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

The prevention of peri-operative deep vein thrombosis (DVT) and the potentially hazardous pulmonary embolism that may follow is still a major medical issue. Intermittent pneumatic compression is one of the many methods currently in use for this purpose. No information is available, however, regarding the venous flow alterations that occur during employment of a pneumatic compression device under general anesthesia. The aim of this study is to delineate these venous flow variations and to determine the optimal pump setting for the prevention of operative venous stasis and its sequelae, postoperative DVT. A new sequential intermittent pneumatic device, the "Veno-Press", was applied on 20 volunteers of whom 10 were undergoing surgery unrelated to the lower limbs, during the pre-anesthesia and during general anesthesia. The venous velocity patterns over the femoral vein were depicted via duplex scanning under different pressure and rhythm settings of the device. The "Veno-Press" induced a marked augmentation in venous blood velocity flow. A further 10-30% augmentation was noted when the patients were under general anesthesia, as well as a 10-30% increase in the femoral vein diameter. None of the patients developed postoperative DVT. This device is a very efficient tool for augmentation of venous blood velocity, especially during general anesthesia. Its effectiveness is most probably the result of the compressive action over the relaxed--and hence enlarged--capacitant veins of the anesthetized patient. We suggest that the "Veno-Press", if properly timed, is very efficient in venostasis prevention, leading presumably to a decline in the occurrence of DVT and pulmonary embolisms in the surgical patient.
 ...
PMID:"Veno-Press"--a new sequential intermittent pneumatic device for the prevention of perioperative deep vein thrombosis. 900 85

Venous thromboembolism is responsible for 500,000 deaths annually in industrialized countries. It is probably the most common preventable cause of death in elective orthopedic surgery patients. Rates of deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in unprotected orthopedic patient populations are high. The overall DVT rate is > 40% in patients undergoing hip or knee arthroplasty or suffering from multiple injuries. The proximal DVT rate for these patients is > or = 15%, and the fatal PE rate is > or = 1%. Risk factors associated with venous thromboembolism are related to the vascular injury, activation of blood coagulation, and venous stasis. Lower extremity orthopedic procedures carry a risk greater than that of surgery itself. Thus, orthopedic patients are at high risk for venous thromboembolic conditions. A systematic assessment of this risk should be performed in every patient, and an appropriate management plan should be implemented.
 ...
PMID:The risk of venous thromboembolism in the orthopedic patient: epidemiological and physiological data. 904

In summary, external compression of the limbs is a mode of therapy that has enjoyed a long history in the treatment of venous and arterial disease. Evidence suggests that its beneficial effects are mediated through enhancement of venous and arterial blood flow, promotion of vasodilation, enhancement of fibrinolysis, and, in the case of obstructive arterial disease, promotion of the development of collateral circulation. The utility of external leg compression in the prevention of deep venous thrombosis and in the management of chronic venous stasis disease has been well documented, and it has become an accepted treatment for these disorders. The use of pneumatic compression in the treatment of atherosclerotic peripheral vascular and cardiovascular disease is less widespread and its indications are less well defined. Though the work of a few investigators in each of these areas shows striking benefits of the technique, further investigation in these areas is warranted. Potential benefits to patients of external limb compression therapy include its non-invasive nature, its ability to be applied in an out-patient setting, and long-term cost savings through possible avoidance of hospitalization and invasive procedures.
 ...
PMID:External leg compression in the treatment of vascular disease. 915 78

The effects of pneumoperitoneum on peak venous flow velocity in the common femoral vein and the vena cava have already been studied. The results suggested that venous stasis occurs during surgical pneumoperitoneum. This study determines the effects of pneumoperitoneum on the overall venous outflow resistance of the lower limbs. Venous outflow resistance was measured during surgical procedures by impedance plethysmography in 12 patients undergoing laparoscopic cholecystectomy, 4 patients undergoing laparoscopic herniorrhaphy, 4 patients undergoing conventional cholecystectomy, and 2 patients undergoing conventional herniorrhaphy. Venous outflow resistance did not change significantly during laparoscopic cholecystectomy or herniorrhaphy. No difference in venous outflow resistance between laparoscopic cholecystectomy and herniorrhaphy was found. During pneumoperitoneum, no obstruction to total lower limb venous outflow could be demonstrated, indicating that venous stasis in the limbs did not occur, and consequently, flow in the iliac and inferior caval veins was not compromised. Hypothetically, active vasodilatation resulting from mild compression may explain this. In our view, no special measures to prevent deep venous thrombosis have to be taken during laparoscopic procedures.
 ...
PMID:Resistance to venous outflow during laparoscopic cholecystectomy and laparoscopic herniorrhaphy. 956 61

An increased incidence of deep vein thrombosis is reported in cancer patients as compared with general population. Several risk factors for deep vein thrombosis have been identified: venous stasis, direct invasion of venous wall by tumor, and hypercoagulability state by inadequate secretion of procoagulant activities. Reports have suggested that chemotherapeutic agents and hormonal treatment may contribute to this risk. Few papers are available concerning the prophylaxis and curative treatment of deep vein thrombosis in cancer patients and no consensus has been reached yet. This predisposition for deep vein thrombosis should be taken into consideration for perioperative prophylaxis. Efficacy and safety of heparin and antivitamin K in the curative treatment of deep vein thrombosis are discussed but can not be accurately evaluated because of diversity of clinical presentations and mechanism of activation of coagulation. Prospective studies are necessary.
 ...
PMID:[Do the prevention and treatment of deep venous thrombosis have specificity in the cancer patient?]. 975 68

Low-dose warfarin prophylaxis has been found to provide safe and effective prophylaxis after TKA. The major advantage of warfarin prophylaxis is that it can be administered orally. However, monitoring of the INR level is required, and there are concerns that TKA patients may be relatively unprotected during the early perioperative period. In addition, further analysis of the impact of asymptomatic clot formation on venous stasis disease is required. Our protocol is to administer 2 weeks of DVT prophylaxis after TKA. Routine screening with ultrasonography is not recommended at this time.
 ...
PMID:Warfarin prophylaxis after total knee arthroplasty. 1005 Jun 94

Recurrent venous thrombotic and thromboembolic disease, once thought to be an uncommon entity, is increasingly being recognized. Etiologies of recurrent deep venous thrombosis usually include elements of Virchow's triad. Venous stasis (e.g., immobilization, congestive heart failure, acute myocardial infarction, obesity), hypercoagulability (e.g., malignancy, inflammatory bowel disease, hyperhomocysteinemia, protein C resistance, antithrombin III, protein C or S deficiency) and endothelial trauma (e.g., surgical trauma, venous trauma, in-dwelling venous instrumentation) are risk factors. Diagnosis is dependent on objective testing, including venography duplex Doppler (color) ultrasonography and impedance plethysmography. Treatment is usually started with heparin or low-molecular-weight heparin and advanced to warfarin (adjusted to international normalized ratio). Prophylaxis may continue using low-molecular-weight heparin, warfarin, venacaval interruption (Greenfield filter), or concomitant use of the platelet-active agent indobufen and graduated compression stockings.
 ...
PMID:Clinical therapeutic conference: recurrent venous thrombotic and thromboembolic disease. 1009 38

Postarthroplasty patients develop venous thromboembolic disease because of venous stasis, hypercoaguability, and vessel wall injury. However, most venous thrombi are nonocclusive or small and elicit few symptoms; pulmonary emboli also tend to be asymptomatic. Noninvasive techniques to detect deep vein thrombosis do not appear to be reliable in this population, so venography may be required. Postoperative perfusion lung scans, with comparison to preoperative perfusion scans, are the best screen for asymptomatic pulmonary emboli. Heparin infusion, followed by oral warfarin, is indicated for symptomatic thromboembolic disease as well as for asymptomatic patients with substantial proximal deep venous thrombosis or large pulmonary emboli.
 ...
PMID:Therapy for postoperative thromboembolic disease: indications and treatment. 1014 78

We report two uncommon cases of venous aneurysm involving the soleus vein and the saphenofemoral junction. Both cases presented with pulmonary embolism. Diagnosis of the venous aneurysm was achieved by Doppler ultrasonography during the evaluation for deep vein thrombosis. Venography showed a large fusiform aneurysm. Both aneurysms were treated by resection and ligation. At follow-up, there was no evidence of recurrent pulmonary embolism. These cases clearly illustrate the risk of pulmonary embolism associated with uncommon localizations of venous aneurysms and the potential for thrombus formation due to the venous stasis. Surgical treatment, as in the case of popliteal aneurysms, is mandatory to avoid such embolic complications.
 ...
PMID:[Venous aneurysm of unusual localization revealed by a pulmonary embolism. Report of two cases]. 1019 37

Two common prophylactic measures to prevent deep vein thrombosis (DVT) in patients after orthopedic lower limb surgeries are pneumatic foot and calf compression and antithrombotic treatment. These preventive measures differ in their mechanisms of operation. Antithrombotic agents are aimed to minimize the risk of clot formation, whereas pneumatic foot and calf compression therapy prevents venous stasis, which is a primary factor leading to thrombus formation in patients with leg trauma. DVT, however, is not the only consequence of patient immobility and venous stasis. Additional sequelae of venous stasis include lower limb swelling and pain resulting from the increase in venous pressures and change of normal compartmental circulatory pressures. We therefore hypothesized in the present study that antithrombotic treatment alone is not as effective as combined with pneumatic foot compression in reducing limb swelling and pain. Forty-eight patients after total knee arthroplasty participated in this randomized, controlled study. Low-molecular-weight heparin was the prophylactic measure used for the control group, whereas the pneumatic compression group received low-molecular-weight heparin and foot compression therapy for approximately 7 days after surgery. Lower limb swelling and pain were significantly reduced for the foot compression group in relation to the control group. Ultrasound and venography demonstrated no significant DVT in either group. We conclude that foot compression therapy is an important prophylactic addition to antithrombotic treatment in overcoming the hazardous clinical implications of venous stasis.
 ...
PMID:Sequential foot compression reduces lower limb swelling and pain after total knee arthroplasty. 1022 Jan 88


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>