall results demonstrate that statins improve VT resolution via profibrinolytic, anticoagulant, antiplatelet, and anti-vein wall scarring effects. Statins may therefore offer a new pharmacotherapeutic approach to improve DVT resolution and to reduce the post-thrombotic syndrome, particularly in subjects who are ineligible for anticoagulation therapy.

  5. Aspectos ultra-sonográficos da trombose da veia porta Ultrasonographic features of portal vein thrombosis

    Directory of Open Access Journals (Sweden)

    Márcio Martins Machado

    2006-04-01

    Full Text Available A trombose da veia porta pode estar associada a várias alterações, como a presença de tumores (por exemplo: hepatocarcinoma, doença metastática hepática e carcinoma do pâncreas, pancreatite, hepatite, septicemia, trauma, esplenectomia, derivações porto-cava, estados de hipercoagulabilidade (por exemplo: gravidez, em neonatos (por exemplo: onfalite e cateterização da veia umbilical e desidratação aguda. Os autores discutem, neste artigo, os aspectos ultra-sonográficos da trombose de veia porta e alguns aspectos de relevância clínica.Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy, in neonates (for example, omphalitis and umbilical vein catheterization and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.

  6. Lower limb and portal veins echography for predicting risk of thrombosis during a 90-day bed rest

    Science.gov (United States)

    Arbeille, P. A.; Kerbeci, P.; Porcher, M.; Audebert, P.; Mohty, D.

    2005-08-01

    The objective was to investigate the main leg, Portal, Jugular veins, and cardiac chambers during a long term head down bedrest (90 days). The population consisted of a control group (Co-gr, n=9) and an exercise Fly wheel counter- measure group (CM-gr, n=9). Method: Internal Saphenous, Common/Superficial Femoral, Popliteal, Posterior Tibial, Gastrocnemian, Portal Jugular veins and Cardiac chambers were investigated by echography. Results: The echographies were performed at HDBR day 28, 60 and 85. All veins and cardiac chambers, on all subjects showed a lumen dark (no structure inside) and were perfectly compressible under the probe pressure except cardiac chambers and Portal vein anatomically not compressible. Conclusion: (a) There was no sign of venous flow stagnation nor venous thrombosis on any subjects at any time during the 90 days in bedrest. (b) There was no difference between the control and the exercise subjects (c) The Cardiac chambers were found normal but the Jugular veins were enlarged at the end of the HDBR.

  7. Inferior vena cava atresia predisposing to acute lower extremity deep vein thrombosis in children: A descriptive dual-center study.

    Science.gov (United States)

    Tarango, Cristina; Kumar, Riten; Patel, Manish; Blackmore, Anne; Warren, Patrick; Palumbo, Joseph S

    2018-02-01

    Thrombosis in the healthy pediatric population is a rare occurrence. Little is known about the optimal treatment or outcomes of children with unprovoked acute lower extremity (LE) deep vein thrombosis (DVT) associated with atresia of the inferior vena cava (IVC). We retrospectively analyzed the records of patients with acute LE DVT subsequently found to have IVC atresia who presented to two tertiary pediatric institutions between 2008 and 2016. Data were reviewed for thrombophilia risk factors, treatment, and outcomes. Eighteen patients, aged 13-18 years (median: 16 years), presenting with acute LE DVT were found to have IVC atresia. Three patients also presented with pulmonary embolism. Fourteen patients underwent site-directed thrombolysis in addition to anticoagulation. Five patients (28%) had confirmed or suspected recurrent thrombosis. Thirteen patients (72%) had no identified provocation for DVT. Ten patients (56%) had post-thrombotic syndrome, and 17 of 18 patients remain on indefinite anticoagulation. This study suggests that IVC atresia is a risk factor for LE DVT and pulmonary embolism in otherwise healthy children and highlights the importance of dedicated imaging of the IVC in young patients with unprovoked LE DVT. Indefinite anticoagulation may be considered in pediatric patients presenting with unprovoked thrombosis secondary to an atretic IVC. © 2017 Wiley Periodicals, Inc.

  8. Antiphospholipid syndrome presenting as acute mesenteric venous thrombosis involving a variant inferior mesenteric vein and successful treatment with rivaroxaban.

    Science.gov (United States)

    Singh, Kevin; Khan, Gulam

    2018-03-26

    Acute mesenteric venous thrombosis (MVT) is the rarest cause of acute mesenteric ischaemia, so thrombosis of a variant inferior mesenteric vein (IMV) is especially uncommon in the setting of antiphospholipid syndrome (APS). Here, we present such a case of seronegative APS initially manifesting as an anomalous IMV thrombosis in a 76-year-old woman. Although guidelines support anticoagulation with vitamin K antagonists in these patients, we anticoagulated with rivaroxaban (a direct oral anticoagulant (DOAC)) due to patient preference, which resulted in complete clinical and endoscopic resolution. IMV thrombosis is a rare form of MVT, only two case reports describe successful anticoagulation with DOACs in the setting of MVT and none report APS as an underlying aetiology. Therefore, this case provides the opportunity to review the pathophysiology of MVT, APS and their medical management including current trends in anticoagulation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis.

    Science.gov (United States)

    Klinger, Christoph; Riecken, Bettina; Schmidt, Arthur; De Gottardi, Andrea; Meier, Benjamin; Bosch, Jaime; Caca, Karel

    2018-03-01

    To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1). Treatment consisted of a combination of transjugular balloon angioplasty, mechanical thrombectomy, and-depending on extent of residual thrombosis-transjugular intrahepatic portosystemic shunt and additional stenting of the portal venous system. Recanalization was successful in 76.5 % of patients despite cavernous transformation in 88.2 %. Both 1- and 2-year secondary PV and TIPS patency rates were 69.5 %. Procedure-related bleeding complications occurred in 2 patients (intraperitoneal bleeding due to capsule perforation, n = 1; liver hematoma, n = 1) and resolved spontaneously. However, 1 patient died due to subsequent nosocomial pneumonia. During follow-up, 3 patients with TIPS occlusion and PVT recurrence experienced portal hypertensive complications. PVR-TIPS is safe and effective in selected patients with chronic non-cirrhotic PVT. Due to technical complexity and possible complications, it should be performed only in specialized centers with high experience in TIPS procedures. © Georg Thieme Verlag KG Stuttgart · New York.

  10. [Soleus veins: anatomic basis and their role in the origin of deep venous lower limb thrombosis].

    Science.gov (United States)

    Sequeira, Carlos Miguel Gomes; Juliano, Yara; Novo, Neil Ferreira; Mayall, Rubens Carlos; Miranda, Fausto

    2007-01-01

    Study of the number, sectorization and termination of the soleus veins. Meticulous, stratigraphical, anatomical dissections were carried out in the posterior crural region of 100 legs of 50 fresh cadavers. Those belonging to subjects with congenital or acquired pathologies in the lower limbs were disregarded. After the skin was reflected on both sides, dissection of superficial and perforating veins, was performed. Then reflection of the subcutaneous tissue and fascia, detachment and reflection of the gastrocnemius and plantaris muscles, detachment of the tibial origin of the soleus muscle, differentiation of the soleus veins and study of morphometric parameters were carried out. The region was divided into six sectors: superior-medial, superior-lateral, medio-medial, medio-lateral, inferior-medial and inferior-lateral. Data obtained from Wilcoxon and Friedman nonparametric tests were utilized for statistical analysis. In the dissected legs 4679 soleus veins were found. The sector with the greatest number of soleus veins was the superior-lateral (1529 veins - 32.7%), followed by the mediomedial (1.256 veins - 26.8%) and the mediolateral sectors (975 veins - 20.8%). The extremities drained into communicant veins (1.207 veins - 25.8%), posterior tibial veins (964 veins - 20.6%), peroneal veins (709 veins - 15.2%) and into 32 other types (1.799 veins 38.4%). The venous drainage of the soleus muscle is carried out by a great number of soleus veins which are frequently located in the superior-lateral, mediomedial and mediolateral sectors, more often going into the posterior tibial, peroneal and communicant veins.

  11. Confirmation of T1-Bright Vein of Galen Aneurysm Spontaneous Thrombosis by Subtraction Magnetic Resonance Venography: A Case Report

    International Nuclear Information System (INIS)

    Irfan, M.; Lohman, B.; McKinney, A.M.

    2009-01-01

    Spontaneous thrombosis of a vein of Galen aneurysmal malformation (VOGM) is rare. We describe a 2-month-old patient with a patent VOGM and hydrocephalus, also confirmed patent at 6 months, but with subsequent lack of filling on pre-embolization catheter digital subtraction angiography (DSA) at 9 months' age. Due to the presence of T1- and T2-bright signal, noncontrast T1-weighted images (T1WI), T2-weighted images (T2WI), two-dimensional (2D) time-of-flight (TOF) magnetic resonance venography (MRV), and postcontrast T1WI were ambiguous for patency. However, subtracting the pre- from the postcontrast MRV images confirmed closure compared to subtracted images at 6 months' age. The factors contributing to thrombosis were likely a combination of a disproportionately small straight sinus, ventriculostomy, and contrast medium from DSA

  12. [A Case of Transverse Colon Cancer with Liver Metastasis and Tumor Thrombosis of Portal Vein Effectively Treated with Chemotherapy].

    Science.gov (United States)

    Aida, Toshiaki; Shiobara, Masayuki; Wakatsuki, Kazuo; Arai, Shuka; Suda, Kosuke; Miyazawa, Kotaro; Miyoshi, Tetsutaro; Takahashi, Yoshihisa; Yoshioka, Shigeru

    2018-02-01

    The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects. In CT and FDG-PET examination after 8 courses of IRIS, the tumor of transverse colon, liver metastasis, and the tumor thrombosis of portalvein became unclear. A year and 6 months have passed since chemotherapy was started, recurrence was not observed. For the patients with unresectable colorectal cancer, it is necessary to consider multidisciplinary treatments including chemotherapy while considering the general condition of them.

  13. Confirmation of T1-Bright Vein of Galen Aneurysm Spontaneous Thrombosis by Subtraction Magnetic Resonance Venography: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Irfan, M.; Lohman, B.; McKinney, A.M. (Dept. of Radiology/Neuroradiology, Univ. of Minnesota, Minneapolis, Minnesota (United States))

    2009-08-15

    Spontaneous thrombosis of a vein of Galen aneurysmal malformation (VOGM) is rare. We describe a 2-month-old patient with a patent VOGM and hydrocephalus, also confirmed patent at 6 months, but with subsequent lack of filling on pre-embolization catheter digital subtraction angiography (DSA) at 9 months' age. Due to the presence of T1- and T2-bright signal, noncontrast T1-weighted images (T1WI), T2-weighted images (T2WI), two-dimensional (2D) time-of-flight (TOF) magnetic resonance venography (MRV), and postcontrast T1WI were ambiguous for patency. However, subtracting the pre- from the postcontrast MRV images confirmed closure compared to subtracted images at 6 months' age. The factors contributing to thrombosis were likely a combination of a disproportionately small straight sinus, ventriculostomy, and contrast medium from DSA.

  14. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs.

    Science.gov (United States)

    Trujillo-Santos, Javier; Lozano, Francisco; Lorente, Manuel Alejandro; Adarraga, Dolores; Hirmerova, Jana; Del Toro, Jorge; Mazzolai, Lucia; Barillari, Giovanni; Barrón, Manuel; Monreal, Manuel

    2015-01-01

    No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. [Jugular vein thrombosis caused by hypercoagulability following in-vitro fertilization-activated protein C resistance and immobilization].

    Science.gov (United States)

    Stölzel, K; Jovanovic, S; Albers, A E

    2013-03-01

    Jugular vein thrombosis (JVT) is extremely difficult to diagnose clinically because of its rarity, the wide range of possible symptoms and the variety of differential diagnoses. A rapid diagnosis is important in order to avoid or prevent imminent life-threatening complications. This study reports a clinical case of extensive JVT due to increased thrombophilia in conjunction with ovarian hyperstimulation syndrome (OHSS) after in vitro fertilization, increased APC resistance and immobilization. It also discusses the current literature that forms the basis for recommendations regarding the diagnosis, therapy and interdisciplinary management.

  16. Diagnosis of deep vein thrombosis of the lower limbs with scintigraphy of red blood cells labelled with 99m technetium

    International Nuclear Information System (INIS)

    Derbekyan, V.; Novalees-Diaz, J.A.; Lisbona, R.

    1986-01-01

    The clinical diagnosis of leg deep vein thrombosis (DVT) is notoriously unreliable. It must be supplemented by objective techniques which all have drawbacks. 99m Tc-RBC venography also has its limitations, yet it is a simple, safe, and useful test for diagnosing DVT of the lower limb. When done carefully, it is a rewarding procedure with good sensitivity and specificity for the condition both in the calf and ilio-femoral regions. Blood pool venography is readily accessible to all nuclear medicine department for the diagnosis of thrombophlebitis and also the follow-up of treated patients

  17. Peripartum Isolated Cortical Vein Thrombosis in a Mother with Postdural Puncture Headache Treated with an Epidural Blood Patch

    Directory of Open Access Journals (Sweden)

    Etienne Laverse

    2013-01-01

    Full Text Available A 32-year-old woman presented with low pressure headache 3 days after delivery of her baby. An assessment of postdural puncture headache was made. This was initially treated with analgesia, caffeine, and fluids for the presumed cerebrospinal fluid (CSF leak. The woman was readmitted two days after her hospital discharge with generalised seizures. A brain scan showed features of intracranial hypotension, and she was treated for CSF leak using an epidural blood patch. Her symptoms worsened and three days later, she developed a left homonymous quadrantanopia. An MRI scan confirmed a right parietal haematoma with evidence of isolated cortical vein thrombosis (ICVT.

  18. [Thrombosis of the superficial femoral vein due to psoas bursitis secondary to particle disease in total hip arthroplasty].

    Science.gov (United States)

    Lax-Pérez, R; Salinas-Gilabert, J E; Lajara-Marco, F; Lax-Pérez, A; Corraliza-Zamorano, A; García-Gálvez, A; Izquierdo-Plazas, L

    2011-01-01

    The case of a male 76 year-old patient with a history of total hip replacement surgery is presented herein. The patient had tumors in the iliac fossa with swelling of the thigh and pain upon hip flexion and extension. The complementary ultrasound and computed tomography show a large lobed cystic tumor in the left iliac fossa, 7 cm in diameter, close to the prosthesis. The diagnosis was psoas bursitis secondary to the release of polyethylene particles that caused compression and thrombosis of the superficial femoral vein. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent.

  19. [Superficial femoral vein thrombosis due to large psoas bursitis secondary to particle disease in total hip arthroplasty].

    Science.gov (United States)

    Lax-Pérez, R; Salinas-Gilabert, J E; Lajara-Marco, F; Lax-Pérez, A; Corraliza-Zamorano, A; García-Gálvez, A; Izquierdo-Plazas, L

    2012-01-01

    Male, 76 year-old patient with a history of total hip arthroplasty who presents with a mass in the iliac fossa with swelling of the thigh and hip pain upon flexion and extension. Complementary ultrasound and computed tomography scan studies show a giant lobulated cystic mass in the left iliac fossa, 7 cm in diameter, near the prosthesis. Cyst formation caused by polyethylene disease after total hip arthroplasty is infrequent. We present a case of large psoas bursitis secondary to the release of polyethylene particles which caused superficial femoral vein compression and thrombosis.

  20. [Femoral superficial vein thrombosis due to a large iliopsoas bursitis secondary to polyethylene wear debris in total hip arthroplasty].

    Science.gov (United States)

    Lax Pérez, R; Salinas Gilabert, J E; Lajara Marco, F; Lax Pérez, A; Ferrero Manzanal, F; García-Gálvez, A; Izquierdo Plazas, L

    2012-01-01

    A 76 year old male patient with a history of implantation of a total hip arthroplasty Perfecta (Orthomet(®)), who presented with an iliac fossa mass, increased diameter of the thigh, and pain during hip flexion and extension. CT and ultrasound show the presence of a giant cystic mass in left iliac fossa about 7 cm in diameter next to the prosthesis. A pseudo-tumour secondary to wear debris after placement of a total arthroplasty is rare. We present a case of a large iliopsoas bursitis caused by polyethylene particles, which caused compression and thrombosis of the superficial femoral vein. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

  1. Acute myocardial infarction, ischemic cerebrovascular disease and variceal bleeding due to portal vein thrombosis in a patient with hereditary thrombophilia.

    Science.gov (United States)

    Baran, Bulent; Yilmaz, Yusuf; Algin, Oktay; Keskin, Murat; Kiyici, Murat; Kocamaz, Guzin; Dolar, Enver

    2008-04-01

    We report on a 43-year-old female patient with multiple thrombotic risk factors who, in a few months, developed acute myocardial infarction, an ischemic cerebrovascular event and variceal bleeding due to portal vein thrombosis. The factor V Leiden mutation was carried in heterozygous form, homocysteine was elevated at 19.6 micromol/l, and methylenetetrahydrofolate reductase C677T mutation was carried in homozygous form. Moderately increased plasma homocysteine level and a reduced protein S activity were evident. Anticardiolipin IgG antibodies were mildly positive. We conclude that the presence of multiple genetic and environmental risk factors greatly amplifies the risk of clinical thrombotic events.

  2. A profile of lower-limb deep-vein thrombosis: the hidden menace of below-knee DVT

    Energy Technology Data Exchange (ETDEWEB)

    Cowell, G.W. [Department of Clinical Radiology, Royal Infirmary of Edinburgh, Edinburgh (United Kingdom); Reid, J.H. [Department of Clinical Radiology, Borders General Hospital, Melrose (United Kingdom); Simpson, A.J. [Department of Respiratory Medicine, Royal Infirmary of Edinburgh, Edinburgh (United Kingdom); Murchison, J.T. [Department of Clinical Radiology, Royal Infirmary of Edinburgh, Edinburgh (United Kingdom)]. E-mail: john.murchison@luht.scot.nhs.uk

    2007-09-15

    Aims: To describe the anatomical site and laterality of deep-vein thrombosis (DVT) in symptomatic patients using contrast venography (CV), and to assess age, sex distribution, and accuracy of pre-test clinical suspicion of DVT. Methods: One thousand, five hundred and seventy-two patients undergoing CV because of a clinical suspicion of DVT at a large teaching hospital from October 1995 to March 2003 were prospectively studied. Results: Thrombi were demonstrated in 511 (32.5%) of all CV studies. Isolated, below-knee thrombi were identified in 29.4% of positive studies. There was a left-sided predominance of DVT (ratio 1.24:1) that was most evident in the elderly and in more proximal veins. Conclusion: Almost a third of positive cases were shown to be isolated, below-knee thrombi. These are thrombi that are more difficult to detect by non-invasive means. A left-sided predominance of DVT is evident.

  3. A profile of lower-limb deep-vein thrombosis: the hidden menace of below-knee DVT

    International Nuclear Information System (INIS)

    Cowell, G.W.; Reid, J.H.; Simpson, A.J.; Murchison, J.T.

    2007-01-01

    Aims: To describe the anatomical site and laterality of deep-vein thrombosis (DVT) in symptomatic patients using contrast venography (CV), and to assess age, sex distribution, and accuracy of pre-test clinical suspicion of DVT. Methods: One thousand, five hundred and seventy-two patients undergoing CV because of a clinical suspicion of DVT at a large teaching hospital from October 1995 to March 2003 were prospectively studied. Results: Thrombi were demonstrated in 511 (32.5%) of all CV studies. Isolated, below-knee thrombi were identified in 29.4% of positive studies. There was a left-sided predominance of DVT (ratio 1.24:1) that was most evident in the elderly and in more proximal veins. Conclusion: Almost a third of positive cases were shown to be isolated, below-knee thrombi. These are thrombi that are more difficult to detect by non-invasive means. A left-sided predominance of DVT is evident

  4. Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis

    International Nuclear Information System (INIS)

    Goodacre, Steve; Sampson, Fiona; Thomas, Steve; Beek, Edwin van; Sutton, Alex

    2005-01-01

    Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy. We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance. We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US

  5. Risk factors for superficial vein thrombosis in patients with primary chronic venous disease.

    Science.gov (United States)

    Musil, Dalibor; Kaletova, Marketa; Herman, Jiri

    2016-01-01

    Primary chronic venous disease (CVD) is associated with an increased risk of superficial vein thrombosis (SVT). While CVD is a predominant factor in SVT, there is a range of additional predisposing factors. The objective was to investigate the association between age, gender, BMI, smoking, oestrogen hormone therapy, family history of venous thromboembolism (VTE) and CEAP clinical classification in patients with CVD and a history of SVT. In a retrospective observational study on consecutive patients with primary CVD, 641 outpatients were enrolled (152 men, 23.7%; 489 women, 76.3%). The prevalence of SVT was evaluated according to age, BMI, smoking, presence of family history of VTE, use of hormone therapy, and clinical class of CVD. Risk of SVT was significantly increased in women (OR 1.68, 95% CI = 1.02-2.76; p = 0.041), older patients (46-69 years, OR 1.57, 95% CI = 1.03-2.4; p = 0.036, ≥ 70 years, OR 2.93, 95% CI = 1.5-5.76; p = 0.001), smokers (OR 1.69, 95% CI = 1.1-2.58; p = 0.015) and in persons with first-degree siblings diagnosed with VTE (OR 2,28, 95% CI = 1.28-4.05; p = 0.004). The risk was significantly increased in older male smokers (p - 0.042). In women, smoking and oestrogen therapy (p = 0.495) did not increase the risk of SVT even older women or in those with increased BMI. In CVD (C0-C3), a history of episodes of SVT was found in 103/550 (18.7%), in chronic venous insufficiency (CVI) in 27/91 (29.7%). There was a significantly higher prevalence of SVT in patients with CVI (OR 1.70, 95% CI = 1.1-2.5; p = 0.016). In patients with primary CVD, SVT was significantly associated with female gender. In men, older age, smoking and positive family history of VTE were relevant SVT risk factors. In women, risk factors were older age, BMI ≥ 25 kg/m2 and positive family history of VTE. Compared with C0-C3 clinical classes, CVI significantly increases the risk of SVT.

  6. Thrombosis of the superior mesenteric vein in association with hormonal contraceptive use. A case report and review of the literature.

    Science.gov (United States)

    Gubitosi, Adelmo; Docimo, Giovanni; Avenia, Nicola; Ruggiero, Roberto; Esposito, Franceso; Esposito, Emanuela; Foroni, Fabrizio; Agresti, Massimo

    2011-01-01

    There are a number of reports in the literature which describe the association of venous thrombosis with oral contraceptives. Venous thrombosis is a rare form of mesenteric ischemia which may be lethal if not diagnosed and treated quickly. Although the non specificity of clinical signs do not always permit an early diagnosis. The patient, aged 52, with a case history characterized by alteration of the alvus with occasional emission of blood, and abdominal pain. She referred with metrorrhagia of about one year, and was being treated with Ethynylestradiol/Gestodene. A CAT scan with contrast showed the signs of thrombosis in the superior mesenteric vein. The patient underwent surgical laparotomy. On opening the peritoneum we found a large tumefaction formed of conglobate iliac loops together with intense inflammation. A resection of the tumefaction was performed "en bloc". Pharmacological contraception remains in various cases as the only identified risk factor and there are reports which also censure a relationship of greater risk with increased hormonal doses and even reports of mesenteric venous thrombosis in patients taking triphasic drugs. Thus, we may state with near certainty, that a relationship between pharmacological contraceptives and mesenteric venous thrombosis exists and is probably more than a simple risk factor in contrast to that which exists for tobacco smoking and obesity. Before the prescription of contraceptive therapy the examination of risk factors is necessary, compiled preferably by hematochemical screening to exclude haematological and/or coagulative pathologies, and not deriding the use of non-pharmalogical methods of contraception when possible. Considering the technological advancement of instrumentation (CAT scan, angiogram), even a diagnosis aimed at a suspected clinical history; starting from less invasive screening by ultrasonographic Doppler, might induce to a rapid intervention and thereby avoid sacrificing too much intestinal tissue

  7. A reporter-targeted approach to reducing the use of the term "superficial femoral vein" in ultrasound reports for deep vein thrombosis.

    Science.gov (United States)

    Brodie, Jonathan; Denton, Erika R E

    2014-10-01

    The term "superficial femoral vein" is felt to be potentially misleading and dangerous in the context of deep venous thrombosis (DVT) of the lower limb, with the preferred term now being "femoral vein." The purpose of this work was to identify a means of reducing its use in reports of lower limb sonographic scans for DVT. A retrospective search of the reports for all lower limb sonographic scans for the detection of DVT in 2011 was performed using the Radiology Information System to identify the baseline rate of use of the term. Nontargeted and subsequently targeted e-mails were then sent to reporters of such sonographic scans over a 6-month follow-up period, and the results were reevaluated. The baseline rate of use of the term was 17% before any intervention. It decreased to 10% following nontargeted intervention, and to 6% following targeted e-mail intervention. There were no cases of patients coming to harm as a result of the use of the term during the study period. A simple and inexpensive system of e-mails to reporters resulted in a decline in the rate of use of the misleading term "superficial femoral vein." © 2014 Wiley Periodicals, Inc.

  8. Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial.

    Science.gov (United States)

    Beyer-Westendorf, Jan; Schellong, Sebastian M; Gerlach, Horst; Rabe, Eberhard; Weitz, Jeffrey I; Jersemann, Katja; Sahin, Kurtulus; Bauersachs, Rupert

    2017-03-01

    Superficial-vein thrombosis can lead to deep-vein thrombosis and pulmonary embolism. Rivaroxaban, an oral factor Xa inhibitor, might simplify treatment compared with fondaparinux because it does not require daily subcutaneous injection and is cheaper. We compared efficacy outcomes in patients with superficial-vein thrombosis and additional risk factors given either rivaroxaban or fondaparinux to assess whether rivaroxaban is non-inferior to fondaparinux in the prevention of thromboembolic complications. In this open-label, masked endpoint, randomised, non-inferiority phase 3b trial, we recruited patients aged 18 years or older with symptomatic superficial-vein thrombosis from 27 sites (academic, community hospitals, and specialist practices) in Germany. We randomly assigned patients (1:1) to receive 10 mg oral rivaroxaban or 2·5 mg subcutaneous fondaparinux once a day for 45 days. Patients were eligible if they had symptomatic thrombosis (at least 5 cm in a supragenual superficial-vein segment) and at least one additional risk factor (older than 65 years, male sex, previous venous thromboembolism, cancer, autoimmune disease, thrombosis of non-varicose veins). Main exclusion criteria were: symptoms for longer than 3 weeks, thrombus within 3 cm of the sapheno-femoral junction, indication for full-dose anticoagulation therapy, and substantial hepatic or renal impairment. Randomisation was done with a central block randomisation process. The primary efficacy outcome was a composite of symptomatic deep-vein thrombosis or pulmonary embolism, progression or recurrence of superficial vein-thrombosis, and all-cause mortality at 45 days in the per-protocol population (all randomly assigned patients without major protocol violations). We used a non-inferiority margin of 4·5% (absolute difference between rivaroxaban and fondaparinux). The main safety outcome was major bleeding. This study is registered with ClinicalTrials.gov, number NCT01499953. Between April 25, 2012, and

  9. Neutrophil elastase-deficient mice form neutrophil extracellular traps in an experimental model of deep vein thrombosis.

    Science.gov (United States)

    Martinod, K; Witsch, T; Farley, K; Gallant, M; Remold-O'Donnell, E; Wagner, D D

    2016-03-01

    ESSENTIALS: Neutrophil elastase (NE) plays a role in extracellular trap formation (NETosis) triggered by microbes. The contribution of NE was evaluated in mouse NETosis models of sterile inflammation and thrombosis. NE is not required for mouse neutrophil NET production in vitro with non-infectious stimuli. NE deficiency had no significant effect on thrombosis in the inferior vena cava stenosis model. Neutrophil serine proteases have been implicated in coagulation and neutrophil extracellular trap (NET) formation. In human neutrophils, neutrophil elastase (NE) translocates to the nucleus during NETosis and cleaves histones, thus aiding in chromatin decondensation. NE(-/-) mice were shown not to release NETs in response to microbes. However, mouse studies evaluating the role of NE in NET formation in sterile inflammation and thrombosis are lacking. We wished to establish if neutrophils from NE(-/-) mice have a defect in NETosis, similar to peptidylarginine deiminase 4 (PAD4(-/-)) mice, and how this might have an impact on venous thrombosis, a model where NETs are produced and are crucial to thrombus development. We performed in vitro NET assays using neutrophils from wild-type (WT), NE(-/-), SerpinB1 (SB1)(-/-) and NE(-/-) SB1(-/-) mice. We compared WT and NE(-/-) animals using the inferior vena cava stenosis model of deep vein thrombosis (DVT). Neutrophil elastase deficiency resulted in a small reduction in ionomycin-induced NET formation in vitro without affecting histone citrullination. However, NET production in response to phorbol 12-myristate 13-acetate or platelet activating factor was normal in neutrophils from two independent NE-deficient mouse lines, and in NE(-/-) SB1(-/-) as compared with SB1(-/-) neutrophils. NE deficiency or inhibition did not prevent NETosis in vivo or DVT outcome. Neutrophil elastase is not required for NET formation in mice. NE(-/-) mice, which form pathological venous thrombi containing NETs, do not phenocopy PAD4(-/-) mice in in

  10. Tinzaparin in intermediate dose for the treatment of superficial vein thrombosis: Results from an observational multicenter study-SeVEN study.

    Science.gov (United States)

    Giannoukas, Athanasios; Karathanos, Christos; Nikolakopoulos, Konstantinos; Georgiadis, George S; Maltezos, Chrisostomos; Ioannou, Christos; Vasdekis, Spyros; Trelopoulos, Georgios

    2017-01-01

    Objectives Low-molecular-weight heparins are recommended in the treatment of superficial vein thrombosis but with low grade of evidence. This study was conducted to assess the treatment outcomes of acute superficial vein thrombosis with intermediate dose of Tinzaparin. Methods Retrospective analysis of records from outpatients over a period of 16 months treated in seven centers with Tinzaparin 0.5 ml (10,000 anti-Xa IU) once daily for a period that was at the treating physician's discretion. All the patients were followed up for at least 12 weeks. Results A total of 296 patients (189 females, mean age 57.4 years) were included. Two thirds of the patients (191/296, 64.5%) received treatment for approximately five weeks (mean 36.9 days) and the remaining (105/296, 35.5%) for a shorter period (mean 16.2 days). There was no difference in patients' characteristics between the two treatment duration groups. The presence of thrombus above the knee and restricted daily activity were associated with longer period of treatment. Only one case with minor bleeding was observed. Recurrence of thrombosis over a 12-week follow-up period occurred in 6% (superficial vein thrombosis in 14 (4.7%), deep vein thrombosis in 3 (1%) and thrombus extension in the superficial veins in 1 (0.3%)). Recurrence was not related to the duration of treatment. Conclusions Intermediate dose of Tinzaparin was an effective and safe treatment for superficial vein thrombosis in the setting of real world practice. Location of thrombus and status of patients' mobilization were associated with longer duration of treatment. Future prospective randomized studies are needed to corroborate these findings.

  11. Lobar Hepatocellular Carcinoma with Ipsilateral Portal Vein Tumor Thrombosis Treated with Yttrium-90 Glass Microsphere Radioembolization: Preliminary Results

    Directory of Open Access Journals (Sweden)

    M. Pracht

    2013-01-01

    Full Text Available Portal vein tumor thrombosis (PVTT is a common complication of hepatocellular carcinoma (HCC and has a negative impact on prognosis. This characteristic feature led to the rationale of the present trial designed to assess the efficacy and the safety of yttrium-90 glass-microsphere treatment for advanced-stage lobar HCC with ipsilateral PVTT. 18 patients with unresectable lobar HCC and ipsilateral PVTT were treated in our institution with 90Y-microS radioembolization. Patients were evaluated every 3 to 6 months for response, survival, and toxicity. Mean follow-up was 13.0 months (2.2–50.6. Outcomes were: complete response (n=2, partial response (n=13, stable disease (n=1, and progressive disease (n=2 giving a disease control rate of 88.9%. Four patients were downstaged. Treating lobar hepatocellular carcinoma with ipsilateral portal vein thrombosis with yttrium-90 glass-microsphere radioembolization is safe and efficacious. Further clinical trials are warranted to confirm these results and to compare 90Y-microS with sorafenib, taking into account not only survival but also the possibility of secondary surgery for putative curative intention after downstaging.

  12. Can we use biomarkers of coagulation to predict which patients with foot and ankle injury will develop deep vein thrombosis?

    Science.gov (United States)

    Hickey, Ben A; Cleves, Andrew; Alikhan, Raza; Pugh, Neil; Nokes, Len; Perera, Anthony

    2017-08-16

    Our aim was to determine whether plasma levels of Tissue Factor (TF), Vascular Cell Adhesion Molecule 1 (VCAM-1), Interleukin 6 (IL-6) or D-dimer after foot and ankle injury could predict which patients would develop deep vein thrombosis (DVT). Patients aged 18-60 years with acute foot and ankle injury had venous blood sample to measure TF, VCAM-1, IL-6 and D-dimer within 3 days of injury. Patients had bilateral lower limb venous ultrasound to assess for DVT on discharge from clinic. 21 of 77 patients were found to have DVT (27%). There was no statistically significant association between levels of TF, VCAM-1, IL-6 or D-dimer and subsequent development of DVT. Tissue Factor (TF), Vascular Cell Adhesion Molecule-1 (VCAM-1), Interleukin-6 (IL-6) and D-dimer levels were not associated with development deep vein thrombosis in patients with acute foot and ankle injury. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  13. Diagnosis of deep vein thrombosis in the lower extremities. Phlebography versus Doppler sonography

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, H.J.

    1986-02-01

    In this retrospective study, the results of Doppler sonography and phlebography are compared. In about 30% cases the diagnosis of thrombosis made by Doppler sonography could not be confirmed. Agreement was better in patients with acute thrombosis or following pulmonary emboli than in those with a longer history of swelling of the lower extremities. These results agree with the findings of other authors using impedance plethysmography; this also shows lack of agreement in about 30% of the cases.

  14. Heterozygous methylene tetrahydrofolate reductase mutation with mild hyperhomocysteinemia associated with deep vein thrombosis.

    Science.gov (United States)

    Pathare, Anil; al Kindi, Salam; al Belushi, Talal; Bayoumi, Riad; Dennison, David; Murlitharan, S

    2002-01-01

    Hyperhomocysteinemia is known to be associated with arterial occlusive vascular disease and venous thrombosis. Here we report a young ethnic Omani patient with recurrent venous thrombosis who was found to be heterozygous for the C677T mutation in the enzyme methyltetrahydrofolate reductase (MTHFR). Moderate hyperhomocysteinemia was also documented in the presence of normal red cell folate and serum B12 levels. No other marker usually associated with hereditary thrombophilia could be demonstrated in the patient, despite extensive investigations on multiple occasions.

  15. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Zhenlei Liu

    Full Text Available Bed rest has been considered as the cornerstone of management of deep vein thrombosis (DVT for a long time, though it is not evidence-base, and there is growing evidence favoring early ambulation.Electronic databases including Medline, PubMed, Cochrane Library and three Chinese databases were searched with key words of "deep vein thrombosis", "pulmonary embolism", "venous thrombosis", "bed rest", "immobilization", "mobilization" and "ambulation". We considered randomized controlled trials, prospective or retrospective cohort studies that compared the outcomes of acute DVT patients managed with early ambulation versus bed rest, in addition to standard anticoagulation. Meta-analysis pertaining to the incidence of new pulmonary embolism (PE, progression of DVT, and DVT related deaths were conducted, as well as the extent of remission of pain and edema.13 studies were included with a total of 3269 patients. Compared to bed rest, early ambulation was not associated with a higher incidence of new PE, progression of DVT, or DVT related deaths (RD -0.03, 95% CI -0.05∼ -0.02; Z = 1.24, p = 0.22; random effect model, Tau2 = 0.01. Moreover, if the patients suffered moderate or severe pain initially, early ambulation was related to a better outcome, with respect to remission of acute pain in the affected limb (SMD 0.42, 95%CI 0.09∼0.74; Z = 2.52, p = 0.01; random effect model, Tau2 = 0.04. Meta-analysis of alleviation of edema cannot elicit a solid conclusion because of significant heterogeneity among the few studies.Compared to bed rest, early ambulation of acute DVT patients with anticoagulation was not associated with a higher incidence of new PE, progression of DVT, and DVT related deaths. Furthermore, for the patients suffered moderate or severe pain initially, a better outcome can be seen in early ambulation group, regarding to the remission of acute pain in the affected limb.

  16. Portal vein thrombosis in a patient with HCV cirrhosis and combined hemophilia A and thrombophilia V Leiden

    Directory of Open Access Journals (Sweden)

    Nikos Eleftheriadis

    2010-10-01

    Full Text Available Nikos Eleftheriadis, Pantelis MakrisHemostatic Unit of The First Propedeutic Department of Internal Medicine, AHEPA Hospital, Aristotles University of Thessaloniki, GreeceAbstract: The relation of hemophilia A with thrombophilia V Leiden is extremely rare in the literature. Furthermore, hemophiliac patients have an increased risk of severe life-threatening hemorrhage, blood transfusions, and therefore hepatitis transmission, mainly hepatitis C (HCV.Aims and methods: We present a 54-year-old male with a 5-year history of decompensated liver cirrhosis on the grounds of HCV hepatitis, hemophilia A, and thrombophilia V Leiden. He was admitted to our department because of severe abdominal distension, resembling ‘tense ascites’ despite the use of diuretics. Clinical examination showed shifting dullness and a protuberant abdomen, while hematological and blood chemistry results revealed thrombopenia (platelets: 77000/mL and hypoalbuminemia. Repeated abdominal paracentesis (under factor VIII administration failed to remove ascitic fluid, while abdominal echosonography and computed tomography revealed severe edema of mesenterium and intraabdominal viscus and the absence of free ascitic fluid, atrophic cirrhotic liver, and splenomegaly. Moreover, abdominal doppler echosonography revealed signs of portal hypertension, previous portal vein thrombosis, and revascularization of the portal vein. Gastroscopy showed esophageal varices grade II, without signs of bleeding. A-FP and all other laboratory examinations were normal.Results: Our patient was intravenously treated with albumine and diuretics (furosemide with mild improvement of his abdominal distension. During his hospitalization he presented an episode of spontaneous bacterial peritonitis and hepatic encephalopathy, which were successfully treated with lactulose clysmas and ciprofloxacine. He was discharged in a good general condition.Conclusion: According to our case we consider the false clinical

  17. Different risk of deep vein thrombosis and pulmonary embolism in carriers with factor V Leiden compared with non-carriers, but not in other thrombophilic defects. Results from a large retrospective family cohort study

    NARCIS (Netherlands)

    Makelburg, Anja B. U.; Veeger, Nic J. G. M.; Middeldorp, Saskia; Hamulyak, Karly; Prins, Martin H.; Buller, Harry R.; Lijfering, Willem M.

    The term factor V Leiden (FVL) paradox is used to describe the different risk of deep vein thrombosis and pulmonary embolism that has been found in carriers of FVL. In a thrombophilic family-cohort, we estimated differences in absolute risks of deep vein thrombosis and pulmonary embolism for various

  18. Prevalence of Janus kinase 2 mutations in patients with unusual site venous thrombosis

    Directory of Open Access Journals (Sweden)

    Ana Lisa Basquiera

    2011-08-01

    Full Text Available We aimed to study patients with splanchnic vein thrombosis (SVT and cerebral vein thrombosis (CVT searching for JAK2 mutations. We evaluated 14 patients (median age: 41.5 years with portal vein thrombosis (PVT = 7; mesenteric vein thrombosis (MVT = 3; and CVT = 4. JAK2 V617F was assessed by allele specific PCR of peripheral blood DNA. In addition, DNA was sequenced for other JAK2 mutations. Other inherited and acquired thrombophilia risk factors were evaluated. JAK2 V617F was positive in four out of seven patients with PVT and in one CVT patient. These five patients had a diagnosis of myeloproliferative disorder (MPD at the moment of the occurrence of thrombosis (n = 2 or later (n = 2. Patients with MVT and CVT were negative for JAK2 V617F, except one patient with CVT and a diagnosis of essential thrombocythemia. No other JAK2 mutations were found in this cohort. Besides MPD, other thrombophilia risk factors were identified in five patients. One patient had MPD as well as thrombophilia risk factor. In this group, 4 out of 7 of the patients with PVT carried the JAK2 V617F mutation with or without overt MPD. However, the investigation of other JAK2 mutations may not be necessary in patients with thrombosis at unusual sites.

  19. Preoperative color duplex echographical venous mapping before autologous fat graft for calf augmentation: a case report of superficial vein thrombosis and prevalence of intersaphenic anastomosis.

    Science.gov (United States)

    Fraccalvieri, Marco; Contessa, Luigi; Salomone, Marco; Zingarelli, Enrico Maria; Bruschi, Stefano

    2014-08-01

    Autologous fat grafting for calf augmentation is considered an easy and safe technique. Only few cases of potential complications have been described in literature; among them, vein thrombosis was never reported. We report a case of superficial vein thrombosis of the intersaphenic anastomosis after fat graft for calf symmetrization in club-foot syndrome. A color duplex echographical study showed that such intersaphenic anastomoses are present in all patients, but they have an ectatic diameter in 70% of patients with great saphenous vein insufficiency and in 50% of patients without insufficiency. The plastic surgeon should be aware of the presence and topography of such anatomical variations before performing the procedure. Moreover, a preoperative color duplex echographical venous mapping may help the surgeon in avoiding the trauma on vein variants and subsequent complications.

  20. Effectiveness and safety of proton beam therapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Park, Joong-Won; Kim, Tae Hyun; Kim, Yeon-Joo; Woo, Sang Myung; Koh, Young-Hwan; Lee, Woo Jin; Park, Sang-Jae; Kim, Dae Yong; Kim, Chang-Min [National Cancer Center, Center for Liver Cancer, Research Institute and Hospital, Goyang-si, Gyeonggi-do (Korea, Republic of)

    2014-09-15

    To evaluate the clinical effectiveness and safety of proton beam therapy (PBT) in advanced hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT). Twenty-seven HCC patients with PVTT underwent PBT, including 22 patients with modified International Union Against Cancer (mUICC) stage IVA,five patients with stage IVB primary tumors, and 16 with main PVTT. A median dose of 55 GyE (range, 50-66 GyE) in 20-22 fractions was delivered to a target volume encompassing both the PVTT and primary tumor. Overall, treatment was well tolerated, with no toxicity of grade ≥ 3. Median overall survival (OS) times in all patients and in stage IVA patients were 13.2 months and 16 months, respectively. Assessments of PVTT response showed complete response in 0 of 27 (0 %) patients, partial response in 15 (55.6 %), stable disease in 10 (37 %), and progressive disease in 2 (7.4 %) patients, with an objective response rate of 55.6 %. PVTT responders showed significantly higher actuarial 1-year local progression-free survival (LPFS; 85.6 % vs. 51.3 %), relapse-free survival (RFS; 20 % vs. 0 %) and OS (80 % vs. 25 %) rates than nonresponders (p < 0.05 each). Multivariate analysis showed that PVTT response and mUICC stage were independent prognostic factors for OS. Our data suggest that PBT could improve LPFS, RFS, and OS in advanced HCC patients with PVTT and it is feasible and safe for these patients. (orig.) [German] In der vorliegenden Arbeit wurde versucht, die klinische Wirksamkeit und Sicherheit der Protonenstrahltherapie (PBT) fuer Patienten mit fortgeschrittenem Leberzellkarzinom (HCC) in Verbindung mit Portadertumorthrombosen (PVTT) zu bewerten. Ausgefuehrt wurde die PBT fuer 27 HCC-Patienten mit PVTT, einschliesslich 22 Patienten im mUICC-Stadium (''International Union Against Cancer'') IVA sowie 5 Patienten mit Primaertumor im Stadium IVB und 16 Patienten mit PVTT im primaeren Stadium nach der geaenderten UICC-Klassifikation. Eine

  1. Thrombosis of a drainage vein in developmental venous anomaly (DVA) leading venous infarction: a case report and review of the literature.

    Science.gov (United States)

    Kiroglu, Yilmaz; Oran, Ismail; Dalbasti, Tayfun; Karabulut, Nevzat; Calli, Cem

    2011-04-01

    Developmental venous anomalies (DVAs) are common congenital venous drainage anomalies. Although they typically have a benign clinical course and a low symptomatic rate, thrombosis of a drainage vein may occur, leading to potentially debilitating complications. We report imaging findings of posterior fossa DVA with a thrombosed drainage vein in a patient with nonhemorrhagic cerebellar infarct. We also review the relevant literature on the subject. Copyright © 2009 by the American Society of Neuroimaging.

  2. Transjugular Intrahepatic Portosystemic Shunt, Mechanical Aspiration Thrombectomy, and Direct Thrombolysis in the Treatment of Acute Portal and Superior Mesenteric Vein Thrombosis

    International Nuclear Information System (INIS)

    Ferro, Carlo; Rossi, Umberto G.; Bovio, Giulio; Dahamane, M'Hamed; Centanaro, Monica

    2007-01-01

    A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contrast-enhanced multidetector computed tomography demonstrated acute portal and superior mesenteric vein thrombosis (PSMVT). The patient was treated percutaneously with transjugular intrahepatic portosystemic shunt (TIPS), mechanical aspiration thrombectomy, and direct thrombolysis, and 1 week after the procedure, complete patency of the portal and superior mesenteric veins was demonstrated. TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT

  3. Simultaneous thrombosis of the mesenteric artery and vein as a novel clinical manifestation of intravascular large B-cell lymphoma.

    Science.gov (United States)

    Arima, Hiroshi; Inoue, Daichi; Tabata, Sumie; Matsushita, Akiko; Imai, Yukihiro; Ishikawa, Takayuki; Takahashi, Takayuki

    2014-01-01

    A 79-year-old man with a 2-month history of fever and weight loss was admitted to our hospital because of an acute abdomen. Abdominal CT scans showed marked sectional thickening and edema of the small intestine. On laparotomy, a 16-cm section of the small intestine was ischemic and necrotic; therefore, segmentectomy of the intestine was performed. A thrombus was noted at the stump of the mesenteric artery branch. Histopathological analysis of the resected intestine revealed fibrin thrombi in both mesenteric arteries and veins. Furthermore, a cluster of large, abnormal lymphoid cells bordering the intima of most branches of the mesenteric veins and small vessels was observed. Immunohistochemical analysis revealed that these abnormal cells were positive for CD20, leading to a diagnosis of intravascular large B-cell lymphoma (IVLBCL). The patient was successfully treated with standard R-CHOP chemotherapy; however, the lymphoma recurred in the central nervous system 18 months after the initial diagnosis, and the patient died. Simultaneous thrombosis of the mesenteric artery and vein is unusual as a clinical manifestation of IVLBCL. However, IVLBCL should be taken into consideration when ischemic disorders of unknown cause, accompanied by fever of unknown origin, are encountered. © 2014 S. Karger AG, Basel.

  4. Type 2 diabetes mellitus as a risk factor for intestinal resection in patients with superior mesenteric vein thrombosis.

    Science.gov (United States)

    Elkrief, Laure; Corcos, Olivier; Bruno, Onorina; Larroque, Beatrice; Rautou, Pierre-Emmanuel; Zekrini, Kamal; Bretagnol, Frédéric; Joly, Francisca; Francoz, Claire; Bondjemah, Vanessa; Cazals-Hatem, Dominique; Boudaoud, Larbi; De Raucourt, Emmanuelle; Panis, Yves; Goria, Odile; Hillaire, Sophie; Valla, Dominique; Plessier, Aurélie

    2014-10-01

    The most serious complication of acute mesenteric vein thrombosis (MVT) is acute intestinal ischaemia requiring intestinal resection or causing death. Risk factors for this complication are unknown. To identify risk factors for severe intestinal ischaemia leading to intestinal resection in patients with acute MVT. We retrospectively analysed consecutive patients seen between 2002 and 2012 with acute MVT in 2 specialized units. Patients with cirrhosis were excluded. We compared patients who required intestinal resection to patients who did not. Among 57 patients, a local risk factor was identified in 14 (24%) patients, oral contraceptive use in 16 (29%), and at least one or more other systemic prothrombotic condition in 25 (44%). Five (9%) patients had diabetes mellitus (DM), 33 (58%) had overweight or obesity, 9 (18%) had hypertriglyceridemia and 10 (19%) had arterial hypertension. Eleven patients (19%) underwent intestinal resection. DM was significantly associated with intestinal resection (P = 0.02) while local factors or prothrombotic conditions were not. Computed tomography (CT) scans performed at diagnosis found that occlusion of second order radicles of the superior mesenteric vein was more frequently observed in patients who underwent intestinal resection (P = 0.009). In acute MVT, patients with underlying DM have an increased risk of requiring intestinal resection. Neither local factors nor systemic prothrombotic conditions are associated with intestinal resection. When CT scan shows the preservation of second order radicles of the superior mesenteric vein, the risk of severe resection is low. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Upper extremity deep vein thrombosis after migration of peripherally inserted central catheter (PICC): A case report.

    Science.gov (United States)

    Wang, Kai; Sun, Wenyan; Shi, Xiaodong

    2017-12-01

    Peripherally inserted central venous catheters (PICC) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate. The tip position of the catheter should be located at the border of lower one-third of the superior vena cava (SVC) and cavo-atrial junction. The migration is malposition at the late stage after PICCs were inserted, and catheter malposition was associated with thrombosis and other complications.After patient's informed consent, we report a case of a 66-year-old male with twice catheter migrations resulting in thrombosis after being diagnosed with cardiac cancer. The correct position of the catheter tip can ensure the normal use of PICC and reduce the complications. For the migrated catheter, it should be removed as soon as possible, and when thrombosis has been developed, standard anticoagulant therapy should be given. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  6. Upper extremity deep vein thrombosis after migration of peripherally inserted central catheter (PICC)

    Science.gov (United States)

    Wang, Kai; Sun, Wenyan; Shi, Xiaodong

    2017-01-01

    Abstract Introduction: Peripherally inserted central venous catheters (PICC) are widely used in cancer patients and ultrasound-guided PICC insertion could improve success rate. The tip position of the catheter should be located at the border of lower one-third of the superior vena cava (SVC) and cavo-atrial junction. The migration is malposition at the late stage after PICCs were inserted, and catheter malposition was associated with thrombosis and other complications. After patient's informed consent, we report a case of a 66-year-old male with twice catheter migrations resulting in thrombosis after being diagnosed with cardiac cancer. Conclusion: The correct position of the catheter tip can ensure the normal use of PICC and reduce the complications. For the migrated catheter, it should be removed as soon as possible, and when thrombosis has been developed, standard anticoagulant therapy should be given. PMID:29390472

  7. Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dennis Martin

    2012-03-01

    Full Text Available Abstract Background Approximately 80,000 patients each year are admitted to UK hospitals with an acute stroke and are immobile. At least 10% will develop a proximal Deep Vein Thrombosis in the first month and 1.5% a pulmonary embolus. Although hydration, antiplatelet treatment and early mobilisation may reduce the risk of deep vein thrombosis, there are currently no preventive strategies which have been clearly shown to be both effective and safe. Anticoagulation increases the risks of bleeding and compression stockings are ineffective. Systematic reviews of small randomized trials of intermittent pneumatic compression have shown that this reduces the risk of deep vein thrombosis in patients undergoing surgery, but that there are few data concerning its use after stroke. The CLOTS trial 3 aims to determine whether, compared with best medical care, best medical care plus intermittent pneumatic compression in immobile stroke patients reduces the risk of proximal deep vein thrombosis. Methods/Design CLOTS Trial 3 is a parallel group multicentre trial; with centralized randomisation (minimisation to ensure allocation concealment. Over 80 centres in the UK will recruit 2800 immobile stroke patients within the first 3 days of their hospital admission. Patients will be allocated to best medical care or best medical care plus intermittent pneumatic compression. Ultrasonographers will perform a Compression Duplex Ultrasound Scan to detect deep vein thrombosis in each treatment group at about 7-10 days and 25-30 days. The primary outcome cluster includes symptomatic or asymptomatic deep vein thrombosis in the popliteal or femoral veins detected on either scan. Patients are then followed up by postal or telephone questionnaire at 6 months from randomisation to detect later symptomatic deep vein thrombosis and pulmonary emboli and to establish their functional outcome (Oxford handicap scale and quality of life (EQ5D-3 L. The ultrasonographers performing the

  8. Case report of isolated vein of trolard thrombosis in an HBsAg-positive patient

    Directory of Open Access Journals (Sweden)

    Sudhakar M Rao

    2014-01-01

    Full Text Available Among the many infective causes of cerebral venous thrombosis (CVT, viral hepatitis is been regarded as a rare associated condition. We report on a 46-years-old man presenting CVT associated with hepatitis B infection. Hepatitis C being a rare cause of CVT is well documented in the literature. There is also mention of association of hepatitis B being associated with CVT to the best of our knowledge. Both these conditions are hypothesized as thrombogenic agents in the available literature, and further research is required to confirm the same. We suggest that virus B serology should be performed in the cases of cerebral venous thrombosis with unknown etiology.

  9. Utility of impedance plethysmography in the diagnosis of recurrent deep-vein thrombosis

    NARCIS (Netherlands)

    Huisman, M. V.; Büller, H. R.; ten Cate, J. W.

    1988-01-01

    Serial impedance plethysmography has been shown to be a safe and effective alternative to venography in the management of patients with clinically suspected acute venous thrombosis. The rate of normalization of an initial abnormal impedance plethysmogram and, consequently, the usefulness of

  10. Deep-vein thrombosis in the era of high HIV and tuberculosis ...

    African Journals Online (AJOL)

    Participants were predominantly black (79.8%) and female (64.6%), with a median age of 46 (interquartile range (IQR) 38 - 57) years. The prevalences of HIV and TB were 53.0% and 21.2%, respectively. The most common risk factors for thrombosis were TB (17.2%) and malignancies (14.1%). Thrombophilia screening had ...

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  12. Accuracy of diagnostic tests for clinically suspected upper extremity deep vein thrombosis: a systematic review

    NARCIS (Netherlands)

    Di Nisio, M.; van Sluis, G. L.; Bossuyt, P. M. M.; Büller, H. R.; Porreca, E.; Rutjes, A. W. S.

    2010-01-01

    Background: The best available test for the diagnosis of upper extremity deep venous thrombosis (UEDVT) is contrast venography. The aim of this systematic review was to assess whether the diagnostic accuracy of other tests for clinically suspected UEDVT is high enough to justify their use in

  13. Validation of the Wells scoring scale for Deep Vein thrombosis in ...

    African Journals Online (AJOL)

    Background: Deep Venous thrombosis (DVT) is difficult to diagnose. Pre-test probability rules used in screening for DVT have not been validated in an African population. Objective: Validation of the Wells Rule in African patients suspected to have DVT. Design: Descriptive cross sectional study. Setting: Moi Teaching and ...

  14. Enhancement by factor V Leiden mutation of risk of deep-vein thrombosis associated with oral contraceptives containing a third-generation progestagen

    NARCIS (Netherlands)

    Bloemenkamp, K. W.; Rosendaal, F. R.; Helmerhorst, F. M.; Büller, H. R.; Vandenbroucke, J. P.

    1995-01-01

    Recent concern about the safety of combined oral contraceptives (OCs) with third-generation progestagens prompted an examination of data from a population-based case-control study (Leiden Thrombophilia Study). We compared the risk of deep-vein thrombosis (DVT) during use of the newest OCs,

  15. Trombosis de la vena ovárica: Factores de riesgo, diagnóstico y tratamiento Ovarian vein thrombosis: risk factors, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Eduardo González-Bosquet

    2009-06-01

    Full Text Available La trombosis de la vena ovárica es una complicación muy poco frecuente (0.002-0.05%, que se observa en mujeres que presentan un incremento en los factores de coagulación. La principal situación en la que es posible detectar esta complicación es el embarazo, aunque no es la única. Se describe el caso de una mujer de 31 años de edad, gestante de 16 semanas, que presenta un aborto espontáneo séptico complicado con una trombosis de la vena ovárica. Se aprovecha el caso clínico para revisar en la literatura los factores de riesgo, el diagnóstico y el tratamiento de esta inusual patología.Ovarian vein thrombosis is an uncommon complication (0.002-0.05% related to hypercoagulated status of women. The most frequent condition associated to ovarian vein thrombosis is pregnancy, but there are other possible causes. We present a case of a 31 year old pregnant woman at 16th week of gestation who had spontaneuos septic abortion complicated with an ovarian vein thrombosis. A discussion of risk factors, diagnostic and treatment options of ovarian vein thrombosis are presented.

  16. Safety and feasibility of a diagnostic algorithm combining clinical probability, D-dimer test and ultrasonography in suspected upper extremity deep vein thrombosis

    NARCIS (Netherlands)

    Kleinjan, A.; Di Nisio, M.; Kamphuisen, P.W.; Büller, H.R.

    2010-01-01

    Background: Ultrasonography is currently used as the reference test for clinically suspected upper extremity deep vein thrombosis (UEDVT) although the diagnostic accuracy of the test for this indication remains less well established compared to DVT of the legs. The safety of withholding

  17. Safety and feasibility of a diagnostic algorithm combining clinical probability, D-dimer and ultrasonography in suspected upper extremity deep vein thrombosis: : A prospective management study

    NARCIS (Netherlands)

    Kleinjan, A.; Di Nisio, M.; Beyer-Westendorf, J.; Cosmi, B.; Camporese, G.; Ghirarduzzi, A.; Kamphuisen, P.W.; Otten, H.M.; Porreca, E.; Büller, H.R.

    2013-01-01

    Background: Traditionally, the focus of the diagnosis of venous thromboembolism (VTE) is on deep vein thrombosis (DVT) of the leg and pulmonary embolism. Until recently, upper extremity DVT (UEDVT) was regarded as an uncommon presentation of VTE; however, the more widespread use of central venous

  18. Predictors of the post-thrombotic syndrome with non-invasive venous examinations in patients 6 weeks after a first episode of deep vein thrombosis

    NARCIS (Netherlands)

    Tick, L.W.; Doggen, Catharina Jacoba Maria; Rosendaal, F.R.; Faber, W.R.; Bousema, M.T.; Mackaay, A.J.C.; van Balen, P.; Kramer, H.H.

    2010-01-01

    Background: Post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) affecting a large number of patients. Because of its potential debilitating effects, identification of patients at high risk for the development of this syndrome is relevant, and only a few predictors

  19. Safety and feasibility of a diagnostic algorithm combining clinical probability, D-dimer and ultrasonography in suspected upper extremity deep vein thrombosis: : A prospective management study

    NARCIS (Netherlands)

    Kleinjan, Ankie; Di Nisio, Marcello; Beyer-Westendorf, Jan; Cosmi, Benilde; Camporese, Giuseppe; Ghirarduzzi, Angelo; Kamphuisen, Pieter W.; Otten, Hans-Martin; Porreca, Ettore; Büller, Harry R.

    2012-01-01

    Introduction: Traditionally, the focus of VTE diagnostic is on deep vein thrombosis (DVT) of the leg and pulmonary embolism. Until recently, upper extremity DVT (UEDVT) was regarded as an uncommon and relatively benign presentation of venous thromboembolism; however, the more widespread use of

  20. Occult cancer in patients with deep-vein thrombosis in a general hospital at Mexico City: A pilot study

    Directory of Open Access Journals (Sweden)

    Christian O Ramirez-Serrano Torres

    2017-01-01

    Full Text Available Background: We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT at a general hospital in Mexico City. Materials and Methods: From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography. In a case-by-case approach, if necessary, computed tomography, endoscopy, colonoscopy, and tumor markers were done. Results: From 182 patients with primary DVT, 30 (16.5% presented occult cancer: Thirteen males and 17 females, with an average age of 61 years. In males, prostate cancer prevailed (6/13, 46%; meanwhile, in females, pelvic gynecologic cancers predominated (7/17, 41%. Conclusion: Our results suggest that in Mexican patients with primary DVT, occult cancer is frequent.