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

Postoperative deep vein thrombosis has been demonstrated in four out of seven (57%) unselected patients undergoing homograft cadaveric renal transplantation, with pulmonary embolism in one. The diagnosis being made by using the combined 125I-fibrinogen and Doppler ultrasound techniques. The late onset of the deep vein thrombosis may be due to the heparin given interoperatively and postoperatively which acted as a prophylactic agent.
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PMID:Deep vein thrombosis after renal transplantation. 78 59

A randomized open trial was undertaken to compare the antithrombotic efficacy of a low molecular weight heparin (LMWH; Sandoparin) with that of dextran 70 in patients undergoing surgery for hip fracture. One hundred thirteen patients received LMWH once daily subcutaneously at a fixed dosage while 103 patients received intravenous dextran 70. Postoperative deep vein thrombosis (DVT) was assessed by a diagnostic algorithm using the 125Iodine fibrinogen uptake test as screening and Duplex ultrasonography and/or ascending venography as confirming techniques for suspected DVT. The frequency of DVT was significantly lower in the LMWH group than in the dextran group (15.5 versus 32.6%, p less than 0.005). Proximal DVT was rare in both groups (LMWH: 2%, Dextran: 1%). Only one case of fatal fat pulmonary embolism was observed during the 10 day prophylaxis period in a patient receiving Dextran. Three cases of pulmonary embolism occurred later; one fatal event in the dextran group on day 14, and two cases in the LMWH group (one fatal and one non-fatal event) on day 14 and 17, respectively. There was no major bleeding complication in either group. We conclude that the LMWH we used is safe, was well tolerated, and has a significantly better thromboprophylactic effect than dextran 70.
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PMID:Prevention of deep vein thrombosis in patients with hip fractures: low molecular weight heparin versus dextran. 128 62

Clinical and laboratory variables were measured on the day before operation in 111 patients who underwent total hip replacement prophylactically treated with acetylsalicylic acid or heparin-dihydroergotamine. Postoperative deep vein thrombosis (DVT) was detected in 16 patients by ascending venography. Stepwise logistic discriminant analysis was used to identify DVT predicting factors. Three such factors, fibrinogen degradation products (FDP), plasminogen activator inhibitor (PA-inhibitor) and tissue type plasminogen activator (t-PA), were found to be significantly associated with DVT and were used to construct a predictive index. The predictive index, I = -2.09 + 0.46 (FDP) + 1.39 (PA-inhibitor) -0.24 (t-PA), was 100% sensitive and 95% specific in the prediction of DVT. This index would allow for identification of those patients in whom routine prophylaxis would be sufficient and for selecting those in whom more effective prophylactic regimens would be necessary.
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PMID:Preoperative identification of patients at high risk of deep venous thrombosis despite prophylaxis in total hip replacement. 336 36

Activated factor X inhibitor (FXaI) activity was measured with a newly developed method during operation and during the postoperative period in 60 patients undergoing total hip replacement. The patients were randomly allotted to three groups. In two groups the effect of prophylactic treatment with dextran and low dose heparin were evaluated, while the third group served as a control. Postoperative deep vein thrombosis was diagnosed with plethysmography and venography and related to observed changes in inhibitor activity. The frequency of deep vein thrombosis was found to be 25, 47 and 33 per cent in the three groups respectively. With the test system for measurements of FXaI-activity which made it possible to determine both the overall ability of the plasma to neutralize FXa and the activity independent of any accelerator or antagonist of XaI-activity, it was possible to demonstrate inhibitor consumption in all groups including the heparin treated group where the overall inhibitor activity was increased. A marked decrease in inhibitor activity was usually observed in the patients developing postoperative thrombosis in the control group, while in the other groups the relationship was less clear.
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PMID:Deep vein thrombosis following hip surgery. Relation to activated factor X inhibitor activity: effect of heparin and dextran. 618 38

Postoperative deep vein thrombosis is considered to be rare in Chinese. The 125I-labelled fibrinogen test was used to determine the true incidence of postoperative deep vein thrombosis in Chinese. Deep vein thrombosis was found in 2.6 per cent, a very low incidence compared with Caucasian series.
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PMID:Incidence of postoperative deep vein thrombosis in Hong Kong Chinese. 738 4

Postoperative deep vein thrombosis is usually asymptomatic so that pulmonary embolism is often the first clinical manifestation of venous thromboembolism. The diagnostic accuracy of impedance plethysmography, 125I-fibrinogen leg scanning and real-time B-mode ultrasonography has been extensively evaluated in patients with asymptomatic deep vein thrombosis. Impedance plethysmography has been evaluated in a number of studies and its sensitivity has been invariably found to be approximately 20% or less. These results seem to be due to the high prevalence in asymptomatic patients of distal, small and nonocclusive thrombi, unable to produce a critical obstruction of the venous flow. The accuracy of 125I-fibrinogen leg scanning has been assessed in a number of studies and found to be significantly different in the initial and more recent studies. This difference has been found to be due to the quality of the study design: the better the methodology, the lower the diagnostic accuracy of 125I-fibrinogen leg scanning. The association of impedance plethysmography and 125I-fibrinogen leg scanning do not result in an improvement of the results obtained by the single diagnostic method. Study methodology strongly influenced the results obtained with real-time B-mode ultrasonography with a reported sensitivity of approximately 50% in the studies performed adopting an appropriate methodology. In conclusion, noninvasive diagnostic methods are inaccurate in the diagnosis of asymptomatic deep vein thrombosis. Thus, venography remains the only accurate diagnostic method for the diagnosis of asymptomatic deep vein thrombosis.
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PMID:Diagnosis of deep vein thrombosis in asymptomatic high-risk patients. 789 21

Sixty-one consecutive patients were enrolled in a randomized, controlled trial of thromboprophylaxis with a low molecular weight heparin (Seleparina, CY 216) in major abdominal oncological surgery. Thirty patients received 2 x 3,825 anti-Xa international units of CY 216 subcutaneously on the day of surgery followed by a single daily 3,825 anti-Xa international units injection for 7 days; thirty-one patients did not receive any form of prophylaxis. The occurrence of deep vein thrombosis (DVT) was detected by 125I-labelled fibrinogen leg scan. Postoperative DVT developed in 2 patients in the CY 216 group and in 11 patients in the control group (6.8% vs 35.4%, p < 0.01). Although there was a higher postoperative transfusional requirement in the group receiving CY216 (p < 0.05), the total number of patients transfused was similar in the two groups (14 vs 13). On day 1 after surgery, the two patients who later developed DVT in the CY216 group had plasma anti-Xa activity significantly lower (p < 0.01) than the remaining patients. As a good relationship was found between plasma anti-Xa activity and body weight, adoption of a personalized dosage schedule might improve efficacy of CY 216 prophylaxis.
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PMID:Prevention of postoperative deep vein thrombosis in cancer patients. A randomized trial with low molecular weight heparin (CY 216). 839 42

Postoperative deep vein thrombosis (DVT) is common following general and orthopaedic surgery. Certain factors are known to increase the risk of DVT. To ascertain how surgeons use these factors to assess DVT risk and modify their DVT prophylaxis for individual cases, we circulated a questionnaire to 100 general and 200 orthopaedic surgeons. We inquired about whether DVT prophylaxis was used, and what risk factors were recognized, and we asked the surgeons to ascribe a level of DVT risk for five imaginary cases. All surgeons claimed to use prophylaxis. Most surgeons were largely aware of the accepted risk factors. There was, however, no consensus in allocating level of risk to individual imaginary cases. In conclusion, in spite of being aware of risk factors, similar patients are being dealt with in widely different ways by different clinicians. Therefore, we feel it is important to formally assess each individual patient's DVT risk and prescribe prophylaxis accordingly.
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PMID:The case for formal stratification analysis when prescribing deep vein thrombosis prophylaxis. 843 49

Venous thromboembolism is a leading cause of in-hospital postoperative morbidity and mortality. Postoperative deep vein thrombosis (DVT) is usually asymptomatic. A number of studies have consistently shown that the non invasive diagnostic methods are inaccurate in the screening of asymptomatic DVT. Failure of non invasive diagnostic methods to detect thrombi in asymptomatic patients has been suggested to be due to the features of thrombi in these patients. The aim of this study was to assess the distribution and the occlusiveness of thrombi in a series of 321 asymptomatic hip surgery patients with adequate bilateral venography of the lower limbs. Venography was performed 10 +/- 1 days after hip surgery. DVT was found in 180 limbs (28.0%). The distribution of thrombi was as follows: 26 (14.4%) isolated proximal thrombi, 55 (30.6%) proximal and distal thrombi, 99 (55.0%) isolated calf thrombi. We found that 14 of the 81 proximal trombi (17.3%) involved the superficial femoral vein either as exclusive location or in association with calf veins. An involvement of common femoral, superficial femoral and popliteal vein was observed in 37 (45.7%), 39 (48.1%) and 44 (54.3%) cases of the 91 proximal DVT. These thrombi were non occlusive in 25 (67.6%), 22 (56.4%) and 26 (59.1%) limbs, respectively. An involvement of at least one peroneal, anterior tibial and posterior tibial veins was observed in 118, 13 and 89 cases of the 220 distal thrombi. These thrombi were non occlusive in 61 (51.7%), 10 (76.9%) and 30 (33.7%) of the cases. We conclude that the majority of thrombi found in asymptomatic hip surgery patients are non occlusive. In view of this, non invasive diagnostic methods based upon venous flow measurement will be unlikely to improve the diagnosis of asymptomatic DVT. The high incidence of isolated superficial femoral vein thrombosis necessitates that real-time B-mode ultrasonography should be performed examining the entire proximal venous system.
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PMID:Distribution and occlusiveness of thrombi in patients with surveillance detected deep vein thrombosis after hip surgery. 881 67

Based on our experience derived from approximately 20,000 varicose vein operations during the last three decades we report about possible complications in varicose vein surgery. We had no postoperative mortality. Crossectomy of the greater saphenous vein may lead to major complications. We describe a case of femoral artery injury. Postoperative deep vein thrombosis and pulmonary embolism are very rare events. Bleeding complications in the groin, necessitating surgical reintervention are seldom, other bleeding complications like suffusions and hematomas can be seen more often. These complications are significantly more frequent if we use low molecular weight heparins for prophylaxis of deep vein thrombosis postoperatively. Lymphatic complications like lymphcysts and -fistulas are harmless in most cases and regress spontaneously. Concerning neurological complications lesions of the saphenous nerve are of some importance. Altogether the risk for a patient undergoing varicose vein surgery is minimal but not zero.
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PMID:[Complications in surgery of varicose veins]. 1150 69


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