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

Objective assessment of venous function based on venous refilling time recorded by photoplethysmography (PPG) was done in 89 patients with postphlebitic syndrome (47), primary varicose veins (29), and after an episode of acute deep vein thrombosis (13). Limbs with symptomatic postphlebitic changes had a shortened venous refilling time of 15.6 +/- 11 seconds (normal greater than 20 seconds). When venographic findings (ascending and descending) in 47 patients with postphlebitic syndrome were analyzed, it was noted that femoral valve incompetence demonstrated by descending venography was a common finding (81%), even in asymptomatic limbs (85%). Venous refilling time bore no relationship to the degree of femoral venous valve reflux. However, if there were associated diseased deep veins with incompetent perforating veins, the venous refilling time was much shorter (14 +/- 4 seconds) than in limbs without calf perforating veins (27 +/- 11.9 seconds, P less than 0.05). A tourniquet was used to impede saphenous flow, and changes in refilling time were recorded in 34 limbs with varicosities of the long saphenous vein. Refilling time normalized after tourniquet application in 31 limbs (14.43 +/- 4.34 to 30.64 +/- 11.9 seconds), and all patients underwent vein stripping. Postoperative recording confirmed the improvement in venous refilling time (29.52 +/- 27.8 seconds, P less than 0.05). Thirteen patients with acute deep vein thrombosis had serial PPG tests during a follow-up period of 27 months (mean 15.8 months). Seven had initial abnormal PPG results and persistently abnormal readings, and all developed postphlebitic changes. Venous refilling time is an useful test to determine the hemodynamic significance of femoral venous valve incompetence and to assess the effect of vein stripping on varicose veins. In acute deep vein thrombosis, follow-up study may help to identify patients at risk for development of postphlebitic changes.
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PMID:Hemodynamic assessment of venous problems. 684 79

This paper deals with some selected complications of operation. The majority arise from technical faults and errors in judgement or documentation. My choice of topics here has been for their immediate treatment and the avoidance and aftercare of the others. Wrong technique. Combined operations resulting in damage to important adjacent structures: a) arteries: divisions, ligations, stripping; veins: ligation, tearing, avulsion of saphena femoral junction; b) nerves: division, femoral, lateral popliteal, cutaneous; c) lymphatics: particularly in recurrent operations, lymphoma and subsequent oedema; d) skin: particularly incisions through thickened skin, inflammatory skin, oedematous skin; e) connective tissues. Major complications. Haemorrhage, shock, problems with skin closure, methods of dressings, post-operative immediate, anaesthetic problems. Haemorrhage, haematoma, swelling, oedema, lymphatic deep vein thrombosis, pulmonary embolism (1 in 3000--fatal 1 in 30,000). Wound healing, skin necrosis, wound infection. Leg complications: persistent varicose veins, recurrent varicose veins, pain, nerve palsies, chronic oedema.
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PMID:Some complications from surgery in varicose veins. 707 Nov 82

There is little objective evidence available when prescribing aids and appliances such as elastic supports for the leg. Doctors are generally ill-informed about effectiveness, fitting and costs of these garments. The claims of competing suppliers cannot be applied to clinical situations because the garments are tested in vitro on rigid forms. Elastic support for the lower limb is required in the treatment of varicose veins and gravitational disease and has been found effective in prevention of deep venous thrombosis. This study examined the in vivo effectiveness of four commercially purchased garments for these two purposes. The legs of 40 patients with varicose veins, 12 with gravitational disease and 20 patients admitted for elective operations were studied. Pressure exerted by the garment was detected by partly fluid filled bags between garment and limb. The results in patients with varicose veins and gravitational disease were similar. Only two garments exerted effective pressure and of these two the combination of a roller bandage and tapered tubigrip is recommended on grounds of least expense and ease of application. Of the four anti-embolism supports only the roller bandage plus tapered tubigrip produced effective compression: two garments produced reversed flow gradients in the majority of tests. Elastic supports should be double tested, firstly by the manufacturer for basic stretch and regain characteristics and secondly in vivo by clinicians to provide objective evidence of cost effectiveness.
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PMID:Clinical comparison of elastic supports for venous diseases of the lower limb and thrombosis prevention. 707 Nov 91

The 125I fibrinogen test was used in 54 patients before and daily for 4 to 6 days after phlebography, for evaluating the incidence of post-phlebographic thrombosis. The indication for phlebography was in all cases varicose veins with perforators. A significantly increased fibrinogen uptake was found after phlebography in 4/54 patients in the calf, suggesting development of deep venous thrombosis, which, however, could not be confirmed with plethysmography or thermography. None had clinical signs of deep vein thrombosis. The rather low incidence of post-phlebographic thrombosis compared with other series is discussed.
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PMID:Thrombosis after elective phlebography as demonstrated with the 125 I-fibrinogen test. 733 70

The development of postoperative deep vein thrombosis (DVT) was determined in 50 South Indian patients aged 50 years or more using the 125I-fibrinogen uptake technique. The overall incidence was 28 per cent. In patients with malignancy the incidence was 47.6 per cent. Predisposing factors such as varicose veins, oral contraceptives and obesity did not appear important. A retrospective analysis of post-mortem examinations performed on 432 patients dying after operation showed major pulmonary embolism to have occurred in only 1.9 per cent. The disproportion between the frequent occurrence of postoperative DVT and the infrequence of fatal pulmonary embolism warrants further study.
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PMID:Incidence of postoperative venous thromboembolism in South India. 742 43

A prospective study was carried out to confirm the validity of a predictive index for patients at risk of developing deep vein thrombosis. The index, which correctly identified nine out of 10 patients and incorrectly identified seven out of 52 patients as being at risk, is based on five variable--namely, the euglobulin lysis time, serum concentration of fibrin-related antigen, age, percentage overweight for height, and presence of varicose veins. Thus a population of patients at particularly high risk of developing postoperative deep vein thrombosis may be identified preoperatively by means of this index, so that prophylaxis may be used more rationally.
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PMID:Postoperative deep vein thrombosis: identifying high-risk patients. 742 71

Three hundred and eighty-three patients underwent superficial femoral vein ligation and distal venous thrombectomy in the treatment of deep venous thrombosis of the lower extremities. Two hundred and forty-eight patients were reviewed clinically. The results are quite satisfactory; no surgical mortality and no fatal pulmonary embolism. On long term follow-up the clinical symptoms such as pain, swelling, varicosities and ulceration are much less marked in the operated group when compared with the post-phlebitis syndrome which develops when the deep venous thrombosis is allowed to extend into the deep pelvic veins.
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PMID:[Superficial femoral vein ligation and distal venous thrombectomy as surgical therapy for recent thrombophlebitis of the lower extremities. A clinical study (author's transl)]. 746 27

Sclerotherapy has been used with satisfactory results, for several years in the treatment of varicose veins. Nevertheless sometimes sclerosis can be incomplete because of the morphology of lower limbs or because the varicose disease is not clinically evident. In addition, sclerotherapy can give rise to severe complications due to intrarterial or extraluminal injections. In order to exceed this limits, some authors suggested to use a new technique, the echosclerotherapy, which was presented for the first time in Strasburg 1989 by Knight and Vin. Echosclerotherapy is a good help for traditional sclerotherapy, especially when it is applied in the sclerosis of the short saphenous veins, of perforating veins or in unfavourable anatomical situations. From May to November 1993 at the Second Surgical Department of Padua University, 31 patients, 29 women and 3 men, have been treated by echosclerotherapy. 25 patients had great saphenous varicose veins; 3 patients had varices due to perforating veins of the popliteal fossa and 3 patients varices due to Hunter perforating veins. In 48.4% of cases we obtained a complete sclerosis of the vessel; in 38.7% a stump remained near the sapheno-femoral junction of about two centimeters; in one case the treatment was not completed and in one case remained a stump of ten centimeters. Only in two cases Echosclerotherapy was not able to obtain sclerosis. None of the patients had major complications and nobody had deep vein thrombosis. If we consider our results altogether we can say that in 87% of cases we had good results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Echo-sclerotherapy in the management of varices of the lower extremities]. 747 42

Insufficiency of epifascial veins promotes venous ulceration and increases thromboembolic risk in general surgery patients. Epifascial varicose vein stripping is therefore considered the most effective prophylactic procedure. Thromboembolic risk of patients undergoing this surgical procedure has not yet been prospectively evaluated but appears to be lower than in general surgery patients. The gold standard of preoperative assessment of varicose surgery patients is ascending pressure phlebography, but this technique is invasive, time consuming and costly. We prospectively investigated 100 consecutive varicose vein surgery patients for postoperative thrombosis. Ascending pressure phlebography (APP) and colour coded duplex sonography (CCDS) were performed before and 10 to 21 days after the stripping operation in 100 and 70 patients, respectively. APP revealed no postoperative deep vein thrombosis in all 100 limbs investigated (0 percent; 95 percent confidence interval: 0 to 2.95). With regard to epifascial vein reflux there was good agreement between APP and CCDS (quadratic weighted kappa: 0.76). In 67 out of 73 superficial veins investigated excellent agreement of diagnostic accuracy was found for both diagnostic procedures (91.78 percent; 95 percent confidence interval: 82.96 to 96.92). We conclude that thrombotic risk of varicose vein surgery is low in properly selected patients. CCDS provides a high degree of accuracy in diagnosis of reflux and regular vein morphology and should therefore replace APP; however, APP does remain essential in the preoperative workup of atypical anatomical variants.
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PMID:Varicose vein stripping--a prospective study of the thrombotic risk and the diagnostic significance of preoperative color coded duplex sonography. 749 65

The positive and negative clinical symptoms and signs of deep venous thrombosis are both insensitive and non-specific. Venography is the reference investigation: Duplex ultrasonography is the usual diagnostic procedure for distal deep venous thrombosis but it is less reliable in proximal lesions. The sensitivity of plethysmography in proximal deep venous thrombosis is high but the diagnosis of isolated calf vein thrombosis and non-obstructive proximal thrombosis escape diagnosis in this technique. Most cases of deep venous thrombosis occur after major surgery, during pregnancy, in the post-partum period, after prolonged immobilisation and in obese patients or those with varicose veins. Congenital and acquired causes should also be investigated when spontaneous deep venous thrombosis occurs or when the condition complicates minor surgical trauma in a young patient. The incidence of deep venous thrombosis varies with the type of surgical procedure: 25% in general surgery, 50% after hip or knee arthroplasty, 43% after fracture of femur, 24% after neurosurgery. Graduated pressure stockings should be used for the prevention of deep venous thrombosis. Other measures include aspirin, dextran, oral and subcutaneous anticoagulants, non-fractionated and low molecular weight heparins. The relative efficacy of these different measures is discussed with respect to each type of surgical procedure.
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PMID:[Prevention of deep venous thrombosis]. 764 53


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