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Venous embolism

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https://www.readbyqxmd.com/read/29470182/diagnosis-and-management-of-vte-in-pregnancy
#1
Kelley C McLean, Andra H James
Venous thromboembolism is a leading cause of maternal death. Because of the low absolute frequency of events, however, outcome-based clinical data are limited. Consequently, clinicians must additionally rely both on published guidelines and on extrapolation of data from studies focused on nonpregnant individuals. The diagnosis and treatment of deep vein thrombosis, pulmonary embolism, and cerebral vein and dural sinus thrombosis are complicated by pregnancy, and often require modifications to standard diagnostic and treatment algorithms outside of pregnancy...
February 21, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29469638/cost-comparison-of-continued-anticoagulation-with-rivaroxaban-versus-placebo-based-on-the-one-year-einstein-extension-trial-efficacy-and-safety-results
#2
Philip S Wells, Anthonie W A Lensing, Lloyd Haskell, Bennett Levitan, François Laliberté, Michael Durkin, Veronica Ashton, Yongling Xiao, Concetta Crivera, Dominique Lejeune, Jeff Schein, Patrick Lefebvre
AIMS: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (versus placebo) after 6-12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo based on the EINSTEIN-EXT event rates. METHODS: Total healthcare cost was calculated as sum of treatment and clinical event costs from a US managed care perspective...
February 22, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29466159/aspirin-or-rivaroxaban-for-vte-prophylaxis-after-hip-or-knee-arthroplasty
#3
David R Anderson, Michael Dunbar, John Murnaghan, Susan R Kahn, Peter Gross, Michael Forsythe, Stephane Pelet, William Fisher, Etienne Belzile, Sean Dolan, Mark Crowther, Eric Bohm, Steven J MacDonald, Wade Gofton, Paul Kim, David Zukor, Susan Pleasance, Pantelis Andreou, Steve Doucette, Chris Theriault, Abongnwen Abianui, Marc Carrier, Michael J Kovacs, Marc A Rodger, Doug Coyle, Philip S Wells, Pascal-Andre Vendittoli
BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty...
February 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29465588/chart-validation-of-inpatient-international-classification-of-diseases-ninth-revision-clinical-modification-icd-9-cm-administrative-diagnosis-codes-for-venous-thromboembolism-vte-among-intravenous-immune-globulin-igiv-users-in-the-sentinel-distributed-database
#4
Eric M Ammann, Adam Cuker, Ryan M Carnahan, Usha S Perepu, Scott K Winiecki, Marin L Schweizer, Charles E Leonard, Candace C Fuller, Crystal Garcia, Cole Haskins, Elizabeth A Chrischilles
The Sentinel Distributed Database (SDD) is a database of patient administrative healthcare records, derived from insurance claims and electronic health records, sponsored by the US Food and Drug Administration for evaluation of medical product outcomes. There is limited information on the validity of diagnosis codes for acute venous thromboembolism (VTE) in the SDD and administrative healthcare data more generally.In this chart validation study, we report on the positive predictive value (PPV) of inpatient administrative diagnosis codes for acute VTE-pulmonary embolism (PE) or lower-extremity or site-unspecified deep vein thrombosis (DVT)-within the SDD...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29463079/prevention-of-venous-thromboembolism-through-the-implementation-of-a-risk-assessment-tool-a-comparative-study-in-medical-and-surgical-patients
#5
Min Y Park, John P Fletcher, Carmen Hoffmann, Alice Lance, Fiona Gavegan, Kerry Hitos
BACKGROUND: Hospitalised patients are at high risk of venous thromboembolism (VTE). Underutilisation of thromboprophylaxis remains common despite existing clinical guidelines. The aim is to evaluate the implementation of a state wide standardised adult VTE risk assessment tool (RAT) to assist in the screening of inpatients and prescribing of appropriate thromboprophylaxis. METHODS: In total, 234 patients were audited using clinical notes and spot assessments for VTE risk at Western Sydney Local Health District over a two year period...
February 19, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29460300/catheter-associated-venous-air-embolism-in-hospitalized-horses-32-cases
#6
Nicholas J Parkinson, Harold C McKenzie, Michelle H Barton, Jennifer L Davis, Bettina Dunkel, Amy L Johnson, Elizabeth S MacDonald
BACKGROUND: Venous air embolism is a potentially life-threatening complication of IV catheter use in horses. Despite widespread anecdotal reports of their occurrence, few cases have been reported in the literature and the prognosis is currently unknown. HYPOTHESIS/OBJECTIVES: Our objective was to describe the surrounding circumstances, clinical signs, treatment, progression, and outcome of venous air embolism in hospitalized horses. ANIMALS: Thirty-two horses with acute onset of compatible clinical signs associated with IV catheter disconnection or damage...
February 20, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29459568/endovascular-repair-of-an-abdominal-aortic-aneurysm-with-iliac-vein-compression-syndrome
#7
Jun Hayashi, Tetsuro Uchida, Azumi Hamasaki, Atsushi Yamashita, Ken Nakamura, Kimihiro Kobayashi, Mitsuaki Sadahiro
An 84-year-old man with chronic obstructive pulmonary disease (COPD) was referred to our institution for further treatment of severe swelling of the left lower extremity. The left iliac vein was compressed by the abdominal aortic aneurysm and a right common iliac arterial aneurysm measuring 62 mm and 45 mm in diameter and was partially thrombosed. Multiple pulmonary artery embolisms were also noted. Endovascular repair of the abdominal aortic aneurysm and the right common iliac arterial aneurysm was performed because of his respiratory dysfunction...
February 16, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29459368/isolated-intraventricular-hemorrhage-secondary-to-dural-arteriovenous-fistula
#8
Krishna Amuluru, Fawaz Al-Mufti, Charles Romero
Isolated intraventricular hemorrhage due to dural arteriovenous fistula (dAVF) is extremely rare and has been reported only a few times in the literature. The pathophysiological cause of isolated intraventricular hemorrhage in these cases was hypothetically attributed to retrograde venous flow into subependymal vessels, although none of these cases demonstrated radiographic evidence of such reflux. We present the first case of a dAVF with radiographic evidence of severe cortical venous reflux into the subependymal venous network causing isolated intraventricular hemorrhage, thus lending proof for the underlying pathophysiology...
February 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#9
Gautam Sharma, Zubaidah Nor Hanipah, Ali Aminian, Suriya Punchai, Emre Bucak, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29454101/venous-thromboembolism-after-inpatient-surgery-in-administrative-data-vs-nsqip-a-multi-institutional-study
#10
David A Etzioni, Cynthia Lessow, Liliana G Bordeianou, Hiroko Kunitake, Sarah E Deery, Evie Carchman, Christina M Papageorge, George Fuhrman, Rachel L Seiler, James Ogilvie, Elizabeth B Habermann, Yu-Hui H Chang, Samuel R Money
BACKGROUND: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative venous thromboembolism (VTE). The goal of this study is to characterize discordance between administrative and registry data in the determination of postoperative VTE. STUDY DESIGN: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals (5 different medical centers) between 2013 and 2015...
February 14, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29452999/chylothorax-as-a-risk-factor-for-thrombosis-in-adults-a-proof-of-concept-study
#11
Sumedh S Hoskote, Hemang Yadav, Prashant Jagtap, Dennis A Wigle, Craig E Daniels
BACKGROUND: Postoperative chylothorax in children is associated with an increased risk of vascular thrombosis, hypothesized to be from loss of antithrombin into chylous fluid resulting in a hypercoagulable state. In adults, an increased thrombotic risk with chylothorax has not been described. Adults undergoing Ivor-Lewis esophagogastrectomy have two strong thrombotic risk factors-active malignancy and postoperative state-allowing for relative homogeneity in baseline thrombotic risk; therefore, we studied the association of chylothorax with thrombosis in this population...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#12
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...
February 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29448895/the-outcome-of-anticoagulation-on-endovenous-laser-therapy-for-superficial-venous-incompetence
#13
Jamie Vatish, Nusrat Iqbal, Viswa Retnasingam Rajalingam, Alok Tiwari
OBJECTIVES: The purpose of this study was to evaluate whether anticoagulation (warfarin or direct oral inhibitors) affected the success of endovenous treatment. METHODS: Patients taking anticoagulation (warfarin or direct oral inhibitors) undergoing endovenous treatment in the form of endovenous laser ablation (EVLA) were matched against controls for sex, age, leg, and vein. Data were collected prospectively between January 2012 and March 2017. The primary endpoint was failure of treatment at 6-week postoperative duplex scan...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29445486/aneurysm-of-the-inferior-vena-cava-with-thrombosis
#14
Masashi Inoue, Takeshi Sudo, Megumi Yamaguchi, Shingo Seo, Tatsuya Miyamoto, Toshihiro Misumi, Wataru Shimizu, Toshimitsu Irei, Takahisa Suzuki, Takashi Onoe, Yosuke Shimizu, Takao Hinoi, Hirotaka Tashiro
Inferior vena cava (IVC) aneurysms are extremely rare. Patients can be asymptomatic, have thrombosis, rupture, or pulmonary embolism. Thrombosis of the IVC aneurysm may mimic a retroperitoneal tumor. Surgical treatment of abdominal venous aneurysms with thrombosis is warranted and is necessary for the management of intraoperative bleeding and thrombosis.
February 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29444699/the-hyster-study-the-effect-of-intracervically-administered-terlipressin-versus-placebo-on-the-number-of-gaseous-emboli-and-fluid-intravasation-during-hysteroscopic-surgery-study-protocol-for-a-randomized-controlled-clinical-trial
#15
Lucilla E Overdijk, Bart M P Rademaker, Paul J M van Kesteren, Peter de Haan, Robert K Riezebos, Oscar C H Haude
BACKGROUND: Transcervical resection of myoma or endometrium is a safe, hysteroscopic, minimally invasive procedure. However, intravasation of distension fluid is a common phenomenon during these procedures. In a previous study we observed venous gas emboli in almost every patient. The severity of hysteroscopic-derived embolization has been shown to be correlated to the amount of intravasation. In addition, paradoxical gas embolism, which is potentially dangerous, was observed in several patients...
February 14, 2018: Trials
https://www.readbyqxmd.com/read/29443835/venous-thromboembolism-incidence-after-craniofacial-surgery
#16
Wilson I Omesiete, James A Walker, Jack C Yu
INTRODUCTION: Current protocols for venous thromboembolism (VTE) prophylaxis after craniofacial surgery (CFS) vary widely with substantial disagreements in both indications and managements. An evidence-based approach to this issue requires the following: the incidence of postoperative VTE, comorbidities associated with coagulopathy, risk reduction after VTE prophylaxis, and complications attributable to prophylaxis. This study addresses the first two. DESIGN: Retrospective cross-sectional study...
February 13, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29437717/isolated-intraventricular-hemorrhage-secondary-to-dural-arteriovenous-fistula
#17
Krishna Amuluru, Fawaz Al-Mufti, Charles Romero
Isolated intraventricular hemorrhage due to dural arteriovenous fistula (dAVF) is extremely rare and has been reported only a few times in the literature. The pathophysiological cause of isolated intraventricular hemorrhage in these cases was hypothetically attributed to retrograde venous flow into subependymal vessels, although none of these cases demonstrated radiographic evidence of such reflux. We present the first case of a dAVF with radiographic evidence of severe cortical venous reflux into the subependymal venous network causing isolated intraventricular hemorrhage, thus lending proof for the underlying pathophysiology...
February 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436450/lesson-of-the-month-2-pulmonary-embolism-in-a-patient-on-rivaroxaban-and-concurrent-carbamazepine
#18
Thomas Burden, Charlotte Thompson, Efstathios Bonanos, Andrew Rl Medford
A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#19
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29429212/-the-sources-of-emboli-in-patients-with-pulmonary-embolism-diagnosed-by-autopsy
#20
H Yang, X M Xu, B M Fang
Objective: To study the sources of emboli in patients with pulmonary embolism diagnosed by autopsy, and therefore to provide help in the diagnosis and treatment of thromboembolism. Methods: We retrospectively analyzed the pathology and clinical data of 43 patients with pulmonary embolism diagnosed by autopsy from 1962 to 2012 in Beijing Hospital. Results: In patients with pulmonary embolism diagnosed by autopsy, 32.6% of the emboli came from deep veins of the lower extremities, 9.3% from the renal vein, 9.3% from the prostate sinus, 7...
February 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
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