SUBCUTANEOUS ADMINISTRATION OF A LOW MOLECULAR WEIGHT HEPARIN (CY 222) COMPARED WITH SUBCUTANEOUS ADMINISTRATION OF STANDARD HEPARIN IN PATIENTS WITH ACUTE DEEP VEIN THROMBOSIS

1987 ◽  
Author(s):  
R FAIVRE ◽  
E NEUHART ◽  
Y KIEFFER ◽  
F TOULEMONDE ◽  
J P BASSAND ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Day Treatment ◽  
Subcutaneous Administration ◽  
Control Value ◽  
Vein Thrombosis ◽  
Group 4 ◽  
Sh Group ◽  
Complete Lysis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

68 patients (pts) with acute deep vein thrombosis (DVT) were randomized to either CY 222 (Choay Institut, Cl, France) (n=33) in a dose of 750 u anti-Xa Cl/kg/day or standard heparin (SH) (n=35), 500 ui/kg/day, both given by 2 daily subcutaneous (sc) injections for 10 days. In SH group, dose was monitored by daily activated partial thromboplastin time to maintain a prolongation between 2 to 3 times the control value ; in CY 222 group dose remained unchanged during the 10-day treatment. Venography was repeated at day 10. Initial DVT localization and derived Marder’s score was similar in both groups (14.1 ± 11.7 in CY 222 group and 14.3 ± 10.6 in SH group, p = NS).The results show that : 1/ no bleeding complication was observed in CY 222 pts, but large hematoma occured in 3 SH pts, 1 patient in each group developed a recurrent pulmonary embolism and 2 others pts (1 in each group) did not undergo control phlebography ; 2/ in CY 222 group, 8 pts obtained complete lysis (CL, thrombolysis more than 90%), 11 partial lysis (PL, thrombolysis between 30% and 90%), and 11 no change (NC, less than 30%) ; 3/ in SH group, 4 pts obtained CL, 15 PL, 8 NC and extension was seen in 2 pts. Thus, phlebographic improvement (thrombolysis more than 30%) was observed in 65% in both groups.In conclusion, these preliminary results suggested that sc administration of CY 222 and SH, both given by 2 daily injections, was equally effective in pts with acute DVT, and CY 222 seemed to be safer than SH.

COMPARISON BETWEEN INITIAL AND ACHIEVED ANTICOAGULATION LEVEL WITH PHLEBOGRAPHIC EVOLUTION IN PATIENTS WITH DEEP VEIN THROMBOSIS TREATED BY DIFFERENT HEPARINS

1987 ◽  
Author(s):  
R FAIVRE ◽  
K KIEFFER ◽  
D DUCELLIER ◽  
F BILSTEIN ◽  
J P BASSAND ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Day Treatment ◽  
Randomized Study ◽  
Low Molecular Weight ◽  
Base Line ◽  
Control Value ◽  
Vein Thrombosis ◽  
Recurrent Pulmonary Embolism ◽  
Graphic Score ◽  
Deep Vein

Effectiveness of standard heparin (SH) in patients (pts) with deep vein thrombosis (DVT) remains contreversial in regard with the subcutaneous (sc) or intravenous administration route.To determine the relation between initial (day 1 after the beginning of treatment) and achieved anticoagulation level with base-line to control (at day 10) phlebo-graphic score variations, we carried out a randomized study including 68 pts with acute (less than 2 weeks) DVT treated either by SH, 500 ui/kg/day or low molecular weight heparin (LMWH, CY 222, institut Choay, 750 u anti-Xa IC/kg/day), both given by 2 daily sc injections for 10 days. Plasma was collected at the middle (at 8 a.m) of 2 sc injections to evaluate aPTT (CK prest, STAGO) and anti-Xa activity (Stachrom, Stago). The results show that : 1/ Thrombus reduction was similar (thrombolysis more than 30%, 65% in SH pts and 64% in LMWH pts, p NS) ; 2/ in SH pts, phlebographic score variations were correlated neither with achieved anticoagulation level (mean aPTT of day 3, 5, 10) nor initial day 1 aPTT (R=-.33 and R = .03 respectively) ; 3/ in CY 222 pts, no modification of aPTT was observed during the 10-day treatment, and phlebographic score variations were correlated neither with initial nor achieved anti-Xa activity (R=.06 and R=.24 respectively) ; 4/ only 2 SH pts extended DVT and 1 patient in each group developed a recurrent pulmonary embolism in spite of a well initial or achieved anticoagulation level (aPTT >1.5 the control value in SH pts).In conclusion, SH- or LMWH-related anti coagulation (or antithrombotic) effect is certainly not the sole prognosis parameter for well achieving venous thrombolysis in patients with DVT.

Endovascular management of extensive lower extremity acute deep vein thrombosis with AngioJet rheolytic thrombectomy plus catheter-directed thrombolysis from contralateral femoral access

2018 ◽  
Vol 34 (4) ◽  
pp. 257-265 ◽  
Author(s):  
Guang Liu ◽  
Zhen Zhao ◽  
Chaoyi Cui ◽  
Kaichuang Ye ◽  
Minyi Yin ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Femoral Access ◽  
Technical Success Rate ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Rheolytic Thrombectomy ◽  
Complete Lysis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

Purpose The aim of the present study was to report the clinical outcomes of endovascular treatment for extensive lower limb deep vein thrombosis with AngioJet rheolytic thrombectomy (ART) plus catheter-directed thrombolysis (CDT) using a contralateral femoral approach. Methods A retrospective analysis of consecutive ART+CDT treatments in 38 deep vein thrombosis patients (LET I-III, from September 2014 to March 2016) was performed. Results The technical success rate was 100%. Complete lysis was achieved in 82% of LET III segments (calf veins), 87% of LET II segments (popliteal-femoral veins), and 90% of LET III segments (iliac veins). The best results were obtained in patients treated within seven days of symptom onset. During follow-up, well-preserved, competent femoral valves were observed in 86% of the patients, and recanalization of LET III, LET II, and LET I segments was achieved in 100%, 94%, and 91% of the patients, respectively. The post-thrombotic syndrome rate was 17% during a mean 20-month follow-up.

Acute Deep Vein Thrombosis Treated with Porcine Plasmin

1974 ◽  
Vol 32 (02/03) ◽  
pp. 468-482 ◽  
Author(s):  
O Storm ◽  
P Ollendorff ◽  
E Drewsen ◽  
P Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Initial Dose ◽  
Treated Group ◽  
Allergic Reactions ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Thrombolytic Effect ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

SummaryThe thrombolytic effect of pig plasmin was tested in a double blind trial on patients with deep venous thrombosis in the lower limb. Only patients with not more than three days old thrombi were selected for this study. The diagnosis of deep vein thrombosis was made clinically and confirmed by phlebography. Lysofibrin Novo (porcine plasmin) or placebo (porcine plasminogen) was administered intravenously to the patients. The enzyme and the placebo were delivered as lyophilized powder in labelled bottles - the contents of the bottles were unknown to the doctor in charge of the clinical administration of the trial. An initial dose of plasmin/plasminogen of 30 unit per kg body weight given slowly intravenously (1-1% hours infusion) was followed by a maintenance dosis of 15 per cent the initial dose per hour for the following 5-7 hours. In most cases a similar maintenance dosis was given the next day. In all patients heparin was administered after ending the plasmin/plasminogen infusion. The results of the treatment was evaluated clinically as well as by control phlebo- grams the following days.A statistically significant improvement was found in the plasmin treated group compared with the placebo (plasminogen) treated group. Thrombolysis was obtained clinically and phlebographically in 65 per cent of the plasmin treated group, but only in 15 per cent of the control patients were improvements found.This study has thus demonstrated that plasmin treatment according to a standard scheme was able to induce thrombolysis. There were only a few and insignificant side effects. Allergic reactions have not been seen and only very simple tests are required.

scholarly journals The Predictive Value of the aCL and Anti-β2GPI at the Time of Acute Deep Vein Thrombosis—A Two-Year Prospective Study

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 901
Author(s):  
Katja Perdan-Pirkmajer ◽  
Polona Žigon ◽  
Anja Boc ◽  
Eva Podovšovnik ◽  
Saša Čučnik ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Prospective Study ◽  
Anticoagulant Therapy ◽  
Predictive Value ◽  
Anticoagulation Therapy ◽  
Time Frame ◽  
Vein Thrombosis ◽  
Therapeutic Decisions ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to current APS classification criteria, APS cannot be confirmed until 24 weeks after DVT. This time frame results in frequent discontinuation of anticoagulant treatment before APS is diagnosed. Therefore, the aim of our study was to evaluate the potential predictive value of anticardiolipin (aCL) and anti-β2glycoprotein I (anti-β2GPI) before discontinuation of anticoagulation therapy. Patients with newly diagnosed DVT were included into a 24-month prospective study. All patients received anticoagulant therapy. aCL and anti-β2GPI were determined at inclusion and every four weeks for the first 24 weeks and then one and two years after inclusion. APS was confirmed in 24/221 (10.9%) patients. At the time of acute DVT 20/24 (83.3%), APS patients had positive aCL and/or anti-β2GPI. Two patients had low aCL levels and two were negative at the time of acute DVT but later met APS criteria due to lupus anticoagulant (LA). Our data indicate that negative aCL and/or anti-β2GPI at the time of acute DVT make further aPL testing unnecessary; however, LA should be determined after discontinuation of anticoagulant therapy. Positive aCL and/or anti-β2GPI at the time of acute DVT have a strong positive predictive value for APS and may support therapeutic decisions.

Correction: preventing and treating deep vein thrombosis (3 February, pages 9–12)

1992 ◽  
Vol 30 (16) ◽  
pp. 64-64
Keyword(s):  
Deep Vein Thrombosis ◽  
Normal Range ◽  
Control Value ◽  
Vein Thrombosis ◽  
Upper Limit ◽  
Dose Heparin ◽  
Deep Vein ◽  
Adjusted Dose ◽  
Prophylaxis Strategy

In the table entitled ‘Anti-thrombotic prophylaxis strategy’ we gave the desired APTT range for the ‘adjusted dose heparin regimen’ as 1.5–2.5 times the control value. The aim should be to maintain the APTT at 1.5 times control (upper limit of ‘normal’ range), and no higher.

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