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Iliofemoral DVT

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https://www.readbyqxmd.com/read/29651929/chronic-iliofemoral-vein-obstruction-an-under-recognized-cause-of-exercise-limitation
#1
Michael J Segel, Ronen Reuveny, Jacob Luboshitz, Dekel Shlomi, Issahar Ben-Dov
Local symptoms of chronic venous insufficiency after deep vein thrombosis (DVT) are well described, but little is known about the effect of residual venous obstruction on exercise capacity. We tested our hypothesis that chronic residual iliofemoral vein occlusion (IFVO) after DVT may impair exercise capacity. Nine post-DVT patients with residual IFVO and effort intolerance were studied; a comparison cohort consisted of 11 healthy volunteers. Exercise tolerance was assessed by bimodality incremental symptom-limited cardiopulmonary testing, using leg and arm ergometers...
April 13, 2018: European Journal of Sport Science
https://www.readbyqxmd.com/read/29518515/malignancy-does-not-affect-outcomes-of-pharmacomechanical-thrombolysis-in-acute-symptomatic-iliofemoral-deep-vein-thrombosis
#2
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
#3
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/29514591/standards-for-recanalisation-of-chronic-venous-outflow-obstructions
#4
Michael Lichtenberg, Rick de Graaf, Christian Erbel
Postthrombotic syndrome (PTS) is the most common complication after iliofemoral deep vein thrombosis. It reduces quality of life and increases deep vein thrombosis (DVT)-related costs. The clinical symptoms and severity of PTS may vary; the most common symptoms include edema, pain (venous claudication), hyperpigmentation, lipodermatosclerosis, and ulceration. PTS is based on the principle of outflow obstruction, which may be caused by venous hypertension and may lead to valvular damage and venous reflux or insufficiency...
March 8, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29502770/catheter-directed-therapy-options-for-iliofemoral-venous-thrombosis
#5
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
#6
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
#7
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
#8
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/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#9
Burr Fong, Daniel Novak, Michael Dalley, Gregory Alfred
BACKGROUND: Deep vein thrombosis (DVT) is a common disease that is diagnosed in approximately 1 in 1000 adults annually. Extensive DVT can lead to life- or limb-threatening diagnoses such as phlegmasia cerulea dolens (PCD), phlegmasia alba dolens, and venous gangrene. PCD, also known as massive iliofemoral venous thrombosis, is rare, and a severe complication of DVT. CASE REPORT: We report a case of a 94-year-old bedridden woman with past medical history of dementia, hypertension, pulmonary embolism, DVT, and atrial fibrillation...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29399526/catheter-directed-thrombolysis-of-deep-vein-thrombosis-literature-review-and-practice-considerations
#10
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/29354628/femoral-endovenectomy-with-iliac-stenting-for-chronic-iliofemoral-venous-occlusion
#11
Won Pyo Cho, Sungsin Cho, Min-Ji Cho, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Seung-Kee Min
A 62-year-old man with progressive swelling on his left thigh and leg was referred to the Division of Vascular Surgery. Anticoagulation therapy did not prevent or improve the symptoms of chronic deep vein thrombosis (DVT) from his left external iliac vein to posterior tibial vein. He had no trauma history nor any accidents. He underwent femoral endovenectomy, thrombectomy and stent insertion in left iliac vein. The patient had additional balloon angioplasty for stenosis in left common femoral vein. He had an uneventful postoperative recovery without complication...
December 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/29132220/catheter-directed-thrombolysis-versus-standard-anticoagulation-for-acute-lower-extremity-deep-vein-thrombosis-a-meta-analysis-of-clinical-trials
#12
Yongming Lu, Linyi Chen, Jinhui Chen, Tao Tang
Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28980513/early-clinical-outcomes-of-a-novel-rheolytic-directional-thrombectomy-technique-for-patients-with-iliofemoral-deep-vein-thrombosis
#13
Jörn F Dopheide, Tim Sebastian, Rolf P Engelberger, Axel Haine, Nils Kucher
BACKGROUND: Rheolytic thrombectomy (RT) for acute iliofemoral deep vein thrombosis (DVT) with first-generation techniques is often incomplete and adjunctive conventional catheter-directed thrombolysis (CDT) is required in more than half of patients to achieve venous patency. PATIENTS AND METHODS: From the prospective Bern Venous Stent Registry, we investigated rates of primary treatment success, primary patency, and post-thrombotic syndrome (PTS) from 40 consecutive patients (mean age 51 ± 19 years, 45 % women) with acute iliofemoral DVT, treated with a novel directional RT technology and stent placement...
January 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28879803/practice-patterns-of-retrievable-inferior-vena-cava-filters-and-predictors-of-filter-retrieval-in-patients-with-pulmonary-embolism
#14
Jieun Kang, Heung-Kyu Ko, Ji Hoon Shin, Gi-Young Ko, Kyung-Wook Jo, Jin Won Huh, Yeon-Mok Oh, Sang-Do Lee, Jae Seung Lee
Retrievable inferior vena cava (IVC) filters are increasingly used in patients with venous thromboembolism (VTE) who have contraindications to anticoagulant therapy. However, previous studies have shown that many retrievable filters are left permanently in patients. This study aimed to identify the common indications for IVC filter insertion, the filter retrieval rate, and the predictive factors for filter retrieval attempts. To this end, a retrospective cohort study was performed at a tertiary care center in South Korea between January 2010 and May 2016...
December 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28818219/contemporary-outcomes-after-venography-guided-treatment-of-patients-with-may-thurner-syndrome
#15
Johnathon C Rollo, Steven M Farley, Adam Z Oskowitz, Karen Woo, Brian G DeRubertis
OBJECTIVE: Patients with May-Thurner syndrome (MTS) present with a spectrum of findings ranging from mild left leg edema to extensive iliofemoral deep venous thrombosis (DVT). Whereas asymptomatic left common iliac vein (LCIV) compression can be seen in a high proportion of normal individuals on axial imaging, the percentage of these persons with symptomatic compression is small, and debate exists about the optimal clinical and diagnostic criteria to treat these lesions in patients with symptomatic venous disease...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818211/evaluation-of-thrombolysis-using-tissue-plasminogen-activator-in-lower-extremity-deep-venous-thrombosis-with%C3%A2-concomitant-femoral-popliteal-venous-segment%C3%A2-involvement
#16
Mayin Lin, John C F Hsieh, Mian Hanif, Alan McDaniel, David K Chew
OBJECTIVE: Current guidelines recommend thrombolytic therapy for iliofemoral deep venous thrombosis (DVT). Anticoagulation is the standard treatment for femoral-popliteal and tibial-level DVT. The objective of this study was to evaluate the efficacy of catheter-directed thrombolysis (CDT) using tissue plasminogen activator vs standard anticoagulation alone in patients with lower extremity DVT involving the femoral-popliteal segment. METHODS: A retrospective review was performed of patients referred to the vascular surgery service with lower extremity DVT from 2006 to 2015...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28736157/prevention-and-treatment-of-the-post-thrombotic-syndrome
#17
REVIEW
Oleg Pikovsky, Anat Rabinovich
Post-thrombotic syndrome (PTS) is a complication that develops in up to 50% of patients with deep vein thrombosis (DVT) and manifests as symptoms and signs of chronic venous insufficiency of varying severity. PTS negatively affects patient's quality of life and causes significant burden to the healthcare system. The risk for PTS development can be markedly reduced by preventing DVT and providing appropriate anticoagulation once it develops. Patients with extensive proximal (iliofemoral) DVT may benefit from invasive interventions, such as catheter-directed thrombolysis...
July 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28719398/interventional-approaches-to-deep-venous-thrombosis
#18
Kristen A Lee, Raja S Ramaswamy
PURPOSE OF REVIEW: Catheter-directed therapy in deep vein thrombosis (DVT) is a beneficial adjunct treatment when anticoagulation alone does not provide an adequate therapeutic response. This review aims to deliver an up-to-date discussion behind the rationale, safety profile, and clinical outcomes in endovascular management of DVT. RECENT FINDINGS: Early studies have shown that the use of catheter-directed thrombolysis (CDT) to be successful in rapid thrombus removal, carry a lower incidence of postthrombotic syndrome (PTS), and improved quality of life...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28618846/comparison-of-direct-iliofemoral-stenting-following-angiojet-rheolytic-thrombectomy-vs-staged-stenting-after-angiojet-rheolytic-thrombectomy-plus-catheter-directed-thrombolysis-in-patients-with-acute-deep-vein-thrombosis
#19
Guang Liu, Jinbao Qin, Chaoyi Cui, Kaichuang Ye, Huihua Shi, Xiaobing Liu, Minyi Yin, Xintian Huang, Min Lu, Mier Jiang, Weimin Li, Xinwu Lu
PURPOSE: To compare the treatment outcomes in patients with acute proximal deep vein thrombosis (DVT) and iliofemoral stenosis who underwent either direct stenting after AngioJet rheolytic thrombectomy or staged stenting after AngioJet thrombectomy plus catheter-directed thrombolysis with urokinase. METHODS: From June 2014 to February 2016, 91 DVT patients underwent 2 treatments for duplex-verified iliofemoral stenosis: direct stenting (n = 46; mean age 54.8 years; 32 men) or staged stenting (n = 45; mean age 56...
February 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28321560/may-thurner-syndrome-old-acquaintance-new-perspective-case-report
#20
Anja Boc, Vinko Boc, Matija Kozak
May-Thurner syndrome (MTS) results from a frequent anatomic variant in which compression of the left common iliac vein between the body of the fifth lumbar vertebra and the pulsating right common iliac artery can cause deep venous thrombosis (DVT) of the left lower limb. While anticoagulation remains the mainstay treatment of acute DVT, catheter-directed thrombolysis combined with stenting provides a safe and effective method for relieving acute symptoms and preventing postthrombotic syndrome in patients with MTS...
May 2017: Wiener Klinische Wochenschrift
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