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venous Malformations anticoagulation

Shrinil Patel, Anmol Cheema, Tejas Karawadia, Michael Carson
Duplication of the inferior vena cava (DIVC) is an uncommon embryological anatomic phenomenon.We report a 63-year-old woman with extensive right leg deep vein thrombosis who required an IVC filter due to contraindications for anticoagulation, but was found to have DIVC which required the placement of two IVC filters with good result. This report will review and summarise past reports of DIVC management to provide a guide for future clinicians, and review the embryological development, diagnosis and IVC filter placement options as they are based on the type of anatomic malformation encountered...
June 4, 2018: BMJ Case Reports
Ahmed Aka Razek, Germeen A Ashmalla
Background Venous malformations may be complicated by localized intravascular coagulopathy which is a serious condition with hematological sequel. Prediction of localized intravascular coagulopathy is mandatory for prompt anticoagulation therapy. Laboratory and routine magnetic resonance imaging can predict localized intravascular coagulopathy in venous malformations; however, the results are variable. Purpose To predict venous malformations with localized intravascular coagulopathy with diffusion-weighted magnetic resonance imaging...
January 1, 2018: Phlebology
Naiem Nassiri, Lauren A Huntress, Mitchell Simon, Susan Murphy
OBJECTIVE: No standardized therapeutic algorithm or embolic agent of choice has yet been identified for management of congenital peripheral venous malformations (VMs). Treatment options and reported outcomes therefore vary widely. Herein, we present an institution-wide algorithm for management of symptomatic congenital peripheral VMs using a single embolotherapeutic modality. METHODS: During 36 months, patients with symptomatic congenital peripheral VMs underwent contrast-enhanced magnetic resonance imaging...
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Dong Hwan Kim, Dong Ha Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
Although the etiology of spontaneous spinal epidural hematoma (SSEH) is unclear, SSEH is known to be associated with anticoagulants, coagulopathy, vascular malformation, hypertension, and pregnancy. However, no report has been issued on the relation between SSEH and venous phlebolith. Here, the authors present an extremely rare case of SSEH associated with phlebolith in the cervical spine and suggest a possible pathogenesis. A 36-year-old man without any relevant medical history presented with neck pain and numbness and severe radiating pain on the left arm...
September 2017: Korean Journal of Spine
Taizo A Nakano, Chadi Zeinati
The presence of a vascular anomaly suggests that capillaries, veins, arteries, and/or lymphatic vessels have demonstrated abnormal development and growth. Often dilated and misshaped, these vessels augment normal flow of blood and lymphatic fluids that increases the overall risk to develop intralesional thrombosis. Abnormal endothelial and lymphoendothelial cells activate hemostasis and hyperfibrinolytic pathways through poorly understood mechanisms, which contribute to the development of localized intravascular coagulopathy...
2017: Frontiers in Pediatrics
Ikutaro Kigawa, Masahiro Aiba, Atsushi Ito
Klippel-Trenaunay syndrome( KTS) is a complex congenital anomaly characterized by lower extremity varix and venous malformations, port-wine stains, and soft tissue and bone hypertrophy. We present a case of a 35-year-old man of KTS with pulmonary embolism (PE). The patient was referred to our hospital complaining of the leg pain and sudden onset of dyspnea. Enhanced computed tomography (CT) showed lower extremity varices, superficial thrombophlebitis and bilateral pulmonary thrombi. No venous malformations except for varicose veins were revealed in the limbs or pelvis...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kim M Keppler-Noreuil, Jay N Lozier, Julie C Sapp, Leslie G Biesecker
Patients with overgrowth and complex vascular malformation syndromes, including Proteus syndrome have an increased risk of thromboembolism. Proteus syndrome is a mosaic, progressive overgrowth disorder involving vasculature, skin, and skeleton, and caused by a somatic activating mutation in AKT1. We conducted a comprehensive review of the medical histories and hematologic evaluations of 57 patients with Proteus syndrome to identify potential risk factors for thrombosis. We found that six of ten patients, who were deceased, died secondary to deep venous thrombosis and/or pulmonary embolism...
September 2017: American Journal of Medical Genetics. Part A
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Haiyan Zhao, Jintao Han, Ming Lu, Yingshuang Zhang, Dongsheng Fan
Objective To explore the incidence and possible underlying pathogenic mechanisms of nontraumatic convexal subarachnoid haemorrhage (cSAH; a rarely reported condition) in a cohort of Chinese patients. Methods Medical records from all patients with subarachnoid haemorrhage (SAH) who had been treated at Peking University Third Hospital, China, between January 2010 and December 2014 were retrospectively reviewed to identify cases of cSAH. Results Of 144 patients with SAH, cSAH was observed in 14 cases (9.7%). The most frequent presenting symptoms in cSAH cases were severe headache ( n = 8) and a focal neurological deficit ( n = 8)...
December 2017: Journal of International Medical Research
Elchanan Bruckheimer
The absolute separation of the right and left circulations and the filtration of blood by the pulmonary circulation are essential to prevent the passage of thrombotic material from the venous system into the systemic arterial circulation. Any breach of the intracardiac septae or circumvention of the pulmonary capillary network may cause a paradoxical embolus. The most common causes are atrial septal defects and pulmonary arteriovenous malformations. This article discusses unusual connections and pathways related to congenital malformations...
May 2016: Cardiology Clinics
Hormuzdiyar H Dasenbrock, Sandra C Yan, Bradley A Gross, Donovan Guttieres, William B Gormley, Kai U Frerichs, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although aspirin usage may be associated with a decreased risk of rupture of cerebral aneurysms, any potential therapeutic benefit from aspirin must be weighed against the theoretical risk of greater hemorrhage volume if subarachnoid hemorrhage (SAH) occurs. However, few studies have evaluated the association between prehemorrhage aspirin use and outcomes. This is the first nationwide analysis to evaluate the impact of long-term aspirin and anticoagulant use on outcomes after SAH. METHODS Data from the Nationwide Inpatient Sample (NIS; 2006-2011) were extracted...
February 2017: Journal of Neurosurgery
Wenjun Ji, Aihua Liu, Xianli Lv, Youxiang Li, Xinjian Yang, Chuhan Jiang, Zhongxue Wu
BACKGROUND: Endovascular coil embolization of pial arteriovenous fistulas (AVF) has been reported as an effective treatment. However, venous thrombosis and intracranial hemorrhage developing after endovascular occlusion of a pial AVF have not been adequately reported. CASE DESCRIPTION: A 37-year-old man presented with left middle cerebral artery (MCA) AVF and right posterior cerebral artery (PCA) AVF with giant venous pouches. Staged endovascular coil embolization was performed...
February 2016: Interventional Neuroradiology
Vishal J Patel, Rishi R Lall, Sohum Desai, Aaron Mohanty
Developmental venous anomalies (DVA) are among the most common congenital malformations of the cerebral angioarchitecture. Spontaneous thrombosis of this entity is rare, and our review of the literature found only 31 reported cases of symptomatic spontaneous thrombosis of developmental venous anomalies. Here, we report a unique case describing the spontaneous thrombosis of a DVA leading to venous infarction and subsequent recanalization. The patient was a previously healthy 21-year-old male who presented with an acute onset of partial seizures...
2015: Curēus
Marcelo M Serra, Bruno L Ferreyro, Oscar Peralta, Ezequiel Levy Yeyati, Natalia Causada Calo, Teresa Garcia-Botta, Diego Andresik, Martín Rabellino, Ricardo Garcia-Mónaco
Hereditary hemorrhagic telangiectasia (HHT) usually presents in association with pulmonary arteriovenous malformations (PAVMs). In addition, the incidence of venous thromboembolism tends to be increased in these patients. A 74-year-old female with HHT presented with cyanosis and hypoxemia. Contrast-enhanced multislice computed tomography (MSCT) revealed two left PAVMs and one in the right upper lobe. Both left PAVMs were treated with embolotherapy. Follow-up MSCT revealed an incidental pulmonary embolism in the right pulmonary branches...
2015: Internal Medicine
Massimiliano Visocchi, Giuseppe La Rocca, Francesco Signorelli, Romeo Roselli, Zhong Jun, A Spallone
INTRODUCTION: Spontaneous idiopathic acute spinal subdural hematoma (SSDH) is a rare cause of acute back pain followed by signs and symptoms of nerve root and/or spinal cord compression, frequently associated with coagulopathies, blood dyscrasias and arterio-venous malformations. Standard management includes non-operative treatment and timely (within 24h) surgical decompression. PRESENTATION OF CASE: We report on the case of a huge 10 levels SSDH treated with decompressive thoracic no-instrumented laminectomy in a 45-year-old woman with good neurological recovery (from ASIA A to D)...
2015: International Journal of Surgery Case Reports
M Hoeltzenbein, E Beck, K Meixner, C Schaefer, R Kreutz
BACKGROUND: New oral anticoagulants are increasingly used in women of childbearing age, but apart from one case report there is no published experience with rivaroxaban exposure during pregnancy. METHODS: From October 2008 to December 2014, the German Embryotox Pharmacovigilance Centre identified 63 exposed pregnancies among 94 requests concerning rivaroxaban use during childbearing age. Follow-up included paediatric checks until 6 weeks after birth. RESULTS: All pregnancies with completed follow-up were exposed at least during the first trimester...
February 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Kevin S H Koo, Christopher F Dowd, Erin F Mathes, Kristina W Rosbe, William Y Hoffman, Ilona J Frieden, Christopher P Hess
BACKGROUND: The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. OBJECTIVE: The aim of this work was to identify MRI features of venous malformation associated with LIC...
October 2015: Pediatric Radiology
A Fekir, X Balguerie, I Bardoux, J-N Dacher, P-H Vivier
Venous malformation (VM) is a frequent soft tissue mass in children that should not be confused with vascular tumors. We report the case of a 10-year-old boy with a bulky thrombosed VM of the shoulder with functional disability. D-dimer levels were high. Pathognomonic phleboliths were demonstrated on conventional x-rays. Echo-doppler confirmed the venous nature of the lesion and areas without flow suspicious for thrombosis. MRI provides the deep extension and can show non-calcified thrombi that are difficult to see with ultrasound...
July 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Morinobu Seki, Mamoru Shibata, Yoshiaki Itoh, Norihiro Suzuki
BACKGROUND: Nowadays, developmental venous anomaly (DVA) is recognized as the most common cerebral vascular malformation. Most DVAs are diagnosed incidentally on routine brain imaging, but they are occasionally symptomatic. We report the case of a 26-year-old Japanese woman with intracerebral hemorrhage due to venous thrombosis of DVA. METHODS: We examined her neurologic examinations carefully. We also observed her laboratory data, brain computed tomography (CT), and magnetic resonance imaging (MRI) findings...
July 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Christopher Dittus, Michael Streiff, Jack Ansell
Hereditary hemorrhagic telangiectasia (HHT) is a relatively common inherited vascular disorder that was first described in 1864, and is notable for epistaxis, telangiectasia, and arterial venous malformations. While genetic tests are available, the diagnosis remains clinical, and is based on the Curacao criteria. Patients with HHT are at increased risk for both bleeding and clotting events. Because of these competing complications, hematologists are often faced with difficult clinical decisions. While the majority of management decisions revolve around bleeding complications, it is not infrequent for these patients to require anticoagulation for thrombosis...
April 16, 2015: World Journal of Clinical Cases
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