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Pulmonary embolism prophylaxis

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https://www.readbyqxmd.com/read/28821379/multicenter-trial-of-the-venatech-convertible-vena-cava-filter
#1
Eric J Hohenwalter, James R Stone, Paul V O'Moore, Steven J Smith, J Bayne Selby, Robert J Lewandowski, Shaun Samuels, Paul M Kiproff, David W Trost, David C Madoff, Jeremy Handel, Eric J Gandras, Athanasios Vlahos, William S Rilling
PURPOSE: To demonstrate rates of successful filter conversion and 6-month major device-related adverse events in subjects with converted caval filters. MATERIALS AND METHODS: An investigational device exemption multicenter, prospective, single-arm study was performed at 11 sites enrolling 149 patients. The VenaTech Convertible Vena Cava Filter (B. Braun Interventional Systems, Inc, Bethlehem, Pennsylvania) was implanted in 149 patients with venous thromboembolism and contraindication to or failure of anticoagulation (n = 119), with high-risk trauma (n = 14), and for surgical prophylaxis (n = 16)...
August 16, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28820759/thromboprophylaxis-in-spinal-surgery
#2
William P Mosenthal, David C Landy, Haroutioun H Boyajian, Olumuyiwa A Idowu, Lewis L Shi, Edwin Ramos, Michael J Lee
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: Determine the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery patients receiving no thromboprophylaxis, mechanoprophylaxis, and chemoprophylaxis. SUMMARY OF BACKGROUND DATA: The incidence of thromboembolic complications after spinal surgery is not well established. While a variety of effective mechanical and chemical thromboprophylaxis interventions exist, their role in spinal surgery remains unclear...
August 17, 2017: Spine
https://www.readbyqxmd.com/read/28807470/persistent-pulmonary-embolism-rates-following-total-knee-arthroplasty-even-with-prophylactic-anticoagulants
#3
Mark P Cote, Anthony Chen, Yue Jiang, Vincent Cheng, Jay R Lieberman
BACKGROUND: Symptomatic pulmonary embolism (PE), a significant and life-threatening complication following total knee arthroplasty (TKA), has been described as a "never event." Despite a number of advancements in care, PE continues to occur following TKA. This study evaluates symptomatic PE rates over time in TKA patients enrolled in multicenter randomized clinical trials assessing the efficacy of venous thromboembolism prophylaxis regimens. METHODS: The MEDLINE and Cochrane Central Register of Controlled Trials were searched to identify clinical trials assessing prophylactic anticoagulation in patients undergoing TKA between January 1995 and December 2016...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28804823/an-overview-of-thrombophilia-and-associated-laboratory-testing
#4
Martina Montagnana, Giuseppe Lippi, Elisa Danese
Venous thromboembolism, usually entailing deep vein thrombosis, pulmonary embolism, or both, is a complex and multifactorial disorder, in which a number of putative conditions interplay and finally contribute to propel the individual risk over a certain degree, so ultimately culminating in the development of venous occlusive disorders. Thrombophilia is commonly defined as a propensity to develop venous thromboembolism on the basis of an underlying hypercoagulable state attributable to inherited or acquired disorders of blood coagulation or fibrinolysis...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28801426/patient-preferences-for-venous-thromboembolism-prophylaxis-after-injury-a-discrete-choice-experiment
#5
Bryce E Haac, Nathan N O'Hara, C Daniel Mullins, Deborah M Stein, Theodore T Manson, Herman Johal, Renan Castillo, Robert V O'Toole, Gerald P Slobogean
OBJECTIVE: Limited evidence for the optimal venous thromboembolism (VTE) prophylaxis regimen in orthopaedic trauma leads to variability in regimens. We sought to delineate patient preferences towards cost, complication profile, and administration route (oral tablet vs. subcutaneous injection). DESIGN: Discrete choice experiment (DCE). SETTING: Level 1 trauma center in Baltimore, USA. PARTICIPANTS: 232 adult trauma patients (mean age 47...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800668/-epidemiology-risk-factors-and-risk-stratification-of-venous-thromboembolism-in-pregnancy-and-the-puerperium
#6
Panagiotis Tsikouras, Georg-Friedrich von Tempelhoff, Werner Rath
Venous thromboembolism (VTE) remains a leading cause of direct maternal deaths in the developed countries. The incidence of VTE has increased significantly during the past two decades. The absolute risk of VTE is estimated 0.6-2.2 per 1000 deliveries. Compared with age-matched non-pregnant women, the daily risk of VTE is increased 7- to 10-fold for antepartum VTE, but it is 15- to 35-fold for postpartum VTE. The incidence of pulmonary embolism (PE) during the first 6 weeks postpartum is nearly 15-fold higher compared to the incidence in pregnancy, and remains significantly increased up to 12 weeks postpartum...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28796427/epidemiology-of-venous-thromboembolism-in-africa-a-systematic-review
#7
C Danwang, M N Temgoua, V N Agbor, A T Tankeu, J J Noubiap
Essentials Venous thromboembolism (VTE) is among the three main causes of cardiovascular disease worldwide. This review is the first to summarize the epidemiology of VTE in African populations. The prevalence of VTE in Africa is high following surgery, in pregnancy and post-partum. At least one quarter of patients at risk of VTE in Africa are not receiving prophylaxis. SUMMARY: Background Venous thromboembolism (VTE) is among the three leading causes of cardiovascular disease worldwide...
August 10, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28780771/low-molecular-weight-heparin-for-prevention-of-venous-thromboembolism-in-patients-with-lower-limb-immobilization
#8
REVIEW
Aniek Ag Zee, Kelly van Lieshout, Maaike van der Heide, Loes Janssen, Heinrich Mj Janzing
BACKGROUND: Immobilization of the lower limb is a risk factor for venous thromboembolism (VTE). Low molecular weight heparins (LMWHs) are anticoagulants, which might be used in adult patients with lower-limb immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. OBJECTIVES: To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-limb immobilization in an ambulatory setting...
August 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28756546/thromboprophylaxis-with-enoxaparin-and-direct-oral-anticoagulants-in-major-orthopedic-surgery-and-acutely-ill-medical-patients-a-meta-analysis
#9
Claudio Cimminiello, Paolo Prandoni, Giancarlo Agnelli, Giovanni Di Minno, Hernan Polo Friz, Francesco Scaglione, Patrizia Boracchi, Giuseppe Marano, Job Harenberg
Subjects undergoing major orthopedic surgery and acutely ill hospitalized medical patients represent a population at medium-high risk for venous thromboembolism (VTE). They are treated with low molecular weight heparin (LMWH) and direct oral anticoagulants [DOACs] for VTE prevention. We conducted a meta-analysis of phase III randomized clinical trials evaluating LMWH enoxaparin versus DOACs for prophylaxis of VTE by combining studies including patients undergoing elective total hip and knee replacement surgery, and acutely ill hospitalized medical subjects...
July 29, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28747317/the-risk-of-postoperative-hemorrhage-and-efficacy-of-heparin-for-preventing-deep-vein-thrombosis-and-pulmonary-embolism-in-adult-patients-undergoing-neurosurgery-a-systematic-review-and-meta-analysis
#10
Xuan Wang, Ying-Chun Zhou, Wen-De Zhu, Yun Sun, Peng Fu, De-Qiang Lei, Hong-Yang Zhao
The aim of this meta-analysis was to examine the risk of postoperative bleeding and efficacy of heparin for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in adult patients undergoing neurosurgery. MEDLINE, Cochrane, and EMBASE databases were searched until October 31, 2016, for randomized controlled trials (RCTs) and non-randomized comparative studies that assessed the rates of postoperative hemorrhage, DVT, PE, and mortality in adult patients undergoing neurosurgery. Nine eligible studies (five RCTs, four retrospective studies) including 874 patients treated with either unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) and 1033 patients in control group (placebo with or without compression device) were analyzed...
July 26, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28736179/venous-thromboembolism-in-burn-patients-is-not-prevented-by-chemoprophylaxis
#11
Sheena Sikora, Anthony Papp
BACKGROUND: Venous thromboembolisms (VTE) including deep venous thrombosis and pulmonary embolism are serious complications following burn trauma. There are inconsistencies in the literature regarding thromboembolic prevention strategies and data suggests that complications occur despite chemoprophylaxis. OBJECTIVE: To determine the prevalence of deep venous thromboembolism and pulmonary embolism in burn patients who are actively being treated with VTE prophylaxis and to determine factors that help predict which anti-coagulated patients are at risk for VTE and may benefit from further treatment...
July 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#12
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#13
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#14
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28678604/a-post-marketing-assessment-of-major-bleeding-in-total-hip-and-total-knee-replacement-surgery-patients-receiving-rivaroxaban
#15
Louis M Kwong, Alexander G G Turpie, Sally Tamayo, W Frank Peacock, Zhong Yuan, Nicholas Sicignano, Kathleen Pillsbury Hopf, Manesh R Patel
BACKGROUND: Rivaroxaban is a novel oral anticoagulant indicated for prophylaxis against deep vein thrombosis and pulmonary embolism in patients undergoing total hip replacement (THR) or total knee replacement (TKR) surgery. OBJECTIVE: To evaluate major bleeding (MB) in THR/TKR patients receiving post-operative rivaroxaban. METHODS: Electronic medical records of nearly 10 million US Department of Defense (DoD) beneficiaries were queried from 1 January 2013 through 30 June 2015...
July 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#16
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#17
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary embolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
June 27, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28645996/treatment-of-suspected-pulmonary-embolism-in-a-morbidly-obese-patient
#18
Viviene Heitlage, Mary Beth Borgstadt, Lisa Carlson
PURPOSE: A case highlighting challenges with enoxaparin dosage and monitoring in obese patients is presented. SUMMARY: A morbidly obese 22-year-old Caucasian female (height, 168 cm; weight, 322 kg; body mass index [BMI], 114 kg/m(2)) who presented to the emergency department with acute-onset dyspnea and hypoxia was empirically initiated on enoxaparin for suspected pulmonary embolism at the institution's standard maximum dosage (160 mg subcutaneously every 12 hours)...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#19
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#20
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
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