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Pulmonary embolism heparin

Giancarlo Agnelli, Cecilia Becattini, Rupert Bauersachs, Benjamin Brenner, Mauro Campanini, Alexander Cohen, Jean Marie Connors, Andrea Fontanella, Gualberto Gussoni, Menno V Huisman, Catherine Lambert, Guy Meyer, Andres Muñoz, Joaquim Abreu de Sousa, Adam Torbicki, Melina Verso, Giorgio Vescovo
International and national guidelines recommend low-molecular-weight heparin for the treatment of venous thromboembolism (VTE) in patients with cancer. The aim of the Caravaggio study is to assess whether oral apixaban is non-inferior to subcutaneous dalteparin for the treatment of acute proximal deep vein thrombosis and/or pulmonary embolism in patients with cancer. The study is an investigator-initiated, multi-national, prospective, randomized, open-label with blind end-point evaluation (PROBE), non-inferiority clinical trial (NCT03045406)...
August 13, 2018: Thrombosis and Haemostasis
(no author information available yet)
Alzghari SK, Seago SE, Garza JE, Hashimie YF, Baty KA, Evans MF, Shaver C and Herrington JD (2017). Retrospective comparison of low molecular weight heparin vs. warfarin vs. oral Xa inhibitors for the prevention of recurrent venous thromboembolism in oncology patients: The Re-CLOT study. Journal of Oncology Pharmacy Practice, published online July 2017. (Original DOI 10.1177/1078155217718382 ). In the above referenced article, sentence 2, line 3 on page 4 should read: One patient presented with a recurrent pulmonary embolism (PE) in the enoxaparin cohort (4...
August 7, 2018: Journal of Oncology Pharmacy Practice
Genki Usui, Jun Matsumoto, Hirotsugu Hashimoto, Takehiro Katano, Masashi Kusakabe, Hajime Horiuchi, Seiji Okubo
Cerebral embolism is a very serious complication after lung cancer surgery. In such cases, cerebral embolism is caused by a thrombus formed in the pulmonary vein stump. Most such cases have been reported to occur within 10 days after left upper lobectomy. The patients were treated with anticoagulation therapy to prevent the recurrence of cerebral embolism, and recurrence or thrombus reformation has not been reported to the best of our knowledge. We present a 68-year-old man with a cerebral embolism detected on the day after left upper pulmonary lobectomy for lung cancer...
August 1, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Bader Al Rawahi, Mosaad Almegren, Marc Carrier
BACKGROUND: Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein thrombosis (CVT) with or without intracranial hemorrhage (ICH). AIM: We conducted a systematic review and meta-analysis to determine the efficacy and safety of LMWH compared to UFH for the treatment of acute CVT. METHODS: An electronic search of MEDLINE, Pubmed, CENTRAL and Google Scholar was performed...
July 25, 2018: Thrombosis Research
Zixia Wu, Zhiyong Liu, Wei Zhang, Wenzheng Zhang, En Mu
OBJECTIVE: To explore the correlation between thromboelastography (TEG) parameters and the risk of venous thromboembolism (VTE) and bleeding in patients receiving anticoagulant therapy in surgical intensive care unit (SICU). METHODS: 205 patients received low molecular weight heparin (LMWH) anticoagulant therapy admitted to SICU of Tianjin Hospital from December 2016 to December 2017 were consecutively enrolled. TEG detection was performed in all patients at 1 day after anticoagulation therapy, and coagulation reaction time (R value), blood clot generation time (K value), blood clot generation rate (α angle) and maximum width value (MA value) were recorded...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Annemarie E Fogerty
PURPOSE OF REVIEW: This manuscript addresses the risks for venous thromboembolism (VTE) during pregnancy and the associated challenges of both diagnosis and treatment. RECENT FINDINGS: The obstacles to diagnosis given lack of specificity of typical biomarkers to predict VTE in pregnancy, as well as the unique fetal and bleeding risks introduced by managing massive pulmonary embolism (PE) with thrombolytics or thrombectomy are highlighted. VTE during pregnancy and the postpartum window occurs at a 6-10-fold higher rate compared with age-matched peers and is a major cause of morbidity and mortality...
July 23, 2018: Current Treatment Options in Cardiovascular Medicine
Tomoyuki Naito, Hiroki Hayashi, Takeru Kashiwada, Yoshinobu Saito, Shinji Abe, Kaoru Kubota, Akihiko Gemma
A 41-year-old woman presented complaining of cough and purpura for one month. On her first visit, a blood test demonstrated peripheral blood eosinophilia, but chest radiography showed no abnormalities. However, 2 days after the first visit, she went to the emergency room because of fever and right-sided chest pain. Contrast-enhanced computed tomography of the chest showed pulmonary embolism and air space consolidation. Thrombosis was present in the popliteal vein. Bronchoscopy revealed alveolar hemorrhage and increased eosinophils in the bronchoalveolar lavage fluid, and a skin biopsy demonstrated a perivascular eosinophilic infiltrate...
2018: Respiratory Medicine Case Reports
Charbel F Matar, Lara A Kahale, Maram B Hakoum, Ibrahim G Tsolakian, Itziar Etxeandia-Ikobaltzeta, Victor Ed Yosuico, Irene Terrenato, Francesca Sperati, Maddalena Barba, Holger Schünemann, Elie A Akl
BACKGROUND: The choice of the appropriate perioperative thromboprophylaxis for people with cancer depends on the relative benefits and harms of different anticoagulants. OBJECTIVES: To systematically review the evidence for the relative efficacy and safety of anticoagulants for perioperative thromboprophylaxis in people with cancer. SEARCH METHODS: This update of the systematic review was based on the findings of a comprehensive literature search conducted on 14 June 2018 that included a major electronic search of Cochrane Central Register of Controlled Trials (CENTRAL, 2018, Issue 6), MEDLINE (Ovid), and Embase (Ovid); handsearching of conference proceedings; checking of references of included studies; searching for ongoing studies; and using the 'related citation' feature in PubMed...
July 11, 2018: Cochrane Database of Systematic Reviews
Takehiko Oami, Taku Oshima, Reiko Oku, Kazuya Nakanishi
Background: Thrombolysis for pulmonary embolism and targeted temperature management for cardiac arrest are controversial treatments in pregnancy. Case: A 37-year-old woman at 23 weeks gestation presented with persistent dyspnea. She experienced cardiac arrest soon after arrival at the emergency room. Massive right ventricular dilatation on echocardiography during the transient return of spontaneous circulation suggested pulmonary embolism. We administered recombinant tissue plasminogen activator for suspected pulmonary embolism to successfully resuscitate the patient experiencing refractory cardiac arrest despite heparin infusion...
July 2018: Acute Medicine & Surgery
Walter Ageno, Beverley J Hunt
Hospitalized acute medically ill patients are vulnerable to venous thromboembolism (VTE), known as hospital-acquired thrombosis (HAT). The elevated risk of HAT is usually due to a combination of factors, with immobility and a prothrombotic state due to acute illness being the most frequent. The HAT risk persists well after hospital discharge, with more than half of events occurring after patient release. These HAT events may be fatal, and patients who survive the initial event may be subject to VTE recurrence, chronic discomfort from post-thrombotic syndrome and, although rare, may develop chronic thrombo-embolic pulmonary hypertension, which is often debilitating...
May 2018: European Heart Journal Supplements: Journal of the European Society of Cardiology
P Priyanka, J T Kupec, M Krafft, N A Shah, G J Reynolds
Background: Newer oral anticoagulants (NOACs) are being utilized increasingly for the treatment of venous thromboembolism (VTE). NOAC use is the standard of care for stroke prophylaxis in nonvalvular atrial fibrillation and treatment of acute VTE involving extremities and pulmonary embolism. In contrast, most guidelines in the literature support the treatment of acute portal vein thrombosis (PVT) with low molecular weight heparin (LMWH) and vitamin K antagonists (VKA). Literature evaluating NOAC use in the treatment of acute portal vein thrombosis is sparse...
2018: International Journal of Hepatology
Hanzhou Li, Serena Jen, Shvetank Agarwal, Eran Rotem
Catheter-directed thrombolysis (CDT) for the treatment of acute pulmonary embolism (PE) has gained popularity in recent years, but potential complications during the procedure and their management are not frequently discussed in the literature. In this case report, we describe the clinical dilemma regarding the postoperative anticoagulation management of a 60-year-old male who developed cardiac perforation during a CDT of an acute saddle PE. Early resumption of systemic heparin in such cases may help in clot resolution; however, it can worsen the hemopericardium...
July 2018: Lung India: Official Organ of Indian Chest Society
Alejandro R Trevino, Luis Perez, Carlos Jerjes-Sanchez, David Rodriguez, Jathniel Panneflek, Claudia Ortiz-Ledesma, Francisco Nevarez, Vicente Jimenez, Felipe Valdes, Eduardo de Obeso
We report the case of a 61-year-old man who presented at the Emergency Department (ED), complaining of sudden-onset dyspnea and chest pain after a long flight from Tokyo to Houston. Considering his clinical stability and sPESI 0, enoxaparin 1 mg/kg BID was started for 24 h, and the patient was then considered for early discharge with apixaban 10 mg BID. Direct-factor Xa inhibition did not improve extensive thrombus burden and right ventricular dysfunction despite D-dimer measurement reduction. Because of the treatment failure, we considered thrombolysis...
June 22, 2018: American Journal of Emergency Medicine
Jing Tao, Elena N Bukanova, Shamsuddin Akhtar
Background: Although factor Xa inhibitors have become a popular choice for chronic oral anticoagulation, effective drug reversal remains difficult due to a lack of specific antidote. Currently, 4-factor prothrombin complex concentrate (4F-PCC) is considered the treatment of choice for factor Xa inhibitor-related major bleeding. However, safety of 4F-PCC and its risk of thrombosis when used for this off-label purpose remain unclear. The purpose of this retrospective study is to determine the rate of thromboembolism when 4F-PCC is used for the emergent reversal of factor Xa inhibitors...
2018: Journal of Intensive Care
Girard Cua, Neal Holland, Ashleigh Wright
BACKGROUND: Anticoagulation is the mainstay of treatment for pulmonary embolism. However, if bleeding unfortunately occurs, the risks and benefits of anticoagulation present a challenge. Management of one hemorrhagic complication, retroperitoneal hematoma, is rare, difficult, and controversial. CASE PRESENTATION: A 73-year-old white man presented with left lower extremity swelling and dyspnea. He was tachycardic, hypertensive, and demonstrated poor oxygen saturation of 81% on ambient air...
June 22, 2018: Journal of Medical Case Reports
Hai-Feng Huang, Jia-Liang Tian, Xian-Teng Yang, Li Sun, Ru-Yin Hu, Zhi-Hui Yan, Shan-Shan Li, Quan Xie, Xiao-Bin Tian
BACKGROUND: Venous thromboembolism (VTE) is considered a potentially serious complication of knee arthroscopy and leads to conditions such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Low-molecular-weight heparin (LMWH) is widely employed in knee arthroscopy to reduce perioperative thromboembolic complications. However, the efficacy and safety of LMWH in knee arthroscopy remains unclear. METHODS: Seven randomized controlled clinical trials on LMWH in knee arthroscopy were identified and included in this meta-analysis...
2018: PloS One
M Sprynger
Venous thromboembolism is the third cardiovascular disease in Europe. The cornerstone of the treatment of deep vein thrombosis is anticoagulation. It aims at avoiding harmful complications : thrombosis extension and recurrence, pulmonary embolism and post-thrombotic syndrome. Due to low molecular weight heparins, and recently, to direct oral anticoagulants, most of the patients can get treatment as outpatients. Unfortunately, despite guideline publications, the management of these patients may be complicated in real life and not correspond to evidence-based medicine...
May 2018: Revue Médicale de Liège
Shannon L Carpenter, Troy Richardson, Matt Hall
Although rare in children, pulmonary embolism (PE) can cause significant morbidity and mortality. Overall rates of venous thromboembolism (VTE) are increasing in hospitalized children. By using the Pediatric Health Information System database, we evaluated incidence, treatment, and outcome of PE in children younger than age 18 years from 2001 to 2014. Demographic characteristics for those admitted with VTE alone and those admitted with PE were compared. Rates of PE by year were compared with the number of hospital and VTE admissions...
June 26, 2018: Blood Advances
Hannah Eberle, Raquel Lyn, Tamara Knight, Emily Hodge, Mitchell Daley
PURPOSE: Current literature on clinical controversies surrounding the use of thrombolytic agents in patients with intermediate-risk pulmonary embolism (PE) is reviewed. SUMMARY: PE is a major cause of morbidity and mortality. When used in conjunction with anticoagulation, thrombolysis has been shown to reduce hemodynamic decompensation in select patients, but thrombolytic therapy is associated with high risks of bleeding and intracranial hemorrhage and its role in treating patients with intermediate-risk PE remains controversial...
June 12, 2018: American Journal of Health-system Pharmacy: AJHP
Sumeet Bhanvadia, Kayvan Kazerouni, Soroush T Bazargani, Gus Miranda, Jie Cai, Siamak Daneshmand, Hooman Djaladat
PURPOSE: To validate the relationship between ABO blood type and risk of VTE post-RC in a large retrospective database. METHODS: Patients with urothelial bladder cancer (UBC) who underwent RC (intent-to-cure) for whom ABO blood type was available between 2003 and 2015 were identified from our IRB-approved database. VTE was defined as deep vein thrombosis (DVT) or pulmonary embolism (PE) within 90 days of surgery. VTE prophylaxis consisted of immediate postoperative Coumadin (2003-2009), unfractionated heparin (UFH) during hospitalization (2009-2015), and UFH during hospitalization plus 4 weeks of enoxaparin after discharge (2013-2015)...
June 6, 2018: World Journal of Urology
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