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https://www.readbyqxmd.com/read/28639418/clinical-course-of-isolated-distal-deep-vein-thrombosis-in-patients-with-active-cancer-a-multicenter-cohort-study
#1
Francesco Dentali, Samuela Pegoraro, Stefano Barco, Matteo Nicola Dario di Minno, Daniela Mastroiacovo, Fulvio Pomero, Corrado Lodigiani, Federica Bagna, Michelangelo Sartori, Giovanni Barillari, Nicola Mumoli, Mariasanta Napolitano, Serena Maria Passamonti, Raffaella Benedetti, Walter Ageno, Marcello Di Nisio
BACKGROUND: Although isolated distal deep vein thrombosis (IDDVT) is frequently associated with cancer, no study has specifically evaluated the long-term clinical course of IDDVT in active cancer patients. AIM: To provide data on the rate of recurrent venous thromboembolism (VTE), major bleeding events, and death in IDDVT patients with active cancer. PATIENTS AND METHODS: Consecutive patients with active cancer and an objective IDDVT diagnosis (January 2011-September 2014) were included from our files...
June 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28594426/new-developments-in-anticoagulants-past-present-and-future
#2
Jeffrey I Weitz, Job Harenberg
Thrombosis is a leading cause of death and disability worldwide, and anticoagulants are the mainstay of its prevention and treatment. Starting with unfractionated heparin (UFH) and vitamin K antagonists (VKAs) such as warfarin, the choices of anticoagulants have exploded in the past 20 years. With over 90 % subcutaneous bioavailability, no need for coagulation monitoring and dose adjustment, and a lower risk of heparin-induced thrombocytopenia, low-molecular-weight heparin and fondaparinux have replaced UFH for prevention and initial treatment of venous thromboembolism and for secondary prevention in cancer patients...
June 8, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28589462/discharge-or-admit-emergency-department-management-of-incidental-pulmonary-embolism-in-patients-with-cancer-a-retrospective-study
#3
Srinivas R Banala, Sai-Ching Jim Yeung, Terry W Rice, Cielito C Reyes-Gibby, Carol C Wu, Knox H Todd, W Frank Peacock, Kumar Alagappan
BACKGROUND: Hospitalization and early anticoagulation therapy remain standard care for patients who present to the emergency department (ED) with pulmonary embolism (PE). For PEs discovered incidentally, however, optimal therapeutic strategies are less clear-and all the more so when the patient has cancer, which is associated with a hypercoagulable state that exacerbates the threat of PE. METHODS: We conducted a retrospective review of a historical cohort of patients with cancer and incidental PE who were referred for assessment to the ED in an institution whose standard of care is outpatient treatment of selected patients and use of low-molecular-weight heparin for anticoagulation...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28586719/a-heparin-conjugate-lhbisd4-inhibits-lymphangiogenesis-and-attenuates-lymph-node-metastasis-by-blocking-vegf-c-signaling-pathway
#4
Jeong Uk Choi, Seung Woo Chung, Taslim A Al-Hilal, Farzana Alam, Jooho Park, Foyez Mahmud, Jee-Heon Jeong, Sang Yoon Kim, Youngro Byun
Clinical studies have found that the incidence of cancer metastasis through the lymphatic vessels are 3-5 times higher than that through the blood vessels. These findings suggest the potency of anti-lymphangiogenic therapy in reducing the incidence of cancer metastasis. Previously, we reported LHbisD4, which is the conjugate of low molecular weight heparin (LMWH) and four bis-deoxycholates as a potent anti-angiogenic drug with less toxicity and orally active property. Here, we show that LHbisD4 could also suppress the formation of new lymphatic vessels and attenuate the incidence of metastasis by blocking VEGF-C signaling pathway...
September 2017: Biomaterials
https://www.readbyqxmd.com/read/28578306/multiple-recurrent-ischaemic-strokes-in-a-patient-with-cancer-is-there-a-role-for-the-initiation-of-anticoagulation-therapy-for-secondary-stroke-prevention
#5
Giselle Alexandra Suero-Abreu, Jia Zhen Cheng, Ryna Karina Then
A 52-year-old woman with a medical history of cervical and thyroid cancer, hypertension, dyslipidaemia, uncontrolled diabetes and heavy smoking was diagnosed with a new metastatic cholangiocarcinoma. While undergoing palliative chemotherapy, she developed dysarthria and left-sided weakness. Imaging studies showed multiple bilateral ischaemic strokes. On hospital days 2 and 5, she developed worsening neurological symptoms and imaging studies revealed new areas of ischaemia on respective days. Subsequent workup did not revealed a clear aetiology for the multiple ischaemic events and hypercoagulability studies were only significant for a mildly elevated serum D-dimer level...
June 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28560389/elemene-inhibits-the-migration-and-invasion-of-4t1-murine-breast-cancer-cells-via-heparanase
#6
Yi Zhang, Xu Sun, Nan Nan, Ke-Xin Cao, Cong Ma, Guo-Wang Yang, Ming-Wei Yu, Lin Yang, Jin-Ping Li, Xiao-Min Wang, Gan-Lin Zhang
Elemene (ELE), a natural plant drug extracted from Curcumae Rhizoma, has been widely used for cancer treatment in China for more than 20 years. Although it is reported to be a broad‑spectrum anticancer drug, the mechanism underlying the action of ELE in the treatment of breast cancer remains to be fully elucidated. Heparanase, a mammalian endo‑D‑glucuronidase, is involved in degradation of the extracellular matrix (ECM), and thus promotes tumor progression and metastasis. The downregulation of heparanase can effectively reduce tumor malignant behaviors...
July 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28550032/a-predictive-score-for-thrombosis-associated-with-breast-colorectal-lung-or-ovarian-cancer-the-prospective-compass-cancer-associated-thrombosis-study
#7
Grigoris T Gerotziafas, Ali Taher, Hikmat Abdel-Razeq, Essam AboElnazar, Alex C Spyropoulos, Salem El Shemmari, Annette K Larsen, Ismail Elalamy
BACKGROUND: The stratification of outpatients on chemotherapy for breast, colorectal, lung, and ovarian cancers at risk of venous thromboembolism (VTE) remains an unmet clinical need. The derivation of a risk assessment model (RAM) for VTE in these patients was the aim of the study "Prospective Comparison of Methods for thromboembolic risk assessment with clinical Perceptions and AwareneSS in real life patients-Cancer Associated Thrombosis" (COMPASS-CAT). PATIENTS AND METHODS: The derivation cohort consisted of 1,023 outpatients...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#8
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28508916/direct-oral-anticoagulants-for-the-treatment-of-cancer-associated-venous-thromboembolism-what-do-we-know-so-far
#9
Minna Voigtlaender, Florian Langer
Cancer patients with venous thromboembolism (VTE) are at increased risk for both bleeding and VTE recurrence. Anticoagulation with low-molecular-weight heparin (LMWH) is the standard of care during the initial and long-term treatment phase (i.e. during the first 3 - 6 months of therapy) based on its overall beneficial safety and efficacy profile compared to vitamin K antagonists (VKAs). The direct oral anticoagulants (DOACs) rivaroxaban, apixaban, edoxaban, and dabigatran are approved for the treatment of acute VTE, and the combined six phase-3 trials have included > 1500 patients with active cancer, as defined by variable selection criteria...
May 16, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28474976/iliac-artery-reconstruction-with-the-superficial-femoral-vein-after-major-oncologic-resection
#10
Leopoldo Fernández-Alonso, Sebastian Fernández-Alonso, Esther Martínez Aguilar
The large size of some retroperitoneal tumors and the complex anatomy of the retroperitoneal structures often require en bloc resection of contiguous organs and, sometimes, resection of critical vascular structures. Vascular reconstructive techniques allow reconstruction of major vascular structures, and autologous vein grafting is the preferred option. Although great saphenous vein can be used in select cases, other options must be explored in cases of caliber mismatch between saphenous vein and native vessel...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28467373/the-impact-of-the-low-molecular-weight-heparin-tinzaparin-on-the-sensitization-of-cisplatin-resistant-ovarian-cancers-preclinical-in-vivo-evaluation-in-xenograft-tumor-models
#11
Thomas Mueller, Daniel Bastian Pfankuchen, Kathleen Wantoch von Rekowski, Martin Schlesinger, Franziska Reipsch, Gerd Bendas
Resistance formation of tumors against chemotherapeutics is the major obstacle in clinical cancer therapy. Although low molecular weight heparin (LMWH) is an important component in oncology referring to guideline-based antithrombotic prophylaxis of tumor patients, a potential interference of LMWH with chemoresistance is unknown. We have recently shown that LMWH reverses the cisplatin resistance of A2780cis human ovarian cancer cells in vitro. Here we address the question whether this LMWH effect is also valid under in vivo conditions...
May 3, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28416213/a-prospective-study-of-rivaroxaban-for-central-venous-catheter-associated-upper-extremity-deep-vein-thrombosis-in-cancer-patients-catheter-2
#12
G A Davies, A Lazo-Langner, E Gandara, M Rodger, V Tagalakis, M Louzada, R Corpuz, M J Kovacs
INTRODUCTION: Patients with cancer are at increased risk of thrombosis, particularly those with central venous catheter (CVC) placement, which may predispose to the development of upper extremity deep vein thrombosis (UEDVT). Standard treatment includes low molecular weight heparin (LMWH) or LMWH bridged to warfarin. The direct oral anticoagulants (DOACs) have become standard of care for uncomplicated venous thromboembolism (VTE), but research in patients with cancer is ongoing. OBJECTIVES: To assess rivaroxaban monotherapy in patients with cancer who develop UEDVT due to CVC for preservation of line function, and safety outcomes of VTE recurrence, bleeding risk and death...
April 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28402864/meta-analysis-on-anticoagulation-and-prevention-of-thrombosis-and-mortality-among-patients-with-lung-cancer
#13
H E Fuentes, D M Oramas, L H Paz, A I Casanegra, A S Mansfield, A J Tafur
BACKGROUND: Venous thromboembolism (Wickham et al., 2012 [1]) is a leading cause of morbidity and mortality among patients with cancer; however, primary thromboprophylaxis is not routinely recommended. We performed a systematic review and meta-analysis of randomized control trials (RCTs) to measure the impact of primary VTE prevention and its effect on mortality among patients with lung cancer. METHODS: With assistance from a master librarian, we searched Ovid, Scopus, DARE, CINAHL, MEDLINE, EMBASE, EBM reviews-Cochrane database of systematic reviews, EBM reviews-ACP journal, and EBM Reviews-Databases for relevant studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#14
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28265129/deep-vein-thrombosis-interventions-in-cancer-patients
#15
REVIEW
Resmi Ann Charalel, Suresh Vedantham
The presence of cancer increases the risk of deep vein thrombosis (DVT), DVT recurrence, and treatment-related bleeding, and therefore offers distinctive clinical considerations when planning treatment. Anticoagulation with a low-molecular-weight heparin is the preferred initial and long-term therapy in cancer patients. Inferior vena cava filters may be used judiciously for patients with cancer-related DVT who have contraindications to anticoagulation or who exhibit breakthrough pulmonary embolism (PE) despite anticoagulation, but should be removed when the PE risk is felt to subside...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28262228/gender-differences-in-patients-with-venous-thromboembolism-and-five-common-sites-of-cancer
#16
Francisco Martín-Martos, Javier Trujillo-Santos, Jorge Del Toro, Alessandra Bura-Riviere, Alicia Lorenzo, Giovanni Barillari, Silvia Soler, Isabelle Mahè, Joan Carles Sahuquillo, Manuel Monreal
BACKGROUND: The outcome of cancer patients with venous thromboembolism (VTE) may differ according to gender. METHODS: We used the RIETE database to compare the rate of VTE recurrences, major bleeding and mortality in patients with lung, colorectal, pancreatic, hematologic or gastric cancer during the course of anticoagulation, according to gender. RESULTS: As of January 2016, 11,055 patients with active cancer were enrolled: 1,727 had lung cancer, 1,592 colorectal, 840 hematologic, 517 pancreatic and 459 had gastric cancer...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28257912/warfarin-associated-venous-limb-gangrene-in-cancer-related-dvt-case-report
#17
Vladimir Cojocari, Dumitru Casian, Eugen Gutu
INTRODUCTION: Warfarin anticoagulation of oncologic patients with DVT may paradoxically progress to phlegmasia cerulea dolens and limb gangrene, due to cancer-associated disseminated intravascular coagulation. This case report, written in line with the SCARE criteria, endorses venous thrombectomy in selected patients to attempt limb salvage. A young woman's warfarin associated acute ileofemoral phlegmasia that developed over cervical cancer radiation therapy induced DVT, was successfully resolved by clot removal...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28243988/fotrocan-delphi-consensus-statement-regarding-the-prevention-and-treatment-of-cancer-associated-thrombosis-in-areas-of-uncertainty-and-low-quality-of-evidence
#18
P Jimenez-Fonseca, A Carmona-Bayonas, C Calderon, J Fontcuberta Boj, C Font, R Lecumberri, M Monreal, A J Muñoz Martín, R Otero, A Rubio, P Ruiz-Artacho, C Suarez Fernández, E Colome, P Pérez Segura
INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method...
February 27, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28242375/gambogic-acid-grafted-low-molecular-weight-heparin-micelles-for-targeted-treatment-in-a-hepatocellular-carcinoma-model-with-an-enhanced-anti-angiogenesis-effect
#19
Xuefei Yan, Ye Yang, Liqin He, Daiyin Peng, Dengke Yin
Gambogic acid (GA) is a potential anti-cancer agent with poor water-solubility, whereas heparin has anti-angiogenesis effects with good hydrophilicity. In this study, GA grafted low molecular weight heparin (GA-LMWH) was prepared and self-assembled into micelles in aqueous solution to improve the solubility and antitumor effects against hepatocellular carcinoma. The substitution of GA-LMWH is 27.5±0.2%. The micelles had a mean size of 190.4±10.8nm, a low critical micelle concentration of 2.4±0.2μgmL(-1), and the highest area under the concentration-time curve and mean retention time in the liver compared to the heart, spleen, lung and kidney (p<0...
February 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#20
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer-associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared with non-cancer patients. The specific profiles of cancer patients, combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself, represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of making a choice between the available drugs for a long-term antithrombotic strategy, linked to their pharmacology, mechanism of action, evidence of clinical benefits, and advantages and limitations in such a complex clinical context...
May 2017: Journal of Thrombosis and Haemostasis: JTH
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