scholarly journals De preventie van diepe veneuze trombose

1994 ◽  
Vol 13 (2) ◽  
pp. 36-45
Author(s):  
M. Verstraete

It is generally held that the clinical diagnosis of deep vein thrombosis constitutes a gross underestimate of the true incidence of the disease. Most cases of venous thrombosis occur after operation, during pregnancy and the puerperium, during prolonged immobilisation, in obese patients with varicose veins or in patients with solid tumours.

2015 ◽  
Vol 14 (2) ◽  
pp. 139-144
Author(s):  
Alberto Okuhara ◽  
Túlio Pinho Navarro ◽  
Ricardo Jayme Procópio ◽  
José Oyama Moura de Leite

BACKGROUND: There is a knowledge gap with relation to the true incidence of deep vein thrombosis among patients undergoing vascular surgery procedures in Brazil. This study is designed to support the implementation of a surveillance system to control the quality of venous thromboembolism prophylaxis in our country. Investigations in specific institutions have determined the true incidence of deep vein thrombosis and identified risk groups, to enable measures to be taken to ensure adequate prophylaxis and treatment to prevent the condition.OBJECTIVE: To study the incidence of deep venous thrombosis in patients admitted to hospital for non-venous vascular surgery procedures and stratify them into risk groups.METHOD: This was a cross-sectional observational study that evaluated 202 patients from a university hospital vascular surgery clinic between March 2011 and July 2012. The incidence of deep venous thrombosis was determined using vascular ultrasound examinations and the Caprini scale.RESULTS: The mean incidence of deep venous thrombosis in vascular surgery patients was 8.5%. The frequency distribution of patients by venous thromboembolism risk groups was as follows: 8.4% were considered low risk, 17.3% moderate risk, 29.7% high risk and 44.6% were classified as very high risk.CONCLUSION: The incidence of deep venous thrombosis in vascular surgery patients was 8.5%, which is similar to figures reported in the international literature. Most vascular surgery patients were stratified into the high and very high risk for deep venous thrombosis groups.


2016 ◽  
Vol 32 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Huw OB Davies ◽  
Matthew Popplewell ◽  
Rishi Singhal ◽  
Neil Smith ◽  
Andrew W Bradbury

Introduction Lower limb venous disease affects up to one half, and obesity up to one quarter, of the adult population. Many people are therefore affected by, and present to health services for the treatment of both conditions. This article reviews the available evidence of pathophysiological and clinical relationship between obesity and varicose veins, chronic venous insufficiency and ulceration and deep vein thrombosis. Methods A literature search of PubMed and Cochrane libraries was performed in accordance with PRISMA statement from 1946 to 2015, with further article identification from following cited references for articles examining the relationship between obesity and venous disease. Search terms included obesity, overweight, thrombosis, varicose veins, CEAP, chronic venous insufficiency, treatment, endovenous, endothermal, sclerotherapy, bariatric surgery and deep vein thrombosis. Results The proportion of the population suffering from lower limb venous disease and obesity is increasing. Obesity is an important risk factor for all types of lower limb venous disease, and obese patients with lower limb venous disease are more likely to be symptomatic as a result of their lower limb venous disease. The clinical diagnosis, investigation, imaging and treatment of lower limb venous disease in obese people present a number of challenges. The evidence base underpinning medical, surgical and endovenous management of lower limb venous disease in obese people is limited and such treatment may be associated with worse outcomes and increased risks when compared to patients with a normal body mass index. Conclusion Lower limb venous disease and obesity are both increasingly common. As such, phlebologists will be treating ever greater numbers of obese patients with lower limb venous disease, and clinicians in many other specialties are going to be treating a wide range of obesity-related health problems in people with or at risk of lower limb venous disease. Unfortunately, obese people have been specifically excluded from many, if not most, of the pivotal studies. As such, many basic questions remain unanswered and there is an urgent need for research in this challenging and increasingly prevalent patient group.


2011 ◽  
Vol 105 (01) ◽  
pp. 31-39 ◽  
Author(s):  
Celine Genty ◽  
Marie-Antoinette Sevestre ◽  
Dominique Brisot ◽  
Michel Lausecker ◽  
Jean-Luc Gillet ◽  
...  

SummarySuperficial venous thrombosis (SVT) prognosis is debated and its management is highly variable. It was the objective of this study to assess predictive risk factors for concurrent deep-vein thrombosis (DVT) at presentation and for three-month adverse outcome. Using data from the prospective multicentre OPTIMEV study, we analysed SVT predictive factors associated with concurrent DVT and three-month adverse outcome. Out of 788 SVT included, 227 (28.8%) exhibited a concurrent DVT at presentation. Age >75years (odds ratio [OR]=2.9 [1.5–5.9]), active cancer (OR=2.6 [1.3–5.2]), inpatient status (OR=2.3 [1.2–4.4]) and SVT on non-varicose veins (OR=1.8 [1.1–2.7]) were significantly and independently associated with an increased risk of concurrent DVT. 39.4% of SVT on non-varicose veins presented a concurrent DVT. However, varicose vein status did not influence the three-month prognosis as rates of death, symptomatic venous thromboembolic (VTE) recurrence and major bleeding were equivalent in both non-varicose and varicose SVTs (1.4% vs. 1.1%; 3.4% vs. 2.8%; 0.7% vs. 0.3%). Only male gender (OR=3.5 [1.1–11.3]) and inpatient status (OR=4.5 [1.3–15.3]) were independent predictive factors for symptomatic VTE recurrence but the number of events was low (n=15, 3.0%). Three-month numbers of deaths (n=6, 1.2%) and of major bleedings (n=2, 0.4%) were even lower, precluding any relevant interpretation. In conclusion, SVT on non-varicose veins and some classical risk factors for DVT were predictive factors for concurrent DVT at presentation. As SVT remains mostly a clinical diagnosis, these data may help selecting patients deserving an ultrasound examination or needing anticoagulation while waiting for diagnostic tests. Larger studies are needed to evaluate predictive factors for adverse outcome.


Author(s):  
Danielle T Vlazny ◽  
Ahmed K Pasha ◽  
Wiktoria Kuczmik ◽  
Waldemar E Wysokinski ◽  
Matthew Bartlett ◽  
...  

1972 ◽  
Vol 10 (23) ◽  
pp. 89-91

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


1981 ◽  
Author(s):  
J J F Belch ◽  
N McMillan ◽  
G D O Lowe ◽  
C D Forbes

Ruptured Baker’s cyst is a well recognised cause of confusion in the diagnosis of deep vein thrombosis (D.V.T.) in patients with arthralgia. Many workers have stressed the need for a high index of clinical suspicion combined with either venography or arthrography, yet in no study has simultaneous arthrography and venography been performed. Ten patients with joint pains admitted because of a swollen calf underwent bilateral ascending venography and unilateral arthrography within 24 hours of admission. Results were compared with the initial clinical diagnosis. On only one out of 10 occasions was the original clinical diagnosis correct. One patient had a D.V.T. alone, 5 patients had a Baker’s cyst and 3 patients had both D.V.T. and Baker’s cyst. One patient had no evidence of either. We conclude that any patient with a history of joint pain who develops a swollen calf should have both a venogram and an arthrogram performed in order to establish the correct diagnosis.


1981 ◽  
Author(s):  
E Briët ◽  
M J Boekhout-Mussert ◽  
L H van Hulsteijn ◽  
C W Koch ◽  
H W C Loose ◽  
...  

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.


2006 ◽  
Vol 96 (08) ◽  
pp. 149-153 ◽  
Author(s):  
Sang Kim ◽  
Dong Lee ◽  
Choong Kim ◽  
Hyun Moon ◽  
Youngro Byun

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.


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