Role of Platelets in Recurrent Deep Vein Thrombosis

1975 ◽  
Author(s):  
K. K. Wu ◽  
R. W. Barnes ◽  
J. C. Hoak
Keyword(s):  
Deep Vein Thrombosis ◽  
Oral Anticoagulant Therapy ◽  
Additional Patient ◽  
Ratio Method ◽  
Vein Thrombosis ◽  
Platelet Survival ◽  
Platelet Aggregate ◽  
Recurrent Deep Vein Thrombosis ◽  
Platelet Aggregates ◽  
Deep Vein

To evaluate the role that platelets play in the pathogenesis of recurrent deep vein thrombosis (DVT), a platelet count ratio method was used for the detection of platelet aggregates and an aggregometric technique was used to measure spontaneous aggregation (SPA) in 27 patients with idiopathic recurrent DVT. Seventeen patients were found to have decreased platelet aggregate ratios (mean 0.63±SEM 0.02) which were significantly lower than those of normals (0.90 ±0.02, p < 0.01). Twelve of the 17 patients had SPA. The mean platelet survival half-time of 5 patients with increased platelet aggregates was 2.9 days±0.49, significantly decreased from that of normals (4.2 ±0.10, p < 0.05). Platelet survival values were normal in patients with normal platelet aggregate ratios. Five patients who failed to improve on oral anticoagulant therapy responded to aspirin and dipyridamole with normalization of platelet aggregates and disappearance of SPA. An additional patient responded to sulfinpyrazone. When the drug was discontinued, pulmonary embolus recurred. These findings suggest that recurrent DVT may involve heterogeneous groups of patients and platelets may play an important pathogenetic role in some of them. The approach to the problem with this panel of 3 tests appears useful in the selection of patients for treatment with antiplatelet agents.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Objective Diagnosis Of Recurrent Deep Vein Thrombosis

1981 ◽  
Author(s):  
R W Barnes ◽  
D G Turley ◽  
G D Qureshi ◽  
M J Fratkin
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Insufficiency ◽  
Leg Pain ◽  
Venous Obstruction ◽  
Vein Thrombosis ◽  
Postphlebitic Syndrome ◽  
Positive Scan ◽  
Recurrent Deep Vein Thrombosis ◽  
Diagnostic Sensitivity And Specificity ◽  
Deep Vein

Recurrent deep vein thrarbosis must be differentiated from other causes of leg pain, swelling and inflammation, including chronic venous insufficiency or the postphlebitic stasis syndrome. Venous obstruction and/or valvular incompetence was evaluated by Dcppler ultrasound in 229 patients with recurrent leg symptoms following one or more prior episodes of clinical deep vein thrombosis. The diagnostic sensitivity and specificity of the Dcppler technique was 96% and 90%, respectively, in 259 consecutive contrast phlebograms. In a subset of 65 patients with abnormal Dcppler examination, I-125 fibrinogen leg scans were performed prior to institution of anticoagulants in order to establish the diagnosis of recurrent active thrarbosis (positive scan) or inactive postphlebitic disease (negative sca.In the 229 symptomatic patients screened, the Dcppler examination was normal in 87 (38.0%). In 65 patients with abnormal deep veins receiving I-125 fibrinogen, leg scans were positive in 25 (38.5%), suggesting active thrarbosis which was treated by anticoagulants. The remaining 40 patients were treated for the postphlebitic syndrome with leg elevation and elastic support and none developed manife stations of venous thrarboerrbolism.This study suggests that many individuals (38%) with suspected recurrent deep vein thrarbosis have normal leg veins and that the majority (62%) of patients with proven venous abnormalities have inactive (postphlebitic) disease which does not require anti coagulation.

scholarly journals Analysis of the Cochrane Review: Thrombolysis for Acute Deep Vein Thrombosis. Cochrane Database Syst Rev. 2014,1: CD002783.

2015 ◽  
Vol 28 (1) ◽  
pp. 12 ◽  
Author(s):  
Liliana Sousa Nanji ◽  
André Torres Cardoso ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Thrombolytic Therapy ◽  
Bleeding Complications ◽  
Controlled Trials ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Recurrent Deep Vein Thrombosis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

<p>The standard treatment for acute deep vein thrombosis (DVT) targets to reduce immediate complications, however thrombolysis could reduce the long-term complications of post-thrombotic syndrome in the affected limb. This systematic review aimed to assess the effects of thrombolytic therapy and anticoagulation <em>versus </em>anticoagulation in people with deep vein thrombosis of the lower limb through the effects on pulmonary embolism, recurrent deep vein thrombosis, major bleeding, post-thrombotic complications, venous patency and venous function. The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last search in April 2013) and CENTRAL (2013, Issue 4). A total of 17 randomised controlled trials (RCTs) and 1103 participants were included. In the experimental group receiving thrombolysis, complete clot lysis occurred more frequently and there was greater improvement in venous patency. The incidence of post-thrombotic syndrome decreased by a 1/3 and venous ulcers were less frequent. There were more bleeding complications and 3 strokes occurred in less recent studies, yet there seemed to be no significant effect on mortality. Data on the occurrence of pulmonary embolism and recurrent deep vein thrombosis were inconclusive. There are advantages to thrombolysis, yet the application of rigorous criteria is warranted to reduce bleeding complications. Catheter-directed thrombolysis is the current preferred method, as opposed to systemic thrombolysis in the past, and other studies comparing these procedures show that results are similar.</p><p><strong>Keywords:</strong> Randomized Controlled Trials as Topic; Thrombolytic Therapy; Venous Thrombosis.</p>

scholarly journals The prevalence of combined pro-thrombotic polymorphisms in patients with recurrent deep vein thrombosis – does genetic testing provide any benefit?

2015 ◽  
Vol 1 ◽  
pp. 14-19
Author(s):  
Alicja Krejner ◽  
Malgorzata Litwiniuk ◽  
Iwona Radziejewska-Choma ◽  
Krystyna Twardowska-Saucha ◽  
Tomasz Grzela
Keyword(s):  
Deep Vein Thrombosis ◽  
Genetic Testing ◽  
Vein Thrombosis ◽  
Recurrent Deep Vein Thrombosis ◽  
Deep Vein
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