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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective randomized controlled study has been undertaken to evaluate two different prophylactic treatments against postoperative thromboembolic complications after hip surgery. Patients with hip fracture (77) and patients undergoing elective hip arthroplasty (213) were separately randomized into one of three groups: control, dextran 70, or low-dose heparin. Deep vein thrombosis was diagnosed in both groups with the 125I-fibrinogen test and pulmonary perfusion defects in the arthroplasty group with a combination of pulmonary X-ray and perfusion scintigraphy. The frequency of thrombosis was significantly higher in untreated hip fracture patients than in untreated arthroplasty patients. In hip fracture patients both treatments significantly reduced the frequency of thrombosis. Only dextran reduced the frequency of major thrombosis and in the heparin group one fatal pulmonary embolism occurred. After elective hip surgery the overall frequency of thrombosis was not influenced by the two treatments, but with dextran 70 thigh thrombi were reduced and with low-dose heparin the frequency of bilateral thrombosis was reduced. Two patients in the control group died of pulmonary embolism, but the frequency of pulmonary perfusion defects was not influenced by the treatment. Bleeding and transfusions were the same in the three groups.
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PMID:Thromboembolism after elective and post-traumatic hip surgery--a controlled prophylactic trial with dextran 70 and low-dose heparin. 38 76

A perspective study by the Royal College of General Practitioners reported that the risk of developing deep venous thrombosis of the legs in women taking oral contraceptives was 5.66 times higher than women not on medication. Estrogen-progestogen compounds are highly potent hormones that produce alterations in metabolic and endocrine functions. Clinical examination of the leg is the most reliable method of determining the earliest indication of thrombophlebitis even with the latest diagnostic tools of venography. The key to diagnosis and treatment of pulmonary embolism, which often occurs with patients with thrombophlebitis, is a patient's complaint of leg pains. Those who have undergone surgery, especially abdominal and pelvic, are bedridden, and those who are taking oral contraceptives are at risk of thrombophlebitis. Deep thrombophlebitis of the leg is not recognized clinically in 50-80% of those with venographically documented thrombophlebitis because the signs and symptoms are so protean. Treatment with heparin and leg bandages is most common. Heparin is often followed with coumarin therapy. Some methods of diagnosis are calf tenderness, edema, skin temperature, Homan's Sign, Lowenberg's Sign, Pratt's Sign, cyanosis, systemic signs, and contrast venogram.
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PMID:A review of the birth control pill and its relationship to thrombophlebitis. 44 35

Dynamic radionuclide phlebography was performed in 50 consecutive patients after total hip replacement to evaluate the diagnostic value of the method compared to contrast phlebography. The investigation was limited to the diagnosis of iliofemoral thrombi. A special injection technique was developed and flow curves, mean transit time and distribution of flow were recorded with a scintillation camera interfaced to a digital computer. Three principally different types of flow curves were observed. Mean transit time was of value in differentiating particle flow in the superficial veins from passage through the deep veins. Out of 15 legs with thrombi in the iliofemoral region, the distribution of flow was significantly changed in 12. Deep vein thrombosis in the lower leg did not influence mean transit time or distribution of flow in the iliofemora region. Extensive collateral flow was rare. Ninety per cent of the thrombi were asymptomatic. The method compares favorably with the 125 I fibrinogen method and cuff impedance phlebography, in diagnosing iliofemoral thrombi after total hip replacement.
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PMID:Dynamic radionuclide phlebography. A clinical study in patients after total hip replacement. 73 84

56 patients undergoing elective major surgery received low dose heparin prophylaxis, 5,000 IU 2 h before surgery and every 8 h for 7 days. The patients were tested by the 125I-fibrinogen uptake test, which, if positive, was controlled by venography. The heparin concentrations were measured by the method of DENSON and BONNAR and by the chromogenic method of TEIEN et al. in blood samples drained immediately before and after surgery and on the 1st and 5th postoperative day 2 and 4h after the injection of heparin. The values were found higher when estimated by the method of DENSON and BONNAR than by the chromogenic method. Deep vein thrombosis (DVT) developed in 11 patients, and in 10 of them within the first 48 after the operative procedure, in 1 after 4 days. The preoperative values were not lower in the patients who developed DVT, and the heparin concentrations found on the 1st and 5th postoperative day were at the same level as in those who did not develop DVT.
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PMID:Low dose heparin in major surgery: clinical relevance of plasma heparin concentrations. 91 83

Small doses of subcutaneous heparin and infusions of dextran both reduce the incidence of fatal pulmonary embolism after elective general surgery. But both methods have disadvantages. Therefore, the protection against deep vein thrombosis afforded by sulfinpyrazone, a drug which can be taken by mouth as well as by injection, was assessed in a prospective study of 119 patients undergoing elective general or urological surgery. The prophylactic administration of sulfinpyrazone was compared with the effects of small doses of sodium heparin and infusions of dextran-70. The 125I-fibrinogen test was carried out in all patients during their hospitalization. Deep vein thrombosis was diagnosed in 13 of 30 patients (43%) who received sulfinpyrazone, in 9 of 29 (31%) receiving dextran-70 and in 2 of 22 (9%) having subcutaneous heparin. The difference between the sulfinpyrazone and heparin groups was statistically significant (p less than 0.01). Sulfinpyrazone in the dose used in this trial was not effective in reducing the incidence of deep vein thrombosis during elective general surgery.
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PMID:Sulfinpyrazone and postoperative deep vein thrombosis. 92 99

One hundred five patients over age 40 undergoing various major operations were randomly divided into control and treated groups; all were treated by subcutaneous injection containing either 5,000 international units aqueous heparin sodium or a placebo one hour prior to operation and every 12 hours thereafter for eight days. Deep vein thrombosis (DVT) was detected by daily -125I-fibrinogen injection and leg scanning, and confirmed by ascending phlebography. Both groups were comparably distributed by age, sex, variety of operation, incidence of previous thromboembolism, and myocardial and cerebrovascular disease. Blood loss was not increased in the treated group. Incidence of DVT was 8.6 percent for the total group, 7.5 percent in the heparin-tested group (four of 53), and 9.6 percent in the control group (five of 52), including one control patient with a normal scan (who later had a pulmonary embolus.
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PMID:Low-dose heparin in postoperative patients: a prospective, coded study. 110 14

Deep vein thrombosis and its sequel, pulmonary embolus, are possibly the greatest threats to recovery after surgical operation. In a randomized, controlled clinical trial in which the 125I-fibrinogen uptake test, Doppler ultrasound, and phlebography were used for diagnosis, it was found that low doses of calcium heparinate administered subcutaneously and sodium pentosan polysulfate intramuscularly were effective in preventing deep vein thrombosis (DVT), postoperatively. The incidence of DVT was as follows: 9% in the group treated with heparinate; 15% in the group treated with sodium pentosan polysulfate; nad 51% in the untreated control group.
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PMID:Drug prevention of postoperative deep vein thrombosis. A compararative study of calcium heparinate and sodium pentosan polysulfate. 124 12

Pulmonary embolism is less frequent in Blacks than in Whites. Deep vein thrombosis is probably not uncommon in Blacks, but relatively few of them develop pulmonary embolism. Postoperative pulmonary embolism in Blacks is probably far less common than in Whites. We are dealing with a relatively young Black population, compared with the White one, and therefore more cases might be expected among the Black population as its life expectancy improves.
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PMID:Pulmonary embolism in the Rhodesian Black. 125 Dec 67

Deep vein thrombosis (DVT) is the most frequent complication after total hip arthroplasty, and proximal DVT is more likely to produce clinical pulmonary emboli than distal DVT. The authors have assessed the incidence and anatomic location of phlebographically proven fresh DVT following total hip arthroplasty in 855 patients over 39 years of age. Eight different regimens (2 warfarin, 3 aspirin, 1 dextran, 1 external pneumatic compression, and 1 dextran combined with external pneumatic compression) were evaluated and compared with an historical placebo control group from the same institution. No significant difference (P < .05) existed in proximal DVT incidence between the placebo group and any of the three aspirin groups, the dextran group, the external pneumatic compression group, or the dextran combined with external pneumatic compression group. In contrast, warfarin, given both in traditional and low-dose regimens, provided a significant reduction in proximal DVT compared with the placebo group (P < .001; statistical power, 0.84 and 0.99, respectively). The low-dose regimen had 10 times fewer bleeding complications than the traditional regimen. All prophylaxis regimens should be evaluated for both proximal and distal DVT formation, as well as for overall incidence. Low-dose warfarin offers the best protection against proximal thrombi of the agents studied, and it is also safer than traditional dosages of warfarin.
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PMID:Influence of prophylaxis on proximal venous thrombus formation after total hip arthroplasty. 128 37

In a double-blind, randomized multicentre trial, the efficacy and safety of two regimens for the prevention of postoperative venous thrombo-embolism, low-molecular-weight heparin (LMWH) CY 216 and unfractionated heparin (UH), were compared in 341 patients undergoing elective total hip replacement. A group of 169 patients received one subcutaneous injection of 48 mg (approximately 10,000 anti-Xa IC units) LMWH and two placebo injections per day and 172 patients received a fixed dose of 5000 IU UH t.i.d. Deep vein thrombosis was assessed by bilateral phlebography on day 14 +/- 1 after surgery. Phlebography was successfully performed in 136 patients in the LMWH group and 137 patients in the UH group. Deep vein thrombosis occurred in 45 of 137 patients (33.1%) treated with LMWH CY 216 and in 47 of 136 patients (34.3%) who received UH. Pulmonary embolism occurred in 2 of 167 evaluable patients (1.2%) in the LMWH group and in 6 of 168 patients (3.6%) in the UH group. In addition, the incidence of proximal deep vein thrombosis was evaluated and was found to be 10.3% (14/137 patients) in the LMWH group and 19% (26/136 patients) in the UH group (P = 0.044, two-sided). The safety of the treatments, as assessed by the incidence of major haemorrhage, intra- and postoperative blood loss, transfusion requirements, haemoglobin drop and frequency of wound haematomata, was similar in the two groups. It is concluded that prophylaxis of postoperative thrombo-embolism in hip surgery with one subcutaneous injection (48 mg) of LMWH CY 216 is as effective and as safe as prevention with fixed low-dose heparin (5000 IU t.i.d.). A tendency to reduced rates of pulmonary embolism (3.6% vs. 1.2%) and proximal deep vein thrombosis (19% vs. 10.3%) was observed in favour of LMWH CY 216.
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PMID:Prevention of deep vein thrombosis with low molecular-weight heparin in patients undergoing total hip replacement. A randomized trial. The German Hip Arthroplasty Trial (GHAT) Group. 131 65


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