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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 measurement of supine pedal venous pressure as a screening test for deep venous thrombosis is re-evaluated. In 83 extremities studied in 50 patients, the false-positive rate was 62%, the false-negative rate 8%. Chronic venous disease, whatever its etiology but particularly in association with the post-phlebitis syndrome, can be a source of error in relying upon this measurement.
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PMID:Supine pedal venous measurement in patients with venous disease. 42 10

The prime therapeutic objective of prophylactic anticoagulation for patients undergoing total hip replacement is to reduce to a minimum fatalities from pulmonary embolism. Our low-dose heparin-warfarin prophylactic anticoagulation protocol affords significant protection in this regard (one fatal pulmonary embolism in 796 cases) without the use of venography or other objective tests to check for deep venous thrombosis and for all patients including those with venous disease or a history of prior thromboembolic disease. The 13.1% hematoma rate (5.0% late major) is a small, nonlethal, and acceptable price to pay for this protection.
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PMID:The efficacy of low-dose heparin--warfarin anticoagulation prophylaxis after total hip replacement arthroplasty. 47 94

A case of pseudothrombophlebitis syndrome occurred in a young man with colitic arthropathy who was seen because of a swollen leg. The salient features of this syndrome, the difficulty in differentiating it clinically from true deep venous thrombosis, and the importance of correct diagnosis are stressed, particularly in light of the fact that patients with inflammatory bowel disease are predisposed to occlusive venous disease.
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PMID:Pseudothrombophlebitis syndrome in the arthropathy of granulomatous colitis. 48 52

Erroneous diagnosis of leg vein thrombosis among pill users could be attributed to the unreliability of clinical diagnosis. To prove this point, the result of Doppler ultrasonic evaluation of pill users with suspected leg vein thrombosis were compared with those of non-pill users suspected of deep vein thrombosis. 129 women (54 cases and 75 controls) of similar age, clinical manifestations, and absence of predisposing factors (e.g., trauma, recent surgery, malignancy) underwent a complete venous Doppler examination. The incidence of venous thrombosis among pill users was confirmed by the Doppler method in only 16.7% of pill users and 30.7% of non-pill users (P = .052). The results of this study, however, did not define the true incidence of venous thrombosis among pill users. This was attributed to the fact that only patients with suspected venous disease were objectively diagnosed; many patients with proven venous thrombosis may be asymptomatic and could not detected by conventional clinical studies. At best, this study demonstrated the necessity of using an objective screening technique, such as the Doppler ultrasonic, on patients (especially women on oral contraceptives) suspected with deep vein thrombosis; it also resulted in establishing some guidelines in managing treatment of such patients.
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PMID:Erroneous clinical diagnosis of leg vein thrombosis in women on oral contraceptives. 65 2

Phleborheography, a recently described noninvasive test for deep venous thrombosis, was compared with leg venography in 75 patients. Acute deep venous thrombosis was accurately diagnosed by phleborheography in 24 patients, with no false-positive diagnoses. External venous compression without thrombosis was diagnosed correctly in two patients. The remaining patients appeared normal or had chronic venous disease by phleborheography; however, 11 of these had acute deep venous thrombosis by venography, for a false-negative rate of 31%. Most undetected thrombi were in small calf veins. The specificity of phleborheography is thus 100%, but the sensitivity is only 69%. Similarly, its positive predictive value is 100% and the negative predictive value is 78%. When phleborheography shows acute deep venous thrombosis, this diagnosis may be accepted with confidence and therapy chosen accordingly, without venographic confirmation. Venography may still be required to withhold anticoagulation when phleborheography is negative.
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PMID:Noninvasive diagnosis of deep venous thrombosis by phleborheography. 67 77

The iliac compression syndrome is caused by impaired venous drainage of the left leg, secondary to compression or stricture of the left iliac vein at, or just before, its junction with inferior vena cava. Serious potential complications are deep vein thrombosis, pulmonary embolism, venous congestion, and the resultant incapacity. Nine patients in whom the diagnosis was confirmed by iliac phlebography are described. Iliac pressure determinations were made in 7 patients. Four patinets underwent resection, and retroplacement of the right iliac artery behind the left iliac vein. The operative results were good. This rare syndrome should always be considered in the differential diagnosis of peripheral venous disease, as it can be treated in the early stages. If it is left untreated, there is a risk of pulmonary embolism or incapacitating peripheral vascular disease.
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PMID:The iliac compression syndrome. 69 50

This report describes a favorable experience with 140 cases of surgical intervention in deep venous disease of the lower extremity, divided between acute and chronic problems. Of these, 107 were treated for acute phlebitis and 33 for deep venous insufficiency. Seventy-seven cases of acute iliofemoral phlebitis underwent thrombectomy. Preoperative venography was done in all, and postoperative venography was done in 57 patients. Of these, 75% had patent iliofemoral segments after a modified surgical approach. A positive correlation has been found between the degree of adherence of the iliofemoral clot and the postoperative patency rate--and this usually can be predicted from the preoperative venographic findings. Clinical follow-up averages 4 years and extends to 11 years. Ligation and division of the superficial femoral vein was done as the sole procedure in 30 patients with acute deep venous thrombosis (DVT) and in five with deep vein insufficiency. Its indications were guided by preoperative venography. It has been successful as a means to control emboli in selected cases. Long-term ill-effects have been minimal. In chronic severe venous insufficiency, expanded applications for surgery are presented. Ligation of incompetent veins, reconstruction of valves, and anastomosis of major segments of the femoral system are presented with preoperative and postoperative studies. Postoperative thrombosis has not been a problem. Specific procedures are presented to remedy chronic problems of the deep venous system.
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PMID:Surgery in acute and chronic venous disease. 75 13

A new strain gauge plethysmography was developed to permit accurate electrical calibration and automatic calculation of limb blood flow from a panel meter. This instrument was used to quantitate maximum venous outflow (MVO) in both limbs of 20 normal volunteers and 387 limbs of 195 patients with clinically suspected leg vein thrombosis. The MVO of normal subjects averaged 45 +/- 18 cc/minute/100 cc of calf tissue (mean +/- 1 SD). In 69 limbs with deep vein thrombosis documented by Doppler ultrasound and/or phlebography, the MVO averaged 17 +/- 13 cc/minute/100 cc, which was significantly less than that of normal limbs (p less than 0.001). Only three of 31 limbs with venous thrombosis above the knee had MVO above 20 cc/minute/100 cc, the lower limit of normal, for a diagnostic sensitivity of 90%. The specificity of a normal MVO in excluding deep vein thrombosis was 81%, with only a 1% rate of false-negative diagnoses above the knee. This automatic strain gauge plethysmograph has the attribute of providing rapid quantitation of limb venous hemodynamics which facilitates noninvasive diagnosis and follow-up assessment of venous disease.
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PMID:Detection of deep vein thrombosis with an automatic electrically calibrated strain gauge plethysmograph. 87 65

The Doppler and phleborheographic technics are highly accurate and convenient methods of diagnosing acute deep venous thrombosis, which cannot be detected reliably by clinical examination. Extent of occlusive disease can be more quantitatively estimated by the Doppler method in the peripheral arteries of the limbs and by oculoplethysmography and phonoangiography in the carotid arteries. Noninvasive methods permit screening of patients suspected of arterial or venous disease and provide physicians with an objective means of assessing therapeutic results.
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PMID:Extending the vascular examination by noninvasive means. 88 25

The complex embryologic development of the vascular system often results in a myriad of clinically relevant anomalies. It has been stated that the classic anatomic venous pattern in the lower extremity is found in only 16 percent of patients. Previous studies on this topic are limited to isolated venous dissections or phlebography that lack complete anatomic detail. The recent introduction of high resolution duplex scanners for the assessment of veins of the lower extremity provides a unique opportunity to determine the incidence of anatomic variation. The current prospective study was done to identify venous or arterial anomalies apparent during routine duplex scanning of the lower extremity performed to rule out deep venous thrombosis (DVT). Limbs that had evidence of acute or chronic extensive DVT were excluded. Of 1,600 consecutive extremity scans, 946 extremities (59 percent) had no evidence of DVT. Of these, there were 43 patients with 64 anomalies in 57 extremities. The mean age of the group was 53.4 years. There were 24 women (55.8 percent) and 19 men (44.2 percent). There were 59 (92.2 percent) venous and five (7.8 percent) arterial anomalies. Duplication of the superficial femoral vein was the most common anomaly noted. Duplication of the deep femoral and popliteal vein was also noted. Unilateral anomalies were more common than bilateral anomalies, namely 67.4 versus 32.6 percent, respectively. Pain and swelling, common complaints in the patients with an anomaly, were noted in 71.4 and 45.7 percent, respectively. The frequency of deep venous anomalies of the lower extremities may be less than previously reported. Knowledge concerning the incidence and distribution of venous anomalies may lead to improved assessment and treatment of venous disease.
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PMID:Venous and arterial anomalies of the lower extremities diagnosed by duplex scanning. 141 86


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