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https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#1
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
#2
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
#3
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...
November 10, 2016: 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
#4
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
#5
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
#6
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...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27790548/osteochondroma-complicated-by-a-popliteal-vein-aneurysm-a-rare-case-report
#7
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
#8
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...
October 8, 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
#9
P A Kyrle, M Kammer, L Eischer, A Weltermann, E Minar, M Hirschl, G Heinze, S Eichinger
BACKGROUND: The long-term recurrence risk (ltRR) of venous thromboembolism (VTE) is uncertain. Objective to assess the ltRR of patients with first unprovoked VTE. PATIENTS/METHODS: Patients were classified into 3 categories; distal deep-vein thrombosis (DVT), proximal DVT, or pulmonary embolism (PE), i.e. PE associated with DVT or isolated PE. Patients with major thrombophilia or antithrombotic therapy were excluded. End point was recurrent symptomatic VTE. RESULTS: 839 patients were followed for a median of 7...
October 2, 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
#10
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...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27468257/extensive-deep-vein-thrombosis-treatment-using-fondaparinux-and-edoxaban-a-case-report
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27297081/clinical-analysis-of-preoperative-risk-factors-for-the-incidence-of-deep-venous-thromboembolism-in-patients-undergoing-posterior-lumbar-interbody-fusion
#17
Jingchao Wei, Wenyi Li, Yueying Pei, Yong Shen, Jia Li
BACKGROUND: The purpose of this study aimed to assess preoperative risk factors for the incidence of deep venous thromboembolism in patients undergoing posterior lumbar interbody fusion (PLIF). METHODS: The diagnosis of preoperative deep vein thrombosis (DVT) was confirmed by Doppler ultrasonography. To examine the preoperative risk factors for DVT admitted for PLIF, comparative analysis of the DVT-positive and DVT-negative groups was done. RESULTS: DVT was detected in 9...
2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27268941/an-algorithmic-approach-to-management-of-venous-thromboembolism
#18
Prajwal Dhakal, Krishna Gundabolu, Vijaya R Bhatt
Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Factors such as the presence of transient risk factors for VTE, risk of bleeding, and location of deep vein thrombosis (DVT) determine the duration of anticoagulation. Extended anticoagulation is offered to patients with unprovoked pulmonary embolism (PE) or proximal DVT and a low risk of bleeding. Anticoagulation for 3 months is advised in patients with provoked DVT or PE, high risk of bleeding, and isolated distal or upper extremity DVT...
June 5, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27246450/apixaban-versus-enoxaparin-in-the-prevention-of-venous-thromboembolism-following-total-knee-arthroplasty-a-single-centre-single-surgeon-retrospective-analysis
#19
D A L King, R E Pow, D M Dickison, P R Vale
BACKGROUND: There is a high risk of developing venous thromboembolism (VTE) following total knee arthroplasty (TKA). Conventional thromboprophylactic agents have limitations, such as route of administration, the need for monitoring, narrow therapeutic windows and interactions. Apixaban is a new oral anticoagulant with the potential to overcome these limitations. AIMS: To report the efficacy and safety of apixaban and low-molecular-weight heparin, enoxaparin, in VTE prophylaxis following TKA...
September 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27231697/an-intact-dissecting-baker-s-cyst-mimicking-recurrent-deep-vein-thrombosis
#20
Sarah Jamshed, L Michael Snyder
We report a case of a 75-year-old female with a history of acute deep vein thrombosis (DVT) 6 years ago who presented with unilateral calf swelling and pain. D-dimer was normal, and compression ultrasound revealed findings typical of DVT, including an incompressible dilated and hypoechoic peroneal vein. Despite 4 months of anticoagulation for supposed recurrent DVT, pain symptoms persisted and repeat D-dimer and compression ultrasound were unchanged. A magnetic resonance imaging scan to investigate the leg demonstrated a 6-cm dissecting Baker's cyst extending posterolaterally resulting in venous compression and distal dilation, which appeared to have been confused with a DVT...
April 2016: Journal of Investigative Medicine High Impact Case Reports
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