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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
#1
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/29454036/percutaneous-endovenous-intervention-plus-anticoagulation-versus-anticoagulation-alone-for-treating-patients-with-proximal-deep-vein-thrombosis-a-meta-analysis-and-systematic-review
#2
Chao-Nan Wang, Hong-Ru Deng
BACKGROUND: Combination treatment with percutaneous endovenous intervention (PEVI) and anticoagulation has been proposed for treating lower-extremity proximal deep vein thrombosis (DVT). We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of PEVI plus anticoagulation versus anticoagulation alone in patients with lower-extremity proximal DVT. METHODS: We systematically searched PubMed, Embase, and the Cochrane Library from inception to May 2016...
February 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29449145/antithrombotic-therapy-following-venous-stenting-international-delphi-consensus
#3
Kristijonas Milinis, Ankur Thapar, Joseph Shalhoub, Alun H Davies
OBJECTIVE/BACKGROUND: Deep venous stenting is increasingly used in the treatment of deep venous obstruction; however, there is currently no consensus regarding post-procedural antithrombotic therapy. The aim of the present study was to determine the most commonly used antithrombotic regimens and facilitate global consensus. METHODS: An electronic survey containing three clinical scenarios on venous stenting for non-thrombotic iliac vein lesions, acute deep vein thrombosis (DVT), and post-thrombotic syndrome was distributed to five societies whose members included vascular surgeons, interventional radiologists, and haematologists...
February 12, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#4
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/29440949/the-prevalence-of-long-term-oral-anticoagulation-therapy-in-a-cardiology-center-in-bucharest-romania
#5
Adelina-Mihaela Sorescu, Tudor Enache, Suzana Guberna
Background and aims: Few studies discuss the prevalence of oral anticoagulation therapy (OAT) in clinical practice, despite their increasing use worldwide. In America, studies established that 20% to 80% of the patients with indication benefit from OAT. In Romania, there is no data regarding the utilization of oral anticoagulants. Thus, this study aims to determine the trends of OAT. Methods: We designed a cross-sectional study of the patients admitted to the Cardiology Department of the "Bagdasar-Arseni" Clinical Emergency Hospital, Bucharest, from the 1st of November 2016 until the 31st of January 2017...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29436096/nephrotic-syndrome-complicated-with-femoral-vein-catheter-related-phlegmasia-cerulea-dolens-a-case-report
#6
Wen-Chun Chen, Shuo-Ming Ou
Nephrotic syndrome is a well-known risk factor of deep vein thrombosis (DVT). Catheter-related DVT under the setting of nephrotic syndrome may be presented as a more fulminant form, phlegmasia cerulea dolens. Phlegmasia cerulea dolens may lead to severe obstruction of venous drainage of the extremities and presents with compartment syndrome that impairs arterial perfusion. Aggressive management with thrombolysis and/or thrombectomy are considered with simultaneous anticoagulant treatment.
February 13, 2018: Hemodialysis International
https://www.readbyqxmd.com/read/29410163/management-of-low-risk-pulmonary-embolism-lope-patients-without-hospitalization-the-lope-prospective-management-study
#7
Joseph Bledsoe, Scott Woller, Scott Stevens, Valerie Aston, Rich Patten, Todd Allen, Benjamin Horne, Lydia Dong, James Lloyd, Greg Snow, Troy Madsen, Gregory Elliott
BACKGROUND: The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic venous thromboembolism (VTE), major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient hospitalization; and to measure patient satisfaction. METHODS: We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five emergency departments...
February 1, 2018: Chest
https://www.readbyqxmd.com/read/29399535/deep-venous-thrombosis-in-pregnancy-incidence-pathogenesis-and-endovascular-management
#8
REVIEW
Paola Devis, M Grace Knuttinen
Deep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399531/deep-vein-thrombosis-pathogenesis-diagnosis-and-medical-management
#9
REVIEW
Jonathan Stone, Patrick Hangge, Hassan Albadawi, Alex Wallace, Fadi Shamoun, M Grace Knuttien, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide. Venous thromboembolism (VTE), which includes DVT and pulmonary embolism (PE), affects an estimated 1 per 1,000 people and contributes to 60,000-100,000 deaths annually. Normal blood physiology hinges on a delicate balance between pro- and anti-coagulant factors. Virchow's Triad distills the multitude of risk factors for DVT into three basic elements favoring thrombus formation: venous stasis, vascular injury, and hypercoagulability...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399526/catheter-directed-thrombolysis-of-deep-vein-thrombosis-literature-review-and-practice-considerations
#10
REVIEW
Drew Fleck, Hassan Albadawi, Fadi Shamoun, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Anticoagulation therefore does little to prevent the venous damage and scarring that occurs following DVT, leaving the patient at risk for permanent venous insufficiency and development of post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399524/statins-as-a-preventative-therapy-for-venous-thromboembolism
#11
REVIEW
Alex Wallace, Hassan Albadawi, Peter Hoang, Andrew Fleck, Sailendra Naidu, Grace Knuttinen, Rahmi Oklu
The anti-inflammatory effects of statins have likely not been used to their fullest extent, particularly in reducing venous thromboembolic events. Current therapy for thrombotic events hinges on anticoagulation via heparin, warfarin or new oral anticoagulants. Interventional procedures with thrombectomy may also play a critical role. Unfortunately, thrombotic events can occur and recur despite meticulous anticoagulation therapy. Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), two complicated and prevalent diseases that can cause chronic disease states such as post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399519/may-thurner-diagnosis-and-endovascular-management
#12
REVIEW
M-Grace Knuttinen, Sailendra Naidu, Rahmi Oklu, Scott Kriegshauser, William Eversman, Lisa Rotellini, Patricia E Thorpe
Common left iliac vein compression, otherwise known as May-Thurner (MT), is an anatomical risk factor for lower extremity deep vein thrombosis (DVT). MT refers to chronic compression of the left iliac vein against the lumbar spine by the overlying right common iliac artery. The compression may be asymptomatic. The syndrome is a clinical spectrum of physical findings and history plus the lesion. It is characterized by the varying degrees of venous hypertension. This can be non-thrombotic, combined with acute DVT or post-thrombotic...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399516/below-knee-deep-vein-thrombosis-dvt-diagnostic-and-treatment-patterns
#13
Drew Fleck, Hassan Albadawi, Alex Wallace, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Background: Guidelines are lacking for isolated below-knee deep vein thrombosis (BKDVT). The American College of Chest Physicians (ACCP) suggests anticoagulation only if symptoms are severe, otherwise surveillance with follow-up ultrasound in 2 weeks is recommended. Yet clinical practice remains highly variable. Little is known about the natural history of BKDVT and how to best manage these patients. Methods: A retrospective analysis was conducted of medical records from 2014-2016...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29382561/optimal-timing-of-initiation-of-thromboprophylaxis-after-nonoperative-blunt-spinal-trauma-a-propensity-matched-analysis
#14
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Michael Truitt, Muhammad Zeeshan, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: Patients with spinal trauma have the highest risk of a venous thromboembolism. While anticoagulation is recommended, its optimal timing is not well-defined. We aimed to assess the impact of early initiation of thromboprophylaxis in spinal trauma patients who were managed non-operatively. STUDY DESIGN: A 2-year (2013-2014) analysis of all isolated spinal-trauma patients managed non-operatively who received thromboprophylaxis in the TQIP. Patients were divided into two groups based on timing of initiation of thromboprophylaxis: Early (<48hours) and Late (≥48hours), and were matched in a 1:1 ratio using propensity score matching for demographics, admission vitals, injury severity, level of spine-injury and type of prophylaxis...
January 27, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29376959/-clinical-experience-with-the-use-of-rivaroxaban-in-the-treatment-of-cancer-patients-with-venous-thrombosis
#15
P F Kravtsov, S E Katorkin, M A Melnicov
The urgency of the problem. The incidence of various thromboembolic complications in patients with oncopathology reaches 5-12%. When treating VTE in patients with oncology it is necessary to choose between two generally recognized alternatives. The recommended two-component scheme of the initiating phase of anticoagulant therapy with subsequent long-term admission of VKA is fraught with the development of clinically significant bleeding during the initial selection of the dose of warfarin and an increased risk of recurrence of VTE...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29375872/subcutaneous-hematomas-from-prophylactic-heparin-use
#16
Abhilash Koratala, Deepti Bhattacharya
Heparin is an anticoagulant, which is frequently used in hospitalized patients for prophylaxis of deep vein thrombosis (DVT). Subcutaneous administration of heparin may lead to complications such as bruising, hematoma, and pain at the injection site. Hematomas can develop without visible bruising, as in our case.
January 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29360741/a-patient-centered-approach-to-guide-follow-up-and-adjunctive-testing-and-treatment-after-first-rib-resection-for-venous-thoracic-outlet-syndrome-is-safe-and-effective
#17
Colin P Ryan, Nicolas J Mouawad, Patrick S Vaccaro, Michael R Go
Controversies in the treatment of venous thoracic outlet syndrome (VTOS) have been discussed for decades, but still persist. Calls for more objective reporting standards have pushed practice towards comprehensive venous evaluations and interventions after first rib resection (FRR) for all patients. In our practice, we have relied on patient-centered, patient-reported outcomes to guide adjunctive treatment and measure success. Thus, we sought to investigate the use of thrombolysis versus anticoagulation alone, timing of FRR following thrombolysis, post-FRR venous intervention, and FRR for McCleery syndrome (MCS) and their impact on patient symptoms and return to function...
January 23, 2018: Diagnostics
https://www.readbyqxmd.com/read/29354628/femoral-endovenectomy-with-iliac-stenting-for-chronic-iliofemoral-venous-occlusion
#18
Won Pyo Cho, Sungsin Cho, Min-Ji Cho, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Seung-Kee Min
A 62-year-old man with progressive swelling on his left thigh and leg was referred to the Division of Vascular Surgery. Anticoagulation therapy did not prevent or improve the symptoms of chronic deep vein thrombosis (DVT) from his left external iliac vein to posterior tibial vein. He had no trauma history nor any accidents. He underwent femoral endovenectomy, thrombectomy and stent insertion in left iliac vein. The patient had additional balloon angioplasty for stenosis in left common femoral vein. He had an uneventful postoperative recovery without complication...
December 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/29348123/rash-associated-with-rivaroxaban-use
#19
Kelly M Rudd, Narmadha Panneerselvam, Anush Patel
PURPOSE: A case of a patient who developed a hypersensitivity reaction to rivaroxaban in the form of a diffuse, exanthematous rash is reported. SUMMARY: After starting rivaroxaban for treatment of cancer-associated deep vein thrombosis (DVT) with pulmonary embolism (PE), a 69-year-old Caucasian woman arrived at an oncology clinic with a diffuse, exanthematous (morbilliform) rash on her neck and torso, spreading to her upper and lower extremities. She reported that the symptoms started to develop about 48 hours after transitioning from subcutaneous enoxaparin to oral rivaroxaban...
January 18, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29345985/cyp3a-activity-and-rivaroxaban-serum-concentrations-in-russian-patients-with-deep-vein-thrombosis
#20
Dmitriy Alexeyevich Sychev, Arshak Vardanyan, Aleksandr Rozhkov, Edita Hachatryan, Ani Badanyan, Valery Smirnov, Anna Ananichuk, Natalya Denisenko
BACKGROUND: Rivaroxaban is metabolized in the liver via CYP3A4, the cytochrome involved in the metabolism of nearly 50% of all medications. Thus, its effective concentration depends on multiple pharmacologic parameters. METHODS: The primary goal of our research was to study the correlation between the CYP3A family activity and the safety and efficacy of anticoagulant therapy with rivaroxaban in patients with deep vein thrombosis (DVT). Thirty one patients with DVT aged 21-83 years, 18 men and 13 women, received rivaroxaban (Xarelto) 30 mg/day for 21 days after diagnosis and 20 mg/day for the follow-up period of 6 months...
January 2018: Genetic Testing and Molecular Biomarkers
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