Risk of Deep Venous Thrombosis With the Use of Foamed Sclerosant for Symptomatic Superficial Venous Insufficiency

2021 ◽  
Vol 9 (2) ◽  
pp. 559-560
Author(s):  
Patrick Beyer ◽  
Thekla Bacharach ◽  
Anand Dayama ◽  
Jean Panneton ◽  
David Dexter
2021 ◽  
Vol 74 (3) ◽  
pp. e37-e38
Author(s):  
Brian M. Grant ◽  
David Dexter ◽  
Patrick Beyer ◽  
Jean M. Panneton ◽  
Thekla Bacharach ◽  
...  

2019 ◽  
Vol 6 (8) ◽  
pp. 2698
Author(s):  
Mostafa A. Elaggory ◽  
Mahmoud S. Eldesouky ◽  
Nehad A. Zeid

Background: It was found that 50% of patients with iliofemoral deep venous thrombosis (DVT) treated by anticoagulant alone and compression stocking developed post thrombotic syndrome (PTS). Accelerated removal of thrombus by thrombolytic agents may increase venous patency and prevent PTS. The objective of the study was to assess short-term efficacy of additional catheter directed thrombolysis (CDT) compared with standard anticoagulant therapy alone.Methods: Prospective, randomized, controlled study on 50 patients (18–75 years) with acute iliofemoral DVT and symptoms <21 days were randomized to receive additional CDT or standard anticoagulant therapy alone. After 6 months, vein patency and insufficiency (reflux) was assessed using duplex ultrasound by an investigator blinded to previous treatments.Results: Fifty patients were allocated additional CDT (n=25) or ACs alone (n=25). After CDT, grade III (complete) lysis was achieved in 17 (68%) and grade II (50%–90%) lysis in 5 patients (20%). One patient suffered major bleeding and two had clinically relevant bleeding related to the CDT procedure. After 6 months, iliofemoral patency was found in 17 (68%) in the CDT group vs. 8 (32%) controls, corresponding to an absolute risk reduction 36% (95% CI, p=0.002). Femoral venous insufficiency was found to be higher among the ACs group 11 patients (44%) vs. 7 patients (28%) in the CDT group.Conclusions: After 6 months, additional CDT increased iliofemoral patency from 32% to 68% and decreased venous insufficiency from 44% to 28%.


2017 ◽  
Vol 41 (1) ◽  
pp. 11-12
Author(s):  
Anita Altawan ◽  
David Golchian ◽  
Mazen Bazzi ◽  
John Iljas ◽  
Bipinchandra Patel

Radiofrequency ablation (RFA) of the saphenous and perforator veins (“closure”) is a relatively newer option for treatment of venous insufficiency patients. A known complication of the RFA is deep vein thrombosis also known as DVT. The purpose of this study is to demonstrate the probability of acute deep venous thrombosis post radio-frequency vein ablation. This research also helped determine medical necessity of a postoperative venous duplex examination within 5 days post-procedure.


2020 ◽  
Vol 29 (04) ◽  
pp. 245-249
Author(s):  
Daniele Camilli ◽  
Alessandro Platone ◽  
Massimo Ruggeri ◽  
Sergio Furgiuele

AbstractEvaluation of the outcomes of OSES (oval-shaped external support), a novel device for external valvuloplasty of the great saphenous vein (GSV) for the conservative treatment of superficial venous insufficiency. Between 2012 and 2015, 30 patients underwent external valvuloplasty of the GSV for a total of 32 limbs. Patients were subjected to clinical and instrumental follow-up by a half-year ultrasound for a minimum of 36 months. The main endpoints were the recurrence of varicose disease, persistent or recurrent venous reflux, and venous thrombosis. Varicose recurrence was verified in six limbs on 32 (18.75%). Four limbs (12.5%) presented a recurrence of the reflux even in the absence of varicose veins. Two limbs (6.25%) underwent saphenectomy after the valvuloplasty intervention at 12 and 18 months, respectively, because of the presence of saphenofemoral reflux and varicose recurrences. No case of venous thrombosis of the saphenous trunk was observed. The external valvuloplasty of the GSV is a well-known technique that used to treat the superficial venous insufficiency. The newly introduced OSES device seems to show better midterm results, due to a better alignment of the valve flaps. In our experience, the use of this device gives better long-term results and allowed to extend the indication to patients with saphenic diameters that were considered not eligible for repair. In conclusion, although our data needs further confirmation, OSES device might represents a new interesting opportunity for reconstructive venous surgery.


2017 ◽  
Vol 33 (6) ◽  
pp. 388-396 ◽  
Author(s):  
Mert Dumantepe ◽  
Ibrahim Uyar

Objective To evaluate the clinical safety and effectiveness of percutaneous rheolytic thrombectomy in patients with acute lower extremity deep venous thrombosis. Method Sixty-eight consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. A percutaneous rheolytic thrombectomy device (Angiojet ® Rheolytic thrombectomy catheter, Boston Scientific, Marlborough, MA, USA) was used in all patients in an angiography suite through ipsilateral popliteal vein access. Thrombus clearance and complications were evaluated. Furthermore, patients underwent a clinical evaluation according to a modified Villalta scale for the investigation of post thrombotic syndrome in follow-up. The Venous Clinical Severity Score, Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Sym questionnaires were completed preoperatively and readministered postoperatively. Results Overall thrombus clearance (complete recanalization was achieved in 58 patients (85.2%) and partial recanalization was achieved in 7 patients (10.2%) confirmed through venographic assessment was achieved in 95.5% of the patient population. The mean Venous Clinical Severity Score preoperatively was 13.1 ± 2.2 and decreased to 4.0 ± 1.3 postoperatively (P < 0.01). The Villalta scale dropped from 12.9 ± 2.8 to 5.5 ± 1.4 postoperatively (P < 0.001). Overall quality of life and symptoms improved as assessed by Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Sym (P < 0.01 and 0.02, respectively). Only three minor bleedings were seen but none of the patients suffered from major bleeding, symptomatic pulmonary embolism, death, or other procedure related complications. Fifty-nine out of 65 patients (90.7%) who were treated successfully with rheolytic thrombectomy remained patent at 12 months according to DUS and five patients (7.3%) developed a mild post thrombotic syndrome. Conclusion Rheolytic thrombectomy with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical symptoms. This technique is a safe, effective and easily performed method of endovascular treatment with a low rate of major treatment complications and shows promising clinical mid-term results.


1993 ◽  
Vol 18 (5) ◽  
pp. 760-766 ◽  
Author(s):  
Charles C. Wolferth ◽  
Todd M. Gerkin ◽  
Hugh G. Beebe ◽  
David M. Williams ◽  
Jess R. Bloom

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Luiz Alberto Bomjardim Pôrto ◽  
Maria Aparecida de Faria Grossi ◽  
Edilamar Silva de Alecrim ◽  
Marcus Henrique de Souza Brito Xavier ◽  
Frederico Paiva e Silva ◽  
...  

Introduction. Erythema nodosum leprosum (ENL) is a type of lepra reaction treated with corticosteroids and thalidomide, but this association increases the risk of deep venous thrombosis (DVT).Objective. To report cases of ENL with DVT in the use of thalidomide/corticosteroid associated.Methodology. The study was conducted between December 2015 and December 2016 at the Eduardo de Menezes Hospital (HEM-FHEMIG).Results. A clinical case series of 16 patients, eight from HEM-FHEMIG and eight from the literature. DVT occurred on 4 continents, mainly in adults and men. All patients were multibacillary; four people had pulmonary embolism (PE); there were 11 unilateral and five bilateral DVT cases; 12 cases were proximal, two distal, and two unspecified. Pharmacological thromboprophylaxis was used on two individuals. Outcome after DVT, 14 patients improved, one had sequelae, and one died.Discussion. DVT increased in association with thalidomide/corticosteroid in multiple myeloma, but this complication is poorly described in ENL. In proximal DVT, there was a greater risk of PE and sequelae venous insufficiency. After DVT, start anticoagulation. ASA 100mg/day as prophylaxis for DVT in case of this drug association in ENL is recommended.Conclusion. The article illustrates the incidence increase of DVT because of the thalidomide/corticosteroid combination in ENL. When this association is necessary, use ASA 100mg/day as prophylaxis.


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