Venous thromboembolism after ultrasound guided foam sclerotherapy

2020 ◽  
pp. 026835552095720
Author(s):  
Eduardo T de Aguiar ◽  
Jorgete B dos Santos ◽  
Danielle D Carvalho
Keyword(s):  
Venous Thromboembolism ◽  
Family History ◽  
Varicose Veins ◽  
Male Gender ◽  
Lower Limbs ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Chi Square ◽  
Significance Level ◽  
History Of

Objective To analyze prevalence of venous thromboembolism (VTE) after ultrasound guided foam sclerotherapy. Method Clinical retrospective study with patients treated from 2004 to 2014. Charts with incomplete data and follow-up less than 60 days were excluded. Polidocanol foam (Tessari method) was used. The primary outcome was the prevalence of VTE and the secondary were possible risk factors. Chi-square test and Marascuillo prodecure were applied at a significance level of 5%. Results 2,616 patients were included with 4,712 lower limbs treated. The mean age was 50.7±0.86, in majority female, 83.7%. VTE occurred in 0.49% (pulmonary embolism 0,3%) in a mean time of 44.0±42.2 days. Male gender, personal or family history of phlebitis or DVT and high caliber varicose veins were significantly associated to VTE. Conclusion incidence of VTE is low, male gender, personal or family history of VTE and caliber of varicose veins greater than 7 mm increased the risk.

Venous thromboembolism in pregnancy: diagnosis, management and prevention

2009 ◽  
Vol 101 (03) ◽  
pp. 428-438 ◽  
Author(s):  
Shannon M. Bates ◽  
Sanjeev D. Chunilal
Keyword(s):  
Pregnant Woman ◽  
Venous Thromboembolism ◽  
Family History ◽  
Developed Countries ◽  
Pulmonary Angiography ◽  
Lower Limbs ◽  
Diagnostic Strategies ◽  
Computed Tomographic ◽  
History Of ◽  
In Pregnancy

SummaryA pregnant woman has a two- to five-fold higher risk of venous thromboembolism (VTE) than a non-pregnant woman of the same age and, in developed countries, she is more likely to die from fatal pulmonary embolism (PE) than from obstetric haemorrhage. The increased VTE risk is mediated through normal physiological changes of pregnancy including alterations in haemostasis that favour coagulation, reduced fibrinolysis and pooling and stasis of blood in the lower limbs. Thrombophilia, smoking, obesity, immobility and postpartum factors such as infection, bleeding and emergency surgery (including emergency caesarian section) also increase the risk of pregnancy-related VTE. The diagnosis of VTE can be safely established with acceptable radiation exposure to the fetus using readily available imaging modalities such as ultrasound, ventilation perfusion lung scanning and computed tomographic pulmonary angiography. However, the optimal diagnostic strategies still remain to be determined. If there is no contraindication to anticoagulation, commencing treatment prior to objective confirmation should be strongly considered. For the mother and fetus, effective and safe treatment is readily available with low-molecular-weight heparin (LMWH), but optimal dosing of these agents in pregnancy remains controversial. Emerging data support antepartum LMWH prophylaxis for women with previous VTE if the event was unprovoked or in the presence of thrombophilia. On the other hand, women with prior provoked VTE and no thrombophilia or women with asymptomatic thrombophilia (but a family history of VTE) can safely be managed with antepartum surveillance. Postpartum prophylaxis is recommended for women with prior VTE or thrombophilia (and a family history of VTE).

Management of venous malformations in Klippel–Trenaunay syndrome with ultrasound-guided foam sclerotherapy

2005 ◽  
Vol 20 (2) ◽  
pp. 63-81 ◽  
Author(s):  
B McDonagh ◽  
S Sorenson ◽  
A Cohen ◽  
T Eaton ◽  
D E Huntley ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Venous Malformation ◽  
Limb Lengthening ◽  
Venous Malformations ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
History Of ◽  
Deep Vein ◽  
Klippel Trenaunay Syndrome

Objective: To study the clinical profile of Klippel–Trenaunay syndrome (KTS) and the management of venous malformations (VMs) with ultrasound-guided foam sclerotherapy using the compass technique. Methods: In this open prospective series, 11 consecutive patients with KTS seeking therapy at a phlebology group practice were included. Seven (64%) of them were post-surgical recurrences. Results: Pain was the commonest presenting complaint (100%), accompanied with VMs/ varicose veins in all except one (91%). Chronic venous insufficiency (CVI) was seen in seven (64%). Soft tissue and bone deformity was present in all (100%). Limb lengthening was frequent and detected in eight (73%), thickening in six (54%); unusually, one patient (9%) presented with severe thinning and shortening of the leg. Venous malformation was the primary vascular problem in nine patients (82%), with capillary malformation (CM)/port wine stain in seven (64%) and isolated lymphatic malformation (LM) in two (18%). The lateral embryonic/Klippel–Trenaunay (KT) vein was detected in 10 patients (91%). Deep vein deformity was not detected in any of them. All the deformities were of the lower limb (100%), while two (18%) had deformities of the thorax and one (9%) had gastrointestinal (GI) malformation. None of the patients gave family history of KTS, while five (45%) had history of varicosities in the family. Eight patients (73%) completed the therapeutic plan with a mean follow-up of 5±3.9 years. An excellent to good type result could be documented in six of the eight cases (75%). These patients had an event-free, good quality of life. Follow-up duplex studies revealed the evolving refluxing tracts requiring sequential therapies. Conclusions: The results in this series demonstrate the utility of foam sclerotherapy using the compass technique in the management of KTS. Chronicity of the VMs in KTS necessitates strict clinical monitoring and sequential therapies.

scholarly journals Aldosterone levels and the -344t/C aldosterone synthase in individuals with a family history of hypertension

2016 ◽  
Vol 15 (3) ◽  
pp. 435-440
Author(s):  
Ika Setyawati ◽  
Sunarti ◽  
Pramudji Hastuti
Keyword(s):  
Family History ◽  
Medical Science ◽  
Plasma Aldosterone ◽  
Chi Square ◽  
Aldosterone Level ◽  
Aldosterone Synthase ◽  
Significance Level ◽  
History Of ◽  
Plasma Aldosterone Level ◽  
Family History Of Hypertension

Background: Genetic factors play an important role in the determination of hypertensive disease in a family. The -344T/C the aldosterone synthase gene has been reported in various populations closely related to hypertension. The aim of this study was to determine the presence of the -344T/C polymorphism of the aldosterone synthase gene and the levels of plasma aldosterone in individuals with and without a family history of hypertension.Methods: This study was a case control design, with healthy individuals with a family history of hypertension as cases (n-42) and those without a family history of hypertension as controls (n=41). The subjects’ plasma aldosterone levels were analysed by enzyme-link immunosorbent assay (ELISA) and the gene polymorphism was analysed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The data were analysed by an independent sample T-test and Chi square test, and the significance level was set at P<0.05.Result: The frequency of the TT + TC genotype was higher in cases, and this increase was significant different compared to the controls (P<0.046). The frequency of the TT + TC genotype was 2.56 higher in cases than controls. The frequency of the C allele in cases was also significantly different compared to the controls (P = 0.039) and 2.29 more frequent in cases than the controls (P = 0.039). The plasma aldosterone level was 42.35 pg/dL in cases and 34.9 pg/dL in controls (P = 0.616). Plasma aldosterone level in cases with the CC, TC and TT genotypes were 48.29, 40.8 and 35.2 pg/dL, respectively (P = 0.774). Our study concludes that individuals with a family history of hypertension are at a higher risk of developing hypertension. Follow-up studies are required to determine the incidence of hypertension in a person with a family history of hypertension and who is a carrier of genetic risk factors.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.435-440

Factors Associated with Varicose Veins in Pregnant Women

2001 ◽  
Vol 16 (4) ◽  
pp. 167-169 ◽  
Author(s):  
L. B. Coughlin ◽  
R. Gandy ◽  
S. Rosser ◽  
L. de Cossart
Keyword(s):  
Family History ◽  
Pregnant Women ◽  
Varicose Veins ◽  
Smoking Habit ◽  
Positive Family History ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Factors Associated ◽  
Multiparous Women ◽  
History Of

Objective: To examine the associated features in pregnant women with superficial venous reflux, compared with those without reflux. Methods: Pregnant women were recruited at booking and underwent colour flow duplex ultrasound scanning of the lower limbs to ascertain the presence or absence of reflux in the superficial veins. Body mass index and CEAP scores were calculated. A questionnaire regarding parity, smoking habit and family history of varicose veins was administered. Statistical analysis was carried out using ARCUS. Results: Three hundred and twenty-nine women were recruited, of whom 83 were identified as having reflux (25%). No relationship was observed between reflux and obesity, smoking or family history. Multiparity was significantly correlated with varicose veins (p<0.03). CEAP scores were higher in multiparous women with varicose veins. An increase in symptoms was associated with a positive family history (especially maternal). Smoking was associated with fewer symptoms in those with reflux, as was obesity. Conclusion: Increased parity increased the likelihood of varicose veins, but obesity and family history appeared to make no difference. Symptoms were greater in multiparous women, but less inobese women. An association was made between smoking and fewer symptoms.

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

Venous Thromboembolism: Genetics and Thrombophilias

2021 ◽  
Vol 42 (02) ◽  
pp. 271-283
Author(s):  
Manila Gaddh ◽  
Rachel P. Rosovsky
Keyword(s):  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Family History ◽  
Morbidity And Mortality ◽  
Inherited Thrombophilia ◽  
Risks And Benefits ◽  
Hereditary Thrombophilia ◽  
The World ◽  
The Future ◽  
History Of

AbstractVenous thromboembolism (VTE) is a major cause of morbidity and mortality throughout the world. Up to one half of patients who present with VTE will have an underlying thrombophilic defect. This knowledge has led to a widespread practice of testing for such defects in patients who develop VTE. However, identifying a hereditary thrombophilia by itself does not necessarily change outcomes or dictate therapy. Furthermore, family history of VTE by itself can increase an asymptomatic person's VTE risk several-fold, independent of detecting a known inherited thrombophilia. In this article, we will describe the current validated hereditary thrombophilias including their history, prevalence, and association with VTE. With a focus on evaluating both risks and benefits of testing, we will also explore the controversies of why, who, and when to test as well as discuss contemporary societal guidelines. Lastly, we will share how these tests have been integrated into clinical practice and how to best utilize them in the future.

scholarly journals Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins

2017 ◽  
Vol 5 ◽  
pp. 2050313X1771264 ◽  
Author(s):  
Mark S Whiteley ◽  
Victoria C Smith
Keyword(s):  
Alopecia Areata ◽  
Varicose Veins ◽  
Clinical Score ◽  
Severe Exacerbation ◽  
Hormonal Changes ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Pelvic Vein ◽  
History Of ◽  
Sodium Tetradecyl Sulphate

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

Family history of venous thromboembolism in the paediatric population: The need for a standardized definition

2019 ◽  
Vol 173 ◽  
pp. 91-95
Author(s):  
Anna Hau ◽  
Eric Wegener ◽  
Vera Ignjatovic ◽  
Shoshana Revel-Vilk ◽  
Paul Monagle
Keyword(s):  
Venous Thromboembolism ◽  
Family History ◽  
Paediatric Population ◽  
History Of

scholarly journals Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Febrile Seizures ◽  
Study Groups ◽  
Clinical Risk Factors ◽  
P Value ◽  
Chi Square ◽  
Clinical Risk ◽  
Significant Difference ◽  
History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

Prospective five-year study of ultrasound-guided foam sclerotherapy in the treatment of great saphenous vein reflux

2009 ◽  
Vol 24 (4) ◽  
pp. 183-188 ◽  
Author(s):  
P Chapman-Smith ◽  
A Browne
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Adverse Outcomes ◽  
Patient Acceptance ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Clinical Recurrence ◽  
Over Time

Objectives The purpose of this study was to determine the long-term efficacy, safety and rate of recurrence for varicose veins associated with great saphenous vein (GSV) reflux treated with ultrasound-guided foam sclerotherapy (UGFS). Methods A five-year prospective study was performed, recording the effect on the GSV and saphenofemoral junction (SFJ) diameters, and reflux in the superficial venous system over time. UGFS was the sole treatment modality used in all cases, and repeat UGFS was performed where indicated following serial annual ultrasound. Results No serious adverse outcomes were observed – specifically no thromboembolism, arterial injection, anaphylaxis or nerve damage. There was a 4% clinical recurrence rate after five years, with 100% patient acceptance of success. Serial annual duplex ultrasound demonstrated a significant reduction in GSV and SFJ diameters, maintained over time. There was ultrasound recurrence in 27% at 12 months, and in 64% at five years, including any incompetent trunkal or tributary reflux even 1 mm in diameter being recorded. Thirty percent had pure ultrasound recurrence, 17% new vessel reflux and 17% combined new and recurrent vessels on ultrasound. Of all, 16.5% required repeat UGFS treatment between 12 and 24 months, but less than 10% in subsequent years. The safety and clinical efficacy of UGFS for all clinical, aetiological, anatomical and pathological elements classes of GSV reflux was excellent. Conclusion The popularity of this outpatient technique with patients reflects ease of treatment, lower cost, lack of downtime and elimination of venous signs and symptoms. Patients accept that UGFS can be repeated readily if required for recurrence in this common chronic condition. The subclinical ultrasound evidence of recanalization or new vein incompetence needs to be considered in this light.

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