scholarly journals Optimization of proper diagnosis of thromboses associated with high risk of embolism in patients with neoplasms

2013 ◽  
Vol 94 (2) ◽  
pp. 202-207
Author(s):  
I A Kamalov ◽  
I R Agliullin ◽  
M G Tukhbatullin
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Inferior Vena Cava ◽  
Distal Part ◽  
Inferior Vena ◽  
Vena Cava ◽  
Main Group ◽  
Control Group ◽  
Proper Diagnosis ◽  
Antineoplastic Treatment

Aim. To optimize a proper diagnosis of thromboses associated with high risk of embolism and pulmonary embolism prevention in patients with neoplasms. Methods. Ultrasonography of veins of lower extremities, iliac veins and the distal part of inferior vena cava was performed in patients with and without neoplasms in a prospective study to detect thromboses associated with high risk of embolism and thrombophlebitis. Ultrasonography was performed once in control group subjects, and before and during specialized antineoplastic treatment (surgical, chemotherapy, radiotherapy) in patients of the main group, the results were compared. A detection of a new thrombus in previously intact venous segment of inferior vena cava system was assessed as a high risk for pulmonary embolism. Results. Thromboses associated with high risk of embolism and thrombophlebitis were found in 6 patients of control group, in 5 patients of the main group before and in 27 patients of the main group while at specialized antineoplastic treatment. Specific measures for pulmonary embolism prevention were taken immediately in all of the cases according to ultrasonography results after the detection of thromboses associated with high risk of embolism. No fatal cases of pulmonary embolism were registered both in main (before and while at treatment) and control groups. Conclusion. Ultrasonography of veins of lower extremities, iliac veins and the distal part of inferior vena cava in patients with neoplasms before the start of specialized antineoplastic treatment allows to optimize the choice of prevention measures for pulmonary embolism and thus significantly decreases mortality from pulmonary embolism.

scholarly journals Required frequency of ultrasonography for detection of thrombosis with high risk for embolism in patients with malignancies

2013 ◽  
Vol 94 (3) ◽  
pp. 335-339
Author(s):  
I A Kamalov ◽  
I R Agliullin ◽  
M G Tukhbatullin ◽  
I R Safin
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Clinical Signs ◽  
Lower Extremities ◽  
Main Group ◽  
Control Group ◽  
Venous Blood Flow

Aim. To determine the optimal terms for detection of thrombosis with high risk for embolism in patients with malignancies receiving specialized treatment. Methods. 117 patients (50 males, 67 females - the main group) with malignancies were randomly picked out (using the random numbers tables) underwent daily ultrasonography of inferior vena cava tributaries for detection of thrombosis with high risk for embolism. Ultrasonography of inferior vena cava distal part, both common iliac veins and veins of lower extremities was done in patients while on surgical treatment, chemotherapy or radiotherapy. The control group consisted of 130 patients (58 males, 72 females) with malignancies in whom ultrasonography was performed only if clinical signs of venous thrombosis were present. Results. Ultrasonic features of venous blood flow decrease (spontaneous contrast phenomenon) in veins of lower extremities were found in 27 out of 117 main group patients on the second day. On the third day features of saphenous veins thrombosis were found in 13 patients. On the fourth day, 4 patients were diagnosed with iliofemoral thrombosis. 5 more patients developed ultrasonic features of venous blood flow decrease (spontaneous contrast phenomenon) on the fourth and fifth day. Signs of thrombosis progression and floating thrombus were found in 6 patients on the 6th and 7th day. No fatal cases of pulmonary embolism were registered in the main group. 10 patients of the control group had clinical signs of inferior vena cava tributaries and underwent distal part of inferior vena cava, both common iliac veins and veins of lower extremities ultrasonography while on specialized treatment. 5 cases of pulmonary embolism were reported in the rest of the control group patients (120 patients). Conclusion. Inferior vena cava tributaries thrombosis with high risk for embolism in patients with malignancies can be reliably detected by repeating ultrasonography every 3-4 days; Reliable diagnosis of thrombosis with high risk for embolism by means of ultrasonography during the post-surgical period allows to prevent pulmonary embolism in a timely and targeted manner.

scholarly journals Pulmonary embolism prevention in out-patients with malignancies during the first year of follow-up

2015 ◽  
Vol 96 (1) ◽  
pp. 13-16
Author(s):  
R Sh Khasanov ◽  
I A Kamalov
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
Very High

Aim. To decrease the one-year mortality rate in out-patients with malignancies undergoing periodic health examination.Methods. The study included 270 patients, who were examined and followed up. The main group included 140 patients, who monthly underwent ultrasonography of inferior vena cava branches during the first year of follow-up. The control group included 130 patients, in whom ultrasonography of inferior vena cava branches was performed only if clinical manifestations of venous thrombosis were registered.Results. Venous thrombosis was diagnosed in 35 patients of the main group, including 21 cases of venous thrombosis at very high risk for embolism. In control group, ultrasonography of inferior vena cava branches was performed in 13 patients who developed clinical manifestations of venous thromboembolic events, in whom 6 patients were diagnosed with deep vein thrombosis of the lower limbs, in 3 patients venous thrombosis was assessed as at very high risk for embolism. In 24 patients (21 in the main group and 3 in the control group), targeted measures to prevent pulmonary embolism were administered, including cava filter implantation, vein ligation above the venous thrombosis at very high risk for embolism site, and crossectomy. The rest of the patients were administered conservative prevention of thromboembolism. In the main group, no deaths associated with pulmonary embolism were registered. In the control group, 19 patients died due to developing pulmonary embolism.Conclusion. Preventive measures for pulmonary embolism, selected according to the results of timely ultrasound diagnosis of venous thrombosis, may reduce the one-year mortality rate in patients with cancer.

scholarly journals Prevention of fatal pulmonary embolism in a patient with stomach cancer

2013 ◽  
Vol 94 (6) ◽  
pp. 903-905
Author(s):  
I A Kamalov ◽  
I R Aglullin ◽  
M G Tukhbatullin ◽  
I R Safin ◽  
A Yu Rodionova
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Inferior Vena Cava ◽  
Lower Extremity ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Set Up

A clinical case of a 71-year old patient with stomach cancer and concomitant lower extremity deep venous thrombosis diagnosed before the surgical treatment is presented. The patient was administered anticoagulants, and despite the treatment, a diagnosis of deep venous thrombosis with high risk for thromboembolism was set up. Considering high risk for pulmonary embolism, an inferior vena cava filter was implanted in infrarenal part of inferior vena cava at the first stage. On the second day after the cancer surgery (subtotal stomach resection with lymphadenectomy), clot detachment and its dislocation from the left common femoral vein to the area where the cava filter was implanted with further fixation were diagnosed. Accurate diagnosis of lower extremity deep venous thrombosis with high risk for thromboembolism set up by ultrasonography and timely inferior vena cava filter implantation saved the patient with cancer from developing pulmonary embolism.

scholarly journals Infrahepatic Inferior Vena Cava Clamping does not Increase the Risk of Pulmonary Embolism Following Hepatic Resection

2021 ◽  
Author(s):  
Emrullah Birgin ◽  
Arianeb Mehrabi ◽  
Dorothée Sturm ◽  
Christoph Reißfelder ◽  
Jürgen Weitz ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Hepatic Resection ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Bile Leakage ◽  
Perioperative Outcomes ◽  
Control Group ◽  
The Impact

Abstract Background Infrahepatic inferior vena cava (IVC) clamping reduces central venous pressure. However, controversies remain regarding its impact on postoperative complications, particularly, the incidence of postoperative pulmonary embolism (PE). The aim of the study was to determine the impact of IVC clamping on the incidence of PE in patients undergoing hepatectomy. Methods A pooled analysis of five prospective trials on patients who underwent hepatic resection over a period of 10 years was performed. Patients with infrahepatic IVC clamping were compared to patients without infrahepatic IVC clamping. Outcomes were studied by univariate and multivariate analyses. Results Of 505 included patients, 141 patients had IVC clamping and 364 patients served as control group. The rate of postoperative PE was comparable between groups (3% vs. 3%; P = 0.762), as were postoperative morbidity (P = 0.932), bile leakage (P = 0.272), posthepatectomy hemorrhage (P = 0.095), and posthepatectomy liver failure (P = 0.605), respectively. No clinicopathological and intraoperative risk factors were found to predict the onset of PE. Subgroup analyses of patients with major hepatectomy and vascular resections confirmed no adverse perioperative outcomes to be associated with IVC clamping. Conclusions Infrahepatic IVC clamping does not increase the incidence of postoperative PE.

scholarly journals The question of whether vena cava filters have a role in trauma patients remains unanswered

2021 ◽  
Vol 64 (2) ◽  
pp. E244-E245
Author(s):  
Ian M. Ball ◽  
Mason Curtis ◽  
Neil Parry ◽  
Fran Priestap ◽  
Kelly N. Vogt
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Trauma Patients ◽  
Difficult Question ◽  
Inferior Vena Cava Filters ◽  
Vena Cava Filters

Whether to temporarily place retrievable inferior vena cava filters for prophylaxis against pulmonary embolism in high-risk trauma patients has been a difficult question to answer. Guidelines regarding the management of these patients are mixed in their recommendations. The question merits further attention.

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