P949 Step by step guidance of MitraClip procedure with a new quantitative parameter

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M T Taramasso ◽  
A P Pozzoli ◽  
M M Miura ◽  
F T Tanner ◽  
...  
Keyword(s):  
Color Image ◽  
Color Doppler ◽  
Second Step ◽  
P Value ◽  
Relative Reduction ◽  
Surface Zone ◽  
Volume Imaging ◽  
Hemodynamic Improvement ◽  
Mitraclip System ◽  
Double Orifice

Abstract Background/Introduction. In step by step guidance of percutaneous mitral valve (MV) repair with MitraClip System (Abbott Vascular, Santa Clara, CA, USA) evaluation of step by step MR reduction by color-Doppler echocardiography can be challenging requiring multiparametric approach and to freeze and process images while the procedure is going. Purpose: This prospective study aimed to assess the role of a new echocardiographic parameter obtained from 3D-Color-Full volume imaging of MR for evaluation of step-by-step MR reduction during MitraClip procedures by a comparison with step-by-step reduction of m-LAP. Methods: We prospectively performed the computation of a new parameter that is obtained by acquisition of MR by 3D-zoomed-color image in dual volume layout for seeing the ventricular aspect of the jet area corresponding to proximal isovelocity surface "zone"; then, measure of that area is traced, so that it represents the 2D area of the proximal isovelocity surface zone visualized from the ventricular view, without any imaging processing ("3D dual volume PISA area"). In double orifice, we added the two computations obtained by the two orifices. We compared the variation of this parameter with variations of m-LAP at the two steps of MitraClip procedures requiring implantation of 2 MitraClips. Results: The study includes dataset of 19 patients. The baseline value of 3D dual volume PISA area was 1,47 ± 0,49 cm2 and the mean change obtained after first clip was 0,25 ± 0,21 cm2 (- 65 % of reduction from baseline, p value: 0.001) and a further change from first to second clip was of 46% (p 0,1). Conversely, the m-LAP decreased more in the second step of procedure: basal m-LAP was 15 ± 13,3 mmHg and decreased by 32% by the end of procedure; in the first step m-LAP was reduced of 12% from baseline (from 15 ± 13,3 to 14,1 ± 9,8 mmHg) and in the second step of 18% (from 14,1 ± 9,8 to 11 ± 4 mmHg). We tested correlation between relative reduction of 3D-PISA and reduction of m-LAP at each of the procedural steps and we observed significant correlation only during the first procedural step (baseline-to-first clip) (R: 0,527, p 0.02), not in the second (1 st-to-2 nd clip) (R: 0,345, p 0.13). Considering the whole procedure, reduction of 3D-PISA was correlated to reduction of m-LAP at the end. Conclusions: Our study demonstrate that this new parameter is related to hemodynamic improvement during procedures, mostly in the first step, when the amount of reduction is marked; for further step invasive monitoring of LAP would be more pivotal. These data need to be confirmed by a larger study.

P4366Application of 3D-dual volume layout imaging for rapid intraprocedural guidance in Mitraclip procedure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M Z Zuber ◽  
M M Miura ◽  
A P Pozzoli ◽  
M T Taramasso ◽  
...  
Keyword(s):  
Color Image ◽  
Surface Zone ◽  
Mean Values ◽  
Echocardiographic Parameter ◽  
Volume Imaging ◽  
Number Of Patients ◽  
Hemodynamic Assessment ◽  
Correct Alignment ◽  
Reliable Parameter ◽  
The Mean

Abstract Introduction Intraprocedural guidance and monitoring with transesophageal echocardiography (TEE) and invasive hemodynamic assessment are currently the best available options for evaluating procedural success of percutaneous mitral valve (MV) repair with Mitraclip System (Abbott Vascular, Santa Clara, CA, USA). However, despite its crucial importance, echocardiography has some limitations in immediate evaluation of residual jets after clip implantation, so that, in absence of validated method for double orifice effective regurgitant orifice (ERO) assessment, the most reliable parameter that is currently used is the mean trans-valvular gradient. Purpose This prospective study aimed to assess the role of a new echocardiographic parameter obtained from 3D-Color-Full volume imaging of MR for evaluation of outcomes of mitraclip procedures, comparing it with invasive LAP measurements. Material and methods We prospectively performed the computation of a new parameter in patients with symptomatic moderate-severe to severe primary or secondary mitral regurgitation (MR) underwent MitraClip procedure. This parameter is easy and fast to be obtained out of 3D dataset and represents the 2D area of the proximal isovelocity surface zone visualized from the ventricular view, without any imaging processing (“3D dual volume PISA area”) (figure). It was obtained as following: i) acquisition of 3D-zoomed-color image of MR jet with adequate frame rates; ii)displaying of the volume sampling in “dual volume layout” so one can see the “ventricular aspect” of the jet area corresponding to proximal isovelocity surface “zone”; iii) awareness of correct alignment to the direction of the flow in proximal zone; iiii) freezing and direct measurement of this area (summarize if more than 1 orifice) (1 attached). We compared the variation of this parameter from the beginning to end of procedure with the variation of LAP measurements, that is currently the most important parameter for assessing outcome of procedures. Results The study includes dataset of 11 patients. The baseline value of 3D dual volume PISA area was 1,191±0,40 cm2 and the mean change we obtained was 0,65±0,30 cm2 (mean of 77% of reduction until the end of procedure). Mean values of LAP were slightly decreased in all cases: basal m-LAP was 12±3,3 mmHg and decreased by 15%. Despite the small number of patients, we observed a significant correlation between the changes of LAP and the change of 3D dual volume PISA area (R: 0.6, p: 0,048). Conclusions This is the first demonstration of the usefulness of echocardiographic parameter obtained by 3Ddual volume layout imaging for rapid intraprocedural guidance in Mitraclip procedure. This parameter is related to hemodynamic variations that it currently considerable surrogate of outcomes. These data need to be confirmed by a larger study.

The Role of Doppler Ultrasound, CT Angiography, and Conventional Angiography in Detection of Peripheral Arterial Disease

2021 ◽  
pp. 154431672110303
Author(s):  
Sayan Sarkar ◽  
Shyam Mohan ◽  
Shakthi Parvathy
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Ct Angiography ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Color Doppler ◽  
Statistical Significance ◽  
Arterial Disease ◽  
P Value ◽  
Peripheral Arterial

The purpose of this study is to analyze how accurate duplex ultrasonography using color Doppler and computed tomography (CT) angiography are in detection of peripheral arterial disease (PAD) in comparison with the Gold Standard of digital subtraction angiography (DSA). This is a single-center prospective, analytical study done on patients with symptoms of PAD referred to the Department of Radiodiagnosis of Medical Trust Hospital (n = 53). All patients were imaged with color Doppler, CT angiography, and DSA. The peak systolic velocity (PSV) ratio was calculated by Doppler ultrasound, and the percentage stenosis for the same vascular segments was calculated using CT angiography and DSA. To test the statistical significance between the results, chi-square test was used. A P value <.05 indicates statistical significance. The PSV ratio for each grade—normal (<1.5), mild (1.5-2.8), moderate (2.9-4.9), and severe (≥5)—and the percentage of stenosis for each grade observed on CT angiography—normal (<20% stenosis), mild (20%-49% stenosis), moderate (50%-74% stenosis), severe (75%-99% stenosis), and total occlusion (100% stenosis)—were found to be highly sensitive and specific with good positive predictive value, negative predictive value, and accuracy level when compared with DSA with narrow confidence intervals for each range. The P value was <.001 for both color Doppler and CT angiography. Computed tomography angiography can be an effective tool as an alternative to DSA for gradation of stenosis if the artifacts resulting from vascular calcification can be avoided. Duplex ultrasonography can be utilized for gradation of stenosis by using the value of PSV ratio and spectral pattern together. However, it can only act as an adjunct to CT angiography because it is incapable of imaging the full length of the arterial segments in 1 frame.

A New Bulk Deformation Method – Cyclic Extrusion

2007 ◽  
Vol 546-549 ◽  
pp. 2293-2300 ◽  
Author(s):  
J. Zhang
Keyword(s):  
Shape Change ◽  
Second Step ◽  
Work Piece ◽  
Surface Zone ◽  
Pure Aluminium ◽  
Grain Refining ◽  
Bulk Deformation ◽  
Deformation Method ◽  
Deformation Degree ◽  
Magnesium Alloy Az31

Cyclic extrusion is a new bulk deformation method. It consists of two steps. In the first step a part of the work piece will be indirectly extruded. In the second step the extruded part will be backwards pressed into the bulk again so that the original shape of the work piece is retained. Similar to ECAP, cyclic extrusion can be repeated many times without shape change. On the other hand, cyclic extrusion can be applied locally on a work piece so that local grain refining or work hardening is possible. Magnesium alloy AZ31 was cyclically extruded at 400 °C with different tools. The grain size was refined from 800 +m to 15 +m. The local grain refining in the surface zone with cyclic extrusion improved the rollability of cast AZ31. Pure aluminium specimens were cyclically extruded up to 2.5 times, which corresponds to a deformation degree of -7. The microstructure changes were examined with EBSD.

scholarly journals P015: Implementing the Canadian CT Head Rule in a community emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S83-S83
Author(s):  
G. Bock ◽  
R. Setrak ◽  
S. Freeman
Keyword(s):  
Emergency Department ◽  
Demographic Data ◽  
Ct Scans ◽  
P Value ◽  
Relative Reduction ◽  
Exclusion Criteria ◽  
Head Ct ◽  
Preliminary Results ◽  
Ct Head ◽  
Significant Injury

Introduction: The Canadian CT Head Rule (‘the rule’) is widely used across the country and its use is specifically recommended by Choosing Wisely Canada. Studies in Canadian hospitals have shown appropriate declines in CT scans when decision tools have been made readily available and useable at the point of care. Research into the implementation of the Canadian CT Head Rule in particular has shown that barriers to its use include an inability to accurately recall each criteria and forgetting to attempt to apply the rule altogether. In an attempt to provide our clinicians with effective access to the rule, we modified CT requisitions and order procedures to facilitate the use of the rule for every head CT in our emergency department (ED). Methods: A quality improvement (QI) approach was used to pilot, implement, and evaluate the modified CT requisition at our hospital. Several Plan-Do-Study-Act cycles involving stakeholders in the hospital resulted in iterative changes to the requisition leading to the implemented version. The new requisition required physicians to indicate which rules or exclusion criteria were met and this was made mandatory for all head CTs ordered. Demographic data was collected on all patients presenting to the ED on age, gender, CTAS level, disposition, and length of stay. Data on which exclusion criteria were appropriate, the rules met leading to CT scans, whether each requisition was used appropriately, and whether there was a significant injury found was collected for each patient receiving a head CT after implementation. Results: In our primary outcome (% of ED visits receiving a head CT), preliminary results have demonstrated a relative reduction in head CT ordering of 10.9%. Our study at completion is powered to detect a ~10% relative change in ordering behaviour, and a Chi square of the data to date yields a P-value of 0.0147. There are no significant differences in visit volume or any of the demographics collected to date. Final results including analysis are anticipated in March, 2016. Conclusion: Preliminary results on this simple, no-cost intervention are very promising. The reduction in head CTs ordered suggests that with mandated access to an easy-to-use, well validated decision tool, ED physicians have been able to confidently defer scans that have a very low risk of having any significant injury present, reducing cost, radiation exposure, and perhaps time in department.

scholarly journals The Effect of Continuous Positive Airway Pressure on Total Cerebral Blood Flow in 23 Healthy Awake Volunteers

2011 ◽  
Author(s):  
Theresia I. Yiallourou ◽  
Céline Odier ◽  
Bryn A. Martin ◽  
José Haba-Rubio ◽  
Raphael Heinzer ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Color Doppler ◽  
Cerebral Arteries ◽  
Color Doppler Ultrasound ◽  
P Value ◽  
Pharyngeal Airway

Continuous Positive Airway Pressure (CPAP) is used as the gold standard treatment for sleep disordered breathing, acting as a pneumatic splint to prevent collapse of the pharyngeal airway. However, the influence that CPAP has on Cerebral Blood Flow (CBF) dynamics is not well understood. This preliminary study investigates the influence of CPAP on total CBF in 23 healthy awake subjects by measuring flow velocity and lumen diameter of the left and right proximal Internal Carotid Arteries (ICA), Vertebral Arteries (VA), and Middle Cerebral Arteries (MCA) using Duplex Color Doppler Ultrasound (US) with and without CPAP at a level of 15 cm H2O. Transcutaneous Carbon Dioxide (PtcCO2) level, heart rate, Blood Pressure (BP), and oxygen saturation (SaO2) were monitored before and after each test. The preliminary measurements indicate that CPAP results in a decrease of CBF by 17% (p-value < 0.05). The theoretically predicted decrease in CBF from PtcCO2 variation was 6%. The study should be further explored in patients with sleep apnea and various types of cerebrovascular and craniospinal disorders.

P1800The benefit of atrial septal defect closure in patients with borderline shunt

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Komar ◽  
T Przewlocki ◽  
B Sobien ◽  
P Prochownik ◽  
U Gancarczyk ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Color Doppler ◽  
Percutaneous Treatment ◽  
Right Atrial ◽  
P Value ◽  
Atrial Septal Defect Closure ◽  
Asd Closure

Abstract Objective Closure of atrial septal defect in patients with borderline shunt is controversial. The aim of the study was to evaluate the outcomes of transcatheter closure of secundum atrial septal defect (ASD) in the patients with the borderline shunt. Methods 215 pts (126 F,89 M) with a mean age of 31.9±18.2 (16–58) years with a small ASD who underwent transcatheter closure were analyzed. All patients had an isolated secundum ASD with pulmonary to systemic blood flow Qp:Qs ratio≤1.5, mean 1.2±0.6 (1.1–1.5). A symptom-limited treadmill exercise test with respiratory gas exchange analysis, transthoracic color Doppler echocardiographic study and Quality of life (QoL) (using the SF36 questionnaire (SF36q)) were repeated in all pts before and 36 months after the procedure. Results The device was successfully implanted in all pts (procedure time 19.1±5.2 (8–38) minutes, fluoroscopy time 8.1±4.4 (6–13) minutes). There were no major complications. The defect echo diameter was 7.7±3.9 (5 - 15) mm. The diameter of the implanted devices ranged from 6 to 18 mm. After 36 months of ASD closure, all the pts showed a significant improvement of exercise capacity. 7 QoL parameters (except mental health) improved at 36 months of follow-up compared with baseline. The mean SF36q scale increased in 168 (78.1%) pts of mean 40.2±20.1 (9–72). The right ventricular dimension decreased in 173 pts (80.4%) (Table 1). Table 1 Parameter Before ASD closure 36 months after ASD closure p value Time of exercise (min) 12.1±5.2 18.6±4.3 <0.001 VO2 peak (ml/kg/min) 10.2±4.7 14.8±4.2 <0.001 SF36q scale 0–100 37.3±22.3 79±29.5 <0.001 Right atrial area (cm2) 20.1±1.7 14.7±1.5 <0.001 Right ventricular area (cm2) 18.1±1.4 12.2±1.5 <0.001 Conclusions ASD closure in patients with borderline shunt resulted in a significant and long-term clinical and hemodynamic improvement after percutaneous treatment.

Discovery and Functional Implications of a Novel Mir-29b/Mir-29a Polymorphism in Acute Myeloid Leukemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1975-1975
Author(s):  
Ramiro Garzon ◽  
Catherine EA Heaphy ◽  
Nicole Stauffer ◽  
Violaine Havelange ◽  
Stefano Volinia ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Normal Population ◽  
K562 Cells ◽  
Northern Blotting ◽  
P Value ◽  
Relative Reduction ◽  
Wild Type ◽  
Expression Ratio ◽  
Monosomy 7 ◽  
Empty Vector

Abstract Abstract 1975 Poster Board I-998 Background: MicroRNAs (miRNAs) are associated with cytogenetics and molecular subtypes of acute myelogeneous leukemia (AML). We have previously shown that miR-29 expression is down-regulated in cytogenetically normal AML (CN-AML) with wild type NPM1 and in t(11q23) primary blasts. Functionally, restoration of miR-29b in AML cell lines and primary samples induces apoptosis and dramatically reduces tumorigenicity in a xenograft leukemia model (Garzon et al, EHA 2008). Despite, these studies supporting a tumor suppressor role of miR-29b in AML, little is known about how miR-29 expression is down-regulated in AML. Since, miRNAs could be target for mutation, here we propose to screen mutations that could affect miR-29 expression and function. Methods: The miR-29 family is comprised of three isoforms arranged in 2 clusters; miR-29b-1 and -a located on chromosome 7q32 and miR-29b-2 and -c located on chromosome 1q23. To screen for mutations, the entire genomic region from blasts of 100 primary AML samples corresponding to the miR-29b-1 and -a cluster, including 200 bp at the 5' and 3' ends was amplified and sequenced using the Applied Biosystems DNA sequencing system. When a deviation from the normal sequence was found, a panel of DNA from the blood of 50 control subjects was screened to identify polymorphisms. Patient characteristics include: CN-AML: 62 (FLT3-ITD 10/43, NPM1 mutated (34/62); inv16: 10; t(8;21): 2; t11q23: 2; complex karyotype (CK): 10; monosomy 7(-7): 7; other cytogenetics: 7. miR-29 expression we performed by miRNA Taqman assays as per manufacturer recommendations. Results: We identified a thymidine (T) base deletion within the miR-29b-1 and -a cluster precursor miRNAs (at -264 bp from the 5' position of miR-29a in chromosome 7q32) in 17/100 patients. The (T) base deletion was observed in 4/10 inv16 and 6/62 CN-AML patients, while the other 7 cases were distributed among CK (2/10), -7 (3/7), 11q23 (1/2) and other cytogenetics (1/7). In 2 patients, normal cells from the buccal mucosa were heterozygous for this abnormality. The frequency of this germline abnormality in the normal population was 16% (8/50 cases). Next, we investigated the miR-29b and -a expression in 35/100 primary AML samples, where RNA was also available. Although miR-29a and -b levels were not significantly different in polymorphism (n=10) versus wild type (WT) (n=35) samples, we observed that the miR-29a/miR-29b ratios were significantly lower in the polymorphism than WT (43.5 vs. 24.9 respectively, P-value=0.007, t-test). To characterize further this abnormality, we cloned the polymorphism harboring miR-29b and -a cluster from 1 patient into p-Retro Super plasmid and transfected into K562 cells (lack miR-29 expression) along with WT and empty vector constructs. Northern blotting after 24-48 hours revealed an accumulation of the precursor miR-29a while the mature miR-29a level was decreased by 2 fold. The level of the mature miR-29b was unchanged. To asses whether this polymorphism affects miR-29 targeting efficiency, we co-transfected a reporter luciferase construct containing the 3' untranslated region of the known miR-29 target, MCL-1 with the WT, empty vector and polymorphism harboring miR-29b and -a cluster and performed luciferase assays. Interestingly, relative normalized luciferase activities were less inhibited with the polymorphism cluster than the WT construct (relative reduction WT:80%, Polym:63%. Likewise, MCL-1 protein down-regulation elicited by the ectopic WT cluster overexpression was stronger than the one observed for the polymorphism harboring cluster (b-actin/MCL-1 rations 0.35 vs 0.48, respectively). Conclusions: Our results identify a novel germline polymorphism within the miR-29b and —a cluster in AML. The frequency of this polymorphism in AML is similar to the normal population. However, the increased frequency observed in the inv16 subgroup (4/10) warrant further confirmation in a large cohort of patients. Functionally, this polymorphism affects the expression ratio of miR-29b and —a by dampening the processing of miR-29a and impacts negatively in the ability of this cluster to target the oncogene MCL-1. Disclosures: No relevant conflicts of interest to declare.

scholarly journals P1577 Mitral regurgitant "splay": an important clue to severity of regurgitation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P C Wiener ◽  
E Friend ◽  
R Bhargav ◽  
L Kadem ◽  
G Pressman
Keyword(s):  
Color Doppler ◽  
Visual Assessment ◽  
Side Lobe ◽  
High Energy ◽  
P Value ◽  
Data Sets ◽  
Flow Acceleration ◽  
Acceleration Signal ◽  
Secondary Mr ◽  
Color Figure

Abstract Background Visual assessment of mitral regurgitation (MR) severity by color Doppler can be difficult, especially in eccentric jets. Examination of the proximal flow acceleration signal (PISA) on the ventricular side of the mitral valve can be helpful but, is not always intuitive. We describe a color signal ("splay") on the atrial side of the valve that can often be helpful in recognizing significant MR. Methods Clinical echocardiograms were reviewed to obtain two data sets: 100 patients with reported mild MR and another 100 with reported severe MR. All echocardiograms were reviewed to confirm that MR was truly mild or severe. Splay was defined as a non-physiologic arc of color (figure) centered at the point where the MR jet emerges into the atrium. Results Splay was present in the large majority of severe MR cases (table). It was seen across 3 vendors’ machines and was present with normal and reduced EF as well as primary and secondary MR. Color scale and transducer frequency did not differ according to presence or absence of splay, but gain was higher when splay was present (57.5 ± 6.8 vs 55.2 ± 6.1, p = 0.04). In mild MR patients, splay was present on fewer frames and had lesser dimensions vs severe MR. Splay was particularly prevalent in patients with wall hugging jets (28/30, 93%). Conclusions The splay signal occurs as a side lobe artifact, at the point where a high energy MR jet emerges into the left atrium. Its presence often indicates significant MR and may be a useful clue in highly eccentric jets which are otherwise difficult to grade. Table 1 Mild MR Severe MR P value Splay Present (%) 18 82 &lt;0.0001 No. of Frames 2 ± 1.6 3.6 ± 1.3 &lt;0.0001 Width of Splay (cm) 2.2 ± 0.5 3.2 ± 0.9 &lt;0.0001 Depth of Splay (cm) 0.36 ± 0.11 0.47 ± 0.16 0.01 Abstract P1577 Figure. Splay Image

A unique case of “double-orifice aortic valve”-comprehensive assessment by 2-, 3-dimensional, and color Doppler echocardiography

2016 ◽  
Vol 33 (9) ◽  
pp. 1436-1437
Author(s):  
James E. Stirrup ◽  
Peter J. Cowburn ◽  
Dimitrios Pousios ◽  
Sunil K. Ohri ◽  
Benoy N. Shah
Keyword(s):  
Aortic Valve ◽  
Doppler Echocardiography ◽  
Color Doppler ◽  
Comprehensive Assessment ◽  
Color Doppler Echocardiography ◽  
Unique Case ◽  
3 Dimensional ◽  
Double Orifice

scholarly journals Incidence of Silent Thrombosis in Myeloproliferative Neoplasm Patients below 60 Years : Single Center Egyptian Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5476-5476
Author(s):  
Mervat Mattar ◽  
Sahar Nassef ◽  
Noha M El Husseiny ◽  
Mohamed Abdel Kader Morad ◽  
Marwa Salah ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Conflicts Of Interest ◽  
Color Doppler ◽  
Myeloproliferative Neoplasm ◽  
Myeloproliferative Disorders ◽  
Color Doppler Ultrasound ◽  
Lower Limbs ◽  
P Value ◽  
Allele Burden ◽  
Venae Cavae

Abstract Background : Identification of JAK-2 mutation even in absence of myeloproliferative disorders was found to be related to venous thromboembolism occurrence. The aim of this work is to screen myeloproliferative neoplasm ( MPN) patients for venous thrombosis and study its correlation with both JAK 2 allele burden and with symptoms the patients presented with. Methods: We enrolled 73 cases with JAK2 positive MPN in the period between August 2015 till Feb 2017. All patients were screened for thrombosis in venous system in neck, upper and lower limbs, superior and inferior Venae Cavae and portal and mesenteric venous systems system using color Doppler Ultrasound. Results: 53 patients (72.6%) were below 60 years. Forty even (64.4%) were females and 26(35%) were males. Twenty two (30%) of cases were Essential Thrombocytosis (ET), 35(248%) were Polycythemia Vera (PV) and 16 (22%) were Myelofibrosis (MF). Twenty seven venous thrombotic attacks were reported in twenty two patients (30.1%). Seventeen patients (23%) had mesenteric and portal vein thrombosis,six patients had iliofemoral (8%) and 4 (5%) had combined lower limb and portal thrombosis. Eight patients (10.8%) had active thrombosis at screening. Only three (4%) patient were symptomatising with pain during screening. Sixteen patients with thrombosis were below 60 (30% of those below 60 years) and 6 were above sixty years (also 30% of those above sixty years). Correlation analysis between JAK2 allele burden and thrombosis was not statistically significant (r=0.3 ,p value=0.5). However, JAK 2 allele burden was statistically higher in those above sixty years in both thrombosed and non-thrombosed cases in comparison to those below sixty years (p= 0.03, 0.017 respectively). The incidence of pruritis (p =0.02) and of abdominal pain (p=0.039) was significantly different between thrombosed and non-thrombosed cases. Comparison of 8 cases with active thrombosis to old thrombosis revealed no statistical difference in the MPN10 score (p>0.05). Conclusion: We recommend routine screen for venous thrombosis in any case of MPNs once diagnosed and screening for MPNs in any case with venous thrombosis . Further research in MPN group age below 60 years of age is highly recommended. Disclosures No relevant conflicts of interest to declare.

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