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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fibrinolytic activity after elective abdominal surgery was studied in 53 middle-aged cancer-free patients. The pattern of their response demonstrated both stable and labile populations. In 10 of the 13 patients in whom fibrinolytic activity fell rapidly to below 5-6 units, deep venous thrombosis (D.V.T.) developed on the first postoperative day. This suggests that reduced fibrinolytic activity after operation is involved in the establishment of postoperative D.V.T. and that the incidence of early thrombosis could be reduced by enhancement of postoperative levels of fibrinolytic activity.
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PMID:Fibrinolytic response to surgery. Labile and stable patterns and their relevance to post-operative deep venous thrombosis. 7 May 86

Mechanical methods of preventing deep vein thrombosis have been surveyed. The best means of preventing venous stasis has been shown to be by intermittent compression of the legs. Use of intermittent compression will prevent isotopically detectable deep venous thrombosis in 82 percent of patients and in malignancy in 90 percent of patients. The only other prophylactic measure of comparable effectiveness is administration of low-dose subcutaneous heparin. Intermittent compression need only be applied during the operation and is cheap, foolproof, and safe. Intermittent compression acts by squeezing empty the soleal sinuses and large valve pockets in the major veins in which thrombi form while venous flow is slowed during operation. A combination of intermittent compression and administration of low-dose subcutaneous heparin has been found to be no more effective than is intermittent compression alone.
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PMID:The prevention of deep vein thrombosis, with particular reference to mechanical methods of prevention. 31 52

We investigated whether the dosage of heparin injected subcutaneously for the postoperative prophylaxis of thromboembolism influences efficacy. We considered prospective, controlled or comparative, randomized studies in which heparin was administered in a dosage of 5,000 U b.i.d. or t.i.d. subcutaneously. In major surgical procedures in general surgery, gynecology, urology and chest surgery, 2 x 5,000 and 3 x 5,000 U of heparin/day lower the frequency of postoperative deep venous thrombosis from about 30% to about one-fourth and one-third that amount, respectively. With regard to orthopedic/traumatic surgery, in a study of only 40 patients, 2 x 5,000 U/day reduced the incidence of thrombosis by one-half. The use of the higher dosage resulted in a decrease in DVT in 5 of 7 reports, but the other two authors measured no prophylactic effect at all. Proof that subcutaneous heparin prophylaxis is also able to reduce the number of fatal postoperative pulmonary emboli has been produced only in the case of the higher dosage. In our own group of patients there is no correlation between body weight and frequency of hemorrhagic complications. In our patients there is no relation between malignant tumor as the primary disease and the occurrence of hemorrhagic complications. There is no evidence that the lower dosage causes fewer hemorrhagic complications than the higher dosage.
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PMID:Dosage in low-dose heparin prophylaxis. 51 Oct 15

Erroneous diagnosis of leg vein thrombosis among pill users could be attributed to the unreliability of clinical diagnosis. To prove this point, the result of Doppler ultrasonic evaluation of pill users with suspected leg vein thrombosis were compared with those of non-pill users suspected of deep vein thrombosis. 129 women (54 cases and 75 controls) of similar age, clinical manifestations, and absence of predisposing factors (e.g., trauma, recent surgery, malignancy) underwent a complete venous Doppler examination. The incidence of venous thrombosis among pill users was confirmed by the Doppler method in only 16.7% of pill users and 30.7% of non-pill users (P = .052). The results of this study, however, did not define the true incidence of venous thrombosis among pill users. This was attributed to the fact that only patients with suspected venous disease were objectively diagnosed; many patients with proven venous thrombosis may be asymptomatic and could not detected by conventional clinical studies. At best, this study demonstrated the necessity of using an objective screening technique, such as the Doppler ultrasonic, on patients (especially women on oral contraceptives) suspected with deep vein thrombosis; it also resulted in establishing some guidelines in managing treatment of such patients.
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PMID:Erroneous clinical diagnosis of leg vein thrombosis in women on oral contraceptives. 65 2

Twenty-eight patients undergoing laparotomy were studied. Blood viscosity at both high and low rates of shear and a yield stress index were measured preoperatively and correlated with the incidence of post-operative deep vein thrombosis (DVT). There was a correlation between a raised index of yield stress and the incidence of DVT. Patients with cancer had a very high incidence of postoperative DVT and a high index of yield stress.
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PMID:Altered viscosity and yield stress in patients with abdominal malignancy: relationship to deep vein thrombosis. 95 52

The influence of several diseases and conditions upon the prevalence of pulmonary embolism in autopsies performed over the July 1, 1964 to June 30, 1974 period at the University of Michigan Medical Center (Ann Arbor, Michigan) were analyzed. The prevalence of pulmonary was 12.3% in the 4600 necropsies in this sample. Patients with pulmonary fat emboli or tumor emboli and patients thought to have thrombosis of the pulmonary artery were not designated as having pulmonary thromboembolism. The patients were categorized with regard to heart disease on the basis of both clinical and necropsy findings. The major factors contributing to an increase in risk of development of pulmonary embolism include heart disease, certain types of cancer, obesity, acute paraplegia and accidental and operative trauma. Other risk factors which could not be assessed in this study include a prior history of venous thromboembolism, pregnancy and the puerperium, use of oral contraceptives, ulcerative colitis and Crohn's disease. Age plays a major role in the prevalence of pulmonary embolism. A portion of the effect of age is related to the age distribution of other diseases contributing to an increased risk, yet advanced age alone may have an independent influence. The risk factors defined should be used in a selective program designed to increase the rate of detection of deep venous thrombosis before pulmonary embolism occurs. Alternatively, patients at increased risk should be treated with prophylactic low dosage heparin during hospitalization.
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PMID:Risk factors in pulmonary embolism. 95 58

In a double blind, randomized trial the hemorrhagic complications of a reduced dose of low molecular weight heparin (LMWH) (Fragmin, KabiPharmacia) were compared to those of the conventional dose of unfractionated heparin (UH). 2500 anti-XaU of LMWH was given once daily and UH in a dose of 5000 anti-XaU twice daily. During a one year period 141 patients undergoing gynecological surgery were included in this study. The patients were examined clinically for hematomas and for deep venous thrombosis (DVT) on the third and fifth day. Venography was performed when DVT was suspected. No patients developed clinical DVT. One woman in the LMWH group had pulmonary embolism 3 days after the prophylaxis was stopped. Two women in the LMWH group died, one from a stroke on day 2, one from cancer on day 39. There was no significant difference in serious bleeding complications between the two regimens, 20% in the LMWH group and 14% in the UH group. Even with the reduced dose of LMWH the mean plasma concentration of heparin in the LMWH group was higher (mean 0.14 anti-XaU/ml) than in the UH group (0.029 anti-XaU/ml) 3 hours after injection on the 2nd postoperative day. A reduced dose of LMWH (2500 anti XaU once daily) does not cause more bleeding complications than the conventional heparin regimen to prevent thrombosis, as was the case in our previous study with 5000 anti XaU of LMWH once daily.
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PMID:Comparison of low molecular weight heparin vs. unfractionated heparin in gynecological surgery. II: Reduced dose of low molecular weight heparin. 132 46

The literature was reviewed in an attempt to determine whether patients with cancer have an increased risk of venous thromboembolism, i.e. deep vein thrombosis and pulmonary embolism. From case reports it was apparent that various thromboembolic or thrombophlebitic manifestations may be found in a small number of patients, although it is possible that not all cases belong to the same clinical or pathogenetic entity. In clinical series it was found that the risk of postoperative venous thromboembolism was increased in cancer patients, but the possibility that this was due to associated risk factors, rather than to the mere presence of a tumour, could not be excluded. Little is known about patients not undergoing surgery. Retrospective postmortem studies have found more thrombi in patients with malignancy, but a prospective study failed to demonstrate an association between malignancy and pulmonary embolism. It is possible that different types of cancer show various degrees of association with venous thromboembolism. We conclude that further studies should be performed to provide a firm clinical and pathoanatomical basis for investigations into the pathogenesis of venous thromboembolism.
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PMID:Venous thromboembolism and cancer. 142 Aug 20

To study possible changes in the clinical use of inferior vena cava (IVC) filters caused by the introduction of percutaneous delivery systems, we reviewed all patients who underwent placement of IVC filters at our institution from 1988 to 1991. Eighty-four patients (52 men and 32 women) ranging in age from 18 to 90 years (mean 67 years) were identified. Filters were required because of contraindications to anticogulation in 64% anticoagulation failure in 25%, and preoperative prophylaxis in 11% of patients. The underlying disease was lower extremity deep vein thrombosis in 50% and pulmonary embolism in 45% of patients. Five percent of patients received prophylactic filters without documented thromboembolism. All filters were placed percutaneously by interventional radiologists, 77 through the common femoral vein and 7 through the internal jugular vein. Three types of filters were used. One procedure-related death occurred because of acute IVC occlusion. Fatal pulmonary embolism within 48 hours after filter placement was documented in one patient and suspected in one late death. No other clinically apparent pulmonary embolism or leg swelling occurred after filter placement. Minor complications related to filter placement occurred in 13 patients, but none required operative intervention. Analysis of complication rates of the three filter types was precluded by the small sample size. After a mean follow-up of 11 months, 42 patients (50%) had died of malignancy (n = 25), multisystem organ failure (MSOF; n = 7), cardiovascular events (n = 4), recurrent pulmonary embolism (n = 2), cerebrovascular events (n = 4), or an unknown cause (n = 1). Twenty-three patients (27%) died before hospital discharge.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Current use of inferior vena cava filters. 143 57

The overall incidence per year of deep vein thrombosis is about one per thousand, but may be much higher in the presence of certain clinical risk factors such as advanced age, immobilization, surgical procedures, pregnancy, puerperium, use of oral contraceptive agents and malignancy. Moreover, homocystinuria, nephrotic syndrome, systemic lupus erythematosus and hematological disorders such as paroxysmal nocturnal hemoglobinuria or myeloproliferative syndromes predispose to thrombotic disease. Evaluation of the patient with thromboembolism should include detailed history, clinical examination and laboratory investigation to exclude these secondary thrombophilic states. Primary or hereditary thrombophilia is suspected mainly in patients suffering from (venous) thromboembolism at an early age (< 45 years), especially if recurrent and/or familial thrombosis is present. Hereditary thrombophilia may be due to deficiency of antithrombin III, protein C, protein S or plasminogen, some other defects being less well-established prethrombotic risk factors. These currently recognized primary prethrombotic molecular defects are found in 10 to 30% of patients with idiopathic thromboembolism. In the majority of cases the cause of thrombosis remains unknown.
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PMID:[Evaluating the origin of thrombophilia: indications and implementation]. 148 83


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