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Venous thrombolysis

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https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#1
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28412100/risk-of-acute-kidney-injury-after-percutaneous-pharmacomechanical-thrombectomy-using-angiojet-in-venous-and-arterial-thrombosis
#2
Guillermo A Escobar, Dillon Burks, Matthew R Abate, Mohammed F Faramawi, Ahsan T Ali, Lewis C Lyons, Mohammed M Moursi, Matthew R Smeds
BACKGROUND: Percutaneous mechanical thrombectomy (PMT) is commonly used to treat acute thrombotic syndromes. Angiojet (AJ) forcibly sprays fibrinolytics to fragment and aspirate thrombus. It's known to cause hemolysis and gross hematuria, yet potential consequences to renal function after AJ remain unstudied. We sought to determine the risk of acute kidney injury (AKI) after AJ when compared to other lysis techniques. METHODS AND RESULTS: We retrospectively reviewed patients treated with thrombolysis over 5 years...
April 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28411702/outcomes-of-iliac-vein-stents-after-pregnancy
#3
Mohini Dasari, Efthimios Avgerinos, Seshadri Raju, Robert Tahara, Rabih A Chaer
OBJECTIVE: Stenting is the first-line treatment for obstructive iliocaval lesions when intervention is required. The aim of the study was to evaluate iliocaval stent patency during and after pregnancy in women of reproductive age who became pregnant after stent placement. METHODS: Female patients of reproductive age (18-45 years old) who underwent iliocaval stenting between May 2007 and March 2014 were identified from a three-center prospectively maintained database...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28400981/new-developments-in-the-pathophysiology-workup-and-diagnosis-of-dural-venous-sinus-thrombosis-dvst-and-a-systematic-review-of-endovascular-treatments
#4
REVIEW
Sanjay Konakondla, Clemens M Schirmer, Fengwu Li, Xiaogun Geng, Yuchuan Ding
Dural venous sinus thrombosis (DVST) is a rare cause of stroke, which typically affects young women. The importance of identifying pre-disposing factors that lead to venous stasis lies in the foundation of understanding the etiology, pathophysiology and clinical presentation. The precise therapeutic role of interventional therapies is not fully understood though the current data do suggest potential applications. The aim of the study was to perform a systematic review and meta-analysis to evaluate the utility of and short-term 30-day survival after endovascular therapy for patients with DVST...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28395416/-application-of-percutaneous-angiojet-thrombectomy-in-patients-with-acute-symptomatic-portal-and-superior-mesenteric-venous-thrombosis
#5
J H Song, X He, W S Lou, L Chen, G P Chen, H B Su, W Y Shi, T Wang, B X Zhao, J P Gu
Objective: To evaluate the clinical value of percutaneous AngioJet thrombectomy in treatment of acute symptomatic portal and superior mesenteric venous thrombosis venous thrombosis (PVMVT) . Method: From January 2014 to January 2016, a total of 8 patients in Nanjing First Hospital with PVMVT verified by color Doppler ultrasound and computed tomographic angiography (CTA) were analyzed retrospectively. Under ultrasound guidance , the branch of the right portal vein(PV) was punctured with a micropuncture set and a 4-F infusion catheter was advanced to the superior mesenteric vein(SMV)...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28393971/-mechanical-and-pharmacomechanical-trombolysis-in-deep-venous-thrombosis-with-no-clinical-response-to-conventional-treatment
#6
Leopoldo Marine, Jesús Urbina, Michel Bergoeing, Francisco Valdés, Renato Mertens, Albrecht Kramer
BACKGROUND: Conventional treatment of deep vein thrombosis (DVT) is anticoagulation, bed rest and limb elevation. Proximal DVT patients with persisting edema, pain and cyanosis of extremities despite of conventional therapy may develop ischemia. Direct treatment of thrombosis becomes necessary. AIM: To report our experience with mechanical trombolysis of proximal lower extremity DVT. MATERIAL AND METHODS: Retrospective review of medical records of proximal DVT patients treated with thrombolysis between March 2012 and August 2015...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28373261/how-we-treat-central-venous-access-device-related-upper-extremity-dvt
#7
Anita Rajasekhar, Michael B Streiff
Central venous access device (CVAD)-related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access and post-thrombotic syndrome. Patient, device and treatment-related factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for prevention of CRT remains to be established...
April 3, 2017: Blood
https://www.readbyqxmd.com/read/28372484/single-center-retrospective-review-of-ultrasound-accelerated-versus-traditional-catheter-directed-thrombolysis-for-acute-lower-extremity-deep-venous-thrombosis
#8
Tony Lu, Thomas M Loh, Hosam F El-Sayed, Mark G Davies
Objective Systemic anticoagulation remains the standard for acute lower extremity (LE) deep venous thrombosis (DVT), but growing interest in catheter-directed thrombolysis (CDT) and its potential to reduce the incidence of post-thrombotic syndrome (PTS) has led to advent of ultrasound-accelerated CDT (US-CDT). Few studies to date have examined the outcomes of US-CDT against traditional CDT (T-CDT). Methods This is a retrospective, single-center review of all patients treated for acute LE DVT over a five-year period with either US- and T-CDT...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28369771/intervention-radiology-for-venous-thrombosis-early-thrombus-removal-using-invasive-methods
#9
REVIEW
Ana I Casanegra, Robert D McBane, Haraldur Bjarnason
The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28352362/feasibility-of-continuous-catheter-directed-thrombolysis-using-low-dose-urokinase-in-combination-with-low-molecular-weight-heparin-for-acute-iliofemoral-venous-thrombosis-in-patients-at-risk-of-bleeding
#10
Guoping Chen, Wangyin Shi, Xu He, Wensheng Lou, Liang Chen, Jianping Gu
The present study aimed to examine the feasibility of catheter-directed thrombolysis (CDT) using continuous infusion of low-dose urokinase in combination with low molecular weight heparin (LMWH) for acute iliofemoral venous thrombosis. This retrospective analysis included patients with symptomatic acute iliofemoral venous thrombosis who received CDT using continuous infusion of low-dose urokinase in combination with LMWH within the past four years. Urokinase was administered at 1×10(4) U/h and 2×10(4) U/h in patients at high-risk and low-risk of bleeding, respectively...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28342731/preferred-management-of-primary-deep-arm-vein-thrombosis
#11
REVIEW
F J Vazquez, P Paulin, D Poodts, E Gándara
OBJECTIVE: Given its rarity, the management of primary upper extremity deep vein thrombosis is controversial. Although anticoagulation alone is commonly advocated for its treatment, it is unclear if this will reduce the risk of developing post-thrombotic syndrome (PTS). The aim of this "Evidence Driven" Clinical Scenario is to evaluate whether more aggressive treatments (including catheter directed thrombolysis or surgery) might help reduce the risk of PTS or recurrent venous thromboembolism in patients with primary upper extremity deep vein thrombosis (DVT)...
March 22, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28341513/impact-of-inferior-vena-cava-filter-placement-on-short-term-outcomes-in-patients-with-acute-pulmonary-embolism
#12
Nathan L Liang, Elizabeth A Genovese, Efthymios D Avgerinos, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Inferior vena cava filters (IVCF) have been associated with improved survival in patients with acute pulmonary embolism (PE) in some studies. However, without randomization, those with early mortality who did not receive an IVCF may have died prior to treatment decision about filter placement, falsely contributing a survival advantage to those receiving IVCF and biasing the results of previous observational studies. The objective of this study is to evaluate the impact of IVCF on in-hospital mortality after adjusting for this survivor treatment selection...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341510/endovascular-stenting-of-portal-vein-for-graft-rescue-after-a-pancreas-transplant-venous-graft-thrombosis-a-case-report
#13
Ossama M Reslan, Jordan M Kirsch, Hitesh Kaul, Stalin Campos, Radi Zaki, Paul S Brady, Kamran Khanmoradi
Venous thrombosis of pancreas transplant allografts often leads to graft loss. Its worrisome complication and difficult to treat, forming the most common nonimmunological cause of graft loss. Multiple risk factors have been implicated in the development of venous thrombosis of pancreas transplant. Color Doppler ultrasonography (CDUS) enables early diagnosis of venous thrombosis, thus increasing the possibility of graft-rescue treatments. Endovascular management of pancreatic transplant vascular complications are scant and in the form of case reports...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341503/endovascular-repair-of-a-large-abdominal-aortic-aneurysm-in-a-patient-presenting-with-lower-extremity-edema-as-a-result-of-inferior-vena-cava-thrombosis
#14
Nan Li, Ming Xue, Deng-Ke Hong, Xing-Sheng Chen
PURPOSE: Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR). CASE REPORT: A 50-year-old man presented with three-day right lower extremity edema...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#15
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28321560/may-thurner-syndrome-old-acquaintance-new-perspective-case-report
#16
Anja Boc, Vinko Boc, Matija Kozak
May-Thurner syndrome (MTS) results from a frequent anatomic variant in which compression of the left common iliac vein between the body of the fifth lumbar vertebra and the pulsating right common iliac artery can cause deep venous thrombosis (DVT) of the left lower limb. While anticoagulation remains the mainstay treatment of acute DVT, catheter-directed thrombolysis combined with stenting provides a safe and effective method for relieving acute symptoms and preventing postthrombotic syndrome in patients with MTS...
March 20, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28294670/-endovascular-treatment-of-acute-iliofemoral-deep-venous-thrombosis-our-results-with-catheter-directed-thrombolysis-and-angiojet
#17
Anikó Berencsi, Edit Dósa, Balázs Nemes, Kálmán Hüttl, Péter Legeza, Zoltán Oláh, Vera Kristóf, György Acsády, Péter Sótonyi
INTRODUCTION: Most of the patients with iliofemoral thrombosis treated with anticoagulants only are affected with postthrombotic syndrome (PTS) that worsens the patients' quality of life. In the acute phase of proximal deep venous thrombosis (DVT) catheter-directed (CDT) and pharmacomechanical thrombolysis may be a reasonable alternative therapeutic method. Our aim was to summarize our results using these methods. METHODS: Since 2009 twenty-four patients with iliofemoral DVT were treated with these endovascular procedures and with stenting at our Institution...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28279597/inferior-vena-cava-filters-in-pulmonary-embolism-a-historic-controversy
#18
Carlos Jerjes-Sanchez, David Rodriguez, Aline Navarrete, Carolina Parra-Cantu, Jorge Joya-Harrison, Eduardo Vazquez, Alicia Ramirez-Rivera
OBJECTIVE: Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. METHODS: Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table...
March 6, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28274514/cerebral-venous-sinus-thrombosis-in-pregnancy-and-puerperium-a-pooled-systematic-review
#19
REVIEW
Ahmed I Kashkoush, Henry Ma, Nitin Agarwal, David Panczykowski, Daniel Tonetti, Gregory M Weiner, William Ares, Cynthia Kenmuir, Ashutosh Jadhav, Tudor Jovin, Brian T Jankowitz, Bradley A Gross
Pregnancy and puerperium are risk factors for cerebral venous sinus thrombosis (CVST); however studies describing diagnosis and management in this population are limited. The objective of this study was to amalgamate published case reports and series regarding diagnosis and management of CVST in pregnancy and puerperium. Searches of PubMed and the Cochrane library were performed using search terms "pregnancy"/"puerperium" and "sinus occlusion"/"sinus thrombosis". Studies were included in our pooled analysis if they included individual patient symptoms, management approach and follow-up condition...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28265129/deep-vein-thrombosis-interventions-in-cancer-patients
#20
REVIEW
Resmi Ann Charalel, Suresh Vedantham
The presence of cancer increases the risk of deep vein thrombosis (DVT), DVT recurrence, and treatment-related bleeding, and therefore offers distinctive clinical considerations when planning treatment. Anticoagulation with a low-molecular-weight heparin is the preferred initial and long-term therapy in cancer patients. Inferior vena cava filters may be used judiciously for patients with cancer-related DVT who have contraindications to anticoagulation or who exhibit breakthrough pulmonary embolism (PE) despite anticoagulation, but should be removed when the PE risk is felt to subside...
March 2017: Seminars in Interventional Radiology
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