Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Combined direct injection venography (DIV) and equilibrium angiography (EA) were performed in 13 patients, by injecting in vitro labeled 99mTc autologous RBC, via pedal veins, and imaging the first pass and the equilibrium phase. This paired comparative study of DIV with EA shows that DIV has advantages over EA because it provides selective information on the deep venous system from the calves to the inferior vena cava. DIV provides information on the flow dynamics and the high contrast first pass images provide better definition of non filling venous segments as well as visualization of collaterals. When using 99mTc-MAA, lung perfusion can also be imaged. DIV is recommended as the procedure of choice for the diagnosis of DVT and EA should be employed only when pedal vein injection is not possible.
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PMID:Radionuclide venography vs Tc-99m-RBC equilibrium angiography: a comparative paired study. 362 64

Chromogenic substrate (CS) assay of heparin may be performed with or without addition of antithrombin (AT) to the test plasma. Both types of assay are used for monitoring of heparin therapy, reflecting either heparin activity (heparin act), or heparin concentration (heparin conc) when AT is added. In plasma samples from 43 patients treated with intravenous heparin for DVT, the ratio between heparin act and heparin conc varied from 0.36 in patients with AT plasma concentration below 0.50 U/ml, to 0.85 in patients with AT above 1.00 U/ml (mean ratio 0.61). A formula expressing heparin act as a function of AT and heparin concentration in the test plasmas of the patients was used to calculate heparin act of the total material comprising 280 patients. Mean heparin act and heparin conc were both significantly correlated to clinical outcomes (bleeding complications, pulmonary embolism and phlebography score). For monitoring heparin therapy, guidelines for plasma heparin activity or concentration ("therapeutic ranges") are requested. When using a heparin act assay, the heparin dose needed in patients with low plasma AT concentration to reach a fixed therapeutic range, may imply undue risk of bleeding. On the other hand, when a heparin conc assay indicate plasma heparin conc within therapeutic range, antithrombotic activity may still be inadequate in patients with low plasma AT concentration.
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PMID:Monitoring of heparin therapy: should heparin assays also reflect the patient's antithrombin concentration? 362 42

The efficacy of fibrinolysis in DVT is dependent upon the age and organization of the thrombus as well as its localization. In consequence, selective evaluation prior to determining the indication for thrombolytic therapy is just as important for therapeutic success as choosing the appropriate fibrinolytic agent. To improve the results of fibrinolysis a team of angiologists, hemostaseologists, radiologists and surgeons are cooperating in a special "thromboembolic care unit". Phlebographic criteria were defined which allow differentiation of fibrinolytic indications depending upon the site of the thrombus. Selection of the fibrinolytic agent and careful monitoring of the thrombolysis should ensure a maximum therapeutic effect with a minimum of bleeding complications. The duration of thrombolysis was established through phlebographic verification and functional tests with venous occlusion plethysmography. The cause and results of 108 cases of thrombolysis shall be presented.
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PMID:[Use of streptokinase and urokinase in deep venous thrombosis and pulmonary embolism: indications and clinical experience]. 368 40

Protein C(PC) is the zymogen of a serine protease which regulates blood coagulation by inactivating activated blood coagulation factors V and VIII. We investigated the plasma level of PC in patients with deep vein thrombosis (DVT, n = 50), Buerger's disease (n = 34), arteriosclerosis obliterans (n = 37) and myocardial infarction (n = 17). PC in plasma was determined by rocket immunoelectrophoresis using a monospecific anti-PC antiserum raised in rabbits. Our study indicated that only in DVT the level of PC was decreased in comparison with the normal control (p less than 0.05). This decrease may be accounted for by increased utilization of PC for the regulation of continuously activated blood coagulation mechanism possibly ongoing in patients with DVT. On the other hand, among the patients with the DVT, we found a homozygous PC deficiency combined with a heterozygous dysplasminogenemia in a 22-year old male who had been suffering from recurrent venous thrombosis since the age of 14. Although the homozygous form of PC deficiency has been reported to be closely associated with fatal thrombotic disorders including purpura furminans during the neonatal period, the patient reported here had surprisingly survived the neonatal period and the childhood without any clinical manifestation relevant to thrombosis.
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PMID:[Protein C dynamics in peripheral arterial occlusive diseases and myocardial infarction: association of homozygous protein C deficiency with heterozygous dysplasminogenemia found among patients with deep vein thrombosis]. 375 30

Surgical therapy for DVT in the legs, including reconstruction of the blood circulation system and thrombectomy with a Fogarty catheter, is not always satisfactory, as indicated by the variety of opinions both for and against them. However, it is also a fact that postphlebitic syndrome can result from incomplete treatment. Therefore, surgical approaches should by given priority in the acute stage of the disease. In 5 patients who showed either complete obstruction or insufficient removal of thrombi from the proximal region in leg DVT, we performed crossover femoro-femoral bypass using EPTFE (including two wire reinforced grafts) and were able to obtain good long-term patency over periods of 8-18 months.
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PMID:Reconstruction with insertion of expanded polytetrafluoroethylene (EPTFE) for iliac venous obstruction. 378 73

With an amidolytic assay plasma heparin activity is measured in patients undergoing elective abdominal surgery and general surgery under LDH-prophylaxis. The data obtained suggest that the response of the hemostatic system to 3 X 5000 U. heparin is individual and unpredictable. In 82 patients undergoing hip fracture surgery it could be demonstrated that there is a correlation between anticoagulant heparin activity and the incidence of DVT.
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PMID:[Prevention of thromboembolism with low-dose heparin]. 380 65

PE, a common and serious pulmonary problem, most often results as a complication of DVT in the lower extremities. There are no specific symptoms or signs that allow a clinical diagnosis of PE. The best approach to the diagnosis is controversial and is at least partially dependent on the diagnostic capabilities and expertise available at a given hospital. Pulmonary arteriography is the definitive diagnostic test and should be considered in patients with results of less-than-high probability V-Q scans, those at high risk of bleeding complications with anticoagulation therapy, and those considered candidates for thrombolytic therapy.
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PMID:Pulmonary embolism. 384 26

The sensitivity of impedance plethysmography (IPG) for diagnosing deep vein thrombosis was evaluated in the presence of dihydroergotamine, an agent with significant venoconstrictor activity. In a prospective, randomized, controlled clinical trial, 105 patients undergoing total hip replacement surgery were investigated to evaluate the thromboprophylactic efficacy of DHE-Heparin using IPG and 125I-Fibrinogen Leg Scanning to monitor the incidence of DVT. Retrospective analysis of the IPG data indicated that DHE-Heparin impaired the sensitivity of impedance plethysmography by decreasing venous capacitance and venous outflow. Although the patient sample size was relatively small, the results showed trends which suggested that the utility of impedance plethysmography for diagnosing DVT was limited in the presence of a vasoactive agent. Alternate noninvasive diagnostic methods may need to be considered in select patients receiving concomitant medications possessing venoconstrictor activity.
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PMID:Limitation of impedance plethysmography in assessing efficacy of dihydroergotamine-heparin prophylaxis of deep vein thrombosis. 388 36

The efficacy and safety of a low-molecular-weight (LMW) heparin fraction in preventing postoperative venous thrombo-embolism, was assessed in a double blind, randomly allocated trial, and in an 'open' study. Of 395 patients included in the double blind trial, 199 received unfractionated (UF) calcium heparin, and 196 the LMW heparin fraction. The data were analysed on an 'intention to treat' basis. The two groups were well matched for risk factors which could predispose to the development of venous thrombosis. Fifteen (7.5 per cent) of one hundred and ninety-nine patients receiving UF heparin, and five (2.5 per cent) of one hundred and ninety-six patients in the LMW heparin group developed DVT (P less than 0.05). There was no significant difference between the two groups in terms of excessive incisional or total blood loss during surgery, postoperative drainage or wound haematoma formation. Of 910 patients included in the 'open' study who received a single injection of LMW heparin every day, 30 (3.2 per cent) died during the postoperative period; in none of the autopsied patients were pulmonary emboli detected. Thirty-one (3.4 per cent) patients developed isotopic DVT; twenty-seven (2.9 per cent) were receiving prophylaxis at the time the DVT was diagnosed. Thirty-six (3.9 per cent) patients developed wound haematoma; twenty-five (12.4 per cent) of those were in the two hundred and one undergoing surgery for gynaecological conditions, and eleven (1.5 per cent) in the seven hundred and nine patients having general abdominal surgery. This difference is statistically significant (P less than 0.001). The results of a double blind trial indicate that a single daily injection of 1850 APTT units (7500 antifactor Xa units) of a LMW heparin is more effective than 10 000 APTT units of commercially available UF heparin in preventing postoperative DVT. The findings of the 'open' study suggest that this regimen also provides an effective prophylaxis against post-operative major pulmonary embolism.
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PMID:Efficacy and safety of low-molecular-weight heparin (CY216) in preventing postoperative venous thrombo-embolism: a co-operative study. 389 40

DVT involving the lower extremities is a frequent (25-40 percent of patients) complication of major thoracic, abdominal, and pelvic surgery in patients beyond the age of 40 years. Herein, we have reported a recently completed large prospective, randomized multicenter investigation of the prophylaxis of postoperative DVT in the United States. A total of 880 patients were randomized into five treatment groups: 0.5 mg of dihydroergotamine plus 5,000 IU of heparin (DHE/H5,000), 0.5 mg of dihydroergotamine plus 2,500 IU of heparin (DHE/H2,500), 5,000 IU of heparin alone (H5,000), 0.5 mg of dihydroergotamine alone (DHE), or placebo. Administration was by the subcutaneous route, using the anterior abdominal wall on a twice daily schedule. Treatment was initiated preoperatively and continued twice daily for 5 days. Daily radiofibrinogen uptake tests revealed the following DVT rates: DHE/H5,000 9.4 percent, DHE/H2,500 16.8 percent, H5,000 16.8 percent, DHE 19.4 percent, and placebo 24.4 percent. DHE/H5,000 was significantly superior (p less than 0.05) to all other treatments in this respect. Adverse drug experiences did not differ significantly between groups and consisted primarily of postoperative bleeding (2 to 3 percent of patients), injection site hematoma (6 to 12 percent of patients), and wound hematoma (1 to 3 percent of patients).
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PMID:United States trial of dihydroergotamine and heparin prophylaxis of deep vein thrombosis. 390 90


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