Angioplasty-stenting vs Optimal Medical Treatment on Post-thrombotic Syndrome Reduction

Author(s):  
Author(s):  
Hasan Erdem ◽  
Emre Selçuk

Objectives: In this study, we present the treatment outcomes of patients with acute deep venous thrombosis (DVT) associated with congenital agenesis of the inferior vena cava (IVCA). Patients and Methods: In this retrospective study, the clinical findings and follow-up data of patients who were scheduled for an interventional procedure due to acute DVT in 2019-2021 and who were found to have IVCA in venography were analyzed retrospectively. Results: A total of 11 patients with acute DVT associated with IVCA were identified during the study period. Eight of the patients (72.7%) were male. The mean age of the patients was 25.5±6.5 years (16-36 years). Five of the patients were followed up with conservative medical treatment. Endovascular procedure was performed in six patients. At the end of the first year, moderate post-thrombotic syndrome was found in 1 patient and mild post-thrombotic syndrome was detected in 2 patients. Patients who received only medical treatment had a significantly higher Villalta score at the end of the first year than patients who received endovascular treatment (6.6±4.1 and 2.1±1.9, p=0.04). Conclusion: Congenital IVCA is a rare diagnosis that should be kept in mind in young patients with deep venous thrombosis. In these patients, endovascular approach may be effective to prevent postthrombotic syndrome.


2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 24-27
Author(s):  
Roger JMW Rennenberg

Introduction Venous thromboembolism is a frequently occurring phenomenon with a high risk of acute and chronic complications. To prevent these, subjects are treated with surgical options to restore venous blood flow combined with medical treatment or medical treatment alone. Despite great therapeutic advances considerable morbidity still persists. For example, thrombosis of the leg can result in post-thrombotic syndrome, which has a great impact on quality of life. The best management to prevent the post-thrombotic syndrome is a topic of research and debate. In this study, we searched the literature to identify studies that used oral anticoagulants and evaluated their properties for resolution of thrombus and hence prevention of the post-thrombotic syndrome. Methods We searched PubMed, The Cochrane Library, and four international medical journals frequently reporting on venous thromboembolism. Furthermore, we looked at Clinicaltrials.gov for current research on this topic. Results Only three suitable articles were identified. Discussion We found experimental evidence that direct thrombin inhibitors and factor Xa inhibitors have an influence on clot lysis favoring a quicker recanalization compared to warfarin. Future studies investigating these effects in humans are warranted.


1983 ◽  
Vol 14 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Betty U. Watson ◽  
Ronald W. Thompson

The purpose of this study was to evaluate parents' reactions and understanding of diagnostic information from written reports and conferences in a clinic which provides multidisciplinary evaluations for children with speech, learning, language, and hearing problems. Previous studies and anecdotal reports suggested that many parents do not receive appropriate diagnostic information about their children. In the present study questionnaires were mailed to parents who had received reports of evaluations and most of whom had attended hour-long conferences covering the findings. Questionnaires were also sent to professionals who had received reports. Fifty-seven percent of the parents, and 63% of the professionals returned the questionnaires. Ninety percent of the parents indicated that they had understood the results as they were presented in the conference. Ninety-three percent of the professionals and 89% of the parents stated they understood the conclusions of the written reports .Further, 83% of the parents and 80% of the professionals reported that the findings had made a change in the child's educational or medical treatment. The percentage of parents who reported understanding the findings was greater than expected. The specific informing techniques used in this study are discussed.


2005 ◽  
Vol 38 (2) ◽  
pp. 68
Author(s):  
Jane Salodof MACNeil

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Diehm ◽  
Schmidli ◽  
Dai-Do ◽  
Baumgartner

Abdominal aortic aneurysm (AAA) is a potentially fatal condition with risk of rupture increasing as maximum AAA diameter increases. It is agreed upon that open surgical or endovascular treatment is indicated if maximum AAA diameter exceeds 5 to 5.5cm. Continuing aneurysmal degeneration of aortoiliac arteries accounts for significant morbidity, especially in patients undergoing endovascular AAA repair. Purpose of this review is to give an overview of the current evidence of medical treatment of AAA and describe prospects of potential pharmacological approaches towards prevention of aneurysmal degeneration of small AAAs and to highlight possible adjunctive medical treatment approaches after open surgical or endovascular AAA therapy.


VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).


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