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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 double-blind trial was performed comparing conventional low-dose heparin with a low molecular weight heparin fragment for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the heparin fragment was given the evening before surgery, and further doses were given thereafter every evening. There were 1002 analysable patients, 826 having received correct prophylaxis. Of these 1002 patients, 64 per cent were operated on for malignant disease. A total of 20 patients died, 10 in each group. The frequency of deep vein thrombosis was significantly reduced among patients with correct prophylaxis with the heparin fragment (9.2-5.0 per cent, P = 0.02) [corrected]. The frequency of bleeding was 6.7 per cent among the heparin fragment patients and 2.7 per cent among the patients given conventional heparin (P = 0.01), but all bleeds were of minor degree and there was no difference in the reoperation rate for bleeding, or in the transfusion requirements. Local pain at the injection site was reported significantly less often among patients given the heparin fragment.
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PMID:Low molecular weight heparin given the evening before surgery compared with conventional low-dose heparin in prevention of thrombosis. 284 13

During a 1-year period, 537 compression ultrasound (CU) examinations were performed in 506 extremities of 485 patients for evaluation of possible deep venous thrombosis (DVT). Decisions regarding therapy were based on the result of this test in both outpatients and inpatients. Doppler ultrasound was also used during the last 7 months of the study, but this procedure did not alter the results obtained with CU alone. Incidental findings (eg, Baker cysts, aneurysms, and lymph nodes) were noted in 42 patients and were thought to be nonthrombotic causes of leg swelling or pain that could not be detected with venography. The reliability and clinical acceptance of CU as a means of diagnosing lower-extremity DVT resulted in a 50% yearly reduction in venography, with a concomitant 130% increase in the number of cases of DVT diagnosed.
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PMID:Lower-extremity deep venous thrombosis: further experience with and refinements of US assessment. 296 84

Ninety-two patients undergoing vascular surgery took part in a controlled clinical trial to study the effectiveness of a new low molecular weight (LMW) heparin for prevention of post-operative deep vein thrombosis. Forty-six patients were treated daily, for 7 days after operation, with a single subcutaneous injection of 15,000 Anti X-activated Factor Units of the new LMW heparin; the remaining 46 patients were treated, for the same period, with 2 daily subcutaneous injections of 5,000 International Units of calcium heparin. Deep vein thrombosis detection was by the radioactive fibrinogen uptake test, performed each day during therapy in all patients. A very low incidence of sub-clinical deep vein thrombosis was observed; in 3 (6.5%) patients in the LMW heparin group and in 4 (8.6%) patients of the calcium heparin group. The results of laboratory investigation showed that the antithrombotic activity (inhibition of Factor Xa) of the LMW preparation was significantly greater than that of calcium heparin, while activated partial thromboplastin time was greater in the calcium heparin group. The new preparation also showed better local tolerance, with less pain on subcutaneous injections.
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PMID:Low molecular weight heparin prevention of post-operative deep vein thrombosis in vascular surgery. 317 26

The purpose of this study was to analyze the various factors that influence the anatomical site of occurrence of DVT and to determine if the clinical course differed in patients afflicted with DVT at different anatomical sites in the lower extremity. Forty four of 92 patients undergoing venography during a 4-1/2 year period had positive venograms for DVT. Patients were grouped into one of three categories: iliofemoral thrombosis (IFT) n = 9, superficial femoral vein thrombosis with or without distal thrombosis (SFV) n = 21, and popliteal/calf thrombosis (clot limited to below the knee) (PCT) n = 14. Patients in the IFT group had a significantly prolonged hospital stay (p less than .05) and a significantly lower mean weight (129 lbs) when compared to the PCT group (173 lbs) (p less than .05). Pain was present equally among the three groups. Swelling was much more common in the SFV group, whereas tenderness was most frequent in the PCT group. Of those patients with swelling, 70% were in the SFV group and of those patients with tenderness, 60% were in the PCT group. DVT as the primary diagnosis was seen in 39% of cases of which half had disease limited to the PCT region. Post-op DVT occurred equally among the groups. DVT occurred much more frequently in the PCT region after myocardial infarctions and after orthopedic procedures, whereas in patients with malignancies, the most common site was the SFV region. Pulmonary embolism developed in 11% of patients and occurred in the IFT and SFV groups only. No patient with DVT of the calf/popliteal developed a pulmonary embolism.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Regional anatomical differences in the venographic occurrence of deep venous thrombosis and long-term follow-up. 318 22

Pulmonary embolism following postoperative deep venous thrombosis is a very serious complication with a high mortality rate. Though this disorder has been thought to be rare in Japanese, its occurrence seems to be increasing recently because of changes in eating habits, increase of average age and the frequent practice of venous catheterization. Two cases of the pulmonary embolism following deep venous thrombosis after surgery are reported, and possible causes of the deep venous thrombosis are discussed. Case 1: A 48 year-old obese female was operated on for a posterior fossa dural arteriovenous malformation. On the 4th postoperative day, she developed a pain and swelling in the left leg and low back pain. On the 18th postoperative day, she fell into a state of shock following the sudden onset of a severe back pain and respiratory distress. After diagnosis of the pulmonary embolism, she was immediately treated with urokinase, warfarin and aspirin. Her obesity was considered to be one of the risk factors of the postoperative deep venous thrombosis. Case 2: A 62 year-old female with a ruptured cerebral aneurysm could not get out of bed because of postoperative mental disturbance. A central venous pressure catheter was inserted into the right femoral vein for two weeks postoperatively. One month after surgery, she complained of swelling and a dull pain in the right leg without cardiorespiratory symptoms. Lung perfusion scintigraphy showed asymptomatic pulmonary embolism. She was treated immediately. Both long bed rest and femoral venous catheterization were considered as risk factors possibly leading to deep venous thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Postoperative pulmonary embolism in neurosurgical practice: report of two cases]. 321 Dec 80

Thrombolytic therapy is an effective, rapid method in treatment of massive lung embolism and major deep venous thrombosis extending to the caval vein. Besides resolution of the thrombus and improving hemodynamics, it prevents evolution to chronic pulmonary hypertension or postphlebitic syndrome. To have a beneficial effect in the early course of acute myocardial infarction, thrombolytic therapy should be instored within about three hours after the onset of pain; a real brief time limit. Intracoronary or systemic fibrinolysis later than the three hours period does not improve cardiac wall motion and hemodynamics and cannot assure infarct size reduction in spite of reestablished coronary flow. In peripheral arterial disease, fibrinolytic therapy of thrombosed grafts or vessels facilitates detection and unmasking of the underlying anatomical lesion permitting definite therapy (graft revision, percutaneous transluminal angioplasty). Selective intraarterial infusion has given encouraging results. Thrombolysis is a reasonably safe therapeutic method, on the condition of respecting all contraindications and avoiding unnecessary punctions. Allergy and hyperthermia are mostly benign and responsive to medical treatment. Cost-effectiveness renders streptokinase the most applicated thrombolytic agent.
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PMID:[Current status of fibrinolysis--a literature review of 25 years of fibrinolytic treatment]. 330 73

Venography using the combination of contrast material given intravenously in a vein in the arm and computed tomography scans allow the accurate diagnosis of deep vein thrombosis of the lower extremities and pelvis. The advantages of this method included actual visualization of the clot in the lumen of the vein, a more precise evaluation of the upper part of the thigh and pelvic area and the demonstration of adjacent abnormalities, which may contribute to the development of the thrombus. The opposite extremity is visualized at the same time for comparison of the venous systems and the associated muscle and limb swelling of the thrombosed side. There is less pain and risk of serious skin extravasation with contrast material given intravenously in the arm compared with the standard method for venogram using a foot vein. Repeat tests can be easily performed for follow-up studies after thrombolytic or anticoagulant therapy.
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PMID:Computed tomography diagnosis of venous thrombosis of the lower extremities and pelvis with contrast material. 338 Nov 79

A 55 year old woman with pain and swelling of the leg was heparinized on the basis of a clinically diagnosed ilio-femoral deep vein thrombosis (DVT). Subsequent investigation showed her to have extensive rhabdomyolysis of the leg. Rhabdomyolysis can mimic the appearance of deep vein thrombosis and this case further illustrates the importance of venography in the assessment of the swollen leg.
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PMID:Unusual causes of calf swelling--2. Rhabdomyolysis mimicking deep vein thrombosis. 342 66

A rare case of crural arterio-venous fistulae due to orthopedic surgery was presented. A 60-year-old female patient received a corrective fibulotomy just below the fibular head under the diagnosis of osteoarthropathy of the left knee joint 3 years ago. Intractable pain and swelling of the left leg appeared shortly after operation, probably due to deep vein thrombosis. A faint thrill on the left saphenous vein afforded a clue for detecting a co-existing arterio-venous fistula. Confirmative cine-angiography revealed a few a-v-fistulae at the level of crural trifurcation, which might have exacerbated the symptoms of deep vein thrombosis. On entering the trifurcation, which was embedded in scar tissues, there were two a-v-fistulae, originating separately from the peroneal artery and the posterior tibial artery. These fistulae were closed directly, one from the peroneal artery through the lateral approach resecting the upper one third of the fibula, and the other from the posterior tibial artery through the standard medial approach. Postoperative course was uneventful, and the swollen leg subsided rapidly with remarkable improvement of symptoms such as pain, dullness, night cramp of the calf and etc. Concerning to the medical literature on iatrogenic arterio-venous fistula due to orthopedic surgery, no similar case has been reported at least in these ten years on crural arterio-venous fistula after corrective fibulotomy.
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PMID:[Crural arterio-venous fistula due to orthopedic surgery. A report of a case]. 344 40

In a randomized, prospective, double-blind multicentre trial, the effect of conventional low-dose heparin 5000 units twice daily, was compared with that of a low molecular weight heparin fragment (4000-5000) 5000 anti-factor Xa units once daily. Four hundred and thirty-two patients fulfilled the inclusion criteria and were analysed for development of deep vein thrombosis (125I-labelled fibrinogen test) and haemorrhagic complications. Thrombosis occurred in a 4.3 per cent of patients in the low-dose heparin group and in 6.4 per cent of patients in the heparin fragment group, a difference which is not significant. There was a significant delay in the onset of thrombosis in the heparin fragment group. Mortality did not differ between the groups, nor did peroperative blood loss or transfusion requirements or infectious complications. Haemorrhagic complications occurred significantly more often in the fragment group (11.6 per cent) than in the conventional heparin group (4.6 per cent). Patients in the heparin fragment group experienced local pain following the subcutaneous injection significantly less often.
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PMID:Low molecular weight heparin once daily compared with conventional low-dose heparin twice daily. A prospective double-blind multicentre trial on prevention of postoperative thrombosis. 351 31


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