scholarly journals Comparative study to establish significance of D-dimer, lipid profile and homocysteine level in cases of deep vein thrombosis

2019 ◽  
Vol 6 (5) ◽  
pp. 1733
Author(s):  
Vishal Sharma ◽  
Mahendra Bendre ◽  
Shahaji Chavan ◽  
Sree Ganesh B.
Keyword(s):  
Deep Vein Thrombosis ◽  
Comparative Study ◽  
Lipid Profile ◽  
Homocysteine Level ◽  
Research Centre ◽  
Control Group ◽  
Study Group ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Background: The purpose of the study was to establish the relationship of D-dimer, lipid profile and homocysteine level in deep-vein thrombosis (DVT). The purpose of this study was to assess the value of D-dimer in the detection of early DVT.Methods: A hospital based comparative study was conducted at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune with 100 patients to compare the level of D-dimer and lipid profile in cases of Deep Vein Thrombosis (DVT) with healthy controls. The study was carried out with following two groups of 50 patients each: study group       : 50 cases with DVT; control group: 50 healthy controls.Results: The D-Dimer levels was significantly higher in study group as compared to control group (748.44±93.17 vs. 426.06±78.11 ng/ml) and statistically significant as per student t-test (p<0.05). It was observed that total cholesterol (r=0.714; p<0.05), triglyceride (r=0.534; p<0.05), LDL (r=0.662; p<0.05), HDL (r=0.655; p<0.05), homocysteine (r=0.285; p<0.05) and D-dimer (r=0.368; p<0.05) were strongly and directly correlated with DVT.Conclusions: In our study most sensitive test for early diagnosis of DVT is D-dimer as it is considered to be useful as a screening test for DVT in hospitalized patients with acute medical diseases/episodes. D-dimer assay is an important preliminary test to detect deep vein thrombosis in post-operative cases. Its extreme sensitivity and high negative predictive value make it an ideal single test to screen patients suspected of having deep vein thrombosis. A negative test rules out deep vein thrombois and a positive test report needs further investigation for its confirmation. In case of increased lipid profile levels, patients are more prone to develop DVT hence there should be regular screening for DVT.

scholarly journals Thrombectomy Combined with Intravascular Angioplasty for the Treat- ment of Iliac Vein Compression Syndrome and Deep Vein Thrombosis

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Yang Baocai
Keyword(s):  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Control Group ◽  
Study Group ◽  
Vein Thrombosis ◽  
Compression Syndrome ◽  
Iliac Vein Compression ◽  
Iliac Vein Compression Syndrome ◽  
Deep Vein ◽  
Better Than

To investigate the effect of thrombectomy combined with in travascular injection (PTA) on the treatment of iliac vein compression syndrome (IVCS) and deep vein thrombosis (DVT). 50 patients with IVCS and DVT were enrolled in this study from January 2013 to December 2016. They were randomly divided into two groups. The control group was treated with thrombolytic therapy. The study group was treated with thrombus aspiration combined with PTA. The therapeutic effect of the study group was significantly better than that of the control group (P < 0.05).Thrombectomy combined with intravascular stenting for the treatment of iliac vein compression syndrome and deep vein thrombosis is better than the second stage.

scholarly journals Role of Nutritional Supplementation with Vitamin B12 and Folic Acid on Serum Homocysteine Levels of Deep Vein Thrombosis

2018 ◽  
Vol 4 (2) ◽  
pp. 232-235
Author(s):  
Simmi Kharb ◽  
Khandelwal A ◽  
Singh K ◽  
Vashist MG
Keyword(s):  
Deep Vein Thrombosis ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Clinical Features ◽  
Control Group ◽  
Study Group ◽  
Vein Thrombosis ◽  
Serum Homocysteine ◽  
Deep Vein

Deep vein thrombosis is a common vascular disorder and association of Homocysteine with DVT is known. Evidence of decrease B12 and folic acid levels in DVT with Hyperhomocysteinemia has also been reported. Scanty data is available regarding role of folate and vitamin B12 on Homocysteine levels in DVT patients. The present study was undertaken in 100 patients. Study group comprised of 50 patients who had clinical features suggestive of DVT and 50 patients, who did not have clinical features suggestive of any venous or arterial disorder, were labelled as control group. All the patients of study group were given vitamin B12 and folic acid treatment along with standard treatment of DVT. Serum Homocysteine, folate, vitamin B12 were measured in all the patients in both the groups and estimated by chemiluminescence technology. After 12 weeks of vitamin B12 and folic acid therapy, serum Homocysteine levels, folic acid levels and vitamin B12 levels of study group were again estimated. The collected records and data was analysed statistically by Student t-test and Chi-square test. Mean Homocysteine level in study group was significantly higher as compared to control group (19.63 ± 19.14 µmol/mL vs. 7.0 ± 4.94 µmol/mL). Mean Homocysteine levels before treatment were 19.63 ± 19.14 µmol/mL and after treatment they were significantly reduced. Hyperhomocysteinemia is a risk factor for deep vein thrombosis. Folic acid and B12 therapy reduced the level of Homocysteine suggesting that this may decrease the chances of recurrence of DVT.

scholarly journals Safety and efficacy of rivaroxaban compared to standard anticoagulant therapy in the treatment of deep vein thrombosis in Indian population

2021 ◽  
Author(s):  
Anantharaju G. S. ◽  
Basavarajappa M. ◽  
Vikram S. B. ◽  
Ravishankar Y. R.
Keyword(s):  
Deep Vein Thrombosis ◽  
Medical Science ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Research Centre ◽  
Control Group ◽  
Minor Bleeding ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Deep Vein

Background: Pulmonary embolism (PE) is relatively a common cardiovascular complication following acute deep vein thrombosis (DVT). Around 10% of DVT patients exhibit clinical manifestations of PE. Oral drugs with adequate efficacy and safety are preferred over parenteral medications in long term prevention of PE. Our study compared rivaroxaban (factor XA inhibitor) with standard therapy (acetrom) in terms of efficacy and safety in the Indian population.Methods: Patients presenting to department of general surgery at S. S. institute of medical science and research centre during the period from March 2018 to September 2020 with clinical signs and venous duplex study proven acute DVT were included in the study. Total of 64 patients were randomized into rivaroxaban group (N=28) and control group (N=36). Treatment included for rivaroxaban group was rivaroxaban (p/o) 15 mg twice daily for 21 days, followed by 20 mg once daily for 6 months. Treatment included for control group was enoxaparin (SC) overlapping with and followed by acitrom (p/o) for 6 months. The patients were looked for symptomatic recurrent PE and major or minor clinically relevant bleeding.Results: Recurrent vein thrombosis noted in 1 (3.57%) patient of the rivaroxaban group and 4 (11.10%) patients in the control group. Minor bleeding seen in 3 (10.70%) patients in the rivaroxaban group and in 7 (19.40%) patients in the control group. No major bleeding was observed in rivaroxaban group and in 1 patient in the control group.Conclusions: In patients with acute DVT, rivaroxaban is as efficacious as enoxaparin followed by acetram therapy, with a significantly lower rate of bleeding. 

scholarly journals TO ASSESS SAFETY OF WITHHOLDING ANTITHROMBOTIC THERAPY IN PATIENTS WITH LOW OR INTERMEDIATE PROBABILITY OF PULMONARY EMBOLISM

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Archi Mangal ◽  
Mahendra Kumar Arya ◽  
Devendra Kumar Khatana ◽  
Dr. Sheetal Singh
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Antithrombotic Therapy ◽  
Anticoagulation Therapy ◽  
Research Centre ◽  
Age Group ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Background & Method: The study was carried out in the Department of Radio diagnosis, Index Medical College, Hospital & Research Centre, Indore, M.P. including 100 chronic bedridden patients with an aim to assess safety of withholding antithrombotic therapy in patients with low or intermediate probability of pulmonary embolism. Result: Males represented about 62% of the entire sample. Majority of male patients were in age group 50 and above. Majority (29%) of female patients were of age group of 20 to 40 yrs. On the basis of B-mode sonography and colour Doppler 20% patients were diagnosed to have acute deep vein thrombosis and 12 % patients were diagnosed to have chronic deep vein thrombosis. Out of 100 chronic bedridden patients in the study, 40% were suspected to have deep vein thrombosis on the basis of clinical signs,45% had a positive d-dimer test, 28% were positive on impedence plethysmography.  30% patients were diagnosed to have deep vein thrombosis by B mode sonography and 32% were diagnosed to have deep vein thrombosis by colour Doppler. Conclusion: Only 32 patients were positive for deep vein thrombosis out of 100 patients so it is safe to withhold unnecessary anticoagulation therapy in all chronic bed   ridden patients because even after 3 month follow up only 1% patients were positive. Impedence plethysmography is less sensitive than ultrasonography and D-dimer test is more sensitive but it lacks specificity so ultrasound and colour Doppler is more sensitive in clinically suspected DVT patients. Ultrasonography and colour Doppler is better predictor of DVT because it is more sensitive and specific, non-invasive, painless, widely available, easy to use, less expensive, no ionizing radiation. Keywords: antithrombotic, pulmonary &embolism.

Deep Vein Thrombosis and Fibrinolysis

1991 ◽  
Vol 66 (04) ◽  
pp. 426-429 ◽  
Author(s):  
Marcel Levi ◽  
Anthonie W A Lensing ◽  
Harry R Büller ◽  
Paolo Prandoni ◽  
Gerard Dooijewaard ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Tissue Type ◽  
Controlled Study ◽  
First Episode ◽  
Control Group ◽  
Vein Thrombosis ◽  
Type Plasminogen Activator ◽  
Deep Vein

SummaryIn the present study 57 consecutive patients with a first episode of venographically proven deep vein thrombosis were investigated to evaluate the release of tissue-type plasminogen activator (t-PA) and of urokinase-type plasminogen activator (u-PA) in response to DDAVP stimulation as well as the resting plasminogen activator inhibitor (PAI) concentration, comparing this to the results obtained in 66 similar patients with a clinical suspicion of thrombosis but with a normal venogram. All assays were performed without knowledge of the patient's status.Four patients in the deep vein thrombosis-group (7%) had an absent u-PA antigen response upon DDAVP infusion, while a normal response was observed in all control subjects. Patients and controls showed similar increases in t-PA antigen level upon DDAVP. High resting PAI antigen levels were encountered in 5 patients in the deep vein thrombosis-group (9%) and in 6 subjects in the control group (9%).The results from this controlled study indicate that a defective release of u-PA may occur in patients with deep vein thrombosis and may have pathogenetic significance. Furthermore it is concluded that elevation of PAI levels cannot be considered as a specific risk factor for venous thrombosis.

D-Dimers, Thrombin Antithrombin III Complexes and Prothrombin Fragments 1 + 2: Diagnostic value in Clinically Suspected Deep Vein Thrombosis

1991 ◽  
Vol 65 (01) ◽  
pp. 028-032 ◽  
Author(s):  
B Boneu ◽  
G Bes ◽  
H Pelzer ◽  
P Sié ◽  
H Boccalon
Keyword(s):  
Deep Vein Thrombosis ◽  
Antithrombin Iii ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
High Negative Predictive Value ◽  
Deep Vein ◽  
D Dimer ◽  
Mercury Strain Gauge

SummaryThis study was performed to determine the accuracy of D-Dimer fibrin derivatives, thrombin-antithrombin III (TAT) complexes and prothrombin fragments 1 + 2 (F 1 + 2) determinations for the diagnosis of deep vein thrombosis (DVT). One hundred and sixteen consecutive patients referred to the angiology unit of our hospital for a clinically suspected DVT were investigated. They were submitted to mercury strain gauge plethysmography and to ultrasonic duplex scanning examination; in cases of inconclusive results or of proximal DVT (n = 35), an ascending phlebography was performed. After these investigations were completed, the diagnosis of DVT was confirmed in 34 and excluded in 82. One half of the patients were already under anticoagulant therapy at the time of investigation. The 3 biological markers were assayed using commercially available ELISA techniques and the D-Dimer was also assayed with a fast latex method. The normal distribution of these markers was established in 40 healthy blood donors. The most accurate assay for the diagnosis of DVT was the D-Dimer ELISA which had both a high sensitivity (94%) and a high negative predictive value (95%). The D-Dirner latex, TAT complexes and F 1 + 2 were far less sensitive and provided negative predictive values which ranged between 78 and 85%. In spite of positive and significant correlations between the levels of ihe 3 markers, their association did not improve their overall accuracy for detecting D\/L Therefore, with the exception of the D-Dimer ELISA, these markers were of little value for the diagnosis of DVT in this specific population.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Evaluation of a New Rapid Quantitative D-dimer Assay in Patients with Clinically Suspected Deep Vein Thrombosis

1996 ◽  
Vol 75 (03) ◽  
pp. 412-416 ◽  
Author(s):  
Armando D’Angelo ◽  
Gabriella D’Alessandro ◽  
Loredana Tomassini ◽  
Jean Louis Pittet ◽  
G Dupuy ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Predictive Value ◽  
Cost Savings ◽  
Pretest Probability ◽  
First Episode ◽  
Consecutive Series ◽  
Vein Thrombosis ◽  
Baseline Testing ◽  
Deep Vein ◽  
D Dimer

SummaryThe sensitivity and specificity for deep vein thrombosis (DVT) of a new rapid, quantitative and precise (total imprecision < 10%) D-dimer assay suitable for individual measurements (VIDAS D-DIMER, bio-Merieux, France) were evaluated in a consecutive series of 103 in- and out-patients submitted to serial compression ultrasonography (C-US) for the clinical suspicion of DVT (n = 66) or of DVT recurrence (n = 37) and symptoms lasting from 1 to 15 days. DVT was found in 22 patients at baseline testing and no patient with an initially negative C-US developed vein incompressibility at follow up. The time elapsed from the onset of symptoms was negatively associated with D-dimer levels both in patients with and in those without DVT. In the entire series of patients, the sensitivity of a positive D-dimer test (≥1.0 Μg/ml) for the presence of DVT was 96% (21/22 patients, 95% confidence interval 75-100%) with a specificity of 75% (64-84%), a negative predictive value of 98% (90-100%), a positive predictive value of 51% (35-67%), and an overall accuracy of 80% (70-87%). A normal D-dimer value (0.22 Μg/ml) was observed in one patient with DVT and symptoms lasting from 15 days. The approach of withholding C-US testing in patients with symptoms lasting from less than 11 days and D-dimer levels below the cut-off value was compared to serial C-US testing alone in a cost-effectiveness analysis subdividing the 66 patients with a first episode according to their clinical pretest probability of DVT. Thrombosis was detected in 6.7% of the patients in the low probability group (n = 15), 16.7% of the patients in the moderate probability group (n = 24), 51.9% of the patients in the high probability group (n = 27) and 8.1% of patients with suspected DVT recurrence. Calculated cost-savings for each DVT diagnosed ranged from 5% in the high pretest probability group to 55% in the low pretest probability group and to 77% in patients with suspected DVT recurrence.The safety of avoiding C-US testing in symptomatic patients with a negative D-dimer test should be evaluated in clinical management studies.

D-Dimer Test and Diagnosis of Deep Vein Thrombosis: A Comparative Study of 7 Assays

1996 ◽  
Vol 76 (04) ◽  
pp. 518-522 ◽  
Author(s):  
A Elias ◽  
I Aptel ◽  
B Huc ◽  
J J Chale ◽  
F Nguyen ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Latex Agglutination ◽  
Lower Limbs ◽  
First Episode ◽  
Lower Sensitivity ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

SummaryThe current D-Dimer ELISA methods provide high sensitivity and negative predictive value for the diagnosis of deep vein thrombosis but these methods are not suitable for emergency or for individual determination. We have evaluated the performance of 3 newly available fast D-Dimer assays (Vidas D-Di, BioMerieux; Instant IA D-Di, Stago; Nycocard D-Dimer, Nycomed) in comparison with 3 classic ELISA methods (Stago, Organon, Behring) and a Latex agglutination technique (Stago). One-hundred-and-seventy-one patients suspected of presenting a first episode of deep vein thrombosis were investigated. A deep vein thrombosis was detected in 75 patients (43.8%) by ultrasonic duplex scanning of the lower limbs; in 11 of them the thrombi were distal and very limited in size (<2 cm). We compared the performance of the tests by calculating their sensitivity, specificity, positive and negative predictive value for different cut-off levels and by calculating the area under ROC curves. The concordance of the different methods was evaluated by calculating the kappa coefficient. The performances of the 3 classic ELISA and of the Vidas D-Di were comparable and kappa coefficients indicated a good concordance between the results provided by these assays. Their sensitivity slightly declined for detection of the very small thrombi. Instant IA D-Di had a non-significantly lower sensitivity and negative predictive value than the 4 previous assays; however its performance was excellent for out-patients. As expected, the Latex assay had too low a sensitivity and negative predictive value to be recommended. In our hands, Nycocard D-Dimer also exhibited low sensitivity and negative predictive value, which were significantly improved when the plasma samples were tested by the manufacturer. Thus significant progress has been made, allowing clinical studies to be planned to compare the safety and cost-effectiveness of D-Dimer strategy to those of the conventional methods for the diagnosis of venous thrombosis.

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