Deep vein thrombosis in pregnancy

Venous thrombotic events (VTE) prevalence is estimated to be 1-2 for every 10,000 pregnancies, making it one of main causes of maternal mortality in developed countries. VTE’s leading risk factors are history of the condition and hereditary thrombophilia. D-dimer tests conducted during pregnancies have in many cases led to false positive results while a few false negatives have also been found. For pregnant women, it is important for evaluation to begin with compression ultrasound before magnetic resonance imaging, which seeks a negative test and focuses on the pelvis. On the other hand, a chest x-ray should be done for pulmonary embolism, which helps in deciding between a CT pulmonary angiogram and perfusion study for normal and abnormal x-ray, respectively. Generally, treatment is composed of heparin of low molecular weight for at least six weeks after childbirth. Thrombolysis can be significant for life-threatening and serious thrombolysis. For populations at high risk, VTE prophylaxis still faces a lot of uncertainty. In fact, there is still little evidence to support the essence of mechanical prophylaxis for all women who have delivered through cesarean.

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Evaluation of an oral direct anti-Xa anticoagulant, apixaban, for the prevention of venous thromboembolism in patients with myeloma treated with IMiD* compounds: A pilot study (MYELAXAT).

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.8019 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 8019-8019 ◽

Cited By ~ 2

Author(s):

Brigitte Pegourie ◽

Gilles Pernod ◽

Lionel Karlin ◽

Lofti Benboubker ◽

Frederique Orsini ◽

...

Keyword(s):

Venous Thromboembolism ◽

Pilot Study ◽

Meta Analysis ◽

Medical Patients ◽

First Line ◽

Bleeding Events ◽

Vte Prophylaxis ◽

Vein Thrombosis ◽

Compression Ultrasound ◽

Deep Vein

8019 Background: The risk of venous thromboembolism (VTE) is higher in myeloma patients recieving IMiD* compounds (IMiD*: registered). A VTE prophylaxis using low-molecular-weight heparin or aspirin is proposed. Apixaban is an oral direct anti-Xa. Several studies have shown the efficiency and safety of apixaban in VTE prophylaxis compared to enoxaparin. The objective of this prospective pilot study was to assess the risk of VTE and bleeding in patients with myeloma treated with IMiD* compounds, using apixaban in a preventive scheme. Methods: Myeloma patients requiring Melphalan-Prednisone-Thalidomide in first line, or Lenalidomide-Dexamethasone in relapse, asymptomatic regarding VTE at inclusion, were enrolled between 2014 - 2016. All patients recieved apixaban, 2.5 mg x 2/day for 6 months, and were monthly monitored. Venous (pulmonary embolism – PE, or symptomatic proximal or distal deep vein thrombosis - DVT, or all proximal asymptomatic events detected by systematic proximal bilateral compression ultrasound) or arterial thrombotic events, and bleeding events (ISTH 2005) were registered. Based on meta-analysis of Carrier regarding VTE recurrence, and results from the ADOPT study in medical conditions regarding hemorrhages, < 13 symptomatic VTE events, < 3 severe and < 14 clinically relevant non major (CRNM) bleeding were expected on the treatment period. Results: 104 patients were enrolled (mean age 69.8 +/- 7.8yrs), 11 in first line, 93 in relapse. No PE or arterial cardiovascular events were reported. Two venous thrombotic events were registered, i.e an asymptomatic proximal DVT (patient in relapse) and a symptomatic distal DVT, although apixaban was stopped 14 days before, due to Lenalidomide-induced thrombopenia. Only one major and 11 CRNM hemorrhages were reported. Conclusions: Referring to the incidence of thromboembolic events in Carrier’s meta-analysis, and to hemorrhagic events in medical patients recieving apixaban in primary VTE prophylaxis, apixaban used in a preventive scheme seems to be efficient and safe in preventing VTE in myeloma patients treated with IMiD* compounds. Clinical trial information: NCT02066454.

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Olanzapine induced DVT: A Case Report

Journal of Psychiatrists Association of Nepal ◽

10.3126/jpan.v3i1.11351 ◽

2014 ◽

Vol 3 (1) ◽

pp. 41-42 ◽

Cited By ~ 1

Author(s):

N Joshi ◽

PM Singh ◽

M Thapa ◽

S Gautam

Keyword(s):

Atypical Antipsychotics ◽

Familial History ◽

Vein Thrombosis ◽

Psychiatric Setting ◽

Life Threatening ◽

History Of ◽

General Physical ◽

Deep Vein ◽

General Physical Health ◽

Life Threatening Event

Deep Vein Thrombosis (DVT) is a serious life threatening event which might not be paid much attention in Psychiatric setting. In this paper, a case of DVT following the use of Olanzapine is presented. The patient was in good general physical health and had no personal or familial history of DVT. There were no known risk factors for DVT. The patient was not overweight (BMI < 25) but she suffered from DVT after initiating Olanzapine. Conclusion: Risk of DVT exists in patients under treatment with atypical antipsychotics in spite of no pre existing risk factor.DOI: http://dx.doi.org/10.3126/jpan.v3i1.11351 J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 41-42

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Spontaneous retroperitoneal haemorrhage secondary to anticoagulation polypharmacy

BMJ Case Reports ◽

10.1136/bcr-2021-242934 ◽

2021 ◽

Vol 14 (8) ◽

pp. e242934

Author(s):

Mohammed M Uddin ◽

Tanveer Mir ◽

Amir Khalil ◽

Zeenat Bhat ◽

Anita Maria Noronha

Keyword(s):

Management Strategies ◽

Vein Thrombosis ◽

Anticoagulation Agents ◽

Concurrent Use ◽

Life Threatening ◽

History Of ◽

Recurrent Deep Vein Thrombosis ◽

Retroperitoneal Haemorrhage ◽

Deep Vein

Retroperitoneal haemorrhage (RH) is not uncommon in patients with provoking events like trauma. However, spontaneous RH (SRH) is a rare and life-threatening complication described as the development of bleeding into the retroperitoneal cavity, appearing spontaneously and without a preceding history of trauma or other predisposing illness. We are reporting a case of an elderly patient with recurrent deep vein thrombosis who had developed SRH secondary to concurrent use of multiple anticoagulation agents, resulting from poor healthcare follow-up and lack of sufficient medication reconciliation. This article highlights the significance of recognising risk factors for SRH, as well as management strategies through literature review.

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Effect of Punarnavadi Mandoor and Shiva Gutika in Acute Deep Vein Thrombosis - A Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i4.9371 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Wasedar Vishwanath S. ◽

Pusuluri YVSM Krishna ◽

Dani Harshikha

Keyword(s):

Lower Limb ◽

Blood Clot ◽

Acute Case ◽

Vein Thrombosis ◽

Oral Medications ◽

Doppler Study ◽

Brown Discoloration ◽

Left Lower Limb ◽

Life Threatening ◽

Deep Vein

Objectives: To minimise the dose of Anti-platelet drugs and to treat the acute case of DVT through Ayurvedic oral medications. Methods: The present diagnosed case of DVT approached to OPD of KLE BMK Ayurveda Hospital with a complaints of swelling and pain in the calf muscle of the left lower limb associated with reddish brown discoloration in the foot and occasionally nasal and gum bleeding was treated consequently for 5 months with Punarnavadi Mandoor and Shiva Gutika orally. Results: There is significant decrease in the symptoms of DVT and also major changes seen in Venous Colour Doppler study of the left lower limb. Conclusion: Acute DVT is caused by a blood clot in a deep vein and can be life threatening as it may leads to serious complication like pulmonary embolism which can be cured through Ayurvedic oral medications.

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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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Deep vein thrombosis in elderly Hong Kong Chinese with hip fractures detected with compression ultrasound and Doppler imaging: incidence and effect of low molecular weight heparin

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s004020050380 ◽

1999 ◽

Vol 119 (3-4) ◽

pp. 156-158 ◽

Cited By ~ 10

Author(s):

J. Kew ◽

Y. L. Lee ◽

I. C. Davey ◽

S. Y. Ho ◽

K. C. Fung ◽

...

Keyword(s):

Molecular Weight ◽

Deep Vein Thrombosis ◽

Hip Fractures ◽

Low Molecular Weight Heparin ◽

Doppler Imaging ◽

Hong Kong Chinese ◽

Low Molecular Weight ◽

Vein Thrombosis ◽

Compression Ultrasound ◽

Deep Vein

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Mortality rates and risk factors for asymptomatic deep vein thrombosis in medical patients

Thrombosis and Haemostasis ◽

10.1160/th04-05-0323 ◽

2005 ◽

Vol 93 (01) ◽

pp. 76-79 ◽

Cited By ~ 91

Author(s):

Alain Leizorovicz ◽

Alexander Cohen ◽

Alexander Turpie ◽

Carl-Gustav Olsson ◽

Samuel Goldhaber ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Mortality Rates ◽

Hazard Ratio ◽

Group Iii ◽

Vein Thrombosis ◽

Group I ◽

Compression Ultrasound ◽

The Difference ◽

Deep Vein

SummaryThe clinical importance of asymptomatic proximal and distal deep vein thrombosis (DVT) remains uncertain and controversial. The aim of this retrospective,post-hoc analysis was to examine mortality and risk factors for development of proximal DVT in hospitalized patients with acute medical illness who were recruited into a randomized, prospective clinical trial of thromboprophylaxis with dalteparin (PREVENT).We analyzed 1738 patients who had not sustained a symptomatic venous thromboembolic event by Day 21 and who had a complete compression ultrasound of the proximal and distal leg veins on Day 21. We examined the 90-day mortality rates in patients with asymptomatic proximal DVT (Group I, N = 80), asymptomatic distal DVT (Group II, N = 118) or no DVT (Group III, N = 1540).The 90-day mortality rates were 13.75%, 3.39%, and 1.92% for Groups I–III, respectively. The difference in mortality between Group I and Group III was significant (hazard ratio 7.63, 95% CI = 3.8–15.3;p < 0.0001),whereas the difference between Groups II and III did not reach significance (hazard ratio 1.36, 95% CI = 0.41–4.45).The association of asymptomatic proximal DVT with increased mortality remained highly significant after adjusting for differences in baseline demographics and clinical variables. Risk factors significantly associated with the development of proximal DVT included advanced age (p = 0.0005), prior DVT (p = 0.001), and varicose veins (p = 0.04). In conclusion, the high mortality rate in patients with asymptomatic proximal DVT underscores its clinical relevance and supports targeting of asymptomatic proximal DVT as an appropriate endpoint in clinical trials of thromboprophylaxis.

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