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https://www.readbyqxmd.com/read/28053388/prevalence-of-deep-vein-thrombosis-in-patients-with-lower-limb-trauma
#1
Chirag S Kapoor, Ashit K Mehta, Krunal Patel, Paresh P Golwala
INTRODUCTION: Venous thrombo-embolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal condition. According to Western literature, DVT of lower limb veins is one of the most common complications following surgeries for lower limb. Few studies have been published from India on the subject and little is known about the true prevalence of the DVT and hence there are no clear guidelines regarding the prophylaxis for DVT for Indian patients...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28052946/dabigatran-related-leukocytoclastic-vasculitis
#2
Josiah An, Rohan Garje, Karolyn A Wanat, José Pablo Leone
Dabigatran is a non-vitamin K antagonist oral anticoagulant that has been approved for atrial fibrillation and prevention of venous thromboembolism. Its use has been increasing in the USA since serum drug levels do not need monitoring. To date, no significant skin side effects have been reported other than 4 cases of non-specific skin lesion and 2 cases of leukocytoclastic vasculitis (LCV), which is a small vessel inflammatory disease that presents as palpable purpura in lower extremities. We present a man aged 57 years with chronic deep vein thrombosis who developed palpable purpura, petechiae, swelling in lower extremities, torso and distal upper extremities on the third day after dabigatran initiation...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#3
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27987616/deep-venous-thrombosis-associated-with-caval-extension-of-iliac-stents
#4
Erin H Murphy, Blake Johns, Elliot Varney, William Buck, Arjun Jayaraj, Seshadri Raju
BACKGROUND: It is generally difficult to place an iliac vein stent precisely at the iliocaval junction with venographic control or even with intravascular ultrasound guidance. Furthermore, mechanical properties of the Wallstent (Boston Scientific, Marlborough, Mass) can predispose precisely placed stents to distal displacement or stent collapse. Our center has thus advocated extending Wallstents 3 to 5 cm into the inferior vena cava to prevent complications of missed proximal lesions or stent migration...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#5
Clive Kearon
The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
November 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27889688/management-of-distal-deep-vein-thrombosis
#7
REVIEW
Helia Robert-Ebadi, Marc Righini
Isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower limb DVT in ultrasound series and is therefore a frequent medical condition. Unlike proximal DVT and pulmonary embolism (PE), which have been extensively studied and for which management is well standardized, much less is known on the optimal management of isolated calf DVT. Recent data arising from registries and non-randomized studies suggest that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
January 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27886952/complex-inferior-vena-cava-filter-retrieval-complicated-by-migration-of-filter-fragment-into-the-aorta-and-subsequent-distal-embolization
#8
Erica M Knavel, Michael A Woods, Mark G Kleedehn, Orhan S Ozkan, Paul F Laeseke
In 2005, a 48-year-old man with a spinal cord injury had an inferior vena cava filter placed for recurrent deep vein thrombosis and pulmonary embolism. He was referred for filter retrieval after a computed tomography scan demonstrated caval stenosis and 2 fractured filter arms, 1 in a pulmonary artery and 1 penetrating into the retroperitoneum and impinging on the aorta. During retrieval, 1 arm was inadvertently advanced into the aorta, and embolization of the arm occurred to the left profunda femoris artery...
December 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27885107/a-systematic-review-of-clinical-prediction-scores-for-deep-vein-thrombosis
#9
REVIEW
Marina Kafeza, Joseph Shalhoub, Nina Salooja, Lucy Bingham, Konstantina Spagou, Alun H Davies
OBJECTIVE: Diagnosis of deep vein thrombosis remains a challenging problem. Various clinical prediction rules have been developed in order to improve diagnosis and decision making in relation to deep vein thrombosis. The purpose of this review is to summarise the available clinical scores and describe their applicability and limitations. METHODS: A systematic search of PubMed, MEDLINE and EMBASE databases was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance using the keywords: clinical score, clinical prediction rule, risk assessment, clinical probability, pretest probability, diagnostic score and medical Subject Heading terms: 'Venous Thromboembolism/diagnosis' OR 'Venous Thrombosis/diagnosis'...
November 24, 2016: Phlebology
https://www.readbyqxmd.com/read/27823597/frequency-of-deep-vein-thrombosis-and-or-pulmonary-embolism-after-coronary-artery-bypass-grafting-investigation-regardless-of-clinical-suspicion
#10
Vitor B Viana, Emanoel R Melo, Mario Terra-Filho, Luis A Dallan, Maria M Gonzalez, Ludhmila A Hajjar, Fabio B Jatene, Luiz A Cesar, Caio B Vianna
Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and/or pulmonary embolism (PE). Many surgeons and clinicians believe that VTE after coronary artery bypass grafting (CABG) has little clinical significance because it is seldom diagnosed. This study aimed to identify VTE after CABG, independent of clinical suspicion. In this prospective, observational, single-center study, 100 patients underwent computed tomographic pulmonary angiography (multidetector-64) and lower extremity venous compressive ultrasound after elective CABG...
January 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27790548/osteochondroma-complicated-by-a-popliteal-vein-aneurysm-a-rare-case-report
#11
Sonali Sethi, Meenakshi Prakash, Anil Dhal, Sunil Kumar Puri
Osteochondroma is the most common benign skeletal tumour. It frequently causes pain and local symptoms, however, vascular complications are rare. The popliteal artery is more commonly affected and there are isolated case reports of popliteal artery pseudoaneurysm in literature. However, venous complications are extremely rare. We hereby report a case of 21-year-old male patient with distal femoral osteochondroma complicated by a popliteal venous aneurysm and deep vein thrombosis. This association has not been described in the past...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27739569/combination-prophylaxis-versus-pharmacologic-prophylaxis-alone-for-preventing-deep-vein-thrombosis-in-hip-surgery
#12
Feng-Fei Lin, Chao-Hui Lin, Bin Chen, Ke Zheng
PURPOSE: To evaluate the comparative efficacy and safety of combination pharmacologic and graduated compression stockings (GCS) prophylaxis versus pharmacological prophylaxis alone for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in hip surgery. METHODS: Relevant publications indexed in PubMed, Cochrane Library, Embase, Web of Science, Wanfang Data, CNKI and Sinomed (CBM) were identified. Appropriate articles identified from the reference lists of the above searches were also reviewed...
November 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27696701/the-long-term-recurrence-risk-of-patients-with-unprovoked-venous-thromboembolism-an-observational-cohort-study
#13
P A Kyrle, M Kammer, L Eischer, A Weltermann, E Minar, M Hirschl, G Heinze, S Eichinger
: Essentials Long-term recurrence risk of venous thromboembolism (VTE) is uncertain. We performed a prospective cohort study of 839 patients with first unprovoked VTE. VTE recurrence risk is high, particularly in men with proximal thrombosis or pulmonary embolism. Sex and VTE site determine the recurrence risk and should be considered for patient counseling. SUMMARY: Background The long-term recurrence risk (ltRR) of venous thromboembolism (VTE) is uncertain. Objective To assess the ltRR of patients with first unprovoked VTE...
December 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27535738/axillary-artery-pseudoaneurysm-resulting-in-brachial-plexus-injury-in-a-patient-taking-new-oral-anticoagulants
#14
Mohammed Monem, Mohamad Khalid Iskandarani, Kishan Gokaraju
We discuss the case of an independent 80-year-old Caucasian woman, being treated with new oral anticoagulants for a previous deep vein thrombosis, who had fallen on her right shoulder. She made a delayed presentation to the emergency department with a wrist drop in her right dominant hand. She had right arm bruising with good distal pulses but had a global neurological deficit in the hand. Plain radiographs of the shoulder, humerus, elbow, forearm and wrist demonstrated no fractures. MRI showed a significant right axillary lesion distorting the surrounding soft tissues, including the brachial plexus, and CT with contrast confirmed this to be a large axillary pseudoaneurysm...
August 17, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27468257/extensive-deep-vein-thrombosis-treatment-using-fondaparinux-and-edoxaban-a-case-report
#15
Kazuhiro Shimizu, Takeshi Sasaki, Takanobu Tomaru, Hirofumi Noike
BACKGROUND: Factor Xa inhibitor is a key drug in the coagulation cascade. Parenteral anticoagulation using low molecular weight heparin or fondaparinux is the recommended form of treatment for most patients presenting with venous thrombosis. Following the acute phase, edoxaban is recommended. We present a case of extensive deep vein thrombosis treated using fondaparinux and edoxaban. CASE PRESENTATION: A 63-year-old man with redness, pain, and swelling of the left leg lasting for more than 1 month was referred to our hospital...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27437827/therapeutic-anticoagulation-for-isolated-calf-deep-vein-thrombosis
#16
Garth H Utter, Tejveer S Dhillon, Edgardo S Salcedo, Daniel J Shouldice, Cassandra L Reynolds, Misty D Humphries, Richard H White
IMPORTANCE: Deep vein thrombosis (DVT) isolated to the calf veins (distal to the popliteal vein) is frequently detected with duplex ultrasonography and may result in proximal thrombosis or pulmonary embolism (PE). OBJECTIVE: To evaluate whether therapeutic anticoagulation is associated with a decreased risk for proximal DVT or PE after diagnosis of an isolated calf DVT. DESIGN, SETTING, AND PARTICIPANTS: All adult patients with ultrasonographic detection of an isolated calf DVT from January 1, 2010, to December 31, 2013, at the Vascular Laboratory of the University of California, Davis, Medical Center were included...
September 21, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27430666/detecting-venous-reflux-using-a-sixty-degree-reverse-trendelenburg-rt-60-position-in-symptomatic-patients-with-chronic-venous-disease
#17
Nicolas W Shammas, Mary F Knowles, W John Shammas, William Hauber, Gail A Shammas, Melissa J Green, Julie Dokas
BACKGROUND: The optimal technique to detect venous reflux requires a patient to be standing with weight on one leg while the other leg is scanned for superficial venous reflux (standing position [SP] technique). This represents a significant hardship for a subset of patients who are unable to stand and adequately maintain their balance. This study examines the predictability of identifying venous reflux using a reverse Trendelenburg 60° (RT-60) when compared with the SP in the great saphenous vein (GSV) and small saphenous vein (SSV)...
September 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27377039/diagnostic-characteristics-of-lower-limb-venous-compression-ultrasonography-in-suspected-pulmonary-embolism-a-meta-analysis
#18
J Da Costa Rodrigues, S Alzuphar, C Combescure, G Le Gal, A Perrier
UNLABELLED: Essentials Lower limb ultrasonography (CUS) could be useful in suspected pulmonary embolism (PE). We performed a metaanalysis on the diagnostic characteristics of CUS in suspected PE. With a sensitivity of 41%, proximal CUS would be positive in one of every 7.3 patients. Complete CUS has a higher sensitivity but specificity for PE is too low to use it in suspected PE. SUMMARY: Background Diagnosis of pulmonary embolism (PE) is commonly based on D-dimer measurement and computed tomography (CT) angiography...
September 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27372555/use-of-a-pneumatic-tourniquet-in-total-knee-arthroplasty-increases-the-risk-of-distal-deep-vein-thrombosis-a-prospective-randomized-study
#19
Noriaki Mori, Shoichi Kimura, Tomohiro Onodera, Norimasa Iwasaki, Izumi Nakagawa, Takeshi Masuda
BACKGROUND: There has been controversy regarding the incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with or without the use of a tourniquet. The aim of this randomized, prospective study was to clarify the effects of tourniquet use on DVT in TKA. METHODS: The subjects were 109 patients scheduled to undergo TKA from April 2008 to March 2009 before the establishment of the American Association of Orthopedic Surgeons (AAOS) practice guidelines...
October 2016: Knee
https://www.readbyqxmd.com/read/27365228/incidence-reasons-and-risk-factors-for-readmission-after-surgery-for-benign-distal-esophageal-disease
#20
Amy K Poupore, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Our aim was to ascertain the incidence of, reasons for, and risk factors associated with hospital readmission after an operation for benign distal esophageal disease. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database (2012-2014), patients with a primary diagnosis of gastroesophageal reflux disease, paraesophageal hiatal hernia, or achalasia who underwent fundoplication, paraesophageal hernia repair, or Heller myotomy were identified...
September 2016: Surgery
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