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

Postoperative deep vein thrombosis has been demonstrated in four out of seven (57%) unselected patients undergoing homograft cadaveric renal transplantation, with pulmonary embolism in one. The diagnosis being made by using the combined 125I-fibrinogen and Doppler ultrasound techniques. The late onset of the deep vein thrombosis may be due to the heparin given interoperatively and postoperatively which acted as a prophylactic agent.
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PMID:Deep vein thrombosis after renal transplantation. 78 59

A randomized open trial was undertaken to compare the antithrombotic efficacy of a low molecular weight heparin (LMWH; Sandoparin) with that of dextran 70 in patients undergoing surgery for hip fracture. One hundred thirteen patients received LMWH once daily subcutaneously at a fixed dosage while 103 patients received intravenous dextran 70. Postoperative deep vein thrombosis (DVT) was assessed by a diagnostic algorithm using the 125Iodine fibrinogen uptake test as screening and Duplex ultrasonography and/or ascending venography as confirming techniques for suspected DVT. The frequency of DVT was significantly lower in the LMWH group than in the dextran group (15.5 versus 32.6%, p less than 0.005). Proximal DVT was rare in both groups (LMWH: 2%, Dextran: 1%). Only one case of fatal fat pulmonary embolism was observed during the 10 day prophylaxis period in a patient receiving Dextran. Three cases of pulmonary embolism occurred later; one fatal event in the dextran group on day 14, and two cases in the LMWH group (one fatal and one non-fatal event) on day 14 and 17, respectively. There was no major bleeding complication in either group. We conclude that the LMWH we used is safe, was well tolerated, and has a significantly better thromboprophylactic effect than dextran 70.
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PMID:Prevention of deep vein thrombosis in patients with hip fractures: low molecular weight heparin versus dextran. 128 62

Subcutaneous low-dose Heparin Ca injections were given as prophylactic treatment to 31 women who were candidates for Caesarean section and were at high risk of thrombo-embolism. Postoperative deep vein thrombosis or pulmonary embolism did not occur in the treated cases. Local or systemic haemorrhages or other reactions were not observed. The controlled haematological parameters changed as expected. According to the opinion of the authors Heparin Ca may be successfully used for the prevention of the postoperative complications of Caesarean section.
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PMID:Thrombosis prophylaxis with subcutaneous heparin Ca injection in the course of caesarean sections. 185 73

Postoperative deep vein thrombosis is usually asymptomatic so that pulmonary embolism is often the first clinical manifestation of venous thromboembolism. The diagnostic accuracy of impedance plethysmography, 125I-fibrinogen leg scanning and real-time B-mode ultrasonography has been extensively evaluated in patients with asymptomatic deep vein thrombosis. Impedance plethysmography has been evaluated in a number of studies and its sensitivity has been invariably found to be approximately 20% or less. These results seem to be due to the high prevalence in asymptomatic patients of distal, small and nonocclusive thrombi, unable to produce a critical obstruction of the venous flow. The accuracy of 125I-fibrinogen leg scanning has been assessed in a number of studies and found to be significantly different in the initial and more recent studies. This difference has been found to be due to the quality of the study design: the better the methodology, the lower the diagnostic accuracy of 125I-fibrinogen leg scanning. The association of impedance plethysmography and 125I-fibrinogen leg scanning do not result in an improvement of the results obtained by the single diagnostic method. Study methodology strongly influenced the results obtained with real-time B-mode ultrasonography with a reported sensitivity of approximately 50% in the studies performed adopting an appropriate methodology. In conclusion, noninvasive diagnostic methods are inaccurate in the diagnosis of asymptomatic deep vein thrombosis. Thus, venography remains the only accurate diagnostic method for the diagnosis of asymptomatic deep vein thrombosis.
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PMID:Diagnosis of deep vein thrombosis in asymptomatic high-risk patients. 789 21

Based on our experience derived from approximately 20,000 varicose vein operations during the last three decades we report about possible complications in varicose vein surgery. We had no postoperative mortality. Crossectomy of the greater saphenous vein may lead to major complications. We describe a case of femoral artery injury. Postoperative deep vein thrombosis and pulmonary embolism are very rare events. Bleeding complications in the groin, necessitating surgical reintervention are seldom, other bleeding complications like suffusions and hematomas can be seen more often. These complications are significantly more frequent if we use low molecular weight heparins for prophylaxis of deep vein thrombosis postoperatively. Lymphatic complications like lymphcysts and -fistulas are harmless in most cases and regress spontaneously. Concerning neurological complications lesions of the saphenous nerve are of some importance. Altogether the risk for a patient undergoing varicose vein surgery is minimal but not zero.
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PMID:[Complications in surgery of varicose veins]. 1150 69

Patients undergoing orthopedic surgery, particularly total hip replacement procedure belong to a group of patients with a high risk of thromboembolic complications. Postoperative deep vein thrombosis may occur in 40-80% of these patients. 4-19% of patients develop clinically evident pulmonary embolism and approximately 7% of cases in this group result in death. A thorough evaluation of coagulation disorders in the perioperative period could lead to detecting risk factors of thromboembolic complications development and could facilitate more effective prophylaxis management. The aim of the study was to evaluate the dynamics of selected blood coagulation and fibrinolysis parameters in patients undergoing total hip replacement surgery. The study included 66 patients undergoing total hip replacement surgery. The group consisted of 51 women and 15 men, within the age range of 47-78, the mean age was 64. In 32 (group A) patients surgery was performed with the use of normovolemic hemodilution, in 34 (group B) the hemodilution procedure was not applied. The patients received low molecular heparin as prophylaxis started 12 hours prior surgery and continued for 5 weeks after. The examination of the coagulation system was performed: in the morning on the day of the operation--examination 1, on the day of the operation in the evening--examination 2, and on the first day after operation--examination 3. We determined the concentrations of thrombin-antithrombin complexes (TAT), prothrombin fragments 1 + 2 (F1 + 2), D-dimers (DD) and plasminantiplasmin complexes (PAP). In all the patients an ultrasound examination of the lower limbs by Doppler method was performed before the surgery and 10-12 days after the procedure. Significant activation of coagulation and fibrinolysis was found in all patients before surgery. 12 hour after the procedure a progressive increase of coagulation disorders was observed. After 24 hours marked decrease of coagulation parameters was noted. In group A significantly less thromboembolic complications was observed. On the basis of the performed examinations the following conclusions were drawn. (1) during total hip replacement surgery and particularly during the period of the first 12 hours after procedure, marked activation of coagulation and fibrinolysis occurred. (2) the application of the hemodilution procedure does not influence significantly the degree of coagulation and fibrinolysis disorders in the perioperative period.
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PMID:[Evaluation of selected parameters of blood coagulation and the fibrinolysis system in patients undergoing total hip replacement]. 1251 38

To analyze the necessity of venous thromboembolism (VTE) prophylaxis for patients undergoing high ligation and stripping of the great saphenous vein (GSV) and to estimate the efficacy and safety of different anticoagulant protocols in a single-center randomized controlled trial with large sample size. A total of 2196 patients undergoing high ligation and stripping of the GSV were randomized to one of the following postoperative VTE prophylaxis protocols: group A, no VTE prophylaxis (n=542); group B, subcutaneous low-dose unfractionated heparin (LDUH) hypodermic injection, 125 U/kg per day in three divided doses (n=531); group C, low-molecular-weight heparin (LMWH) 6000 IU once a day (n=573); and group D, LMWH 4000 IU twice daily (n=550). Groups were compared for the incidence of VTE and major hemorrhage within 1 month following surgery. Varicose vein severity was classified by CEAP (Clinical, Etiologic, Anatomic, Pathophysiologic elements) score. The clinical characteristics of the patients were equally matched between groups. Postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) were significantly higher in group A (DVT 5.17%, PE 1.48%) compared to groups B (0.56%, 0%), C (0.35%, 0%) and D (0.36%, 0%) (p<0.01). The incidence of VTE did not differ between the three active chemoprophylaxis arms. Hemorrhagic complications were low for each group but higher in group B (0.75%) compared to the other groups (group A 0.18%; group C 0.17%; group D 0.18%, p<0.01). Hemorrhagic complications did not differ amongst groups A, C and D. In conclusion, postoperative VTE chemoprophylaxis following high ligation and GSV stripping effectively reduces the venous thrombosis complications of this procedure. Of the three active strategies tested, no difference in efficacy was noted; however, thrice daily LDUH did increase bleeding complications.
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PMID:Postoperative prophylaxis of venous thromboembolism (VTE) in patients undergoing high ligation and stripping of the great saphenous vein (GSV). 2560 17