Gene/Protein Disease Symptom Drug Enzyme Compound
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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 15-year experience with 27 patients, 20 to 75 years of age, with refractory venous stasis ulcers is presented. All patients had been managed with support hose, elevation, elastic wraps, Unna's paste boots, and graduated compression stockings. Because of multiple recurrences of their ulcers, the patients were offered surgical treatment to reduce the venous hypertension in the areas of ulceration. The 27 patients had 32 modified Linton procedures. Five had bilateral procedures. At the time of operation, 18 limbs had medial malleolar ulcers, five had bimalleolar ulcers, four had lateral ulcers, three had posterior ulcers, and two patients were free of ulcer. Medial incisions were used in 20 limbs, lateral incisions in six, medial and lateral incisions in three, and midposterior incisions in three. Split-thickness skin grafts were placed on six limbs the day of surgery and on 22 limbs 4 to 7 days later. Postoperative complications included deep venous thrombosis in two, partial flap necrosis in three, and cellulitis of the lower leg in three patients. Follow-up has ranged from 6 months to 10 years. During the most recent clinic visits, 21 limbs were completely healed, whereas six limbs had a recurrence of the ulcer. Five patients have been lost to follow-up. The good long-term results in 78% of the cases indicate that patients with recurrent venous stasis ulcers may receive lasting benefit from modified Linton procedures.
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PMID:Surgical management of refractory venous stasis ulceration. 334 63

Morbid obesity is a serious disease that is responsible for several co-morbid conditions. Increased risks of hypertension, adult onset diabetes mellitus, dyslipidemia, pulmonary disease (Pickwickian syn- drome), musculo-skeletal disorders, gallbladder disease, deep vein thrombosis, venous stasis ulcers, and increased prevalence of certain types of cancers (uterine, breast, colon carcinoma) have been reported, ( together with severe psychological and social disability.' Nonsurgical treatment options including various combinations oflow-calorie or very-low-calorie diets, behavior modification, exercise, and drug therapy may achieve acceptable transient weight reduction but fail to maintain reduced body weight in most patients.'
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PMID:Laparoscopic adjustable silicone gastric banding (LASGB) for the treatment of morbid obesitiy. 1585 31

The post-thrombotic syndrome represents a poorly understood and significant vascular health problem. This review focuses on our current understanding of the pathogenesis of post-thrombotic syndrome. We emphasize the cellular and molecular mechanisms that are responsible for the critical components of post-thrombotic syndrome. These include the initiation of deep venous thrombosis, the pathogenesis of elevated venous pressure, and the factors responsible for nonhealing of venous stasis ulcers.
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PMID:Molecular characterization of post-thrombotic syndrome. 1754 32

May-Thurner syndrome (MTS) is an anatomically variable condition of venous outflow obstruction caused by extrinsic compression. Although this syndrome is rare, its prevalence is likely underestimated. The pathology of this condition is secondary to a partial obstruction of the common iliac vein by an overlying common iliac artery with subsequent entrapment of the left common iliac vein. Regardless of the mechanism, this causes partial or complete impedance to the iliac vein outflow with subsequent possible obstruction and extensive ipsilateral deep vein thrombosis (DVT) of the ipsilateral extremity. Clinical presentations include, but are not limited to pain, swelling, venous stasis ulcers, and skin discoloration. With extensive DVT, postphlebetic syndrome, with all of its sequelae, may also develop. Treatment is based on the clinical presentation and includes staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement, followed by angioplasty/stenting of the left iliac vein in MTS patients with extensive DVT. This review highlights the variable presentations of MTS and outlines possible management within the current Society for Vascular Surgery consensus.
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PMID:May-Thurner syndrome: update and review. 2385 Mar 14

Acute deep vein thrombosis (DVT) is associated with significant morbidity in the form of acute limb-threatening compromise from phlegmasia cerulea dolens, development of the postthrombotic syndrome (PTS), and even death secondary to pulmonary embolism. Initial therapy for DVT is anticoagulation, which inhibits thrombus propagation but lacks the thrombolytic properties to facilitate active thrombus removal. The existing thrombus burden can cause increased venous hypertension from occlusion as well as damage to venous valves by initiating an inflammatory response, which can ultimately result in PTS in up to half of patients on anticoagulation. The manifestations of PTS include leg pain, swelling, lifestyle-limiting venous claudication, skin hyperpigmentation, venous varicosities, and, in rare cases, venous stasis ulcers. Furthermore, patients with iliocaval DVT and large, free-floating thrombus are at an increased risk for pulmonary embolism despite adequate anticoagulation. Early attempts at thrombus removal with surgical thrombectomy or systemic thrombolysis or both demonstrated reductions in the incidence of PTS but were of limited utility owing to their invasiveness and increased risk of bleeding complications. New minimally invasive endovascular therapies, such as pharmacomechanical catheter-directed thrombolysis, have been proposed, which focus on rapid thrombus removal while decreasing the rate of bleeding complications associated with systemic therapy. This article provides an overview of the current pharmacomechanical catheter-directed thrombolysis protocol utilized at the Mount Sinai Hospital for acute iliocaval DVT.
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PMID:Catheter-directed interventions for acute iliocaval deep vein thrombosis. 2484 Sep 64

May-Thurner syndrome (MTS) is an anatomically variable condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine with subsequent development of a left deep vein thrombosis (DVT). Although this syndrome is rare, its true prevalence is likely underestimated. Mainly, clinical symptoms and signs include, but are not limited to, pain, swelling, venous stasis ulcers, skin pigmentation changes and post-thrombotic syndrome. Correct treatment is not well established and is based on clinical presentation. Staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement followed by angioplasty/stenting of the left iliac vein appears to be the best option in MTS patients with extensive DVT. The aim of this review is to present in a simple and didactic form all variable clinical presentations of MTS and to outline possible management within the current guidelines.
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PMID:What the Young Physician Should Know About May-Thurner Syndrome. 2704 35

May-Thurner syndrome (MTS) is an anatomically variable condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine with subsequent development of a left deep vein thrombosis (DVT). Although this syndrome is rare, its true prevalence is likely underestimated. Mainly, clinical symptoms and signs include, but are not limited to, pain, swelling, venous stasis ulcers, skin pigmentation changes and post-thrombotic syndrome. Correct treatment is not well established and is based on clinical presentation. Staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement followed by angioplasty/stenting of the left iliac vein appears to be the best option in MTS patients with extensive DVT. The aim of this review is to present in a simple and didactic form all variable clinical presentations of MTS and to outline possible management within the current guidelines.
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PMID:What the young physician should know about May-Thurner syndrome. 2884 92

Thrombosis of the inferior vena cava and iliac veins, known as iliocaval thrombosis, is a common cause of significant morbidity. Patients with chronic iliocaval obstruction often present with life-limiting occlusive symptoms secondary to recurrent lower extremity deep venous thrombosis, swelling, pain, venous stasis ulcers, or phlegmasia. Endovascular iliocaval reconstruction is a technically successful procedure that results in favorable clinical outcomes and stent patency rates with few complications and is often able to relieve debilitating symptoms in affected patients. This review presents an approach to endovascular iliocaval stent reconstruction in patients suffering from chronic iliocaval thrombosis, including background, patient selection, timing of intervention, procedural steps, technical considerations, patient follow-up, and a brief review of outcomes. Schematic illustrations and clinical cases outlining iliocaval stent reconstruction and crossing chronic venous occlusions have been provided.
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PMID:Endovascular iliocaval reconstruction for the treatment of iliocaval thrombosis: From imaging to intervention. 2950 92

Introduction Iliocaval thrombosis or thrombosis of the inferior vena cava (IVC) is associated with significant morbidity in the form of venous limb-threatening compromise. Patients often present with life-limiting occlusive symptoms secondary to recurrent lower extremity deep venous thrombosis, swelling, pain, venous stasis ulcers, or phlegmasia. Materials and Methods A retrospective analysis, between January 2018 and September 2020, of all patients suffering chronic iliocaval or IVC thrombosis and submitted to endovascular reconstruction were taken into consideration. Background, patient selection and indications, timing of intervention, procedural steps, technical considerations, postprocedural care and outcomes were registered. Additionally, a systematic review of the published literature between 2015 and 2020 searching MEDLINE/PubMed was performed. All published case series, case reports, potential randomized controlled trials, prospective and retrospective comparative cohort studies, and case-control studies where used for the qualitative synthesis of the systematic review. Results During the mentioned period, the authors found five clinical cases, 4 men, with a mean age of 58 years. Symptoms included lower extremity swelling or pain (n = 2), ulcers (n = 1), phlegmasia (n = 1), shortness of breath (n = 1). Procedural technical success with venous recanalization was achieved in 100% with every patient presenting clinical improvement. One patient suffered a major complication, with acute renal failure. At a mean follow-up of 13.8 months, three, six and twelve- -month, primary iliocaval stent patency rates were 100%, 100%, and 75%, respectively. From the systematic review, a total of 804 potentially eligible articles published were identified from literature searches. After screening on eligible criteria, 12 were selected for full- -text review, describing 56 patients. Overall technical success was 93% with a 96% clinical improvement and a primary patency rate at 12 months of 87%. Conclusions Endovascular iliocaval reconstruction is an effective treatment for iliocaval thrombosis with high levels of technical success, favourable clinical outcomes and stent patency rates, and few complications.
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PMID:Iliocaval Endovascular Reconstruction - Clinical Cases Presentation And Systematic Review Publication. 3328 Mar 14