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

Current methods used for the prevention of vein thrombosis were evaluated with the help of radioisotopic investigation in 175 patients, aged 40 to 74 years, after extensive abdominal surgery. Deep vein thrombosis of the lower limbs was detected by radioisotopic investigation in 6% of the patients after preventive treatment with low-dose heparin, in 14% after treatment with rheopolyglucin, and in 16% after sequential external intermittent pneumatic compression of the lower extremities, versus 26% in the group of patients who had received no special preventive treatment. As shown by the clinical pattern, most cases of thrombosis were asymptomatic. Hemorrhagic complications are extremely rare where preventive medication is used properly.
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PMID:[Experience with the prevention of venous thrombosis]. 247 75

The antithromboembolic efficacy of once a day low molecular weight heparin in fixed combination with dihydroergotamine (LMWH-DHE) was compared with conventional heparin-DHE in combination with Acenocoumarol (heparin-DHE/A) in 191 patients undergoing gynaecological surgery. LMWH-DHE proved equally effective in preventing thromboembolic complications, with a similar incidence of postoperative bleeding and side effects. Deep vein thrombosis occurred once in each group and one non-fatal pulmonary embolism occurred in the LMWH-DHE group. The main advantage of LMWH-DHE was significantly better patient acceptance of the single daily subcutaneous injection as compared with the two injections of conventional heparin-DHE (P = 0.02). On the other hand, LMWH-DHE was associated with significantly increased incidence of intraoperative bleeding (P less than 0.02). The bleeding did not, however, cause any clinical problems. Discontinuation of therapy due to bleeding or pain at the site of injection occurred three times in each group. We consider the use of LMWH-DHE to be an attractive, economic and safe method of thromboembolic prophylaxis.
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PMID:A prospective randomized trial of low molecular weight heparin-DHE and conventional heparin-DHE (with acenocoumarol) in patients undergoing gynaecological surgery. 254 52

In a randomized, prospective, double-blind trial, the effect of conventional low-dose heparin (5,000 units every 8 hours) was compared with that of a low molecular weight fragment (2165 LMWH, Kabi Vitrum AB, starting 2,500 units 2 hr before surgery, and then 5,000 units subcutaneously every morning for 9 days). A total of 90 patients admitted because of hip fracture fulfilled the inclusion criteria and were analyzed for development of pulmonary embolism and deep vein thrombosis: 46 patients were included in the low molecular weight heparin (LMWH) group, and 44 in the conventional heparin group. Two and three, respectively, died before diagnostic tests were performed. In the remaining patients a ventilation-perfusion lung scan was performed 8 days after intervention. In the first 57 patients studied a bilateral ascending venography was performed on the ninth day only if clinical symptoms suggested a deep venous thrombosis. Because of the rate of venous thrombosis detected in those patients was unexpectedly low, venography was requested in the remaining 33 patients, even if the screening tests were negative. Pulmonary embolism occurred in six patients, all in the LMWH group. Deep vein thrombosis occurred in 14 patients in the LMWH group and in six patients in the conventional heparin group. Both differences are statistically significant. Mortality did not differ between the groups, nor did haemorrhagic complications. Our findings suggest that, in patients with hip fracture, LMWH is not useful at the dosage used.
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PMID:A prospective double-blind trial of a low molecular weight heparin once daily compared with conventional low-dose heparin three times daily to prevent pulmonary embolism and venous thrombosis in patients with hip fracture. 216 34

The overall incidence of pulmonary embolism (PE) among neurosurgical in-patients, whose ages ranged from 23 to 80, was 0.7%. Our report here is based on five cases of patients with PE. Four of these five patients were over 50 years of age. They had been admitted because of such reasons as brain tumor, spinal cord injury, intracerebral hematoma, and venous sinus thrombosis. Deep vein thrombosis (DVT) was seen in four but none were diagnosed before they had developed PE. Decreased level of consciousness and prolonged bed rest appeared to be common risk factors for PE. Mean duration between admission and onset of PE was 31 days. Although non-specific, tachycardia, tachypnea and hypoxemia were the most common signs and symptoms. As a definitive diagnostic procedure, pulmonary angiography was performed in most of cases. One patient required surgical embolectomy and others were treated with anticoagulation or fibrinolytic agents. In order to prevent recurrent thromboembolic phenomena, ligation of the inferior vena cava was a useful mode of treatment when anticoagulation was not indicated. And this approach seemed to be valid in most neurosurgical patients. We conclude that PE and DVT were not uncommon complications among Japanese neurosurgical patients and they can be treated successfully in collaboration with a cardiovascular surgeon if the diagnosis can be made correctly.
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PMID:[Pulmonary embolism as a complication in neurosurgical patients]. 261 3

In a randomized trial of neurosurgical patients, groups wearing graduated compression stockings alone (group 1) or graduated compression stockings plus intermittent pneumatic compression (IPC) (group 2) were compared with an untreated control group in the prevention of deep vein thrombosis (DVT). In both active treatment groups, the graduated compression stockings were continued for 14 days or until hospital discharge, if earlier. In group 2, IPC was continued for seven days. All patients underwent DVT surveillance with iodine 125-labeled fibrinogen leg scanning and impedance plethysmography. Venography was carried out if either test became abnormal. Deep vein thrombosis occurred in seven (8.8%) of 80 patients in group 1, in seven (9.0%) of 78 patients in group 2, and in 16 (19.8%) of 81 patients in the control group. The observed differences among these rates are statistically significant. The results of this study indicate that graduated compression stockings alone or in combination with IPC are effective methods of preventing DVT in neurosurgical patients.
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PMID:Prevention of deep vein thrombosis in potential neurosurgical patients. A randomized trial comparing graduated compression stockings alone or graduated compression stockings plus intermittent pneumatic compression with control. 264 46

A previously healthy 70-year-old woman was hospitalized for acute pain and edema of her right leg. Deep vein thrombosis was suspected, and she was put on anticoagulant therapy. Ten hours later, she developed a massive swelling of the leg with a well-demarcated violaceous discoloration of the skin and hemorrhagic bullae. She was in deep shock with signs of disseminated intravascular coagulation and adult respiratory distress syndrome. Gram stain of an aspirate from the bullae revealed short chains of Gram-positive cocci, and multiple blood cultures showed abundant growth of Streptococcus pyogenes. Despite intensive treatment, the patient died within hours. Autopsy findings showed extensive pyomyonecrosis of the leg muscles and changes secondary to septicemia. The misleading initial clinical picture and the rarity of this disease entity in temperate climates delayed the correct diagnosis and resulted in a fatal outcome.
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PMID:Fulminant streptococcal myositis. 264 2

Deep vein thrombosis and pulmonary embolism are significant hazards of surgery, especially in orthopedic procedures. However, the true incidence of these complications is unknown. Many surgeons are now using prophylactic methods to prevent the postoperative occurrence of thromboembolic disease. Pneumatic compression devices are recommended in some instances, especially in cases where increased bleeding could be devastating. Several pharmacologic agents are also used, alone or in combination with pneumatic devices. These include subcutaneous heparin, warfarin, dextran, and aspirin. Each agent has advantages and disadvantages. The US National Institutes of Health (NIH) and numerous ongoing clinical trials are attempting to establish recommendations and guidelines for the use of prophylaxis against postoperative deep vein thrombosis and pulmonary embolism.
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PMID:Prophylactic methods against thromboembolism. 265 62

The accuracy of Doppler examination was evaluated for the diagnosis of catheter-related venous thrombosis in 40 postoperative patients. Deep vein thrombosis was detected by venography in 15 patients and confirmed by the Doppler technique in a double blind study. Only one false-positive and one false-negative result were obtained with the Doppler technique. This technique appears to be valuable for the early diagnosis of catheter-related vein thrombosis, even in asymptomatic patients.
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PMID:Evaluation of Doppler examination for diagnosis of catheter-related deep vein thrombosis. 266 53

Deep vein thrombosis (DVT) of the arm unrelated to central venous cannulation is an uncommon occurrence in patients with malignancy. The author reports six cases encountered in a large county hospital over an 8-year period. Three of the patients had gastric carcinoma, esophageal adenocarcinoma, and testicular carcinoma, respectively. These neoplasms have not been previously reported to be associated with DVT of the arm. Three episodes of DVT resulted from venous compression by the tumor, and a hypercoagulable state may have contributed to the pathogenesis of DVT in the other three cases. Venography is required for confirmation of the diagnosis; however, a computed tomographic scan with contrast media may be a valuable adjunct. A review of the literature indicated that the incidence of pulmonary embolism is significant in these patients. Therefore, anticoagulation within 7 days of clinical onset is recommended.
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PMID:Deep vein thrombosis of the arm associated with malignancy. 273 99

Twelve cases of pulmonary embolism were found among 4,896 autopsies during 18 years in Ramathibodi hospital. This gives an incidence of 0.24 per 100 necropsies. Deep vein thrombosis occurred in two of the twelve cases and was not the main cause of pulmonary embolism in this series.
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PMID:Autopsy proven cases of pulmonary thromboembolism: 18-year study at Ramathibodi Hospital. 276 21


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