scholarly journals Warfarin Induced Necrosis of The Breast: A Case Report

2018 ◽  
pp. 189-191
Author(s):  
Sanaz Zand ◽  
Roghayye Jalili ◽  
Seyed Hasan Emami Razavi ◽  
Massoome Najafi ◽  
Ahmad Kaviani
Keyword(s):  
Breast Tissue ◽  
Rare Complication ◽  
Oral Anticoagulant Therapy ◽  
Left Breast ◽  
Advancement Flap ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Simple Mastectomy ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

Background: Warfarin induced breast necrosis is a rare complication of oral anticoagulant therapy. Although it can be related to protein C, S, and antithrombin III deficiency; the pathogenesis of necrosis is still unknown. Case presentation: We report a case of a 38-year-old woman with extensive left breast necrosis after receiving warfarin for treatment of deep vein thrombosis. Simple mastectomy was performed and the wound was closed secondarily with an abdominal advancement flap. Rivaroxaban was prescribed after discontinuation of warfarin. Conclusion: Although breast necrosis following warfarin usage is uncommon, it should be considered in women presenting with breast symptoms after initiation of warfarin. Early diagnosis and appropriate management are essential to prevent extensive loss of breast tissue.

scholarly journals Warfarin Induced Necrosis of The Breast: A Case Report

2018 ◽  
pp. 187-189
Author(s):  
Sanaz Zand ◽  
Roghayye Jalili ◽  
Seyed Hasan Emami Razavi ◽  
Massoome Najafi ◽  
Ahmad Kaviani
Keyword(s):  
Breast Tissue ◽  
Rare Complication ◽  
Oral Anticoagulant Therapy ◽  
Left Breast ◽  
Advancement Flap ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Simple Mastectomy ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

Background: Warfarin induced breast necrosis is a rare complication of oral anticoagulant therapy. Although it can be related to protein C, S, and antithrombin III deficiency; the pathogenesis of necrosis is still unknown. Case presentation: We report a case of a 38-year-old woman with extensive left breast necrosis after receiving warfarin for treatment of deep vein thrombosis. Simple mastectomy was performed and the wound was closed secondarily with an abdominal advancement flap. Rivaroxaban was prescribed after discontinuation of warfarin. Conclusion: Although breast necrosis following warfarin usage is uncommon, it should be considered in women presenting with breast symptoms after initiation of warfarin. Early diagnosis and appropriate management are essential to prevent extensive loss of breast tissue.

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.

Congenital Antithrombin III Deficiency in 3 Families (7 Affected Members)

1979 ◽  
Author(s):  
J. Conard ◽  
M. Samama ◽  
M. H. Horellou ◽  
B. Cazenave ◽  
P. Griguer ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Antithrombin Iii ◽  
Oral Anticoagulants ◽  
Vena Cava ◽  
Oral Contraception ◽  
Vein Thrombosis ◽  
Heparin Treatment ◽  
At Iii ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

A congenital Antithrombin III (AT III) deficiency affecting 7 members of 3 families is reported.The first throrabo-embolic accidents were observed between the age of 22 and 35 : they were spontaneous or occured after delivery or oral contraception. in one patient, a deep vein thrombosis was observed during heparin treatment. in 2 cases, recurrent pulmonary embolic episodes required vena cava ligation. No thromboembolic accident was observed during oral anticoagulation.AT III was measured by an amidolytic method and by the Mancini method on plasma and serum ; the antithrombin activity was determined on serum by the von Kaulla method. in 7 patients, a decreased AT III was found by all the methods performed. The AT III level was around 50 % in patients treated or not by oral anticoagulants One patient was studied during heparin treatment and then under oral anticoagulants : AT III levels were lower under heparin.

Role of Platelets in Recurrent Deep Vein Thrombosis

1975 ◽  
Author(s):  
K. K. Wu ◽  
R. W. Barnes ◽  
J. C. Hoak
Keyword(s):  
Deep Vein Thrombosis ◽  
Oral Anticoagulant Therapy ◽  
Additional Patient ◽  
Ratio Method ◽  
Vein Thrombosis ◽  
Platelet Survival ◽  
Platelet Aggregate ◽  
Recurrent Deep Vein Thrombosis ◽  
Platelet Aggregates ◽  
Deep Vein

To evaluate the role that platelets play in the pathogenesis of recurrent deep vein thrombosis (DVT), a platelet count ratio method was used for the detection of platelet aggregates and an aggregometric technique was used to measure spontaneous aggregation (SPA) in 27 patients with idiopathic recurrent DVT. Seventeen patients were found to have decreased platelet aggregate ratios (mean 0.63±SEM 0.02) which were significantly lower than those of normals (0.90 ±0.02, p < 0.01). Twelve of the 17 patients had SPA. The mean platelet survival half-time of 5 patients with increased platelet aggregates was 2.9 days±0.49, significantly decreased from that of normals (4.2 ±0.10, p < 0.05). Platelet survival values were normal in patients with normal platelet aggregate ratios. Five patients who failed to improve on oral anticoagulant therapy responded to aspirin and dipyridamole with normalization of platelet aggregates and disappearance of SPA. An additional patient responded to sulfinpyrazone. When the drug was discontinued, pulmonary embolus recurred. These findings suggest that recurrent DVT may involve heterogeneous groups of patients and platelets may play an important pathogenetic role in some of them. The approach to the problem with this panel of 3 tests appears useful in the selection of patients for treatment with antiplatelet agents.

scholarly journals External iliac vein compression and lower-extremity swelling caused by an iliopectineal ganglion: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Kiyokazu Fukui ◽  
Ayumi Kaneuji ◽  
Norio Kawahara
Keyword(s):  
Lower Extremity ◽  
Femoral Vein ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Needle Aspiration ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
External Iliac Vein ◽  
Iliac Vein Compression ◽  
Deep Vein

Abstract Background A hip joint ganglion is a rare cause of lower-extremity swelling. Case presentation We report a case of a Japanese patient with ganglion of the hip with compression of the external iliac/femoral vein that produced signs and symptoms mimicking those of deep vein thrombosis. Conclusions Needle aspiration of the ganglion was performed, and swelling of the lower extremity promptly decreased. At 7.5 years after aspiration, there was no recurrence of swelling of the leg. Although the recurrence rate for ganglions after needle aspiration is high, it is worthwhile trying aspiration first.

scholarly journals Trombosis venosa profunda en cirugías de tobillo y pie. Algoritmo de profilaxis [A prophylaxis algorithm for deep vein thrombosis in ankle and foot surgery]

2019 ◽  
Vol 84 (3) ◽  
pp. 252-259
Author(s):  
Héctor Masaragian ◽  
Fernando Perin ◽  
Hernán Coria ◽  
Luciano Mizdraji ◽  
Nicolás Ameriso ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Rare Complication ◽  
Major Complication ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
Vein Thrombosis ◽  
Ankle Surgery ◽  
Preventive Drug ◽  
Deep Vein ◽  
Trombosis Venosa Profunda

Introducción: La enfermedad tromboembólica es una de las complicaciones serias en la cirugía ortopédica. La tromboprofilaxis para las cirugías de tobillo y pie no está estandarizada, porque la incidencia es baja, según la bibliografía. El objetivo de este estudio es aportar un algoritmo de prevención para la trombosis venosa profunda y una revisión de la bibliografía.Materiales y Métodos: Se llevó a cabo una revisión de las historias clínicas de los pacientes operados entre 2011 y 2017. La muestra estaba integrada por 696 hombres (28,98%) y 1706 mujeres (71,02%), con un promedio de edad de 51 años (rango 20-82). Se realizaron 2402 procedimientos, 575 (23,94%) fueron por patologías traumáticas y 1827 (76,06%), por patologías ortopédicas.Resultados: Nueve pacientes (0,37%) presentaron trombosis venosa profunda y solo dos, tromboembolismo pulmonar (0,08%). Los procedimientos en los que ocurrieron fueron: artroscopia, reparación aguda del tendón de Aquiles, hallux valgus y fractura del 5.° metatarsiano.Conclusiones: Se recomienda un enfoque multimodal para la profilaxis de la trombosis venosa profunda. Esto incluye abordar los factores de riesgo modificables, mediante la profilaxis mecánica, la movilización temprana y la profilaxis química. La heparina de bajo peso molecular es eficaz para reducir la tasa de trombosis venosa profunda y tromboembolismo pulmonar. AbstractIntroduction: Deep vein thrombosis (DVT) is a major complication in orthopedic surgery. According to the literature, thromboprophylaxis in foot and ankle surgery is not a standardized practice due to the low incidence of DVT.Materials and Methods: We reviewed the medical records of surgical patients. Between 2011 and 2017, 1591 surgeries were performed, 6 of them due to symptomatic DVT.Results: The incidence of DVT in major orthopedic surgeries, such as knee and hip, is well documented, but there are only a few reports about its incidence in foot and ankle surgery. It is considered a relatively rare complication in many published studies; thus, preventive drug therapy is not routine practice.Conclusions: A multimodal approach to DVT prophylaxis for high-risk patients is recommended. All risk factors should be addressed, such as mechanical prophylaxis, early mobilization, and the use of chemoprophylaxis. Low molecular weight heparin is effective in reducing the rate of clinically significant DVT and is also likely to reduce the rate of pulmonary embolism.

scholarly journals The breast necrosis caused by oral anticoagulant therapy

2020 ◽  
Vol 148 (5-6) ◽  
pp. 372-375
Author(s):  
Aleksandar Guzijan ◽  
Radoslav Gajanin ◽  
Bozana Babic ◽  
Vesna Gajanin ◽  
Bojan Jovanic
Keyword(s):  
Anticoagulant Therapy ◽  
Breast Tissue ◽  
Oral Anticoagulant Therapy ◽  
Pectoral Muscle ◽  
Left Breast ◽  
Limited Mobility ◽  
Small Vessels ◽  
The Right ◽  
Two Stages ◽  
First Time

Introduction. Described in 1943 for the first time, breast necrosis during anticoagulant therapy is only rarely encountered in clinical practice. The objective of the article is to describe a patient who underwent anticoagulant therapy and developed breast necrosis during it. Case outline. A 57-year-old female patient was admitted to hospital with pain in her left breast, which upon examination showed to be erythematous, swelled, and hard. She had started experiencing the symptoms a few days earlier, and denied having had a fever. Over the previous four weeks she had received anticoagulant treatment (acenocoumarol) as popliteal embolectomy prophylaxis. The breast was firm, edematous, of limited mobility, and with no pectoral muscle infiltration. The breast ultrasound showed a homogeneous mass, with no signs of fluid retention or suspicious lesions. Upon admission, the patient began receiving intravenous antibiotic treatment and underwent blood tests. The second day upon admission, the patient?s breast revealed a clearly demarcated area of necrotic skin. Surgical treatment was indicated. The surgery was performed in two stages, the first of which included a partial resection of the necrotic breast tissue, and the second simplex mastectomy. Histological analysis showed severe superficial necrosis, with underlying diffuse deep venous thrombosis and marked arteritis of medium and small vessels. Focal areas of extensive necrosis were found deep in the breast parenchyma. Conclusion. Considering that breast necrosis is extremely rare, it is usually not suspected initially. Learning about the patient?s undergoing anticoagulant therapy is of crucial importance for reaching the right diagnosis. Breast abscesses should also be ruled out. Surgery is the treatment of choice, as changes to the breast tissue are usually irreversible.

The Significance of the Chronic Anticoagulant Treatment in Recurrent Thromboembolic Caused by Hereditary Antithrombin III Deficiency

1975 ◽  
Author(s):  
I. Nagy ◽  
H. Losonczy
Keyword(s):  
Functional Activity ◽  
Antithrombin Iii ◽  
Young Patients ◽  
The Other ◽  
Anticoagulant Treatment ◽  
Vein Thrombosis ◽  
Modified Method ◽  
Recurrent Venous Thromboembolism ◽  
Antithrombin Iii Deficiency ◽  
Deep Vein

It has been known since the publication of Egeberg (1965, 1970) and Marciniak (1974) that herditary antithrombin III deficiency could be the cause of recurrent venous thromboembolism.The authors observed in 5 cases of severe repeated venous thrombosis in young patients an antithrombin III decrease, which proved to be a hereditary abnormality. In the case of a 15 years old girl the late introduced anticoagulant treatment could not save the life of the patient, she died after repeated deep vein thrombosis. In the other cases the long-lasting anticoagulant treatment resulted in a perfect clinical improve, while the behaviour of antithrombin III was different; in some cases its quantity (determined by radial -immunodiffusion) and functional activity (examined by modified method of Gerendás and Rák) remained decreased, while in the other cases its functional activity increased during the anticoagulant treatment as it was found by Marciniak, too.It is most likely, that there are two types of hereditary antithrombin III decrease; in one of them the quantitative and functional decrease goes parallel, in the other there is mainly a functional decrease, which improves during the chronic anticoagulant treatment. The authors demonstrated the significance of the prolonged anticoagulant treatment in the patients with hereditary antithrombin III decrease.

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