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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the past ten years, we have observed 407 patients with thrombophlebitis using a standardized outpatient regimen including subcutaneously self-administered heparin therapy. A definite protocol for tapering and discontinuing anticoagulants was applied which allows a correlation between duration of heparin administration, decreasing heparin resistance and symptomatic improvement. In acute and subacute thrombophlebitis, this method induced symptomatic resolution within less than two months in half of the patients and within less than six months in 78%. The number of recurrences during the follow-up period was acceptable and the frequency of complications minimal. We conclude that, except in the most severe, toxic instances of thrombophlebitis or in suspected pulmonary embolism, hospitalization--complete bedrest and intravenously administered anticoagulants--is unnecessary and wasteful.
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PMID:A ten year study of heparin therapy for thrombophlebitis in ambulatory patients. 87 37

Ligation of some major veins can produce deleterious effects. Based on clinical and experimental research, there is a recent increased interest in repairing injured veins. Despite remaining limitations, successful venous repair has been possible without complications of thrombophlebitis or pulmonary embolism.
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PMID:Venous trauma: successful venous reconstruction remains an interesting challenge. 88 36

The Doppler Ultrasonic Velocity Detector has been shown to be of significant value in the evaluation of patients with suspected deep venous thrombosis. Our experience in 121 patients demonstrates a false-negative rate of 10% for "minimal" thrombophlebitis and 3.2% for ileofemoral thrombosis when the Doppler was used as a diagnostic aid. Since ileofemoral thrombosis represents the greatest threat to the patient in terms of pulmonary embolism, this appears to be a sensitive and specific technic for the detection of ileofemoral thrombosis.
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PMID:Practical role for ultrasound in diagnosis of deep venous thrombosis of lower extremities. 89 21

A 20-year-old man with a known history of thrombophlebitis experienced massive pulmonary embolism with hypoxia and shock. Embolectomy was performed with hyperbaric oxygenation for cardiopulmonary support. Ligation of the inferior vena cava was required postoperatively to prevent further embolism. Hyperbaric oxygenation is an effective method of cardiopulmonary support for pulmonary embolectomy.
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PMID:Pulmonary embolism: surgery in a hyperbaric chamber. 95 48

Forty-two months follow-up examinations on 30 total knee arthroplasties revealed the following significant complications: phlebothrombosis, 13 knees (46%); pulmonary embolism 3 patients (11%); asymptomatic loosening, 8 knees (11.4%); symptomatic loosening, 3 knees (4.8%); superficial infections, 4 knees (5.4%); deep infections, 4 knees (5.4%); peroneal palsy, 3 patients (4.3%). Early detection of thrombophlebitis by 125I fibrinogen scan and possible aspirin prophylaxis were evaluated. In view of the limited number of encouraging results, e.g. excellent 58.6 per cent; good 28.5 per cent; fair 5.4 per cent and poor 7.1 per cent, caution is advocated until extensive time elapses for more clinical experience with total knee arthroplasty.
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PMID:Complications following total knee replacement. 99

A case is reported in which anticoagulant therapy for thrombophlebitis and pulmonary embolism produced bilateral massive intrarenal hematomas (pseudotumors). The role of radiologic investigation (nephrotomography, renal scan and selective high dose arteriography) was found to identify and localize the intrarenal hematomata and exclude underlying renal pathology. Although an abnormal kidney is more likely to bleed, this case presentation demonstrates that even carefully monitored anticoagulation within the therapeutic range can induce massive intrarenal hemorrhage in previously normal kidneys. The renal architecture returned to normal on late follow-up examination on simple conservative management.
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PMID:Bilateral intrarenal hematomas from anticoagulants. 99 38

Fifty-four patients with phlebogram-proven deep vein thrombophlebitis limited to the tibial and popliteal veins were studied for evidence of pulmonary embolism, both symptomatic and silent. All but two patients were symptomatic of either phlebitis or embolism. Pulmonary embolism, as judged by lung scan defects with V-Q imbalance, changing serial scans, or positive pulmonary angiograms were found in 50%. Popliteal thrombi had an embolism incidence of 66%, whereas tibial thrombi had a 33% incidence. Emboli from the popliteal veins were more extensive than were tibial emboli. Forty-five percent of all emboli were silent. Bilateral phlebitis was accompanied by a 75% incidence of pulmonary embolism. Emboli from tibial veins were minor in five of nine instances, but three instances involved 20% or more of total lung volume and one involved over 40% of total lung volume. These results support the belief that popliteal thrombophlebitis merits anticoagulant therapy. They also suggest caution in the management of tibial vein phlebitis. Objective tests are recommended to monitor for pulmonary embolism and for propagation of the thrombus before deciding to withhold anticoagulants in tibial thrombophlebitis.
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PMID:Importance of calf vein thrombophlebitis. 100 21

A case of acute deep vein thrombophlebitis and pulmonary embolism in late gestation has been presented with a discussion of diagnostic modalities, therapeutic regimens, and theoretical considerations. It is our belief that aggressive medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is not effective or if embolism occurs, surgical intervention, consisting of vena caval clipping and ovarian vein ligation with scrupulous attention to detail, is indicated. Further, support to prophylaxis of abruptio placenta secondary to the mechanism espoused by Mengert et al is added by the course of this patient.
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PMID:Thrombophlebitis and pulmonary embolism with surgical intervention in the third trimester. 101 83

Primary superior mesenteric venous thrombosis is sometimes preceded by peripheral thrombophlebitis. Inherited antithrombin-III deficiency is a recently recognized autosomal dominant trait, which is characterized by thrombophlebitis and pulmonary embolism. This case report illustrates many features of both entities and strongly suggest a causal relationship. While long-term therapy has yet to be established, prophylactic therapy is recommended when asymptomatic individuals with known antithrombin-III deficiency are at increased risk of thrombosis. The efficacy of heparin alone has been unreliable, whereas Coumadin has been encouraging. Antithrombin-III concentrates are being developed and theoretically should be helpful. Patients with thrombophlebitis or pulmonary embolism should be suspected of having antithrombin-III deficiency. Such individuals also represent one mechanism to explain "primary" mesenteric venous thrombosis.
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PMID:Inherited antithrombin-III deficiency causing mesenteric venous infarction: a new clinical entity. 113 28

Propagating illofemoral venous thrombosis that occurs despite adequate anticoagulation can be detected by the serial fibrinogen uptake test. Twenty-three patients who were receiving heparin sodium for confirmed iliofemoral thrombophlebitis underwent the serial fibrinogen uptake test. There was an increasing percentage of isotope uptake at the groin and the upper part of the thigh in eight of these patients, three of whom subsequently developed clinical signs, perfusion, and ventiliation lung scan findings compatible with the occurrence of pulmonary embolism. The remaining 15 patients had decreasing serial fibrinogen uptake during heparin therapy and no sequelas indicative of pulmonary embolism. Progressive thrombosis in adequately heparinized patients indicates failure of anticoagulation therapy and, when this occurs, we believe that interior vena cava interruption should be considered before a first, but potentially lethal, pulmonary embolus develops.
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PMID:Inferior vena cava interruption: a new indication? 116 84


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