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iliofemoral thrombosis

Anastasia Plotkin, Matthew G Bartley, Kathryn E Bowser, Jeniann A Yi, Omid Jazaeri, Gregory A Magee
INTRODUCTION: Iliofemoral vein thrombosis can lead to debilitating edema and venous claudication that significantly worsens quality of life, especially in young active individuals. Venous reconstruction becomes increasingly complex and has worsening patency with subsequent revisions so preoperative planning is critical to success. METHODS: We report a case of a 54 year-old man in active military service with profoundly symptomatic leg swelling after failure of three previous common femoral vein (CFV) reconstructions...
November 23, 2018: Annals of Vascular Surgery
Wei Wei, Xuemei Jiang, Bo Xu, Yikuan Chen
Stents have been widely used to restore the patency of the iliac vein in the treatment of its obstruction. However, various complications related to those stents have been reported. This case report covers a 67-year-old male who was diagnosed with left iliofemoral venous post-thrombotic syndrome with recurrent acute deep venous thrombosis. Thrombosis of the inferior vena cava was induced by pronounced extension of left iliac vein stents. Extending stents in this way covers the outlet of the contralateral common iliac vein and may induce thrombosis in the inferior vena cava...
January 2018: Thoracic and Cardiovascular Surgeon Reports
Yang Shen, Xiang Wang, Sha-Sha Jin, Rui-Li Zhang, Wen-Jun Zhao, Guang Chen
OBJECTIVE: The objective of this study was to investigate the risk of postoperative acute kidney injury (AKI) in patients with acute iliofemoral deep venous thrombosis (IFDVT) who underwent percutaneous pharmacomechanical thrombectomy (PMT) using AngioJet (Boston Scientific, Marlborough, Mass) or catheter-directed thrombolysis. METHODS: Electronic medical records of patients with acute IFDVT from January 2014 to September 2017 were reviewed. Those who received PMT with AngioJet (AJ-PMT group) or catheter-directed thrombolysis (CDT group) were included in this study...
November 12, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Dalibor Musil
The treatment of deep vein thrombosis (DVT) is based on anticoagulation with heparin, warfarin and direct oral anti-coagulants. According to the 9th ACCP Recommendation, for patients with DVT of the lower limbs, where the clinical state and home conditions permit, preference is given to home treatment over hospitalization. Despite that, the majority of patients with acute DVT still tend to be hospitalized, in particular when proximal thrombosis from the popliteal vein upward is involved. Furthermore, the recommendations do not describe proximal (iliofemoral) DVT as exceptional and more serious...
2018: Vnitr̆ní Lékar̆ství
Tim Sebastian, Lawrence O Hakki, David Spirk, Frederic A Baumann, Daniel Périard, Martin Banyai, Rebecca S Spescha, Nils Kucher, Rolf P Engelberger
BACKGROUND: The optimal anticoagulant following catheter-based therapy of acute iliofemoral deep vein thrombosis (IFDVT) is unknown. METHODS: From the Swiss Venous Stent registry, an ongoing prospective cohort study, we performed a subgroup analysis of patients with acute IFDVT who underwent catheter-based early thrombus removal followed by nitinol stent placement. Duplex ultrasound and Villalta scores were used to determine patency rates and incidence of the post-thrombotic syndrome (PTS) in patients treated with either rivaroxaban (n = 73) or a vitamin K-antagonist (VKA; n = 38) for a minimum duration of 3 months...
October 26, 2018: Thrombosis Research
Ulrike Huegel, Daniel Surbek, Beatrice Mosimann, Nils Kucher
Catheter-directed thrombolysis for iliofemoral deep venous thrombosis (DVT) aims to reduce acute leg symptoms and to prevent the post-thrombotic syndrome. There are no data from controlled trials in pregnant patients. Reports of thrombolysis for treatment of DVT during pregnancy are scarce. Pregnancy is considered a relative contraindication to thrombolytic therapy because of the risk of bleeding and concerns about the effects of radiation exposure on the fetus. We report on a catheter-directed thrombolysis procedure without radiation and contrast medium exposure in a first-trimester pregnant patient with massive iliofemoral DVT and free-floating thrombus extending to the suprarenal inferior vena cava...
October 29, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Nicolas W Shammas, Gail A Shammas, Susan Jones-Miller, Qais Radaideh
BACKGROUND: We report on intraprocedural and up to 1-year outcomes on the safety of the Atlas Gold balloon (Bard) in iliofemoral venous interventions. METHODS: All patients who underwent iliofemoral vein compression treatment in our laboratory from September 1, 2013 to May 30, 2017 were identified and medical records were reviewed. The primary safety endpoint was the intraprocedural freedom from major device-related serious adverse events (≥95%) for the Atlas Gold balloon in iliofemoral venous treatment...
November 2018: Journal of Invasive Cardiology
Haijie Che, Jingjun Jiang, Hao Liu, Jichang Wei, Xiaoming Zhang
Background Iliofemoral vein stenosis or occlusion is a common cause of severe chronic venous insufficiency. Endovascular venous stenting has become a preferred treatment because it is minimally invasive and has a high safety profile. Despite the wide application of the wallstent, it is not specifically designed for veins. There are currently few studies on braided stents in the field of veins. We designed a novel braided vein stent, which has higher radial resistive force and more optimized looped ends structure compared with the wallstent...
September 18, 2018: Phlebology
Stephen Black, Adam Gwozdz, Narayan Karunanithy, Justinas Silickas, Karen Breen, Beverley Hunt, Alberto Smith, Ander Cohen, Prakash Saha
OBJECTIVE/BACKGROUND: The aim was to assess two year outcomes with placement of the Vici Venous Stent® in patients with chronic iliofemoral venous occlusions (complete blockage). METHODS: This was a retrospective single centre study comprising patients treated with the Vici Venous Stent for venographically verified iliofemoral venous occlusion and post-thrombotic syndrome (Villalta score ≥ 5 points) at least 12 months after acute deep vein thrombosis. Venography and intravascular ultrasound were used peri-operatively; duplex ultrasound was used to assess stent patency during follow up...
November 2018: European Journal of Vascular and Endovascular 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
Martin Rabellino, Pedro Moltini, Vanesa Di Caro, Ricardo García-Mónaco
INTRODUCTION: Proximal (iliocaval and iliofemoral) deep vein thrombosis (DVT) and pulmonary thromboembolism are the second cause of death in patients with cancer. MATERIAL AND METHODS: A retrospective analysis was performed in 35 patients with cancer treated with endovascular therapy for proximal DVT. The primary objective was to evaluate the technical success of the procedure and the 30-day and long-term symptom improvement. RESULTS: Thirty-five patients with a mean age of 57...
November 2018: Vascular and Endovascular Surgery
Jin Ueda, Akihiro Tsuji, Takeshi Ogo, Ryotaro Asano, Nao Konagai, Shigefumi Fukui, Yoshiaki Morita, Tetsuya Fukuda, Satoshi Yasuda
BACKGROUND: Post-thrombotic syndrome (PTS), the most common complication of deep venous thrombosis (DVT), develops in ≥50% of patients with iliofemoral DVT. However, the benefit of endovascular treatment in Japanese patients with chronic DVT and PTS remains unclear. Methods and Results: Between June 2014 and May 2016, endovascular treatment was performed in 11 consecutive Japanese patients with chronic iliofemoral DVT and PTS refractory to anticoagulant therapy and elastic compression stockings...
September 25, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
A V Pokrovskiĭ, I M Ignat'ev, E G Gradusov
OBJECTIVE: The purpose of the study was to assess the immediate and remote results of endovascular treatment of obstructive lesions of the veins of the iliofemoral segment. PATIENTS AND METHODS: We performed balloon angioplasty and stenting for iliofemoral venous thrombosis in a total of 75 patients. Of these, 60 patients were subjected to stenting of post-thrombotic obstructions and 15 patients underwent stenting of non-thrombotic obstructive lesions of the iliac veins (for May-Thurner syndrome - in 11, for extravasal tumour-induced compression and cicatricial stenosis - in 4)...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Song Jin, Ziqiang Sun, Xiaoqin Li, Tao Jian, Xing Jin, Sheng Li, Guodong Wang, Chong Ma, Kai Cui, Peng Xu
OBJECTIVE: Pulmonary embolism (PE) is the most common complication of deep venous thrombosis (DVT). May-Thurner syndrome (MTS) is known to increase the risk of DVT, but an association between MTS and PE has not been established. This study investigated an association between MTS and the risk of PE in patients with acute lower extremity DVT. METHODS: Between June 2014 and September 2016, there were 112 patients with DVT at our hospital who underwent venous angiography and computed tomography pulmonary angiography...
July 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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
Mohamed Ah Taha, Andrew Busuttil, Roshan Bootun, Alun H Davies
Objectives The aim is to evaluate venous stent patency, the development of post-thrombotic syndrome, recurrence, quality of life and the optimal post-procedural anticoagulation regimen in the treatment of iliofemoral deep venous thrombosis. Method and results EMBASE and Medline databases were interrogated to identify studies in which acute deep venous thrombosis patients were stented. Twenty-seven studies and 542 patients were identified. Primary, assisted primary and secondary patency rates 12 months after stent placement ranged from 74 to 95, 90 to 95 and 84 to 100%, respectively...
January 1, 2018: Phlebology
Joshua L Moore, Kelly M Pirozzi, Corine Creech, Benjamin Marder
May-Thurner syndrome (MTS) is a rare condition in which patients develop iliofemoral deep venous thrombosis owing to an anatomic variant in which the right common iliac artery overlies and compresses the left common iliac vein against the lumbar spine. Data regarding lower extremity trauma in patients with previously diagnosed MTS are rare. We discuss the operative approach for ankle trauma occurring 3 weeks after endovascular surgery for the treatment of MTS.
September 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
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
Trong Binh Le, Jun Ho Kim, Keun-Myoung Park, Yong Sun Jeon, Kee Chun Hong, Soon Gu Cho
Iatrogenic iliac vein dissection secondary to femoral artery puncture is a rare complication that has not yet been documented. A 55-year-old woman presented to our institution with acute right iliofemoral thrombosis 2 weeks after transfemoral cerebral angiography. She was previously healthy and was not taking any medication. Right iliofemoral vein dissection was diagnosed by computed tomography angiography and confirmed by conventional venography. The patient was treated endovascularly with stent insertion, and the venous outflow was patent on the 6-month follow-up computed tomography angiogram...
August 2018: Vascular and Endovascular Surgery
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