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https://www.readbyqxmd.com/read/28437037/use-of-fondaparinux-for-thromboprophylaxis-in-an-unfractionated-heparin-intolerant-pregnant-woman-with-thrombotic-predisposition
#1
Shoji Haruta, Kana Maruta, Yoshiyuki Nakajima, Naoki Masaoka
A 34-year-old primigravida who had undergone thrombectomy for deep venous thrombosis (DVT) in her leg and exhibited low protein S activity, indicating predisposition to thrombosis, developed DVT of the leg. No pulmonary embolism was detected. After anticoagulant therapy with unfractionated heparin was discontinued because of liver dysfunction, danaparoid treatment was administered in hospital. The patient had a normal delivery after 39 weeks' gestation with no recurrence of thrombosis. During her second pregnancy four years later, she gave herself fondaparinux injections...
April 24, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28414674/a-clot-possibly-due-to-loss-of-tnf-%C3%AE-supression
#2
J Broussard, M Berlinger, D Lauret
INTRODUCTION: Inflammation and venous thrombosis enjoy a close Relationship. We present a patient who had multiple DVTs following the discontinuation of anti- TNF-α therapy. CASE: A 34 year old African American female with a history of multiple DVT's, miscarriages, and reported Crohn's disease presented with shortness of breath. In the Emergency Department, CTA showed bilateral pulmonary emboli. The patient had been off adalimumab for one year and reported abdominal pain with 6-7 non-bloody bowel movements daily...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413884/incidence-and-risk-factors-of-venous-thromboembolism-after-orthopaedic-foot-and-ankle-surgery
#3
Jamal Ahmad, Mary-Katherine Lynch, Mitchell Maltenfort
BACKGROUND: This study examines the incidence and risk of postoperative symptomatic venous thromboembolism (VTE) after orthopaedic foot/ankle surgery. MATERIALS: Patients that received foot/ankle surgery between 2006 and 2016 were reviewed. Inclusion criteria were surgical patients that were without coagulopathy, previous VTE, and/or using anticoagulation medications including aspirin. Age, sex, body mass index, medical comorbidities, and surgical diagnosis and procedure(s) were noted...
April 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28413581/robotic-assisted-inferior-vena-cava-filter-retrieval
#4
Shahin Owji, Tony Lu, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28411120/effectiveness-and-safety-of-rivaroxaban-and-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-matched-nationwide-cohort-study
#5
Torben B Larsen, Flemming Skjøth, Jette N Kjældgaard, Gregory Y H Lip, Peter B Nielsen, Mette Søgaard
BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are collectively known as venous thromboembolism (VTE), which is a common vascular disease and a major cause of morbidity and mortality worldwide. We compare effectiveness and safety of rivaroxaban versus warfarin in a prospective cohort of routine care patients with incident unprovoked VTE. METHODS: In this propensity-matched cohort study, we linked nationwide Danish health registries to identify all patients with a first hospital diagnosis of unprovoked VTE who were new users of rivaroxaban or warfarin...
April 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28407492/residual-vein-thrombosis-and-serial-d-dimer-for-the-long-term-management-of-patients-with-deep-venous-thrombosis
#6
Paolo Prandoni, Valentina Vedovetto, Maurizio Ciammaichella, Eugenio Bucherini, Sara Corradini, Iolanda Enea, Benilde Cosmi, Nicola Mumoli, Adriana Visonà, Giovanni Barillari, Carlo Bova, Roberto Quintavalla, Nello Zanatta, Simona Pedrini, Sabina Villalta, Giuseppe Camporese, Sofie Testa, Roberto Parisi, Cecilia Becattini, Stefano Cuppini, Vittorio Pengo, Gualtiero Palareti
BACKGROUND: The optimal long-term strategy for preventing recurrent venous thromboembolism (VTE) in patients with deep-vein thrombosis (DVT) is uncertain. METHODS: In 620 consecutive outpatients with a first proximal DVT who had completed at least three months of anticoagulation (unprovoked in 483, associated with minor risk factors in 137), the ultrasound presence of residual vein thrombosis (RVT) was assessed and defined as an incompressibility of at least 4mm...
April 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28402686/the-creation-and-implementation-of-an-outpatient-pulmonary-embolism-treatment-protocol
#7
Christopher Kabrhel, Rachel Rosovsky, Christopher Baugh, Blair Alden Parry, Erin Deadmon, Charlotte Kreger, Nicholas Giordano
The ability to rapidly and accurately risk-stratify patients with venous thromboembolism (VTE), and the availability of direct acting oral anticoagulants have reduced the need for intravenous anticoagulation for patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). Emergency physicians are generally reluctant to discharge patients with VTE without defined and reliable follow up in place, and VTE patients treated with anticoagulants can be at risk for complications related to recurrent VTE and bleeding...
April 21, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28395685/the-benefit-of-pharmacological-venous-thromboprophylaxis-in-foot-and-ankle-surgery
#8
N P Saragas, P N F Ferrao, B F Jacobson, E Saragas, A Strydom
BACKGROUND: Ten percent of patients with a deep-vein thrombosis (DVT) will develop a fatal pulmonary embolism (PE), often initially asymptomatic. The risks and benefits of pharmacological thromboprophylaxis are well documented in respect of total joint arthroplasty and hip fractures, but little is understood about the incidence of venous thromboembolism (VTE) or the potential risks and benefits of chemoprophylaxis in foot and ankle surgery. OBJECTIVE: To determine whether prophylactic chemoprophylaxis had any impact on the prevention of VTE in a cohort of foot and ankle surgical patients requiring the combination of below-knee cast immobilisation and non-weightbearing for ≥4 weeks...
March 29, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28393971/-mechanical-and-pharmacomechanical-trombolysis-in-deep-venous-thrombosis-with-no-clinical-response-to-conventional-treatment
#9
Leopoldo Marine, Jesús Urbina, Michel Bergoeing, Francisco Valdés, Renato Mertens, Albrecht Kramer
BACKGROUND: Conventional treatment of deep vein thrombosis (DVT) is anticoagulation, bed rest and limb elevation. Proximal DVT patients with persisting edema, pain and cyanosis of extremities despite of conventional therapy may develop ischemia. Direct treatment of thrombosis becomes necessary. AIM: To report our experience with mechanical trombolysis of proximal lower extremity DVT. MATERIAL AND METHODS: Retrospective review of medical records of proximal DVT patients treated with thrombolysis between March 2012 and August 2015...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28380473/successful-management-of-a-patient-with-autoimmune-hemorrhaphilia-due-to-anti-factor-xiii-13-antibodies-complicated-by-pulmonary-thromboembolism
#10
Yoshiyuki Ogawa, Kunio Yanagisawa, Masayoshi Souri, Masahiro Mihara, Chiaki Naito, Makiko Takizawa, Takuma Ishizaki, Takeki Mitsui, Hiroshi Handa, Tsukasa Osaki, Yoshihisa Nojima, Akitada Ichinose
Autoimmune hemophilia-like disease (hemorrhaphilia) due to anti-factor XIII (FXIII) antibodies (AH13) is a very rare, life-threatening bleeding disorder. A 77-year-old woman developed macrohematuria and a right renal pelvic hematoma. The coagulation times were not prolonged, but FXIII activity and antigen levels were severely and moderately reduced to 9 and 29% of normal values, respectively. Accordingly, the FXIII-specific activity turned out to be low. FXIII inhibitor and anti-FXIII-A subunit autoantibodies were detected by a 1:1 crossmixing test and immunoblot and immunochromatographic assays...
April 6, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28374884/low-molecular-weight-heparins-or-heparinoids-versus-standard-unfractionated-heparin-for-acute-ischaemic-stroke
#11
REVIEW
Peter Ag Sandercock, Tze Shin Leong
BACKGROUND: Low-molecular-weight heparins (LMWHs) and heparinoids are anticoagulants that may have more powerful antithrombotic effects than standard unfractionated heparin (UFH) but a lower risk of bleeding complications. This is an update of the original Cochrane Review of these agents, first published in 2001 and last updated in 2008. OBJECTIVES: To determine whether antithrombotic therapy with LMWHs or heparinoids is associated with a reduction in the proportion of people who are dead or dependent for activities in daily living compared with UFH...
April 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28373261/how-we-treat-central-venous-access-device-related-upper-extremity-dvt
#12
Anita Rajasekhar, Michael B Streiff
Central venous access device (CVAD)-related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access and post-thrombotic syndrome. Patient, device and treatment-related factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for prevention of CRT remains to be established...
April 3, 2017: Blood
https://www.readbyqxmd.com/read/28372484/single-center-retrospective-review-of-ultrasound-accelerated-versus-traditional-catheter-directed-thrombolysis-for-acute-lower-extremity-deep-venous-thrombosis
#13
Tony Lu, Thomas M Loh, Hosam F El-Sayed, Mark G Davies
Objective Systemic anticoagulation remains the standard for acute lower extremity (LE) deep venous thrombosis (DVT), but growing interest in catheter-directed thrombolysis (CDT) and its potential to reduce the incidence of post-thrombotic syndrome (PTS) has led to advent of ultrasound-accelerated CDT (US-CDT). Few studies to date have examined the outcomes of US-CDT against traditional CDT (T-CDT). Methods This is a retrospective, single-center review of all patients treated for acute LE DVT over a five-year period with either US- and T-CDT...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28369826/increased-incidence-of-vte-in-sickle-cell-disease-patients-risk-factors-recurrence-and-impact-on-mortality
#14
Ann Brunson, Amy Lei, Aaron S Rosenberg, Richard H White, Theresa Keegan, Ted Wun
Previous reports show increased incidence of venous thromboembolism [VTE, deep-vein thrombosis (DVT) and pulmonary embolus (PE)] in sickle cell disease (SCD) patients but did not account for frequency of hospitalization. We determined the incidence of VTE in a SCD cohort versus matched controls. For SCD patients, risk factors for incident VTE, recurrence and the impact on mortality were also determined. Among 6237 patients with SCD, 696 patients (11·2%) developed incident-VTE: 358 (51·6%) had PE (±DVT); 179 (25·7%) had lower-extremity DVT only and 158 (22·7%) had upper-extremity DVT...
April 3, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28364690/recanalization-rate-in-patients-with-proximal-vein-thrombosis-treated-with-the-direct-oral-anticoagulants
#15
Paolo Prandoni, Walter Ageno, Nicola Mumoli, Nello Zanatta, Davide Imberti, Adriana Visonà, Maurizio Ciammaichella, Livio Simioni, Roberto Cappelli, Eugenio Bucherini, Marcello Di Nisio, Giampiero Avruscio, Giuseppe Camporese, Roberto Parisi, Stefano Cuppini, Giacomo Turatti, Franco Noventa, Lucia Sarolo
BACKGROUND: The recanalization rate in patients with deep venous thrombosis (DVT) of the legs treated with the direct oral anticoagulants (DOAC) is unknown. METHODS: In an Italian cohort, we investigated the rate of residual vein thrombosis (RVT) after three and/or six months in 352 patients with proximal DVT who had been treated with the DOACs as a stand-alone therapy or lead-in parenteral anticoagulants, and compared it to that recorded in a historical cohort of 1094 patients in which vitamin K antagonists (VKAs) had been employed...
March 27, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28342731/preferred-management-of-primary-deep-arm-vein-thrombosis
#16
REVIEW
F J Vazquez, P Paulin, D Poodts, E Gándara
OBJECTIVE: Given its rarity, the management of primary upper extremity deep vein thrombosis is controversial. Although anticoagulation alone is commonly advocated for its treatment, it is unclear if this will reduce the risk of developing post-thrombotic syndrome (PTS). The aim of this "Evidence Driven" Clinical Scenario is to evaluate whether more aggressive treatments (including catheter directed thrombolysis or surgery) might help reduce the risk of PTS or recurrent venous thromboembolism in patients with primary upper extremity deep vein thrombosis (DVT)...
March 22, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28341503/endovascular-repair-of-a-large-abdominal-aortic-aneurysm-in-a-patient-presenting-with-lower-extremity-edema-as-a-result-of-inferior-vena-cava-thrombosis
#17
Nan Li, Ming Xue, Deng-Ke Hong, Xing-Sheng Chen
PURPOSE: Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR). CASE REPORT: A 50-year-old man presented with three-day right lower extremity edema...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28334639/inferior-vena-cava-filters-in-patients-with-cancer-and-venous-thromboembolism-vte-does-not-improve-clinical-outcomes-a-population-based-study
#18
Ann Brunson, Gwendolyn Ho, Richard White, Ted Wun
BACKGROUND: There are few studies that have determined clinical outcomes following inferior vena cava filter (IVCF) insertion in cancer patients hospitalized for acute deep-vein-thrombosis (DVT) or pulmonary embolism (PE). METHODS AND RESULTS: We analyzed hospital discharge records of all patients with active cancer who were admitted to a California hospital specifically for acute DVT or PE between 2005 through 2009. Propensity and competing risk methodology were used to determine if IVCF-use lowered either 30-day mortality or the risk of recurrent PE, DVT, and major bleeding within 180days...
March 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28321710/association-between-tlr9-rs5743836-polymorphism-and-risk-of-recurrent-venous-thromboembolism
#19
Abrar Ahmad, Kristina Sundquist, Bengt Zöller, Peter J Svensson, Jan Sundquist, Ashfaque A Memon
Recent gene knockout studies on mice have shown the role of toll-like receptor 9 (TLR9) in resolution of venous thromboembolism (VTE) through sterile inflammation. However, the role of a putative functional TLR9 polymorphism (rs5743836) in risk assessment of VTE recurrence remains unknown. The aim of our study was to investigate the TLR9 rs5743836 polymorphism in VTE patients and its association with the risk of VTE recurrence. We analyzed TLR9 rs5743836 polymorphism in Malmö thrombophilia study patients; a prospective follow-up study of 1465 VTE patients by Taqman PCR...
March 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28321560/may-thurner-syndrome-old-acquaintance-new-perspective-case-report
#20
Anja Boc, Vinko Boc, Matija Kozak
May-Thurner syndrome (MTS) results from a frequent anatomic variant in which compression of the left common iliac vein between the body of the fifth lumbar vertebra and the pulsating right common iliac artery can cause deep venous thrombosis (DVT) of the left lower limb. While anticoagulation remains the mainstay treatment of acute DVT, catheter-directed thrombolysis combined with stenting provides a safe and effective method for relieving acute symptoms and preventing postthrombotic syndrome in patients with MTS...
March 20, 2017: Wiener Klinische Wochenschrift
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