scholarly journals Spontaneous arterial thrombosis in a patient with advanced ovarian clear cell cancer: a case report and literature review

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092674
Author(s):  
Jing Chen ◽  
Huimin Sun ◽  
Minrong Wu ◽  
Xiaolin Zhong ◽  
Yuqin Zhang
Keyword(s):  
Ovarian Cancer ◽  
Venous Thrombosis ◽  
Arterial Thrombosis ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Cell Cancer ◽  
Underlying Disease ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Patients with ovarian cancer are often in a hypercoagulable state and have a high risk of venous thrombosis, including deep vein thrombosis and pulmonary embolism. However, arterial thrombosis is relatively rare in ovarian cancer. We report a case a 46-year-old woman with ovarian clear cell carcinoma who developed arterial and venous thrombosis in the lower extremities as the first manifestation. Her arterial thrombosis-related ischemic symptoms were not responsive to anticoagulant treatment of low-molecular-weight heparin, but improved after neoadjuvant chemotherapy and surgery. Therefore, we hypothesize that the optimal therapy for arterial thrombosis in ovarian cancer is treatment for the underlying disease (i.e., ovarian cancer). A thorough investigation is required to determine the relationships between arterial thrombosis and ovarian cancer and antithrombotic treatments for ovarian cancer related-arterial thrombosis.

A DOUBLE BLIND RANDOMIZED TRIAL OF ORG 10172 LOW MOLECULAR WEIGHT HEPARINOID IN THE PREVENTION OF DEEP VEIN THROMBOSIS IN PATIENTS WITH THROMBOTIC STROKE

1987 ◽  
Author(s):  
A G G Turple ◽  
M N Levin ◽  
J Hirish ◽  
C J Carter ◽  
R M Jay ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Placebo Group ◽  
Venous Thrombosis ◽  
Randomized Trial ◽  
Thrombosis Prophylaxis ◽  
Low Molecular Weight ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Deep Vein

The optimal method of venous thrombosis prophylaxis in patients with stroke is uncertain. ORG 10172 is a low molecular weight heparinoid consisting principally of heparan and dermatan sulphates. In animal studies, ORG 10172 is as effective as unfractionated heparin in preventing venous thrombosis but produces less bleeding. There have been a limited number of descriptive studies on its use in humans, but to date randomized efficacy trials of ORG 10172 in the prevention of venous thrombosis have not been reported. A double blind randomized trial was carried out to compare ORG 10172 with placebo in the prevention of deep vein thrombosis in patients with thrombotic stroke. Seventy-five patients were randomized to receive ORG 10172 (50 patients) in a loading dose of 1,000 anti-Xa units intravenously followed by 750 anti-Xa units subcutaneously 12 hourly or placebo (25 patients). Prophylaxis was commenced within 7 days of stroke onset, continued for 14 days or until discharge from hospital, if earlier. Venous thrombosis surveillance was carried out with 125-1 fibrinogen leg scanning and impedance plethysmography. Venous thrombosis was confirmed by venography which occurred in 2 of 50 (4%) in the ORG 10172 group and 7 of 25 (28%) in the placebo group (p=0.005). The corresponding rates for proximal vein thrombosis were 0% and 16%, respectively (p=0.01). There was one major haemorrhage in the treated group and one minor haemorrhage in the placebo group. The anti-factor Xa levels (units/ml; mean ± SE) gradually rose from 0.18 ± 0.001 and 0.06 ± 0.01 six and 12 hours after injection on the first day to 0.24 ± 0.02 and 0.12 ± 0.01 after 11 days treatment. The results of this study indicate that ORG 10172 heparinoid is effective prophylaxis against deep vein thrombosis in patients with acute thrombotic stroke.

EFFICACY AND SAFETY OF A LOW MOLECULAR WEIGHT HEPARIN (LMW-HEPARIN SANDOZ) IN PATIENTS WITH DEEP VEIN THROMBOSIS

1987 ◽  
Author(s):  
G Vogel ◽  
M Machulik
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Complete Lysis ◽  
Deep Vein

28 patients with deep venous thrombosis (DVT) were randomized to low molecular heparin (LMWH) SANDOZ ( Nurnberg, F.R.G.) 3 OOO U/day per infusio-nem during 10 days or to unfractionated heparin(UFH) 30 000 U/day per infusionem during 10 days. Venography was repeated at day 11. of 14 patients given UFH 5 obtained complete lysis, 6 incomplete lysis and 3 no lysis. The differences were not statistically Significant. No haemorrhagic complications were seen in LMWH grouup but 5 large hamtomas were observed in UFH group. The result suggest that LMWH Sandoz and UFH were equally effecetive on thrombus reduction whereas hemorrgic complications were more common with UFH than with LMWH

Outpatient Use of Low Molecular Weight Heparin (Dalteparin) for the Treatment of Deep Vein Thrombosis of the Upper Extremity

1999 ◽  
Vol 82 (09) ◽  
pp. 1008-1010 ◽  
Author(s):  
K. J. Savage ◽  
P. S. Wells ◽  
V. Schulz ◽  
D. Goudie ◽  
B. Morrow ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Low Molecular Weight Heparin ◽  
Cost Savings ◽  
Underlying Disease ◽  
Central Line ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryUpper extremity deep vein thrombosis (DVT) is now recognized as a major cause of morbidity and mortality. There is little information regarding the most effective treatment of this condition. We report a prospective cohort study of the use of low molecular weight heparin (LMWH) in the outpatient management of upper extremity DVT. Forty-six patients were managed as outpatients for objectively documented upper extremity DVT with dalteparin (200 aXa u/kg), for a minimum of five days. Warfarin was usually initiated on the first day with a target INR of 2.0-3.0. Most patients had an underlying malignancy or a history of a central line. All patients were followed for 12 weeks from diagnosis. Only one patient had a major bleed. No patients developed pulmonary emboli. One patient had a recurrence of DVT during the treatment with LMWH with extension of the existing thrombus. Seven patients died, all due to their underlying disease. This study supports the safety and effectiveness of dalteparin in the treatment of upper extremity DVT. Given that these patients were treated as outpatients, there is a potential for huge cost savings.

scholarly journals CEREBRAL SINUS VENOUS THROMBOSIS PADA PENDERITA SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Destika Fahrina ◽  
Mohammad Arief Rachman Kemal ◽  
Adiel Amaris Syah ◽  
Melita Melita ◽  
Lyna Soertidewi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Venous Thrombosis ◽  
Lupus Erythematosus ◽  
Low Molecular Weight ◽  
Systemic Lupus ◽  
Vein Thrombosis ◽  
Cerebral Sinus Venous Thrombosis ◽  
Cerebral Sinus ◽  
Deep Vein ◽  
Sinus Venous Thrombosis

    CEREBRAL SINUS VENOUS THROMBOSIS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTABSTRACTCerebral sinus venous thrombosis (CSVT) may sometimes be associated with autoimmune disorder like systemic lupus erythematosus (SLE). It is characterized by dural venous thrombosis which can cause variety of symptoms including headache, convulsion, motor weakness, and decreased level of consciousness. Thrombosis often occurs in the lower extremities in postpartum women due to prolonged bed rest and caesarean section. We reported a 33-year-old woman, who presented with chief complaint of weakness in the left arm and leg, a history of headache and seizures, the following 3 weeks, she had swelling and pain which started at the tip of the left foot then right leg and to the waist. D-dimer level was increased with positive ANA test. Diagnostic investigations include non-contrast head CT scan, CTV, DSA, Doppler ultrasound and thoracoabdominal vasculare CT. Low molecular weight heparin (LMWH) was given for 5 days, continued with oral anticoagulant.Keywords: Cerebral sinus venous thrombosis, deep vein thrombosis, LMWH, postpartum, systemic lupus erythematosusABSTRAKCerebral sinus venous thrombosis (CSVT) dapat berkaitan dengan gangguan autoimun seperti systemic lupus erythematosus (SLE). Hal ini ditandai adanya trombosis vena dural yang menyebabkan berbagai gejala, seperti nyeri kepala, kejang, kelemahan motorik, serta penurunan kesadaran. Trombosis juga sering terjadi di ekstremitas bawah pada perempuan postpartum akibat tirah baring yang lama dan tindakan seksio sesaria. Dilaporkan kasus seorang perempuan 33 tahun dengan keluhan kelemahan tubuh sisi kiri serta riwayat nyeri kepala dan kejang yang 3 minggu kemudian dijumpai bengkak dan nyeri mulai dari ujung kaki kiri kemudian kaki kanan, hingga naik sampai pinggang. Terdapat peningkatan D-dimer dengan tes ANA (+). Pemeriksaan penunjang diagnostik berupa head CT scan nonkontras, CTV, DSA, USG doppler ekstremitas serta CT vascular thoracoabdominal. Pasien diberikan terapi low molecular weight heparin (LMWH) selama 5 hari, dilanjutkan dengan antikoagulan oral.Kata kunci: Cerebral sinus venous thrombosis, deep vein thrombosis, LMWH, postpartum, systemic lupus erythematosus  

Efficacy of an Intravenous Low-Molecular-Weight Dermatan Sulphate (Desmin) in Patients with Acute Proximal Deep Venous Thrombosis and Silent Pulmonary Embolism. A Pilot Study

1997 ◽  
Vol 25 (2) ◽  
pp. 98-107 ◽  
Author(s):  
S Venosi ◽  
V Zamboni ◽  
L Irace ◽  
R Stumpo ◽  
R Massa ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Low Molecular Weight ◽  
Dermatan Sulphate ◽  
Doppler Examination ◽  
Vein Thrombosis ◽  
Lung Scan ◽  
Deep Vein

Ten patients affected by proximal deep venous thrombosis were treated in an open study with a low-molecular-weight dermatan sulphate (Desmin), administered at doses of 400 mg (intravenous bolus) followed by 1200 mg/day infused intravenously for 10 days, without activated partial thromboplastin adjustment. The evolution of the deep vein thrombosis and the presence of silent pulmonary embolism were evaluated by phleboscintigraphy and lung scan, performed before treatment and after 10 days of treatment, and by repeated echocolour-Doppler examination (every 2 days during treatment). The evolution of deep vein thrombosis showed a considerable improvement; similarly, lung scan showed a substantial reperfusion of lung, with regression of perfusional deficit. Repeated echocolour-Doppler examination of the deep venous system during treatment did not document further thrombus extension in any patient. Tolerance and safety were excellent. No adverse effects were observed. These preliminary results indicate that the tested dose of Desmin can be effective in treating deep vein thrombosis and silent pulmonary embolism.

Factor VII and Fibrinogen Levels as Risk Factors for Venous Thrombosis

1994 ◽  
Vol 71 (06) ◽  
pp. 719-722 ◽  
Author(s):  
T Koster ◽  
F R Rosendaal ◽  
P H Reitsma ◽  
P A van der Velden ◽  
E Briët ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Arterial Thrombosis ◽  
Plasma Fibrinogen ◽  
Factor Vii ◽  
Thrombotic Risk ◽  
Vein Thrombosis ◽  
Thrombosis Risk ◽  
Deep Vein

SummaryThe plasma levels of coagulation factor VII and fibrinogen are well known risk factors for arterial thrombosis. We tested the hypothesis that this association also exists for venous thrombosis. Additionally, MspI and Haelll polymorphisms in the factor VII and fibrinogen genes have recently been reported to be associated with the concentration of both proteins in the plasma. However, no conclusion could be drawn with respect to an increase or decrease in thrombosis risk. We undertook a population-based case-control study, in which 199 patients with a first, objectively confirmed episode of deep vein thrombosis, aged less than 70, and without a known malignant disorder were compared to 199 age-and sex-matched healthy controls, to evaluate the clinical importance of these reported findings.For fibrinogen we found a positive level-related association between the plasma fibrinogen level and thrombotic risk. Subjects with a plasma fibrinogen greater than 5 g/1 had an almost 4-fold increase of thrombosis risk. The frequencies of the different Haelll genotypes were out of balance only for the thrombosis patients, with a deficit of the H1H2 genotype. Possession of an H1H2 genotype was associated with a 40% reduction in thrombosis risk.For factor VII, neither the plasma level nor the MspI genotypes were related to deep vein thrombosis, although possession of a M2 allele was clearly associated with significantly lower factor VII levels. The frequencies of the Mspl-genotypes were the same for patients and control subjects and, exhibited Hardy-Weinberg equilibrium.Our results support that plasma fibrinogen, a determinant of arterial thrombosis is also a risk factor for venous thrombosis, while factor VII plasma concentration is unrelated to deep vein thrombosis, which is supported by the data from the DNA analysis of polymorphisms.

scholarly journals COVID-19 Presented with Deep Vein Thrombosis in a Patient with Paroxysmal Nocturnal Haemoglobinuria

2021 ◽  
Author(s):  
Zlatko Pravdic ◽  
Mirjana Mitrovic ◽  
Andrija Bogdanovic ◽  
Marijana Virijevic ◽  
Nikica Sabljic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Venous Thrombosis ◽  
Arterial Thrombosis ◽  
Distress Syndrome ◽  
Bone Marrow Failure ◽  
Rare Event ◽  
Paroxysmal Nocturnal Haemoglobinuria ◽  
Vein Thrombosis ◽  
High Incidence ◽  
Deep Vein

AbstractParoxysmal nocturnal haemoglobinuria (PNH) is a rare, acquired clonal haematological disease characterized by complement-mediated haemolysis, bone marrow failure and venous thrombosis. Anticomplement therapy eculizumab improves survival and reduces complications. Severe acute respiratory distress syndrome corona virus 2 (SARS-CoV-2) disease 2019 (COVID-19) is associated with high incidence of both venous and arterial thrombosis in hospitalized patients with pneumonia. Deep venous thrombosis (DVT) as the presenting symptom of COVID-19 is a rare event. We describe a well-controlled PNH patient on eculizumab for more than 5 years who presented with DVT, while on warfarin, as the first sign of COVID-19. To our knowledge, this is the first described case of DVT in a PNH patient with COVID-19.

Low Molecular Weight Heparin Therapy: Is Monitoring Needed?

1994 ◽  
Vol 72 (03) ◽  
pp. 330-334 ◽  
Author(s):  
B Boneu
Keyword(s):  
Molecular Weight ◽  
Clinical Trials ◽  
Plasma Proteins ◽  
Bleeding Risk ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Meta Analyses ◽  
Deep Vein ◽  
Initial Check

SummaryRecent meta-analyses indicate that low molecular weight heparins (LMWH) are more effective than unfractionated heparin (UH) in preventing and treating deep vein thrombosis. This article presents the arguments for and against the need for laboratory monitoring. At the present time, the only tests currently available for monitoring LMWH therapy are those which measure the anti Xa activity in the plasma. Due to lower binding to plasma proteins and to cell surfaces,the plasma anti Xa activity generated by a given dose of LMWH is more predictable than for UH.Some clinical trials suggest that LMWH delivered at the recommended dose expose the patient to less bleeding risk than UH. Several . meta-analyses indicate comparable risk while any overdose unaccept-ably increases the haemorrhagic risk. The lowest dose of LMWH still effective in treating established DVT is presently unknown; some reports indicate that inadequate doses of LMWH are associated with a lack of efficacy for prevention. An overview of the published clinical trials indicates that the LMWH dose has never been monitored for prevention of DVT. In the treatment of established DVT, several trials have been performed without any monitoring, while in others the dose was adapted to target a given anti Xa activity. These considerations suggest that in prevention of DVT, monitoring the dose is not required. In the treatment of established DVT, considering the haemorrhagic risk of LMWH, the risk of undertreating the patient and the absence of large clinical trials comparing the advantages of monitoring the dose or not, it might be useful to check anti Xa activity at least once at the beginning of the treatment but the need for this initial check remains to be established. Because a large proportion of patients will be in the desired range, dose adjustments will be far less frequent than for UH.

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