Incidence of post-thrombotic syndrome in patients with previous pulmonary embolism

2004 ◽  
Vol 92 (11) ◽  
pp. 993-996 ◽  
Author(s):  
Vincenza Rossi ◽  
Roberto Ricchio ◽  
Antonio Greco ◽  
Antonio Bloise ◽  
Filomena Daniele ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Clinical Score ◽  
Tertiary Care Centre ◽  
True Incidence ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
The Difference ◽  
Deep Vein

SummaryThere is little information available about the true incidence of post-thrombotic syndrome (PTS) after pulmonary embolism (PE). The aim of this study was to investigate the incidence of PTS in patients with previous pulmonary embolism without concomitant ultrasonographically-detectable deep vein thrombosis (DVT). A retrospective cohort study was conducted at a single tertiary care centre, Cosenza, Italy. Forty-seven consecutive patients with proved PE without DVT within the previous 2 to 6 years, 45 patients with previous DVT in the same years, and 45 patients with diseases unrelated to venous thrombo-embolism (VTE) underwent a blind assessment for PTS using a clinical score. Two of 47 (4.2%, 95%CI: 0.01-9.9) patients with PE, 2 of 45 (4.4%, 95%CI: 0.01-10.4) patients with diseases unrelated to VTE, and 23 of 45 (53.3%, 95%CI: 38.7-67.9) patients with DVT showed signs and symptoms of PTS. The difference between the first two groups was not statistically significant (p = 0.7). In conclusion, the incidence of PTS after pulmonary embolism without DVT is low, and no different from that of patients without previous VTE.

High incidence of in-hospital pulmonary embolism following joint arthroplasty with dalteparin prophylaxis

2010 ◽  
Vol 103 (01) ◽  
pp. 123-128 ◽  
Author(s):  
Jason Kerr ◽  
Lori-Ann Linkins
Keyword(s):  
Pulmonary Embolism ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Joint Arthroplasty ◽  
Vein Thrombosis ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Deep Vein

SummaryThe in-hospital incidence of pulmonary embolism (PE) in patients undergoing elective joint arthroplasty who receive a minimum of 10 days of dalteparin prophylaxis is reported to be less than 1%. Recent clinical experience raised suspicion that the incidence of PE was significantly higher at our tertiary care institution. It was the objective of this study to determine the incidence of in-hospital PE and symptomatic deep-vein thrombosis following elective joint arthroplasty in patients who received a minimum of 10 days of dalteparin prophylaxis. Consecutive charts of patients who underwent elective joint arthroplasty at our institution between January 2008 and June 2008 were reviewed. Data on risk factors for venous thromboembolism, objectively documented venous thromboembolic events, and signs and symptoms of PE were abstracted. Patients who received concomitant warfarin in the postoperative period were excluded. The study population consisted of 437 knee arthroplasty and 246 hip arthroplasty patients. The incidence of in-hospital PE following knee arthroplasty and hip arthroplasty was 4.6% and 0.4%, respectively. One out of every 10 knee patients, and one out of every 20 hip patients underwent testing for pulmonary embolism. Pulmonary embolism was diagnosed a median of 3.5 days after knee arthroplasty. The incidence of in-hospital PE in knee arthroplasty patients who received dalteparin prophylaxis was significantly higher than expected. Potential explanations for this finding include poor efficacy of dalteparin started 12–24 hours postoperatively and/or a low threshold for ordering diagnostic imaging for PE. Studies to clarify these issues are needed.

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 Deep vein thrombosis: experience from a tertiary care centre in central India

2019 ◽  
Vol 7 (9) ◽  
pp. 3391
Author(s):  
Vinod Khandait ◽  
Harshwardhan Khandait ◽  
Shadman Ali
Keyword(s):  
Deep Vein Thrombosis ◽  
Tertiary Care ◽  
Central India ◽  
Tertiary Care Centre ◽  
Predisposing Factor ◽  
Diagnostic Modality ◽  
Vein Thrombosis ◽  
Detailed Assessment ◽  
Management Approaches ◽  
Deep Vein

Background: Deep vein thrombosis is a disease of potentially serious consequences and is still often unsuspected. The present study was undertaken to look into etiological factors, management approaches and complications in patients presenting primarily with DVT at a tertiary care centre.Methods: This was a descriptive study profiling 75 confirmed DVT cases admitted at a tertiary care government hospital over two years. Detailed assessment included thorough clinical examination, duplex venous ultrasound and basic investigations, along with special investigations and CT angiography in selected few. Appropriate management was provided, and details recorded. Patients were followed up clinically and by ultrasound after 1 week, 2 weeks and 3 months. The complications, if any were also recorded.Results: The mean age of participants was 39.5±14.4 years, with 28% between 30-39 years. Majority (40%) did not have any obvious predisposing factor and most of them presented with pain and swelling. Most (52%) of the cases had involvement of both proximal and distal veins, 45.33% cases had involvement of only proximal veins whereas only 2.67% had restricted involvement of distal veins. Around 60% of cases have complete clinical resolution and approximately 50% cases have complete ultrasonographic resolution at the end of 3 months.Conclusions: Young adults without any obvious risk factors may develop and present with DVT and hence factors leading to thrombosis in them are recommended to be thoroughly evaluated. Duplex venous ultrasound is reliable non-invasive diagnostic modality and is recommended for diagnosis of DVT in clinically suspected cases.

Economic burden of deep-vein thrombosis, pulmonary embolism, and post-thrombotic syndrome

2006 ◽  
Vol 63 (20_Supplement_6) ◽  
pp. S5-S15 ◽  
Author(s):  
David A. MacDougall ◽  
Anthony L. Feliu ◽  
Stephen J. Boccuzzi ◽  
Jay Lin
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Economic Burden ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Deep Vein

Pre-operative Plasma Levels of Thrombin-Antithrombin III Complexes Correlate with the Development of Venous Thrombosis after Major Hip or Knee Surgery

1995 ◽  
Vol 74 (02) ◽  
pp. 602-605 ◽  
Author(s):  
Jeffrey S Ginsberg ◽  
Patrick Brill-Edwards ◽  
Akbar Panju ◽  
Ameen Patel ◽  
Joanne McGinnis ◽  
...  
Keyword(s):  
Antithrombin Iii ◽  
Tertiary Care ◽  
Knee Surgery ◽  
Referral Centre ◽  
Study Objective ◽  
Cut Points ◽  
Vein Thrombosis ◽  
Major Orthopedic Surgery ◽  
The Mean ◽  
Deep Vein

SummaryStudy objective. To determine whether levels of thrombin-antithrombin III (TAT) in plasma, taken two weeks pre-operatively, predict the development of deep vein thrombosis (DVT) in patients undergoing major hip or knee surgery.Design. Prospective cohort.Setting. Tertiary-care referral centre, university-affiliated hospital.Patients. Ninety eight consecutive patients undergoing elective hip or knee surgery.Intervention. All eligible consenting patients were seen in a preoperative clinic two weeks prior to surgery and had blood taken for measurement of plasma TAT level. After surgery, they received a combination of unfractionated heparin 5000 Units 12-hourly subcutaneously, and antiembolism stockings (TEDS), as prophylaxis against DVT. Contrast venography was performed prior to discharge, and according to the results, patients were classified as having proximal (popliteal and/or more proximal) DVT (n = 12), calf DVT (n = 7) or no DVT (n = 79).Measurements and Results. The mean TAT level was significantly higher in patients who developed DVT (5.7 μg/l) than in those who did not (4.1 μg/l), p = 0.035. Using cut-points of 3.5 and 5.5 μg/l for the TAT level, patients could be categorized as high, intermediate, and low risk for the development of DVT. The proportion of patients with TAT levels of ≥3.5μg/l who developed calf or proximal DVT was significantly higher than the proportion of patients with TAT levels of <3.5 μg/l who developed calf or proximal DVT (p = 0.02). The proportion of patients with TAT levels >5.5 μg/l who developed proximal DVT was significantly higher than the proportion of patients with TAT levels of ≤5.5 μg/l who developed proximal DVT (p = 0.03).Conclusions. This study demonstrates that pre-operative TAT levels correlate with the risk of developing DVT after major orthopedic surgery. Further studies are needed to determine the reason(s) for this observation and whether rational recommendations about prophylaxis and screening for DVT can be made based on the results of a pre-operative TAT level.

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