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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 effects of peroperative electrical calf muscle stimulation with groups of impulses giving a short lasting tetanus of the calf muscles on postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE) were compared with that of dextran 40 given per and postoperatively. The incidence of DVT and PE during the first 4-6 postoperative days was recorded. The diagnosis of DVT was based on the 125I-fibrinogen uptake test and phlebography and of PE on pre- and postoperative perfusion pulmonary scintigram and chest X-ray examination. Both methods reduced the incidence of PE. Calf muscle stimulation reduced the DVT incidence in patients with malignant disease while the reduction in DVT incidence for the whole group only was significant in the stimulation as well as the dextran 40 group. Mean values for preoperatively determined levels of antithrombin III, beta-thromboglobulin, fibrinopeptide A, plasminogen and ability to release fibrinolytic activity during venous stasis did not differ between those patients who developed or those who did not develop postoperative DVT or PE. However, antithrombin III levels below 80 per cent appeared to predispose to postoperative thromboembolism. The two prophylactic methods have similar effects on the incidence of postoperative thromboembolism. The stimulation method has certain advantages due to its safety and simplicity.
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PMID:Prediction and prophylaxis of postoperative thromboembolism--a comparison between peroperative calf muscle stimulation with groups of impulses and dextran 40. 618 44

The fibrosis of the hypodermis in the lower part of the leg is a sign of venous stasis. But it appears in various forms. One is diffuse, circular, atrophic sclerosis, in a patch, occurring frequently in old post-thrombotic syndromes, another is sclerous hypodermititis in plaque form, submalleolar, well circumscribed and without aetiopathogenic links with deep venous thrombosis. This latter form is the only one to respond favorably to surgical resection.
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PMID:[Does hypodermectomy have a role in surgery for postphlebitic syndrome?]. 651 4

The authors focus their prevention of post-operative deep venous thrombosis in hip- surgery on the struggle against venous stasis bearing the following points in mind: pre-operative angiological examination whenever that is possible (investigation of haemodynamic parameters in deficient venous zone, motivating the patient by explanations of why and how he will have an important active role to play); systematic pre- and post-operative, even per-operative, elastic compression; early nursing, respiratory reeducation, static and dynamic muscular exercise; leaving bed early on the day after the operation, with pressure on the planta, anti-inflammatory medication, never systematic anti-coagulants except in a few very rare specific cases. The authors' view has been confirmed by the clinical results following the analysis of 353 surgical hip operations. In the two months following operation, there have been only 11 regrettable cases (that is 3%) of possible thrombo-embolie incidence: 5 cases of phlebitis; one benign pulmonary embolism (three of these patients were on a course of preventive anti-coagulation treatment) and five sudden deaths (massive pulmonary embolism mentioned on principle) in patients of extremely advanced age: 88 years average.
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PMID:[Prevention of phlebitis in orthopedic traumatology. Personal experience in surgery of the hip]. 671 2

The primary factors that result in pulmonary embolism are venous stasis, intimal damage and hypercoagulability. Although pulmonary embolism is rare after calcaneal fracture, the possibility should not be overlooked because of the gravity of the consequences. Awareness of the risk factors resulting from the combination of long-term bed rest and immobilization may reduce the occurrence of deep venous thrombosis and pulmonary embolism.
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PMID:Calcaneal fracture with pulmonary embolism. 672 60

Electrical calf muscle stimulation during surgery has been used for the prevention of deep vein thrombosis (DVT) with varied results in several studies. This effect is mainly achieved by the reduction of venous stasis in the legs. Another possible beneficial effect might be an increased fibrinolytic activity of the blood secondary to the muscle contractions. Previously, single electrical impulses have been used for stimulation, giving rise to 'single twitches' in the muscles. In the present study the effect on calf volume of muscle stimulation with groups of impulses giving a short-lasting tetanus was investigated. Changes in calf volume were recorded by strain gauge plethysmography. Optimal values for duration, number and frequency of the impulses within the groups were determined. Stimulation with groups of impulses reduced calf venous volume approximately three times more efficiently than stimulation with single impulses. Calf muscle stimulation did not enhance the increase in fibrinolytic activity of venous blood observed after oesophago- or laryngoscopies under general anaesthesia.
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PMID:Electrically induced short-lasting tetanus of the calf muscles for prevention of deep vein thrombosis. 697 52

Despite venous stasis and a hypercoagulable state during pregnancy, the reported incidences of deep venous thrombosis and pulmonary embolism are remarkably low, about 1 in 2,000 and 1 in 10,000 cases, respectively. Mortality from antepartum thromboembolism has been reported in about 15 percent of untreated patients and less than 1 percent of treated patients. Adequate anticoagulant therapy significantly reduces maternal mortality and decreases postpartum morbidity. The proper anticoagulant agent for use during pregnancy has been widely debated. Coumarin compounds pass through the placenta and into the fetus. Hemorrhagic complications in the fetus are uncommon if prothrombin times are carefully controlled and if the drug is discontinued before delivery. However, coumarin during the first trimester has the teratogenic hazard of producing chondrodysplasia punctata. Heparin, in contrast, does not cross the placental barrier and is considered more effective treatment for deep venous thrombosis; however, long-term intravenous administration during pregnancy has been considered both impractical and possibly hazardous due to the risk of osteoporosis after 6 months of therapy. In our study, a combined regimen of intravenous and subcutaneous heparin was used successfully in four women with deep venous thrombosis. One patient who had recurrent embolization while on adequate intravenous heparin underwent vena caval clipping and had an uneventful Cesarian section at term with a normal infant. Another patient also underwent Caesarian section with a normal infant, while the other two women had normal vaginal deliveries at term. Miniheparin therapy was continued for 3 months postpartum, followed by long-term aspirin and Ascriptin therapy. Carefully controlled heparin therapy in a pregnant woman with deep venous thrombosis both safe and beneficial for mother and fetus.
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PMID:Management of deep venous thrombosis and pulmonary embolism during pregnancy. 709 23

To compare the ability of intermittent calf compression with that of sequential leg compression to prevent venous stasis, the clearance time of radiopaque dye, as determined by sequential phleborheograms performed on anesthetized patients, were compared. Calf compression was superior to no compression in clearing the dye from the calf alone, but did not aid clearance from the rest of the leg. Sequential leg compression was superior to intermittent calf compression in clearing dye from the calf and popliteal areas. Since intermittent leg compression has been as effective as small-dose heparin therapy in preventing postoperative deep venous thrombosis [7], the use of sequential leg compression may prove to be more effective and have less complication than heparin administration.
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PMID:Effectiveness of leg compression in preventing venous stasis. 714 16

Patients with neurologic dysfunction, particularly spinal cord-injured and stroke patients, are at risk for developing thromboembolic complications due to a variety of factors, especially impaired mobility. Venous stasis, altered coagulability and endothelial vessel damage create a triad of pathophysiological changes that place patients at risk for developing deep vein thrombosis. Prophylactic use of pneumatic compression boots is highly recommended while administration of anticoagulants remains controversial and varied. Inferior vena cava filters are placed in patients who are high risk for pulmonary emboli. Nursing interventions focus on assessments of risk potential and clinical signs and symptoms and implementation of prevention strategies.
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PMID:Deep vein thrombosis and pulmonary emboli in neuroscience patients. 749 27

Venous stasis occurs when people are at bedrest, because of altered venous flow characteristics. This is commonly believed to be one etiology behind the development of deep venous thrombosis (DVT). The hemostatic effects of bedrest and their possible role in DVT development have not been fully examined. We hypothesized that bedrest would lead to increases in hemostatic function and that these increases could be important in the development of DVT. Twelve non-smoking volunteers were studied during supine positioning for 36 hours. Platelet reactivity and plasma concentrations of fibrinogen, alpha 2-antiplasmin, plasminogen, thromboxane beta 2, plasminogen activator inhibitor-1, tissue plasminogen activator and neuroendocrine hormones (cortisol, epinephrine and norepinephrine) were measured at 8:00 a.m., 10:00 a.m., 4:00 p.m. and 8:00 a.m. Cortisol demonstrated an early morning increase while catecholamines were unchanged throughout. Fibrinogen, alpha 2-antiplasmin, plasminogen and platelet reactivity were no different at any time point. Fibrinolytic proteins changed over time, manifested by decreased PAI-1 antigen and activity levels at 24 h. Based upon the parameters measured, bedrest causes no increase in hemostatic function. In fact, bedrest causes the potential for enhanced fibrinolysis, that differs from that previously reported for normal activity over 24 h. This may represent a protective mechanism to counter the effects of stasis from bedrest.
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PMID:The effects of bedrest on circadian changes in hemostasis. 753 Mar 85

Various experimental models have been developed in order to more clearly understand deep vein thrombosis, the mechanisms involved and its treatment. These models are based on venous stasis, either alone or combined with the injection of thrombogenic substances or endothelial lesions. Other models only use endothelial lesions. Thrombogenic substances are mostly composed of activated factor X or thrombin, which raises the problem of purity of the substances and determination of the antithrombotic activities of the substance tested, especially heparin and hirudin and their derivatives, and consequently their efficacy. Endothelial lesions can be induced by chemical, physical or electrical agents or by repeated application of clamps, or cellular crushing. These models result in the formation of various forms of venous thrombus. The development and improvement of experimental models is very important in every case. Experimental models of thrombosis constitute the best tool for the study of thrombosis, in which many points remain to be elucidated. They also allow the study and development of various antithrombotic substances the improvement of their efficacy. These models must be validated, standardized, reproductible and in agreement with local legislation in each country.
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PMID:[Experimental models of venous thrombosis]. 757 61


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