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

Increases in whole blood coagulability in patients undergoing abdominal surgery have been measured with the thrombelastograph. A continuous, low dose intravenous infusion of heparin has been administered in the operative period in an attempt to control these coagulability increases without increasing the risk of haemorrhage. A preliminary sub-cutaneous dose of heparin followed by a continuous infusion throughout the operation and for two hours afterwards effectively prevented the expected coagulability increase and resulted in reduction of early deep venous thrombosis incidence from 9/20 in controls to 1/19 in treated patients (p less than 0.05). The infusion has also been used in conjunction with a pre-operative test to predict the risk of deep venous thrombosis. Of 20 patients examined, 11 were designated as high risk and received an intra-operative heparin infusion and 9 predicted low risk patients received no specific prophylaxis. No venous thrombosis occurred in any patient within 48 hours of surgery.
J Cardiovasc Surg (Torino)
PMID:Prophylaxis of early post-operative deep venous thrombosis by monitored heparin infusion. 708 48

Nineteen patients undergoing aortic surgery during which 5,000 units of heparin were given intravenously were compared with 39 patients undergoing laparotomy or herniorrhaphy. There was an expected significant reduction in coagulability as measured by thrombelastography in those patients undergoing aortic surgery. Moreover, the early post-operative deep vein thrombosis (DVT) rate was significantly less. This implies that a reduction in coagulability by I.V. heparin during surgery is associated with a lower incidence of early post-operative deep vein thrombosis. Among the laparotomy and hernia group who developed a DVT, coagulability was significantly greater both before and during the operation and on the first post-operative day.
J Cardiovasc Surg (Torino)
PMID:Coagulation changes during major surgery and relationship to post-operative deep vein thrombosis. 727 77

A series of 400 consecutive patients subjected to reconstructive arterial surgery were randomly allocated into four equal groups in order to study the effect of dipyridamole and acetylsalicylic acid (ASA) in the prevention of deep venous thrombosis and pulmonary embolism. There were 11 drop-outs. In the dipyridamole-ASA group there were no thrombotic complications while in the control group without antithrombotic therapy five cases of deep venous thrombosis and two cases of fatal pulmonary embolism were encountered (p < 0.05). In the groups receiving either dipyridamole or ASA alone two and four cases of deep venous thrombosis, respectively, were found. It is concluded that treatment with dipyridamole and ASA combined is useful in preventing postoperative thrombotic complication after peripheral vascular reconstructive surgery.
J Cardiovasc Surg (Torino)
PMID:Prevention of deep venous thrombosis and thrombo-embolism by dipyridamole and acetylsalicylic acid after reconstructive arterial surgery. 741 61

Two hundred and twenty-nine patients with the diagnosis of deep venous thrombosis admitted to the hospital prior and subsequent to the development of our vascular laboratory were reviewed. The institution of a clinical vascular laboratory improved the accuracy of diagnosis of deep venous thrombosis. The percentage of patients undergoing venography increased from 34 to 110 (31%) to 70 of 119 (59%), documenting an increased demand by the clinician for objective confirmation of the clinical diagnosis of deep venous thrombosis. Fifty-five patients had both phlebography and vascular laboratory examination. Twenty-seven of these had phlebograms along with pulse volume recordings of maximum venous outflow with Doppler ultrasound. The overall accuracy was 71.4%, with false positives in 22.2% (6 patients) and false negatives in 7.4% (2 patients). Phleborheography and phlebography were done in 28 patients. The overall accuracy of phleborheographic examination was 89.3%. The false positive rate was 3.6% (1 patient) and the false negative rate was 7.1% (2 patients).
J Cardiovasc Surg (Torino)
PMID:Vascular laboratory and deep venous thrombosis: impact on management. 745 63

The aim of this study was to evaluate the effect of lacidipine and nifedipine on lower limb veins. Forty hypertensive patients, aged 30-50 years, with no deep venous thrombosis, venous insufficiency, or hypothyroidism underwent double-blind treatment with placebo (1 week), lacidipine 4 mg once daily (1 week), and slow-release nifedipine 20 mg twice daily (1 week) in randomized sequence. Echo-color Doppler examination of superficial, deep, communicating, and perforating veins of the legs was performed. The results showed venous insufficiency and hypertension after 1-week administration of lacidipine (5 and 15%, respectively) and nifedipine (10 and 25%, respectively) and only two cases (5%) of venous hypertension during placebo administration. Lower limb edema was observed in two patients (5%) during treatment with nifedipine slow-release (SR). The hemodynamic effects of lacidipine and nifedipine were reversible but may contribute to the mechanism of lower limb edema.
J Cardiovasc Pharmacol 1994
PMID:Effects of lacidipine and nifedipine on lower limb veins in nonphlebopathic patients. 760 97

The incidence of deep venous thrombosis or pulmonary embolism after lung or heart-lung transplantation has not been well defined. Pulmonary embolism may be of particular concern in the postoperative period owing to an inadequately developed or absent collateral bronchial circulation and potential risk of pulmonary infarction. Fourteen (12.1%) of 116 patients undergoing either lung (n = 87) or heart-lung (n = 29) transplantation developed thromboembolic complications 10 days to 36 months after operation. Deep vein thrombosis developed in nine patients, including three with upper body thrombosis related to indwelling central venous catheters. Seven patients (6%) had pulmonary embolism, and three of them died. Resolution of pulmonary embolism was successfully accomplished by selective pulmonary artery infusion of urokinase in three patients without complications. Our experience indicates that deep vein thrombosis and pulmonary embolism are significant problems after lung transplantation. Mortality is high in those patients in whom pulmonary embolism develops. Therefore, a comprehensive prevention protocol is warranted.
J Thorac Cardiovasc Surg 1995 Aug
PMID:Deep venous thrombosis and pulmonary embolism after lung transplantation. 763 73

Primary venous aneurysms are rarely encountered lesions. Case reports have been described throughout the venous system. The lesions are usually symptom-free being found as a subcutaneous mass, an incidental finding on an imaging study, or during the work-up for deep venous thrombosis. However, embolism and rupture have been rarely described. A femoral vein aneurysm is reported, along with a current review of the literature of venous aneurysms.
Cardiovasc Surg 1995 Jun
PMID:Femoral vein aneurysm: a case report and review of the literature. 765 48

In this chapter, various tests have been discussed in the diagnosis of DVT and have been classified according to various patient categories. To summarize, the following guidelines may be of clinical use in the management of patients with suspected DVT. Acute, First Event of Suspected DVT These patients often suffer from occluding, proximal thrombi. Therefore, noninvasive tests such as CUS or IPG are most suitable for these patients. If an abnormal CUS or IPG result is found, the diagnosis is virtually proven, and this may serve as a basis to treat the patient with anticoagulants. If a normal CUS or IPG result is obtained, serial testing is indicated to detect extending calf vein thrombi or nonoccluding DVT, which becomes occlusive at follow up. Anticoagulants may be withheld safely if the test remains normal within 1 week. Acute, Recurrent Suspected DVT These patients may have residual thrombi present, which makes the noninvasive tests (CUS/IPG) less useful. However, if a normal noninvasive test was documented previous to the acute recurrent event, this test may be used. If an abnormal test result is found in the presence of a documented, normal previous-test outcome, this may serve as a basis for anticoagulant therapy. Although no formal studies have been performed to evaluate the safety of withholding anticoagulants if a normal CUS or IPG result is obtained, serial testing is likely to be adequate in these circumstances. Phlebography is the only truly evaluated approach, and this could be considered in all suspected recurrent DVT. Furthermore, contrast venography is the test of choice to discern acute from old thrombi. Asymptomatic DVT in High-Risk Patients The majority of these thrombi are mostly localized in the calf veins only and are often nonocclusive. This makes noninvasive tests unreliable for their detection. Therefore, only contrast venography should be used in this patient category.
Prog Cardiovasc Dis
PMID:Diagnosis of deep vein thrombosis. 802 82

Patients with major trauma often cannot be given the benefit of preventive measures such as pneumatic compression boots and low-dose heparin against pulmonary embolism. The Greenfield filter is accepted as a safe and effective method of prophylaxis of this complication. The aim of this study was to evaluate the efficacy of placement of the Greenfield filter in 161 patients with major trauma. Between January 1984 and July 1988, 94 patients with an injury severity score (ISS) of > 16 were treated. This score is predictive of a mortality rate of at least 10% and defines major trauma based on anatomic injury. Some 20% (19 of 94) of these patients developed deep vein thrombosis despite standard prophylactic measures and 8% (eight of 94) suffered pulmonary embolism, two of which were fatal. Pulmonary embolism occurred without antecedent evidence of deep vein thrombosis in another 15% of patients (14 of 94), three of which caused death. From August 1988 until July 1992, of 67 other patients with an ISS > 16, 13% (nine of 67) developed deep vein thrombosis and 1% (one of 67) had a pulmonary embolism; this was not statistically significant (P > 0.25). Of these 67 patients who were considered to be at high risk of pulmonary embolism, because of a contraindication to anticoagulation or physical impediment to sequential compression boots, 29 had prophylactic placement of a Greenfield filter. No pulmonary emboli occurred in these patients. During long-term follow-up (mean 32.8 (range 4-58) months), 84% of the surviving patients (21 of 25) underwent duplex ultrasonography of the inferior vena cava; patency of the vessel was confirmed in all patients.
Cardiovasc Surg 1994 Feb
PMID:Use of the Greenfield filter in patients with major trauma. 804 25

In a review of 52 cases of deep venous thrombosis (DVT) of the upper extremity, the predisposing factors, clinical manifestations, topography of thrombosis, treatment employed, presence of complications, and evolution of the disease were investigated. In all patients, clinical manifestations were confirmed by bilateral phlebography and superior cavography. Thirty-five (67%) of the patients were male; the mean age was 45.4 years. Clinical manifestations were edema in 51 patients (98%), dilated collateral circulation in 37 (71%), and pain in 33 (63%). One patient presented with pulmonary embolism and another with phlegmasia cerulea dolens-like signs in an extremity. The right axillosubclavian segment was involved in 23 patients (44%), the left in 17 (33%), and both left and right segments associated with DVT of the superior vena cava in 11 (21%). One patient had left and right axillosubclavian thrombosis without superior vena cava involvement. The main predisposing factors identified were central venous catheterization in 15 patients (29%) and extrinsic compression, caused mainly by cancer, in 15 (29%). There were three cases of DVT related to effort and three to thoracic outlet syndrome. The majority of patients were treated with systemic heparin therapy followed by oral anticoagulation. During a follow-up of 6 months, nine patients died, one from pulmonary embolism; 21 patients (40%) were symptom-free, 11 (21%) had minimal edema, and seven (13%) had symptomless edema. Four patients (8%) were lost to follow-up. The overall incidence of pulmonary embolism was 4%.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovasc Surg 1993 Feb
PMID:Upper-extremity deep venous thrombosis: analysis of 52 cases. 807 87


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