scholarly journals Predictors of recurrence of venous thromboembolic disease after discontinuing of anticoagulation: a prospective cohort study

Medwave ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. e002068-e002068
Author(s):  
María Lourdes Posadas-Martínez ◽  
Felipe Torres Gómez ◽  
Daniela Mezzarobba ◽  
Natalia Schutz ◽  
Jesica Ruberto ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Vena Cava ◽  
Thromboembolic Disease ◽  
First Episode ◽  
Venous Thromboembolic Disease ◽  
Anticoagulation Treatment ◽  
Venous Thromboembolic ◽  
One Year ◽  
D Dimer

Objective We aim to evaluate factors associated with the recurrence of thromboembolic episodes among patients with a first episode of venous thromboembolic disease during anticoagulation treatment and at least one year after treatment suspension. Methods A prospective cohort of patients with a first episode of deep vein thrombosis confirmed by Doppler ultrasound and initiated anticoagulation treatment. Participants were registered in the Institutional Registry of Thromboembolic Disease between June 2015 and March 2019. Patients with cancer, with permanent inferior vena cava filter implant, and those who refused to participate or did not provide informed consent were excluded. All patients were evaluated within treatment at 30 days and at least one year after the suspension of anticoagulation with a D-dimer study and an ultrasound. All patients were evaluated for recurrence, bleeding (major and minor), and death. Results A total of 304 patients were recruited during the study period. Seventy-three percent were female, and the median age was 80 years. The rate of recurrence rate during anticoagulation treatment was 5% (N = 16/303; 95% confidence interval: 3 to 8), and 5% during post-suspension follow-up (N = 11/202; 95%CI: 3 to 9). The overall bleeding rate was 13% (N = 39; 95%CI: 9 to 17), and 5% for major bleeding. Patients who recurred had higher basal D-dimer mean, higher neutrophils and monocytes, and a higher prevalence of age-adjusted D-dimer ratio greater than 0.5 before discontinuation. In addition, they more frequently had complete leg involvement by ultrasound and received a shorter treatment. Conclusions Although some baseline and pre-suspension parameters had a higher recurrence incidence, statistical significance was not reached, probably due to small statistical power and a short-term follow-up.

Contribution of a New, Rapid, Individual and Quantitative Automated D-Dimer ELISA to Exclude Pulmonary Embolism

1996 ◽  
Vol 75 (01) ◽  
pp. 011-013 ◽  
Author(s):  
Philippe de Moerloose ◽  
Sylvie Desmarais ◽  
Henri Bounameaux ◽  
Guido Reber ◽  
Arnaud Perrier ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Single Dose ◽  
Predictive Value ◽  
Quantitative Measurement ◽  
Thromboembolic Disease ◽  
Venous Thromboembolic Disease ◽  
Venous Thromboembolic ◽  
A Prospective Study ◽  
D Dimer

SummaryThe performance of a new automated ELISA for a rapid, individual and quantitative measurement of plasma D-dimer (VIDAS D-dimer) has been evaluated. First, a study of 100 patients was performed in order to choose the best couple of antibodies in comparison with an already clinically validated ELISA. Then the results were certified in a prospective study including 195 consecutive patients suspected of pulmonary embolism (PE). For a cut-off level of 500 ng/ml VIDAS D-dimer showed a sensitivity of 100% (95% confidence interval 92-100), a specificity of 37.6%, a negative predictive value of 100% (95% CI 93.3-100) and a positive predictive value of 33.1%. During a 6 months’ follow-up no patient (95% CI 0-6.4) with D-dimer <500 ng/ml presented a new suspicion of venous thromboembolic disease. These results suggest that this rapid and single-dose ELISA provides a very useful tool for the clinician to exclude on a day-to-day basis the diagnosis of PE.

Vena caval filters: a comprehensive review

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3669-3677 ◽  
Author(s):  
Michael B. Streiff
Keyword(s):  
Insertion Site ◽  
Vena Cava ◽  
Case Series ◽  
Thromboembolic Disease ◽  
Therapeutic Modality ◽  
Primary Therapy ◽  
Venous Thromboembolic Disease ◽  
Filter Placement ◽  
Comprehensive Review ◽  
Venous Thromboembolic

Hematologists are often asked to treat patients with venous thromboembolic disease. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. To assess the evidence supporting the utility of these devices, a comprehensive review of the English language literature was performed. Except for one randomized trial, the vena caval filter literature consists of case series or consecutive case series. The mean duration of follow-up for each of the 5 filter types varies from 6 to 18 months. All are about equally effective in the prevention of pulmonary embolism (2.6%-3.8%). Deep venous thrombosis (6%-32%) and inferior vena cava thrombosis (3.6%-11.2%) after filter placement vary widely among different filter types primarily because of differences in outcome assessment. Thrombosis at the insertion site is a common complication of filter placement (23%-36%). In view of the absence of randomized comparisons, no filter can be designated as superior in safety or efficacy. Vena caval filters represent a potentially important but poorly evaluated therapeutic modality in the prevention of pulmonary emboli. Randomized trials are necessary to establish the appropriate place for vena caval filters in the treatment of venous thromboembolic disease.

scholarly journals Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort

2013 ◽  
Vol 11 (1) ◽  
pp. 16 ◽  
Author(s):  
Fernando Vázquez ◽  
María Posadas-Martínez ◽  
Jimena Vicens ◽  
Fernán González Bernaldo de Quirós ◽  
Diego Giunta
Keyword(s):  
Medical Care ◽  
Incidence Rate ◽  
Prospective Cohort ◽  
Buenos Aires ◽  
Care Program ◽  
Thromboembolic Disease ◽  
Venous Thromboembolic Disease ◽  
Venous Thromboembolic

Use of the Bedside-Placed Angel Catheter IVC Filter for Venous Thromboembolic Disease in Critically Ill Medical Patients

2019 ◽  
Vol 35 (3) ◽  
pp. 225-232
Author(s):  
Yuri Matusov ◽  
Aaron S. Weinberg ◽  
Richard Liang ◽  
Joseph Meza ◽  
Oren Friedman ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Vena Cava ◽  
Case Series ◽  
Thromboembolic Disease ◽  
Clinical Consequence ◽  
Ivc Filter ◽  
Venous Thromboembolic Disease ◽  
Medical Patients ◽  
Venous Thromboembolic

Venous thromboembolic disease is a major problem among critically ill patients, with significant associated morbidity and mortality. Many critically ill patients have contraindications to systemic anticoagulation, and inferior vena cava (IVC) filters are an important alternative in preventing pulmonary emboli (PE) in this population. The Angel Catheter (Mermaid, Stenlose, Denmark) is a novel percutaneous and removable IVC filter attached to the end of a triple lumen central venous catheter which has been demonstrated to reduce PE in surgical and trauma patients. This case series describes 18 critically ill medical patients who had an Angel catheter placed either for diagnosed PE or due to high risk for PE; over half had at least submassive PE at the time of Angel catheter placement. None of the patients had a recurrence of PE during Angel catheter use, 29.4% had clot found in the filter via cavogram upon removal, and only one had a minor complication which had no clinical consequence. In 2 patients, the placement of the Angel Catheter resulted in the prevention of PE during catheter-directed thrombolysis of extensive deep vein thrombosis. This case series demonstrates that in a population of critically ill, elderly, and obese medical patients the bedside placement of the Angel IVC filter is feasible, safe, and may be effective for preventing PE.

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