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DVT in cancer patients

Simon Mantha, Eva Laube, Yimei Miao, Debra M Sarasohn, Rekha Parameswaran, Samantha Stefanik, Gagandeep Brar, Patrick Samedy, Jonathan Wills, Stephen Harnicar, Gerald A Soff
Low-molecular weight heparin (LMWH) has been the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. Rivaroxaban was approved in 2012 for the treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), but no prior studies have been reported specifically evaluating the efficacy and safety of rivaroxaban for cancer-associated thrombosis (CAT). Under a Quality Assessment Initiative (QAI), we established a Clinical Pathway to guide rivaroxaban use for CAT and now report a validation analysis of our first 200 patients...
September 30, 2016: Journal of Thrombosis and Thrombolysis
Mohammadreza Mortazavizadeh, Yasaman Ayoughi, Nasrollah Bashardoost, Pedram Fadavi
Venous thromboembolism (VTE), which mostly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is associated with considerable morbidity and mortality in patients with cancer. As little is known about VTE associated with gastrointestinal cancers among the populations in the Middle East. This study aimed to determine the relative frequency of symptomatic VTE in patients with gastrointestinal malignancies in Iran. The charts of patients with gastrointestinal cancers in our institute from April 2010 to March 2015 were investigated for symptomatic VTE in a retrospective study...
September 21, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Kari Kurtzhalts, Megan E Gee, Lindsey Feuz, Kristin C Krajewski
PURPOSE: A case of supratherapeutic International Normalized Ratio (INR) values and hematomas subsequent to concomitant administration of warfarin and intravesical gemcitabine is reported. SUMMARY: A 90-year-old man with bladder cancer refractory to bacillius Calmette-Guérin was diagnosed with deep vein thrombosis (DVT) and started on warfarin one month before starting treatment with intravesical gemcitabine 2 g (one dose per week for six weeks). Before intravesical gemcitabine was started, the patient reached consecutive therapeutic INR values...
October 1, 2016: American Journal of Health-system Pharmacy: AJHP
Mohammed Jeraq, David J Cote, Timothy R Smith
Venous thromboembolism (VTE) is a common medical condition, particularly after surgical interventions. Many studies have shown that development of VTE, including both deep vein thrombosis (DVT) and pulmonary embolism (PE), is more common in surgical patients with cancer than in patients without cancer. This chapter focuses on VTE in brain tumor patients, including their pathogenesis, presentation, diagnosis, and treatment. Topics discussed included a brief overview of VTE followed by an in-depth discussion of the VTE risks brain tumor patients face in the post-operative period...
September 15, 2016: Advances in Experimental Medicine and Biology
Miriam Bach, Rupert Bauersachs
Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE...
September 28, 2016: Thrombosis and Haemostasis
Sumi Sinha, Sidharth V Puram, Rosh K V Sethi, Neerav Goyal, Kevin S Emerick, Derrick Lin, Marlene L Durand, Daniel G Deschler
Patients with head and neck cancer who undergo reconstructive surgery are at risk for deep venous thrombosis (DVT), but the risk profile for patients undergoing major flap reconstruction is highly variable. Herein, we report our findings from a retrospective analysis of head and neck cancer patients (n = 517) who underwent free (n = 384) or pedicled (n = 133) flap reconstructive operations at a major tertiary care center from 2011 to 2014. DVTs developed perioperatively in 9 (1.7%) patients. Compared with pedicled flap patients, free flap patients had a longer mean operative time (421...
September 6, 2016: Otolaryngology—Head and Neck Surgery
Lauren N Bell, Richard L Berg, John R Schmelzer, Hong Liang, Joseph J Mazza, Rajan Kanth, Christopher L Bray, Calixto B Zaldivar, Steven H Yale
Superficial vein thrombosis (SVT) may be associated with complications such as venous thromboembolism (VTE) and recurrent SVT. The purpose of this study was to explore risk factors among patients with a first isolated episode of SVT (index SVT) involving upper and lower extremities and to estimate the prevalence of VTE complications within 1 year of index SVT. Retrospective chart review of electronic records at Marshfield Clinic in Wisconsin identified 381 subjects with a first isolated SVT diagnosis (male/female: 170/211; median age 59...
August 26, 2016: Journal of Thrombosis and Thrombolysis
Joshua D Brown, Jeffery C Talbert
INTRODUCTION: There is a wide variation in the use of vena cava filter (VCF). OBJECTIVE: This study assessed the hospital and patient characteristics associated with VCF use in deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS: Inpatient discharge data from all acute care hospitals with DVT/PE during 2008-2014 in Kentucky were used. Hierarchical logistic regression models were used to evaluate the relationships of study variables with VCF use...
August 19, 2016: Medical Care
Daniel D Joyce, Sarah P Psutka, Ryan T Groeschl, R Houston Thompson, Stephen A Boorjian, John C Cheville, Suzanne B Stewart-Merrill, Christine M Lohse, Brian A Costello, Florencia G Que, Bradley C Leibovich
OBJECTIVES: To assess the safety and utility of more aggressive surgical resection of renal cell carcinoma (RCC) involving the liver at the time of nephrectomy. METHODS: We identified 34 cases at our institution where patients underwent simultaneous nephrectomy and hepatic resection for direct hepatic invasion (n=17) or metastatic RCC (n=21). Perioperative outcomes and complication rates were compared to a matched referent cohort (n=68) undergoing simultaneous nephrectomy and resection of non-hepatic locally invasive/metastatic disease...
August 17, 2016: Urology
Daniel T Y Ang, Johanne M Simpson, Isaiah C Stewart, John T Murchison, Khalida A Lockman
BACKGROUND: Deep venous thrombosis (DVT) is increasingly being managed in the outpatient setting, particularly patients deemed low-risk at presentation. The long-term outcomes of these patients remain unclear. AIM: To determine the long-term outcomes of patients with DVT and those with raised D-dimer without DVT managed exclusively by an ambulatory care pathway. DESIGN: Retrospective cohort analysis. METHODS: 828 consecutive patients assessed at the Ambulatory Care Clinic of a tertiary care university hospital between 1 January and 31 December 2008 for potential lower limb DVT were analysed...
August 9, 2016: QJM: Monthly Journal of the Association of Physicians
Haider Mahdi, Qataralnada Aljebori, David Lockart, Laura Moulton
STUDY OBJECTIVE: To determine the incidence of venous thromboembolism (VTE) after laparoscopic surgery for gynecologic cancer DESIGN: Retrospective analysis of the ACS-NSQIP database DESIGN CLASSIFICATION: Retrospective analysis of a national surgical database SETTING: Academic and community health care institutions across the United States PATIENTS: Women who underwent at least one major laparoscopic surgery for uterine, ovarian and cervical cancers INTERVENTION: Data was collected on surgical procedure, patient demographic variables type of malignancy and VTE and mortality outcomes within 30 days of surgery MEASUREMENTS: VTE was defined as deep venous thrombosis requiring therapy (DVT) and pulmonary embolism (PE) confirmed by imaging or autopsy within 30 days of surgery...
June 21, 2016: Journal of Minimally Invasive Gynecology
Hiroyuki Naito, Shiro Aoki, Naoko Sumi, Kazuhide Ochi, Naohisa Hosomi, Hirofumi Maruyama, Masayasu Matsumoto
CASE REPORT: A 66-year-old man with acute ischemic stroke in the setting of lung adenocarcinoma developed acute-onset deep vein thrombosis (DVT) of the lower limbs after changing to warfarin from a heparin combination. The diagnosis of warfarin-resistant DVT was established based on the laboratory data and clinical evaluation. Heparin administration resulted in good control of thrombin regulation. Cancer patients are at high risk of venous thromboembolism, and the combination of these 2 conditions is known as Trousseau's syndrome...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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
Maria Spavor, Jacqueline Halton, Kevin Dietrich, Sara Israels, Evan Shereck, Jian Yong, Yutaka Yasui, Lesley Gayle Mitchell
INTRODUCTION: Pediatric oncology patients are at increased risk for deep venous thrombosis (DVT). Determining the sub-population of children at increased DVT risk is critical for optimum clinical management. Therefore, the aim of the current study was to identify clinical risk factors for DVT which are easily identifiable at cancer diagnosis. MATERIALS AND METHODS: A Canadian multicenter case control study in survivors of childhood cancer. Survivors who had DVT (Cases) while being treated for pediatric cancer where matched by center with a minimum of two survivors who did not experience DVT (Controls)...
August 2016: Thrombosis Research
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
Lawrence M Dagrosa, Johann P Ingimarsson, Ivan P Gorlov, John H Higgins, Elias S Hyams
While robotic-assisted laparoscopic radical prostatectomy (RALRP) is an effective treatment for localized prostate cancer, the risk of complications in older patients can be a deterrent to surgery. We evaluated the rate of medical complications following RALRP in a national dataset of safety events, and assessed whether age is an independent risk factor for these complications. Retrospective analysis of patients undergoing RALRP between 2009 and 2012 in the prospectively maintained American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database was performed...
June 4, 2016: Journal of Robotic Surgery
Styliani Mantziari, Caroline Gronnier, Arnaud Pasquer, Johan Gagnière, Jérémie Théreaux, Nicolas Demartines, Markus Schäfer, Christophe Mariette
BACKGROUND: Major oncologic surgery is associated with a high incidence of venous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE). However, the incidence and risk factors for symptomatic VTE during curative treatment for patients with esophageal cancer are poorly documented. METHODS: Data were collected from 30 European centers from 2000 to 2010. The incidence of in-hospital VTE was assessed in 2,944 patients with esophageal cancer having surgery with curative intent, and 50 clinically relevant parameters were assessed as potential risk factors for VTE...
September 2016: Annals of Thoracic Surgery
T I Hussain, J A Stephenson, B Das, S Naqvi, R Verma, D Barnes
AIM: To investigate and review the diagnostic yield for occult malignancy in patients who underwent abdominopelvic computed tomography (CT) after the diagnosis of unprovoked venous thromboembolism (VTE) with reference to the guidelines set by The National Institute for Health and Clinical Excellence (NICE). MATERIALS AND METHODS: We retrospectively reviewed all unprovoked VTE diagnosed within a large teaching hospital over a period of 21 months for subsequent imaging investigations and cancer diagnoses...
October 2016: Clinical Radiology
A Mancuso, M C Vedovati, L Pierpaoli, U Paliani, S Conti, E Filippucci, A Ascani, S Radicchia, G Galeotti, G Agnelli, C Becattini
INTRODUCTION: Cancer associated thrombosis (CAT) has an increased risk of recurrent venous thromboembolism (VTE). Type, stage of cancer and chemotherapy (CHT) influence thromboembolic risk. The use of novel oral anticoagulants (NOACs) is controversial in patients with CAT. AIM: The aim of this study is to assess mortality, recurrent VTE and bleeding complications in patients with CAT and in patients without cancer receiving NOACs. MATERIALS AND METHODS: Consecutive patients with acute objectively confirmed VTE receiving NOACs within 1 month from diagnosis are included from September 2013 in an ongoing prospective cohort study...
April 2016: Thrombosis Research
N A Davies, S Noble, N K Harrison, R H K Morris, P A Evans
INTRODUCTION: Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE) are common complications in patients with cancer, affecting up to 18% of patients. VTE risk is increased by surgery and disease progression, whilst chemotherapy further increases risk up to 7-fold compared to patients without cancer. VTE contributes significantly to morbidity and mortality in patients with cancer, and is the second most common cause of death. Lung cancer is well established to be high risk for VTE, with up to a 22-fold increase in VTE risk associated with this malignancy, and 12% incidence in a recent study of patients with lung cancer undergoing chemotherapy...
April 2016: Thrombosis Research
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