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

The relationship between the functional status of the venous valves in the superficial and deep veins and ulceration was evaluated in 42 patients. Twenty-five patients had ulcers, 12 of these patients had a history of previous deep venous thrombosis and 13 of these patients denied such an event. Seventeen patients had normal ankle skin, 10 of these patients had a documented history of deep vein thrombosis and seven of these patients had varicose veins only. An ultrasonic duplex scanner was used to document the presence of reflux in all segments of the superficial and deep system. In the entire group of 25 limbs with ulceration, valvular incompetence was noted in 22 limbs at levels involving segments that communicated with the ulcer-bearing area. Of the 17 limbs with normal ankle skin, in only two instances was a single segment of posterior tibial vein in midcalf found to be incompetent. For those patients with normal ankle skin and a history of varicose veins, the deep veins below the common femoral vein level were always competent.
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PMID:Status of the valves in the superficial and deep venous system in chronic venous disease. 204 91

When performed by a well-trained operator, ultrasonic exploration of the deep veins has a more than 90% sensitivity and specificity in the diagnosis of deep vein thrombosis. Despite technical problems in the ileal and sural regions, it is the first examination to be carried out in patients with clinical signs of venous thrombosis. In distal thrombosis of the leg and calf ultrasonography might even be more sensitive than phlebography. In superficial phlebitis ultrasounds can be used to evaluate the extent of thrombosis. In varicose vein disease, they are also a crucial element in the choice of treatment.
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PMID:[Echography and venous pathology]. 210 56

Increased urinary metabolites of the antiaggregatory vasodilator prostacyclin (PGI2) and the proaggregatory vasoconstrictor thromboxane A2 (TXA2) have been reported in deep vein thrombosis; however, the tissue(s) of origin is uncertain. Because little is known about the formation of PGI2 or TXA2 from its common precursor, prostaglandin (PG) endoperoxide H2 (PGH2), by varicose veins, we determined the formation of 6-keto-PGF1 alpha (the stable metabolite of PGI2), TXB2 (the stable metabolite of TXA2), and PGE2. Segments of normal saphenous vein and varicose vein (nine and six patients, respectively) were incubated with 10 microM [14C]PGH2 for 2 min at 37 degrees C; products were separated by thin-layer chromatography. Surface area and mass of normal and varicose vascular segments were 19.5 +/- 0.8 versus 18.8 +/- 0.6 mm2 and 11.6 +/- 1.4 versus 10.7 +/- 0.7 mg, respectively. Formation of 6-keto-PGF1 alpha and TXB2 by the segments of varicose vein was significantly increased over that of normal vein: 157 +/- 14 versus 243 +/- 17 pmole of 6-keto-PGF1 alpha (P less than 0.005) and 22 +/- 3 versus 35 +/- 5 pmole of TXB2 (P less than 0.01). The formation of PGE2 by segments of varicose vein was not significantly different from that of normal vein (201 +/- 9 vs 219 +/- 11, respectively). Deoxyribonucleic acid (DNA) content of normal and varicose vein was 1.69 +/- 0.12 and 1.51 +/- 0.13 mg per gram of tissue, respectively. The data suggest that the increased PGI2 formation may reflect increased activity or content of PGI2 synthase. The increase in TXA2 formation may reflect increased productivity or an increased presence of residual platelets or microemboli.
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PMID:Increased prostacyclin and thromboxane A2 formation in human varicose veins. 211 84

During recent years, upon investigation of the meridian which is an important part of the traditional concept in Chinese medicine, we have obtained several significant findings using radionuclide: 1. By subcutaneous injection (SC) of Tc-99m pertechnetate at acupuncture points K-3 and B-60, it was found that certain acupuncture points may be closely related to the venous drainage. 2. A new technique of radionuclide venography, namely SC-RNV of the lower limbs, was established through the above study. The SC-RNV subsequently proved to be clinically available in diagnosis of DVT and calf varicose veins. By SC injection of Tc-99m pertechnetate at various acupuncture points (APP) and nonacupuncture points (non-APP) it seemed that not every APP is closely related to venous drainage, and so is not the non-APP. As for the mechanism of SC-RNV, through SC injection of T1-201 chloride and Ga-67 citrate at K-3 respectively, it was found that the Na-K pumping system may play a major role in the drainage of soft tissue fluid from the APP into th venous flow. We now continue to investigate the meridian with radionuclide and hope to understand more clearly the physiological function of the APP, especially its relationship with the veins.
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PMID:[Radionuclide study of acupuncture points]. 217 43

Doppler velocimetry enables three haemodynamic parameters that are extremely useful for the study of venous diseases to be evaluated: blood flow direction, the morphology of the velocity wave and venous pressure. These three parameters are used in association depending on the particular requirements of the diagnostic problem. In the case of suspected deep venous thrombosis, study of the morphology of the velocity wave and clinostatism pressure give good diagnostic possibilities for the iliaco-femoral axis but poor for the leg trunks. In post-thrombotic syndrome, Doppler velocimetry is not so useful because the patient has to remain immobile during the examination while this specific pathology features insufficiency of the muscular pump during walking. In varicose disease, the investigation offers a very high diagnostic capability by evidencing the site and extent of valvular incontinence in the saphena and perforating vessels. The only limitation is the presence of numerous incontinent perforating vessels, but this is infrequent. In this pathology, Doppler v. has almost completely supplanted phlebography because it responds to the needs of modern medicine to replace invasive diagnostic investigations with non-invasive techniques that are equally effective. Finally, two other fields of application are very important for this investigation: the study of a patient with varices prior to saphenic stripping and prior to sclerotherapy. Definition of the origin and course of the reflux ways makes an optimal result possible, even allowing for the evolution of varicosity.
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PMID:[Venous Doppler velocimetry: ten years of development of a method]. 219 4

Forty-two consecutive patients diagnosed with superficial phlebitis were seen during a 5-year period. Thirty-five of the 42 patients were outpatients. The diagnosis of superficial phlebitis was made by the presence of palpable subcutaneous cords in the course of the greater saphenous vein or its tributaries in association with tenderness, erythema, and edema. The presence of concurrent deep venous thrombosis (DVT) was assessed by impedance plethysmography in 37 patients, compression venous ultrasonography in 3 patients, and venography in 8 patients. Five of the 42 patients (12%) had DVT. Four of these five patients had a positive impedance plethysmographic or ultrasonographic test result followed by a confirmatory venogram. The fifth patient had a positive ultrasonographic test result, but no venogram was performed. Two of the five patients had clots that involved the popliteal or femoral veins. Four of 23 patients (17%) with superficial phlebitis at or above the knee had DVT. Only 1 of the 19 patients (5%) with superficial phlebitis below the knee had DVT. Three of the five patients with both superficial phlebitis and DVT had undergone surgery recently. All but 3 of the 42 patients (93%) had varicose veins. No patients had clinically apparent pulmonary emboli. DVT occurred in 17% of the patients with above-knee extension of the superficial phlebitis. In the clinical management of superficial lower-limb thrombophlebitis, noninvasive tests should be performed to guide therapy. When superficial phlebitis develops after recent surgery or the superficial phlebitis extends above the knee, diagnostic surveillance should be especially strict. When the noninvasive test results are equivocal, phlebography is indicated to rule out DVT.
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PMID:Simultaneous occurrence of superficial and deep thrombophlebitis in the lower extremity. 219 77

Our experience at Hippokration Athens Hospital with high-resolution real-time ultrasonography of the deep veins of the lower extremities is described, drawn from the results of a prospective comparative study of 65 patients. We used a combination of sonography and contrast venography for the detection of deep venous thrombosis (DVT). Of the study group, 33 had clinically suspected DVT, 20 were asymptomatic high-risk patients, while 12 with varicosities of the leg and scheduled for saphenectomy were examined preoperatively for deep venous patency confirmation. For all patients, venography, the reference method, was performed within 12 hours of the ultrasound scan. Since 29 of the examinations were bilateral, the total number of extremities studied was 94. The sonographic criteria analyzed were the intraluminal echogenicity and the venous compressibility with the ultrasound transducer probe. In addition, the response of the common femoral vein to the Valsalva maneuver was studied. Among these three criteria, compressibility was by far the most accurate. Noncompressible abnormal veins were noted in all of the 24 extremities with proximal thrombosis and in six of the 12 with thrombosis limited to the calf veins. Thus, the sensitivity of the compressibility criterion was 100 per cent for proximal and 50 per cent for isolated calf venous thrombosis (83 per cent). All venographically patent veins were fully compressible (specificity, 100 per cent). Abnormal intraluminal echoes were found in 18 of the 36 extremities with thrombosis but not in those with negative findings on venography. Sensitivity of intraluminal echogenicity was, therefore, 50 per cent and specificity, 100 per cent. For the Valsalva criterion, the standard lower normal limit of 10 per cent was applied, leading to 40 per cent sensitivity and 93 per cent specificity rates. In comparison with venography, ultrasonography underestimated the extent of thrombosis in 60 per cent of the true-positive examinations, although never to a clinically significant degree. In conclusion, compression ultrasonography, a technique based upon the unique criterion of venous compressibility, is a highly accurate and objective noninvasive diagnostic method, and is also suitable as a screening test. We urge clinicians to support their therapeutic decisions concerning the management of DVT with it.
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PMID:Compression ultrasonography as a reliable imaging monitor in deep venous thrombosis. 220 Oct 94

The authors present the results of their blind prospective comparative study of the postoperative thromboembolic protection of 490 gynecologic patients. Among them 250 (51%) were protected by a low dose heparin (LDH) subcutaneously in 12-hour intervals, 240 (49%) received heparindihydergot (HDHE). Thromboembolisms diagnosed by the 125J fibrinogen uptake test appeared in 26 (10.4%) patients protected by LDH and 23 (9.6%) by HDHE. The most frequent risk factors in patients with thromboembolisms were malignant diseases, obesity, varicose veins, hypertension and a history of deep vein thrombosis or pulmonary embolism. Haemorrhages appeared in 7 (2.8%) patients protected by LDH and 8 (3.3%) by HDHE.
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PMID:[Prevention of thromboembolic disease in gynecologic surgery]. 221 51

Deep venous thrombosis and its complication pulmonary embolism are responsible for more than 50,000 deaths annually in the US, 2/3 of which occur postoperatively. Nearly 75% of such deaths could be avoided by adequate prophylaxis. All forms of surgery entail some risk of deep venous thrombosis, ranging from 10% after endoscopic prostate resection to over 50% for total hip replacement. 1.6 of thromboses will embolize and 1/4 of pulmonary emboli are fatal. The goal of prevention is to decrease the incidence of fatal pulmonary emboli while limiting the risks related to prevention. A secondary goal is to reduce the frequency of postthrombotic syndrome, a late complication of deep venous thrombosis which frequently causes invalidism. A preoperative evaluation of risks of deep venous thrombosis and of the likelihood of bleeding problems should be followed by selection of appropriate preventive measures. The evaluation should be repeated postoperatively, taking into account such factors as the duration of the intervention, the diagnosis, and the predicted duration of bed rest. Evaluation of the risk of deep venous thrombosis requires knowledge of its etiopathogenesis. Deep venous thrombosis results from a multifactorial process involving venous stasis, lesion of the vascular wall, and anomalies of blood composition. All the clinical risk factors for deep venous thrombosis are related to 1 or more of these elements. Risk factors related to stasis include immobilization, postoperative or postpartum status, pregnancy, and Cockett's syndrome. Risk factors related to lesions of the vascular wall include hip surgery, trauma, age, sepsis, varices and obesity, and postthrombotic syndrome. Risk factors related to blood anomaly include postoperative status, pregnancy, oral contraceptive use, cancer, nephrotic syndrome, hypercoagulability, trauma, and heredity. The most common clinical risk factors for deep venous thrombosis are age, surgical intervention, trauma, burns, cancer, pregnancy and delivery, oral contraceptive use, varices, obesity, and postthrombotic syndrome. The relative risk of deep venous thrombosis among OC users is 4.0 overall and higher for those with type A blood. The pathogenic mechanisms are similar to those of pregnancy except that the fibrinolytic capacity is not change. The principal mechanism is perhaps the declining level of antithrombin III, observed with estrogens and some progestins. Among methods of prevention are different forms of compression, use of heparin alone or in combination with other drugs, and oral anticoagulants.
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PMID:[Epidemiology and etiopathogenesis of deep venous thrombosis of the lower limbs]. 224 Apr 6

Pregnancy is associated with DVT, pelvic thrombophlebitis, and lower extremity varicosities. Pelvic venous compression by the gravid uterus is blamed. A prospective controlled study using plethysmography was performed. Venous capacitance and outflow were measured at term, and at 1 week, 6 weeks and 3 months following delivery. Results show decreased venous capacitance and venous outflow at term pregnancy, no improvement 1 week after delivery, modest improvement at 6 weeks, and dramatic statistically significant improvement in both parameters by 3 months. The persistence of venous dysfunction for several weeks after delivery indicates that changes in venous function at term pregnancy are largely the result of factors other than pelvic venous compression by the gravid uterus.
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PMID:Venous dysfunction of late pregnancy persists after delivery. 226


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