After deep vein thrombosis, which patients refer to vascular specialist for anticoagulant withdrawal? A Delphi study results between general practitioners and vascular specialists

2017 ◽  
Vol 46 (5) ◽  
pp. e77-e83
Author(s):  
Antonin Zoubian ◽  
Laurent Bertoletti ◽  
Paul Frappé
Keyword(s):  
Deep Vein Thrombosis ◽  
General Practitioners ◽  
Delphi Study ◽  
Vein Thrombosis ◽  
Study Results ◽  
Deep Vein

scholarly journals Clinical characteristics of first venous thrombosis among women under and over 45 years of age

2014 ◽  
Vol 67 (9-10) ◽  
pp. 328-333 ◽  
Author(s):  
Mirjana Kovac ◽  
Zeljko Mikovic ◽  
Vesna Mandic ◽  
Dragica Radojkovic ◽  
Valentina Djordjevic ◽  
...  
Keyword(s):  
Risk Factor ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Young Women ◽  
Clinical Characteristics ◽  
Factor V Leiden ◽  
Factor V Leiden Mutation ◽  
Vein Thrombosis ◽  
Study Results ◽  
Deep Vein

Introduction. Venous thromboembolism is a multifactorial disease defined by multiple interactions between genetic and acquired risk factors. After coronary heart disease and stroke, venous thromboembolism is the most common cause of cardiovascular death and disability. Material and Methods. In order to investigate the clinical characteristics of first venous thromboembolism, 447 women younger than 45 and 174 over 45 years of age with confirmed venous thromboembolism, who had been tested for the presence of thrombophilia in the period 1998-2012, were included in the study. Results. Proximal deep vein thrombosis occurred most often among young women, while distal deep vein thrombosis was the most frequent in the older group. The most common reported risk for venous thromboembolism observed in 49.8% of the young women was pregnancy and puerperium, while 25.2% of them developed venous thromboembolism without any obvious cause. Among women over the age of 45, venous thromboembolism developed without an obvious cause in 38.5%, while malignant disease was identified as the most important risk factor in 23% of them. Thrombophilia was observed in 48.7% of the young women in comparison to 28.7% of the older ones (p < 0.0001). As for venous thromboembolism recurrence, it developed in 26.3% of young women and 17.8% of the older ones (p = 0.03). Conclusion. Younger women developed more severe forms of thrombosis than the older ones. Inherited risk factor for thrombosis was detected in almost half of all young women, and in every fourth elderly women. With the exception of factor V Leiden mutation, other types of congenital thrombophilia are almost negligible among older women. Therefore, thrombophilia testing in case of first thrombosis is fully justified only in young women.

scholarly journals PREVALENCE, DISTRIBUTION AND DETERMINANTS OF DEEP VEIN THROMBOSIS IN ADULT INDOOR STROKE POPULATION OF PESHAWAR DIVISION, PAKISTAN

2020 ◽  
Vol 18 (2) ◽  
pp. 59-67
Author(s):  
Muhammad Bilal ◽  
Imran Ullah ◽  
Syed Abdurehman Shah ◽  
Zahidullah Khan ◽  
Taj Muhammad Khan ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Public Health Problem ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Base Line ◽  
Cross Sectional ◽  
Vein Thrombosis ◽  
Stroke Population ◽  
Study Results ◽  
Deep Vein

Background: Stroke is a devastating public health problem worldwide, considered as the third leading cause of death in developed countries, and the leading cause of disability among adults. Deep vein thrombosis (DVT), including pulmonary embolism (PE) as a sequel, is a serious complication of various medical conditions including stroke. The purpose of this study was to determine frequency of deep vein thrombosis among patients presented with stroke. Materials and methods: This study was descriptive (cross-sectional) study, conducted in the Department of Neurology, Lady Reading Hospital, Peshawar over 6 months. In the study a total of 196 patients were observed. Base line investigations were done and ultrasound was carried out to diagnose deep vein thrombosis. All the laboratory investigations and ultrasound were done by single experience pathologist and sonologist having minimum of five years of experience respectively. Observation and examination was done by neurologist who was not aware about the study and data was recorded in a predesigned proforma. To control confounders and bias in the study results, strict exclusion criteria had been followed. Results: In this study mean age was 63 years with standard deviation ± 28.34. Forty two percent patients were male and 58% patients were female. More over 8% patients had deep vein thrombosis. Conclusion:Our study concludes that the frequency of deep vein thrombosis was 8% among patients presented with stroke.

scholarly journals Expert Consensus on the Contraindications and Cautions of Foam Rolling—An International Delphi Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5360
Author(s):  
Katja Martina Bartsch ◽  
Christian Baumgart ◽  
Jürgen Freiwald ◽  
Jan Wilke ◽  
Gunda Slomka ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Delphi Study ◽  
Bone Fractures ◽  
Methodological Approach ◽  
A Priori ◽  
Delphi Process ◽  
Medical Professionals ◽  
Foam Rolling ◽  
Vein Thrombosis ◽  
Deep Vein

Background: Foam rolling is a type of self-massage using tools such as foam or roller sticks. However, to date, there is no consensus on contraindications and cautions of foam rolling. A methodological approach to narrow that research gap is to obtain reliable opinions of expert groups. The aim of the study was to develop experts’ consensus on contraindications and cautions of foam rolling by means of a Delphi process. Methods: An international three-round Delphi study was conducted. Academic experts, defined as having (co-) authored at least one PubMed-listed paper on foam rolling, were invited to participate. Rounds 1 and 2 involved generation and rating of a list of possible contraindications and cautions of foam rolling. In round 3, participants indicated their agreement on contraindications and cautions for a final set of conditions. Consensus was evaluated using a priori defined criteria. Consensus on contraindications and cautions was considered as reached if more than 70% of participating experts labeled the respective item as contraindication and contraindication or caution, respectively, in round 3. Results: In the final Delphi process round, responses were received from 37 participants. Panel participants were predominantly sports scientists (n = 21), physiotherapists (n = 6), and medical professionals (n = 5). Consensus on contraindications was reached for open wounds (73% agreement) and bone fractures (84%). Consensus on cautions was achieved for local tissue inflammation (97%), deep vein thrombosis (97%), osteomyelitis (94%), and myositis ossificans (92%). The highest impact/severity of an adverse event caused by contraindication/cautions was estimated for bone fractures, deep vein thrombosis, and osteomyelitis. Discussion: The mechanical forces applied through foam rolling can be considered as potential threats leading to adverse events in the context of the identified contraindications and cautions. Further evaluations by medical professionals as well as the collection of clinical data are needed to assess the risks of foam rolling and to generate guidance for different applications and professional backgrounds.

Long-Term Outcomes of Post-Surgical Deep-Vein Thrombosis in Asia: The AIDA-Extension Study.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1621-1621
Author(s):  
Franco Piovella ◽  
Ching-Jen Wang ◽  
Lai Heng Lee ◽  
Won Chul Lee ◽  
Alexander G. Turpie ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
South Korea ◽  
Extension Study ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Vein Thrombosis ◽  
Study Results ◽  
Deep Vein

Abstract Background: We have recently demonstrated in a large multinational, multiethnic study that the incidence of venographic deep-vein thrombosis (DVT) in Asian patients undergoing major orthopedic surgery of the lower limbs and not receiving thromboprophylaxis was similar to that observed in orthopedic patients in Western countries. Overall, 407 patients (20–99 years) undergoing THR (n=175), TKR (n=136) or HFS (n= 96) were recruited in 19 centres across Asia (Indonesia, South Korea, Malaysia, Philippines, Taiwan and Thailand). 72.5% of the enrolled patients had adequate venograms. Total DVT was diagnosed in 121 of 295 evaluable patients (41.0%, [95% confidence interval: 35.4–46.7]). Proximal DVT was found in 30 patients (10.2% [7.0–14.2]). However the long-term outcomes following deep vein thrombosis such as recurrence of DVT, incidence of pulmonary embolism (PE), and post-thrombotic syndrome (PTS) remain unknown. PTS has received little attention in the literature, and particularly in Asia. Objectives: To assess the long-term complication rates (at 1 and 2 years) of patients with objectively assessed DVT compared to those observed in patients without post-operative DVT. Methods: Annual visits were performed to record the occurrence of DVT/PE, incidence of PTS, cumulative incidence rates and related predictive factors. PTS scoring were assessed using the Villalta scale (signs and symptoms). In addition in a subset of 18 out of 27 (66%) patients from South Korea with centrally adjudicated venographic DVT, a second venogram was performed at 1 year in order to verify possible spontaneous modifications of the thrombus (none of these patients had undergone any anticoagulant treatment). Results: From the 332 patients having completed the AIDA study in the 19 centres involved in the extension study, 236 patients (71.1%) agreed to participate in the extension phase and were assessed at year 1. Year 2 follow up visits were completed in May 2005. Complete data analysis of the final study results are ongoing and should be completed by September 2005. Of the 18 patients who underwent a second follow-up bilateral or unilateral ascending venography at 1 year ± 3 months post-operatively, 11 (61%) patients demonstrated resolution of the thrombus, with 3 (16%) patients showing incomplete resolution or persistence of the venous thrombosis. The venograms of the remaining four (23%) patients presented with development of collateral circulation confirming the progressive state of PTS. The majority of patients with centrally adjudicated venographic DVT demonstrated positive resolution following venographic assessment at year 1. The high incidence of thrombus resolution may have been due to the fact that most patients were diagnosed with distal DVT, which would suggest that a high percentage of DVT of the distal veins may resolve spontaneously compared to other types of DVT.

Feasibility Study of Catheter-directed Thrombolysis with Recombinant Staphylokinase in Deep Venous Thrombosis

1998 ◽  
Vol 79 (03) ◽  
pp. 517-519 ◽  
Author(s):  
Stephane Heymans ◽  
Raymond Verhaeghe ◽  
Luc Stockx ◽  
Désiré Collen
Keyword(s):  
Deep Vein Thrombosis ◽  
Continuous Infusion ◽  
High Speed ◽  
Minor Bleeding ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Long Term Follow Up ◽  
Valve Function ◽  
Rotating Impeller ◽  
Deep Vein

SummaryThe feasibility of catheter-directed thrombolysis with recombinant staphylokinase was evaluated in six selected patients with deep vein thrombosis. The patients underwent intrathrombus infusion of recombinant staphylokinase (2 mg bolus followed by a continuous infusion of 1 mg/h). Heparin was given via the catheter as a bolus (5000 U) and as a continuous infusion (1000 U/h). Complete lyis was obtained in five patients and partial lysis in one patient. Complications consisted of minor bleeding in four subjects. Symptomatic reocclusion occurred in one. Debulking of the thrombus mass by a high speed rotating impeller (n = 1) and stenting (n = 3) were used as additional interventions. An underlying anatomical abnormality was present in two patients. Long term follow up revealed normal patency in all patients and normal valve function in four patients. Symptomatic venous insufficiency with valve dysfunction was present in the two with a second thrombotic episode.Thus catheter-directed infusion of recombinant staphylokinase in patients with deep vein thrombosis appears feasible and may be associated with a high frequency of thrombolysis. Larger studies to define the clinical benefit of this treatment appear to be warranted.

Deep Vein Thrombosis and Fibrinolysis

1991 ◽  
Vol 66 (04) ◽  
pp. 426-429 ◽  
Author(s):  
Marcel Levi ◽  
Anthonie W A Lensing ◽  
Harry R Büller ◽  
Paolo Prandoni ◽  
Gerard Dooijewaard ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Tissue Type ◽  
Controlled Study ◽  
First Episode ◽  
Control Group ◽  
Vein Thrombosis ◽  
Type Plasminogen Activator ◽  
Deep Vein

SummaryIn the present study 57 consecutive patients with a first episode of venographically proven deep vein thrombosis were investigated to evaluate the release of tissue-type plasminogen activator (t-PA) and of urokinase-type plasminogen activator (u-PA) in response to DDAVP stimulation as well as the resting plasminogen activator inhibitor (PAI) concentration, comparing this to the results obtained in 66 similar patients with a clinical suspicion of thrombosis but with a normal venogram. All assays were performed without knowledge of the patient's status.Four patients in the deep vein thrombosis-group (7%) had an absent u-PA antigen response upon DDAVP infusion, while a normal response was observed in all control subjects. Patients and controls showed similar increases in t-PA antigen level upon DDAVP. High resting PAI antigen levels were encountered in 5 patients in the deep vein thrombosis-group (9%) and in 6 subjects in the control group (9%).The results from this controlled study indicate that a defective release of u-PA may occur in patients with deep vein thrombosis and may have pathogenetic significance. Furthermore it is concluded that elevation of PAI levels cannot be considered as a specific risk factor for venous thrombosis.

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