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Pulmonary embolism heparin

Kevin M Roy, Govind R Rajan
ε-Aminocaproic acid is routinely used in cardiac surgery to prevent excess bleeding. It is rarely associated with thrombotic events. This case report illustrates the formation of intracardiac thrombi leading to massive pulmonary embolism during a coronary artery bypass graft surgery, secondary to the administration of ε-aminocaproic acid as confirmed by intraoperative transesophageal echocardiogram. After a failure of resolution with high-dose heparin, tissue plasminogen activator was used to successfully reverse the patient's hypercoagulable state...
December 13, 2018: A&A practice
Shan Lin, Yan Wang, Wei Guan, Yingqing Shi
RATIONALE: Pulmonary embolism (PE) is a relatively common disease; however, myasthenia gravis leading to PE has been rarely reported in the literature. We report a case of PE in a patient with myasthenia gravis and discuss the possible mechanism underlying the development of PE. We hypothesize that inflammatory mediators may lead to endothelial injury, resulting in PE or deep venous thrombosis (DVT) in patients with myasthenia gravis. PATIENT CONCERNS: A 45-year-old woman had a 9-year history of myasthenia gravis...
December 2018: Medicine (Baltimore)
Thomas A Verbeek, Jonathan G Stine, Fuat H Saner, Dmitri Bezinover
In this review, we analyze the epidemiology of thromboses related to end-stage liver disease (ESLD), discuss causes of hypercoagulability, describe susceptible populations, and critically evaluate proposed prophylaxis and treatment of thromboses. Classically, ESLD has been regarded as a model for coagulopathy, and patients were deemed to be at high risk for bleeding complications. Patients with ESLD are not auto-anticoagulated, and they do not have a lower risk of portal vein thrombosis, intracardiac thrombus formation, pulmonary embolism or hepatic artery thrombosis...
November 2018: Transplantation Direct
A E Velcea, S Mihaila Baldea, D Muraru, L P Badano, D Vinereanu
Neck venous malformations and their potentially life-threatening complications are rarely reported in the available literature. Cases of aneurysmal or hypo-plastic jugular vein thrombosis associated with systemic embolization have not been frequently reported. We present the case of a 60-year-old male, without any known risk factors for thromboembolic disease, admitted for sudden onset dyspnea. The physical examination was remarkable for a right lateral cervical mass, expanding with Valsalva maneuver. Thoracic CT with contrast established the diagnosis of bilateral pulmonary embolism and raised the suspicion of superior vena cava and right atrial thrombosis...
December 1, 2018: Echo Research and Practice
Seth Felder, Morten Schnack Rasmussen, Ray King, Bradford Sklow, Mary Kwaan, Robert Madoff, Christine Jensen
BACKGROUND: This an update of the review first published in 2009.Major abdominal and pelvic surgery carries a high risk of venous thromboembolism (VTE). The efficacy of thromboprophylaxis with low molecular weight heparin (LMWH) administered during the in-hospital period is well-documented, but the optimal duration of prophylaxis after surgery remains controversial. Some studies suggest that patients undergoing major abdominopelvic surgery benefit from prolongation of the prophylaxis up to 28 days after surgery...
November 27, 2018: Cochrane Database of Systematic Reviews
Andrea T Obi, Christopher J Tignanelli, Benjamin N Jacobs, Shipra Arya, Pauline K Park, Thomas W Wakefield, Peter K Henke, Lena M Napolitano
BACKGROUND: An association between increased venous thromboembolism (VTE) events and influenza A H1N1 (H1N1) was noted in the first 10 patients with severe acute respiratory distress syndrome (ARDS). An empirical systemic anticoagulation protocol (heparin intravenous infusion) was initiated when autopsy of patients with severe hypoxemia confirmed multiple primary pulmonary thrombi and emboli. The purpose of this study was to examine the relationship between H1N1 and VTE events and to assess the efficacy of empirical systemic heparin anticoagulation in preventing VTE and death in H1N1 severe ARDS patients...
November 23, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Amna Ejaz, Munis M Ahmed, Azka Tasleem, Muhammad Rafay Khan Niazi, Muhammad Farhan Ahsraf, Imama Ahmad, Asma Zakir, Awais Raza
Thromboembolism is a major complication in hospitalized patients. Intensive care unit (ICU) patients have a greater risk of thrombotic events due to additional risk factors such as immobilization, mechanical ventilation, and central catheters. The diagnosis and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in critically ill patients are challenging and these conditions are associated with high mortality. Medical thromboprophylaxis with low molecular weight heparin (LMWH) as well as unfractionated heparin (UFH) has been shown to reduce the incidence of thromboembolic events in such patients...
September 21, 2018: Curēus
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Narong Kulvatunyou, Andrew Tang, Lynn Gries, Bellal Joseph
BACKGROUND: Thromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively. METHODS: A 4-y (2013-2016) review of the Trauma Quality Improvement Program database. We included all patients with an isolated spine trauma (Spine-abbreviated injury scale ≥3 and other-abbreviated injury scale <3) who were managed nonoperatively and received thromboprophylaxis with either low molecular weight heparin (LMWH) or Xa-Inh...
December 2018: Journal of Surgical Research
Alexis A Coulis, William C Mackey
PURPOSE: This study aims to review the published literature concerning the use of novel oral anticoagulants (NOACs) in the treatment and prevention of venous thromboembolism (VTE) and to identify the appropriate niche for each NOAC by comparing their behaviors in Phase III and Phase IV clinical trial settings. METHODS: The database was used to identify Phase III and postmarketing (Phase IV) randomized controlled trials concerning the efficacy and safety profiles of the oral NOACs (apixaban, dabigatran etexilate, exodaban, and rivaroxaban) for the treatment or prevention of VTE...
November 5, 2018: Clinical Therapeutics
Charles Hennemeyer, Abdul Khan, Hugh McGregor, Cheyenne Moffett, Gregory Woodhead
BACKGROUND: Catheter directed therapy (CDT) offers an alternative treatment to systemic thrombolysis for patients with massive and submassive pulmonary embolism. METHODS: A retrospective review of 105 consecutive massive and submassive pulmonary embolisms over two years was performed. Thirty-six patients (9 massive, 27 submassive) were treated with CDT, consisting of aspiration thrombectomy (18), ultrasound-assisted thrombolysis (8) or both (10). Forty-three patients (8 massive, 35 submassive) were treated with heparin anticoagulation alone...
October 24, 2018: American Journal of Medicine
Aikaterini Mastoraki, Sotiria Mastoraki, Dimitrios Schizas, Raphael Patras, Nikolaos Krinos, Ioannis S Papanikolaou, Andreas Lazaris, Theodore Liakakos, Nikolaos Arkadopoulos
Venous thromboembolism (VTE) refers to a hypercoagulable state that remains an important and preventable factor in the surgical treatment of malignancies. VTE includes two identical entities with regards to deep vein thrombosis and pulmonary embolism. The incidence of VTE after major abdominal interventions for gastro-intestinal, hepato-biliary and pancreatic neoplastic disorders is as high as 25% without prophylaxis. Prophylactic use of classic or low-molecular-weight heparin, anti-Xa factors, antithrombotic stocking, intermittent pneumatic compression devices and early mobilization have been described...
October 15, 2018: World Journal of Gastrointestinal Oncology
Bethany R Samuelson Bannow, Agnes Y Y Lee, Alok A Khorana, Jeffrey I Zwicker, Simon Noble, Cihan Ay, Marc Carrier
<AbstractText Label="Background" NlmCategory="UNASSIGNED">The management of anticoagulation for cancer-associated thrombosis (CAT) in patients with thrombocytopenia is controversial. Whereas some studies suggest that administration of reduced-dose low-molecular-weight heparin (LMWH) or temporary discontinuation for moderate and severe thrombocytopenia may be a safe and effective, others suggest full-dose anticoagulation with transfusion support. We sought to address this important knowledge gap and summarize the literature comparing these two common management strategies...
October 2018: Research and practice in thrombosis and haemostasis
E T Van Matre, P M Reynolds, R MacLaren, S W Mueller, G C Wright, M Moss, E L Burnham, P M Ho, R W Vandivier, T H Kiser
Essentials Critically ill cancer patients require pharmacologic prophylaxis for venous thromboembolism (VTE). Patients from 566 hospitals in the United States between 2010 and 2014 were included. Low-molecular-weight heparin (LMWH) prophylaxis was not associated in a reduction of VTE rates. LMWH prophylaxis was associated with a reduction in bleeding and heparin induced thrombocytopenia. SUMMARY: Background Critically ill patients with cancer are at increased risk of venous thromboembolism (VTE) from physical and cellular factors, requiring pharmacologic prophylaxis to reduce the risk of VTE...
October 22, 2018: Journal of Thrombosis and Haemostasis: JTH
Wenzhen Geng, Ying Zhang, Juan Shi
Objective: To analyze the clinical values of modified injection of low-molecular-weight heparin in reducing subcutaneous bleeding and pain. Methods: Two hundred and sixty patients with cerebral infarction, acute myocardial infarction or pulmonary embolism who underwent subcutaneous injection of low-molecular weight heparin in the hospital between December 2015 and December 2016 were selected. They were randomly divided into a control group and a research group, 130 each...
September 2018: Pakistan Journal of Medical Sciences Quarterly
M Felber, F Rozet, S Droupy, V Misraï, D M Smadja, M Rouprêt
INTRODUCTION: Active cancer is a risk factor in the occurrence of venous thromboembolism (VTE). This is the second cause of death for these patients. In onco-urology, some cancers are associated with an increased risk of VTE. The aim of this study was to propose a focus of epidemiology and VTE therapy management. MATERIAL AND METHODS: A systematic analysis of the PubMed® database was performed through the PRISMA methodology using the followings keywords : "neoplasm", "venous thromboembolism", "prophylaxis", "pulmonary embolism", "urology"...
October 10, 2018: Progrès en Urologie
Hui Xu, Hu Liao, Guowei Che, Kun Zhou, Mei Yang, Lunxu Liu
BACKGROUND: The incidence of pulmonary embolism (PE) in lung cancer patients who underwent surgery increased during the perioperative period, and prophylactic anticoagulation therapy was important part of enhanced recovery after surgery (ERAS). However, the timing of preventive anticoagulation in patients with lung cancer remained controversial. This study was designed to investigate the safety and efficacy of perioperative prophylactic anticoagulation therapy for lung cancer patients...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Barry Burstein, Rodrigo S Barbosa, Michelle Samuel, Eli Kalfon, François Philippon, David Birnie, Iqwal Mangat, Damian Redfearn, Roopinder Sandhu, Laurent Macle, John Sapp, Atul Verma, Jeff S Healey, Giuliano Becker, Vijay Chauhan, Benoit Coutu, Jean-François Roux, Peter Leong-Sit, Jason G Andrade, George D Veenhuyzen, Jacqueline Joza, Martin Bernier, Vidal Essebag
PURPOSE: Femoral venous access is required for most electrophysiology procedures. Limited data are available regarding post-procedure venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE). Potential preventative strategies are unclear. We aimed to survey Canadian centers regarding incidence of VTE and strategies for prevention of VTE after procedures that do not require post-procedure anticoagulation. METHODS: An online survey was distributed to electrophysiologists representing major Canadian EP centers...
October 8, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
T A A Seghda, N V Yaméogo, G R C Millogo, L Kagambega, J Kologo, T Boro, A Samadoulougou, P Zabsonré
OBJECTIVE: To describe the management and evolution of high risk of death pulmonary embolism associated with right heart thrombi. MATERIAL AND METHODS: We conducted a prospective cohort survey over a 54 month-period, from March 1st, 2012 to September 30th 2015. Were included all patients with pulmonary embolism and having high or intermediate-high risk of death. Patients were divided into two groups according to whether cardiac Doppler-echography found a thrombus in the right chambers or not (ICT+ vs...
October 3, 2018: Annales de Cardiologie et D'angéiologie
Kohki Nakamura, Takehito Sasaki, Yutaka Take, Yoshinori Okazaki, Mitsuho Inoue, Hiroyuki Motoda, Yuko Miki, Katsura Niijima, Eiji Yamashita, Keiko Koyama, Nobusada Funabashi, Shigeto Naito
INTRODUCTION: This prospective observational study aimed to investigate the incidence of symptomatic and silent cerebral embolisms after balloon-based ablation of atrial fibrillation (AF) in patients receiving periprocedural anticoagulation with direct oral anticoagulants (DOACs), and compare that between cryoballoon and HotBalloon ablation (CBA and HBA). METHODS AND RESULTS: We enrolled 123 consecutive AF patients who underwent a balloon-based pulmonary vein isolation (PVI) and brain magnetic resonance (MR) imaging after the ablation procedure (CBA, n = 65; HBA, n = 58)...
October 4, 2018: Journal of Cardiovascular Electrophysiology
Junji Yamaguchi, Nobuhiro Hara, Tetsuo Yamaguchi, Yasutoshi Nagata, Toshihiro Nozato, Takamichi Miyamoto
We report a case of acute massive pulmonary embolism in a patient with antithrombin III deficiency. The patient was treated with rivaroxaban. The patient responded well to the therapy, and contrast-enhanced computed tomography showed nearly complete disappearance of the pulmonary embolism. Patients with low antithrombin III activity may have resistance to heparin therapy, leading to insufficient anticoagulation during the acute phase of thromboembolism. This case suggests that direct oral anticoagulants, such as rivaroxaban, may be effective first-line agents for treating venous thromboembolism in patients with antithrombin III deficiency...
November 2017: Journal of Cardiology Cases
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