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

The incidence of thrombo-embolic complications in pregnancy varies between 2 and 5 per 1000 deliveries. Deep-vein thrombosis (DVT) is classically associated with pulmonary embolism and chronic venous insufficiency, which are leading causes of maternal morbidity and mortality. An accurate diagnosis of iliofemoral or calf vein thrombosis should be confirmed by either Doppler ultrasonography, impedance plethysmography or ascending phlebography. Full-dose continuous intravenous heparin for 5-10 days is the established method of therapy for acute DVT and pulmonary embolism occurring during pregnancy or in the puerperium. Thereafter, long-term treatment with self-administered subcutaneous injections of heparin in low doses is feasible and effective. During pregnancy, coumarin administration results in embryopathy as it readily crosses the placenta; it should be avoided until after delivery. In view of its safety and effectiveness, low-dosage intravenous heparin or heparin by subcutaneous injection seems to be the anticoagulant of choice for the expectant mother.
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PMID:Deep-vein thrombosis in pregnancy. A case report. 399 8

Postoperative thrombosis detected with the 125I-labelled fibrinogen uptake test (FUT) is frequent. FUT correlates well with phlebography and a positive FUT is associated with high incidence of pulmonary embolism. This study has been performed to evaluate venous function 3-5 years after FUT-detected thrombosis. A follow-up examination was performed in 381 patients who had been studied after operation with FUT. The follow-up included a questionnaire, clinical examination, venous occlusion strain-gauge plethysmography, ambulatory strain-gauge plethysmography, venous pressure examination and, in some cases, Doppler ultrasound examination of venous valve function in the leg. No statistically significant differences were found in any parameters used between legs with and without FUT-detected postoperative thrombosis, except that more FUT-positive legs had an abnormal venous pressure decrease during exercise than FUT-negative legs. The frequency of deep venous insufficiency was equal in FUT-positive and FUT-negative legs. Moreover the frequency of deep venous insufficiency was not affected by the site of the FUT-detected thrombosis or by the different kinds of prophylactics used. The frequency of venous insufficiency was high.
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PMID:Deep venous insufficiency after postoperative thrombosis diagnosed with 125I-labelled fibrinogen uptake test. 673 24

The 125I-fibrinogen uptake test (FUT) has been widely used in the past decade to detect postoperative thrombosis. FUT has been shown to correlate well with phlebography, and positive FUT is associated with a high frequency of pulmonary embolism. The long-term venous function of the leg after FUT-detected postoperative thrombosis, however, is inadequately documented. In 179 patients who had been studied after operation with FUT, a follow-up evaluation of FUT as an indicator of risk for development of deep venous insufficiency was made four to five years later. The patients replied to a questionnaire, were clinically examined, and underwent venous strain-gauge plethysmography, venous pressure measurement, and, in some cases, phlebography. No statistically significant differences were found in any of the parameters between legs that had been FUT-positive and those that were FUT-negative at the time of the operation. The frequency of deep venous insufficiency thus was equal in FUT-positive and FUT-negative legs. It was also independent of the site of FUT-detected thrombus in the leg.
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PMID:Venous function in the leg after postoperative thrombosis diagnosed with 125I-fibrinogen uptake test. 682 75

A 39-years-old male patient with chronic venous insufficiency, deep venous thrombosis and recurrent pulmonary embolism in the past medical history. After syncopal event was diagnosed of bilateral chronic pulmonary embolism, pulmonary hypertension and right ventricular failure. Fibrinolytic treatment was no effective therapeutic modality. Under cardiopulmonary bypass, bilateral pulmonary thromboendarterectomy with extension into lobe arteries, plus insertion of caval filter was performed. We present our experience with this case and a review of the literature.
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PMID:[Bilateral pulmonary thromboendarterectomy in chronic pulmonary thromboembolism. A case report and review of the literature]. 748 Oct 40

At the request of the Ad Hoc Committee on Reporting Standards of the Joint Council of the Society for Vascular Surgery and the North American Chapter of the International Society for Cardiovascular Surgery, this report updates and modifies "Reporting standards in venous disease" (J Vasc Surg 1988;8:172-81). As in the initial document, reporting standards for publications dealing with (1) acute lower extremity venous thrombosis, (2) chronic lower extremity venous insufficiency, (3) upper extremity venous thrombosis, and (4) pulmonary embolism are presented. Numeric grading schemes for disease severity, risk factors, and outcome criteria present in the original document have been updated to reflect increased knowledge of venous disease and advances in diagnostic techniques. Certain recommendations of necessity remain arbitrary. These standards are offered as guidelines whose observance will in our opinion improve the clarity and precision of communications in the field of venous disorders.
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PMID:Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease. 880 76

During the last 10 years anticoagulant (AC) therapy and thrombolytic treatment of venous thromboembolism (VT) have been evaluated in randomized studies. Adjusted subcutaneous (s.c.) heparin and low molecular weight heparin (LMWH) are found at least as effective as intravenous (i.v.) infusion of heparin in deep venous thrombosis (DVT) without an increased bleeding risk. In pulmonary embolism (PE) randomized trials assessing the efficacy of s.c. heparin and LMWH are missing. Oral AC-treatment can be initiated from the first or second day in VT. The recommended duration is three months for medical patients, and 4 weeks seem appropriate for surgical patients that are completely mobilized and without persisting predisposing factors. Long-term efficacy of thrombolytic treatment of DVT has only been assessed in small trials showing a trend towards reduced risk of developing chronic venous insufficiency. Short-term thrombolytic treatment of DVT is evaluated in ongoing trials. In the treatment of PE short-term thrombolysis with either t-PA or urokinase is found to be as effective as long-term thrombolytic treatment with a reduced bleeding risk. Thrombolytic therapy rapidly reduces embolic mass and stabilizes haemodynamics, but mortality and long-term efficacy of thrombolysis and AC-treatment versus AC-treatment alone in PE are being assessed in ongoing studies.
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PMID:[Anticoagulant and thrombolytic therapy in deep venous thrombosis and pulmonary embolism]. 778 97

Deep venous thrombosis (DVT) is responsible for approximately 200,000 hospitalizations annually in the United States. DVT is easier and less expensive to prevent than to diagnose and treat. For every one million patients undergoing surgery who do receive prophylaxis against venous thrombosis, approximately $60 million will be saved in direct health care costs because effective mechanical and pharmacologic modalities are available to prevent most venous thrombi. The therapy for DVT should be based upon the anatomic extent of the thrombus as well as upon the patient's risk for pulmonary embolism, recurrent DVT, and chronic venous insufficiency. In patients with paradoxical embolism, a patent foramen ovale, occult leg vein thrombosis (particularly isolated calf vein thrombosis) is frequently present.
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PMID:Venous thrombosis: prevention, treatment, and relationship to paradoxical embolization. 780 83

Limited accuracy in the clinical diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutic management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous system also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insufficiency the deep venous system should be assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system.
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PMID:[The radiologic diagnosis of venous diseases. A challenge]. 823 75

A follow-up of 40 cases of Mobin-Uddin-umbrella implants for prophylaxis of secondary pulmonary embolism is presented. The all-over lethality was 35% (14 patients) including one embolic recurrence. 25 patients could be re-examined 0.2-11.1 years after the implantation, using the patient's history, clinical examination, native X-ray of the umbrella, B-scan of the inferior vena cava, phlebodynamometry of the legs, spirometry, ergometry, manometry of the pulmonary artery pressure. Possible or probable recurrences of embolism were recorded in 15% (5 patients). The umbrella was totally occluded in 48% and partially occluded in 23%. Umbrella-related complications due to faulty insertion were not observed. Patients without additional cardiopulmonary diseases did not show pulmonary hypertension or ventilatory disorders at rest. 86% of the patients suffered from a symptomatical chronic venous insufficiency of one or both legs. Today the Mobin-Uddin-umbrella has been replaced by other percutaneously applicable cava filters. However, their application may also be followed by complications. Therefore the decision to use cava filters of any type should be based on severe selection criteria.
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PMID:[Long-term follow-up of Mobin-Uddin umbrella filter implantation for prevention of pulmonary embolism]. 846 93

A total 30,040 pregnancies were reviewed at one institution over 5 years to determine the incidence of venous thrombotic complications. Thirty-one patients experienced such complications related to pregnancy (incidence 0.1%); 13 had deep venous thrombosis and 14 had superficial venous thrombophlebitis diagnosed by duplex ultrasound. Four had pelvic vein thrombophlebitis diagnosed by computed tomography scan; three patients (one from each group) sustained a non-fatal pulmonary embolus. Of those with deep venous thrombosis, 10 (77%) were left-sided, and three (23%) were right-sided. Three had a prior history of deep venous thrombosis and one of pulmonary embolism. Of those with superficial venous thrombophlebitis, seven (50%) were left-sided, six (43%) were right-sided, and one (7%) was bilateral. Most with deep venous thrombosis presented later in pregnancy; three in the first trimester, two in the second, three in the third, and five early postpartum. Most (10/14) with superficial venous thrombophlebitis presented within 48 hours of delivery. Distribution of thrombi in those with deep venous thrombosis was compared with 643 non-pregnant women with a similar condition. A pattern of proximal involvement on the left was found, with left common femoral vein (54% versus 28%, P = 0.03) and superficial femoral vein (62% versus 26%, P = 0.006) more often involved in pregnant patients. The average number of vein segments involved was greater on the left than the right (5.3 versus 3.7). Symptoms of chronic venous insufficiency developed in three with deep venous thrombosis (25%) and in three with superficial venous thrombophlebitis (27%). None had recurrence of deep venous thrombosis. It is concluded that venous thrombotic complications associated with pregnancy are not necessarily benign, with the risk of pulmonary embolism and chronic venous insufficiency not limited to patients with deep venous thrombosis only.
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PMID:Venous thrombotic complications of pregnancy. 901 9


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