scholarly journals Idiopathic Deep Vein Thrombosis and Subsequent Cancer: Suggestions for a Patient-Oriented and Practical Approach

2001 ◽  
Vol 7 (4) ◽  
pp. 321-324 ◽  
Author(s):  
Antonio Girolami
Keyword(s):  
Deep Vein Thrombosis ◽  
Extensive Study ◽  
Personal History ◽  
Vein Thrombosis ◽  
Wait And See ◽  
Deep Vein ◽  
The Relationship ◽  
Subsequent Cancer ◽  
Selection Of ◽  
Made In

The relationship between an idiopathic deep vein thrombosis and a cancer is well established. It is not clear yet whether all patients with an idiopathic deep vein thrombosis should be thoroughly investigated for an occult cancer or only some. As a matter of fact, once a physician is faced with a patient who has an idiopathic deep vein thrombosis, three approaches are possible, mainly: 1) a wait and see approach; 2) a limited investigation; and 3) an extensive or invasive investigation. No sure criteria for the selection of the patients who should be extensively investigated are available. Suggestions have been made in this regard. Negative family or personal history for thrombosis, advanced age, deep vein thrombosis of upper limbs, existence of silent deep vein thrombosis in contralateral leg, tendency to relapse and/or to migrate, constitutional symptoms, or smoking may represent important clues that may justify an extensive study. This patient-oriented approach is mainly based on the experience of the caring physician.

Catheter-directed thrombolysis for deep vein thrombosis: 2021 update

2021 ◽  
pp. 1358863X2110429
Author(s):  
Samuel Z Goldhaber ◽  
Elizabeth A Magnuson ◽  
Khaja M Chinnakondepalli ◽  
David J Cohen ◽  
Suresh Vedantham
Keyword(s):  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Related Quality ◽  
Health Related ◽  
Deep Vein ◽  
Major Reduction ◽  
Selection Of Patients ◽  
Selection Of

Catheter-directed thrombolysis (CDT) has been utilized as an adjunct to anticoagulant therapy in selected patients with deep vein thrombosis (DVT) for approximately 30 years. CDT used to be limited to patients with DVT causing acute limb threat and those exhibiting failure of initial anticoagulation, but has expanded over time. Randomized trials evaluating the first-line use of CDT for proximal DVT have demonstrated that CDT does not produce a major reduction in the occurrence of post-thrombotic syndrome (PTS) and that it is poorly suited for elderly patients and those with limited thrombus extent or major risk factors for bleeding. However, CDT does offer selected patients with acute iliofemoral DVT improvement in reducing early DVT symptoms, in achieving reduction in PTS severity, and in producing an improvement in health-related quality of life (QOL). Clinical practice guidelines from medical and surgical societies are now largely aligned with the randomized trial results. This review offers the reader an update on the results of recently completed clinical trials, and additional guidance on appropriate selection of patients with DVT for catheter-directed thrombolytic therapy.

scholarly journals A Case Report on VT from TV: DVT and PE from Prolonged Television Watching

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alan Lucerna ◽  
James Espinosa ◽  
Lindsey Ackley ◽  
Philip Carhart ◽  
Douglas Stranges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Pulmonary Embolus ◽  
Thromboembolic Events ◽  
Television Watching ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Made In

Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.

The Persistance of Residual Vein Thrombosis, after an Episode of Deep Vein Thrombosis, and the Risk of New Overt Cancer and Cardiovascular Disease.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 262-262 ◽  
Author(s):  
Sergio Siragusa ◽  
Alessandra Malato ◽  
Raffaela Anastasio ◽  
Ignazio Abbene ◽  
Carlo Arcara ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Deep Vein Thrombosis ◽  
Cardiovascular Event ◽  
Independent Risk Factor ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Recurrent Vte ◽  
Deep Vein ◽  
Subsequent Cancer

Abstract Background. We have recently demonstrated that the presence of Residual Vein Thrombosis (RVT), UltraSonography (US)-detected at the 3rd month after an episode of Deep Vein Thrombosis (DVT) of the lower limbs, is an independent risk factor for developing recurrent Venous Thromboembolism (VTE). The management of DVT patients by detection of RVT may, therefore, represent a simple and reproducible method for establishing the individual risk of recurrence and for tailoring the optimal duration of Oral Anticoagulants (OA) (Siragusa S et al. Blood2003;102(11):OC183a). At the present, it is unknown whether RVT may also identify patients at increased risk for cancer and/or cardiovascular disease (CD). Objective of the study. In patients with DVT of the lower limbs, we conducted a prospective study for evaluating the correlation between RVT and the risk of new overt cancer and/or CD. Materials and methods. Consecutive patients, with an episode of idiopathic or provoked DVT, were evaluated after 3 months from the index DVT; presence/absence of RVT was detected and patients managed consequently (table). The incidence of VTE recurrence, overt cancer and new CD was evaluated over a period of 3 years after the index DVT. Survival curves (Kaplan-Mayer) and related Breslow test have been used for statistics. Results. Three-hundred fourty-five patients were included in the analysis. The results are listed in the table and figures. The incidence of recurrent VTE and new overt cancer was statistically lower in patients without RVT than in those with RVT; no significant differences were found in the incidence of new CD. These data are applicable in patients with idiopathic or provoked index DVT. In patients with RVT, the advantage of prolonging anticoagulation for 12 months was lost at the end of the treatment. Conclusions. This is the first study evaluating the relationship between US-detected RVT and the risk of developing cancer and CD; RVT presence, at 3rd month from the index DVT, is an independent risk factor for recurrent VTE and indicates patients at risk for new overt cancer. This risk remains over a period of 3 years, independently whether index DVT was idiopathic or provoked. In these patients, the advantage of indefinite anticoagulation should be assessed in properly designed study. Incidence of events over a period of 3 years accordingly to RVT findings Group Number of patients Presence of RVT at the 3rd months of OA from the index DVT Duration of OA from the index DVT Incidence of recurrent VTE Incidence of new cancer Incidence of new CD *Part of these patients were originally randomized to receive 3 or 12 months of OA Group *A1 142 yes 12 months 11 (7.7%) 8 (5.6%) 7 (4.9%) Group *A2 91 yes 3 months 16 (17.5%) 9 (9.9%) 7 (7.7%) Group B 112 no 3 months 1 (0.9%) 3 (2.6%) 4 (3.5%) Figure 1: Relationship between RVT and subsequent Cancer Figure 1:. Relationship between RVT and subsequent Cancer Figure 2: Relationship between RVT and subsequent Cardiovascular Event Figure 2:. Relationship between RVT and subsequent Cardiovascular Event

scholarly journals The Relationship Between the East Japan Earthquake and Deep Vein Thrombosis: Study of Risk Factors for Refugee Women Over Age 40

2012 ◽  
Vol 23 (3) ◽  
pp. 255-259
Author(s):  
Shigeki Hirooka ◽  
Masaji Ishii ◽  
Yoko Sotoda ◽  
Hitoshi Ishikawa ◽  
Hirouki Orita
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Refugee Women ◽  
Deep Vein ◽  
The Relationship

scholarly journals The diagnostic value of the fibrinogen/fibrin fragment E antigen assay in clinically suspected deep vein thrombosis

Blood ◽  
1982 ◽  
Vol 59 (2) ◽  
pp. 346-350 ◽  
Author(s):  
A Zielinsky ◽  
J Hirsh ◽  
G Straumanis ◽  
CJ Carter ◽  
M Gent ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Diagnostic Value ◽  
Normal Range ◽  
Vein Thrombosis ◽  
Normal Test ◽  
Antigen Assay ◽  
Deep Vein ◽  
Test Result ◽  
Made In

Abstract We have evaluated the fibrinogen/fibrin fragment E antigen assay as a diagnostic test in patients with clinically suspected venous thrombosis by comparing the results of this assay with venography in 272 patients. The result of the fragment E antigen assay was elevated in 79 of 80 patients with positive venograms for recent venous thrombosis (sensitivity 99%) and within the normal range in 161 of 192 patients with normal venograms (specificity 84%). The fragment E assay was also evaluated in 130 medical and surgical controls without evidence of venous thrombosis by leg scanning and the test was found to be relatively nonspecific. However, in the patient group under study, a correct clinical diagnosis of no thrombosis, based on a normal fragment E result, was made in 161 of 162 cases (negative predictive value of 99%). Therefore, a normal test result effectively excludes a diagnosis of venous thrombosis in clinically symptomatic patients. The assay, as currently performed, is technically demanding and takes 24 hr to complete. Therefore, it will have to be simplified before it can be applied to clinical practice.

scholarly journals Inconsistencies in the planning of the duration of anticoagulation among outpatients with acute deep-vein thrombosis

2011 ◽  
Vol 105 (02) ◽  
pp. 239-244 ◽  
Author(s):  
Torsten Willenberg ◽  
Martin Banyai ◽  
Ulrich Frank ◽  
Thomas Baldi ◽  
Beatrice Amann-Vesti ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Treatment Initiation ◽  
Anticoagulation Therapy ◽  
Interquartile Range ◽  
Patient Treatment ◽  
Vein Thrombosis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein ◽  
Limited Duration ◽  
Made In

SummaryThree-month anticoagulation is recommended to treat provoked or first distal deep-vein thrombosis (DVT), and indefinite-duration anticoagulation should be considered for patients with unprovoked proximal, un-provoked recurrent, or cancer-associated DVT. In the prospective Out-patient Treatment of Deep Vein Thrombosis in Switzerland (OTIS-DVT) Registry of 502 patients with acute objectively confirmed lower extremity DVT (59% provoked or first distal DVT; 41% unprovoked proximal, unprovoked recurrent, or cancer-associated DVT) from 53 private practices and 11 hospitals, we investigated the planned duration of anticoagulation at the time of treatment initiation. The decision to administer limited-duration anticoagulation therapy was made in 343 (68%) patients with a median duration of 107 (interquartile range 91–182) days for provoked or first distal DVT, and 182 (interquartile range 111–184) days for unprovoked proximal, unprovoked recurrent, or cancer-associated DVT. Among patients with provoked or first distal DVT, anticoagulation was recommended for <3 months in 11%, ≥3 months in 63%, and for an indefinite period in 26%. Among patients with unprovoked proximal, unprovoked recurrent, or cancer-associated DVT, anticoagulation was recommended for <6 months in 22%, 6–12 months in 38%, and for an indefinite period in 40%. Overall, there was more frequent planning of indefinite-duration therapy from hospital physicians as compared with private practice physicians (39% vs. 28%; p=0.019). Considerable inconsistency in planning the duration of anticoagulation therapy mandates an improvement in risk stratification of outpatients with acute DVT.

scholarly journals Breast cancer presenting as subclavian/axillary deep vein thrombosis and upper limb lymphoedema

2012 ◽  
Vol 94 (2) ◽  
pp. e55-e56 ◽  
Author(s):  
SJ Kruger
Keyword(s):  
Breast Cancer ◽  
Deep Vein Thrombosis ◽  
Inflammatory Breast Cancer ◽  
Delayed Diagnosis ◽  
Rare Condition ◽  
Treatment Modalities ◽  
Vein Thrombosis ◽  
Relationship Of ◽  
Deep Vein ◽  
The Relationship

This case report describes the delayed diagnosis of inflammatory breast cancer following initial presentation with a subclavian/axillary deep vein thrombus. The relationship of thrombosis and cancer is discussed and the typical presentation of inflammatory breast cancer described. Understanding the relationship between thromboembolism and cancer is crucial to support the early diagnosis of breast cancer, which can present insidiously. The literature is reviewed, highlighting the improving prognosis of this rare condition and the current preferred treatment modalities.

The Relationship between 125I-Fibrinogen Detected Thrombosis and Pulmonary Embolism

1975 ◽  
Author(s):  
G. V. Ruckley ◽  
D. R. B. Jones ◽  
I. M. C. Macintyre ◽  
C. Vasilescu
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Cause Of Death ◽  
Screening Test ◽  
Medical Patients ◽  
Vein Thrombosis ◽  
Lung Scan ◽  
Fibrinogen Test ◽  
Deep Vein ◽  
The Relationship

A total of 846 surgical and medical patients have been screened by the 125I-fibrinogen test (I.F.T.). Deep vein thrombosis (D.V.T.) was detected in 174 (21%). In 49% of positives the condition was bilateral and in 33% the D.V.T. involved popliteal veins or above. In 14 patients pulmonary embolism was diagnosed by lung scan or at autopsy. In one massive embolism was the cause of death. All 14 had positive I.F.T’s. ; 10 bilateral and 10 with both calf and thigh vein thrombus. The relationship between positive I.F.T. and iliofemoral D.V.T. was studied with bilateral phlebography in 60 patients. In no case was isolated iliofemoral D.V.T found. We confirm the value of the I.F.T. as a screening test for potential embolism and observe that embolism from isolated iliofemoral D.V.T. is extremely rare.

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