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Post Thrombotic Syndrome

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https://www.readbyqxmd.com/read/28101432/atypical-hemolytic-uremic-syndrome-in-first-trimester-pregnancy-successfully-treated-with-eculizumab
#1
Gabriela Andries, Michael Karass, Srikanth Yandrapalli, Katherine Linder, Delong Liu, John Nelson, Rahul Pawar, Savneek Chugh
BACKGROUND: Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28098065/the-treatment-of-post-thrombotic-syndrome
#2
Karina Schleimer, Mohammad Esmaeil Barbati, Alexander Gombert, Volker Wienert, Jochen Grommes, Houman Jalaie
BACKGROUND: Post-thrombotic syndrome (PTS) arises in 20-50% of patients who have sustained a deep vein thrombosis and markedly impairs their quality of life. METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed and the Cochrane Library, and on the guidelines of the German Societies of Phlebology and Vascular Surgery (Deutsche Gesellschaft für Phlebologie, Deutsche Gesellschaft für Gefässchirurgie). RESULTS: The treatment options are conservative treatment with compression and patient exercises, endovascular recanalization with stent angioplasty, and open bypass surgery of the iliac obstructions...
December 16, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28077026/a-case-control-study-of-risk-factors-of-chronic-venous-ulceration-in-patients-with-varicose-veins
#3
Gohar Abelyan, Lusine Abrahamyan, Gayane Yenokyan
Background/objectives Venous ulcers carry psychological and high financial burden for patients, causing depression, pain, and limitation of mobility. The study aimed to identify factors associated with an increased risk of venous ulceration in patients with varicose veins in Armenia. Methods A case-control study design was utilized enrolling 80 patients in each group, who underwent varicose treatment surgery in two specialized surgical centers in Armenia during 2013-2014 years. Cases were patients with varicose veins and venous leg ulcers...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28073316/clinical-implications-of-the-anatomical-variation-of-deep-venous-thrombosis
#4
Ayman El-Menyar, Mohammad Asim, Gaby Jabbour, Hassan Al-Thani
Introduction Little is known about the anatomic variation and its implication in patients with lower limb deep venous thrombosis (DVT). We studied the clinical presentation, site of thrombosis and risk factors based on the anatomic distribution of lower limb DVT. Methods A retrospective analysis of clinically suspected DVT cases was conducted between 2008 and 2012. DVT was categorized by the location of the thrombosed segment and limb involved. The DVT anatomic segments were assessed according to left-to-right ratio, predisposing factors and clinical presentations...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28068529/impact-of-high-dose-statins-on-vitamin-d-levels-and-platelet-function-in-patients-with-coronary-artery-disease
#5
Monica Verdoia, Patrizia Pergolini, Roberta Rolla, Matteo Nardin, Alon Schaffer, Lucia Barbieri, Veronica Daffara, Paolo Marino, Giorgio Bellomo, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Statins represent a pivotal treatment in coronary artery disease, offering a reduction in cardiovascular risk even beyond their lipid-lowering action. However, the mechanism of these "pleiotropic" benefits of statins is poorly understood. Vitamin D has been suggested as a potential mediator of the anti-inflammatory, anti-thrombotic and vascular protecting effects of statins. Aim of present study was to assess the impact of a high-intensity statin therapy on vitamin D levels and platelet function in patients with coronary artery disease...
December 28, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28060108/diagnostic-utility-of-complement-immunohistochemical-studies-in-post-stem-cell-transplant-intestinal-thrombotic-microangiopathy-case-report
#6
Jenna E Rossoff, Jennifer Schneiderman, Sonali Chaudhury, Nicoleta C Arva
Thrombotic complications are a significant source of morbidity and mortality following hematopoietic stem cell transplants. Among them, transplant-associated thrombotic microangiopathy (TA-TMA) is a well-recognized syndrome that can affect various organ systems. Its etiology is related to endothelial injury accompanied by complement activation. As many of the signs and symptoms of the disease are also encountered in other complications following hematopoietic stem cell transplant, it can often be difficult to establish the diagnosis based on clinical data alone...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28050545/intraosseous-anomalous-drainage-a-rare-case-of-pretibial-varicose-vein
#7
Frederico Barra de Moraes, Carolina Parreira Ribeiro Camelo, Marcelo Luiz Brandão, Pedro Ivo Fávaro, Tercília Almeida Barbosa, Raul Carlos Barbosa
Valve failure with reflux and post-thrombotic syndrome are the factors most commonly correlated with varicose disease. Other rare etiologies can be put forward when these two main causes are ruled out. We report a case in which a young man presented chronic pain in the left tibia, varicose veins in the lower limbs and frequent occurrences of erysipelas. During investigation of the etiology of the varicose veins, radiographs and magnetic resonance imaging of the left leg were requested. These showed images suggestive of an osteolytic lesion in the tibia, but led us to the diagnosis of an intraosseous vein with anomalous drainage...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27987604/common-femoral-endovenectomy-in-conjunction-with-iliac-vein-stenting-to-improve-venous-inflow-in-severe-post-thrombotic-obstruction
#8
Himanshu Verma, Ramesh K Tripathi
Post-thrombotic syndrome secondary to iliofemoral deep venous thrombosis is a significant contributor to advanced chronic venous insufficiency. Iliac vein stenting is a standard procedure to treat iliocaval obstruction. In cases with obstruction extending across the groin, venous inflow for an iliac vein stent may be poor and compromise results of iliac vein stenting. Treatment options include extension of stents across the inguinal ligament that may have limitations in improving inflow only from only one vessel...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27986482/high-dose-rate-brachytherapy-for-the-treatment-of-lower-extremity-in-stent-restenosis
#9
Karen J Ho, Phillip M Devlin, Arin L Madenci, Marcus E Semel, Edwin C Gravereaux, Louis L Nguyen, Michael Belkin, Matthew T Menard
OBJECTIVE: Historically, edge stenosis and late thrombosis limited the effectiveness of adjunctive endovascular brachytherapy (EVBT) for in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) and stenting. We evaluated an updated protocol of PTA and EVBT for ISR among patients with lower extremity occlusive disease. METHODS: This is a retrospective, single-center review of patients treated with PTA and EVBT for ISR in the iliac and femoropopliteal segments between 2004 and 2012...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27974406/thrombotic-microangiopathy-in-inverted-formin-2-mediated-renal-disease
#10
Rachel C Challis, Troels Ring, Yaobo Xu, Edwin K S Wong, Oliver Flossmann, Ian S D Roberts, Saeed Ahmed, Michael Wetherall, Giedrius Salkus, Vicky Brocklebank, Julian Fester, Lisa Strain, Valerie Wilson, Katrina M Wood, Kevin J Marchbank, Mauro Santibanez-Koref, Timothy H J Goodship, David Kavanagh
The demonstration of impaired C regulation in the thrombotic microangiopathy (TMA) atypical hemolytic uremic syndrome (aHUS) resulted in the successful introduction of the C inhibitor eculizumab into clinical practice. C abnormalities account for approximately 50% of aHUS cases; however, mutations in the non-C gene diacylglycerol kinase-ε have been described recently in individuals not responsive to eculizumab. We report here a family in which the proposita presented with aHUS but did not respond to eculizumab...
December 14, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27974007/impact-of-optimal-anticoagulation-therapy-on-chronic-venous-ulcer-healing-in-thrombophilic-patients-with-post-thrombotic-syndrome
#11
C A Hinojosa, S Olivares-Cruz, H Laparra-Escareno, S Sanchez-Castro, B Tamayo-Garcia, J E Anaya-Ayala
OBJECTIVE: Post-thrombotic syndrome (PTS) is the long-term sequelae of deep venous thrombosis (DVT). PTS clinical manifestations include chronic leg pain, oedema, lipodermatosclerosis and ulcers. The objective of this study is to determine in patients with documented history of thrombophilias and DVT whether the number of previous thrombotic events and optimal anticoagulation therapy are associated with the time to venous ulcer healing following the start of compression therapy. METHOD: Retrospective analysis performed in thrombophilic patients under the age of 50 years old with chronic venous ulcers secondary to DVT at the wound clinic in the National Institute of Medical Sciences and Nutrition 'Salvador Zubirán ' in Mexico City...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27965311/accurate-diagnosis-of-iliac-vein-thrombosis-in-pregnancy-with-magnetic-resonance-direct-thrombus-imaging-mrdti
#12
Charlotte E A Dronkers, Alexandr Srámek, Menno V Huisman, Frederikus A Klok
A pregnant woman aged 29 years, G1P0 at 21 weeks of gestation of a dichorionic diamniotic twin, presented with suspected deep vein thrombosis (DVT) of the left leg. Repeated (compression) ultrasonography was not diagnostic for DVT but showed reduced flow over the left external iliac vein, common femoral vein and superficial femoral vein. In pursue of a definite diagnosis, magnetic resonance direct thrombus imaging was performed showing a clear high signal in the left common iliac vein which is diagnostic for acute thrombosis in this venous segment...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27927086/long-term-follow-up-of-endo-vascular-recanalization-of-chronic-inferior-vena-cava-occlusion-secondary-to-inferior-vena-cava-filters
#13
Sasan Partovi, Sanjeeva P Kalva, T Gregory Walker, Sabir M Taj, Suvranu Ganguli
BACKGROUND: The long term efficacy of endovascular recanalization for chronic iliocaval occlusion secondary to inferior vena cava (IVC) filters is unknown. The purpose of this study was to evaluate the effectiveness of endovascular recanalization and stent placement across the filter in patients with filter-associated chronic iliocaval occlusion. PATIENTS AND METHODS: Seven patients (mean age 56 ± 15 yrs; seven males) with symptomatic chronic iliocaval occlusion and occluded IVC filter were included...
December 8, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27914131/the-role-of-pharmacomechanical-endovascular-intervention-for-iliofemoral-vein-thrombosis-compared-to-conventional-anticoagulation-therapy
#14
In Sub Kim, Won Min Jo
Although anticoagulation therapy is the primary treatment for deep vein thrombosis (DVT), it has not been associated with the rapid recanalization of the venous occlusion. Moreover, it is associated with long-term disability due to post-thrombotic syndrome (PTS). In contrast, pharmacomechanical endovascular intervention (PMI) results in more rapid clinical improvement in DVT patients, but there are few reports on its long-term outcomes. This retrospective study evaluated the clinical effectiveness of PMI compared to conventional anticoagulation therapy (ACA) for acute and subacute iliofemoral DVT...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913753/neutrophil-derived-microparticles-are-released-into-the-coronary-circulation-following-percutaneous-coronary-intervention-in-acute-coronary-syndrome-patients
#15
Gonzalo J Martínez, Jennifer Y Barraclough, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David S Celermajer, Sanjay Patel
To evaluate (i) local coronary and systemic levels of microparticles (MP) in acute coronary syndrome (ACS) and stable angina pectoris (SAP) patients and (ii) their release after plaque disruption with percutaneous coronary intervention (PCI). MP are small vesicles originating from plasma membranes of cells after activation or apoptosis and are implicated in the pathogenesis of atherosclerosis. Neutrophils play a role in plaque destabilization and shed neutrophil-derived MP that have the potential to drive significant proinflammatory and thrombotic downstream effects...
February 28, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/27913509/the-post-thrombotic-syndrome
#16
Susan R Kahn
The post-thrombotic syndrome (PTS) is a frequent, sometimes disabling complication of deep vein thrombosis (DVT) that reduces quality of life and is costly. This article discusses risk factors for PTS after DVT and available means to prevent and treat PTS, with a focus on new information in the field. After DVT, PTS will develop in 20% to 50% of patients, and severe PTS, including venous ulcers, will develop in 5% to 10%. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, persistent leg symptoms 1 month after acute DVT, obesity, and older age...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27903022/-recanalization-techniques-for-venous-outflow-obstruction
#17
Michael K W Lichtenberg, Houman Jalaie
Deep vein thrombosis (DVT) is associated with a high cost burden for health care systems because of secondary cost intensive complications like pulmonary embolism and especially the post thrombotic syndrome (PTS). The current standard therapy of anticoagulation for DVT therapy has not changed through the years leaving patients especially with iliofemoral vein thrombus on a high-risk situation for developing PTS. Current study situation for endovascular treatment of iliofemoral DVT treatment gives a rationale for active thrombus removal using catheter directed therapy (CDT) or pharmacomechanical thrombectomy (PMT) which improves valvular vein function and luminal patency reducing the potential complication of PTS...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27860129/the-postthrombotic-syndrome-current-evidence-and-future-challenges
#18
REVIEW
A Rabinovich, S R Kahn
Post thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT), which develops in 20%-50 % of patients. PTS manifests as a spectrum of symptoms and signs of chronic venous insufficiency that can impose significant morbidity and have a negative impact on quality of life. Chronic venous hypertension caused by a combination of residual venous obstruction and valvular reflux is believed to play a major role in the pathophysiology of PTS. The Villalta scale is the most widely applied clinical scale used to diagnose and define PTS...
November 18, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27830895/thrombolysis-for-acute-deep-vein-thrombosis
#19
REVIEW
Lorna Watson, Cathryn Broderick, Matthew P Armon
BACKGROUND: Standard treatment for deep vein thrombosis aims to reduce immediate complications. Use of thrombolysis or clot dissolving drugs could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the third update of a review first published in 2004. OBJECTIVES: To assess the effects of thrombolytic therapy and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function...
10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27823643/an-overview-of-hematopoietic-stem-cell-transplantation-related-thrombotic-complications
#20
REVIEW
Ugur Sahin, Pinar Ataca Atilla, Erden Atilla, Selami Kocak Toprak, Taner Demirer
Thrombotic episodes are far less common than bleeding complications after hematopoietic stem cell transplantation (HSCT). However, they lead to significant morbidity and mortality. These complications are classified into four groups, including venous thromboembolic events (VTE), catheter-induced thrombosis (CIT), transplant-associated thrombotic microangiopathy (TA-TMA) and sinusoidal obstruction syndrome (SOS) or veno-occlusive disease (VOD). The frequency of VTE is increased among patients undergoing HSCT due to some acquired conditions including underlying malignancy, infections, administration of myeloablative conditioning regimens and/or total body irradiation, prolonged hospitalizations leading to immobility and presence of central venous catheters...
November 2016: Critical Reviews in Oncology/hematology
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