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Post Thrombotic Syndrome

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https://www.readbyqxmd.com/read/28811041/post-thrombotic-syndrome-in-children
#1
Marisol Betensky, Neil A Goldenberg
The post-thrombotic syndrome (PTS) is the most common long-term complication of pediatric deep venous thrombosis (DVT). It is a burdensome condition that can lead to severe disability and poor quality-of-life of affected children. Although its pathophysiology remains poorly understood, it is thought to be the result of chronic venous hypertension. Recent studies have shown that the inflammatory response associated with an acute DVT likely plays a key role in the development of PTS. The Manco-Johnson Instrument and the modified Villalta Scale are the most widely used instruments for the diagnosis of pediatric PTS...
July 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28808631/painless-swollen-calf-muscles-of-a-75-year-old-patient-caused-by-bilateral-venous-malformations
#2
Roderick S M Piekaar, Eline W Zwitser, Paul P A Hedeman Joosten, Joris A Jansen
A 75-year-old man presented with knee pain due to medial osteoarthritis of the knee in the orthopedic outpatient clinic. Conservative treatment was started with steroid infiltration. Besides his knee complaint reported a bilateral painless swollen calf muscle without traumatic cause, and also without any pain at night, fever or medical illness. On physical examination the soleus muscle had a swollen aspect in both calfs. The skin appeared normal without deformities and the arterial pulsations were intact. An X-ray did not show abnormalities in the tibia...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28801959/outcomes-of-patients-with-atypical-hemolytic-uremic-syndrome-with-native-and-transplanted-kidneys-treated-with-eculizumab-a-pooled-post-hoc-analysis
#3
Christophe M Legendre, Josep M Campistol, Thorsten Feldkamp, Giuseppe Remuzzi, John F Kincaid, Åsa Lommelé, Jimmy Wang, Laurent E Weekers, Neil S Sheerin
Atypical hemolytic uremic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant, and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, hematologic and renal parameters, and adverse events...
August 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28801136/outcomes-of-pharmacomechanical-catheter-directed-thrombolysis-for-acute-and-subacute-inferior-vena-cava-thrombosis-a-retrospective-evaluation-in-a-single-institution
#4
K Ye, J Qin, M Yin, X Liu, X Lu
OBJECTIVE/BACKGROUND: The objective was to assess the mid-term results of pharmacomechanical catheter-directed thrombolysis (PCDT) for symptomatic acute and subacute inferior vena cava (IVC) thrombosis; the risk factors of early thrombosis recurrence and iliocaval patency were also evaluated. METHODS: From January 2010 to December 2015, 54 patients (33 men; mean age 47.1 years) with symptomatic acute and subacute IVC thrombosis were treated with PCDT. Primary technical success (clot lysis ≥ 50% after PCDT), stent-assisted technical success (residual stenosis < 30% after stenting), clinical success (freedom from thrombosis recurrence within 30 days), complications, frequency of post-thrombotic syndrome (PTS; Villalta score ≥ 5), and iliocaval patency were recorded at follow-up evaluation...
August 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28761995/intermediate-term-thrombotic-risk-in-contemporary-total-cavo-pulmonary-connection-for-single-ventricle-circulations
#5
Jenna M Faircloth, Olivia Roe, Tarek Alsaied, Joseph S Palumbo, Alexander Vinks, Gruschen R Veldtman
Despite the common occurrence of thrombosis in Fontan circulations, the mid-term thrombotic risk beyond the first two postoperative years is poorly defined especially in total cavo pulmonary Fontan. This study examines the thrombotic incidence and risk beyond the first 2 years after contemporary Fontan surgery. Using a retrospective cohort study design, 89 Fontan patients, 50 male, were included and evaluated with a median of 8.3 years (IQR 6.8-11.4) follow-up. Hospital records were reviewed for known risk factors of thrombosis, thrombotic events, antiplatelet and anticoagulation management, and basic characteristics...
July 31, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#6
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28739469/acute-venous-iliofemoral-thrombosis-early-surgical-thrombectomy-is-effective-and-durable
#7
Stefan Ockert, Matthias von Allmen, Michaela Heidemann, Juliette Brusa, Jan Duwe, Robert Seelos
BACKGROUND: The first-line recommendation for treatment of acute iliofemoral deep vein thrombosis (IFDVT) is catheter-directed or pharmaco-mechanical thrombolysis (CDT/PCDT). Recent analysis of surgical thrombectomy has shown comparable results. However this procedure is not commonly given as much importance as interventional techniques. We analyzed patient outcome of surgical thrombectomy using modern endovascular techniques in both the short and long term. METHODS: All consecutive patients who underwent surgical thrombectomy at our institution between April 2008 and April 2017 were included...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28736157/prevention-and-treatment-of-the-post-thrombotic-syndrome
#8
REVIEW
Oleg Pikovsky, Anat Rabinovich
Post-thrombotic syndrome (PTS) is a complication that develops in up to 50% of patients with deep vein thrombosis (DVT) and manifests as symptoms and signs of chronic venous insufficiency of varying severity. PTS negatively affects patient's quality of life and causes significant burden to the healthcare system. The risk for PTS development can be markedly reduced by preventing DVT and providing appropriate anticoagulation once it develops. Patients with extensive proximal (iliofemoral) DVT may benefit from invasive interventions, such as catheter-directed thrombolysis...
July 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28688917/real-world-economic-burden-associated-with-transplantation-related-complications
#9
Miguel-Angel Perales, Machaon Bonafede, Qian Cai, Phillip M Garfin, Donna McMorrow, Neil C Josephson, Akshara Richhariya
Approximately 20,000 hematopoietic cell transplantation (HCT) procedures are performed annually in the United States. Real-world data on the costs associated with post-transplantation complications are limited. Patients with hematologic malignancies aged ≥18 years undergoing autologous HCT (auto-HCT) or allogeneic HCT (allo-HCT) between January 1, 2011, and June 30, 2014, were identified in the Truven Health MarketScan Research Databases. Patients were required to have 12 months of continuous medical and pharmacy enrollment before and after HCT; patients who experience inpatient death within 12 months post-HCT were also included...
July 5, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28686155/paediatric-venous-thromboembolism-a-report-from-the-italian-registry-of-thrombosis-in-children-riti
#10
Paola Giordano, Massimo Grassi, Paola Saracco, Angelo C Molinari, Chiara Gentilomo, Agnese Suppiej, Giuseppe Indolfi, Donatella Lasagni, Matteo Luciani, Fiammetta Piersigilli, Maria C Putti, Lidia L Rota, Stefano Sartori, Paolo Simioni
BACKGROUND: The Italian Registry of Thrombosis in Children (RITI) was established by a multidisciplinary team with the aims of improving knowledge about neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. MATERIALS AND METHODS: We analysed the subset of RITI data concerning paediatric systemic venous thromboembolic events that occurred between January 2007 and June 2013...
June 30, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28667425/effectiveness-of-catheter-directed-thrombolysis-and-stent-implantation-on-iliofemoral-vein-thrombosis-caused-by-iliac-vein-compression
#11
Zhi-Bing Ming, Wen-Dong Li, Rui-Fan Yuan, Xiao-Qiang Li, Wen-Bin Ding
The purpose of this study was to objectively assess the morbidity of post-thrombotic syndrome (PTS) in iliofemoral vein thrombosis treated with catheter-directed thrombolysis (CDT) and stenting under the protection of inferior vena cava (IVC) filter. All patients with an unprovoked episode of iliofemoral vein thrombosis combined with iliac vein compression syndrome (IVCS) during January 2011 and January 2015 were enrolled. Clinical records of all patients were evaluated. Firstly, cox regression was performed to find out the factors impacted the incidence of PTS...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28647635/new-vein-compression-entities-in-patients-with-unexplained-leg-swelling
#12
Alaina Garrie, Lauren E Jones, Julia F Chen, Robert W Feldtman, Kenneth R Kollmeyer, Jasmine L Richmond, Craig A Ferrara, Pablo V Uceda, Lelesse Mocio, Samuel S Ahn
BACKGROUND: This retrospective study identifies often overlooked anatomical sites for non-thrombotic venous outflow obstruction (NTVO) in patients with unexplained lower extremity edema and pain. MATERIALS AND METHODS: We retrospectively reviewed the charts of 75 consecutive patients experiencing symptoms of unexplained lower extremity edema with pain that were unexplained by ultrasound, computed tomography angiography (CTA), and magnetic resonance imaging (MRI), who subsequently underwent venography in an outpatient medical office from 2010 to 2014...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28644135/evaluation-of-thromboelastometry-parameters-as-predictive-markers-for-sinusoidal-obstruction-syndrome-in-patients-undergoing-allogeneic-stem-cell-transplantation-for-acute-leukaemia
#13
Joanna Rupa-Matysek, Lidia Gil, Ewelina Wojtasińska, Zuzanna Kanduła, Adam Nowicki, Magdalena Matuszak, Mieczysław Komarnicki
Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied.We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence...
June 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28643239/serum-histones-as-biomarkers-of-the-severity-of-heatstroke-in-dogs
#14
Yaron Bruchim, Isaac Ginsburg, Gilad Segev, Ahmad Mreisat, Yochai Avital, Itamar Aroch, Michal Horowitz
Heatstroke is associated with systemic inflammatory response syndrome, leading to multiple organ dysfunction and death. Currently, there is no specific treatment decreasing hyperthermia-induced inflammatory/hemostatic derangements. Emerging studies indicate that histones leaking from damaged cells into the extracellular space are toxic, pro-inflammatory, and pro-thrombotic. We therefore hypothesize that serum histones (sHs) are elevated during heatstroke and are associated with the severity of the disease. Sixteen dogs with heatstroke and seven healthy controls were included in the study...
June 22, 2017: Cell Stress & Chaperones
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#15
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28637667/thrombocytopenia-in-pregnancy
#16
Douglas B Cines, Lisa D Levine
Thrombocytopenia develops in 5-10% of women during pregnancy or in the immediate post-partum period. A low platelet count is often an incidental feature, but it can also provide a biomarker of a coexisting systemic or gestational disorder and a potential reason for a maternal intervention or treatment that might pose harm to the fetus. This chapter reflects our approach to these issues with an emphasis on advances in understanding and managing the more common causes of thrombocytopenia in pregnancy made over the past 5-10 years...
June 21, 2017: Blood
https://www.readbyqxmd.com/read/28621343/current-evidence-on-the-discontinuation-of-eculizumab-in-patients-with-atypical-haemolytic-uraemic-syndrome
#17
COMMENT
Manuel Macia, Fernando de Alvaro Moreno, Tina Dutt, Ingela Fehrman, Karine Hadaya, Christoph Gasteyger, Nils Heyne
Background. Atypical haemolytic uraemic syndrome (aHUS) is a rare, life-threatening disorder for which eculizumab is the only approved treatment. Life-long treatment is indicated; however, eculizumab discontinuation has been reported. Methods. Unpublished authors' cases and published cases of eculizumab discontinuation are reviewed. We also report eculizumab discontinuation data from five clinical trials, plus long-term extensions and the global aHUS Registry. Results. Of six unpublished authors' cases, four patients had a subsequent thrombotic microangiopathy (TMA) manifestation within 12 months of discontinuation...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28613113/complex-interventional-iliocaval-recanalization-due-to-plasmacytoma-and-cystic-echinococcosis
#18
Felicitas Stoll, Nils Kucher, Britta Vogel, Hugo A Katus, Oliver J Müller, Christian Erbel
Post-thrombotic syndrome is common after iliofemoral vein thrombosis. Conservative therapy, mainly limited to compression and anticoagulation therapy, might not be sufficient in controlling symptoms. Interventional recanalization of the chronically occluded iliac veins is an evolving method, promising rapid relief of symptoms. Here, we present two cases of complex interventions in one patient with preceding pelvic radiotherapy due to a plasmacytoma and in another patient in whom a cava wedge resection had been performed because of cystic echinococcosis in the liver...
June 14, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28596415/hemolytic-uremic-syndrome-in-pregnancy-and-postpartum
#19
Alexandra Bruel, David Kavanagh, Marina Noris, Yahsou Delmas, Edwin K S Wong, Elena Bresin, François Provôt, Vicky Brocklebank, Caterina Mele, Giuseppe Remuzzi, Chantal Loirat, Véronique Frémeaux-Bacchi, Fadi Fakhouri
BACKGROUND: Pregnancy is associated with various forms of thrombotic microangiopathy, including hemolytic uremic syndrome. A previous small French study suggested that pregnancy-associated hemolytic uremic syndrome was to be included in the spectrum of atypical hemolytic uremic syndrome linked to complement alternative pathway dysregulation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We sought to retrospectively analyze the presentation, outcome, and frequency of complement alternative pathway gene variants in a larger international (France, United Kingdom, Italy) cohort of patients with pregnancy-associated hemolytic uremic syndrome...
June 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28595505/wound-complications-after-common-femoral-vein-endophlebectomy-influence-on-outcome
#20
Alexander Gombert, Mohammad E Barbati, Jochen Grommes, Ralph Lm Kurstjens, Mark Af deWolf, Cees Ha Wittens, Houman Jalaie
Introduction Venous recanalization of obstructed femoral and iliac veins is associated with good results regarding the feasibility and patency rate. If the common femoral vein with its inflow vessels is involved, open surgical desobliteration or endophlebectomy has been described as a crucial part of the intervention. However, when performing the hybrid procedure, a number of specific complications have been described. We present our results after venous recanalization including an endophlebectomy, focussing on wound complications and its impact on outcome...
January 1, 2017: Phlebology
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