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

Natural contrast from flow void potentiates the diagnosis of the intimal flap of aortic dissection, the dilated contour of aortic aneurysm, the protruding plaque of atherosclerotic disease, the recognition of deep vein thrombosis, and the identification of a number of acquired and congenital vascular abnormalities. Although MRI is costly at the present, the advantages of vascular MRI include noninvasive multiplanar imaging, no ionizing radiation, no contrast material requirements, and its use as an alternative to technically limited ultrasonography or computed tomography. MRI can define anatomy, measure blood flow, and be used for serial examinations in following disease processes and response to treatment. Future research with tissue characterization of atherosclerotic plaque may allow for early diagnosis and treatment of this ubiquitous disease. Not only chemical but also metabolic studies, including tissue perfusion in the heart and other solid viscera, would be of great value. Undoubtedly, MRI will have a permanent role in cardiovascular diagnosis.
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PMID:Vascular magnetic resonance imaging. 352 32

The fibrosis of the hypodermis in the lower part of the leg is a sign of venous stasis. But it appears in various forms. One is diffuse, circular, atrophic sclerosis, in a patch, occurring frequently in old post-thrombotic syndromes, another is sclerous hypodermititis in plaque form, submalleolar, well circumscribed and without aetiopathogenic links with deep venous thrombosis. This latter form is the only one to respond favorably to surgical resection.
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PMID:[Does hypodermectomy have a role in surgery for postphlebitic syndrome?]. 651 4

Ultrasonic imaging provides a non-invasive assessment of the arterial and venous circulation in the lower limb and is accepted as a valuable diagnostic technique. Grey-scale images identify plaque and thrombus, duplex assessment provides a measurement of blood velocity through a vessel, and colour Doppler imaging enables the rapid localization of arterial stenoses and occlusions and the identification of incompetent veins. This article outlines the principles of the different techniques and presents normal images. Procedures for investigating arterial stenoses, superficial venous incompetence and deep venous thrombosis are described, abnormal images presented and the limitations discussed. It is hoped to provide an insight into the strengths and limitations of ultrasonic vascular investigations for those involved in tissue viability and ulcer management.
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PMID:Review of duplex and colour Doppler imaging of lower-limb arteries and veins. 1048 Sep 71

As blood clots it goes through predictable stages that reflect the oxygenation state of hemoglobin within the red cells. One of these stages results in the formation of methemoglobin. This substance acts an endogenous contrast agent when imaged using a T1-weighted magnetic resonance sequence (Magnetic Resonance Direct Thrombus Imaging, MRDTI) - appearing as high signal. MRDTI can therefore be used to detect subacute thrombosis. This technique has been applied in a number of clinical settings arising as a result of thrombosis. Deep vein thrombosis and pulmonary embolism are both readily detected using MRDTI, providing a single imaging modality for the detection of venous thromboembolic disease. The technique is also effective in the peripheral arterial tree. Furthermore, thrombosis within vessel wall atherosclerosis is a marker of vulnerable plaque likely to produce symptoms. The MRDTI technique has thus proved useful in identifying complicated plaque in the carotid arteries in the setting of transient and permanent cerebral ischemia. MRDTI therefore holds promise as a technique that is capable of detecting high risk vessel wall disease prior to significant or permanent end organ damage. Because of the non-invasive nature of magnetic resonance imaging (MRI), application of MRDTI in the research setting for the monitoring of therapeutic interventions in a wide number of settings within vascular disease is very appealing.
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PMID:Magnetic resonance direct thrombus imaging. 1287 Dec 74

Neurosonological examinations play an important role in the diagnosis of cerebrovascular disease. The target used to be limited to the extracranial carotid artery but is now extended to the intracranial arteries. Carotid artery ultrasound can evaluate not only the degree of stenosis but also the vulnerability of plaque. Transcranial Doppler can detect the micro-embolus in the intracranial artery. Transesophagial echocardiography and cruralvein ultrasound are indispensable to detect embolic source. Transesophagial echocardiography is able to detect thrombus, tumor and vegitation in the heart, patent foramen ovale (PFO) and atheroma of aorta. Because PFO is found rather commonly in healthy subjects, the detection of deep vein thrombosis (DVT) is essential for the diagnosis of paradoxical embolism. In stroke patients with PFO, RI venography can rarely detect DVT, while cruralvein ultrasound commonly detect DVT in small vein. The demand of neurosonological examinations is considered to increase more and more because of their non-invasiveness and convenience.
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PMID:[Neurosonological examinations]. 1565 31

Laser first emerged as a technology for use in the vascular arena nearly 20 years ago. The ability of laser to evaporate atherosclerotic plaque was extensively studied; however, the goal of creation of an adequate channel without arterial wall perforation proved to be elusive, and the technique fell into disfavor. More than a decade later, interest in lasers was sparked again with its application to endovenous thermal ablation of axial superficial venous reflux. The mechanism of action of endovenous laser therapy involves thermal damage of the vein wall, resulting in destruction of the intima and collagen denaturation of the media with eventual fibrotic occlusion of the vein. Apart from the obvious attraction of a minimally invasive procedure to ablate superficial venous reflux with its attendant benefits, another advantage of laser ablation includes a potentially decreased incidence of neovascularization in the groin secondary to preservation of superficial venous drainage of the abdominal wall. Early success in terms of ablation of the refluxing saphenous vein has been reported as 90% to 95%. Minor complications are reported in 3% to 10% of patients and include bruising around the puncture site, transient paresthesias, superficial phlebitis, and skin burns or pigmentation. The more serious complications of deep venous thrombosis or extension of thrombus into the femoral vein have been variously reported in 0% to 2.3% of limbs treated. Pulmonary embolism is extremely rare. There is a learning curve, with a decrease in the incidence of all complications with experience. The importance of detailed preoperative and intraoperative duplex ultrasound examination cannot be overemphasized. The identification of all refluxing venous segments and their ablation is the key to optimizing the rate of successful ablation to 97% at 1 year and minimizing recurrence of varicose veins. With encouraging early and mid-term results with endovenous laser therapy, future developments in this field must mandate standardization of technical aspects, follow-up imaging, and reporting.
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PMID:Fifteen years ago laser was supposed to open arteries, now it is supposed to close veins: what is the reality behind the tool? 1662 17

An 81 year old female patient with chronic heart failure and atrial fibrillation receiving anticoagulant therapy, was admitted with progressive pain on her right leg for the past 24 hours, associated to local erythema, edema and warmth. The lesion evolved at the same site where she presented a chronic ulcer for the previous 5 months managed only with local care. At admission a necrotic plaque on the affected site was perceived; there was no hypotension or mental confusion but signs of a deep venous thrombosis on the involved leg were found. She was febrile (37.8 degrees C) and with tachychardia (126 per minute). Laboratory evaluation revealed normal white blood cell count and a subtherapheutic anticoagulant INR value. A chest x-ray showed infiltrates on the left lower lung lobe. On the following hours the lesion evolved with increasing pain, haemorrhagic bullae and a purulent discharge through the ulcer, with the patient developing mental deterioration, hypotension, respiratory failure and shock. The patient received intravenous ciprofloxacin and clindamycin and was operated 15 hours after admission performing an over-the knee amputation. A cardiac catheterization demonstrated a low cardiac output (2.3 L/min), and both a high systemic vascular resistance (2888 din.s.cm(-5)) and pulmonary capillary wedge pressure (17 cm H(2)0), results compatible with cardiogenic shock. Evolution was progressively worse and she died of multiple organic failure 36 hours after admission. Two blood culture samples grew Serratia marcescens. No necropsy was performed and cultures taken from the leg remained negative.
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PMID:[Fatal necrotizing fasciitis due to Serratia marcescens]. 1772 22

Acute coronary syndrome most commonly begins with atherosclerotic plaque rupture and intracoronary thrombus formation. Therefore, the primary goal of treatment for acute coronary syndrome is the achievement of early and complete reperfusion. The diagnosis of acute myocardial infarction (AMI) is made from typical symptoms, characteristic rises in serum enzyme levels, and changes in the electrocardiographic pattern. Although rapid developments in technology in the field of serum biomarkers have redefined the diagnosis of AMI, the electrocardiogram still remains significant in the diagnosis of AMI. Moreover, the identification of high-risk subgroups based on the admission electrocardiogram is essential to estimate the severity of AMI. Pulmonary embolism is an another thromboembolic disorder leading to mortality worldwide. The relationship between deep vein thrombosis and pulmonary embolism has been emphasized. The early detection of free-floating deep venous thrombosis by venous ultrasonography of the lower extremities is critical to prevent pulmonary embolism. For the detection of atherosclerosis, the identification of myocardial necrosis and thrombi by imaging tests is important. This paper reports the clinical usefulness of various noninvasive diagnostic approaches in cardiovascular disease.
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PMID:[Clinical significance of physiological function testing in cardiovascular disease]. 2007 24

The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin), especially in high risk groups (such as those who are immobile and on high dose chemotherapy), may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.
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PMID:Arterial and venous thrombosis in cancer patients. 2140 76

Glanzmann thrombasthenia (GT) is a rare autosomal recessive disorder characterized by a deficiency or functional defect of platelet glycoprotein (GP) IIb/IIIa. Physiologically, this platelet receptor mediates aggregation of activated platelets by binding the adhesive proteins, fibrinogen, von Willebrand factor (VWF) and fibronectin. This facilitates attachment and aggregation of platelets at sites of vascular injury. We reported the management of a pterional meningioma resection in a patient with Glanzmann thrombasthenia, with recombinant factor VIIa (rFVIIa - NovoSeven) as haemostatic agent. A 48-year-old woman suffering from Glanzmann thrombasthenia was scheduled for spheno-orbital meningioma en plaque surgery. Because of repeated platelet transfusions, this patient developed isoantibodies against missing GPIIbIIIa and alloantibodies against Human Leukocyte Antigen (HLA) leading to refractoriness to platelet transfusions. We observed that Novoseven offered sufficient haemostasis conditions. Therefore, we noticed a deep vein thrombosis. This imposed us to use low weight molecular heparin despite recent surgery.
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PMID:Surgical resection of a sphenoid wing meningioma in a patient with Glanzmann thrombasthenia. 2191 74


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