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

The role of catheter material in the formation of deep venous thrombosis during parenteral nutrition has been widely emphasized. Systematic venograms show central venous thrombosis in 20 to 33% of cases with polyethylene catheters and in 4% of cases with silicone catheters. Heparin infusion through the catheter diminishes but does not totally eliminate the risk of thrombosis. The aim of this study was to define the conditions under which the risk of thrombophlebitis was minimal. Four series of experiments were carried out, each on five rabbits. Catheters were inserted into the vena cava and, after 10 days, venograms were performed. The animals were then sacrificed, and the vena cava was macroscopically and microscopically studied. Plastic catheters were used in the first series, heparin-Benzalkonium-bonded plastic catheters in the second, silicone catheters in the third, and heparin-Benzalkonium-bonded silicone catheters in the fourth. The results revealed thrombosis of the vena cava and a fibrin sleeve around the catheters in series 1; thrombosis of the vena cava in series 2; a fibrin sleeve around the catheters in series 3; and neither thrombosis nor a fibrin sleeve in series 4. In conclusion, heparin-Benzalkonium-bonded silicone catheters appear to provide the best protection against thrombophlebitis by reducing the damage caused to the intima by the catheters and by slowing down platelet-aggregation around them.
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PMID:Experimental approach to prevention of catheter-related central venous thrombosis. 642 67

In a prospective study, 280 patients with phlebographically proven deep venous thrombosis received intravenous heparin infusion; 224 of the patients were subjected to control phlebography after 5-8 days of treatment. Females above 70 years showed least phlebographic improvement despite similar heparin dosage and heparin activity. Heparin activity in daily drawn blood samples was determined by four different assays. Chromogenic substrate (CS) assay (Coatest heparin), activated partial thromboplastin time (Cephotest), and thrombin time with recalcified plasma (CaTT) showed weak but significant correlations with thrombus resolution judged by phlebography (p = 0.004, 0.003 and 0.018, respectively). A linear prediction equation showed that the phlebographic result was about equally influenced by the mean dose and by the result of any of the three heparin assays. Thrombin time with citrated plasma showed no correlation. CS assay and CaTT showed significantly lower mean heparin activity in patients with (n = 13) than without clinically diagnosed pulmonary embolism (p = 0.012 and 0.001, respectively).
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PMID:The antithrombotic effect of heparin in deep venous thrombosis: relation to four heparin assays. 649 86

Primary thrombosis of the deep veins of the upper arms accounts for less than 2% of total cases of deep venous thrombosis, and fewer than 10 reported cases of venous thromboembolism in association with oral contraceptive (OC) use have involved the upper extremity. This article describes the case of a 20-year old woman with recurrent arm swelling and pain who had been in good health until developing a small area of redness in her right arm and fever to 99.8 degrees Fahrenheit 6 weeks previously. The condition had been diagnosed as spider bite, for which no medication was given, and cellulitis with axillary lymphadenopathy, for which oral antibiotics were prescribed. Gradual improvement in pain and swelling occurred, but the arm did not return to normal size or consistency. Hospitalization and treatment with 9 days of intravenous Cefamandole provided some resolution. The patient had taken OCs for 2 1/2 years to regulate menses and was a cigarette smoker. She was discharged on oral Tetracycline but was referred for further evaluation because of persistent symptoms. The physical examination was normal except for an increased right upper extremity circumference, increased turgor of upper arm tissues, and some tenderness along the axillary vein and in the axilla itself. A venogram showed complete obstruction of the axillary and subclavian veins on the right with remarkable collateral circulation. The superior vena cava was patent. Treatment with intravenous Heparin followed by oral Warfarin produced no improvement in clinical condition. Primary upper extremity thrombosis is generally a disease of young men. In this case OCs may have served as a thrombogenic risk factor.
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PMID:A painful swollen arm in a young woman. 657 28

The authors report ten observations of thrombocytopenia induced by heparin complicated with two arterial thrombosis and four deep venous thrombosis. Two deaths and two amputations are to mention. This retrospective study leads to a review of literature: this iatrogenic disease, which frequency is variously estimated, has no relation with the dose and the mode of administration of Heparin. It's mechanism might be immuno-allergic. It's diagnosis depends mainly on the repetition of platelet numerations at the outset period of treatment, and on the rapid and lasting climbing of platelet countings when heparin is stopped. This uncommon and unforeseeable complication indicates to stop Heparin and to start K antivitamin's if necessary.
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PMID:[Thrombocytopenia induced by heparin. Apropos of 10 cases]. 663 Dec 53

A case of skin necrosis caused by subcutaneously administered heparin is reported. A 76-year-old woman received subcutaneous injections of porcine sodium heparin twice a day to prevent deep vein thrombosis. Nineteen days after heparin therapy began, black necrotic areas were noted on her abdomen, and heparin injections were discontinued. The patient received small amounts of heparin intravenously for three additionally days without apparent complications. Proposed mechanisms for heparin-induced skin necrosis include allergic vasculitis and localized platelet aggregation with intravascular thrombosis. Heparin therapy should be stopped if necrosis develops. Intravenous administration of heparin to sensitive patients may be followed by life-threatening reactions. Necrotic areas may heal spontaneously, but often require debridement and skin grafting. Various agents, including steroids, may be useful in preventing the development of necrotic lesions.
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PMID:Heparin-induced skin necrosis. 671 77

The effect of heparin, 5000 units every 8 hours, on deep venous thrombosis in patients with proximal femoral fractures was investigated in a controlled, double blind, randomised study. Heparin or placebo was administered as soon as possible after the fracture, and before 6 hours had passed, and was continued for 14 days. The diagnosis of deep venous thrombosis was made using daily I125 fibrinogen scans. A total of 130 patients endured the trial and the results were registered on a sequential diagram. This showed that the 0-hypothesis could not be rejected, and that consequently no difference in the frequency of deep-vein thrombosis was detected.
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PMID:Low-dose heparin in proximal femoral fractures. Failure to prevent deep-vein thrombosis. 701 Aug 93

Despite venous stasis and a hypercoagulable state during pregnancy, the reported incidences of deep venous thrombosis and pulmonary embolism are remarkably low, about 1 in 2,000 and 1 in 10,000 cases, respectively. Mortality from antepartum thromboembolism has been reported in about 15 percent of untreated patients and less than 1 percent of treated patients. Adequate anticoagulant therapy significantly reduces maternal mortality and decreases postpartum morbidity. The proper anticoagulant agent for use during pregnancy has been widely debated. Coumarin compounds pass through the placenta and into the fetus. Hemorrhagic complications in the fetus are uncommon if prothrombin times are carefully controlled and if the drug is discontinued before delivery. However, coumarin during the first trimester has the teratogenic hazard of producing chondrodysplasia punctata. Heparin, in contrast, does not cross the placental barrier and is considered more effective treatment for deep venous thrombosis; however, long-term intravenous administration during pregnancy has been considered both impractical and possibly hazardous due to the risk of osteoporosis after 6 months of therapy. In our study, a combined regimen of intravenous and subcutaneous heparin was used successfully in four women with deep venous thrombosis. One patient who had recurrent embolization while on adequate intravenous heparin underwent vena caval clipping and had an uneventful Cesarian section at term with a normal infant. Another patient also underwent Caesarian section with a normal infant, while the other two women had normal vaginal deliveries at term. Miniheparin therapy was continued for 3 months postpartum, followed by long-term aspirin and Ascriptin therapy. Carefully controlled heparin therapy in a pregnant woman with deep venous thrombosis both safe and beneficial for mother and fetus.
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PMID:Management of deep venous thrombosis and pulmonary embolism during pregnancy. 709 23

Patients who are bedridden because of debilitating illness and patients who are recovering from major surgery are at particularly high risk of deep venous thrombosis and subsequent pulmonary embolism. "Mini-dose" heparin therapy has proved useful in preventing deep venous thrombosis. Because the clinical signs of pulmonary embolism are nonspecific, the patient's condition may deteriorate before the diagnosis is suspected. Ventilation and perfusion scans or pulmonary angiography confirm the diagnosis. Heparin continues to be the mainstay of therapy for pulmonary embolism.
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PMID:Pulmonary embolism. 712 79

Heparin of five commercially available brands was used to study the disappearance of heparin anticoagulant activity in normal humans. The drug was administered intravenously by bolus injection and by continuous infusion. Heparin anticoagulant activity was determined by two assays: a diluted activated partial thromboplastin time (APTT) and an assay based on inactivation of bovine factor Xa, using a clotting system. After a bolus injection, the data fitted neither single exponential nor zero-order clearance. In semilogarithmic plots, heparin anticoagulant activity disappeared according to a slightly convex curve almost always preceded by a rapid initial loss of heparin anticoagulant activity. This disappearance profile was observed with all heparin regardless of the brand or assay system. Heparin anticoagulant activity estimated by the APTT disappeared faster than heparin anticoagulant activity estimated by the anti-Xa activity in the first phase. As expected, higher anticoagulant levels with the anti-Xa assay than with the APTT were also found on continuous infusion in normals as well as in patients treated for deep vein thrombosis or pulmonary embolism. The experimental data suggested a model based on the combination of a saturable and a linear clearance mechanism. These experimental data provide reliable guidelines for adjustment of the dose of heparin in single patients.
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PMID:Kinetics of intravenously administered heparin in normal humans. 713 19

A randomised trial was undertaken in one hundred patients with heart failure and/or chest infection to determine whether low-dose subcutaneous heparin induced the frequency of deep vein thrombosis (DVT) in the legs. Heparin, (5000 units 8 hourly) significantly reduced the frequency of DVT, diagnosed by the 125I-fibrinogen scan technique, from 26 to 4 per cent (p less than 0.01). Heparin was started within 12 hours of admission to hospital and continued until the patient was fully mobile. Heparin did not cause bleeding problems except for a 20 per cent incidence of injection site bruising. We therefore recommend prophylaxis with low-dose subcutaneous heparin in patients with heart failure or chest infection who require more than three days bed rest.
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PMID:Prevention of deep vein thrombosis in medical patients by low-dose heparin. 729 71


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