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DVT treatment duration

Miriam Bach, Rupert Bauersachs
Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE...
September 28, 2016: Thrombosis and Haemostasis
K K Tiwari, K G Shrestha, B Sah, D J Reddy
INTRODUCTION: Lower-extremity ulcers represent the largest group of ulcers presenting to an outpatient department. It is a cumbersome, difficult to treat disease, which causes high morbidity and huge cost for the patient and healthcare system. Current standard treatment includes compression therapy.  However, majority of patients need long term treatment with minimal efficacy. Aim of our study is to evaluate efficacy of four layers compressive bandages for the management of chronic venous ulcers...
July 2015: JNMA; Journal of the Nepal Medical Association
Jong Kwon Park, Do Hoon Koo, Doo Hwan Yoon, Jeong Nyeo Lee
BACKGROUND: D-dimer levels are closely related to the clinical status of deep vein thrombosis (DVT). This study aimed to investigate the factors which were associated with the normalization of D-dimer level by vitamin K antagonist (VKA) therapy, the maintenance of normal D-dimer levels for 6 months during VKA therapy, and the recurrent elevations of D-dimer above normal level after VKA withdrawal, in DVT of the legs. METHODS: The 469 consecutive patients with first-episode leg swelling were examined...
July 2016: Annals of Vascular Surgery
A Young, J Phillips, H Hancocks, C Hill, N Joshi, A Marshall, J Grumett, J A Dunn, A Lokare, O Chapman
INTRODUCTION: Venous thromboembolism (VTE) in cancer patients is an increasingly frequent clinical problem. The overall impact of VTE on cancer patients can be considerable. Targeted patient selection by identifying patients with clinically significant recurrent VTE may have wider health economic benefits whilst reducing patient risk through over-treatment. In the UK, dalteparin is one licensed anticoagulant for the extended treatment and prevention of recurrence of VTE in cancer patients...
April 2016: Thrombosis Research
F Dentali, S Pegoraro, S Barco, M N D di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S Passamonti, R Benedetti, W Ageno, M Di Nisio
INTRODUCTION: Isolated distal deep vein thrombosis (IDDVT) accounts for one-fourth to one-half of all deep vein thrombosis (DVT) of the leg. Patients with IDDVT are frequently treated for a shorter period of time compared to patients with proximal DVT and/or pulmonary embolism (PE) due to a perceived lower risk of recurrence. About 10-20% of patients with venous thromboembolic events (VTEs) have concomitant cancer. Guidelines recommend long-term anticoagulant treatment in this group of patients due to their high risk of VTE recurrence...
April 2016: Thrombosis Research
Ruixia Song, Junyan Li, Chenming Dong, Jing Yang
OBJECTIVE: To compare the sedative effect and safety of dexmedetomidine and midazolam in the intensive care unit (ICU) patients undergoing ventilator bundle treatment. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Ninety patients receiving ICU ventilator-assisted therapy and ventilator bundle treatments for more than 3 days in the First Department of Critical Care Medicine of the Second Hospital of Lanzhou University from January 2013 to December 2014 were enrolled...
October 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Kang-Ling Wang, Pao-Hsien Chu, Cheng-Han Lee, Pei-Ying Pai, Pao-Yen Lin, Kou-Gi Shyu, Wei-Tien Chang, Kuan-Ming Chiu, Chien-Lung Huang, Chung-Yi Lee, Yen-Hung Lin, Chun-Chieh Wang, Hsueh-Wei Yen, Wei-Hsian Yin, Hung-I Yeh, Chern-En Chiang, Shing-Jong Lin, San-Jou Yeh
UNLABELLED: Deep vein thrombosis (DVT) is a potentially catastrophic condition because thrombosis, left untreated, can result in detrimental pulmonary embolism. Yet in the absence of thrombosis, anticoagulation increases the risk of bleeding. In the existing literature, knowledge about the epidemiology of DVT is primarily based on investigations among Caucasian populations. There has been little information available about the epidemiology of DVT in Taiwan, and it is generally believed that DVT is less common in Asian patients than in Caucasian patients...
January 2016: Acta Cardiol Sin
Martin H Prins, Anthonie W A Lensing, Tim A Brighton, Roger M Lyons, Jeffrey Rehm, Mila Trajanovic, Bruce L Davidson, Jan Beyer-Westendorf, Ákos F Pap, Scott D Berkowitz, Alexander T Cohen, Michael J Kovacs, Philip S Wells, Paolo Prandoni
BACKGROUND: Patients with venous thromboembolism and cancer have a substantial risk of recurrent venous thromboembolism and bleeding during anticoagulant therapy. Although monotherapy with low-molecular-weight heparin is recommended in these patients, in clinical practice many patients with venous thromboembolism and cancer do not receive this treatment. We aimed to assess the efficacy and safety of a single-drug regimen with oral rivaroxaban compared with enoxaparin followed by vitamin K antagonists, in the subgroup of patients with cancer enrolled in the EINSTEIN-DVT and EINSTEIN-PE randomised controlled trials...
October 2014: Lancet Haematology
Rachel Forster, Marlene Stewart
BACKGROUND: The optimal duration of thromboprophylaxis after total hip or knee replacement, or hip fracture repair remains controversial. It is common practice to administer prophylaxis using low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) until discharge from hospital, usually seven to 14 days after surgery. International guidelines recommend extending thromboprophylaxis for up to 35 days following major orthopaedic surgery but the recommendation is weak due to moderate quality evidence...
2016: Cochrane Database of Systematic Reviews
P Thangaraju, V C Giri, U Aravindan, V Sajitha, M K Showkath Ali
In 1998 a 57-year-old man having skin leisons of 6 months duration reported to Central Leprosy Teaching and Research Institute (CLTRI), Chengalpattu. It was diagnosed as a case of borderline lepromatous leprosy with a type 2 lepra reaction, was treated with multi bacillary-multi drug therapy (MBMDT) for a period of 12 months and the patient was released from treatment (RFT) in September 1999. For reactions the patient was treated with prednisolone for more than 10 months. After 14 years in April 2013 the same patient presented to CLTRI with complaints of weakness of both hands with loss of sensation for 4 months, so making a diagnosis suggestive of MB relapse with neuritis the patient was started with MB-MDT for period of 12 months with initial prednisolone 25 mg OD dose then increased to 40 mg for painful swollen leg and to follow the neuritis associated pain and swelling...
July 2015: Indian Journal of Leprosy
Efthymios D Avgerinos, Eric S Hager, Abdallah Naddaf, Ellen Dillavou, Michael Singh, Rabih A Chaer
BACKGROUND: Catheter-directed thrombolysis (CDT) with adjunctive mechanical techniques, when successful, is reported to alleviate symptoms of acute iliofemoral deep venous thrombosis (IFDVT) and to lower the occurrence of the post-thrombotic syndrome (PTS). This study aimed to determine longer term outcomes of catheter-based interventions for IFDVT and to identify predictors of immediate and mid-long-term failures that would guide optimal patient selection. METHODS: Consecutive patients who underwent CDT or pharmacomechanical thrombolysis for IFDVT between May 2007 and March 2013 were identified from a prospectively maintained database...
January 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Eric Hager, Theodore Yuo, Efthymios Avgerinos, Abdullah Naddaf, Geetha Jeyabalan, Luke Marone, Rabih Chaer
OBJECTIVE: Pharmacomechanical thrombolysis (PMT) and catheter-directed thrombolysis (CDT) are commonly used for the treatment of iliofemoral deep venous thrombosis (DVT). The purpose of this study was to examine the short- and long-term venous patency and venous valvular function as well as clinical outcomes of patients treated for iliofemoral DVT by PMT and CDT. METHODS: A retrospective review of all patients with symptomatic DVT treated between 2006 and 2011 with PMT or CDT was performed...
July 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Elliot J P Stephenson, Timothy K Liem
BACKGROUND: Clinical trials have shown that the presence of ultrasound-identified residual venous obstruction (RVO) on follow-up scanning may be associated with an elevated risk for recurrence, thus providing a potential tool to help determine the optimal duration of anticoagulant therapy. We performed a systematic review to evaluate the clinical utility of post-treatment duplex imaging in predicting venous thromboembolism (VTE) recurrence and in adjusting duration of anticoagulation...
July 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
I Mahé, H Puget, J C Buzzi, M Lamuraglia, J Chidiac, A Strukov, Hélène Helfer, A Perozziello
PURPOSE: French 2008 treatment guidelines recommend low-molecular-weight heparins (LMWH) for the treatment of cancer-associated thrombosis (CAT) with treatment duration of at least 3 months and up to 6 months and beyond if cancer remains active. Our aim was to assess adherence to guidelines in hospital clinical practice. METHODS: The French hospital database (PMSI) was used to identify patients with CAT admitted to three hospitals of the Paris region to be included in a retrospective cohort study...
August 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
R E Kalinin, I A Suchkov, A S Pshennikov, A B Agapov
OBJECTIVE OF THE STUDY: To assess the effectiveness of anticoagulant therapy (ACT) for the treatment of patients with deep venous thrombosis (DVT) of the lower extremities. MATERIAL AND METHODS: The study considered ultrasonic characteristics of lysis of the proximal part of thrombus: localization and nature of venous thrombosis, the length and diameter of the proximal floating part of the thrombus, and duration of the venous thrombosis. Depending on the ACT options patients were divided into 3 groups: Group 1 (18 patients) received rivaroxaban, group 2 (19 patients) received enoxaparin sodium with subsequent transition to warfarin, and 3 group (19 patietns) received enoxaparin sodium, followed by administration of rivaroxaban...
2016: Khirurgiia
Sebastian Werth, Rupert Bauersachs, Horst Gerlach, Eberhard Rabe, Sebastian Schellong, Jan Beyer-Westendorf
Patients with superficial vein thrombosis (SVT) are commonly treated with low-molecular weight heparin or fondaparinux in prophylactic, intermediate or therapeutic dosages for treatment periods of 10-45 days. This practice is also reflected by the current guideline recommendations. However, given the broad range of thromboembolic complication rates in SVT (between 0 and 30 % have been reported) it seems reasonable to suspect that risk stratification is needed to differentiate patients at low risk who may not benefit from anticoagulation from those at high risk who may need higher dosages or a longer duration of anticoagulation...
August 2016: Journal of Thrombosis and Thrombolysis
Giovanni Barillari, Ambrogio P Londero, Benjamin Brenner, Dolores Nauffal, Juan Francisco Sánchez Muñoz-Torrero, Fátima Del Molino, Farès Moustafa, Olga Madridano, Francisco Martín-Martos, Manuel Monreal
INTRODUCTION: The aim of this study was to investigate the recurrence rate of venous thromboembolism (VTE) and the prevalence of major bleeding or death in patients with previous VTE in pregnancy and puerperium. Risk factors for VTE recurrence were also assessed. MATERIALS AND METHODS: We evaluated a cohort of patients enrolled in the international, multicenter, prospective Registro Informatizado de la Enfermedad Trombo-Embólica (RIETE) registry with objectively confirmed VTE...
July 2016: European Journal of Internal Medicine
Caitriona B O'Neill, Coral L Atoria, Eileen M O'Reilly, Martin C Henman, Peter B Bach, Elena B Elkin, Caitriona B O'Neill, Coral L Atoria, Eileen M O'Reilly, Martin C Henman, Peter B Bach, Elena B Elkin
PURPOSE: Hospital readmissions are often cited as a marker of poor quality of care. Limited data suggest some readmissions may be preventable depending upon definitions and available outpatient support. METHODS: General criteria to define preventable and not preventable admissions were developed before data collection began. The records of sequential nonsurgical oncology readmissions were reviewed independently by two reviewers. When the reviewers disagreed about assigning admissions as preventable or not preventable, a third reviewer was the tie breaker...
February 2016: Journal of Oncology Practice
Pedro Garcia, Wilson Ruiz, César Loza Munárriz
BACKGROUND: Venous thromboembolism (VTE) is a common condition in hospital patients. Considerable controversy is ongoing regarding optimal initial warfarin dosing for patients with acute deep venous thrombosis (DVT) and pulmonary embolism (PE). Achieving a therapeutic international normalized ratio (INR) with warfarin as soon as possible is important because this minimizes the duration of parenteral medication necessary to attain immediate anticoagulation, and it potentially decreases the cost and inconvenience of treatment...
2016: Cochrane Database of Systematic Reviews
Chuanlin Zhang, Qining Fu, Yu Zhao, Shaoyu Mu, Liping Liu
BACKGROUND: Prompt recanalization of the vein containing the thrombus is an important goal during the initial treatment of DVT, and risk factors for delayed recanalization in patients with deep vein thrombosis (DVT) in the lower extremities need to be determined. MATERIAL/METHODS: A total of 174 patients with DVT in lower extremities were recruited from June 2014 to March 2015 at our hospital. Duplex ultrasound scanning was conducted for all patients at 1 and 6 months after baseline evaluation...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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