Report from Ultrasound Assessment of Deep Venous Thrombosis and Venous Insufficiency Study Day Friday, 15th September, 2000 British Institute of Radiology, London

Background: It was found that 50% of patients with iliofemoral deep venous thrombosis (DVT) treated by anticoagulant alone and compression stocking developed post thrombotic syndrome (PTS). Accelerated removal of thrombus by thrombolytic agents may increase venous patency and prevent PTS. The objective of the study was to assess short-term efficacy of additional catheter directed thrombolysis (CDT) compared with standard anticoagulant therapy alone.Methods: Prospective, randomized, controlled study on 50 patients (18–75 years) with acute iliofemoral DVT and symptoms <21 days were randomized to receive additional CDT or standard anticoagulant therapy alone. After 6 months, vein patency and insufficiency (reflux) was assessed using duplex ultrasound by an investigator blinded to previous treatments.Results: Fifty patients were allocated additional CDT (n=25) or ACs alone (n=25). After CDT, grade III (complete) lysis was achieved in 17 (68%) and grade II (50%–90%) lysis in 5 patients (20%). One patient suffered major bleeding and two had clinically relevant bleeding related to the CDT procedure. After 6 months, iliofemoral patency was found in 17 (68%) in the CDT group vs. 8 (32%) controls, corresponding to an absolute risk reduction 36% (95% CI, p=0.002). Femoral venous insufficiency was found to be higher among the ACs group 11 patients (44%) vs. 7 patients (28%) in the CDT group.Conclusions: After 6 months, additional CDT increased iliofemoral patency from 32% to 68% and decreased venous insufficiency from 44% to 28%.

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A study of risk factors of chronic venous insufficiency and its association with features suggestive of preceding or present deep venous thrombosis

Indian Journal of Dermatology ◽

10.4103/ijd.ijd_271_18 ◽

2019 ◽

Vol 64 (5) ◽

pp. 366

Author(s):

RamH Malkani ◽

Rusina Karia ◽

Sneh Thadani

Keyword(s):

Risk Factors ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency

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Deep Vein Thrombosis Post Radiofrequency Ablation of the Saphenous and Perforator Veins: Is Duplex Ultrasound Necessary within Five Days?

Journal for Vascular Ultrasound ◽

10.1177/154431671704100101 ◽

2017 ◽

Vol 41 (1) ◽

pp. 11-12

Author(s):

Anita Altawan ◽

David Golchian ◽

Mazen Bazzi ◽

John Iljas ◽

Bipinchandra Patel

Keyword(s):

Deep Vein Thrombosis ◽

Radiofrequency Ablation ◽

Venous Thrombosis ◽

Radio Frequency ◽

Deep Venous Thrombosis ◽

Venous Insufficiency ◽

Duplex Ultrasound ◽

Vein Thrombosis ◽

Post Procedure ◽

Deep Vein

Radiofrequency ablation (RFA) of the saphenous and perforator veins (“closure”) is a relatively newer option for treatment of venous insufficiency patients. A known complication of the RFA is deep vein thrombosis also known as DVT. The purpose of this study is to demonstrate the probability of acute deep venous thrombosis post radio-frequency vein ablation. This research also helped determine medical necessity of a postoperative venous duplex examination within 5 days post-procedure.

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The effect of Angiojet rheolytic thrombectomy in the endovascular treatment of lower extremity deep venous thrombosis

Phlebology The Journal of Venous Disease ◽

10.1177/0268355517711792 ◽

2017 ◽

Vol 33 (6) ◽

pp. 388-396 ◽

Cited By ~ 6

Author(s):

Mert Dumantepe ◽

Ibrahim Uyar

Keyword(s):

Quality Of Life ◽

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Venous Insufficiency ◽

Clinical Severity ◽

Economic Study ◽

Venous Clinical Severity Score ◽

Rheolytic Thrombectomy

Objective To evaluate the clinical safety and effectiveness of percutaneous rheolytic thrombectomy in patients with acute lower extremity deep venous thrombosis. Method Sixty-eight consecutive patients with acute massive lower extremity deep venous thrombosis were included in this retrospective study. A percutaneous rheolytic thrombectomy device (Angiojet ® Rheolytic thrombectomy catheter, Boston Scientific, Marlborough, MA, USA) was used in all patients in an angiography suite through ipsilateral popliteal vein access. Thrombus clearance and complications were evaluated. Furthermore, patients underwent a clinical evaluation according to a modified Villalta scale for the investigation of post thrombotic syndrome in follow-up. The Venous Clinical Severity Score, Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Sym questionnaires were completed preoperatively and readministered postoperatively. Results Overall thrombus clearance (complete recanalization was achieved in 58 patients (85.2%) and partial recanalization was achieved in 7 patients (10.2%) confirmed through venographic assessment was achieved in 95.5% of the patient population. The mean Venous Clinical Severity Score preoperatively was 13.1 ± 2.2 and decreased to 4.0 ± 1.3 postoperatively (P < 0.01). The Villalta scale dropped from 12.9 ± 2.8 to 5.5 ± 1.4 postoperatively (P < 0.001). Overall quality of life and symptoms improved as assessed by Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Sym (P < 0.01 and 0.02, respectively). Only three minor bleedings were seen but none of the patients suffered from major bleeding, symptomatic pulmonary embolism, death, or other procedure related complications. Fifty-nine out of 65 patients (90.7%) who were treated successfully with rheolytic thrombectomy remained patent at 12 months according to DUS and five patients (7.3%) developed a mild post thrombotic syndrome. Conclusion Rheolytic thrombectomy with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical symptoms. This technique is a safe, effective and easily performed method of endovascular treatment with a low rate of major treatment complications and shows promising clinical mid-term results.

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Popliteal vein entrapment presenting as deep venous thrombosis and chronic venous insufficiency

Journal of Vascular Surgery ◽

10.1067/mva.1993.48846 ◽

1993 ◽

Vol 18 (5) ◽

pp. 760-766 ◽

Cited By ~ 1

Author(s):

Charles C. Wolferth ◽

Todd M. Gerkin ◽

Hugh G. Beebe ◽

David M. Williams ◽

Jess R. Bloom

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Chronic Venous Insufficiency ◽

Venous Insufficiency ◽

Popliteal Vein

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Deep Venous Thrombosis in Patients with Erythema Nodosum Leprosum in the Use of Thalidomide and Systemic Corticosteroid in Reference Service in Belo Horizonte, Minas Gerais

Case Reports in Dermatological Medicine ◽

10.1155/2019/8181507 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Luiz Alberto Bomjardim Pôrto ◽

Maria Aparecida de Faria Grossi ◽

Edilamar Silva de Alecrim ◽

Marcus Henrique de Souza Brito Xavier ◽

Frederico Paiva e Silva ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Venous Insufficiency ◽

Erythema Nodosum ◽

Case Series ◽

Erythema Nodosum Leprosum ◽

Reference Service ◽

Belo Horizonte ◽

Pharmacological Thromboprophylaxis ◽

Incidence Increase

Introduction. Erythema nodosum leprosum (ENL) is a type of lepra reaction treated with corticosteroids and thalidomide, but this association increases the risk of deep venous thrombosis (DVT).Objective. To report cases of ENL with DVT in the use of thalidomide/corticosteroid associated.Methodology. The study was conducted between December 2015 and December 2016 at the Eduardo de Menezes Hospital (HEM-FHEMIG).Results. A clinical case series of 16 patients, eight from HEM-FHEMIG and eight from the literature. DVT occurred on 4 continents, mainly in adults and men. All patients were multibacillary; four people had pulmonary embolism (PE); there were 11 unilateral and five bilateral DVT cases; 12 cases were proximal, two distal, and two unspecified. Pharmacological thromboprophylaxis was used on two individuals. Outcome after DVT, 14 patients improved, one had sequelae, and one died.Discussion. DVT increased in association with thalidomide/corticosteroid in multiple myeloma, but this complication is poorly described in ENL. In proximal DVT, there was a greater risk of PE and sequelae venous insufficiency. After DVT, start anticoagulation. ASA 100mg/day as prophylaxis for DVT in case of this drug association in ENL is recommended.Conclusion. The article illustrates the incidence increase of DVT because of the thalidomide/corticosteroid combination in ENL. When this association is necessary, use ASA 100mg/day as prophylaxis.

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Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis

BMC Medical Imaging ◽

10.1186/s12880-020-00527-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ebba Beller ◽

Mattes Becher ◽

Felix G. Meinel ◽

Jens-Christian Kröger ◽

Rengarajan Rajagopal ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Chart Review ◽

Venous Insufficiency ◽

Past History ◽

Clinical Information ◽

Ultrasound Evaluation ◽

Electronic Chart ◽

History Of ◽

One Year

Abstract Background To investigate the prevalence, spectrum, and predictors of alternative diagnoses explaining leg symptoms in patients negative for suspected acute deep venous thrombosis (DVT), which can be detected with whole-leg ultrasound. Methods We retrospectively analyzed a cohort of 789 patients (median age 70 years, 50.6% women) evaluated with a whole-leg ultrasound examination for suspected acute DVT within one year. All findings in the radiology report were analyzed and electronic chart review was performed to collect clinical information. Results Ultrasound was negative for acute DVT in 531 patients (67.3%). Among these, alternative diagnoses explaining leg symptoms were seen in 349 patients (65.7%). The most frequent alternative diagnoses were chronic venous insufficiency (147 patients, 27.7%), followed by lymphedema (48 patients, 9.0%) and chronic post-thrombotic changes (41 patients, 7.7%). Patients with alternative diagnoses were older (median 71 vs. 66 years, p = 0.0226), as well as more likely to present with leg swelling (39.5% vs. 23.1%, p = 0.0002), difference in leg circumference (25.5% vs. 14.8%, p = 0.0055) and redness (7.7% vs. 2.7%, p = 0.0213) than patients without alternative diagnosis. Independent predictors of finding alternative diagnoses on whole-leg ultrasound were older age (odds ratio 1.014 per year, p = 0.0119), leg swelling (OR 1.949, p = 0.0020) and history of previous DVT (OR 2.235, p = 0.0154). Conclusions Alternative diagnoses explaining leg symptoms can be detected on whole-leg ultrasound in two thirds of patients with no evidence of acute DVT. Our data supports performing a comprehensive ultrasound evaluation beyond the venous system, particularly, in older patients, who present with leg swelling and a past history of DVT.

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