Clot busting in kids: less PTS?

Blood ◽  
2007 ◽  
Vol 110 (1) ◽  
pp. 4-5
Author(s):  
Leslie Raffini
Keyword(s):  
Deep Vein Thrombosis ◽  
High Risk ◽  
Lower Extremity ◽  
Thrombolytic Therapy ◽  
Retrospective Analysis ◽  
Pediatric Patients ◽  
Postthrombotic Syndrome ◽  
Mechanical Thrombolysis ◽  
Vein Thrombosis ◽  
Deep Vein

Goldenberg and colleagues' retrospective analysis of pediatric patients with high-risk, occlusive lower extremity deep vein thrombosis (DVT) suggests that thrombolytic therapy with tPA (with or without mechanical thrombolysis) may decrease the risk of postthrombotic syndrome (PTS).

scholarly journals Clinical Predictive Factors of Lower Extremity Deep Vein Thrombosis in Relative High-Risk Patients after Neurosurgery: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Juhua Li ◽  
XinZhen Ren ◽  
Xiaole Zhu ◽  
Huayu Chen ◽  
Zhen Lin ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
High Risk ◽  
Lower Extremity ◽  
Predictive Factors ◽  
High Risk Patients ◽  
Vein Thrombosis ◽  
Risk Patients ◽  
Gcs Score ◽  
Deep Vein ◽  
D Dimer

Introduction. It is acknowledged that patients undergoing neurosurgery with neurological illness are at higher risk of lower extremity deep vein thrombosis (DVT). As an underlying life-threatening complication, the incidence and risk factors for high-risk patients with lower extremity deep vein thrombosis are still controversial in relative high-risk patients after neurosurgery. Materials and Methods. A total of 204 patients who underwent neurosurgery and were considered as a high-risk group of DVT according to times of stay in bed more than 3 days were enrolled in this study. We evaluated the lower extremity DVT by using Color Doppler Ultrasound System (CDUS). Clinical parameters of patients at the time of admission and postoperation were recorded and prepared for further analysis. Early predictive factors for postoperative lower extremity DVT were established. Diagnostic performance of predictive factors was evaluated by using receiver operating characteristic (ROC) curve analysis. Results. The overall incidence rate of DVT in 204 enrolled patients was 30.9%. Multivariate logistic regression indicated that hypertension (OR 3.159, 95% CI 1.465-6.816; P=0.003), higher postoperative D-dimer (OR 1.225, 95% CI 1.016-1.477; P=0.034), female (OR 0.174, 95% CI 0.054-0.568; P=0.004), and lower GCS score (OR 0.809, 95% CI 0.679-0.965; P=0.013) were independently associated with incidence of DVT in patients after neurosurgery. The logistic regression function (LR model) of these four independent risk factors had a better performance on diagnostic value of DVT in patients after neurosurgery. Conclusion. The combined factor was constructed by hypertension, postoperative D-dimer, gender, and GCS score, and it might be a more handy and reliable marker to stratify patients at risk of DVT after neurosurgery.

Midterm Outcomes of Pharmacomechanical Thrombectomy in the Treatment of Lower Extremity Deep Vein Thrombosis With a Rotational Thrombectomy Device

2017 ◽  
Vol 51 (5) ◽  
pp. 301-306 ◽  
Author(s):  
Ahmet Yuksel ◽  
Oktay Tuydes
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Postthrombotic Syndrome ◽  
Technical Success Rate ◽  
Vein Thrombosis ◽  
Rotational Thrombectomy ◽  
Thrombectomy Device ◽  
Deep Vein

Background: The purpose of this study was to assess the safety and efficacy with midterm outcomes of pharmacomechanical thrombectomy (PMT) performed by using a relatively new thrombectomy device in the treatment of lower extremity deep vein thrombosis (DVT). Methods: Between February 2014 and February 2016, a total of 46 patients with lower extremity DVT were treated with PMT by using Cleaner rotational thrombectomy system. Preprocedural, intraprocedural, postprocedural, and follow-up records of patients were collected and retrospectively analyzed. Results: Mean age of patients was 50.5 (14.8) years, and 58.7% of them were female. Technical success rate of procedure was 91.3%. Mean procedure time was 81.8 (40.3) minutes. Early clinical improvement was observed in all patients with successful treatment. No serious adverse event related to procedure and mortality was observed. Mean follow-up time was 16.0 (7.9) months. Reocclusion was observed in 7 (17.5%) patients during the follow-up period. Venous patency rates of patients at 1-, 3-, 6-, and 12-month follow-up visits were 95%, 92.5%, 89.7%, and 79.5%, respectively. Mild, moderate, and severe postthrombotic syndrome were observed in 8 (20%) patients, 4 (10%) patients, and 1 (2.5%) patient, respectively. Postthrombotic syndrome–free survival rate was 67.5%. Conclusion: Cleaner rotational thrombectomy system appears to be safe and effective in the treatment of lower extremity DVT. Further larger randomized studies are needed to determine the long-term outcomes of this treatment modality.

scholarly journals Catheter-Directed Thrombolysis Versus Standard Anticoagulation for Acute Lower Extremity Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

2017 ◽  
Vol 24 (7) ◽  
pp. 1134-1143 ◽  
Author(s):  
Yongming Lu ◽  
Linyi Chen ◽  
Jinhui Chen ◽  
Tao Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Postthrombotic Syndrome ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Deep Vein

Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis. Compared with anticoagulant alone, CDT was shown to significantly increase the percentage patency of the iliofemoral vein ( P < .00001; I2 = 44%) and reduce the risk of PTS ( P = .0002; I2 = 79%). In subgroup analysis of randomized controlled trials, CDT was not shown to prevent PTS ( P = .2; I2 = 59%). A reduced PTS risk was shown, however, in nonrandomized trials ( P < .00001; I2 = 47%). Meta-analysis showed that CDT can reduce severe PTS risk ( P = .002; I2 = 0%). However, CDT was not indicated to prevent mild PTS ( P = .91; I2 = 79%). A significant increase in bleeding events ( P < .00001; I2 = 33%) and pulmonary embolism (PE) ( P < .00001; I2 = 14%) were also demonstrated. However, for the CDT group, the duration of stay in the hospital was significantly prolonged compared to the anticoagulant group ( P < .00001; I2 = 0%). There was no significant difference in death ( P = .09; I2 = 0%) or recurrent venous thromboembolism events ( P = .52; I2 = 58%). This meta-analysis showed that CDT may improve patency of the iliofemoral vein or severe PTS compared with anticoagulation therapy alone, but measuring PTS risk remains controversial. However, CDT could increase the risk of bleeding events, PE events, and duration of hospital stay.

scholarly journals Postthrombotic syndrome and other outcomes of lower extremity deep vein thrombosis in children

Blood ◽  
2016 ◽  
Vol 128 (14) ◽  
pp. 1862-1869 ◽  
Author(s):  
Maria Laura Avila ◽  
Eleanor Pullenayegum ◽  
Suzan Williams ◽  
Natasha Yue ◽  
Peter Krol ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Postthrombotic Syndrome ◽  
Vein Thrombosis ◽  
Key Points ◽  
Deep Vein

Key Points The frequency of PTS, PE, and DVT recurrence was higher in children with Non-LR DVT than in children with LR DVT. Thrombus resolution, DVT triggering event, and sex were predictors of LE PTS in children.

scholarly journals Low-dose Systemic Thrombolytic Therapy for Deep Vein Thrombosis in Pediatric Patients

2010 ◽  
Vol 32 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Sarah E. Leary ◽  
Virginia L. Harrod ◽  
Pedro A. de Alarcon ◽  
Ulrike M. Reiss
Keyword(s):  
Deep Vein Thrombosis ◽  
Thrombolytic Therapy ◽  
Low Dose ◽  
Pediatric Patients ◽  
Vein Thrombosis ◽  
Systemic Thrombolytic Therapy ◽  
Deep Vein
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