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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 occurrence of a "rebound hypercoagulable state" in patients after dicontinuation of oral anticoagulants is still a matter of debate and no definite recommendation can be made on the best procedure for anticoagulant withdrawal. The present study investigated the changes in the levels of markers of activated blood coagulation in 32 patients (pts) in whom warfarin treatment (for venous thromboembolic disease) was randomly withdrawn abruptly (n = 17, group A) or gradually (n = 15, group B: 2/3 of initial dose the 1st week, 1/3 the 2nd weeks and nothing from the 3rd week on). Blood was sampled at baseline, once a week for the first three weeks and after 2 months. At the 1st week group A had significantly higher F1+2 and TAT values (p < 0.001); at the 2nd week F1+2 levels remained higher (p < 0.05) though INR values were not different from those of group B. After baseline, higher than normal F1+2 levels were recorded in 32/66 (48%) controls in group A vs 15/60 (25%) in group B (p < 0.01); at the 2nd week, 10/17 (59%) patients in group A vs 1/15 (7%) in group B still had higher than normal F1+2 levels (p < 0.01). The values of areas under curve (AUC) and maximum concentrations of all variables were not statistically different in the two groups; however, very high levels were observed in a few cases of group A. Thrombotic events (one DVT recurrence and one thrombophlebitis in a varicose vein) occurred in 2 pts of group A, both with high F1+2 and TAT AUC values.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Activation of blood coagulation after abrupt or stepwise withdrawal of oral anticoagulants--a prospective study. 783 56

Day-only admissions for surgery are strongly encouraged, in an effort to keep costs down. Varicose vein surgery has been considered too major for day-only management despite the fact that there have been studies from overseas showing that it can be done with a morbidity comparable to inpatient surgery. The morbidity of day-only surgery for varicose veins (both long and short saphenous procedures) was assessed and compared with the results of inpatient surgery. Patients were also asked whether they were satisfied with the surgery being done this way. There were 165 consecutive patients available for study, 64 day-only and 101 inpatient. All patients attending Shellharbour Hospital. Shellharbour, had surgery done as day-only (as it was a morning list and allowed adequate time for recovery). Patients attending Bulli Hospital, Bulli, had surgery done as an inpatient (afternoon list). All surgery was performed by one surgeon. There was no difference (Chi-squared) in the age distribution (mean 48 years for day-only, 51 years for inpatient) or sex proportion in either group (Chi-squared test of proportions with continuity correction). Assessment of the results was done by review of the surgeon's notes, as well as telephone interviews for day-only subjects. The complication rate in both groups was similar. Wound problems represented the main complication with an incidence of 10.5% in each group. There was one deep venous thrombosis (DVT) in each group (diagnosed by duplex scan). Response to the telephone interview suggested that most patients were happy to have the surgery done as a day-only procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Day-only admission for varicose vein surgery. 794 66

Chronic venous insufficiency of the lower limbs is a frequent disorder that has costly repercussions for society as a whole. It is important to distinguish between abnormality of venous function and its most frequent causes, which are sequelae of deep venous thrombosis and varices of the lower limbs. Chronic venous insufficiency manifests by functional symptoms, based on the heavy leg syndrome, which is very frequent but not specific, and on objective distal signs that are highly specific. Both prognosis and cost of the disorder are based on such objective signs, cutaneous and subcutaneous complications of stasis and of venous hypertension, ranging from simple ochre dermatitis to recurring ulcers and ankylosis of the ankle. Dermo- and hypodermatitis and ulcers complicate less than 10% of chronic venous insufficiency but are responsible for most of the cost involved, two-thirds of which is linked to invalidity. Clinical grades of chronic venous insufficiency have been established, which should facilitate standardisation and comparison of epidemiological, pathophysiological and therapeutic data. Diagnosis of chronic venous insufficiency is by clinical examination, while etiological investigation should most often be done by technical investigation.
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PMID:[Mechanisms, epidemiology and clinical evaluation of venous insufficiency of the lower limbs]. 805 8

Chronic venous insufficiency of the lower limbs has varied expressions: purely functional disorders, varicose veins, varicosities, oedema and trophic cutaneous disorders. For a given individual, these aspects are not necessarily increasing stages of severity of the same disease. On the other hand, many associations are possible; they are determined by the mechanism and the degree of chronic venous insufficiency, as well as by the clinical situation in which they develop. Work-up is based on careful clinical examination. Doppler examination and echography are useful for varices if radical treatment is considered. Ultrasound examination is required in case of cutaneous ulcer in order not to mistake a varicose ulcer for a trophic disorder due to incontinence of deep venous trunks, most often of thrombotic origin. Varicose veins can become complicated. Varicose haemorrhage requires immediate treatment by compression. Superficial phlebitis needs doppler examination and echography because it can be associated to deep venous thrombosis. With regard to varices and chronic venous insufficiency, treatment varies according to the concerns of the patients. Elastic compression stockings are useful whatever the clinical expression of the disease. "Phlebotropic" drugs can be used whenever venous insufficiency is associated with functional symptoms. The use of radical treatment, whether sclerosing injections or surgery, depends on anatomic lesions, the degree of venous incontinence and the severity of symptoms, but also on the desires of the patients, fully informed as to the advantages and the limitations of each technique. Personalized treatment is thus possible.
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PMID:[Essential varicose veins and chronic venous insufficiency]. 805 10

Venous post-thrombotic disease is a common complication of deep venous thrombosis of the lower limbs. Prevalence is around 75% after a five-year follow-up and 25% of these patients suffer from severe disorders. The clinical symptoms are non-specific and begin months or years after the acute thrombosis. The patients' claims range from uncomplicated oedema, leg cramps and superficial varicose veins to permanent skin changes (dermatitis, hypodermatitis, leg ulcers). Functional vascular exploration (continuous-wave Doppler, plethysmography, pulsed-wave echo-Doppler, exceptionally venography) allows a better knowledge of the haemodynamic consequences of the post-thrombotic disease: deep persistent truncular obstruction, partial or total recanalization, valvular incompetence and reflux in the deep veins, superficial varicose veins, incompetence of the perforating veins in the gaiter area, failure of the calf venous pump and microangiopathy.
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PMID:[Venous post-thrombotic disease]. 805 11

Indications for duplex scan in venous surgery. Vascular surgeons are led to request Duplex Scan examination of patients with chronic venous insufficiency in a number of circumstances: A) To obtain information supporting the diagnosis and treatment plan: Chronic venous insufficiency may be due to isolated superficial venous insufficiency or (and) deep venous insufficiency (post-thrombotic syndrome, primary deep valvular insufficiency, congenital malformation). In practice, Duplex Scan examination of the deep venous system is indicated whenever the patient's history is suggestive of deep venous thrombosis or the clinical status is stage 2 or 3 (Ad Hoc Committee classification). In patients with reflux in the popliteal fossa, Duplex Scan is helpful because physical examination and Doppler cannot correctly differentiate short saphenous insufficiency, gastrocnemius insufficiency and reflux in the popliteal-tibial axis, especially as these physiopathologic mechanisms may be associated. In patients with atypical varices, Duplex Scan can demonstrate: Absence of reflux in the greater saphenous vein-femoral vein termination or the short saphenous vein-popliteal vein termination. Varices in the lateral or posterior thigh. In patients with varicose vein thrombosis, Duplex Scan can reveal: The extent of any association with deep venous system. The extent of superficial venous thrombosis. When the results of varicose vein surgery are unsatisfactory, Duplex Scan can determine whether a redo surgery is justified: Persistence of a major leak between the deep and superficial venous system usually prompts redo surgery. Less often, recurrence is due to primary deep valvular insufficiency, in which case valvuloplasty may be indicated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The contribution of Doppler echography in the diagnostic and therapeutic plan in chronic venous insufficiency surgery]. 811 81

Color Doppler is a technique which performs a real-time opacification of the vascular system with blue indicating reverse flow and red indicating forward flow (directional color coding). In venous pathology, the use of color Doppler improves significantly the anatomical evaluation of the inferior vena cava, the iliac vein, the deep femoral vein, and the sural system. Color Doppler facilitates the study of deep venous thrombosis (providing useful information to differentiate ancient from most recent thrombus) and also the study of post-thrombotic conditions (assessment of reverse flow, repermeation phenomena). Finally, color Doppler produces a better insight for the study of varicose veins, especially with regard to mapping, identification of communicante veins, and study of the external saphenous vein.
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PMID:[Venous Doppler color echography: importance and inconveniences]. 811 80

During a 5-year period 131 patients with symptomatic deep venous thrombosis of the lower extremities (DVT) were identified in a black Caribbean population. Eighty-one patients (61%) had objective evidence (ascending venography), while in 39% the diagnosis was based on clinical findings only. The overall annual incidence rate for definite DVT was 11 per 100,000 person years; there was a steep increase with age in both sexes. Proximal DVT was present in 69% of patients. Swelling (92%), pain on palpation (89%) and tenderness (87%) were the most frequent symptoms, while immobilization (43%) and varicosities (42%) were the most frequent risk factors; DVT was rare during pregnancy (1 in 15,000 deliveries). Seventeen patients (21%) developed pulmonary embolism and five patients (6.2%) died during the hospital stay (four of fatal pulmonary embolism, one due to toxic epidermolysis after venography). We conclude, that symptomatic DVT of the lower extremities has a low incidence in this black Caribbean population, but is nonetheless associated with considerable morbidity and mortality due to pulmonary embolism.
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PMID:Incidence and course of symptomatic deep venous thrombosis of the lower extremities in a black Caribbean population. 811 81

Patients with venous leg ulcers have a readily recognized clinical syndrome of shallow ulcers, oedema, leg pain, venous ankle blush, lipodermatosclerosis, varicose veins, hyperpigmentation, and atrophie blanche, and they are assumed to have venous abnormalities. We examined 43 patients with venous leg ulcers, and compared those with obvious venous abnormalities (defined as historical or clinical evidence of deep venous thrombosis or varicose veins) with those with presumed venous abnormalities (defined as lacking any such evidence), to see if they presented with different clinical features. We found that both groups had similar clinical features, with the exception that lipodermatosclerosis was present more frequently in those patients with obvious venous abnormalities (94 vs. 36%, P < 0.001). Most patients with presumed venous abnormalities had musculoskeletal conditions which might cause calf pump dysfunction (91%). Using air plethysmography, we were unable to confirm that all patients with presumed venous abnormalities did have intrinsic venous abnormalities. We propose that ulcers occurring in this clinical syndrome be designated as calf pump dysfunction ulcers (CPD ulcers), rather than venous ulcers.
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PMID:Venous leg ulcers: an analysis of underlying venous disease. 828 23

Of the more than 200 patients recently evaluated for venous disease, 8 were diagnosed with lower extremity masses. Three patients were referred for superficial phlebitis and four for deep venous obstructive disease. The eighth mass was found during work-up for varicose veins. Five masses were identified by palpation, and three were identified by duplex scan. All were confirmed by magnetic resonance imaging (MRI) or computed tomography (CT). Of the eight masses, three were malignant: a metastatic melanoma, a histiocytoma, and a myxoid liposarcoma. Nonmalignant masses included a hematoma, an inflammatory lesion, a hemangioma, and an intramuscular lipoma. One patient presented with deep venous thrombosis secondary to an occluded popliteal artery aneurysm compressing the popliteal vein. Thus, patients presenting with ostensible venous disease may have other pathologic conditions responsible for symptomatology. Careful physical examination will reveal a mass in a majority of patients who have one. Duplex scanning will identify masses that should be confirmed by MRI or CT. Definitive diagnosis should be made by biopsy, due to the high possibility of malignancy.
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PMID:Patients evaluated for venous disease may have other pathologic conditions contributing to symptomatology. 839 61


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