Potential Association between Distal Deep Vein Thrombosis and Asymptomatic Atherosclerosis

Abstract Background Several studies have previously reported an association between idiopathic proximal deep vein thrombosis (DVT) and atherosclerosis, but whether spontaneous distal DVT is associated with asymptomatic atherosclerosis is still unknown. Methods Ultrasonography of the carotid arteries was done for plaque detection and intima-media thickness (IMT) evaluation, and the ankle-brachial index (ABI) in 116 patients with spontaneous DVT and without symptomatic atherosclerosis. Fifty-seven patients (M/F 19/38, age range 54–78 years) had distal DVT and 59 (M/F 24/35, age range 51–73 years) had proximal DVT. A group of 57 (M/F 21/36, age range 64–70 years) matched subjects acted as controls. Results No significant difference was found in carotid plaques between patients with distal or proximal DVT versus controls (p> 0.05 in all comparisons). Carotid IMT (mean ± SD) was significantly increased in patients with distal (1.00 ± 0.20 mm) and proximal (0.98 ± 0.16 mm) DVT versus controls (0.88 ± 0.15 mm, p <0.01 in both comparisons). An ABI £ 0.9 was found in 3/57 (5.3%) and 5/59 (8.5%) patients with distal and proximal DVT, respectively versus no controls with abnormal ABI. Conclusion Our results revealed that there may be an association between spontaneous distal DVT and asymptomatic atherosclerosis, and confirmed the known association between idiopathic proximal DVT and asymptomatic atherosclerosis. Larger studies are needed to confirm our results and to evaluate their clinical implications.

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P6461The long-term clinical comparisons of symptomatic patients of pulmonary embolism with and those without deep vein thrombosis: from the COMMAND VTE Registry

European Heart Journal ◽

10.1093/eurheartj/ehz746.1053 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Murata ◽

Y Yamashita ◽

T Morimoto ◽

H Amano ◽

T Takase ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Acute Phase ◽

Clinical Presentation ◽

Vein Thrombosis ◽

Significant Difference ◽

Severe Clinical Presentation ◽

Recurrent Vte ◽

Deep Vein

Abstract Background Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), has significant morbidity and mortality. Acute PE, in particular, is fatal if we miss it, and symptomatic patients of PE sometimes have concomitant DVT. Purpose This study compared the risk of mortality in symptomatic patients of PE with and those without DVT in the long term. Methods The COMMAND VTE Registry is a multicenter registry enrolling consecutive 3027 patients with acute symptomatic VTE objectively confirmed by imaging examination or by autopsy among 29 centers in Japan between January 2010 and August 2014. Patients with both PE and DVT (N=1334) were regarded as PE patients, and the current study population consisted of 1715 PE patients and 1312 DVT patients. Results There were 1203 symptomatic patients of PE, including 381 without and 822 with DVT. In our cohort, the mean age was 67.9±14.9 years, 63% was female, 44% had hypertension, 12% diabetes mellitus, 5% history of VTE. There were 20% of active cancer. Baseline characteristics were well matched except for dyslipidemia (18% vs. 23%, p=0.021) and atrial fibrillation (8% vs. 5%, p=0.045). Patients without DVT had a more severe clinical presentation compared to those with DVT, including hypoxemia, shock and arrest. Moreover, Initial parenteral anticoagulation therapy in the acute phase was administered less frequently in patients without DVT (89% vs. 96%, P=0.0001). Two groups received thrombolysis (20% vs. 26%, P=0.18) and mechanical supports (Ventilator 14% vs. 5%, p<0.001, PCPS 5% vs. 3%, p<0.001, respectively). During follow-up, 93 (8%) patients experienced recurrent VTE events and 98 (8%) major bleeding events, and 323 (27%) patients died. The most frequent cause of death was cancer (11%). There were a significant differences in the cumulative incidences of all-cause death between the groups (32% vs. 24%, P=0.006), whereas there was significant difference in VTE-related death (13% vs. 4%, p<0.001). Estimated freedom rates from death for patients of PE without and those with DVT were as follows: 88% vs 99% at 10-day, 86% vs 95% at 1-month, 75% vs 83% at 1-year, and 64% vs 71% at 5-year, respectively. Landmark analysis Conclusions In symptomatic patients of PE, there was a difference in mortality between groups, but no difference in recurrent VTE. Patients without DVT had a more severe clinical presentation compared to those with DVT, and many VTE-related deaths in the acute phase. The one-month mortality rate differed statistically between groups, but there was no significant difference in long-term survival beyond one month. Most of deaths were due to underlying diseases, mainly cancer, and less commonly due to VTE in the long term. Acknowledgement/Funding Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation

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Comparative Study of Deep Vein Thrombosis Recanalization Using Doppler Ultrasound in Different Post-Treatment Intervals in Traumatic Patients

ACTA MEDICA IRANICA ◽

10.18502/acta.v60i1.8324 ◽

2022 ◽

Author(s):

Nazanin Farshchian ◽

Negin Farshchian ◽

Parisa Bahrami Kamangar

Keyword(s):

Deep Vein Thrombosis ◽

Doppler Ultrasound ◽

Statistical Tests ◽

Significance Level ◽

Sonographic Diagnosis ◽

Vein Thrombosis ◽

Significant Difference ◽

High Incidence ◽

Deep Vein ◽

Comparative Examination

Deep vein thrombosis (DVT) is a prevalent vascular disease characterized by pelvic and limb deep vein thrombophlebitis, and it has a high incidence in traumatic patients. Contrary to older studies, recent research has reported that recanalization in DVT is not a slow process. The present study aimed at the comparative examination of DVT recanalization with Doppler ultrasound in different intervals following treatment with heparin or enoxaparin. This prospective study was conducted on all traumatic patients hospitalized in Imam Reza Hospital of Kermanshah, Iran, with the clinical and sonographic diagnosis of DVT in limb veins. Doppler ultrasound was performed two weeks, one month, and three months following treatment in order to examine recanalization. Data were analyzed using statistical tests in SPSS16 at the significance level of <0.05. Based on Doppler ultrasound, a significant difference was found between the degree of recanalization in patients aged <45 years and those aged >45 years, between male and female patients, and between different DVT locations (P<0.05). After three months of treatment with heparin and enoxaparin, the degree of recanalization was increased in DVT. Moreover, it was found that Doppler ultrasound is a useful tool for the diagnosis of recanalization in patients with DVT.

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Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials

Acta Radiologica ◽

10.1080/02841859709172072 ◽

1997 ◽

Vol 38 (2) ◽

pp. 320-326 ◽

Cited By ~ 21

Author(s):

P. Kälebo ◽

B.-A. Anthmyr ◽

B. I. Eriksson ◽

B. E. Zachrisson

Keyword(s):

Deep Vein Thrombosis ◽

Screening Method ◽

Clinical Suspicion ◽

Vein Thrombosis ◽

Asymptomatic Patients ◽

Significant Difference ◽

Venous Filling ◽

Anterior Tibial ◽

Deep Vein ◽

Better Than

Purpose: Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling. Material and Methods: Sixty consecutive patients with a clinical suspicion of deep vein thrombosis (DVT) were examined by 2 different techniques, A according to GREITZ and B according to LEA THOMAS. All deep veins were scored according to a protocol as DVT, normal or inadequate. Venous evaluability and DVT rates were compared. Bilateral phlebograms according to the A-technique from 92 asymptomatic patients in a different trial were reviewed to allow comparison with the symptomatic subjects. Results: the A-technique resulted in a significantly higher degree of overall evalu-able patients compared to the B-technique, 95% vs 47%. A vein-by-vein analysis showed that the A-technique was significantly better than the B-technique in filling the gastrocnemius muscular (82% vs 38%), anterior tibial (85% vs 43%), and deep femoral (28% vs 18%) veins. No significant difference was found in the other veins. the DVT rates were 42% and 40% respectively for the A- and B-techniques. About 94% of the phlebograms in the asymptomatic patients were adequate. Conclusion: the A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.

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Deep Vein Thrombosis, Demographic Characteristics and Risk Factors in Iran

Galen Medical Journal ◽

10.31661/gmj.v2i4.81 ◽

2013 ◽

Vol 2 (4) ◽

pp. 135-140

Author(s):

Shokoufeh Hajsadeghi ◽

Scott Reza Jafarian Kerman ◽

Rashin Joodat ◽

Maral Hejratie ◽

Helen Vaferi ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Deep Vein Thrombosis ◽

Health Care Systems ◽

Care Providers ◽

Female Ratio ◽

Vein Thrombosis ◽

Significant Difference ◽

Care Systems ◽

Deep Vein

Background: Deep vein thrombosis (DVT) can be an ethnicity related disease and an important health issue for health-care systems. Thus, domestic recognition of risk factors and disease characteristics seem to be inevitable. This study was designed to evaluate the epidemiology, basic characteristics, and risk factors in patients with DVT.Materials and Methods: In this descriptive cross-sectional study, all patients with primary or final diagnosis of DVT, confirmed by Doppler ultrasound in a 5-year period were included. Demographic data and prognosis were extracted from medical files. To evaluate the outcome of the patients after discharge, a phone-call follow-up was performed for all available patients.Results: Three-hundred seventy-one DVT patients were included with 232/139 male to female ratio. The mean age was 55.72±20.01 years with significant difference between genders (p=0.006). Mean weight was 88.97±10.2 kg with no significant difference between genders (p=0.74). The most common affected veins were common femoral vein (257 cases, 69.2%), followed by Popliteal, iliac, axillary, and subclavian veins. No season preference was seen in DVT occurrence. One-year survival of the patients after discharge was 92.6% and two-year survival was 87.7%.Conclusion: By knowing local information about this disease, health-care providers can give accurate warnings and suggestions to prevent the probable thrombosis chances. As Iran lacked information about DVT characteristics, this study can be an epidemiologic guide for health-care systems and an opening path for future studies.

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COMPARISON OF LONG-TERM RESULTS OF FEMORAL VEIN LIGATION AND TRANSCATHETER THROMBOLYSIS IN THROMBOSIS OF THE FEMORAL SEGMENT

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2019-178-5-62-68 ◽

2019 ◽

Vol 178 (5) ◽

pp. 62-68

Author(s):

Yu. A. Bezlepkin ◽

I. N. Sonkin ◽

A. V. Gusinskiy ◽

O. V. Fionik ◽

V. Yu. Melnik ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Pulmonary Thromboembolism ◽

Femoral Vein ◽

Detailed Comparison ◽

Long Term Results ◽

Superficial Femoral Vein ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Significant Difference ◽

Deep Vein

INTRODUCTION. The problem of preventing massive pulmonary thromboembolism and post-thrombotic syndrome in deep vein thrombosis has been studied for a long period. The introduction of new treatments for deep vein thrombosis requires a detailed comparison of their effectiveness.The OBJECTIVE of this work was a comparative analysis of ligation of the superficial femoral vein and regional thrombolytic therapy.MATERIAL AND METHODS. A retrospective multicenter study involving 30 patients with femoproplite thrombosis, who had received catheter-directed thrombolysis or ligation of the superficial femoral vein, was performed. The investigated patients underwent inpatient treatment.RESULTS. The data on the effectiveness of both methods in preventing pulmonary thromboembolism were obtained. When comparing both groups, we revealed a statistically significant difference in the frequency of the development of PTS and the severity of its development in 1 year after treatment. With ligation vein, 73.3 and 6.7% in the thrombolysis group (p=0.0005).CONCLUSION. Regional thrombolysis was an effective treatment for deep vein thrombosis and prevention of PTS.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

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Comparison of the Effects of Epidural Anesthesia and General Anesthesia on Perioperative Cognitive Function and Deep Vein Thrombosis in Patients Undergoing Total Knee Arthroplasty

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/1565067 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Zhenyu Wu ◽

Yan Zhu

Keyword(s):

Total Knee Arthroplasty ◽

Deep Vein Thrombosis ◽

General Anesthesia ◽

Epidural Anesthesia ◽

Control Group ◽

Observation Group ◽

Vein Thrombosis ◽

Significant Difference ◽

Total Knee ◽

Deep Vein

Objective. To explore the effects of epidural anesthesia and general anesthesia on perioperative cognitive function and deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods. Total of 68 patients undergoing TKA in our hospital from September 2019 to March 2021 were selected and divided into the control group under general anesthesia and the observation group under epidural anesthesia according to the different anesthesia methods, 34 patients in each group. TKA was selected in both groups and performed by the same group of physicians, anesthesiologists, and nursing staff. The mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2) were observed immediately before anesthesia (T1), 30 min after anesthesia (T2), after surgery (T3), and 1 d after surgery (T4). The changes of platelet (PLC), fibrinogen (Fbg), prothrombin time (PT), activated partial thrombin time (APTT), and other coagulation indicators were recorded. The Montreal Cognitive Assessment (MoCA) scores before surgery and 1 d and 3 d after surgery were observed. The blood samples of the two groups were collected before surgery and 1 d and 3 d after surgery, and the levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the peripheral blood of the two groups were measured by ELISA. The number of postoperative mental disorders and DVT in the two groups was calculated. Results. The MAP and HR of T4 were lower than those of T1, T2, and T3. The MAP of T2, T3, and T4 in the observation group was lower than that in the control group ( P < 0.05 ), and the SpO2 of T1–T4 in the two groups did not change significantly, and there was no significant difference between the two groups ( P > 0.05 ). Compared with T1, there was no significant difference in PLC, Fbg, and PT in the observation group T4 ( P > 0.05 ), and APTT was lower than T1 ( P < 0.05 ). The PLC, PT, and APTT of T4 in the control group were all lower than those of T1 ( P < 0.05 ), and there was no significant difference between Fbg and T1 ( P > 0.05 ). The PLC, Fbg, and PT of T4 in the observation group were higher than those in the control group, while APTT was lower than that in the control group ( P < 0.05 ). The MoCA scores of patients in both groups on the 1st and 3rd day after operation were lower than those before operation, and the observation group was higher than that in the control group ( P < 0.05 ). The BDNF and NGF of patients in both groups were lower than those before operation on the 1st day after operation, and the BDNF and NGF in the observation group were higher than those in the control group on the 1st and 3rd day after operation ( P < 0.05 ). The mental disorder (2.94%) and DVT incidence (2.94%) in the observation group were lower than those in the control group (29.41%, 26.47%) ( P < 0.05 ). Conclusion. Epidural anesthesia for patients with TKA can obtain better clinical effects, maintain stable hemodynamic and coagulation states, reduce stress response of patients at the same time, and reduce perioperative cognitive dysfunction and the incidence of DVT in patients.

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The conundrum of deep vein thrombosis prophylaxis in burns in India and review of literature

Indian Journal of Plastic Surgery ◽

10.4103/ijps.ijps_179_15 ◽

2017 ◽

Vol 50 (03) ◽

pp. 288-294

Author(s):

S. S. Shirol ◽

Srinivas Kodaganur ◽

M. Raghavendra Rao ◽

Vinaykumar Tiwari

Keyword(s):

Deep Vein Thrombosis ◽

Thrombosis Prophylaxis ◽

New Delhi ◽

Review Of Literature ◽

Low Molecular Weight Heparins ◽

Vein Thrombosis ◽

Dvt Prophylaxis ◽

Significant Difference ◽

Deep Vein Thrombosis Prophylaxis ◽

Deep Vein

ABSTRACTObjective: The aim is to assess the practice of deep vein thrombosis (DVT) prophylaxis among the plastic surgeons attending National Academy of Burns India Conference 2012 (NABICON 2012). Background: DVT prophylaxis in burns is a controversial issue as there is no consensus among the community of burn surgeons about the prevalence of DVT, the incidence of pulmonary embolism, the indications for DVT prophylaxis, dosage and duration of low molecular weight heparins (LMWH) and the complications related to DVT and LMWH. Methodology: A survey was conducted among plastic surgeons attending the NABICON 2012 held at New Delhi, by circulating a questionnaire. The respondents were divided into two groups based on whether burns constituted more than or less than 50% of their practice. The data thus collected were tabulated and analysed. Results: Almost 70% of all the respondents practice some form of DVT prophylaxis. There was significantly higher incidence of complications related to the use of LMWH among the surgeons whose practice of burns was >50%. There was no significant difference between the two groups in relation to the incidence and complication of DVT or recommendation of DVT prophylaxis. Conclusion: Majority of plastic surgeons practice DVT prophylaxis routinely and consider multiple criteria such as percentage of burns, age, lower limb involvement, the degree of burns and associated co-morbidities for starting the LMWH.

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Differences in Clinical Presentation, Rate of Pulmonary Embolism, and Risk Factors Among Patients With Deep Vein Thrombosis in Unusual Sites

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029619872550 ◽

2019 ◽

Vol 25 ◽

pp. 107602961987255 ◽

Cited By ~ 2

Author(s):

Angelo Porfidia ◽

Enrica Porceddu ◽

Daniela Feliciani ◽

Marzia Giordano ◽

Fabiana Agostini ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

University Hospital ◽

Cerebral Vein ◽

Jugular Vein Thrombosis ◽

Unusual Site ◽

Vein Thrombosis ◽

Significant Difference ◽

Deep Vein

Unusual site deep vein thrombosis (USDVT) is an uncommon form of venous thromboembolism with heterogeneous signs and symptoms, unknown rate of pulmonary embolism (PE), and poorly defined risk factors. We conducted a retrospective analysis of 107 consecutive cases of USDVTs, discharged from our University Hospital over a period of 2 years. Patients were classified based on the site of thrombosis and distinguished between patients with cerebral vein thrombosis, jugular vein thrombosis, thrombosis of the deep veins of the upper extremities, and abdominal vein thrombosis. We found statistically significant differences between groups in terms of age ( P < .0001) and gender distribution ( P < .05). We also found that the rate of symptomatic patients was significantly different between groups ( P < .0001). Another interesting finding was the significant difference between groups in terms of rate of PE ( P < .01). Finally, we found statistically significant differences between groups in terms of risk factors for thrombosis, in particular cancer ( P < .01). Unprovoked cases were differently distributed among groups ( P < .0001). This study highlights differences between patients with USDVT, which depend on the site of thrombosis, and provides data which might be useful in clinical practice.

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Venous Thromboembolism in Patents With Lung Cancer

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029620977910 ◽

2020 ◽

Vol 26 ◽

pp. 107602962097791

Author(s):

Takahito Suzuki ◽

Susumu Fujino ◽

Shouta Inaba ◽

Ryo Yamamura ◽

Hiromasa Katoh ◽

...

Keyword(s):

Lung Cancer ◽

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Cancer Patients ◽

Cause Of Death ◽

Clinicopathological Characteristics ◽

Lung Cancer Patients ◽

Vein Thrombosis ◽

Significant Difference ◽

Deep Vein

Lung cancer is the leading cause of death from cancer in Japan. Studies in other countries have reported a venous thromboembolism (VTE) rate of 4%–20% in cancer patients. In this study, we aimed to determine the incidence of VTE in lung cancer patients in Japan and compared the characteristics of patients with and without VTE. In this retrospective cohort study, the clinicopathological characteristics of study patients with and without concomitant VTE were compared. Patients with lung cancer treated at Fukui Prefectural Hospital, Japan from 2008 to 2017. Of the 1471 patients with lung cancer studied, 28 developed VTE. Five patients developed pulmonary thromboembolism (PTE) alone, 9 PTE with concomitant deep vein thrombosis, and 14 deep vein thrombosis alone. Compared with patients in the non-VTE group, the VTE group was significantly younger (mean value ± SD 66.3 ± 10.1 vs. 73.0 ± 10.6 years, p = 0.001), contained significantly more patients with stage IIIb–IV disease (p = 0.002), and had a significantly higher rate of chemotherapy (p < 0.001) and radiation therapy (p = 0.007). There was no significant difference in median survival time from lung cancer diagnosis between the VTE and non-VTE groups. The 1-year mortality rate after VTE diagnosis was 60.7%. Lung cancer was the most frequent cause of death, followed by infection and VTE. Several baseline characteristics differed between patients with and without VTE. The prognosis may worsen after development of VTE, suggesting that lung cancer patients should be carefully monitored for it.

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Does COVID-19 infection increase the risk of pulmonary embolism in ambulatory patients with deep vein thrombosis

Vascular ◽

10.1177/17085381211052207 ◽

2021 ◽

pp. 170853812110522

Author(s):

Salih Salihi ◽

Bilal Perçin ◽

Halil Ibrahim Erkengel ◽

Bilhan Özalp ◽

Hakan Saçlı ◽

...

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Statistical Significance ◽

Survival Rates ◽

Vein Thrombosis ◽

Significant Difference ◽

Prophylactic Drug ◽

Ambulatory Patients ◽

Thrombotic Complications ◽

Deep Vein

Objectives Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications including venous thromboembolism. This study compares the development of pulmonary embolism, post-thrombotic syndrome, and clinical outcomes of COVID-19 and non-COVID-19 patients with deep vein thrombosis (DVT). Methods One hundred and eight patients diagnosed with acute deep vein thrombosis (DVT) between June 2020 and February 2021 in our institution were included in this retrospective study. Thirty-nine patients had been previously diagnosed with COVID-19 and specified as the COVID-19 group. Sixty-nine patients did not have COVID-19 and specified as the non-COVID-19 group. Mean ages of both groups were 64.3 ± 15.8 and 60.1 ± 19.7 years, respectively ( p = .37). Results The median duration from the onset of the COVID-19 to diagnosis of DVT was 22 (2–120) days in the COVID-19 group. The patients of two groups were mostly treated outpatient at rates of 94.9% vs 94.2%, respectively ( p = .88). Pulmonary embolism was seen in six patients (15.4%) in the COVID-19 group and in three patients (4.3%) in the non-COVID-19 group ( p = .04). Kaplan–Meir curves showed that patients with COVİD-19 had significantly higher pulmonary embolism than those without COVID-19 ( p = .015). The recurrence rate of DVT was 2.6% in the COVID-19 group ( n = 1), and 4.3% in the non-COVID-19 group ( n = 3), indicating no statistically significant difference ( p = .63). Mortality was seen in six patients (15.4%) in the COVİD-19 group, and in seven patients (10.1%) in the non-COVID-19 group. According to the Kaplan–Meir method, 10 months survival rates were 73.9 ± 10% in the COVID-19 group, and 66.3 ± 12.8% in the non-COVID-19 group with no statistical significance ( p = .218). Conclusions Our data draw attention to the fact that deep vein thrombosis should not be considered a safe and self-limited condition. Efficient preventive measures such as mobilization and prophylactic drug use should be considered to prevent DVT during the management of COVID-19.

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