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Journal articles on the topic 'Venous thrombosis'
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1
Sands, Jeffrey J., and Carol L. Miranda. "State-of-the-Art Review : Treatment of Hemodialysis Access Failure: A Role for Thrombolysis." Clinical and Applied Thrombosis/Hemostasis 2, no. 3 (July 1996): 164–68. http://dx.doi.org/10.1177/107602969600200304.
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Thrombosis of hemodialysis accesses remains a major source of morbidity, hospitalization, and expense for patients with end-stage renal disease. Treatment of hemodialysis accesses includes strategies to prevent ac cess failure and methods for treating acute thromboses. Such techniques as Doppler ultrasonography, venous pressure monitoring during dialysis, measurement of ra tios of venous to systemic pressures, and measurement of recirculation have been used to predict accesses at risk of thrombosis. Elective interventions, including surgical re visions and angioplasties, have been shown to lessen the thrombosis rate in both polytetrafluoroethylene (PTFE) grafts and arterio-venous fistulas. Elective revision has also improved long-term patency of both grafts and fistu las when compared with repairing the accesses only after thrombosis. Despite these attempts, acute thrombosis of hemodialysis accesses remains a common complication for patients with end-stage renal disease. Historically, surgical thrombectomy has been the gold standard for treatment of acute hemodialysis access failure. Over the past 10 years, thrombolytic therapy has gained an in creasing role in the treatment of acutely thrombosed PTFE grafts. Thrombolysis has had at least comparable results to surgical thrombectomy in the best centers, with similar complication rates. Thrombolytic therapy is also significantly less expensive than surgical thrombectomy. In summary, we believe that hemodialysis access treat ment should encompass a comprehensive program, in cluding access surveillance to select accesses at risk of failure. Elective intervention should be performed in an attempt to prevent thrombosis and increase long-term ac cess patency. When thrombosis does occur, pharmaco mechanical thrombolysis is the preferable first interven tion for acutely occluded PTFE hemodialysis accesses.
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Palazzo, Paola, Pierre Agius, Pierre Ingrand, Jonathan Ciron, Matthias Lamy, Aline Berthomet, Paul Cantagrel, and Jean-Philippe Neau. "Venous Thrombotic Recurrence After Cerebral Venous Thrombosis." Stroke 48, no. 2 (February 2017): 321–26. http://dx.doi.org/10.1161/strokeaha.116.015294.
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Rana, K. G. S., A. Jhamb, Mukul Verma, and Harsh Rastogi. "Thrombolysis for Cerebral Venous Thrombosis." Apollo Medicine 4, no. 1 (March 2007): 69–71. http://dx.doi.org/10.1016/s0976-0016(11)60439-0.
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Comerota, Anthony J. "Thrombolysis for deep venous thrombosis." Journal of Vascular Surgery 55, no. 2 (February 2012): 607–11. http://dx.doi.org/10.1016/j.jvs.2011.06.005.
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Renowden, Shelley. "Cerebral venous thrombosis: Local thrombolysis." Journal of the Royal Society of Medicine 93, no. 5 (May 2000): 241–43. http://dx.doi.org/10.1177/014107680009300507.
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Pilger, E., M. Decrinis, A. Obernosterer, and G. Stark. "Thrombolysis in deep venous thrombosis." Vascular Medicine Review vmr-1, no. 2 (September 1990): 167–78. http://dx.doi.org/10.1177/1358836x9000100206.
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Rana, K. G. S., A. Jhamb, Mukul Verma, and Harsh Rastogi. "Thrombolysis for Cerebral Venous Thrombosis." Apollo Medicine 4, no. 1 (March 2007): 69–71. http://dx.doi.org/10.1177/0976001620070114.
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Heidrich, Konau, and Hesse. "Asymptomatic venous thrombosis in cancer patients – a problem often overlooked. Results of a retrospective and prospective study." Vasa 38, no. 2 (May 1, 2009): 160–66. http://dx.doi.org/10.1024/0301-1526.38.2.160.
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Background: Venous thrombosis with and without pulmonary embolism is a frequent complication of malignancies and second among the causes of death in tumour patients. Its incidence is reported to be 10 to 15%. Since for methodological reasons, this rate can be assumed to be too low and to disregard asymptomatic venous thrombosis, a combined retrospective and prospective study was performed to examine the actual frequency of venous thrombosis in tumour patients. Patients and methods: The histories of 409 patients (175 women, 234 men, mean age 69 years [19 to 96 years]) with different tumours, consecutively enrolled in the order of their altogether 426 inpatient treatments, were checked in retrospect for the frequency of venous thrombosis and pulmonary embolism. Subsequently, 97 tumour inpatients (36 women, 61 men, mean age 70 years [42 to 90 years]) were systematically screened, by means of duplex sonography and/or venography, for venous thromboses in the veins of the pelvis and both legs. Results: In the retrospective analysis, where no systematic screening for thromboses was performed and only symptomatic thrombosis was recorded, venous thrombosis was found in 6.6% of all tumour patients, whereas in the prospective examination with systematic duplex sonography and / or venography of all patients, the percentage was 33%. In the prospective study, 31.3% of venous thromboses were symptomatic and 68.7% asymptomatic. In 39.3% of the cases in the retrospective analysis and 25% in the prospective analysis, venous thrombosis occurred during chemotherapy, surgery or radiation therapy. Venous thrombosis was most often seen in metastasizing tumours and in colorectal carcinoma (40%), haematological system diseases (28.6%), gastric cancer (30%), bronchial, pancreas and ovarian carcinoma (28.6%), and carcinoma of the prostate (16.7%). Conclusion: Regular screening for thrombosis is indicated even in asymptomatic tumour patients because asymptomatic venous thrombosis is frequent, can lead to pulmonary embolism and has to be treated like symptomatic venous thrombosis. This is particularly true for metastasization during chemotherapy, surgical interventions, or radiation.
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Mouton, Zehnder, Wagner, and Mouton. "Follow-up after deep venous thrombosis in azygos continuation." Vasa 34, no. 4 (November 1, 2005): 266–68. http://dx.doi.org/10.1024/0301-1526.34.4.266.
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Background: To determine the sequelae of patients after deep venous thrombosis in patients with azygos continuation defined as agenesis of the inferior vena cava with collateral flow. Patients and methods: Five patients post deep venous thrombosis in the context of azygos continuation were followed up clinically and with colour duplex ultrasonography. Results: All five patients had to our knowledge after the initial deep venous thrombosis no further thromboembolic events. Three patients after isolated iliac thromboses are symptom free or nearly symptom free, two after more extended thromboses still suffer from venous claudication. Four patients are without anticoagulation, one patient is permanently orally anticoagulated. Conclusions: Azygos continuation may not influence the risk of recurrent venous thrombo-embolism nor the outcome of a deep venous thrombosis. Careful deep venous thrombosis prophylaxis in patients with azygos continuation may be sufficient when a risk factor is present but conclusions lack due to the small numbers of patients of enough supportive data.
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Stefano, Valerio De, and Ida Martinelli. "Rare thromboses of cerebral, splanchnic and upper-extremity veins." Thrombosis and Haemostasis 103, no. 06 (2010): 1136–44. http://dx.doi.org/10.1160/th09-12-0873.
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SummaryVenous thrombosis typically involves the lower extremity circulation. Rarely, it can occur in the cerebral or splanchnic veins and these are the most frightening manifestations because of their high mortality rate. A third site of rare venous thrombosis is the deep system of the upper extremities that, as for the lower extremity, can be complicated by pulmonary embolism and post-thrombotic syndrome. The authors conducted a narrative review focused on clinical manifestations, risk factors, and treatment of rare venous thromboses. Local risk factors such as infections or cancer are frequent in thrombosis of cerebral or portal veins. Upper extremity deep-vein thrombosis is mostly due to local risk factors (catheter- or effort-related). Common systemic risk factors for rare venous thromboses are inherited thrombophilia and oral contraceptive use; chronic myeloproliferative neoplasms are closely associated with splanchnic vein thrombosis. In the acute phase rare venous thromboses should be treated conventionally with low-molecular-weight heparin. Use of local or systemic fibrinolysis should be considered in the case of clinical deterioration in spite of adequate anticoagulation. Anticoagulation with vitamin K-antagonists is recommended for 3–6 months after a first episode of rare venous thrombosis. Indefinite anticoagulation is recommended for Budd-Chiari syndrome, recurrent thrombosis or unprovoked thrombosis and permanent risk factors. In conclusion, the progresses made in the last couple of decades in diagnostic imaging and the broadened knowledge of thrombophilic abnormalities improved the recognition of rare venous thromboses and the understanding of pathogenic mechanisms. However, the recommendations for treatment mainly derive from observational studies.
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Bick, Rodger L. "Sticky Platelet Syndrome: A Common Cause of Unexplained Arterial and Venous Thrombosis." Clinical and Applied Thrombosis/Hemostasis 4, no. 2 (April 1998): 77–81. http://dx.doi.org/10.1177/107602969800400201.
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Sticky platelet syndrome (SPS) was first described in 1983. However, not until 1995 did the prevalence of SPS receive significant recognition in the medical literature. In 1995 we began to routinely add an SPS evaluation to patients re ferred for assessment for causation of arterial and venous thromboses to a large thrombosis hemostasis referral center. The results of our first 2-year experience suggest SPS to be a common cause of arterial and venous thromboses. With respect to otherwise unexplained venous thrombosis, the prevalence of SPS approximates that of activated protein C resistance (APC- R). During the past 24 months, we have evaluated 153 patients referred for evaluation of unexplained arterial or venous events. An evaluation for common and uncommon blood coagulation protein defects and SPS has been applied to these patients. It has been found that SPS accounted for about 21 % of otherwise unexplained arterial events (acute myocardial infarction, cere brovascular thrombosis, transient cerebral ischemic attacks, retinal thrombosis, and peripheral arterial thrombosis) and ac counted for about 13.2% of otherwise unexplained venous events (deep vein thrombosis, with or without pulmonary em bolus). These findings strongly suggest SPS to be a common cause of arterial and venous thromboses and a workup for SPS should be considered a routine assay in the workup of indi viduals with otherwise unexplained arterial or venous throm botic events. Because treatment with heparin or warfarin will not alleviate the thrombotic tendency of SPS, but simple aspirin therapy almost always will correct the defect and protect the individual from second events, it is particularly important to define the presence of this defect. Key Words: Thrombosis— Platelet defects—DVT—Coronary thrombosis—Cerebral thrombosis—Recurrent miscarriage.
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Teter, Katherine, Frank Arko, Patrick Muck, Patrick J. Lamparello, Minhaj S. Khaja, Bella Huasen, Mikel Sadek, and Thomas S. Maldonado. "Aspiration thrombectomy for the management of acute deep venous thrombosis in the setting of venous thoracic outlet syndrome." Vascular 28, no. 2 (December 31, 2019): 183–88. http://dx.doi.org/10.1177/1708538119895833.
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Objectives Venous thoracic outlet syndrome, known by the eponym Paget–Schroetter syndrome, is seen in healthy, young individuals with “effort-induced thrombosis.” Endovascular therapies, including catheter-directed thrombolysis, have been described in the acute management of the upper extremity deep venous thrombosis; however, we assessed the technical success of treating this entity using a mechanical aspiration thrombectomy system. Methods This was a multi-center retrospective review of patients with venous thoracic outlet syndrome with acute thrombosis treated with the Indigo continuous aspiration mechanical thrombectomy system. Charts from patients with venous thoracic outlet syndrome and acute deep venous thrombosis treated with this system at our institution along with three data sharing locations were reviewed for demographics, deep venous thrombosis risk factors, imaging modalities used for diagnosis, extent of axillosubclavian deep venous thrombosis, treatment details, adjunctive therapies, and complications. The primary outcome was technical success (resolution of >70% of thrombus). Results There were 16 patients (50% male) with a mean age of 33 years (range 17–69 years). Six patients had underlying venous thromboembolism risk factors including use of contraceptives ( n = 2), prior deep venous thrombosis ( n = 3), and known thrombophilia ( n = 1). Fifteen patients had complete venous occlusion, and the extent of venous involvement included subclavian ( n = 14), axillary ( n = 16), and brachial ( n = 7). The majority (81.25%) of patients were treated in a single setting, and technical success was achieved in all cases with the use of adjunctive therapies. Only three patients required additional overnight thrombolytic therapy. Conclusions The Penumbra Indigo system, often in combination with adjunctive catheter-directed thrombolysis and venoplasty, is a safe and effective device for the treatment of acute upper extremity deep venous thrombosis in the setting of Paget–Schroetter syndrome. No patients experienced central embolization or post-operative renal insufficiency. One-third of patients avoided any additional catheter-directed thrombolysis exposure, and technical success was achieved in all cases. A single bleeding complication was observed in a patient undergoing overnight adjunctive catheter-directed thrombolysis. All patients maintained patency until time of first rib resection.
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Kröger, K., C. Schelo, C. Gocke, and G. Rudofsky. "Colour Doppler Sonographic Diagnosis of Upper Limb Venous Thromboses." Clinical Science 94, no. 6 (June 1, 1998): 657–61. http://dx.doi.org/10.1042/cs0940657.
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1. Upper limb venous thromboses are considered to be a rare event, but in large hospitals with a lot of patients who receive aggressive intravenous therapy the number of thromboses seem to increase. 2. We have analysed all the cases of upper limb venous thrombosis which occurred at the Essen University Hospital between the years of 1992–1996. All patients were examined using colour Doppler sonography. 3. Out of 827 patients that were examined, a thrombosis was diagnosed in 334 cases. The subclavian vein was involved in 69% of all thromboses. Isolated jugular vein thrombosis was found in 17% of the thromboses, combined thromboses of the jugular and subclavian vein in 19%. In 182 cases the patients were treated for primarily a malignant illness. In 96 cases we found an association with venous port-systems or central venous catheters. 4. More than 40000 patients a year were treated at the university hospital. Considering this huge number of patients the thrombosis of the upper limb is still rare. The use of colour Doppler sonography allows an early and safe diagnosis of the thrombosis without straining the patient.
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Taha, Mohamed AH, Andrew Busuttil, Roshan Bootun, and Alun H. Davies. "A systematic review of paediatric deep venous thrombolysis." Phlebology: The Journal of Venous Disease 34, no. 3 (June 3, 2018): 179–90. http://dx.doi.org/10.1177/0268355518778660.
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Objectives The aim was to assess the effectiveness and safety of catheter-directed thrombolysis in children with deep venous thrombosis and to evaluate its long-term effect. Method and results EMBASE, Medline and Cochrane databases were searched to identify studies in which paediatric acute deep venous thrombosis patients received thrombolysis. Following title and abstract screening, seven cohort studies with a total of 183 patients were identified. Technical success was 82% and superior in regional rather than systemic thrombolysis (p < 0.00001). One cohort study identified significant difference in thrombus resolution at one year between thrombolytic and anticoagulant groups (p = 0.01). The complication rate was low, with incidence rates of major bleeding, pulmonary embolism and others at 2.8%, 1.8% and 8.4%, respectively. The overall post-thrombotic syndrome rate was 12.7%. The incidence of re-thrombosis ranged from 12.3% to 27%. Conclusion Thrombolysis for paediatric deep venous thrombosis is an effective and relatively safe therapeutic option, lowering the incidence of post-thrombotic syndrome and deep venous thrombosis recurrence.
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Drábková, Lucie. "Cerebral venous thrombosis after caesarean section." Česká gynekologie 86, no. 5 (October 22, 2021): 339–42. http://dx.doi.org/10.48095/cccg2021339.
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Objective: Case report of a patient with cerebral venous thrombosis after caesarean section. Case report: We present a case of a 22-year-old patient after an acute caesarean section, which was complicated by cerebral venous thrombosis. The etiology of the thrombosis was multifactorial. Diagnosis was determined using imaging methods once the neurological symptoms were expressed. Follow-up care for the patient included comprehensive care in the intensive care unit, including a temporary decompresive craniectomy. Conclusion: Cerebral venous thrombosis is a rare disease with a varied clinical manifestation whose development is aff ected by a number of acquired and congenital factors. The incidence is increased in women in the puerperium, but we can also see it in gynecological practice in young contraception users. Contextual knowledge is essential in early dia gnosis as well as using a correct treatment strategy with a multidisciplinary approach and interdisciplinary collaboration. Key words: cerebral venous thrombosis – caesarean section – laparotomy dehiscence – headache
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Dr. Arun kumar.N, Dr Arun kumar N., Dr Ramesh S. S. Dr.Ramesh. S.S, Dr M. M. Basavaraju Dr.M.M.Basavaraju, Dr Mohan kumar V. Dr.Mohan kumar.V, and Dr Shekar M. A. Dr.Shekar.M.A. "Bee sting with cortical venous thrombosis." Indian Journal of Applied Research 4, no. 5 (October 1, 2011): 488–89. http://dx.doi.org/10.15373/2249555x/may2014/152.
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Stephen, James M., and Craig F. Feied. "Venous thrombosis." Postgraduate Medicine 97, no. 1 (January 1995): 36–47. http://dx.doi.org/10.1080/00325481.1995.11945944.
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Shaw, Colette M., Deirdre M. O’Hanlon, and Gerry P. McEntee. "Venous thrombosis." American Journal of Surgery 186, no. 2 (August 2003): 167–68. http://dx.doi.org/10.1016/s0002-9610(03)00184-3.
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Greaves, M. "Venous Thrombosis." Journal of Clinical Pathology 41, no. 3 (March 1, 1988): 358–59. http://dx.doi.org/10.1136/jcp.41.3.358-c.
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Steven, Andrew, Prashant Raghavan, Wilson Altmeyer, and Dheeraj Gandhi. "Venous Thrombosis." Hematology/Oncology Clinics of North America 30, no. 4 (August 2016): 867–85. http://dx.doi.org/10.1016/j.hoc.2016.03.008.
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Strijkers, Rob HW, Mark AF de Wolf, and Cees HA Wittens. "Risk factors of postthrombotic syndrome before and after deep venous thrombosis treatment." Phlebology: The Journal of Venous Disease 32, no. 6 (June 1, 2016): 384–89. http://dx.doi.org/10.1177/0268355516652010.
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Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.
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Comerota, Anthony J., and Vijay Kamath. "Thrombolysis for iliofemoral deep venous thrombosis." Expert Review of Cardiovascular Therapy 11, no. 12 (December 2013): 1631–38. http://dx.doi.org/10.1586/14779072.2013.852955.
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Yadollahikhales, Golnaz, Afshin Borhani-Haghighi, Anahid Safari, Mohammad Wasay, and Randall C.Edgell. "Cerebral venous sinus thrombosis." Galen Medical Journal 5 (May 24, 2016): 48–61. http://dx.doi.org/10.31661/gmj.v5is1.594.
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Cerebral venous thrombosis (CVT) is occlusion of dural sinuses and/or cortical veins due to clot formation. It is a potentially life-threatening condition that requires rapid diagnosis and urgent treatment.Cerebral venous thrombosis is more common in females and young people. Pregnancy, postpartum state, contraceptive pills, infection, malignancy, hyper-coagulable state, rheumatological disorders, trauma are among the major etiologies of cerebral venous thrombosis. Headache, focal neurologic deficits and seizure were the most common clinical presentations. Different techniques of unenhanced and contrast enhanced brain computerized tomography(CT scan) and ,magnetic resonance imaging(MRI) are the most helpful ancillary investigations for diagnosis of Cerebral venous thrombosis.Specific treatment of the underlying cause of cerebral venous thrombosis should be considered as the mainstay of the treatment. Anticoagulation with heparin or low molecular weight heparinoids is the most accepted treatment. In acute phase, medical or surgical management to decrease intracranial pressure (ICP) is also recommended. If the patient's clinical condition aggravates despite adequate anticoagulation, thrombolysis or mechanical thrombectomy can be an additive option.
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Semenov, S. "Thrombosed Cerebral Venous Vessel Recanalization and Radiological Control Methods." Rivista di Neuroradiologia 18, no. 2 (April 2005): 225–30. http://dx.doi.org/10.1177/197140090501800215.
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The last effect of any thrombosis is recanalization. The aim of this study was to investigate the possibility of thrombosed cerebral venous vessels recanalization and the determination of optimal control methods after thrombolytic therapy. A group of 106 patients with adiagnosis of cerebral venous thrombosis after MRI, MR-angiography, ultrasound duplex scanning and CT-angiography underwent dynamic control examinations after thrombolytic therapy. MR-angiography and ultrasound duplex scanning appeared to be satisfactory and effective control methods to disclose thrombosed cerebral venous vessel recanalization. In our study venous vessels were recanalized in 15 cases (14%). The majority of cases of recanalization were revealed in the acute period of thrombosis.
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Mattar, Mervat, Sahar Nassef, Noha M. El Husseiny, Mohamed Abdel Kader Morad, Marwa Salah, Mohamed Roshdy El Masry, and Ahmed Abdul Gawad. "Incidence of Silent Thrombosis in Myeloproliferative Neoplasm Patients below 60 Years : Single Center Egyptian Study." Blood 132, Supplement 1 (November 29, 2018): 5476. http://dx.doi.org/10.1182/blood-2018-99-116025.
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Abstract Background : Identification of JAK-2 mutation even in absence of myeloproliferative disorders was found to be related to venous thromboembolism occurrence. The aim of this work is to screen myeloproliferative neoplasm ( MPN) patients for venous thrombosis and study its correlation with both JAK 2 allele burden and with symptoms the patients presented with. Methods: We enrolled 73 cases with JAK2 positive MPN in the period between August 2015 till Feb 2017. All patients were screened for thrombosis in venous system in neck, upper and lower limbs, superior and inferior Venae Cavae and portal and mesenteric venous systems system using color Doppler Ultrasound. Results: 53 patients (72.6%) were below 60 years. Forty even (64.4%) were females and 26(35%) were males. Twenty two (30%) of cases were Essential Thrombocytosis (ET), 35(248%) were Polycythemia Vera (PV) and 16 (22%) were Myelofibrosis (MF). Twenty seven venous thrombotic attacks were reported in twenty two patients (30.1%). Seventeen patients (23%) had mesenteric and portal vein thrombosis,six patients had iliofemoral (8%) and 4 (5%) had combined lower limb and portal thrombosis. Eight patients (10.8%) had active thrombosis at screening. Only three (4%) patient were symptomatising with pain during screening. Sixteen patients with thrombosis were below 60 (30% of those below 60 years) and 6 were above sixty years (also 30% of those above sixty years). Correlation analysis between JAK2 allele burden and thrombosis was not statistically significant (r=0.3 ,p value=0.5). However, JAK 2 allele burden was statistically higher in those above sixty years in both thrombosed and non-thrombosed cases in comparison to those below sixty years (p= 0.03, 0.017 respectively). The incidence of pruritis (p =0.02) and of abdominal pain (p=0.039) was significantly different between thrombosed and non-thrombosed cases. Comparison of 8 cases with active thrombosis to old thrombosis revealed no statistical difference in the MPN10 score (p>0.05). Conclusion: We recommend routine screen for venous thrombosis in any case of MPNs once diagnosed and screening for MPNs in any case with venous thrombosis . Further research in MPN group age below 60 years of age is highly recommended. Disclosures No relevant conflicts of interest to declare.
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Azamar-Solis, Brizeida, Yahveth Cantero-Fortiz, Juan Carlos Olivares-Gazca, Jesús Mauricio Olivares-Gazca, Gisela Berenice Gómez-Cruz, Iván Murrieta-Álvarez, Guillermo J. Ruiz-Delgado, and Guillermo J. Ruiz-Argüelles. "Primary Thrombophilia in Mexico XIII: Localization of the Thrombotic Events in Mexican Mestizos With the Sticky Platelet Syndrome." Clinical and Applied Thrombosis/Hemostasis 25 (January 1, 2019): 107602961984170. http://dx.doi.org/10.1177/1076029619841700.
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The sticky platelet syndrome (SPS) is a common cause of both arterial and venous thrombosis, being a dominant autosomal disease with qualitative platelet alterations and familial occurrence. It is characterized by platelet hyperreactivity with increased platelet aggregability in response to low concentrations of platelet agonists: epinephrine, adenosine diphosphate, or both. The clinical manifestations involve venous or arterial thrombosis, recurrent pregnancy loss, and fetal growth retardation. To analyze the localization of the thrombotic episodes in a cohort of Mexican mestizo patients with SPS. Between 1992 and 2016, 86 Mexican mestizo patients with SPS as the single thrombophilic condition were prospectively identified; all of them had a history of thrombosis. There were 15 males and 71 females. The thrombotic episodes were arterial in 26 cases and venous in 60 (70%). Arterial thrombosis was mainly pulmonary thromboembolism, whereas venous thromboses were identified most frequently in the lower limbs. Mexican mestizo population with SPS is mainly female; the type I of the condition is the most frequent; both arterial and venous thrombosis can occur, and they are mainly pulmonary embolism and lower limbs venous thrombosis, respectively.
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Smalberg, Jasper H., Manon V. M. C. W. Spaander, Kon-Siong G. Jie, Peter M. T. Pattynama, Henk R. van Buuren, Bart van den Berg, Harry L. A. Janssen, and Frank W. G. Leebeek. "Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis." Thrombosis and Haemostasis 100, no. 12 (2008): 1084–88. http://dx.doi.org/10.1160/th08-01-0015.
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SummaryTranscatheter local thrombolytic therapy in patients with acute, extended splanchnic venous thrombosis is controversial. Here we present our single-center experience with transcatheter thrombolytic therapy in these patients. All consecutive patients (n=12) with acute,extended splanchnic venous thrombosis who underwent transcatheter thrombolytic therapy in our hospital, were included in this study. Thrombolytic therapy was successful for three thrombotic events and partially successful for four thrombotic events.Two patients developed minor procedure-related bleeding (17%).Six patients (50%) developed major procedure-related bleeding, with a fatal outcome in two. Transcatheter thrombolytic therapy in patients with acute, extended splanchnic vein thrombosis is found to be associated with a high rate of procedure-related bleeding. Therefore, thrombolysis should be reserved for patients in whom the venous flow cannot be restored by using conventional anticoagulant therapy or stent placement across the thrombosed vessel segment.H.L.A. Janssen and F.W.G. Leebeek are both Clinical Fellows of the Netherlands Organisation for Scientific Research (NWO).
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Philips, Matthew F., Linda J. Bagley, Grant P. Sinson, Eric C. Raps, Steven L. Galetta, Eric L. Zager, and Robert W. Hurst. "Endovascular thrombolysis for symptomatic cerebral venous thrombosis." Journal of Neurosurgery 90, no. 1 (January 1999): 65–71. http://dx.doi.org/10.3171/jns.1999.90.1.0065.
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Object. The authors sought to treat potentially catastrophic intracranial dural and deep cerebral venous thrombosis by using a multimodality endovascular approach.Methods. Six patients aged 14 to 75 years presented with progressive symptoms of thrombotic intracranial venous occlusion. Five presented with neurological deficits, and one patient had a progressive and intractable headache. All six had known risk factors for venous thrombosis: inflammatory bowel disease (two patients), nephrotic syndrome (one), cancer (one), use of oral contraceptive pills (one), and puerperium (one). Four had combined dural and deep venous thrombosis, whereas clot formation was limited to the dural venous sinuses in two patients. All patients underwent diagnostic cerebral arteriograms followed by transvenous catheterization and selective sinus and deep venous microcatheterization. Urokinase was delivered at the proximal aspect of the thrombus in dosages of 200,000 to 1,000,000 IU. In two patients with thrombus refractory to pharmacological thrombolytic treatment, mechanical wire microsnare maceration of the thrombus resulted in sinus patency. Radiological studies obtained 24 hours after thrombolysis reconfirmed sinus/vein patency in all patients. All patients' symptoms and neurological deficits improved, and no procedural complications ensued. Follow-up periods ranged from 12 to 35 months, and all six patients remain free of any symptomatic venous reocclusion. Factors including patients' age, preexisting medical conditions, and duration of symptoms had no statistical bearing on the outcome.Conclusions. Patients with both dural and deep cerebral venous thrombosis often have a variable clinical course and an unpredictable neurological outcome. With recent improvements in interventional techniques, endovascular therapy is warranted in symptomatic patients early in the disease course, prior to morbid and potentially fatal neurological deterioration.
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Bregel, L. V., O. S. Efremova, M. M. Kostik, N. Yu Rudenko, T. S. Korinets, N. S. Drantusova, A. O. Barakin, et al. "MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN ASSOCIATED WITH COVID-19 AND COMPLICATED BY VENOUS AND ARTERIAL THROMBOSES: A SERIES OF CLINICAL CASES." Pediatria. Journal named after G.N. Speransky 103, no. 3 (June 14, 2024): 56–70. http://dx.doi.org/10.24110/0031-403x-2024-103-3-56-70.
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SARS-CoV-2 causative agent may result in adulthood in hyperinflammatory syndrome and cytokine storm in some patients leading to the microvascular bed thromboses as well as those of large venous and arterial vessels. In the COVID-19 critical form, multisystem inflammatory syndrome in children (MIS-C), thromboses are less common. Authors represent a series of 8 patients’ cases with both thromboses and MIS-C associated with COVID-19 of different localization hospitalized in Nov. 2020-Nov. 2022 aged 4 months to 17 years old (Me 7.5 y/o): 4 aged 4 m/o to 5 y/o and 4 aged 8 to 17 y/o; 6 boys/2 girls. The incidence of thromboses was 13.3% (8/60 pediatric patients with MIS-C); venous thrombosis occurred in 6 (10% of 60), arterial thrombosis in 4 (6.6%), large cerebral vessels thrombosis coupled with the development of bilateral stroke occurred in 2 (3.3%), secondary thrombotic microangiopathy (TMA) in 3 (5%), distal gangrene in a single case (1.7%) and the cerebral venous sinus thrombosis in a single case (1.7%) as well. Treatment was carried out with anticoagulants, aspirin, immunomodulators (intravenous immunoglobulin, glucocorticosteroids, genetically engineered biological drugs). One of 8 patients with thromboses had died from pulmonary embolism (1.7% among all 60 patients with MIS-C), 6 of the 7 survivors continue to be followed up without complications and a single patient continues to have residual severe neurological deficits. Conclusion: venous thrombosis, secondary TMA and large cerebral arteries thrombosis predominated. Treatment of thrombosis with unfractionated heparin intravenously by continuous infusion with a transition to low molecular weight heparins against the background of pathogenetic therapy for MIS-C with immunomodulators was effective in most patients. Acetylsalicylic acid was used in 3 (with coronary dilatation and/or absence of severe thrombocytopenia). Risk factors for thromboses were male gender, severe congenital underlying diseases.
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Haas, Sylvia. "Management of venous thromboembolism." Hämostaseologie 18, no. 01 (January 1998): 18–26. http://dx.doi.org/10.1055/s-0038-1655324.
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SummaryThe therapy of deep venous thrombosis consists of several elements and depends on the localization, the age and the extent of the thrombus. In addition, the patient’s age and the life expectancy may influence the modality of treatment. The present overview discusses various types of initial therapy and long-term treatment of venous thromboembolism and also reviews future perspectives of pharmacological treatment. The initial treatment regimens comprise thrombolysis, thrombectomy, inferior vena cava filters and the anticoagulation with either unfractionated heparin or low molecular weight heparins. Thrombolysis is only effective in the initial phase of acute thromboembolic disorders, and the potential benefits must be balanced against the risk of hemorrhage. In the case of totally occlusive venous thrombosis, a successful outcome is more likely if the thrombolytic agent is infused into the thrombus via catheter directed thrombolysis. Thrombectomy should be considered in patients with acute iliofemoral venous thrombosis of less than seven days duration and a life expectancy of more than ten years. A filter device should be inserted in the inferior vena cava in patients with venous thrombosis above the knee when anticoagulation is contraindicated or when adequate anticoagulation fails to prevent recurrent embolism. The intravenous administration of unfractionated heparin has been the modality of choice for initial treatment of venous thromboembolism during several decades, however, this type of therapy requires an aPTT-adjusted dosing due to a broad interindividual variation of laboratory results. Numerous clinical trials have provided firm evidence that low molecular weight heparins given subcutaneously are significantly superior to intravenous, unfractionated heparin with regard to thrombus regression and reductions of severe hemorrhages, mortality and recurrent thromboembolism. Thus, these preparations may become the treatment of choice in the near future. Pulmonary embolism may be treated with low molecular weight heparins as well.Long-term treatment of venous thromboembolism is usually performed with oral anticoagulants. The recommended therapeutic range is an INR of 2.0 to 3.0, however the optimal duration of oral anticoagulant therapy for patients with acute proximal deep venous thrombosis is uncertain.Various thrômbin-inhibitors have been tested for initial treatment of thrombosis, however further investigations of their efficacy, safety and cost-effectiveness will have to provide firm evidence on their superiority when compared to unfractionated or low molecular weight heparins.
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Mirza, Aram Jamal, and Abdulsalam Yaseen Taha. "Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq." Journal of the Faculty of Medicine Baghdad 63, no. 2 (July 13, 2021): 74–79. http://dx.doi.org/10.32007/jfacmedbagdad.6321822.
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Abstract
As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onset of thromboses, they were successfully managed by catheter directed thrombolysis (CDT) using tissue plasminogen activator (tPA). Owing to the increased morbidity and mortality of vascular thrombosis, there is a need to identify COVID-19 patients who need prophylaxis and prescribe them the right prophylactic drug (s). The excellent outcome of CDT in these two patients, from Sulaymaniyah/Iraq, supports the use of this treatment modality as a valid, safe and effective option for acute arterial and venous thromboses.
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Oliveira, Nelson, Emanuel Dias, Ricardo Lima, Fernando Oliveira, and Isabel Cássio. "Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient." Case Reports in Medicine 2011 (2011): 1–5. http://dx.doi.org/10.1155/2011/123041.
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Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging.Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation.Phlegmasia alba dolensinstalled progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy.Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.
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Schmidt, Barbara, and Maureen Andrew. "Neonatal Thrombosis: Report of a Prospective Canadian and International Registry." Pediatrics 96, no. 5 (November 1, 1995): 939–43. http://dx.doi.org/10.1542/peds.96.5.939.
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Objective. We sought to obtain representative data on the risk factors, diagnosis, current management, and short-term outcome of neonatal thrombosis. Research Design. A case registry was established at McMaster University. Standardized questionnaires were mailed to collaborators at participating centers every 4 to 6 months. Setting. Eighty-five level III and modified level II neonatal units in North America, Europe, and Australia were invited to join the registry. Patients. Eligible infants were born between January 1990 and June 1993. Large-vessel thrombosis was diagnosed during the first month of life or up to 44 weeks post-conception after premature birth. The clinical impression of thrombotic vessel obstruction was confirmed using at least one imaging technique. Results. Physicians in 64 centers expressed their willingness to participate. A total of 97 cases (excluding stroke) were registered from 29 centers. Spontaneous renal venous thrombosis (n = 21) was diagnosed at a median age of 2 days. The other venous (n = 39), arterial (n = 33), and mixed (n = 4) thromboses presented later; 89% of them were associated with an intravascular catheter and 29% with systemic infection. Doppler ultrasonography was the definitive diagnostic test in 68% of cases; contrast angiography was performed infrequently (14%). A third of all patients (but 62% of infants with renal venous thrombosis) received supportive therapy only. Thrombolytic agents were prescribed for 28% of catheter-associated venous thromboses and 30% of all arterial thromboses. The remainder of the patients were given heparin. Most patients (82%) survived to hospital discharge. Mortality rates were highest among infants with aortic thrombosis or central venous line-associated thrombosis affecting the right atrium or the superior vena cava (33%). Conclusions. Neonatal thrombosis is diagnosed fairly rarely. With the exception of spontaneous renal venous thrombosis, almost all cases are associated with indwelling catheters. Doppler ultrasound techniques are the most popular means of confirming the diagnosis in virtually all centers. Treatment varies greatly among different centers, probably because of the lack of scientific evidence about the optimum management of affected infants.
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Altunayoglu, Vildan, Suleyman Turedi, Abdulkadir Gunduz, Yunus Karaca, and Remzi Adnan Akdogan. "Cerebral venous thrombosis and hepatic venous thrombosis during pregnancy." Journal of Obstetrics and Gynaecology Research 33, no. 1 (February 2007): 78–82. http://dx.doi.org/10.1111/j.1447-0756.2007.00479.x.
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&NA;. "Cerebral Venous Thrombosis and Hepatic Venous Thrombosis During Pregnancy." Ultrasound Quarterly 23, no. 2 (June 2007): 152–53. http://dx.doi.org/10.1097/01.ruq.0000277022.69640.b7.
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Laurin, S., and N. R. Lundström. "Venous Thrombosis after Cardiac Catheterization in Infants." Acta Radiologica 28, no. 3 (May 1987): 241–46. http://dx.doi.org/10.1177/028418518702800304.
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Factors influencing the rate of post-catheterization venous thrombosis were studied in 180 infants below one year of age. The initial cardiac catheterization was performed either with ***cut-down technique or percutaneously. At repeat catheterization on the ipsilateral side presence or absence of thrombosis was noted. The overall thrombosis frequency was higher than previously reported, 15.6 per cent. The rate increased with decreasing weight. An increased rate of thrombosis was also found with indwelling femoral vein catheter left in place for more than 24 hours, and infection. In 6 cases, thrombosis involved only the catheterized side and would have been missed by recatheterization from the contralateral side. It was noteworthy that 9 of the thromboses spared the catheterized vessel and engaged only the vena cava. Among factors not influencing thrombosis rate were age, type of cardiac malformation, cyanosis, early operation, catheterization time or balloon septostomy. Percutaneous or ***cut-down technique did not influence thrombosis rate.
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Wever, M. L. G., K. D. Liem, W. B. Geven, and R. B. Tanke. "Urokinase Therapy in Neonates with Catheter Related Central Venous Thrombosis." Thrombosis and Haemostasis 73, no. 02 (1995): 180–85. http://dx.doi.org/10.1055/s-0038-1653748.
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SummaryThe results of fibrinolytic therapy with urokinase were evaluated in 26 neonates with catheter related central venous thrombosis. Complete thrombolysis could be achieved in 13 patients (50%), partial thrombolysis in 3 patients (12%). No effect was seen in 10 patients (38%). Therapy success was influenced by age, size and location of the thrombus. Coincidence of infection occurred in 16 patients (62%). Mild hemorrhagic complications were seen in 2 patients (8%), no other significant side effects were observed. Nine patients with residual thrombosis were treated with oral anticoagulants following urokinase resulting in resolution of the thrombus in 6 patients within 3 months (67%). The incidence of asymptomatic recurrent thrombosis was high (28%). Urokinase might be an effective and safe treatment for central venous thrombosis in neonates. Prophylactic antibiotic therapy during the infusion of urokinase and long-term treatment with oral anticoagulants after thrombosis are advisable. Early detection of thrombosis might enhance the success rate of fibrinolytic therapy. Therefore, we strongly recommend routine echocardiographic screening of central venous catheters.
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Cancer, Susana, Salvador Luján, and Enrique Puras. "Intraoperative Venous Balloon Angioplasty during Surgical Thoracic Outlet Decompression in Paget-Schrötter Syndrome." Vascular 12, no. 2 (March 2, 2004): 136–39. http://dx.doi.org/10.1258/rsmvasc.12.2.136.
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The management of primary subclavian-axillary vein thrombosis is controversial. Indications and time of operative or endovascular intervention after successful thrombolysis remain unresolved. To improve the long-term functional outcomes in patients with primary subclavian-axillary vein thrombosis, early reestablishment of venous patency and prevention of recurrent thrombosis are required. We present a case in which, after catheter-directed thrombolysis, positional venography showed costoclavicular compression of the subclavian vein. At the time of surgical thoracic outlet decompression, transluminal venous angioplasty was performed.
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Demey, Hendrik E., Guy Lambrecht, Greta Moorkens, Peter Michielsen, Jef Van Den Ende, and Leo L. Bossaert. "Thrombolysis in Central Splanchnic Thrombosis." Journal of Intensive Care Medicine 12, no. 5 (September 1997): 269–75. http://dx.doi.org/10.1177/088506669701200508.
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We present 4 patients treated with streptokinase for different forms of abdominal venous thrombosis. Two patients suffered from central splanchnic venous thrombosis (superior mesenteric vein and bilateral iliac veins in Patient A, portal and superior mesenteric veins in Patient B). Both patients' presenting complaint was abdominal pain. In both, a temporary infection-associated circulating lupus anticoagulant presumably caused this condition. Two other patients presented with isolated portal vein thrombosis without lupus anticoagulant. Thrombolysis with high dose streptokinase (9 MU over 6 hours) successfully reopened the veins involved in all 4 patients. A literature survey showed that thrombolysis is a therapeutic option for mesenteric vein thrombosis, but there was no consensus on which thrombolytic drug should be given or on method of administration.
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Zhou, Wei, Lorraine Choi, Peter H. Lin, Alan Dardik, Andrea Eraso, and Alan B. Lumsden. "Percutaneous Transhepatic Thrombectomy and Pharmacologic Thrombolysis of Mesenteric Venous Thrombosis." Vascular 15, no. 1 (February 2007): 41–45. http://dx.doi.org/10.2310/6670.2007.00013.
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Mesenteric venous occlusion is a rare yet highly morbid condition that is traditionally treated with anticoagulation while surgery serves as the last resort. Percutaneous intervention provides an effective option with relatively low mortality and morbidity. We herein describe use of transhepatic percutaneous thrombectomy and pharmacologic thrombolysis in treating two cases of symptomatic mesenteric venous thrombosis. These cases underscore the fact that transhepatic thrombectomy and thrombolysis are a highly effective strategy for treating acute symptomatic mesenteric venous thrombosis. Several percutaneous techniques are also reviewed.
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Johansen, Michelle C., Rebecca F. Gottesman, and Victor C. Urrutia. "Cerebral venous thrombosis." Neurology: Clinical Practice 10, no. 2 (May 17, 2019): 115–21. http://dx.doi.org/10.1212/cpj.0000000000000670.
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BackgroundPlasma cardiac troponin (cTn) elevation occurs in acute ischemic stroke and intracranial hemorrhage and can suggest a poor prognosis. Because acute cerebral venous thrombosis (CVT) might lead to venous stasis, which could result in cardiac stress, it is important to evaluate whether cTn elevation occurs in patients with CVT.MethodsInpatients at Johns Hopkins Hospital from 2005 to 2015 meeting the following criteria were included: CVT (ICD-9 codes with radiologic confirmation) and available admission electrocardiogram (ECG) and cTn level. In regression models, presence of ECG abnormalities and cTn elevation (>0.06 ng/mL) were evaluated as dependent variables in separate models, with location and severity of CVT involvement as independent variables, adjusted for age, sex, and hypertension.ResultsOf 81 patients with CVST, 53 (66%) met the inclusion criteria. Participants were, on average, aged 42 years, white (71%), and female (66%). The left transverse sinus was most commonly thrombosed (47%), with 66% having >2 veins thrombosed. Twenty-two (41%) had cTn elevation. Odds of cTn elevation increased per each additional vein thrombosed (adjusted OR 2.79, 95% CI [1.08–7.23]). Of those with deep venous involvement, 37.5% had cTn elevation compared with 4.4% without deep clots (p = 0.02). Venous infarction (n = 15) was associated with a higher mean cTn (0.14 vs 0.02 ng/mL, p = 0.009) and was predictive of a higher cTn in adjusted models (β = 0.15, 95% CI [0.06–0.25]).ConclusionsIn this single-center cohort study, markers of CVT severity were associated with increased odds of cTn elevation; further investigation is needed to elucidate causality and significance.
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Kazmers, Andris, Harvey Groehn, and Chris Meeker. "Do Patients with Acute Deep Vein Thrombosis Have Fever?" American Surgeon 66, no. 6 (June 2000): 598–601. http://dx.doi.org/10.1177/000313480006600615.
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The purpose of this study was to determine whether those with lower extremity acute venous thrombosis have fever. During a recent 14.5-month period, 1847 patients undergoing lower extremity venous duplex scanning also had their oral temperature measured using a digital thermometer at the time of duplex examination. Patients were 57.8 ± 17.3 years of age (range, 14 to 99). Temperature was 98.5 ± 1.1° F. Twenty-three patients had acute inferior vena cava thrombosis, 60 had acute iliac vein thrombosis, 138 had acute femoral venous thrombosis, and 131 had acute popliteal venous thrombosis. Calf vein thromboses were present in 102 patients, and 43 patients had superficial venous thrombosis. A total of 228 patients had acute lower extremity venous thrombosis in one or more of these venous segments. Temperature with acute lower extremity venous thrombosis was 98.7 ± 1.05° F versus 98.5 ± 1.10° F in those with no acute thrombosis. Although small, this temperature difference was statistically significant ( P < 0.02). Acute deep venous thrombosis (DVT) was defined as acute popliteal or more proximal femoral, iliac, or vena cava thrombosis. The temperature for the 175 patients with acute DVT was 98.7 ± 1.10° F versus 98.5 ± 1.10° F for those without DVT ( P < 0.035). There was no temperature that served to accurately differentiate those who did from those who did not have DVT. The frequency that patients with DVT had fever, defined as a temperature ≥100° F, was 9.1 per cent (16 of 175) with DVT versus 7.5 per cent (126 of 1678) without DVT (not significant). In the subgroup with a temperature ≥101° F, 4.6 per cent (8 of 175) with DVT had such a fever versus 3.4 per cent (57 of 1672) without DVT (not significant). Those undergoing venous duplex who were found to have acute lower extremity venous thrombosis, including acute DVT, had statistically higher temperatures, but such temperature differences were minimal. The incidence of fever, defined as a temperature ≥100° F or ≥101° F, was not different between those with and those without acute DVT. It appears that the presence of fever may not be a sensitive or specific indicator for the presence of underlying acute DVT.
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Nezi-Cahn, Sandra, Isabel Sicking, Kathrin Almstedt, Marco Battista, Anne-Sophie Heimes, Slavomir Krajnak, Joscha Steetskamp, Annette Hasenburg, and Marcus Schmidt. "Risk Factors for Chemotherapy-Associated Venous Thromboses in Gynaecological Oncology Patients." Geburtshilfe und Frauenheilkunde 79, no. 10 (June 5, 2019): 1100–1109. http://dx.doi.org/10.1055/a-0834-6468.
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Abstract Introduction Venous thromboses and their consequences are among the main causes of death in patients with tumour diseases. The objective of this study is the analysis of risk factors and the evaluation of the applicability of two risk scores in a purely gynaecological oncology patient collective. The identification of patients at high risk for the occurrence of venous thromboses could enable the implementation of targeted medication-based thrombosis prophylaxis which has a significant benefit and, simultaneously, a low risk. Materials and Methods A retrospective case-control study on 152 patients who were undergoing oncological treatment in the Department of Gynaecology of the Mainz University Medical Centre between 2006 and 2013 investigated the data from 104 patients with breast, 26 with ovarian and 22 with cervical cancer. A control was assigned to 76 subjects in the case group who suffered a venous thrombosis during chemotherapy and this control coincided in the points of tumour location, age, lymph node involvement, metastasis and time of initial diagnosis. The group differences were analysed using the χ2 test, t test, Mann-Whitney-U test and a logistic regression analysis. Results There were clear group differences in the lack of inpatient thrombosis prophylaxis (p = 0.014), elevated leukocyte counts (p = 0.018) prior to the start of chemotherapy and port systems (p = 0.032). Surgical interventions were confirmed to be an independent risk factor (p ≤ 0.001). The Khorana and Protecht scores did not emerge from the analysis as independent predictors for a thrombosis. More patients died in the case group than in the control group (p = 0.028; OR: 8.1; CI: 1.254 – 52.162). Conclusion In this patient collective, surgeries represent an independent risk factor for venous thromboses. In addition, a correlation was seen between inpatient thrombosis prophylaxis, leukocytosis as well as port systems and an increased risk of thrombosis. Neither the Khorana nor the Protecht score were independent risk factors for venous thromboses. Significantly more thrombosis patients died during the observation period.
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Fink, John N., and David L. McAuley. "Lateral venous sinus thrombosis associated with MRI abnormalities in the mastoid air sinus." Stroke 32, suppl_1 (January 2001): 347. http://dx.doi.org/10.1161/str.32.suppl_1.347-a.
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P45 Background: Lateral venous sinus thrombosis can be associated with mastoiditis. We encountered several cases of lateral sinus thrombosis associated with MRI abnormalities in the ipsilateral mastoid air sinus that had no clinical evidence of mastoiditis. The relationship between lateral sinus thrombosis and mastoid abnormalities was evaluated systematically. Method: The clinical records and radiology of all adult cases of cerebral venous sinus thrombosis (CVT) diagnosed or treated at Auckland Hospital 1990–1999 were reviewed retrospectively. Results: Twenty-six cases of CVT were identified. Thrombosis was present in 23 lateral sinuses in 20 cases. Mastoid abnormalities were detected ipsilateral to nine of 23 thrombosed lateral sinuses (39%) and were associated with none of 29 unaffected lateral sinuses (p<0.001). Clinical evidence of mastoiditis was not present in any case. One case with mastoid abnormality and lateral sinus thrombosis received antibiotics; eight did not. All made uneventful recoveries. Reversal of the MRI abnormality after anticoagulation but without antibiotic treatment was demonstrated. Conclusion: Lateral venous sinus thrombosis is commonly associated with ipsilateral MRI abnormalities in the mastoid air sinus. These abnormalities are most likely to be due to venous congestion as a consequence of venous thrombosis and do not inevitably represent infective mastoiditis. Patients presenting with lateral sinus thrombosis and mastoid congestion should have a thorough clinical assessment for the presence of mastoiditis. When there is no clinical evidence of infection, treatment should be directed at the underlying cerebral venous thrombosis; additional treatment with antibiotics is not required.
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Sloot, S., J. Van Nierop, JJ Kootstra, C. Wittens, and WM Fritschy. "Bilateral catheter-directed thrombolysis in a patient with deep venous thrombosis caused by a hypoplastic inferior vena cava." Phlebology: The Journal of Venous Disease 30, no. 4 (February 13, 2014): 293–95. http://dx.doi.org/10.1177/0268355514524194.
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Introduction Deep venous thrombosis treatment using catheter-directed thrombolysis is advocated over systemic thrombolysis because it reduces bleeding complications. With the development of a catheter that combines ultrasound vibrations and the local delivering of thrombolytics, new and safer treatments appear that are suitable for more complex problems. Report An adolescent male presented with bilateral iliofemoral thrombosis based on a hypoplastic inferior vena cava that had existed for more than two weeks. He was succesfully treated by bilateral ultrasound-accelerated catheter-directed thrombolysis using EkoSonic® (Small Vessel) Endovascular System (EKOS) and stenting of the inferior vena cava. After eight months of follow-up, the inferior vena cava is still patent. Conclusion EKOS thrombolysis of longer existing bilateral deep venous thrombosis in the central venous system is a succesful treatment modality in congenital inferior vena cava anomalies.
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Chiasakul, Thita, and Kenneth A. Bauer. "Thrombolytic therapy in acute venous thromboembolism." Hematology 2020, no. 1 (December 4, 2020): 612–18. http://dx.doi.org/10.1182/hematology.2020000148.
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Abstract Although anticoagulation remains the mainstay of treatment of acute venous thromboembolism (VTE), the use of thrombolytic agents or thrombectomy is required to immediately restore blood flow to thrombosed vessels. Nevertheless, systemic thrombolysis has not clearly been shown to improve outcomes in patients with large clot burdens in the lung or legs as compared with anticoagulation alone; this is in part due to the occurrence of intracranial hemorrhage in a small percentage of patients to whom therapeutic doses of a thrombolytic drug are administered. Algorithms have been developed to identify patients at high risk for poor outcomes resulting from large clot burdens and at low risk for major bleeding in an effort to improve outcomes in those receiving thrombolytic therapy. In acute pulmonary embolism (PE), hemodynamic instability is the key determinant of short-term survival and should prompt consideration of immediate thrombolysis. In hemodynamically stable PE, systemic thrombolysis is not recommended and should be used as rescue therapy if clinical deterioration occurs. Evidence is accumulating regarding the efficacy of administering reduced doses of thrombolytic agents systemically or via catheters directly into thrombi in an effort to lower bleed rates. In acute deep venous thrombosis, catheter-directed thrombolysis with thrombectomy can be used in severe or limb-threatening thrombosis but has not been shown to prevent postthrombotic syndrome. Because the management of acute VTE can be complex, having a rapid-response team (ie, PE response team) composed of physicians from different specialties may aid in the management of severely affected patients.
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Fukushima, Yoshihisa, Kenji Takahashi, and Ichiro Nakahara. "Successful endovascular therapy for cerebral venous sinus thrombosis accompanied by heparin-induced thrombocytopenia." Interventional Neuroradiology 26, no. 3 (March 1, 2020): 341–45. http://dx.doi.org/10.1177/1591019919887821.
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Introduction Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin exposure. A limited number of studies have reported cerebral venous sinus thrombosis accompanied by heparin-induced thrombocytopenia. Here, we present a case of successful endovascular therapy (EVT) without periprocedural heparinization in this situation. Case presentation A 47-year-old woman taking an oral contraceptive was admitted to our hospital with severe headache to be diagnosed as cerebral venous sinus thrombosis. Initially, she got improved by medical treatment with intravenous unfractionated heparin. However, she rapidly developed disturbance of consciousness and right hemiplegia due to cerebral venous sinus thrombosis accompanied by heparin-induced thrombocytopenia on the 14th hospital day. She underwent emergent EVT by immediate conversion of anticoagulation from heparin to argatroban. Despite a large clot burden, sufficient recanalization and anterograde venous drainage were re-established by combined EVT including aspiration, balloon sinoplasty, and local thrombolysis with urokinase infusion. She got improved immediately after the intervention and discharged home without any neurological sequelae after two months. Conclusion This unique case of cerebral venous sinus thrombosis worsened by occurrence of heparin-induced thrombocytopenia during the treatment finally resulted in excellent outcome highlights effectiveness of emergent endovascular intervention for critical cerebral venous sinus thrombosis resistant to initial medical treatment and of immediate establishment of effective anticoagulant strategy for both of heparin-induced thrombocytopenia and cerebral venous sinus thrombosis. Neuroendovascular therapy for cerebral venous sinus thrombosis using alternative argatroban to heparin for periprocedural anticoagulation might be safe and feasible.
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Green, David. "Risk of future arterial cardiovascular events in patients with idiopathic venous thromboembolism." Hematology 2009, no. 1 (January 1, 2009): 259–66. http://dx.doi.org/10.1182/asheducation-2009.1.259.
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Abstract Venous and arterial thromboses have traditionally been considered distinct pathophysiologic entities. However, the two disorders have many features in common, and there is evidence that persons with venous thrombosis may be at greater risk for arterial events. The pathogenesis of both disorders includes endothelial injury, platelet activation, elevated levels of intrinsic clotting factors and inflammatory markers, increased fibrinogen, and impaired fibrinolysis. In addition, older age, obesity, dyslipidemia, and smoking predispose to both venous and arterial thrombosis. While the evidence that arterial disease is a risk factor for venous thrombosis is inconclusive, arterial disease does appear to occur with a modestly increased frequency in patients with a history of venous thromboembolism. Reported odds ratios in such patients were 1.2 for myocardial infarction, 1.3 for stroke, 2.3 for carotid plaque, and 4.3 for coronary calcification. Of note, in persons under age 40 with unprovoked venous thrombosis, the odds ratio for acute myocardial infarction was as high as 3.9. In general, however, venous disease is considered to be a weak risk factor for arterial thrombosis, and the use of agents specifically targeted to the prevention of heart attack or stroke in the majority of persons with VTE cannot be recommended at present.
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Rahman, Maryam, Gregory J. Velat, Brian L. Hoh, and J. Mocco. "Direct thrombolysis for cerebral venous sinus thrombosis." Neurosurgical Focus 27, no. 5 (November 2009): E7. http://dx.doi.org/10.3171/2009.7.focus09146.
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Cerebral venous sinus thrombosis (CVST) is an increasingly diagnosed disease with a wide range of symptoms, ranging from a mild headache to cerebral herniation. A potentially devastating syndrome, CVST has been associated with a mortality rate of 6–10%. In prospective studies, the overall rate of death and dependency from CVST ranges from 8.8 to 44.4%. Systemic anticoagulation remains the first-line treatment. However, a percentage of patients deteriorate despite medical therapy. These cases have resulted in the development of thrombolysis or endovascular treatment for CVST. Initial reports of the use of endovascular treatment of CVST have been promising. However, enthusiasm for the use of endovascular thrombolysis and thrombectomy should be tempered by an understanding of possible risks such as intracerebral hemorrhage and/or vessel dissection. The authors review the literature regarding endovascular treatment of CVST with a description of the chemical and mechanical thrombolytic techniques.
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Semba, Charles P., Mahmood K. Razavi, Stephen T. Kee, Daniel Y. Sze, and Michael D. Dake. "Thrombolysis for lower extremity deep venous thrombosis." Techniques in Vascular and Interventional Radiology 7, no. 2 (June 2004): 68–78. http://dx.doi.org/10.1053/j.tvir.2003.12.001.
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