Deep Vein
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2021 ◽  
pp. 16-33
A. A. Kulesh ◽  
D. A. Demin ◽  
A. V. Belopasova ◽  
S. A. Mekhryakov ◽  
O. I. Vinogradov ◽  

Cryptogenic stroke (CS) is defined as a subtype of stroke associated with a heterogeneous group of pathogenetic mechanisms that remained undetermined in the course of advanced diagnostic research. One third or fourth of the ischemic strokes is cryptogenic. Paradoxical embolism is considered the important cause of cryptogenic stroke and transient ischaemic attack (TIA) in young patients. It may occur via the following: patent foramen ovale (PFO), atrial septal defect (ASD), and pulmonary arteriovenous malformation (PAVM). When interviewing patients with suspected paradoxical embolism to obtain their health history, a practitioner should consider factors associated with Valsalva maneuvers, deep vein thrombosis/PE or predisposing conditions or situations, as well as symptoms of hereditary hemorrhagic telangiectasia (telangiectasia of the skin and mucous membranes, hemorrhagic syndrome) and pulmonary arteriovenous malformations (PAVMs) (shortness of breath, hemoptysis). If paradoxical embolism is suspected, it is necessary to conduct a stepwise diagnostic search, including transcranial Doppler ultrasound with bubble test, contrast-enhanced transesophageal echocardiography, and CT angiopulmonography. Diagnosis of relevant clinical conditions involves a search of atrial tachyarrhythmias, deep vein thrombosis, and thrombophilia. As the pathogenetic role of ASD and PAVMs in the development of embolic cryptogenic stroke is beyond doubt, the clinical significance of PFO should be determined taking into account several factors, including the presence of deep vein thrombosis/PE, the severity of the right-left shunt, the presence of ASD, the RoPE score, and detection of thrombophilia. The secondary prevention techniques of ischemic stroke or TIA with underlying PFO should be selected on a case-by-case basis, depending on the clinical significance of the anomaly, comorbid pathology, life expectancy of the patient: endovascular occlusion, anticoagulant or antiplatelet therapy. The secondary prevention with underlying ASD and LAVM includes surgical techniques such as endovascular occlusion or open surgery followed by monitoring of their effectiveness.

2021 ◽  
Vol Volume 14 ◽  
pp. 9273-9286
Churong Lin ◽  
Ling Sun ◽  
Qinchang Chen

Bioengineered ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 9668-9677
Jiayi Liu ◽  
Cuiqin Sang ◽  
Zhenyu Zhang ◽  
Ying Jiang ◽  
Shuzhen Wang ◽  

Emanuele Valeriani ◽  
Marcello Di Nisio ◽  
Enrica Porceddu ◽  
Fabiana Agostini ◽  
Roberto Pola ◽  

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Xushu An ◽  
Jinyuan Zhou ◽  
Xuenan Ma ◽  
Bingbing Song

The objective is to explore the application effect of comprehensive nursing intervention in prevention of lower extremity deep vein thrombosis and pulmonary embolism in urological patients undergoing laparoscopic and robot-assisted laparoscopic surgery. From April 2019 to April 2020, 200 patients who received urological laparoscopic surgery and robot-assisted laparoscopic surgery were selected. According to the random number table method, they were divided into control group and observation group, 100 cases in control group and 100 cases in observation group. Patients in control group received routine nursing, while patients in observation group received comprehensive nursing intervention. The skin condition, swelling, pain, and occurrence of deep venous thrombosis and pulmonary embolism of lower extremities in 2 groups were observed. The experimental results showed that the lower limb swelling, lower limb pain, and lower limb deep vein thrombosis in the control group were significantly higher than those in the observation group, but all patients were cured and discharged after taking effective symptomatic treatment and nursing measures in time. In the control group, pulmonary embolism occurred in 3 patients, all of whom died. There was no significant difference in skin changes of lower limbs ( P > 0.05 ), and there were significant differences in other skin changes ( P < 0.05 ). It proved that comprehensive nursing intervention can effectively prevent the formation of lower extremity deep vein thrombosis and pulmonary embolism in urological patients undergoing laparoscopic and robot-assisted laparoscopic surgery with high-risk factors.

Medicines ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 75
Jose Maria Pereira de Godoy ◽  
Gleison Juliano da Silva Russeff ◽  
Carolina Hungaro Costa ◽  
Debora Yuri Sato ◽  
Desirée Franccini Del Frari Silva ◽  

Background: Current evidence points to a state of hypercoagulability (consequence of hyperinflammation) as an important pathogenic mechanism that contributes to the increase in mortality in cases of COVID-19. The aim of the present study was to investigate the influence of deep-vein thrombosis on mortality patient’s infected with SARS-CoV-2. Method: A clinical trial was conducted involving 200 consecutive patients with COVID-19—100 patients who were positive for deep-vein thrombosis (venous Doppler ultrasound) and 100 who were negative for deep-vein thrombosis at a public hospital. Results: The mortality rate was 67% in the group positive for DVT and 31% in the group negative for DVT. Conclusion: Deep-vein thrombosis is associated with an increase in mortality in patients with COVID-19 and failures can occur with conventional prophylaxis for deep-vein thrombosis.

2021 ◽  
Vol 8 (12) ◽  
pp. 3634
Manoj D. Togale ◽  
Pulkit Gupta

Background: Venous thromboembolism which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE) is one of the major cardiovascular causes of death along with myocardial infarction and stroke. DVT is a common problem in non-ambulatory and hospitalized patients. It is a major cause of morbidity and mortality in these patients. Venous thromboembolism mimics other illnesses making its diagnosis difficult. In such circumstances clinical improvement often fails to occur despite standard medical treatment of the concomitant illness.Methods: A prospective cross-sectional study was conducted at tertiary care hospital in which 40 patients with complaint of limb swelling were included. Risk was calculated according to the wells criteria and confirmed with color Doppler of the affected limb.Results: Majority of people were more than 50 years with male preponderance and with history of smoking present. Subjects had leg swelling with edema and calf tenderness. Results were well established in favor of Wells criteria for making diagnosis of DVT. This criterion showed 100% sensitivity with a negative predictive value of 100% and an accuracy of 90%.Conclusions: This criterion can help the clinicians to treat the disease before it takes a violent course and help the patients live a healthy life. The present study was done in a small proportion of patients. It is highly recommended that thorough studies and researches be conducted so that modern medicine can be highly efficacious, with newer techniques and procedures which can be beneficial for the patients.

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