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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 authors report their experience with graded-pressure elastic hose (TED Stockings) for the prevention of deep venous thrombosis of the lower limbs and pulmonary embolism in high-risk, bedridden postoperative patients. The trial was designed according to a closed sequential program and gave positive, statistically significant results in terms of preventing pathology with this type of hose.
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PMID:[Graduated and constant compression of the lower extremities in the prevention of postoperative deep venous thrombosis and of pulmonary thromboembolism. Clinical trial]. 39 49

In 79 patients undergoing hip or knee replacement surgery the preoperative condition of the popliteal vein valves was assessed by Doppler ultrasonography. Presence of postoperative deep vein thrombosis was determined by bilateral ascending phlebography seven to ten days after surgery. Antithrombotic prophylaxis consisted solely of TED stockings and early mobilization. The overall incidence of deep vein thrombosis was 20%. All thrombi were calf vein thrombi. One of these thrombi extended into the popliteal region and two into the femoral region. The incidence of deep vein thrombosis in patients with preoperative popliteal vein reflux when compared with patients with a normal popliteal valvular function was 55-15% (p less than 0.01). The incidence of deep vein thrombosis was also significantly lower in patients operated under epidural anaesthesia compared with patients under general anaesthesia. It is concluded that valvular incompetence of the popliteal vein predisposes to postoperative deep vein thrombosis.
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PMID:Popliteal valve incompetence and postoperative deep vein thrombosis. 219 17

In an open controlled study, 248 consecutive patients (age more than 40 yrs) admitted for major abdominal surgery were randomized to one of three prophylactic antithrombotic treatments. Eighty-five patients received subcutaneous heparin, 74 patients had graduated compression stockings to the knee (TED stockings), and 89 patients had both subcutaneous heparin and stockings. Treatment began on the evening before operation and continued to complete mobilization, or for not less than five days postoperatively. On the fourth or fifth postoperative day, the patients underwent a 99mTc-plasmin test of the lower limbs as a test for deep vein thrombosis. There were 29.7% positive tests in the stocking group, 29.4% in the group with heparin prophylaxis, and 25.8% in the combined group. Differences between treatments were not statistically significant.
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PMID:Venous thrombosis after abdominal surgery. A comparison between subcutaneous heparin and antithrombotic stockings, or both. 297 90

In a prospective, controlled clinical study prevention of postoperative deep venous thrombosis by low-dose heparin (Heparin Leo 5 000 I.U. subcutaneously twice daily) was compared with graded compression stockings (TED stockings, Kendall Co.). One hundred and twelve patients, admitted during a period of one year for elective major surgery, were allocated to one of the two treatment groups. In order to detect deep venous thrombosis the 99mTc-plasmin test was performed before the operative procedure and again 5 days later. Ninety-seven patients completed the study (45 patients in the heparin group and 52 patients in the stocking group). Venous thromboembolism was detected in 4 patients (8.9%) in the heparin group and in 3 patients (5.8%) in the stocking group (p greater than 0.05). In 6 patients the plasmin test was positive and one patient in the heparin group died following pulmonary embolism. It is concluded that graded compression stockings can be used as an alternative to low-dose heparin for prophylaxis against deep venous thrombosis in elective general surgery.
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PMID:Prevention of postoperative deep venous thrombosis. Low-dose heparin versus graded pressure stockings. 389 94

The incidence of postoperative deep vein thrombosis in 120 patients undergoing elective total hip replacement was determined venographically. Significantly more blood was administered to those developing thrombosis, particularly in the subgroups given general anaesthesia (P less than 0.05). There were no differences in the postoperative haemoglobin values in any of these groups. The distribution of other risk factors identified, namely previous thrombo-embolism, malignancy and previous vein surgery or injections did not influence this finding. The use of TED stockings (Kendall) was effective. It is suggested that greater emphasis should be placed on techniques that reduce blood loss such as regional anaesthesia and the posterior approach to the hip. Further research into the fluids used for blood volume maintenance will be beneficial.
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PMID:The effect of blood transfusion on the incidence of deep vein thrombosis. 657 54

Based on morphological features of the lymphatic microcirculation of the skin from healthy subjects, and from paraplegic patients who had no evidence of ilio-femoral venous thrombosis (thromboembolic disease: TED), the leg terminal lymphatic vessels from skin biopsies of five male paraplegic patients with acute traumatic spinal cord lesions and with documented TED were studied. Paraplegic patients with TED had lymph vessels with a dilated lumen surrounded by a rarefacted perivascular connective tissue characterized by dissociation and disruption of collagen and elastic fibres. The lymphatic wall was generally attenuated and some open junctions and channels delimited by endothelial protrusions were observed. The venous outflow obstruction caused by deep venous thrombosis accompanied by the absence of ambulatory venous pressure in the paretic leg determines skin microlymphatic dilatation, lymph stasis and changes in the interstitial connective tissues. These alterations may be considered to be the morphological aspect of the dystrophic alterations seen in the skin of legs from paraplegic patients with TED. The results are discussed in view of the correct rehabilitative medical treatment necessary, and adequate prophylaxis of TED.
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PMID:Morphological changes in the skin microlymphatics in recently injured paraplegic patients with ilio-femoral venous thrombosis. 747 43

This study was undertaken to survey the current practice for venous thromboembolism (VTE) prophylaxis in Irish hospitals. A questionnaire was completed by 293 Irish consultant hospital doctors for the period October 1991 to December 1992 regarding their policy for VTE prophylaxis. Of the doctors surveyed, 36.85% are physicians, 27.3% are surgeons, 20.1% obstetricians and gynaecologists and 15.7% anaesthetists. 94% of physicians initiated DVT prophylaxis in their 'at risk' patients. 94% of the surgeons and 92% of the obstetricians/gynaecologists had used VTE prophylaxis and usage in both groups was more common in high risk patients. Anaesthetists reported VTE prophylaxis being used in an average of 20% of operations. Physicians considered the most important risk factors to be immobility, the period post myocardial infarction and a history of previous DVT. Other factors considered important by surgeons included advancing patient age and malignancy while obstetricians thought obesity to be a major risk factor. The most favoured prophylactic measures used by all doctors surveyed were subcutaneous heparin and elastic (TED) stockings.
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PMID:Prophylaxis of venous thromboembolism in Irish hospitals. 810 28

We prospectively studied the incidence of deep vein thrombosis (DVT) of the thigh in 117 patients having posterior lumbar spinal fusion with instrumentation and bone grafting for degenerative disk disease or spondylolisthesis. Patients with neoplasm, infection, trauma, or history of DVT were excluded. Patients were randomized into two groups. In the operating room, group 1 patients were placed in thigh-high antiembolic compression stockings (TED hose), and group 2 patients were placed in antiembolic stockings and pneumatic compression stockings. In both groups, the stockings were used until discharge. Postoperatively, patients in both groups received 600 mg buffered aspirin twice daily. Comparative analysis of the two groups showed no difference in operative time, blood loss, number of levels of lumbar vertebrae fused, time to mobilization, weight, age, or sex. All patients had duplex scanning of the thigh postoperatively. No patient in the series was observed to have acute DVT by clinical examination or by ultrasonography.
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PMID:Deep vein thrombosis in lumbar spinal fusion: a prospective study of antiembolic and pneumatic compression stockings. 888 5

Deep venous thrombosis and subsequent pulmonary embolism due to venous pooling/stasis commonly occur in patients during hip and/or knee arthroplasty (i.e., replacement). This problem may be alleviated by using techniques to promote lower limb blood flow. Electrical stimulation-induced contractions have been shown to activate the skeletal muscle pump, promote limb blood flow, and may be effective for reducing venous pooling/stasis and edema. Therefore, electrical stimulation may reduce the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) during and following surgery. The overall goal of this project was to evaluate the clinical efficacy of sequential electrical stimulation-induced leg muscle contractions on the venous blood flow during surgery. The degree of venous pooling/stasis was monitored via electrical impedance changes in the thorax. The changes in the patient's central hemodynamics were then calculated. Thirty patients were recruited and randomly assigned to either a control group (n = 15, mean age = 66.4 +/- 7.3) or experimental group (n = 15, age = 60.7 +/- 9.7). Both groups received the standard medical treatment for prevention of DVT (i.e., coumadin, heparin, etc.) and compression stockings (TED, Kendall). The control group used the sequential compression device (SCD + TED) and the experimental group used electrical stimulation (ES + TED). Electrical stimulation was applied via surface electrodes to the lower-limb muscles (tibialis anterior and gastrocnemius) and upper limb muscles (quadriceps femoris and hamstrings). These muscles contracted sequentially, using an eight-channel electrical stimulator. Four seconds of calf (contraction/compression) were followed by 7-s of calf and thigh (contraction/compression) interspersed by 60-s rest period during both electrical stimulation or sequential compression device. This cycle continued throughout the surgery (60-75 min) for both groups. At 15 min intervals, venous return was monitored by impedance cardiograph. Physiologic responses including ventricular stroke volume (SV), cardiac output (CO), heart rate (HR), total peripheral resistance (TPR), as well as mean arterial pressure (MAP) were monitored. These responses were statistically analyzed and compared throughout the surgery within each group and between the two groups. The results show stroke volume and cardiac output to be higher throughout surgery in the electrical stimulation group as compared with the sequential compression device group. The heart rate was consistently lower during electrical stimulation for both groups. Total peripheral resistance did not change in the electrical stimulation group; but increased in the sequential compression device group. The data suggest that continuous electrical stimulation-induced contractions could improve lower leg circulation by eliciting the physiologic muscle pump. This will lead to improved venous circulation and reduction of blood stasis during total hip and/or knee surgery. This technique may offer greater protection against DVT and PE during surgery than the commonly used sequential compression device.
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PMID:Electrical stimulation-induced contraction to reduce blood stasis during arthroplasty. 908 86

In order to prevent fatal pulmonary embolism, TED stockings, foot pumps and early mobilisation on the second post-operative day are used at our centre. Only patients deemed to be high risk (previous DVT/PE or obese) are given clexane as inpatients and warfarin for six weeks post-op. From the hospital database 1137 primary total hip replacements and 1017 primary total knee re-placements were identified and the figures were confirmed with the theatre implant order books. The cause of death for those patients on the database, now deceased, was obtained from the coroner. Where a postmortem had not been performed the patient was assumed to have died of a PE. Within three months of surgery, a fatal PE rate of 0.09% (95% CI 0.00-0.26%) following hip replacement and 0.20% (95% CI 0.00-0.46%) after knee replacement was found. Thirty-four patients had been discharged on warfarin according to the pharmacy records. We would therefore not recommend the routine use of chemical thromboprophylaxis following joint replacement.
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PMID:Fatal pulmonary embolism following hip and knee replacement. A study of 2153 cases using routine mechanical prophylaxis and selective chemoprophylaxis. 1921 78


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