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DVT thrombolysis

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https://www.readbyqxmd.com/read/29768935/catheter-directed-thrombolysis-with-a-continuous-infusion-of-low-dose-alteplase-for-subacute-proximal-venous-thrombosis-efficacy-and-safety-compared-to-urokinase
#1
Maofeng Gong, Xu He, Jinhua Song, Boxiang Zhao, Wanyin Shi, Guoping Chen, Jianping Gu
The purpose of this study was to compare the efficacy and safety associated with catheter-directed thrombolysis (CDT) using either recombinant tissue plasminogen activator (rt-PA) or urokinase (UK) for subacute deep venous thrombosis (DVT). From January 2014 to December 2016, we conducted a retrospective analysis on a total of 49 patients who underwent consistent CDT with either rt-PA (rt-PA-CDT group) or UK (UK-CDT group) treatment. The thrombolytic rate of the rt-PA-CDT group was significantly higher than that of the UK-CDT group (87...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29701417/surgical-thrombectomy-fibrinolysis-angioplasty-and-stenting-a-combined-approach-for-treatment-of-a-may-thurner-syndrome-presenting-as-phlegmasia-cerulea-dolens
#2
Carlos Veiga, João Gonçalves, Pedro Sousa, Carolina Vaz, Ivone Silva, Pedro Sá-Pinto, Rui Almeida
INTRODUCTION: Phlegmasia cerulea dolens (PCD) is a rare complication of deep venous thrombosis (DVT). Massive ileo-femoral DVT is usually the cause and prompt treatment is mandatory as it represents a medical emergency. Reported amputation rates range from 12% to 25% and mortality ranges from 25% to 40%. Limb ischemia results from obstruction to arterial inflow secondary to extreme levels of venous hypertension. Primary treatment goal is restoration of venous outflow and can be achieved by endovascular or surgical techniques...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29655806/is-there-a-role-for-intervention-radiology-for-the-treatment-of-lower-limb-deep-vein-thrombosis-in-the-era-of-direct-oral-anticoagulants-a-comprehensive-review
#3
REVIEW
Marco Marietta, Elisa Romagnoli, Benilde Cosmi, Valeria Coluccio, Mario Luppi
Despite recent advances in the treatment of Deep Vein Thrombosis (DVT) provided by Direct Oral Anticoagulants (DOAC), a substantial proportion of lower limb DVT patients will develop some degree of post-thrombotic syndrome (PTS) within 2 years. Systemic thrombolysis, although effective in reducing the risk of PTS and leg ulceration, is associated with a high risk of major bleeding, making it unsuitable for the vast majority of patients. A local approach, aimed at delivering the fibrinolytic drug directly into, or near to, the thrombus surface, is attractive because of the possibility of lowering of the administered drug dose, thus reducing the bleeding risks...
April 11, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29642860/atrophic-inferior-vena-cava-is-a-marker-of-chronicity-of-intra-filter-and-inferior-vena-cava-thrombosis-based-on-ct-findings
#4
Liang Chen, Wanyin Shi, Jianping Gu, Xu He, Wensheng Lou
BACKGROUND: A permanently indwelling filter in the inferior vena cava (IVC) may induce caval thrombosis, which could develop and evolve from an acute to a chronic phase. The differential diagnosis of acute and chronic thromboses determines the treatment strategy. The role of computed tomography (CT) in diagnosing acute and chronic intra-filter and IVC thromboses has not been well established. This retrospective study summarizes the CT signs that indicate acute and chronic phases of intra-filter and IVC thromboses...
April 11, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29545327/how-i-treat-the-post-thrombotic-syndrome
#5
Anat Rabinovich, Susan R Kahn
The post-thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT) that imposes significant morbidity, reduces quality of life and is costly. After DVT, 20-50% of patients will develop PTS, and up to 5% will develop severe PTS. The principal risk factors for PTS are anatomically extensive DVT, recurrent ipsilateral DVT, obesity and older age. By preventing the initial DVT and DVT recurrence, primary and secondary prophylaxis of DVT will reduce the occurrence of PTS. The effectiveness of elastic compression stockings (ECS) for PTS prevention is controversial...
March 15, 2018: Blood
https://www.readbyqxmd.com/read/29522873/catheter-directed-thrombolysis-versus-pharmacomechanical-thrombectomy-for-upper-extremity-deep-venous-thrombosis-a-cost-effectiveness-analysis
#6
Osman Mahmoud, Pirkka Vikatmaa, Jari Räsänen, Erno Peltola, Eero Sihvo, Leena Vikatmaa, Kimmo Lappalainen, Maarit Venermo
BACKGROUND: Upper extremity deep vein thrombosis represents (UEDVT) 2-3% of all deep vein thrombosis. Catheter directed thrombolysis (CDT) was replaced largely by pharmacomechanical thrombolysis (PMT) in our institution. In this study we compared the immediate and 1-year results as well as the total hospital costs between CDT and PMT in the treatment of UEDVT. METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital...
March 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29518515/malignancy-does-not-affect-outcomes-of-pharmacomechanical-thrombolysis-in-acute-symptomatic-iliofemoral-deep-vein-thrombosis
#7
William J Yoon, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
BACKGROUND: Cancer patients demonstrate increased risk for venous thromboembolism (VTE), VTE recurrence, and anticoagulation-associated bleeding. Pharmacomechanical thrombolysis (PMT) aand thrombectomy improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral deep vein thrombosis (DVT). It remains unknown whether pharmacomechanical thrombolysis can be used safely in patients with active cancer. We hypothesized that perioperative and short-term outcomes of pharmacomechanical iliofemoral DVT thrombolysis would not differ between patients with cancer and those without cancer...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29516242/addressing-infra-popliteal-thrombus-in-iliofemoral-dvt-the-criss-cross-technique
#8
Duarte C Rego, Ahmed Khairy Sayed Ahmed, Gerard J O'Sullivan
PURPOSE: The purpose of this work was to describe the results of a technique of simultaneous antegrade and retrograde vascular access ("criss-cross") to the popliteal vein to achieve venous recanalization in patients with acute, extensive, iliofemoral DVT with concomitant popliteal and calf vein thrombosis. MATERIALS AND METHODS: Seven patients were treated using this technique, in three patients as a bailout option after failed posterior tibial vein puncture and in four as a first option...
March 7, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29515698/management-of-pulmonary-thromboembolism-based-on-severity-and-vulnerability-to-thrombolysis
#9
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
https://www.readbyqxmd.com/read/29502770/catheter-directed-therapy-options-for-iliofemoral-venous-thrombosis
#10
REVIEW
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
https://www.readbyqxmd.com/read/29499353/underutilization-of-thrombolytic-therapy-for-patients-diagnosed-with-acute-deep-venous-thrombosis-in-the-outpatient-setting
#11
Mark Archie, Meena Archie, Jessica O'Connell, Brian G DeRubertis
BACKGROUND: Catheter-directed thrombolysis (CDT) has been shown to be a safe and effective treatment for the management of acute iliofemoral deep venous thrombosis (DVT). The potential benefits of this therapy include more rapid resolution of symptoms and possible reduction in the long-term sequelae. Many patients diagnosed with DVT in the inpatient setting have contraindications to lytic therapy, but less is known regarding the suitability of thrombolysis for outpatients diagnosed with acute DVT...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29481922/recurrent-iliofemoral-venous-thrombosis-in-the-setting-of-may-thurner-syndrome-as-the-presenting-symptom-of-behcet-s-disease
#12
Sameer Lakha, Chien Yi Maximilian Png, Kevin Chun, Windsor Ting
BACKGROUND: Vascular manifestations including pulmonary artery aneurysms and venous thrombosis are seen in up to 14% of patients with Behcet's disease. We report a patient who had recurrent deep vein thrombosis (DVT) as the presenting symptom of Behcet's Disease. METHODS: A 19-year-old male who presented with acute iliofemoral DVT, confirmed by intravascular ultrasound (IVUS) and venogram. May-Thurner syndrome was also observed. Repeated catheter-based pharmacomechanical thrombolysis, thrombectomy, and subsequent iliac vein stenting were performed...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29454036/percutaneous-endovenous-intervention-plus-anticoagulation-versus-anticoagulation-alone-for-treating-patients-with-proximal-deep-vein-thrombosis-a-meta-analysis-and-systematic-review
#13
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...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29436096/nephrotic-syndrome-complicated-with-femoral-vein-catheter-related-phlegmasia-cerulea-dolens-a-case-report
#14
Wen-Chun Chen, Shuo-Ming Ou
Nephrotic syndrome is a well-known risk factor of deep vein thrombosis (DVT). Catheter-related DVT under the setting of nephrotic syndrome may be presented as a more fulminant form, phlegmasia cerulea dolens. Phlegmasia cerulea dolens may lead to severe obstruction of venous drainage of the extremities and presents with compartment syndrome that impairs arterial perfusion. Aggressive management with thrombolysis and/or thrombectomy are considered with simultaneous anticoagulant treatment.
February 13, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29428534/midterm-results-of-endovascular-treatment-for-iliac-vein-compression-syndrome-from-a-single-center
#15
Chongqing Huang, Guanfeng Yu, Jingyong Huang
BACKGROUND: The efficacy of endovascular interventional treatment for iliac vein compression syndrome (IVCS) is not well studied. The purpose of our study was to investigate the clinical outcome of endovascular interventional treatment for IVCS. METHODS: Data of 68 patients with IVCS, who underwent interventional treatment in our hospital, were analyzed retrospectively. Among these patients, 46 had lower extremity varicose veins. Sixty-five patients underwent stent implantation, and 3 patients underwent simple balloon angioplasty...
February 9, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29417407/a-systematic-review-of-ultrasound-accelerated-catheter-directed-thrombolysis-in-the-treatment-of-deep-vein-thrombosis
#16
REVIEW
Yadong Shi, Wanyin Shi, Liang Chen, Jianping Gu
To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened...
April 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29399535/deep-venous-thrombosis-in-pregnancy-incidence-pathogenesis-and-endovascular-management
#17
REVIEW
Paola Devis, M Grace Knuttinen
Deep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399526/catheter-directed-thrombolysis-of-deep-vein-thrombosis-literature-review-and-practice-considerations
#18
REVIEW
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
https://www.readbyqxmd.com/read/29360741/a-patient-centered-approach-to-guide-follow-up-and-adjunctive-testing-and-treatment-after-first-rib-resection-for-venous-thoracic-outlet-syndrome-is-safe-and-effective
#19
Colin P Ryan, Nicolas J Mouawad, Patrick S Vaccaro, Michael R Go
Controversies in the treatment of venous thoracic outlet syndrome (VTOS) have been discussed for decades, but still persist. Calls for more objective reporting standards have pushed practice towards comprehensive venous evaluations and interventions after first rib resection (FRR) for all patients. In our practice, we have relied on patient-centered, patient-reported outcomes to guide adjunctive treatment and measure success. Thus, we sought to investigate the use of thrombolysis versus anticoagulation alone, timing of FRR following thrombolysis, post-FRR venous intervention, and FRR for McCleery syndrome (MCS) and their impact on patient symptoms and return to function...
January 23, 2018: Diagnostics
https://www.readbyqxmd.com/read/29222321/thrombectomy-and-thrombolysis-for-the-prevention-and-treatment-of-postthrombotic-syndrome
#20
REVIEW
Suresh Vedantham
Postthrombotic syndrome (PTS) is a frequent complication of lower-extremity deep vein thrombosis (DVT), occurring in approximately 40% of patients despite the use of anticoagulant therapy. PTS causes significant impairment of patients' health-related quality of life, and no evidence-based therapies have been consistently effective. Catheter-directed thrombolysis and thrombectomy have been shown to remove acute thrombus, and it has been hypothesized they could prevent or reduce PTS. However, because these procedures can be associated with complications, mainly bleeding, randomized trial data are needed to determine when they should be used...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
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