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https://www.readbyqxmd.com/read/29222260/should-we-diagnose-and-treat-distal-deep-vein-thrombosis
#1
REVIEW
Helia Robert-Ebadi, Marc Righini
Ultrasound series report that isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower-limb DVTs and, therefore, is a frequent medical condition. Unlike proximal DVT and pulmonary embolism, which have been studied extensively and for which management is well standardized, much less is known about the optimal management of isolated calf DVT. Recent data arising from registries and nonrandomized studies have suggested that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222259/controversies-in-venous-thromboembolism-to-treat-or-not-to-treat-superficial-vein-thrombosis
#2
REVIEW
Jan Beyer-Westendorf
The management of superficial vein thrombosis (SVT) is poorly defined and remains controversial overall. SVT has long been considered a benign, self-limited disease, but recent studies show that SVT carries a nonnegligible risk for recurrence, deep vein thrombosis, or pulmonary embolism. Current guidelines recommend the use of low-molecular-weight heparin or fondaparinux, but results of several surveys indicate that the majority of patients with SVT receive nonanticoagulant therapy only, which includes compression stockings or bandages, nonsteroidal anti-inflammatory drugs, topical application of heparin gel, or surgical interventions...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222246/incidental-venous-thromboembolism-is-anticoagulation-indicated
#3
REVIEW
Marcello Di Nisio, Marc Carrier
Patients with cancer have a high risk of venous thromboembolism (VTE) and about one-half of these events are incidentally detected. The prognosis of incidental VTE appears to be similar to symptomatic events, with comparably high rates of recurrent VTE in this patient population. In the absence of major contraindications, anticoagulant treatment with low-molecular-weight heparin for 3 to 6 months is generally recommended for incidental proximal deep vein thrombosis as well as for incidental pulmonary embolism that involves multiple subsegmental or more proximal pulmonary arteries...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221853/venous-thromboembolism-events-after-breast-reconstructions-with-diep-free-flaps-in-192-consecutive-case
#4
A Modarressi, A-V Schettini, E M Rüegg, B Pittet-Cuénod
BACKGROUND: Patient candidates for breast reconstruction with free deep inferior epigastric perforator flap (DIEP) may present several risk factors for venous thromboembolism (VTE). Risk identification is essential for appropriate VTE prophylaxis measures to be put in place. This study aims to investigate VTE incidence after DIEP flap breast reconstruction and to assess the accuracy of the Caprini Risk Assessment Model (RAM), which is the unique score validated to assess the VTE risk for plastic surgery procedures and identify patients at high VTE risk...
December 5, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#5
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29217234/outcomes-following-three-factor-inactive-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-administration-during-cardiac-surgery
#6
Patrick C Harper, Mark M Smith, Nathan J Brinkman, Melissa A Passe, Darrell R Schroeder, Sameh M Said, Gregory A Nuttall, William C Oliver, David W Barbara
OBJECTIVE: To compare outcomes following inactive prothrombin complex concentrate (PCC) or recombinant activated factor VII (rFVIIa) administration during cardiac surgery. DESIGN: Retrospective propensity-matched analysis. SETTING: Academic tertiary-care center. PARTICIPANTS: Patients undergoing cardiac surgery requiring cardiopulmonary bypass who received either rFVIIa or the inactive 3-factor PCC. INTERVENTIONS: Outcomes following intraoperative administration of rFVIIa (263) or factor IX complex (72) as rescue therapy to treat bleeding...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29215498/postoperative-deep-vein-thrombosis-pulmonary-embolism-and-myocardial-infarction-complications-after-therapeutic-anticoagulation-in-the-patient-with-spine-trauma
#7
Brian Shiu, Elizabeth Le, Ehsan Jazini, Tristan B Weir, Timothy Costales, Nicholas Caffes, Ebrahim Paryavi, Nathan O'Hara, Daniel E Gelb, Eugene Y Koh, Steven C Ludwig
STUDY DESIGN: A retrospective review (2001-2014) was conducted using prospectively collected data at a level I trauma center. OBJECTIVE: We sought to determine the incidence and characteristics of complications occurring secondary to therapeutic anticoagulation in adult spine trauma patients. SUMMARY OF BACKGROUND DATA: Numerous studies have assessed prophylactic anticoagulation after spine surgery, but none has investigated the risks of therapeutic doses of anticoagulation for treatment of postoperative thromboembolic events...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29211373/-deep-vein-thrombosis-in-uncommon-localisations
#8
Andreas Erdmann, Barbara Ney, Salah Dine Qanadli, Luca Calanca, Lucia Mazzolai
Venous thromboembolism (VTE) with its two components, deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common disease with an incidence of 0,75‑2,69/1000. Deep vein thrombosis is localized in unusual sites in about 10 %, and rare DVT's have specific symptoms and risk factors. Uncommon DVT's are often related to local factors, inflammation, cancer, hematologic diseases and thrombophilia. Their diagnostic workup is less straightforward than in suspected VTE of lower limbs and PE, and rare DVT's are often unexpected findings of imaging studies...
December 6, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29206790/aspirin-for-prophylaxis-against-venous-thromboembolism-after-orthopaedic-oncologic-surgery
#9
Gregory M Mendez, Yash M Patel, Daniel A Ricketti, John P Gaughan, Richard D Lackman, Tae Won B Kim
BACKGROUND: Patients who undergo orthopaedic oncologic surgical procedures are at increased risk of developing a venous thromboembolism (VTE). Guidelines from surgical societies are shifting to include aspirin as a postoperative VTE prophylactic agent. The purpose of this study was to review our experience using aspirin as postoperative VTE prophylaxis for orthopaedic oncologic surgical procedures. METHODS: This study was a retrospective review of patients diagnosed with a primary malignant soft-tissue or bone tumor or metastatic carcinoma...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29204306/facial-palsy-after-embolization-of-dural-arteriovenous-fistula-a-case-report-and-literature-review
#10
Luana Antunes Maranha Gatto, Fernando Saurin, Gelson Luis Koppe, Zeferino Demartini
Background: Dural arteriovenous fistulas (DAVF) are unusual intracranial vascular malformations consisting of anomalous connections between meningeal arteries and dural sinuses or the veins that pass through them. They have variable clinical presentation and prognosis, which depend on their location and venous hemodynamics. Treatment is based on the closure of the abnormal connections, which is usually conducted via arterial and/or transvenous endovascular techniques. Case Description: We present a male patient who complained of headaches and left-sided pulsatile tinnitus due to DAVF from the external carotid artery branches draining directly into the ipsilateral sigmoid sinus...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29203438/risk-of-venous-thromboembolism-in-patients-with-mycosis-fungoides-and-parapsoriasis-a-danish-nationwide-population-based-cohort-study
#11
Lise M Lindahl, Morten Schmidt, Dora K Farkas, Henrik T Sørensen, Lars Iversen
BACKGROUND: Mycosis fungoides (MF) and parapsoriasis are characterized by malignant proliferation and chronic inflammation, which may impact the risk of venous thromboembolism (VTE). OBJECTIVES: To examine the risk of VTE in patients with MF and parapsoriasis. METHODS: We conducted a nationwide population-based cohort study in Denmark to examine the relative risk (RR) of VTE in 525 patients with MF and 634 patients with parapsoriasis compared with sex- and age-matched controls from the general population...
December 1, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29202213/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial
#12
Alok A Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay K Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
November 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29197610/thromboembolic-risk-of-endovascular-intervention-for-lower-extremity-deep-venous-thrombosis
#13
Philip Lindsey, Angela Echeverria, Mun J Poi, Jesus Matos, Carlos F Bechara, Mathew Cheung, Peter H Lin
INTRODUCTION: This study evaluated the risk of thromboembolism during endovascular interventions in patients with symptomatic lower extremity deep vein thrombosis (DVT) METHODS: Clinical records of all patients who underwent endovascular interventions for symptomatic lower extremity DVT from 2001 to 2017 were retrospectively analyzed using a prospectively maintained database. Only patients who received an IVC filter were included in the analysis. Trapped intra-filter thrombus was assessed for procedural-related thromboembolism...
November 29, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29196988/analysis-of-spontaneous-postmarket-case-reports-submitted-to-the-fda-regarding-thromboembolic-adverse-events-and-jak-inhibitors
#14
Abril Verden, Mo Dimbil, Robert Kyle, Brian Overstreet, Keith B Hoffman
INTRODUCTION: The Janus kinase (JAK) inhibitor baricitinib is approved in Europe and Japan for the treatment of rheumatoid arthritis. In April 2017, the US FDA expressed concern about thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolism [PE]) observed in placebo-controlled clinical trials of baricitinib. The European and Japanese labels for baricitinib were recently updated to include a precaution related to potential thromboembolic events in patients at risk. Given that the FDA-approved drugs tofacitinib and ruxolitinib are in the same class, we conducted a safety review of the FDA's Adverse Event Reporting System (FAERS) to assess postmarketing reporting rates for related thromboembolic risks...
December 2, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29196310/endovascular-management-of-a-case-of-spontaneous-retroperitoneal-haematoma-complicated-with-deep-vein-thrombosis-and-pulmonary-embolism
#15
Balbir Singh, Prashant Bharadwaj, Nitin Bajaj, Davinder Chadha
Spontaneous retroperitoneal haematoma (SRH) can be a life-threatening emergency presenting with hypovolaemic shock. SRH has been rarely reported with May-Thurner syndrome (MTS) where it occurs due to rupture of the iliac vein or venous collaterals. We report a case of MTS that presented with deep venous thrombosis of the left lower limb complicated by bilateral pulmonary embolism (PE) and a large pelvic haematoma. The simultaneous occurrence of a large pelvic haematoma and PE offered a therapeutic challenge...
December 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29194315/hereditary-thrombophilia-in-trauma-patients-with-venous-thromboembolism-is-routine-screening-necessary
#16
Kathleen A Cannon, Jayraan Badiee, Jason B Brill, Erik J Olson, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), remains a common complication following trauma. The role of hereditary thrombophilia (HT) in post-traumatic VTE is unknown. In the general population with a first-time DVT, Factor V Leiden (FVL) and prothrombin G20210A mutation (PGM) are the most common types of HT with an incidence of 20-25% and 6-18%, respectively. The objective of this study was to identify the incidence of FVL and PGM in post-traumatic VTE to determine whether routine screening for HT in trauma should be performed...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29192863/precipitating-hydrophobic-injectable-liquid-embolization-of-intracranial-vascular-shunts-initial-experience-and-technical-note
#17
Shriram Varadharajan, Arvinda Hanumanthapura Ramalingaiah, Jitender Saini, Arun Kumar Gupta, B Indira Devi, Ullas V Acharya
Precipitating hydrophobic injectable liquid (PHIL) is a newly available liquid embolic agent for endovascular therapy. It is nonadhesive and composed of a biocompatible polymer dissolved in dimethyl sulfoxide solvent and bonded covalently with iodine. In this report, the authors present their preliminary experience using PHIL in the treatment of intracranial vascular shunts. Between July 2015 and December 2015, 11 patients underwent endovascular embolization using the PHIL embolic agent. Five patients had arteriovenous malformations, 4 had dural arteriovenous fistulas, 1 patient had a carotid-cavernous fistula, and 1 patient had a pial arteriovenous fistula...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29183526/do-transferred-patients-increase-the-risk-of-venous-thromboembolism-in-trauma-centers
#18
Brian K Yorkgitis, Olubode A Olufajo, David Metcalfe, Gally Reznor, Joaquim M Havens, Zara Cooper, Ali Salim
Trauma patients often require initial stabilization followed by transfer for ongoing trauma care. Thus, the administration of VTE prophylaxis is often delayed until admission to the receiving hospital. It is unclear if transfer status is a risk factor for VTE. The National Trauma Database v6.2 was used to identify patients admitted to Level I and II trauma centers. Exclusions included patients on anticoagulation, <18 years, known VTE before trauma, or pregnant. Patients transferred were compared with nontransferred patients...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29181174/rapid-occurrence-of-left-ventricular-thrombus-associated-with-platinum-based-chemotherapy-plus-cetuximab-for-the-treatment-of-metastatic-squamous-cell-carcinoma-of-the-head-and-neck-a-case-report
#19
Atsushi Ikeda, Eiki Yamachika, Masahide Mizutani, Masakazu Matsubara, Norifumi Moritani, Kazuki Nakatsuji, Seiji Iida
Platinum-based chemotherapy plus cetuximab represents the first-line treatment for recurrent or metastatic squamous cell carcinoma of the head and neck. The most common adverse events associated with cetuximab are infusion reactions and skin reactions, and a risk of venous thromboembolic events has also recently been reported in association with cetuximab. It is well known that thrombosis is a common complication of malignancy, and represents the second most frequent cause of mortality in cancer patients. The present study reports the case of a 79-year-old man who presented with lung and liver metastases from tongue squamous cell carcinoma, for which platinum-based chemotherapy plus cetuximab was administered...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29180170/money-well-spent-a-cost-and-utilization-analysis-of-prophylactic-inferior-vena-cava-filter-placement-in-high-risk-trauma-patients
#20
Margo Nicole Carlin, Alireza Daneshpajouh, Joseph Catino, Marko Bukur
BACKGROUND: Inferior vena cava filters (IVCF) for venous thromboembolic prophylaxis in high-risk trauma patients is a controversial practice. Utilization of IVCF prophylaxis was evaluated at a level 1 trauma center. Daily cost of IVCF prophylaxis, time to IVCF, duration between IVCF and chemoprophylaxis, and number of patients needed to treat (NNT) to prevent pulmonary embolism (PE) was calculated. METHODS: A retrospective review of prophylactic IVCF over a 5-year period (2010-2014)...
December 2017: Journal of Surgical Research
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