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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 review of the clinical records of 25 patients with IVC thrombus, proved by cavography during a ten year period, showed that this form of venous thrombosis accounted for less than 5 per cent of all phlebographically documented DVT at this institution. Before phlebography was performed, only eight patients (32 per cent) were suspected clinically of having IVC thrombus because of the absence of classic signs of bilateral lower extremity edema and pain in the majority of patients. Five patients presented with an acute PE, one being fatal. The majority of patients, 19 of 25 (80 per cent), had IVC thrombus contiguous with either iliofemoral (eight patients) or infrainguinal (11 patients) DVT. Nineteen patients were given anticoagulation therapy with heparin, and three patients underwent IVC compartmentalization. No subsequent PE developed in either group. Despite the potential for large lethal PE, heparin therapy appears to be the appropriate form of treatment for patients with IVC thrombus.
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PMID:The clinical implications of acute thrombosis of the inferior vena cava. 669 8

Iopamidol, a non-ionic, tri-iodinated radiographic contrast medium, was superior to the ionic substances ioxaglate, ioglicinate and ioxitalamate in the ascending phlebography. In 180 examinations on 90 patients (report I), which were carried out intraindividually by double blind technique, distinct differences were recorded in particular at pain registration. Since iopamidol was well tolerated in nearly all cases, pain was registered in 10% in ioxaglate, in 22% in ioglicinate and in 37% in ioxitalamate. Anaphylactoid reactions had been observed in one case (1.1%) with iopamidol, in 7% with ioglicinate, in 10% with ioxitalamate and in 17% with ioxaglate. The low incidence of clinically manifest postphlebographic thrombophlebitis and deep venous thrombosis was surprising. In no case was deep venous thrombosis seen after the application of low-osmolar substances, whereas transitory superficial vein irritations could be observed more frequently (10% in iopamidol and 21% in ioxaglate). In ioglicinate as well as in ioxitalamate one deep vein thrombosis and in 10% resp. 30% superficial thrombophlebitis were recorded.
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PMID:[Systemic and local reactions in leg phlebography with special reference to iodine-containing contrast media. Randomized, prospective, intraindividual double-blind study using iodine-containing contrast media of different osmolarity and iodine concentration. I]. 670 79

Muscle disease associated with alcohol abuse is more common than is generally realized. The chronic painless form of alcohol myopathy is thought by some to be an atypical neuropathy. Patients with the acute painful variety have pain, swelling, tenderness, cramps and weakness in one or more muscle groups, usually after an alcoholic binge. Clinical differentiation of this form of myopathy from deep vein thrombosis can be challenging. Ethanol and its metabolite, acetaldehyde, have direct pathologic effects on skeletal muscle.
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PMID:Acute alcoholic myopathy. 673 Dec 43

Patients who underwent radiographic phlebography were studied to determine the frequency of postphlebographic venous thrombosis. In a group of 23 patients who had negative phlebograms performed with standard contrast agent (60% sodium methylglucamine diatrizoate), nine had positive 125I-fibrinogen leg scans. On repeat phlebography, three had confirmed deep vein thrombosis, six overall developed deep or superficial thrombosis, and three had positive scans without demonstrable thrombi. In a second group of 34 patients studied with the contrast material diluted to 45%, only three developed positive scans, one due to deep venous thrombosis and two to superficial thrombosis. There was also a reduction in the incidence of postphlebographic symptoms of pain, tenderness, and erythema, but no apparent sacrifice in diagnostic accuracy.
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PMID:Reduction of venous thrombosis complicating phlebography. 677 Jun 25

The versatility of impedance plethysmography (IPG) in the diagnosis of arterial and venous disease was evaluated in the clinical setting. Eighty-eight consecutive patients suspected of acute or chronic deep venous thrombosis (DVT) and undergoing ascending venography were evaluated using IPG. Venous capacitance (VC) and venous outflow (VO) were expressed as a per cent impedance change (% delta I). The evaluation was considered as abnormal if the VC was less than 1.85% delta I and the VO less than 0.95% delta I. The overall accuracy was 90 per cent with a sensitivity of 92 per cent and specifity of 93 per cent. Arterial blood flow (ABF) was measured in normal volunteers (20 limbs) and patients with intermittent claudication (20 limbs) and rest pain (16 limbs). Resting ABF (cc/100 ml/min) did not differ (P greater than 0.05) in the normal volunteer (4.3 +/- 0.4) and patients with intermittent claudication (4.6 +/- 0.5), but both were significantly greater (P less than 0.05) than ABF in patients with rest pain (3.2 +/- 0.2). Peak ABF during reactive hyperemia (RH) was significantly greater (P less than 0.001) in normal volunteers (24.8 +/- 1.6) than in claudicators (10.5 +/- 1.3), and both flows were significantly greater (P less than 0.0001) than the peak ABF in patients with rest pain (5.3 +/- 0.5). IPG may be used in the assessment of arterial and venous disease. It provides a sensitive test with which to screen patients with suspected DVT. In addition, it is a valuable adjunct in differentiating normal limbs from those with intermittent claudication and/or rest pain.
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PMID:Impedance plethysmography. Noninvasive diagnosis of deep venous thrombosis and arterial insufficiency. 682 36

The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacaine with epinephrine intraoperatively; for pain relief in the postoperative period (24 h), 0.25% bupivacaine with epinephrine was given every 3 h. General anesthesia (N = 30) consisted of controlled ventilation with N2O-O2 and intravenous fentanyl and pancuronium bromide; postoperatively, narcotic analgesics were given intramuscularly on demand for pain relief. Significantly lower frequencies were found following epidural anesthesia than after general anesthesia in deep venous thrombosis involving the popliteal and femoral veins (13% and 67%, respectively), deep venous thrombosis involving both calf and thigh veins (40% and 77%), and pulmonary embolism (10% and 33%). Possible explanations for these differences include increased circulation in the lower extremities, less tendency for intravascular clotting to occur, and more efficient fibrinolysis in association with continuous epidural anesthesia. The decrease in blood loss associated with epidural anesthesia with lower transfusion requirements also might play a role. Epidural analgesia prolonged into the postoperative period, in addition to other appropriate thromboprophylactic measures, should be of value in patients undergoing operations associated with a high risk of thromboembolic complications.
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PMID:Thromboembolism after total hip replacement: role of epidural and general anesthesia. 682 20

Twenty-eight patients with the diagnosis of deep vein thrombosis (DVT) were subjected to a prospective, randomized study comparing continuous and intermittent heparin treatment, utilizing the same doses and duration of therapy. The effect on pain (estimated with a scoring system) and the antithrombotic effect (assessed by the inhibition of 125I-fibrinogen accretion), followed for one week, were unrelated. Pulmonary embolism was scored and studied from lung perfusion scans and chest X-rays. A high frequency was found in both groups. The therapeutic efficacy and side-effects did not differ between the two treatment groups. Bleeding, preferentially from vein puncture (post-phlebography), was more common in women, while a heparin-induced elevation of serum aminotransferases (S-ALAT adn S-ASAT) (in 2/3 of the patients) was not related to age, sex or bleeding complications.
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PMID:Heparin treatment of deep vein thrombosis. Effects and complications after continuous or intermittent heparin administration. 703 44

This paper deals with some selected complications of operation. The majority arise from technical faults and errors in judgement or documentation. My choice of topics here has been for their immediate treatment and the avoidance and aftercare of the others. Wrong technique. Combined operations resulting in damage to important adjacent structures: a) arteries: divisions, ligations, stripping; veins: ligation, tearing, avulsion of saphena femoral junction; b) nerves: division, femoral, lateral popliteal, cutaneous; c) lymphatics: particularly in recurrent operations, lymphoma and subsequent oedema; d) skin: particularly incisions through thickened skin, inflammatory skin, oedematous skin; e) connective tissues. Major complications. Haemorrhage, shock, problems with skin closure, methods of dressings, post-operative immediate, anaesthetic problems. Haemorrhage, haematoma, swelling, oedema, lymphatic deep vein thrombosis, pulmonary embolism (1 in 3000--fatal 1 in 30,000). Wound healing, skin necrosis, wound infection. Leg complications: persistent varicose veins, recurrent varicose veins, pain, nerve palsies, chronic oedema.
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PMID:Some complications from surgery in varicose veins. 707 Nov 82

The authors present a case of proximal myopathy secondary to epsilon-aminocaproic acid (EACA) administration. This well recognized entity does not occur immediately after institution of therapy, but follows a delay of several days and a cumulative dose. Its consequences include a spectrum of symptoms from myalgias to severe myopathy with rhabdomyolysis, myoglobinuria, and acute tubular necrosis. A presenting symptom of calf pain in a patient receiving EACA should not automatically imply deep vein thrombosis. Serial creatine phosphokinase measurements are essential in monitoring a patient undergoing EACA therapy, especially after 2 weeks of treatment and a total dose of greater than 500 gm.
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PMID:Myopathy induced by epsilon-aminocaproic acid. Case report. 708 89

A patient with psoriatic arthritis presented to the Geisinger Medical Center emergency department after the sudden onset of pain and swelling in his left calf. Initially, the patient was thought to have acute thrombophelebitis. Upon further examination, the diagnosis of a ruptured popliteal cyst was considered, and was confirmed with arthrography. The case illustrates an occurrence of a dissecting popliteal cyst simulating an cute deep vein thrombosis in a patient with an inflammatory process involving the knee.
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PMID:A dissecting popliteal cyst presenting as acute thrombophlebitis. 724 91


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