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Deep vein thrombosis and catheter directed thrombolysis

Tomoya Hasegawa, Hiroaki Tabata, Mitsuru Kagoshima
Although upper-extremity deep vein thrombosis (UEDVT) is considered rare, its prevalence appears to be increasing, and this may be related to expanding indications for catheter-based interventions. In contrast, few cases have been reported related to strenuous exercise, especially in healthy young adults with thoracic outlet syndrome (Paget-Schroetter syndrome). In contrast to lower-extremity DVT, optimal treatment strategies for UEDVT have not been robustly studied. In this report, we describe a 56-year-old man with primary UEDVT presenting with left arm swelling, paresthesia, and visible collateral veins around the shoulder...
December 2017: Journal of Cardiology Cases
Haiyang Wang, Xiaotong Qi, Hailong Luo, Qian Zhang, Yikuan Chen, Jianming Sun
OBJECTIVE: The objective of this study was to evaluate the feasibility, efficacy, and safety of catheter-directed thrombolysis (CDT) through an anterior tibial vein approach for acute extensive lower extremity deep venous thrombosis (DVT). METHODS: There were 125 consecutive patients with acute extensive lower extremity DVT who received CDT through an anterior tibial vein approach between October 2014 and June 2017. The patients with iliac vein compression syndrome were treated with balloon dilation and stent implantation after CDT...
August 17, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Cassius Iyad Ochoa Chaar, Afsha Aurshina
The surgical treatment of deep venous thrombosis (DVT) has significantly evolved and is focused on different strategies of early thrombus removal in the acute phase and deep venous recanalization or bypass in the chronic phase. Along with the use of anticoagulation agents, endovascular techniques based on catheter-directed thrombolysis and pharmacomechanical thrombectomy have been increasingly used in patients with acute extensive DVT. Patient selection is crucial to provide optimal outcomes and minimize complications...
September 2018: Clinics in Chest Medicine
Ashraf Odeh Alshabatat, Mohammad Esmaeil Barbati, Omran Alzoubi, Houman Jalaie, Cees H A Wittens
BACKGROUND: May-Thurner syndrome (MTS) leads to an increased incidence of deep vein thrombosis (DVT). Early thrombus removal decreases the post-thrombotic morbidities. Our aim was to better elucidate the relationship between MTS and venous patency after catheter-directed thrombolysis (CDT). METHODS: The medical records of all patients who underwent CDT from January 2005 to December 2011 due to acute DVT were reviewed retrospectively. Patient characteristics and clinical variables were evaluated to determine association with vein patency...
August 6, 2018: Annals of Vascular Surgery
Ronald S Winokur, Akhilesh K Sista
PURPOSE OF REVIEW: Patients suffering from acute lower extremity deep vein thrombosis (DVT) are at risk for developing chronic limb pain, heaviness, and fatigue, known as the post-thrombotic syndrome (PTS). RECENT FINDINGS: Although several studies have shown that catheter-directed therapy reduces clot burden and may improve clinical outcomes, the multicenter randomized controlled ATTRACT trial showed no difference in PTS or quality of life at 2 years between patients treated with pharmacomechanical catheter-directed thrombolysis (PCDT) and those treated with anticoagulation alone, and a higher major bleeding rate in the PCDT group...
August 6, 2018: Current Treatment Options in Cardiovascular Medicine
Sidra Khalid, Aariez Khalid, Tessy Meridores, Hamed Daw
May-Thurner syndrome (MTS) is a medical condition where the left iliac vein is compressed by the right iliac artery, which in turn predisposes patients to deep venous thrombosis (DVT). We present a case of a 67-year-old female who had pain and swelling of the left leg. Ultrasound of the deep veins of the leg revealed DVT of the distal external iliac vein. She was treated with catheter-directed thrombolysis and stent placement. Finally, she was discharged on long-term anticoagulation with warfarin. The purpose of presenting this case is to highlight the clinical presentation, diagnosis, and treatment of MTS...
May 29, 2018: Curēus
Guang Liu, Zhen Zhao, Chaoyi Cui, Kaichuang Ye, Minyi Yin, Xaiobing Liu, Jinbao Qin, Xintian Huang, Min Lu, Mier Jiang, Weimin Li, Xinwu Lu
Purpose The aim of the present study was to report the clinical outcomes of endovascular treatment for extensive lower limb deep vein thrombosis with AngioJet rheolytic thrombectomy (ART) plus catheter-directed thrombolysis (CDT) using a contralateral femoral approach. Methods A retrospective analysis of consecutive ART+CDT treatments in 38 deep vein thrombosis patients (LET I-III, from September 2014 to March 2016) was performed. Results The technical success rate was 100%. Complete lysis was achieved in 82% of LET III segments (calf veins), 87% of LET II segments (popliteal-femoral veins), and 90% of LET III segments (iliac veins)...
July 27, 2018: Phlebology
Arina J Ten Cate-Hoek
<AbstractText>Post thrombotic syndrome (PTS) is a common chronic complication of deep vein thrombosis of the leg (DVT). Treatment options are limited therefore emphasis is placed on its prevention. Several risk factors have been recognized, but were so far not used for risk stratification or translation into prediction models. Early interventions did not yet result in more successful preventive treatment strategies; for the acute phase of DVT there is equipoise on the value of elastic compression, as well as on catheter directed thrombolysis...
April 2018: Research and practice in thrombosis and haemostasis
Jacqueline N Poston, David A Garcia
No abstract text is available yet for this article.
July 24, 2018: Blood Advances
Thita Chiasakul, Adam Cuker
No abstract text is available yet for this article.
July 24, 2018: Blood Advances
Othman S Akhtar, Vladimir Lakhter, Chad J Zack, Hafiz Hussain, Vikas Aggarwal, Estefania Oliveros, Yevgeniy Brailovsky, Huaqing Zhao, Ravi Dhanisetty, Resmi A Charalel, Matthew Zhao, Riyaz Bashir
OBJECTIVES: The aim of this study was to investigate the contemporary trends and comparative effectiveness of adjunctive inferior vena cava filter (IVCF) placement in patients undergoing catheter-directed thrombolysis (CDT) for treatment of proximal lower extremity or caval deep vein thrombosis. BACKGROUND: CDT is being increasingly used in the management of proximal deep vein thrombosis. Although a significant number of patients treated with CDT undergo adjunctive IVCF placement, the benefit of this practice remains unknown...
July 23, 2018: JACC. Cardiovascular Interventions
Gudula Boon, L F Van Dam, F A Klok, M V Huisman
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most frequent cardiovascular disease besides myocardial infarction and stroke. Because DVT may cause life-threatening conditions, treatment should be started as soon as possible. This comprises certain challenges in special populations. Areas covered: In cancer-associated VTE, current treatment is different from non-cancer VTE due to disease-related interventions and higher bleeding risks. In the treatment of patients with extensive DVT, the role of catheter-directed thrombolysis has been investigated in two randomized trials, but results do not yield a recommendation for standard thrombolysis...
September 2018: Expert Review of Hematology
Young-Ah Kim, Shin-Seok Yang, Woo-Sung Yun
Purpose: The aim of this study is to identify risk factors of postthrombotic syndrome (PTS) and evaluate the efficacy of catheter-directed thrombolysis (CDT) for preventing the development of PTS in patients with lower extremity deep vein thrombosis (DVT). Materials and Methods: From 2005 January to 2013 December, 139 limbs of 126 patients were included in this study who had the first episode of proximal DVT at the affected limb and who had visited our out-patient clinic...
June 2018: Vascular Specialist International
Wang Li, Zhang Chuanlin, Mu Shaoyu, Chao Hsing Yeh, Chen Liqun, Zhang Zeju
OBJECTIVES: To evaluate case series studies that quantitatively assess the effects of catheter-directed thrombolysis (CDT) and compare the efficacy of CDT and anticoagulation in patients with acute lower extremity deep vein thrombosis (DVT). METHODS: Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE and Scopus, were searched through January 2017. The inclusion criteria were applied to select patients with acute lower extremity DVT treated with CDT or with anticoagulation...
June 21, 2018: Revista Latino-americana de Enfermagem
Gerard J O'Sullivan, Rick de Graaf, Steven A Black
Venous thromboembolism (VTE) is a major public health issue; deep vein thrombosis (DVT) affects about 1/1000 patients. Each year, VTE kills more patients in Western Europe than breast cancer, prostate cancer, acquired immune deficiency syndrome (AIDS) and road traffic accidents combined and is responsible for the deaths of approximately 370,000 European citizens (Cohen et al. in Thromb Haemost 98:756-764, 2007; Bĕlohlávek et al. in Exp Clin Cardiol 18(2):129-138, 2013). The recently published ATTRACT trial (Acute Venous Thrombosis Thrombus Removal with Adjunctive Catheter-directed Thrombolysis) (Vedantham et al...
September 2018: Cardiovascular and Interventional Radiology
N Denny, S Musale, H Edlin, F Serracino-Inglott, J Thachil
Deep vein thrombosis (DVT) is an important cause of short-term mortality and long-term morbidity. Among the different presentations of DVT, thrombus in the iliofemoral veins may be considered the severest form. Although anticoagulation is the mainstay of the management of iliofemoral thrombosis, despite adequate anticoagulant treatment, complications including post-thrombotic syndrome is not uncommon. The latter is often overlooked but can cause considerable morbidity to the affected individuals. Preventing this condition remains a challenge but recent clinical trials of catheter directed thrombolysis and elasticated compression stockings provide some advance in this context...
2018: Acute Medicine
Paul O'Connor, Robert Lookstein
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome...
June 2018: Techniques in Vascular and Interventional Radiology
Liangxi Yuan, Ye Lu, Guanglang Zhu, Tianchi Hu, Xiaoyu Sun, Junmin Bao, Qingsheng Lu, Zaiping Jing
BACKGROUND: To evaluate the applicability of endovascular treatment for iliofemoral vein thrombosis with composite stents. METHODS: Between September 2013 and August 2016, 29 consecutive patients underwent endovascular therapy with composite stents for iliofemoral vein thrombosis and were followed up at our institution. All the patients with acute or chronic iliofemoral vein thrombosis enrolled in this study were evaluated by color Doppler ultrasonography and diagnosed by venography...
August 2018: Annals of Vascular Surgery
Yub Raj Sedhai, Reshma Golamari, Aliaksei Salei, Joseph Alukal, Soney Basnyat, Sunil Pathak, Santosh Timalsina, Subtain Zia, Suraj Malhan, Priyanka T Bhatacharya
This single-center, retrospective review identified 6 patients (n = 6, 100% female) treated by endovascular therapy for May-Thurner syndrome from June 2013 to September 2015. Patients consisted of 3 African American, 2 Caucasian and 1 Asian; mean age was 53.50 ± 8.31 years, range: 39-63 years. Clinical presentations consisted of left lower extremity deep vein thrombosis in 4, left lower extremity deep vein thrombosis with pulmonary embolism in 1 and pulmonary embolism with left common iliac vein thrombosis in 1 patient...
May 2018: American Journal of the Medical Sciences
Carlos Veiga, João Gonçalves, Pedro Sousa, Carolina Vaz, Ivone Silva, Pedro Sá-Pinto, Rui Almeida
INTRODUCTION: Phlegmasia cerulea dolens (PCD) is a rare complication of deep venous thrombosis (DVT). Massive ileo-femoral DVT is usually the cause and prompt treatment is mandatory as it represents a medical emergency. Reported amputation rates range from 12% to 25% and mortality ranges from 25% to 40%. Limb ischemia results from obstruction to arterial inflow secondary to extreme levels of venous hypertension. Primary treatment goal is restoration of venous outflow and can be achieved by endovascular or surgical techniques...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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