Deep Vein Thrombosis Associated With COVID-19

The novel coronavirus disease 2019 (COVD-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immunothrombosis could occur during infectionwith viruses. Deep vein thrombosis (DVT) is a devastating condition that usually involves the lower extremities. The typical course of DVT is associated with an episode of enormous limbswelling and pain. In this case report, we aimed to present one of the COVID-19 possible complications: DVT in a 38 years old man infected with SARS-CoV-2. A 38 years old manpresented with leg pain. He had a dry cough and fatigue suspicious symptoms of COVID-19. For further evaluations, the lung Computed Tomography scan (CT-scan), labratoricalassessments, and doppler sonography of the common femoral vein (CFV) of both legs were done. Also, for investigating the other underlying causes of DVT, abdominopelvic CT-scan andlumbosacral Magnetic Resonance Imaging (MRI) were done. The CT-scan showed GroundGlass Opacity (GGO) view. Labratorical assessment proposed a thrombotic condition. Thedoppler sonography of the CFV of both legs revealed a massive thrombosis in the left CFV suggesting an acute DVT. Abdominopelvic CT-scan and lumbosacral MRI were negativefor other underlying causes of DVT. COVID-19 is associated with the classical syndrome named disseminated intravascular coagulation and the subsequent consumption coagulopathypresented as DVT.

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Pharmacomechanical Catheter-Directed Thrombolysis in Acute Femoral–Popliteal Deep Vein Thrombosis: Analysis from a Stratified Randomized Trial

Thrombosis and Haemostasis ◽

10.1055/s-0039-1677795 ◽

2019 ◽

Vol 119 (04) ◽

pp. 633-644 ◽

Cited By ~ 12

Author(s):

Clive Kearon ◽

Chu-Shu Gu ◽

Jim Julian ◽

Samuel Goldhaber ◽

Anthony Comerota ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Femoral Vein ◽

Leg Pain ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Recurrent Venous Thromboembolism ◽

Thrombus Removal ◽

Deep Vein

Background and Objectives The Acute Venous Thrombosis: Thrombus Removal with Adjunctive Catheter-Directed Thrombolysis (ATTRACT) trial reported that pharmacomechanical catheter-directed thrombolysis (PCDT) did not reduce post-thrombotic syndrome (PTS), but reduced moderate-to-severe PTS and the severity of PTS symptoms. In this analysis, we examine the effect of PCDT in patients with femoral–popliteal deep vein thrombosis (DVT) (without involvement of more proximal veins). Patients and Methods Within the ATTRACT trial, 300 patients had DVT involving the femoral vein without involvement of the common femoral or iliac veins and were randomized to receive PCDT with anticoagulation or anticoagulation alone (no PCDT). Patients were followed for 24 months. Results From 6 to 24 months, between the PCDT versus no PCDT arms, there was: no difference in any PTS (Villalta scale ≥ 5: risk ratio [RR] = 0.97; 95% confidence interval [CI], 0.75–1.24); moderate-or-severe PTS (Villalta scale ≥ 10: RR = 0.93; 95% CI, 0.57–1.52); severity of PTS scores; or general or disease-specific quality of life (p > 0.5 for all comparisons). From baseline to both 10 and 30 days, there was no difference in improvement of leg pain or swelling between treatment arms. From baseline to 10 days, major bleeding occurred in three versus none (p = 0.06) and any bleeding occurred in eight versus two (p = 0.032) PCDT versus no PCDT patients. Over 24 months, recurrent venous thromboembolism occurred in 16 PCDT and 12 no PCDT patients (p = 0.24). Conclusion In patients with femoral–popliteal DVT, PCDT did not improve short- or long-term efficacy outcomes, but it increased bleeding. Therefore, PCDT should not be used as initial treatment of femoral–popliteal DVT. (NCT00790335).

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‘Hospice inpatient deep vein thrombosis detection (HIDDen) in advanced non-malignant diseases’: a longitudinal pilot study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2019-002039 ◽

2020 ◽

pp. bmjspcare-2019-002039

Author(s):

Clare White ◽

Simon Noble ◽

Flavia Swan ◽

Max Watson ◽

Victoria Allgar ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Venous Thromboembolism ◽

Malignant Disease ◽

Femoral Vein ◽

Descriptive Analysis ◽

Leg Pain ◽

Cross Sectional ◽

Vein Thrombosis ◽

Deep Vein ◽

Prospective Longitudinal

ObjectivesTo gain preliminary data regarding the prevalence of proximal deep vein thrombosis (DVT) in those with non-malignant conditions admitted to specialist palliative care units (SPCUs).MethodsData were collected as part of a prospective longitudinal observational study in five SPCUs in England, Wales and Northern Ireland (Registration: ISRCTN97567719) to estimate the prevalence of proximal femoral vein DVT in people admitted to SPCUs. The primary outcome for this exploratory substudy was the prevalence of DVT in patients with non-malignant palliative conditions. Consecutive consenting adults underwent bilateral femoral vein ultrasonography within 48 hours of admission. Data were collected on symptoms associated with venous thromboembolism. Patients were ineligible if the estimated prognosis was <5 days. Cross-sectional descriptive analysis was conducted on baseline data and prevalence estimates presented with 95% CIs.Results1390 patients were screened, 28 patients had non-malignant disease and all were recruited. The mean age 68·8 (SD 12·0), range 43–86 years; men 61%; survival mean 86 (SD 108.5) range 1–345 days. No patient had a history of venous thromboembolism. Four (14%) were receiving thromboprophylaxis. Of 22 evaluable scans, 8 (36%, 95% CI: 17% to 59%) showed femoral vein DVT. The level of reported relevant symptoms (leg oedema, leg pain, chest pain and breathlessness) was high irrespective of the presence of DVT.ConclusionsOur exploratory data indicate one in three people admitted to an SPCU with non-malignant disease had a femoral vein DVT. Although definitive conclusions cannot be drawn, these data justify a larger prospective survey.

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Chronic lower extremity deep vein thrombosis associated with femoral vein compression by a lipoma.

American Journal of Roentgenology ◽

10.2214/ajr.172.6.10350325 ◽

1999 ◽

Vol 172 (6) ◽

pp. 1697-1698 ◽

Cited By ~ 5

Author(s):

P S Brady ◽

L D Spence

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Femoral Vein ◽

Vein Thrombosis ◽

Deep Vein

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A murine model of deep vein thrombosis Characterization and validation in transgenic mice

Thrombosis and Haemostasis ◽

10.1160/th05-03-0170 ◽

2005 ◽

Vol 94 (09) ◽

pp. 498-503 ◽

Cited By ~ 25

Author(s):

Linda Szema ◽

Chao-Ying Chen ◽

Jeffrey P. Schwab ◽

Gregory Schmeling ◽

Brian C. Cooley

Keyword(s):

Deep Vein Thrombosis ◽

Murine Model ◽

Femoral Vein ◽

Previous History ◽

Bed Rest ◽

Major Surgery ◽

Vein Thrombosis ◽

Transgenic Lines ◽

History Of ◽

Deep Vein

SummaryDeep vein thrombosis (DVT) occurs with high prevalence in association with a number of risk factors, including major surgery, trauma, obesity, bed rest (>5 days), cancer, a previous history of DVT, and several predisposing prothrombotic mutations. A novel murine model of DVT was developed for applications to preclinical studies of transgenically constructed prothrombotic lines and evaluation of new antithrombotic therapies. A transient direct-current electrical injury was induced in the common femoral vein of adult C57Bl/6 mice. A non-occlusive thrombus grew, peaking in size at 30 min, and regressing by 60 min, as revealed by histomorphometric volume reconstruction of the clot. Pre-heparinization greatly reduced clot formation at 10, 30, and 60 min (p<0.01 versus non-heparinized). Homozygous FactorV Leiden mice (analogous to the clinical FactorV Leiden prothrombotic mutation) on a C57Bl/6 background had clot volumes more than twice those of wild-types at 30 min (0.121±0.018 mm3 vs. 0.052±0.008 mm3, respectively; p<0.01). Scanning electron microscopy revealed a clot surface dominated by fibrin strands, in contrast to arterial thrombi which showed a platelet-dominated structure. This new model of DVT presents a quantifiable approach for evaluating thrombosis-related murine transgenic lines and for comparatively evaluating new pharmacologic approaches for prevention of DVT.

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TCTAP C-223 Catheter-directed Thrombolysis, Iliac and Common Femoral Vein Stenting in May-thurner Syndrome with Refractory Deep Vein Thrombosis

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2016.03.438 ◽

2016 ◽

Vol 67 (16) ◽

pp. S373-S374

Author(s):

Chiung-Ray Lu ◽

Ke Wei Chen

Keyword(s):

Deep Vein Thrombosis ◽

Femoral Vein ◽

Common Femoral Vein ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Deep Vein

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Objective Diagnosis Of Recurrent Deep Vein Thrombosis

10.1055/s-0038-1652466 ◽

1981 ◽

Author(s):

R W Barnes ◽

D G Turley ◽

G D Qureshi ◽

M J Fratkin

Keyword(s):

Deep Vein Thrombosis ◽

Venous Insufficiency ◽

Leg Pain ◽

Venous Obstruction ◽

Vein Thrombosis ◽

Postphlebitic Syndrome ◽

Positive Scan ◽

Recurrent Deep Vein Thrombosis ◽

Diagnostic Sensitivity And Specificity ◽

Deep Vein

Recurrent deep vein thrarbosis must be differentiated from other causes of leg pain, swelling and inflammation, including chronic venous insufficiency or the postphlebitic stasis syndrome. Venous obstruction and/or valvular incompetence was evaluated by Dcppler ultrasound in 229 patients with recurrent leg symptoms following one or more prior episodes of clinical deep vein thrombosis. The diagnostic sensitivity and specificity of the Dcppler technique was 96% and 90%, respectively, in 259 consecutive contrast phlebograms. In a subset of 65 patients with abnormal Dcppler examination, I-125 fibrinogen leg scans were performed prior to institution of anticoagulants in order to establish the diagnosis of recurrent active thrarbosis (positive scan) or inactive postphlebitic disease (negative sca.In the 229 symptomatic patients screened, the Dcppler examination was normal in 87 (38.0%). In 65 patients with abnormal deep veins receiving I-125 fibrinogen, leg scans were positive in 25 (38.5%), suggesting active thrarbosis which was treated by anticoagulants. The remaining 40 patients were treated for the postphlebitic syndrome with leg elevation and elastic support and none developed manife stations of venous thrarboerrbolism.This study suggests that many individuals (38%) with suspected recurrent deep vein thrarbosis have normal leg veins and that the majority (62%) of patients with proven venous abnormalities have inactive (postphlebitic) disease which does not require anti coagulation.

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Advantages of a Sequential Compression Device in Prevention of Deep Vein Thrombosis

10.1055/s-0039-1684785 ◽

1979 ◽

Author(s):

A.N. Nicolaides ◽

J. Fernandas ◽

A.V. Pollock

Keyword(s):

Deep Vein Thrombosis ◽

Femoral Vein ◽

Test Group ◽

Heparin Group ◽

Similar Time ◽

Vein Thrombosis ◽

Compression Device ◽

Fibrinogen Test ◽

Group B ◽

Deep Vein

A sequential compression device (SCD) (6 chambers) compressing the ankle, calf end thigh sequentially at 35, 30 and 20 mm Hg for 12 seconds in every minute produced a 240% increase in peak velocity in the femoral vein. A non-sequential device (NSD) inflated to 25 mm Hg with a similar time cycle produced only an 180% increase in blood velocity.The two devices were tested clinically; 250 surgical patients were randomised to 3 groups scanned with the 125 I-fibrinogen test. Group A: 7 days subcutaneous heparin. Group B: NSD for 24 hours. Group C: SCD for 24 hours. The SCD was found to be as effective as heparin during the period it was used and more effective than NSD in preventing deep vein thrombosis proximal to the calf.

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Associations between injecting illicit drugs into the femoral vein and deep vein thrombosis: A case control study

Drug and Alcohol Review ◽

10.1111/dar.12359 ◽

2015 ◽

Vol 35 (5) ◽

pp. 605-610 ◽

Cited By ~ 7

Author(s):

Nat M. J. Wright ◽

Victoria Allgar ◽

Charlotte N. E. Tompkins

Keyword(s):

Deep Vein Thrombosis ◽

Illicit Drugs ◽

Case Control Study ◽

Femoral Vein ◽

Case Control ◽

Vein Thrombosis ◽

Deep Vein ◽

Control Study

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Deep vein thrombosis in children

Pediatric Reports ◽

10.4081/pr.2013.e12 ◽

2013 ◽

Vol 5 (2) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Kanakkande Aabideen ◽

Michael Ogendele ◽

Ijaz Ahmad ◽

Laweh Amegavie

Keyword(s):

Differential Diagnosis ◽

Deep Vein Thrombosis ◽

Early Diagnosis ◽

Rare Disease ◽

Rare Case ◽

Differential Diagnoses ◽

Leg Pain ◽

Vein Thrombosis ◽

Deep Vein

We describe a rare case of deep vein thrombosis (DVT) in children, highlight the importance of early diagnosis of rare disease with potential complications. In a 5 year old boy presented with persistent leg pain without any obvious cause. Detailed investigation led to diagnosis of DVT. As there are common differential diagnoses for leg pain in children, pediatricians usually have a low index of suspicious of DVT in children. This case highlight that paediatricians must consider DVT in their differential diagnosis when children present with leg pain.

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