scholarly journals Use of Rivaroxaban for Prophylaxis of Superficial Venous Thrombosis in Klippel-Trenaunay-Weber Syndrome

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Hina Qamar ◽  
Cynthia Wu
Keyword(s):  
Venous Thrombosis ◽  
Young Male ◽  
Tissue Growth ◽  
Treatment Modalities ◽  
Vein Thrombosis ◽  
Tissus Mous ◽  
Weber Syndrome ◽  
Vaisseaux Lymphatiques ◽  
Thrombose Veineuse ◽  
Deep Vein

Klippel-Trenaunay-Weber syndrome (KTWS) is a congenital malformation syndrome involving blood and lymph vessels and disturbed bone and soft tissue growth. Complications of KTWS include deep-vein thrombosis, pulmonary embolism, gastrointestinal bleeding, and vascular (usually lymphatic) blebs within capillary malformations. We present a case of a young male patient with KTWS who presented with superficial venous thrombosis and microangiopathic hemolytic anemia in a presentation similar to disseminated intravascular coagulation. He was ultimately maintained on prophylactic rivaroxaban to prevent recurrent thrombotic events. We performed a literature search to identify similar cases and to summarize common presenting features and treatment modalities that were offered. Résumé Le syndrome de Klippel-Trenaunay-Weber (KTWS) est un syndrome de malformation congénitale impliquant le sang et les vaisseaux lymphatiques et les os perturbés et la croissance des tissus mous. Les complications de la KTWS comprennent la thrombose veineuse profonde, l'embolie pulmonaire, les saignements gastro-intestinaux et les bulles vasculaires (habituellement lymphatiques) dans les malformations capillaires. Nous présentons un cas d'un jeune patient mâle avec KTWS qui a présenté une thrombose veineuse superficielle et une anémie hémolytique microangiopathique dans une présentation semblable à la coagulation intravasculaire disséminée. Il a finalement été maintenu sur des rivaroxaban prophylactiques pour prévenir les épisodes récurrents de purpura. Nous avons effectué une recherche documentaire pour identifier des cas similaires et pour résumer les caractéristiques communes de présentation et les modalités de traitement qui ont été offerts.    

Treatment of Venous Thromboembolism

1999 ◽  
Vol 82 (08) ◽  
pp. 870-877 ◽  
Author(s):  
Shannon Bates ◽  
Jack Hirsh
Keyword(s):  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Clinical Problem ◽  
Treatment Modalities ◽  
Recurrent Thrombosis ◽  
Vein Thrombosis ◽  
Rate Of Dissolution ◽  
Recurrent Venous Thrombosis ◽  
Deep Vein ◽  
Common Clinical Problem

IntroductionVenous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common clinical problem. If untreated or inadequately treated, there is a high risk of fatal PE1 and recurrent venous thrombosis.2-4 The objectives of treatment are to prevent local extension of thrombus, embolization, and recurrent thrombosis.It is now widely accepted that VTE is a single disorder and, therefore, the treatment of venous thrombosis and PE is essentially the same. Four treatment modalities are available. Anticoagulant therapy prevents the growth of an existing thrombus or embolus, thrombolytic therapy accelerates the rate of dissolution of thrombi or emboli, caval interruption intercepts venous thrombi that break off and embolize, thereby preventing dangerous PE, and surgical therapy removes thrombi or emboli.

Outcome of Anticoagulation in Isolated Distal Deep Vein Thrombosis Compared to Proximal Deep Venous Thrombosis

2021 ◽  
Author(s):  
Danielle T Vlazny ◽  
Ahmed K Pasha ◽  
Wiktoria Kuczmik ◽  
Waldemar E Wysokinski ◽  
Matthew Bartlett ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Vein Thrombosis ◽  
Distal Deep Vein Thrombosis ◽  
Deep Vein

Low-dose subcutaneous heparin in prevention of deep-vein thrombosis

1972 ◽  
Vol 10 (23) ◽  
pp. 89-91
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Low Dose ◽  
Fatal Pulmonary Embolism ◽  
Vein Thrombosis ◽  
Subcutaneous Heparin ◽  
Prevention And Treatment ◽  
Deep Vein ◽  
Low Dosage

Earlier this year1 we discussed the prevention and treatment of venous thrombosis and concluded that heparin in low dosage seemed the most promising drug for preventing deep-vein thrombosis postoperatively, although the optimum regimen was not yet known. Sharnoff and his associates who began this work 10 years ago claim to have shown that this treatment largely prevents fatal pulmonary embolism.2

Venous Thromboembolism

2020 ◽  
Author(s):  
Samuel Z. Goldhaber
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Antithrombotic Agents ◽  
Vein Thrombosis ◽  
Recurrent Venous Thrombosis ◽  
Deep Vein ◽  
D Dimer ◽  
In Pregnancy

Venous thromboembolism, which involves venous thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in hospitalized patients and is being seen with increasing frequency in outpatients. This chapter discusses the risk factors, etiology, classification, pathophysiology, natural history, prognosis, diagnosis (including venous thrombosis, recurrent venous thrombosis, and pulmonary embolism), prophylaxis, and treatment of venous thromboembolism (including the pharmacology of antithrombotic agents), as well as venous thromboembolism in pregnancy and miscellaneous thromboembolic disorders (including thrombosis of unusual sites).  This review contains 8 figures, 16 tables, and 79 references. Keywords: Venous thromboembolism, pulmonary embolism, deep vein thrombosis, embolectomy, thrombolysis, hypercoagulability, duplex ultrasonography, D-dimer, anticoagulation

The Clinical Diagnosis Of Deep Venous Thrombosis

1981 ◽  
Author(s):  
E Briët ◽  
M J Boekhout-Mussert ◽  
L H van Hulsteijn ◽  
C W Koch ◽  
H W C Loose ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Doppler Ultrasound ◽  
Clinical Examination ◽  
False Positive ◽  
False Negative ◽  
Diagnostic Strategies ◽  
Vein Thrombosis ◽  
Deep Vein

Fifty-three patients were examined because of suspected deep venous thrombosis, by means of clinical examination, Doppler ultrasound and venography. Eighty-two legs were examined with all three methods. Venography was positive in 40 and normal in 42. The clinical examination was false positive in 4 legs and false negative in 6. The Doppler ultrasound studies gave false positive results in 3 legs and false negative results in 6. These results are better than those reported in the literature probably because the thrombosis extended to the popliteal vein or the more proximal veins in 38 of the 40 legs with deep vein thrombosis. This high percentage of upper leg vein thrombosis can be explained by the fact that 47 of the 53 patients were ambulant when they developed the signs and symptoms of thrombosis. It is concluded, that the clinical examination and Doppler ultrasonography can be used to diagnose deep vein thrombosis in ambulant patients in our clinic. We presume that the findings reported in the literature cannot be used indiscriminately as a basis for diagnostic strategies in other hospitals because of widely varying categories of patients, referral patterns and diagnostic criteria that are virtually impossible to standardize.

Venous Thrombo-Embolism in Childhood

1975 ◽  
Author(s):  
I. M. G. Macintyre ◽  
D. R. B. Jones ◽  
G. V. Ruckley
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Umbilical Vein ◽  
Correct Diagnosis ◽  
Renal Vein Thrombosis ◽  
Axillary Vein ◽  
Vein Thrombosis ◽  
Axillary Vein Thrombosis ◽  
Atrial Shunt ◽  
Deep Vein

Venous thrombo-embolism has been considered to be rare in infancy and childhood. Hospital in-patient statistics in Scotland over a 4-year period were examined. Forty-nine patients aged 15 years or less had been coded as venous thrombosis. After computer and clinical errors had been removed 36 cases remained. Renal vein thrombosis accounted for 12 of these, caval thrombosis following ventriculo-atrial shunt 4, cerebral thrombophlebitis 3, umbilical vein thrombosis 2, pulmonary thrombosis in infancy 2, axillary vein thrombosis 2 and jugular venous thrombosis 1. There were 10 cases of deep vein thrombosis of the lower limb and a clinical study of these is the subject of this paper. Two patients also had pulmonary embolism and two others developed chronic venous insufficiency. Children at high risk are those with sepsis or trauma. Venous thrombosis may simulate osteomyelitis and pulmonary embolism may be misdiagnosed as bronchopneumonia. Clinicians must be aware of the possibility of thrombo-embolism in childhood if correct diagnosis and treatment is to be instituted.

scholarly journals Venous Thrombosis in Acquired Hemophilia: The Complex Management of Competing Pathologies

TH Open ◽  
2019 ◽  
Vol 03 (04) ◽  
pp. e325-e330 ◽  
Author(s):  
Manu Chhabra ◽  
Zhen Wan Stephanie Hii ◽  
Joseph Rajendran ◽  
Kuperan Ponnudurai ◽  
Bingwen Eugene Fan
Keyword(s):  
Venous Thrombosis ◽  
Vena Cava ◽  
Cost Effective ◽  
Major Surgery ◽  
High Dose ◽  
Acquired Hemophilia ◽  
Vein Thrombosis ◽  
Associated Conditions ◽  
Activated Prothrombin Complex Concentrates ◽  
Deep Vein

Abstract Introduction Venous thrombosis is rare in the setting of factor VIII (FVIII) deficiency. Cases of deep vein thrombosis (DVT) have been described in hemophiliacs after recent major surgery, or in association with the administration of FVIII concentrate and activated prothrombin complex concentrates, but occurrence of spontaneous DVT is even more uncommon. Aim We describe the challenging management of extensive DVT in a patient with acquired hemophilia A with concurrent hemorrhagic manifestations and review similar published cases. Methods We summarize a series of 10 cases with the following demographics: 6 males and 4 females; median age at presentation of 65 (21–80); mean inhibitor titer of 68.5 Bethesda Units (BU 1.9 to BU 350). Results Four cases were idiopathic and six had associated conditions (cancer [two cases], recent pregnancy [two cases], and recent surgery [two cases]). Three cases had an inferior vena cava filter inserted for acute lower limb DVT/pulmonary embolism. Inhibitor eradication was achieved with high-dose steroids with or without cyclophosphamide, and adjunct Rituximab administration was used in three cases. One patient received concurrent therapeutic plasma exchange (TPE). Inhibitor eradication was fastest with concurrent TPE at 6 days (range: 6–733 days). The 30-day survival was 90%. Conclusions There was adequate response of inhibitors to immunosuppression with steroids and cyclophosphamide therapy. For more refractory disease, Rituximab is emerging as a beneficial and cost-effective adjunct with better rates of complete remission, and the threshold for its use may be lowered in this complex cohort with dual competing pathologies.

Prevention effect of orally active heparin derivative on deep vein thrombosis

2006 ◽  
Vol 96 (08) ◽  
pp. 149-153 ◽  
Author(s):  
Sang Kim ◽  
Dong Lee ◽  
Choong Kim ◽  
Hyun Moon ◽  
Youngro Byun
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Thrombus Formation ◽  
Sprague Dawley ◽  
Vein Thrombosis ◽  
Sprague Dawley Rats ◽  
Acid Conjugate ◽  
Deep Vein ◽  
Orally Active

SummaryThe use of heparin as the most potent anticoagulant for the prevention of deep vein thrombosis and pulmonary embolism is nevertheless limited, because it is available to patients only by parenteral administration. Toward overcoming this limitation in the use of heparin, we have previously developed an orally active heparin-deoxycholic acid conjugate (LMWH-DOCA) in 10% DMSO formulation. The present study evaluates the anti-thrombogenic effect of this orally active LMWH-DOCA using a venous thrombosis animal model with Sprague-Dawley rats. When 5 mg/kg of LMWH-DOCA was orally administered in rats, the maximum anti-FXa activity in plasma was 0. 35 ± 0. 02, and anti-FXa activity in plasma was maintained above 0. 1 IU/ml [the minimum effective anti-FXa activity for the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE)] for five hours. LMWH-DOCA (5 mg/kg, 430 IU/kg) that was orally administered reduced the thrombus formation by 56. 3 ± 19. 8%;on the other hand, subcutaneously administered enoxaparin (100 IU/kg) reduced the thrombus formation by 36. 4 ± 14. 5%. Also, LMWH-DOCA was effectively neutralized by protamine that was used as an antidote. Therefore, orally active LMWH-DOCA could be proposed as a new drug that is effective for the longterm prevention of DVT and PE.

scholarly journals Current Challenges in Diagnosis of Venous Thromboembolism

2020 ◽  
Vol 9 (11) ◽  
pp. 3509
Author(s):  
Zachary Liederman ◽  
Noel Chan ◽  
Vinai Bhagirath
Keyword(s):  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Cost Effective ◽  
Diagnostic Approach ◽  
Medical Patients ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Risk Patients ◽  
Diagnostic Framework ◽  
Deep Vein

In patients with suspected venous thromboembolism, the goal is to accurately and rapidly identify those with and without thrombosis. Failure to diagnose venous thromboembolism (VTE) can lead to fatal pulmonary embolism (PE), and unnecessary anticoagulation can cause avoidable bleeding. The adoption of a structured approach to VTE diagnosis, that includes clinical prediction rules, D-dimer testing and non-invasive imaging modalities, has enabled rapid, cost-effective and accurate VTE diagnosis, but problems still persist. First, with increased reliance on imaging and widespread use of sensitive multidetector computed tomography (CT) scanners, there is a potential for overdiagnosis of VTE. Second, the optimal strategy for diagnosing recurrent leg deep venous thrombosis remains unclear as is that for venous thrombosis at unusual sites. Third, the conventional diagnostic approach is inefficient in that it is unable to exclude VTE in high-risk patients. In this review, we outline pragmatic approaches for the clinician faced with difficult VTE diagnostic cases. In addition to discussing the principles of the current diagnostic framework, we explore the diagnostic approach to recurrent VTE, isolated distal deep-vein thrombosis (DVT), pregnancy associated VTE, subsegmental PE, and VTE diagnosis in complex medical patients (including those with impaired renal function).

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