scholarly journals Left lower limb deep venous thrombosis, May-Thurner syndrome and endovascular management

2022 ◽  
Vol 43 (1) ◽  
pp. 108-112
Author(s):  
Khawaja B. Waheed ◽  
Hassan R. Mohammed ◽  
Khaled S. Salem ◽  
Mohamed A. Shaltout ◽  
Ali S. Alshehri ◽  
...  
2019 ◽  
Vol 03 (03) ◽  
pp. 180-184 ◽  
Author(s):  
Hiok Yang Chan ◽  
Edward Tieng Chek Choke ◽  
Tjun Yip Tang ◽  
Chandramohan Sivanathan ◽  
Chua Ming Er Jasmine ◽  
...  

AbstractMay-Thurner syndrome (MTS) is rare condition thought to occur due to an anatomical variation. In MTS, there is left iliac vein compression by the right iliac artery and lumbar spine resulting in left lower limb deep venous thrombosis. The authors report a rare cause of MTS postarterial intervention. They describe the unusual case of an Asian man who presented with acute left lower limb deep venous thrombosis 5 days following left common iliac artery angioplasty and stent insertion. Computed tomographic (CT) venogram demonstrated the left iliac vein compression by the left iliac artery stent. Successful recanalization of the thrombosed iliac vein was achieved with a combination of pulse spray thrombolysis and rheolytic mechanical thrombectomy, followed by angioplasty and stent placement in the iliac vein. There was rapid and complete resolution of symptoms. This report illustrates the use of complementary imaging modalities and a multidisciplinary team approach to achieve a successful technical and clinical outcome following an unusual case of MTS postarterial intervention and the subsequent successful endovascular management.


1993 ◽  
Vol 69 (01) ◽  
pp. 008-011 ◽  
Author(s):  
Cedric J Carter ◽  
D Lynn Doyle ◽  
Nigel Dawson ◽  
Shauna Fowler ◽  
Dana V Devine

SummaryThe serial use of non-invasive tests has been shown to be a safe method of managing outpatients who are suspected of having lower limb deep venous thrombosis (DVT). Objective testing has shown that the majority of these outpatients do not have venous thrombosis. A rapid test to exclude DVT in these patients, without the need for expensive and inconvenient serial non-invasive vascular testing, would have practical and economic advantages.Studies measuring the fibrin degradation product D-dimer using enzyme-linked immunoassays (EIA) in patients with veno-graphically proven DVT suggest that it should be possible to exclude this condition by the use of one of the rapid latex bead D-dimer tests.We have examined 190 patients with suspected DVT using both a latex and an EIA D-dimer assay. The latex D-dimer test used in this study was negative in 7 of the 36 proven cases of DVT. This sensitivity of only 80% is not sufficient to allow this type of assay, in its current form, to be used as an exclusion test for DVT. The same plasma samples were tested with an EIA assay. This information was used to mathematically model the effects of selecting a range of D-dimer discriminant cut off points for the diagnosis of DVT. These results indicate that 62% of suspected clinically significant DVT could have this diagnosis excluded, with a 98% sensitivity, if the rapid latex or equivalent D-dimer test could be reformulated to measure less than 185 ng/ml of D-dimer.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Maryam Rahiminejad ◽  
Anshul Rastogi ◽  
Shirish Prabhudesai ◽  
David Mcclinton ◽  
Peter MacCallum ◽  
...  

Aims. Colour doppler ultrasonography (CDUS) is widely used in the diagnosis of deep venous thrombosis (DVT); however, the number of scans positive for above knee DVT is low. The present study evaluates the reliability of the D-dimer test combined with a clinical probability score (Wells score) in ruling out an above knee DVT and identifying patients who do not need a CDUS. Materials and Method. This study is a retrospective audit and reaudit of a total of 816 outpatients presenting with suspected lower limb DVT from March 2009 to March 2010 and from September 2011 to February 2012. Following the initial audit, a revised clinical diagnostic pathway was implemented. Results. In our initial audit, seven patients (4.9%) with a negative D-dimer and a low Wells score had a DVT. On review, all seven had a risk factor identified that was not included in the Wells score. No patient with negative D-dimer and low Wells score with no extra clinical risk factor had a DVT on CDUS (negative predictive value 100%). A reaudit confirmed adherence to our revised clinical diagnostic pathway. Conclusions. A negative D-dimer together with a low Wells score and no risk factors effectively excludes a lower limb DVT and an ultrasound is unnecessary in these patients.


2019 ◽  
Vol 23 (2) ◽  
pp. 111-120
Author(s):  
David Canty ◽  
Kavi Mufti ◽  
Lindsay Bridgford ◽  
André Denault

2020 ◽  
Vol 35 (7) ◽  
pp. 533-537
Author(s):  
Samir Henni ◽  
Pierre Ramondou ◽  
Guillaume Duval ◽  
Jean Picquet ◽  
Georges Leftheriotis ◽  
...  

Objectives Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superficial venous thrombosis + deep venous thrombosis). Methods We retrospectively analyzed the results of venous ultrasound investigations performed among 11,739 patients (aged 67 ± 19 years old, 56.1% males) referred for suspected lower-limb thrombotic events over a 12-year period. Chi-square test was used to compare the superficial venous thrombosis/lower-limb thrombotic events ratio observed by trimesters to a homogeneous distribution. Results The proportion of lower-limb thrombotic events were 30.7%, 28.8%, 31.1%, and 31.4% (Chi2: 0.133; p = 0.987) of total investigations, while that of superficial venous thrombosis among all lower-limb venous thrombotic events were 27.2%, 30.0%, 31.4%, and 31.0%, for the first, second, third, and fourth trimesters respectively (Chi2: 0.357; p: 0.949). Conclusion No trimestral variation of the superficial venous thrombosis/lower-limb venous thrombotic events ratio was observed.


2000 ◽  
Vol 55 (1) ◽  
pp. 36-39 ◽  
Author(s):  
JULIAN ELFORD ◽  
IRVING WELLS ◽  
JIM COWIE ◽  
CAROL HURLOCK ◽  
HILARY SANDERS

1991 ◽  
Vol 6 (4) ◽  
pp. 241-248 ◽  
Author(s):  
Håkan Ahlström ◽  
Stefan Nilsson ◽  
Göran Hellers

One-hundred-and-eleven consecutive patients who were referred for routine phlebography because of clinically suspected deep vein thrombosis (DVT) were also investigated with a new, simplified, computerized strain-gauge plethysmograph (Phlebotest, Eureka AB). An occlusion plethysmograph curve was obtained from each leg simultaneously. Four different numerical parameters were defined and determined from this curve. These parameters were correlated with the phlebographic diagnosis. Three of the parameters of the plethysmograph curve correlated well with the phlebographic diagnosis, which proved correct in 54 patients without DVT, including two false negative cases, and in 12 patients with thrombosis. In 45 patients, plethysmography alone was not sufficient to establish a diagnosis. The plethysmograph described is easy to handle and is suggested for use in selecting those patients, with or without thrombosis, who do not require supplementary phlebography.


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