scholarly journals PREVENTION AND TREATMENT OF VENOUS THROMBOSIS AND THROMBOEMBOLISM IN SURGICAL TREATMENT PELVIC NEOPLASMS

2020 ◽  
pp. 74-80
Author(s):  
A. V. Chikin
Keyword(s):  
Surgical Treatment ◽  
Venous Thrombosis ◽  
Vena Cava ◽  
Fold Increase ◽  
Initial State ◽  
Pelvic Neoplasms ◽  
Surgical Interventions ◽  
Vein Thrombosis ◽  
Prevention And Treatment ◽  
Before And After

Summary. Venous thromboembolic complications — a collective concept that combines thrombosis of the saphenous and deep veins, as well as pulmonary thromboembolism. In the clinical practice of a doctor of any specialty, especially surgical, the possibility of timely diagnosis, treatment and preventive measures for deep vein thrombosis and pulmonary embolism are extremely important. Purpose. To study the most informative measures for the prevention and treatment of venous thrombosis and thromboembolism in the surgical treatment of pelvic neoplasms. Materials and methods. The analysis of the results of the examination and treatment of 112 patients observed for tumors of the pelvic organs and tumors of the retroperitoneal space is presented. Results and discussion. When studying the initial state of the hemostasis system in 48 patients, a significant shortening of activated partial thromboplastin time (APTT), a 1.5-fold increase in the concentration of fibrinogen, which indicates activation of the procoagulant link, as well as an increase in platelet aggregation by 20.0 %, were established. Studies of the hemostatic system showed that surgical interventions and injuries contribute to increased hypercoagulation. Conclusions. The most informative methods for determining thrombosis in the system of the inferior vena cava and the optimal examination algorithm are: ultrasonic dynamic angioscanning, determination of the amount of D-dimer, computer, magnetic resonance bolus venography and retrograde ileocavagography. The use of unfractionated and low molecular weight heparins effectively prevents the development of thrombosis and thromboembolism before and after surgery and does not cause bleeding. Nonspecific and specific prophylaxis of venous thrombosis and embolism allowed a 2.8-fold reduction in their number in patients of the main group.

IS IT POSSIBLE TO PREDICT THE EFFICIENCY OF THE FIBRINOLYTIC AND SURGICAL TREATMENT OF DEEP VEIN THROMBOSIS BY ULTRASOUND IMAGING AND DOPPLER ?

1987 ◽  
Author(s):  
A Elias ◽  
J L Bouvier ◽  
G Le Corff ◽  
A Serradimigni
Keyword(s):  
Surgical Treatment ◽  
Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Complete Obstruction ◽  
Complete Occlusion ◽  
Vein Thrombosis ◽  
Floating Thrombus ◽  
Deep Vein ◽  
Total Disappearance

The sucess of the fibrinolytic or surgical treatment of venous thrombosis depends largely on how old the thrombosis is.To study the therapeutic predictibility of the ultrasonographic signs,their pretherapeutic aspects were compared to the results of the fibrinolytic treatment during 3 days or to the anatomic aspects intra-operatively. This prospective study was carried out on 21 patients presenting an isolated venous thrombosis confirmed by venography. 65 involved venous segments from the popliteal to the inferior vena cava were studied.The following are analyzed : 1) The C.W. Doppler signal when there is a complete obstruction of the femoral iliac junction : absence or presence of flow (MEDAS0NICS BF4A 5.3MHZ).2)The morphological and dynamic aspects of the vein, the thrombus and the flow using echographic test (DIASONICS DRF 400. 10-7.5-5MHZ) were retained as predictible signs of sucessfull treatment a hypodens^homogeneous thrombus with major venous dilation (about twice the controlateral vein) where there is a total obstruction, and a free floating thrombus or even “elastic”,soft,compressible when there is a partial obstruction.The opposite signs were interpreted as predicting a therapeutic failure : a dense heterogeneous adherent and hard thrombus.The criteria for thrombolysis efficiency is the total disappearance of the thrombus when there was a partial obstruction,or a recanalization (>50%)where there was a complete occlusion.The ultrasonographic predictible signs compared with the effective results are indicated in the following tables.Ultrasonography enables most cases tne recognition or a “recent” thrombus from an “old” one and allows talcing thus a cal-lated risk. If the evaluation of the echotexture of the thrombus is subjective and technique dependant, and if an objective measurement of the density distribution insight the clot as reported is preferable, a combined study of the other ultrasonographic parameters seems to be essential.

scholarly journals STMO-07 Adverse events related to the glioblastoma surgery and their perioperative management in our hospital

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii10-ii10
Author(s):  
Hideki Kashiwagi ◽  
Shinji Kawabata ◽  
Seigo Kimura ◽  
Ryokichi Yagi ◽  
Naokado Ikeda ◽  
...  
Keyword(s):  
Adverse Events ◽  
Venous Thrombosis ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Epileptic Seizures ◽  
Residual Tumor ◽  
Complete Removal ◽  
Tumor Localization ◽  
Vein Thrombosis ◽  
Before And After

Abstract Background: The standard treatment for glioblastoma is surgical resection following chemoradiation therapy. The rate of removal or the amount of residual tumor has some impact on the prognosis of patients with glioblastoma, but the highly invasive nature of this tumor makes complete removal limited to the contrast-enhanced lesions difficult due to its localization. Furthermore, when postoperative seizures and venous thrombosis are included in surgery-related complications, these perioperative adverse events can cause delays in the initiation of chemoradiotherapy and delay the return to work and home, such as prolonged hospitalization and rehabilitation time. Methods: We retrospectively reviewed the perioperative status of the recent 50 consecutive cases with histologically confirmed as glioblastoma at our hospital, the patient background, tumor localization, and perioperative treatment, and so on. Results: The major perioperative complications were ischemic or hemorrhagic complications, epileptic seizures, venous thrombosis, and pneumonia; CTCAE grade 2 or higher, grade 3 or higher, and grade 4 occurred in about 40%, 20%, and 10%, respectively, with some patients having multiple complications. Discussion: Although there was a tendency for ischemic changes around the cavity of the resection as the resection rate increased, most cases were asymptomatic and it seemed to be acceptable if residual brain function could be preserved. Residual tumors tended to show hemorrhagic changes and epileptic seizures because this is thought to be that the tumor was deliberately left in place to preserve function, based on the localization of the tumor. Postoperative FDP levels were useful in predicting the development of deep vein thrombosis and pulmonary artery thromboembolism. Conclusion: Because glioblastoma has short survival time and patient PS before and after surgery varies greatly depending on tumor localization, it is important to consider risk-benefit strategies for each case and to establish a scheme for a seamless transition from perioperative management to the introduction of postoperative therapy and maintenance therapy.

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

Tumoural portal vein thrombosis

1997 ◽  
Vol 38 (5) ◽  
pp. 655-659
Author(s):  
L. Marti-Bonmati ◽  
E. Lonjedo ◽  
D. Mathieu ◽  
C. Coffin ◽  
C. Poyatos ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Portal Vein ◽  
Imaging Techniques ◽  
Vena Cava ◽  
Tumour Thrombus ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Before And After ◽  
Portal Veins ◽  
Cellular Carcinoma

Purpose: Intrahepatic thrombus is usually associated with either cirrhosis or hepato-cellular carcinoma (HCC). Most HCCs enhance after the administration of MnDPDP (Teslascan). Our objective was to analyze the enhancement characteristics of tumour portal vein thrombi. Material and Methods: Thrombi affecting the main or segmental portal veins (17 cases) and the suprahepatic inferior vena cava (1 case) were retrospectively selected from a series of 128 patients studied with MR imaging before and after the administration of MnDPDP. Enhancement was assessed qualitatively and quantitatively. Results: All tumour thrombi enhanced after MnDPDP administration. The enhancement was more conspicuous in the GRE images. On the quantitative evaluation, the portal thrombus enhancement was greater for GRE images than SE images. Portal thrombi enhanced more than the liver and the HCCs. There was a significant difference between the enhancement of the HCCs and the thrombi with both MR imaging techniques. Conclusion: The greater enhancement of the tumour thrombus associated with the liver and HCC may suggest that other mechanisms, apart from accumulation of the contrast medium within the hepatocytes inside the thrombi, are involved in thrombus enhancement.

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.

Management of Acute Iliofemoral Deep Vein Thrombosis

2018 ◽  
Author(s):  
Albeir Y Mousa
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
External Compression ◽  
Vein Thrombosis ◽  
Surgical Thrombectomy ◽  
Deep Vein

Acute deep venous thrombosis (DVT) of iliofemoral segment is one of the most dreaded presentations of venous thromboembolism, as it can not only compromise the function of the extremity but may also result in pulmonary embolism and even death. There are many causes for acute iliofemoral DVT, including underdiagnosed May-Thurner syndrome, hypercoagulable syndrome, and external compression on iliocaval segment. The available treatment depends on the acuity of the symptoms. Acute iliofemoral DVT can be treated with medical anticoagulation, pharmacomechanical therapy, including thrombolysis or surgical thrombectomy. Chronic iliofemoral occlusion may be treated with recanalization of the occluded segments with angioplasty stenting. This review contains 4 Figures, 4 Tables and 63 references Key Words: acute, angioplasty, deep venous thrombosis, iliofemoral, inferior vena cava, pharmacomechanical therapy, occlusion, stent

Management of Acute Iliofemoral Deep Vein Thrombosis

2018 ◽  
Author(s):  
Albeir Y Mousa
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
External Compression ◽  
Vein Thrombosis ◽  
Surgical Thrombectomy ◽  
Deep Vein

Acute deep venous thrombosis (DVT) of iliofemoral segment is one of the most dreaded presentations of venous thromboembolism, as it can not only compromise the function of the extremity but may also result in pulmonary embolism and even death. There are many causes for acute iliofemoral DVT, including underdiagnosed May-Thurner syndrome, hypercoagulable syndrome, and external compression on iliocaval segment. The available treatment depends on the acuity of the symptoms. Acute iliofemoral DVT can be treated with medical anticoagulation, pharmacomechanical therapy, including thrombolysis or surgical thrombectomy. Chronic iliofemoral occlusion may be treated with recanalization of the occluded segments with angioplasty stenting. This review contains 4 Figures, 4 Tables and 63 references Key Words: acute, angioplasty, deep venous thrombosis, iliofemoral, inferior vena cava, pharmacomechanical therapy, occlusion, stent

scholarly journals Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

2016 ◽  
Vol 62 (2) ◽  
pp. 266-268 ◽  
Author(s):  
Carmen Duicu ◽  
Gabriela Bucur ◽  
Iunius Simu ◽  
Florin Tripon ◽  
Oana Marginean
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vein Thrombosis ◽  
Reduced Frequency ◽  
Angio Ct ◽  
Deep Vein

AbstractCongenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

Prophylactic P-selectin inhibition with PSI-421 promotes resolution of venous thrombosis without anticoagulation

2008 ◽  
Vol 99 (02) ◽  
pp. 343-351 ◽  
Author(s):  
Daniel D. Myers ◽  
Shirley K. Wrobleski ◽  
Paul J. Zajkowski ◽  
Angela E. Hawley ◽  
Patricia W. Bedard ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Vein Wall ◽  
Experimental Animals ◽  
Vein Thrombosis ◽  
Tissue Factor Activity ◽  
Baboon Model ◽  
Subcutaneous Dose ◽  
Molecule Inhibitor ◽  
Prevention And Treatment ◽  
Deep Vein

SummaryP-selectin inhibition has been evaluated as a therapeutic for prevention and treatment of venous thrombosis. In this study, a novel oral small-molecule inhibitor of P-selectin, PSI-421, was evaluated in a baboon model of stasis induced deep vein thrombosis (DVT). Experimental groups included i) primates receiving a single oral dose of 1 mg/kg PSI-421 two days prior and continued six days after thrombosis (n=3); ii) primates receiving a single daily subcutaneous dose of 0.57 mg/kg enoxaparin sodium two days prior and continued six days post thrombosis (n=3); and iii) primates receiving no treatment (n=3).PSI-421 treated primates had greater percent vein reopening and less vein wall inflammation than the enoxaparin and controls at day 6. Microparticle tissue factor activity (MPTFA) was significantly lower in the animals receiving PSI-421 immediately after thrombosis (T+6 hours day 0) suggesting lower potential for thrombogenesis in these animals. PSI-421 also reduced soluble P-selectin levels versus controls at T+6 hours day 0, day 2 and 6. Experimental animals in any group showed no adverse effects on coagulation. This study is the first to demonstrate a reduction in MPTFA associated with vein reopening and reduced vein inflammation due to oral P-selectin inhibition in a baboon model of DVT.

scholarly journals Complete Recovery of Deep Venous Thrombosis From Coombs (+) Thrombotic Thrombocytopenic Purpura: Case Report

2021 ◽  
Author(s):  
Mi Zhou ◽  
Jie Yin
Keyword(s):  
Mortality Rate ◽  
Venous Thrombosis ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Anticoagulation Therapy ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Complete Recovery ◽  
Pulse Therapy ◽  
Thrombocytopenic Purpura ◽  
Vein Thrombosis

Abstract Background: Acute thrombotic thrombocytopenic purpura (TTP) is an aggressive thrombotic microangiopathy that if not treated, can have a 90% mortality rate. Timely, extensive plasma exchange (PEX) has been indicated to reduce the mortality rate to<10%, but its side effects are not well-known. We present here a case of a patient presented with Comb (+) TTP and developed catheter-associated deep vein thrombosis (DVT).Case presentation: A 27-year-young man presented with persistent thrombocytopenia and Coombs positive anemia was firstly diagnosed with Evans syndrome. However, he was refractory to a methylprednisolone pulse therapy with a combination of platelet transfusion and eventually developed microangiopathy of central nerve system. Sever pathogenesis was prevented by PEX. The immediate start of PEX (1500ml/d) induced a complete remission of acquired TTP and disappearance of neurological signs and symptoms. However, external iliac and femoro-popliteal venous thrombosis was diagnosed subsequently, inferior vena cava filter (IVC) filter was immediately planting accompanied with anticoagulation therapy. Meanwhile, PEX session was sustained as well as oral anticoagulant (rivaroxaban). 14 days later, the patient got full recovery.Conclusions: Catheter-related DVT under the setting of TTP should be cautious. It is necessary to start anticoagulation and antiplatelet therapy for thrombosis early, especially in such cases when PLT count > 50×109/L.

Sign in / Sign up

Export Citation Format

Share Document