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DVT thrombolysis

Ajay U Mahajan, Deepak S Laddhad, Deepak Bohara, Sangeeta D Laddhad, Yogita T Dinde, Sachin S Bhabad
A 32 yrs old man presented with shortness of breath and syncopal episode with preceding history of DVT 15days above. Patient has tachycardia hypoxia and hypotension, on evaluation ECG Showed S1 Q3 T3 Pattern, bedside Echo Showed visible thrombus of 3cm in pulmonary artery, successfully thrombolysed with tenecteplase and streptokinase. This case study is presented to stress importance of urgent bedside echo in all sudden onset dysponea and hypoxia to rule out pulmonary Embolism which can be successfully thrombolysed without delay...
June 2016: Journal of the Association of Physicians of India
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
September 24, 2016: Advances in Experimental Medicine and Biology
Efthymios D Avgerinos, Omar El-Shazly, Geetha Jeyabalan, George Al-Khoury, Eric Hager, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Inferior vena cava (IVC) thrombosis may occur in patients with iliofemoral deep venous thrombosis (DVT), and its impact on thrombolysis outcomes is poorly defined. This study compared outcomes of patients undergoing thrombolysis for acute iliofemoral DVT with and without IVC involvement. METHODS: Patients who underwent thrombolysis for iliofemoral DVT between May 2007 and March 2014 were identified from a prospectively maintained database and divided into two groups: those with IVC involvement and those without...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
James X Chen, Deepak Sudheendra, S William Stavropoulos, Gregory J Nadolski
The treatment for iliofemoral deep venous thrombosis (DVT) is challenging, as the use of anticoagulation alone can be insufficient for restoring venous patency and thus lead to prolongation of acute symptoms and an increased risk of chronic complications, including venous insufficiency and postthrombotic syndrome (PTS). In these cases, earlier and more complete thrombus removal can ameliorate acute symptoms and reduce long-term sequelae. Endovascular therapies involving the use of pharmacologic, mechanical, and combined pharmacomechanical modalities have been developed to achieve these goals...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Lucia C DeLisa, Craig P Hensley, Steven Jackson
BACKGROUND AND PURPOSE: Paget-Schroetter syndrome (PSS) is a rare condition of vein thrombosis that can be manifested in athletes and laborers who overuse their upper extremities. If diagnosed early, PSS can be managed and the symptoms can be fully reversed. Venous duplex ultrasound (US), the modality most commonly used to diagnose deep vein thrombosis (DVT), has high sensitivity and specificity for detecting DVT. This case report describes the differential diagnosis and management of PSS in a weight lifter...
September 1, 2016: Physical Therapy
Bin Yang, Xiao-Dong Xu, Peng Gao, Ji-Xiang Yu, Yu Li, Ai-Dong Zhu, Ran-Ran Meng
BACKGROUND There is little data comparing catheter-directed thrombolysis (CDT) via small saphenous veins vs. systematic thrombolysis on complications and efficacy in acute deep venous thrombosis patients. The aim of our study was to compare the efficacy and safety of CDT via the small saphenous veins with systematic thrombolysis for patients with acute deep venous thrombosis (DVT). MATERIAL AND METHODS Sixty-six patients with acute DVT admitted from June 2012 to December 2013 were divided into 2 groups: 27 patients received systemic thrombolysis (ST group) and 39 patients received CDT via the small saphenous veins (CDT group)...
August 23, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jianguang Jiang, Jianfei Tu, Zhongzhi Jia, Jiezhong Chen, Haitao Cao, Qingli Meng, Tyler A Fuller, Feng Tian
OBJECTIVE: To retrospectively evaluate the incidence and outcomes of inferior vena cava (IVC) filter thrombus during catheter-directed thrombolysis (CDT) for acute proximal deep venous thrombosis (DVT). METHODS: From October 2006 to June 2015, patients diagnosed with acute proximal DVT and received CDT after a retrievable IVC filter was placed were included. The incidence, treatment and outcomes of IVC filter thrombus during CDT were recorded and analyzed. RESULTS: A total of 189 patients (91 women, 98 men, mean age, 57...
August 12, 2016: Annals of Vascular Surgery
Haiyan Li, Zhongzhi Jia, Xin Chen, Feng Tian, Xin Wang
BACKGROUND: The aim of this study was to retrospectively evaluate the safety, efficacy, and retrievability of the Aegisy vena cava filter (LifeTech Scientific Co. Ltd, Shenzhen, China). METHODS: Data from all patients who underwent Aegisy vena cava filter placement for pulmonary embolism (PE) prophylaxis during catheter-directed thrombolysis (CDT) or aspiration thrombectomy for the proximal deep venous thrombosis (DVT) were included and analyzed. RESULTS: From October 2006 to September 2015, a total of 213 patients were included in this study...
June 16, 2016: Annals of Vascular Surgery
Haijie Che, Juwen Zhang, Guifeng Sang, Jun Yong, Lubin Li, Mu Yang
BACKGROUND: Catheter-directed thrombolysis (CDT) is an effective method for the treatment of deep venous thrombosis (DVT). The most widely used puncture technique involves the popliteal vein of the affected leg. We introduce a new puncture technique based on bony landmark positioning. METHODS: Between May 2012 and December 2014, we performed CDT in 96 cases of DVT using the puncture technique. The procedure is performed with the patient in the prone position on the angiography table...
August 2016: Annals of Vascular Surgery
Vladimir Y I G Tichelaar, Ellen E Brodin, Anders Vik, Trond Isaksen, Finn Egil Skjeldestad, Satish Kumar, Nora C Trasti, Kulbir Singh, John-Bjarne Hansen
BACKGROUND: Recent studies have suggested that catheter-directed thrombolysis (CDT) reduces development of post-thrombotic syndrome (PTS). Ultrasound-assisted CDT (USCDT) might enhance the efficiency of thrombolysis. We aimed to compare USCDT with CDT on efficacy, safety, development of PTS, and quality of life after long-term follow-up. METHODS: We describe a retrospective case series of 94 consecutive patients admitted with iliofemoral or more proximal deep vein thrombosis (DVT) to the University Hospital from 2002 to 2011, treated either with CDT or USCDT...
August 2016: Cardiovascular and Interventional Radiology
Joshua D Lenchus, Michelle Biehl, Jorge Cabrera, Alice Gallo de Moraes, Cameron Dezfulian
Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep venous thrombosis (DVT), is a major cause of morbidity and mortality of particular relevance for intensivists and hospitalists. Acute VTE is usually managed with parenteral unfractionated heparin or low-molecular-weight heparin, followed by an oral vitamin K antagonist. Data are lacking for optimal treatment of less common occurrences, such as upper extremity DVT, and for approaches such as thrombolysis for PE associated with early signs of hemodynamic compromise or inferior vena cava filters when anticoagulation is contraindicated...
May 13, 2016: Journal of Intensive Care Medicine
LeGrand Belnap, George M Rodgers, Daniel Cottam, Hinali Zaveri, Cara Drury, Amit Surve
BACKGROUND: Portal vein thrombosis (PVT) is a serious problem with a high morbidity and mortality, often exceeding 40% of affected patients. Recently, PVT has been reported in patients after laparoscopic sleeve gastrectomy (LSG). The frequency is surprisingly high compared with other abdominal operations. OBJECTIVE: We present a series of 5 patients with PVT after LSG. The treatment was not restricted simply to anticoagulation alone, but was determined by the extent of disease...
March 8, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Marco Zuin, Gianluca Rigatelli, Loris Roncon
To report the combined use of rheolytic thrombectomy (RT) and inferior vena cava (IVC) filter placement in the setting of acute pulmonary embolism (PE), heparin-induced thrombocytopenia (HIT) type II (HIT-II) and recent ischemic stroke. A 66-year-old man with an HIT-II and recent ischemic stroke was referred to our institution from a secondary regional center for acute PE and left deep vein thrombosis (DVT), confirmed at chest computed tomography (CT) and lower limb ultrasound, respectively. RT was attempted because intravenous heparin anticoagulation was contraindicated by the patient's medical history while recent ischemic stroke contraindicated thrombolysis...
April 25, 2016: Perfusion
Jia-Yao Dong, Qiao-Hua Zhu, Mei-Hua Luo, Cheng-Yu Zhou, Wei Huang, Xin-Fa Yu
OBJECTIVE: To investigate the patterns of changes in serum levels of of D-dimer, fibrinogen (FIB) and fibrin degradation product (FDP) during catheter-directed thrombolysis (CDT) in patients with acute lower-extremity deep venous thrombosis (DVT) and explore their clinical significance. METHODS: From June, 2014 to June, 2015, 50 patients with acute lower-extremity DVT received CDT. The serum concentrations of D-dimer, FIB and FDP were measured before, during and after CDT in all the subjects, with 50 healthy subjects serving as the control group...
April 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Gaurav Sundar, Shyamkumar N Keshava, Vinu Moses, George K Chiramel, Munawwar Ahmed, Suraj Mammen, Sunil Aggarwal, Edwin Stephen
BACKGROUND: Lower extremity deep vein thrombosis (DVT) is a common illness with an annual incidence of 1 per 1000 adults. The major long-term complication of DVT is post-thrombotic syndrome (PTS) which occurs in up to 60% of patients within 2 years of an episode of DVT. AIMS: We aim to evaluate the outcomes of catheter-directed treatment (CDT) for symptomatic acute or subacute lower extremity DVT. MATERIALS AND METHODS: A retrospective 12-year study was conducted on the outcomes of CDT on 54 consecutive patients who presented with acute or subacute lower extremity DVT to our hospital...
January 2016: Indian Journal of Radiology & Imaging
B C Srinivas, Soumya Patra, C M Nagesh, Babu Reddy, C N Manjunath
Deep vein thrombosis (DVT) is a major health problem in pregnancy and postpartum period. Catheter-directed thrombolysis (CDT) is safe and effective in the management of symptomatic DVT. Value of CDT in postpartum DVT is not fully evaluated. We describe five patients presenting with acute iliofemoral DVT in their early postpartum period who were treated with mechanical thromboaspiration and CDT. The CDT was done using streptokinase infusion and unfractionated heparin. Percutaneous angioplasty was done in patients with symptomatic residual lesion following thrombolysis...
December 2015: Indian Heart Journal
Zhongzhi Jia, Jianfei Tu, Jinwei Zhao, Baosheng Ren, Feng Tian, Kai Wang, Shaoqin Li, Guomin Jiang
OBJECTIVE: This study retrospectively evaluated the safety and efficacy of aspiration thrombectomy using a large-size catheter for acute lower extremity deep vein thrombosis (DVT). METHODS: All patients who underwent aspiration thrombectomy using 9F or 10F catheters for acute lower extremity DVT were included and analyzed. Aspiration thrombectomy was performed in all patients. Additional intravenous thrombolysis was performed in patients with residual thrombus, and stent placement was performed in patients with iliac vein compression syndrome...
April 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
John J Lee, Mustafa Al-Jubouri, Robin Acino, Anthony J Comerota, Fedor Lurie
BACKGROUND: It has been reported that early clot removal benefits patients with iliofemoral deep venous thrombosis (DVT) by removing obstruction and preserving valve function. However, a substantial number of patients who had successful clot removal develop post-thrombotic syndrome (PTS). Residual thrombus and rethrombosis play a part in this phenomenon, but the role of coexisting primary chronic venous disease (PCVD) in these patients has not been studied. METHODS: All patients who underwent catheter-based techniques of thrombus removal for symptomatic acute iliofemoral DVT during a 5-year period compose the study group...
October 2015: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Marijn M L van den Houten, Regine van Grinsven, Sjaak Pouwels, Lonneke S F Yo, Marc R H M van Sambeek, Joep A W Teijink
Approximately 10% of all cases of deep vein thrombosis (DVT) occur in the upper extremities. The most common secondary cause of upper-extremity DVT (UEDVT) is the presence of a venous catheter. Primary UEDVT is far less common and usually occurs in patients with anatomic abnormalities of the costoclavicular space causing compression of the subclavian vein, called venous thoracic outlet syndrome (VTOS). Subsequently, movement of the arm results in repetitive microtrauma to the vein and its surrounding structures causing apparent 'spontaneous' thrombosis, or Paget-Schrötter syndrome...
March 2016: Phlebology
Prakash Saha, Stephen Black, Karen Breen, Ashish Patel, Bijan Modarai, Alberto Smith
INTRODUCTION: This review aims to provide an update on the management of deep vein thrombosis (DVT). SOURCES OF DATA: A systematic search of PubMed, Google Scholar and Cochrane databases was carried out. AREAS OF AGREEMENT: Direct oral anticoagulants (DOACs) are as effective and easier to use than vitamin K antagonists for the treatment of DVT. Catheter-directed thrombolysis can reduce post thrombotic syndrome in patients with iliofemoral DVT...
March 2016: British Medical Bulletin
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