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proximal dvt

Yaseen Arabi, Fahad Al-Hameed, Karen E A Burns, Sangeeta Mehta, Sami Alsolamy, Mohammed Almaani, Yasser Mandourah, Ghaleb A Almekhlafi, Ali Al Bshabshe, Simon Finfer, Mohammed Alshahrani, Imran Khalid, Yatin Mehta, Atul Gaur, Hassan Hawa, Hergen Buscher, Zia Arshad, Hani Lababidi, Abdulsalam Al Aithan, Jesna Jose, Sheryl Ann I Abdukahil, Lara Y Afesh, Maamoun Dbsawy, Abdulaziz Al-Dawood
BACKGROUND: The Pneumatic CompREssion for Preventing VENous Thromboembolism (PREVENT) trial evaluates the effect of adjunctive intermittent pneumatic compression (IPC) with pharmacologic thromboprophylaxis compared to pharmacologic thromboprophylaxis alone on venous thromboembolism (VTE) in critically ill adults. METHODS/DESIGN: In this multicenter randomized trial, critically ill patients receiving pharmacologic thromboprophylaxis will be randomized to an IPC or a no IPC (control) group...
March 15, 2018: Trials
Wakako Fukuda, Satoshi Taniguchi, Ikuo Fukuda, Mari Chiyoya, Chikashi Aoki, Norihiro Kondo, Kaoru Hattori, Kazuyuki Daitoku, Ryosuke Kowatari, Masahito Minakawa, Yasuyuki Suzuki
Background : The incidence of pulmonary thromboembolism has been considered rare in Japan. However, its occurrence has been increasing because of westernized lifestyle and diet, increased diagnostic technique, and recognition of this disease. Method : Between January 2003 and September 2014, 179 patients were treated for pulmonary thromboembolism. We classified these patients into 3 groups; Massive (n=35), Sub-massive (n=29) and Nonmassive (n=115) and retrospectively reviewed the treatment options and the outcome...
December 25, 2017: Annals of Vascular Diseases
Deepak Sudheendra, Suresh Vedantham
Proximal deep venous thrombosis (DVT) is linked to a 50% risk of pulmonary embolism and a 50% risk of postthrombotic syndrome. This article reviews catheter-directed thrombolysis options for iliofemoral DVT and discusses the risks, benefits, and techniques commonly used in performing endovascular procedures for iliofemoral DVT.
April 2018: Surgical Clinics of North America
Albeir Y Mousa, Mike Broce, David De Wit, Mina Baskarioun, Shadi AbuHalema, Michael Yacoub, Mark C Bates
BACKGROUND: The D-Dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude Deep Venous Thrombosis (DVT). The objective for this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VDU remains over utilized in low-risk patients with negative DD and that higher DD levels may correlate with thrombus burden and location. METHODS: Patients who presented to a high volume tertiary care center with lower limb swelling with or without associated pain were retrospectively examined through June and July for four consecutive years (2012 to 2015)...
March 1, 2018: Annals of Vascular Surgery
Miguel Jiménez-Alcázar, Andreas Limacher, Rachita Panda, Marie Méan, Josephine Bitterling, Sven Peine, Thomas Renné, Jürg H Beer, Drahomir Aujesky, Bernhard Lämmle, Tobias A Fuchs
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in elderly patients. Extracellular DNA is a pro-inflammatory and pro-thrombotic mediator in vitro and in animal models. Levels of circulating extracellular DNA (ceDNA) are increased in VTE patients, but the association of ceDNA with VTE extent and clinical outcome is poorly understood. OBJECTIVES: We analyzed the association of ceDNA with the extent of VTE, categorized as distal and proximal deep vein thrombosis and pulmonary embolism, and with the clinical outcomes VTE recurrence and mortality...
2018: PloS One
David R Anderson, Michael Dunbar, John Murnaghan, Susan R Kahn, Peter Gross, Michael Forsythe, Stephane Pelet, William Fisher, Etienne Belzile, Sean Dolan, Mark Crowther, Eric Bohm, Steven J MacDonald, Wade Gofton, Paul Kim, David Zukor, Susan Pleasance, Pantelis Andreou, Steve Doucette, Chris Theriault, Abongnwen Abianui, Marc Carrier, Michael J Kovacs, Marc A Rodger, Doug Coyle, Philip S Wells, Pascal-Andre Vendittoli
BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty...
February 22, 2018: New England Journal of Medicine
Chao-Nan Wang, Hong-Ru Deng
BACKGROUND: Combination treatment with percutaneous endovenous intervention (PEVI) and anticoagulation has been proposed for treating lower-extremity proximal deep vein thrombosis (DVT). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of PEVI plus anticoagulation versus anticoagulation alone in patients with lower-extremity proximal DVT. METHODS: We systematically searched PubMed, Embase, and the Cochrane Library from inception to May 2016...
February 14, 2018: Annals of Vascular Surgery
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Shuwei Tian, Zheyuan Shen, Yang Liu, Yanlong Zhang, Aqin Peng
OBJECTIVE: To investigate the effect of tranexamic acid (TXA) on hidden bleeding in older intertrochanteric fracture patients treated with intramedullary nails. METHOD: Between January 2016 and January 2017, 100 cases of intertrochanteric fractures eligible for the study were treated with proximal femoral nail antirotation (PFNA) in our hospital. All patients were divided into two groups of 50 patients each: the TXA group and a blank control group. In the TXA group, all patients received TXA at a dose of 10 mg/kg-1 intravenously, 10 min preoperatively and 5 h postoperatively...
February 2, 2018: Injury
Joseph Bledsoe, Scott Woller, Scott Stevens, Valerie Aston, Rich Patten, Todd Allen, Benjamin Horne, Lydia Dong, James Lloyd, Greg Snow, Troy Madsen, Gregory Elliott
BACKGROUND: The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic venous thromboembolism (VTE), major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient hospitalization; and to measure patient satisfaction. METHODS: We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five emergency departments...
February 1, 2018: Chest
Drew Fleck, Hassan Albadawi, Fadi Shamoun, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Anticoagulation therefore does little to prevent the venous damage and scarring that occurs following DVT, leaving the patient at risk for permanent venous insufficiency and development of post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
M-Grace Knuttinen, Sailendra Naidu, Rahmi Oklu, Scott Kriegshauser, William Eversman, Lisa Rotellini, Patricia E Thorpe
Common left iliac vein compression, otherwise known as May-Thurner (MT), is an anatomical risk factor for lower extremity deep vein thrombosis (DVT). MT refers to chronic compression of the left iliac vein against the lumbar spine by the overlying right common iliac artery. The compression may be asymptomatic. The syndrome is a clinical spectrum of physical findings and history plus the lesion. It is characterized by the varying degrees of venous hypertension. This can be non-thrombotic, combined with acute DVT or post-thrombotic...
December 2017: Cardiovascular Diagnosis and Therapy
Drew Fleck, Hassan Albadawi, Alex Wallace, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Background: Guidelines are lacking for isolated below-knee deep vein thrombosis (BKDVT). The American College of Chest Physicians (ACCP) suggests anticoagulation only if symptoms are severe, otherwise surveillance with follow-up ultrasound in 2 weeks is recommended. Yet clinical practice remains highly variable. Little is known about the natural history of BKDVT and how to best manage these patients. Methods: A retrospective analysis was conducted of medical records from 2014-2016...
December 2017: Cardiovascular Diagnosis and Therapy
Luca Spiezia, Elena Campello, Fabio Dalla Valle, Chiara Simion, Anna Colpo, Paolo Simioni
Post-thrombotic syndrome (PTS) has been associated to DVT recurrence, increased FVIII, inflammatory biomarker plasma levels, and persistence of vein obstruction. These same features have also been widely reported in non-O blood type subjects. Our aim was to investigate the correlation between the incidence of PTS and ABO blood types. Consecutive patients referred to the Department of Medicine of University of Padua between January 2004 and January 2012 following the diagnosis of a first episode of proximal DVT were enrolled...
February 1, 2018: Annals of Hematology
Joseph M Banno, Katherine Shield, Krunal Patel, Anupam A Sule
Mycobacterium abscessus is a fast growing, non-tubercular mycobacterium (NTM) found in water. NTM bacteremia is usually seen in immunocompromised patients who have intravascular catheters. Mycobacterium abscessus bacteremia is often caused by exposure to contaminated water supply in hemodialysis units. A 28-year-old female with poorly controlled diabetes mellitus, end stage renal disease (on hemodialysis via Ash catheter), and recurrent deep vein thrombosis presented to the hospital with proximal right leg deep vein thrombosis...
November 27, 2017: Curēus
Shang Piao, Yong-Gang Zhou, Yin-Qiao Du, Hai-Yang Ma, Jing-Yang Sun, Zhi-Sen Gao, Ya-Wen Peng, Wen-Ming Wu
OBJECTIVE: To investigate and the clinical effect of S-ROM modular stem in femur reconstruction in hip revision arthroplasty. METHODS: From January 2008 to January 2016, 21 patients received revision hip arthroplasties using S-ROM stems. There were 5 males and 16 females with an average of 48.33 years old(range, 29 to 73 years old). There were 13 cases caused by aseptic loosening, 4 cases by infection, 2 cases by nonunion of sub-tuberosity osteotomy, 1 case for repeated dislocation, 1 case for traumatic great trochanter fracture...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
David Nygren, Caroline Hård Af Segerstad, Catarina Ellehuus Hilmersson, Johan Elf, Ekelund Ulf, Jakob Lundager Forberg
Good outcomes when emergency physicians diagnosed deep vein thrombosis Deep vein thrombosis of the lower limb is best diagnosed with ultrasound. Internationally, several studies have shown promising and often equal results when emergency physicians have been compared with radiologists in diagnosing thrombosis. Our results confirm these findings in a non-academic hospital and for the first time in a Swedish setting. Our findings form the basis for a multi-centre study on new diagnostic routines in patients with suspected proximal deep vein thrombosis in the emergency department, potentially resulting in faster and more resource-effective management...
January 15, 2018: Läkartidningen
Behnood Bikdeli, Babak Sharif-Kashani, Bavand Bikdeli, Reina Valle, Conxita Falga, Antoni Riera-Mestre, Lucia Mazzolai, Peter Verhamme, Philip S Wells, Juan Francisco Sánchez Muñoz Torrero, Luciano Lopez-Jiménez, Manuel Monreal
Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001-2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality...
January 12, 2018: Seminars in Thrombosis and Hemostasis
Dainis Krievins, Janis Savlovskis, Natalija Ezite, Andrew Hill, Kaspars Kisis, Marcis Gedins, Edgars Zellans, Andrew Holden
BACKGROUND: Long segment occlusive disease in the superficial femoral artery remains a treatment challenge despite advances in open surgical and endovascular approaches. We report initial clinical results of an entirely new procedure to perform femoropopliteal bypass using the DETOUR System to create a stentgraft bypass which originates in the SFA, travels through the femoral vein, and ends in the popliteal artery, bypassing the diseased segment. METHODS: Review the initial results of the first five patients at a single site enrolled in IRB-approved, prospective clinical study using the DETOUR System...
January 9, 2018: Journal of Cardiovascular Surgery
Yuji Hashimoto, Toshiyuki Onda, Tatsufumi Nomura, Yasuyuki Yonemasu, Osamu Honda, Masahiko Toshima, Akira Takahashi, Tadashi Nonaka, Masahiko Daibo
Little is known about the incidence and characteristics of deep venous thrombosis(DVT)developing shortly after neurological surgery. Lower extremity venous ultrasound scanning was performed before and after surgery, and retrospective data of 157 surgical cases, including endovascular surgery(42.0%), craniotomy(28.7%), burr hole(24.2%), and shunt(3.2%), were evaluated. DVT that had not been pre-operatively observed was discovered in five cases of surgery(five patients, 3.2%)on the day following the surgery, and it was asymptomatic in all cases...
December 2017: No Shinkei Geka. Neurological Surgery
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