MONITORING OF DEEP VEIN THROMBOSIS BY D DIMER DETERMINATION. INFLUENCE OF HEPARIN REGIMEN

In 49 patients the level of plasma fibrin degradation products (FbDP) was measured during the first ten days of deep vein thrombosis (DVT) in order to determine whether FbDP may be used as a non invasive marker to follow the evolution of DVT. Plasma FbDP was measured precisely and reliably by Elisa using a personal anti D neo monoclonal antibody. Thrombus size was determined angiographically on day 0 and day 10 and expressed according to Marder score. Patients were treated by standard or by a very low molecular weight heparin (CY 222 from Choay Laboratory, Paris France).It is shown that before treatment, in 45 cases of DVT the level of FbDP was dramatically increased as compared to control and remained normal or slightly elevated in 4 cases of DVT. The correlation between thrombus size and FbDP level at day 0 was poor (p = 0.3). During the 10 days of treatment, FbDP determination may give some informations about the evolution of DVT. Three groups were defined :1 There was no reduction of thrombus size in patients who presented a normal or only slightly elevated FbDP level, leading to the evidence that thrombolysis was almost inexistant in these patients.2 Thrombolysis was almost complete in 10 days in patients presented both a high FbDP level before treatment and a dramatic decrease of FbDP after 10 days treatment. Taking into account the half life of FbDP, the decrease in FbDP level is related to the reduction in thrombus size.3 A partial or absence of recanalization was evidenced in patients presenting a high FbDP level throughout the 10 days on therapy. In cases without recanalization we have to assume that thrombolysis evidenced by plasma FbDP level was continuously counteract by a clotting process.Similar results were observed in patient treated by standard and CY 222.

Download Full-text

Plasma Fibrin Degradation Products Evolution in Patients with Deep-Vein Thrombosis Treated with a Low Molecular Weight Heparin Fraction (CY222) and Standard Heparin

Annals of the New York Academy of Sciences ◽

10.1111/j.1749-6632.1989.tb22530.x ◽

1989 ◽

Vol 556 (1 Heparin and R) ◽

pp. 441-443

Author(s):

RENE FAIVRE ◽

ERIC NEUHART ◽

CLAUDINE SORIA ◽

JEANNETTE SORIA ◽

YVONNE KIEFFER ◽

...

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Low Molecular Weight Heparin ◽

Degradation Products ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Fibrin Degradation Products ◽

Deep Vein

Download Full-text

Occurrence of thrombosis and haemorrhage, relationship with anti-Xa, anti-IIa activities, and D-dimer plasma levels in patients receiving a low molecular weight heparin, enoxaparin or tinzaparin, to prevent deep vein thrombosis after hip surgery

British Journal of Haematology ◽

10.1046/j.1365-2141.1999.01153.x ◽

1999 ◽

Vol 104 (2) ◽

pp. 230-240 ◽

Cited By ~ 64

Author(s):

Lucienne Bara ◽

André Planes ◽

Meyer-Michel Samama

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Plasma Levels ◽

Low Molecular Weight Heparin ◽

Hip Surgery ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Deep Vein ◽

D Dimer

Download Full-text

The diagnosis and treatment of venous thromboembolism

Hematology ◽

10.1182/asheducation-2013.1.457 ◽

2013 ◽

Vol 2013 (1) ◽

pp. 457-463 ◽

Cited By ~ 35

Author(s):

Philip Wells ◽

David Anderson

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Low Molecular Weight Heparin ◽

Pretest Probability ◽

Low Molecular Weight ◽

Major Hemorrhage ◽

Vein Thrombosis ◽

Deep Vein ◽

D Dimer

Abstract Venous thromboembolism (VTE) is a common condition that can lead to complications such as postphlebitic syndrome, chronic pulmonary artery hypertension, and death. The approach to the diagnosis of has evolved over the years and an algorithm strategy combining pretest probability, D-dimer testing, and diagnostic imaging now allows for safe, convenient, and cost-effective investigation of patients. Patients with low pretest probability and a negative D-dimer can have VTE excluded without the need for imaging. The mainstay of treatment of VTE is anticoagulation, whereas interventions such as thrombolysis and inferior vena cava filters are reserved for special situations. Low-molecular-weight heparin has allowed for outpatient management of most patients with deep vein thrombosis at a considerable cost savings to the health care system. Patients with malignancy-associated VTE benefit from decreased recurrent rates if treated with long-term low-molecular-weight heparin. The development of new oral anticoagulants further simplifies treatment. The duration of anticoagulation is primarily influenced by underlying cause of the VTE (whether provoked or not) and consideration of the risk for major hemorrhage. Testing for genetic and acquired thrombophilia may provide insight as to the cause of a first idiopathic deep vein thrombosis, but the evidence linking most thrombophilias to an increased risk of recurrent thrombosis is limited.

Download Full-text

Deep vein thrombosis with pulmonary thromboembolism in a case of severe COVID-19 pneumonia

BMJ Case Reports ◽

10.1136/bcr-2020-240932 ◽

2021 ◽

Vol 14 (1) ◽

pp. e240932

Author(s):

Sujata Devi ◽

Sudipta Mohakud ◽

Nilanjan Kar ◽

Divya Muthuvel

Keyword(s):

Deep Vein Thrombosis ◽

Pulmonary Thromboembolism ◽

Ground Glass ◽

Low Molecular Weight ◽

Colour Doppler ◽

Vein Thrombosis ◽

Acute Deep Vein Thrombosis ◽

The Common ◽

Deep Vein ◽

D Dimer

A 53-year-old man with diabetes came to the emergency department with fever and dry cough for 5 days, swelling of the left leg for 2 days, shortness of breath and chest pain for 1 hour. He had raised temperature, tachycardia, tachypnoea, reduced oxygen saturation and swollen tender left leg on examination. The frontal chest radiograph showed bilateral ground-glass opacities; he tested positive for COVID-19 with elevated D-dimer. The colour Doppler examination of the left leg revealed acute deep vein thrombosis (DVT) of the common femoral and the popliteal veins. The chest CT showed bilateral diffuse ground-glass opacities predominantly involving peripheral zones and the lower lobes. The CTPA revealed left pulmonary thromboembolism (PTE), treated with low-molecular-weight heparin. COVID-19 predominantly affects the respiratory system. DVT and PTE are common in COVID-19 but lethal. They should be diagnosed early by clinical and radiological examinations and treated promptly with anticoagulants.

Download Full-text

Prevention of subclinical deep vein thrombosis in abdominal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20182748 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2475

Author(s):

Tazeem M. D. ◽

Wasim M. D. ◽

Sabia Amin ◽

Tahmida Ali

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Lower Limb ◽

Low Molecular Weight Heparin ◽

Lower Limbs ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Group I ◽

Deep Vein ◽

D Dimer

Background: Deep vein thrombosis (DVT) is a common but elusive illness that can result in disability and death if not recognized and treated effectively. The reported incidence has not changed much over past couple of decades. The aim of this study was to identify the risk of deep vein thrombosis related to the number of days of immobility and the role of low molecular weight heparin in the prevention of deep vein thrombosis.Methods: A total of hundred (n=100) patients undergoing laparotomy were studied in the post-operative period between January 2014 and December 2016. Patients were divided into two groups alternatively; Group I patients did not receive any DVT prophylaxis and Group II patients were given low molecular weight heparin once a day till mobilization. From 3rdPOD, all the patients were evaluated with detailed history and lower limb examination. D-dimer study was done in all the patients and if positive then followed by Color Venous Doppler. Regular follow-ups were done weekly once for a month, every two weeks for next month and once a month thereafter, minimum for 6 months.Results: A total of hundred (n=100) patients, including 65 men and 35 women, with median age of 40 years underwent laparotomies in 2 years by a single unit. The incidence of Lower Limb DVT in Group I was 8%. The risk factors associated with DVT were sex, BMI, smoking and Malignancy. The signs and symptoms associated with DVT were swelling of lower limbs, pain and tenderness, fever and Homan’s and Moses signs. The D-dimer test results were positive in 9 patients. Color Venous Doppler identified DVT in 8 patients. On regular follow- ups, remissions of clinical symptoms were recorded and repeat Doppler scans showed recanalization in all the patients after 6 months.Conclusions: Deep Vein Thrombosis is multifactorial, and post-operative patients account for majority of cases. Early mobilization and Prophylactic Low Molecular Heparin prevents DVT in abdominal surgeries.

Download Full-text

Effects of rosuvastatin as an adjuvant treatment for deep vein thrombosis

VASA ◽

10.1024/0301-1526/a000507 ◽

2016 ◽

Vol 45 (2) ◽

pp. 133-140 ◽

Cited By ~ 12

Author(s):

Enrique María San Norberto ◽

María Victoria Gastambide ◽

James Henry Taylor ◽

Irene García-Saiz ◽

Carlos Vaquero

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Duplex Ultrasound ◽

Final Analysis ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Rosuvastatin Group ◽

Deep Vein ◽

D Dimer

Abstract. Background: Statins have been reported to help prevent the development and the recurrence of deep vein thrombosis (DVT). We conducted a prospective randomized clinical trial to compare the effects of rosuvastatin plus a low-molecular-weight heparin (LMWH), bemiparin, with conventional LMWH therapy in the treatment of DVT. Patients and methods: In total, 234 patients were randomized into two groups, 116 in the LMWH group and 118 in the statin plus LMWH group. All patients underwent lower limb duplex ultrasound and analytic markers at diagnosis and three months of follow-up. The final analysis included 230 patients. Results: No significant differences were observed in D-dimer levels after three months of follow-up between patients treated with LMWH+rosuvastatin compared to the LMWH group (802.51 + 1062.20 vs. 996.25 + 1843.37, p = 0.897). The group of patients treated with statins displayed lower levels of CRP (4.17 + 4.27 vs. 22.39 + 97.48, p = 0.018) after three months of follow-up. The Villalta scale demonstrated significant differences between groups (3.45 + 6.03 vs. 7.79 + 5.58, p = 0.035). There was a significant decrease in PTS incidence (Villalta score> 5) in the rosuvastatin group (38.3 % vs. 48.5%, p = 0.019). There were no differences in EuroQol score between groups. Conclusions: Adjuvant rosuvastatin treatment in patients diagnosed of DVT improve CRP levels and diminish PTS incidence.

Download Full-text