scholarly journals AB0778 VENOUS THROMBOSIS IN UNUSUAL SITES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1415.3-1415
Author(s):  
A. Fraj ◽  
O. Berriche ◽  
S. Arfa ◽  
O. Jomaa ◽  
W. Romdhane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Vena Cava ◽  
Heparin Therapy ◽  
Lower Limbs ◽  
University Hospital ◽  
Duration Of Treatment ◽  
Unusual Site ◽  
Surgical Interventions ◽  
Hemorrhagic Event

Background:Unusual site venous thrombosis (USVT), which includes venous thromboses of the upper limbs, digestive tract, cellar and brain, are rarely observed compared to those of the lower limbs and require both an etiological approach and a rigorous management.Objectives:Our objective is to identify the epidemiological, clinical, therapeutic and evolutionary characteristics of USVT.Methods:Retrospective study including 33 patients files with USVT followed in The Internal Medicine Departments at Tahar Sfar University Hospital Mahdia TUNISIA over a period of 10 years.Results:They were 21 females (63.6 %) and 12 males (36.4%) with an average age of 45.2 ± 18 years. Cerebral venous thrombosis was the most frequent localization identified in 10 patients (30.3%), followed by gastrointestinal thrombosis in 9 cases (27.3%), vena cava thrombosis in 9 cases (27.3%) and upper limb thrombosis in 5 cases (15.2%). The risk factors were respectively: age (42.4%), obesity (42.4%), smoking (30%), prolonged downtime (24.2%), surgical interventions (6.1%) and pregnancy (3%). An etiology was identified in 21 patients (66.6%), dominated by constitutional thrombophilia (27.3%), followed by BVL (15.1%) and Behçet’s disease (16.4%). Rare causes were neoplasia in one case (3%), scleroderma in one case (3%) and inflammatory bowel disease in one case (3%). The etiological investigation was negative in 36.3% of cases. Treatment was based on heparin therapy followed by vitamin K therapy. Progression was favourable without accident or recurrence in 25 patients (75.5%). Complications were dominated by recurrence in 12.1% of cases, post-thrombotic disease in 6% of cases and pulmonary embolism in 3% of cases. We reported one death related to a hemorrhagic event.Conclusion:USVT is a multifactorial pathology that involves both acquired and constitutional risk factors. Heparin therapy with an early relay by antivitamin K remains the treatment of choice today. The duration of treatment depend on the etiology, the recurrence of venous thrombosis and the risk of hemorrhagic complications.Disclosure of Interests:None declared

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.

Deep venous thrombosis of lower limbs in adolescents: a study in a tertiary hospital

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Catarina Faria ◽  
Henedina Antunes ◽  
Teresa Pontes ◽  
Ana Antunes ◽  
Sofia Martins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Oral Contraceptive ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Positive Family History ◽  
Oral Contraceptive Pill ◽  
Tertiary Hospital ◽  
Lower Limbs ◽  
Factor V Leiden Mutation

AbstractBackgroundVenous thromboembolism (VTE) – which includes deep venous thrombosis (DVT) and pulmonary embolism (PE) – has been increasingly recognized in the pediatric population. The estimated incidence is 0.07–0.14 cases per 10,000 children. Most cases are associated with two or more risk factors. Medium and long-term complications include recurrence and post-thrombotic syndrome (PTS).ObjectiveTo characterize the adolescent population with the diagnosis of DVT of lower limbs in a tertiary hospital, regarding its clinical presentation, associated risk factors, treatment and outcome.MethodsRetrospective analysis of adolescents with the diagnosis of DVT of lower limbs in our hospital for a period of 7 years.ResultsEight patients were identified; seven were females; median age was 15 years. The main symptoms were local pain and edema. Left lower limb was affected in six patients. PE occurred in two cases. Positive family history of venous thromboembolism was found in five patients. Seven patients had at least two identifiable risk factors. Combined oral contraceptive pill use was the most common (seven patients). Factor V Leiden mutation was found in three patients and protein C deficiency in one. Iliac vein compression syndrome was diagnosed in one patient. The median time for discharge was 8 days. Election treatment was enoxaparin followed by warfarin, for a median period of 10.9 months. Three patients developed PTS.ConclusionsAlthough uncommon, VTE is an emerging reality in adolescents, particularly in females using oral contraceptive pills. Appropriated prevention strategies and treatment are required as most orientations are extrapolated from adults.

scholarly journals Arterial and Venous Thrombosis Complicated in COVID-19: A Retrospective Single Center Analysis in Japan

2021 ◽  
Vol 8 ◽  
Author(s):  
Seiya Oba ◽  
Tadashi Hosoya ◽  
Miki Amamiya ◽  
Takahiro Mitsumura ◽  
Daisuke Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Clinical Symptoms ◽  
Epidemiological Data ◽  
Japanese Patients ◽  
University Hospital ◽  
Bleeding Complications ◽  
Protein Mutants ◽  
Tokyo Medical ◽  
D Dimer

Background: Thrombosis is a characteristic complication in coronavirus disease 2019 (COVID-19). Since coagulopathy has been observed over the entire clinical course, thrombosis might be a clue to understanding the specific pathology in COVID-19. Currently, there is limited epidemiological data of COVID-19-associated thrombosis in the Japanese population and none regarding variant strains of SARS-CoV-2. Here, we elucidate the risk factors and the pattern of thrombosis in COVID-19 patients.Methods: The patients consecutively admitted to Tokyo Medical and Dental University Hospital with COVID-19 were retrospectively analyzed. SARS-CoV-2 variants of concern/interest (VOC/VOI) carrying the spike protein mutants E484K, N501Y, or L452R were identified by PCR-based analysis. All thrombotic events were diagnosed by clinical symptoms, ultrasonography, and/or radiological tests.Results: Among the 516 patients, 32 patients experienced 42 thromboembolic events. Advanced age, severe respiratory conditions, and several abnormal laboratory markers were associated with the development of thrombosis. While thrombotic events occurred in 13% of the patients with a severe respiratory condition, those events still occurred in 2.5% of the patients who did not require oxygen therapy. Elevated D-dimer and ferritin levels on admission were independent risk factors of thrombosis (adjusted odds ratio 9.39 and 3.11, 95% confidence interval 2.08–42.3, and 1.06–9.17, respectively). Of the thrombotic events, 22 were venous, whereas 20 were arterial. While patients with thrombosis received anticoagulation and antiinflammatory therapies with a higher proportion, the mortality rate, organ dysfunctions, and bleeding complications in these patients were higher than those without thrombosis. The incidence of thrombosis in COVID-19 became less frequent over time, such as during the replacement of the earlier strains of SARS-CoV-2 by VOC/VOI and during increased use of anticoagulatory therapeutics.Conclusion: This study elucidated that elevated D-dimer and ferritin levels are useful biomarkers of thrombosis in COVID-19 patients. The comparable incidence of arterial thrombosis with venous thrombosis and the development of thrombosis in less severe patients required further considerations for the management of Japanese patients with COVID-19. Further studies would be required to identify high-risk populations and establish appropriate interventions for thrombotic complications in COVID-19.

scholarly journals Clinical presentations, radiological characteristics, and biological risk factors of cerebral venous thrombosis at a University Hospital in Saudi Arabia

2021 ◽  
Vol 42 (2) ◽  
pp. 213-218
Author(s):  
Abdullah S. Alamri ◽  
Mohammed F. Almuaigel ◽  
Zafar Azra ◽  
Foziah J. Alshamrani ◽  
Noor M. AlMohish ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
University Hospital ◽  
Biological Risk ◽  
Clinical Presentations

scholarly journals Incidence and Mortality of Cerebral Venous Thrombosis in a Norwegian Population

Stroke ◽  
2020 ◽  
Vol 51 (10) ◽  
pp. 3023-3029
Author(s):  
Espen Saxhaug Kristoffersen ◽  
Charlotte Elena Harper ◽  
Kjersti Grøtta Vetvik ◽  
Svetozar Zarnovicky ◽  
Jakob Møller Hansen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
International Classification Of Diseases ◽  
Population Based ◽  
University Hospital ◽  
Motor Deficits ◽  
Cross Sectional ◽  
Norwegian Population ◽  
Incidence And Mortality

Background and Purpose: There are conflicting figures of the incidence of cerebral venous thrombosis (CVT). The incidence was previously estimated to around 0.5/100 000/y, but more recent studies have suggested 1 to 1.5/100 000/y. The purpose of this study was to explore the incidence and mortality of CVT in a Norwegian population. Methods: A retrospective cross-sectional hospital population-based study conducted at Akershus University Hospital serving roughly 10% of the total Norwegian population. Patients were identified through chart reviews based on the relevant International Classification of Diseases ( Tenth Revision ) codes for new CVT cases in a 7-year period between January 1, 2011, and December 31, 2017. Only inhabitants living in the hospital’s catchment area were included. Results: Sixty-two patients aged 0 to 80 years were identified and included. The median age was 46 years and 53% were females. The overall incidence of CVT was 1.75 (95% CI, 1.36–2.23) per 100 000/y with no significant sex differences. The incidence for children and adolescents (<18 years, n=9) was lower than for adults (≥18 years, n=53); 1.08 (0.52–1.97) versus 1.96 (1.49–2.55) per 100 000/y per year, with the highest incidence for those >50 years with 2.10 (1.38–3.07)/100 000/y. Headache was the most prevalent symptom, reported in 83%, followed by nausea, motor deficits, and seizures observed in 45%, 32%, and 32% of the patients. Transverse sinuses and the jugular vein were the most frequent sites of thrombosis. In most patients (61%), thrombosis occurred in multiple sinuses/veins. Risk factors were found in 73% of the patients, and most of the patients had a combination of 2 or more risk factors. The 30-day and 1-year mortality rates were 3% and 6%. Conclusions: The incidence of CVT in this population was higher than previously reported. The mortality rate was similar to previous studies.

A two adenine insertion polymorphism in the 3’ untranslated region of factor VII gene is associated with peripheral arterial disease but not with venous thrombosis

2007 ◽  
Vol 98 (10) ◽  
pp. 733-737 ◽  
Author(s):  
Emilie Serve ◽  
Jean-Luc Reny ◽  
Sepideh Akhavan ◽  
Joseph Emmerich ◽  
Anne-Marie Fischer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Venous Thrombosis ◽  
Untranslated Region ◽  
Smoking Status ◽  
Arterial Disease ◽  
Lower Limbs ◽  
Factor Vii ◽  
Insertion Polymorphism ◽  
Peripheral Arterial

SummaryPolymorphic variants of genes encoding blood coagulation proteins have been extensively studied as risk factors for venous or arterial thrombosis A variation in the 3' untranslated region (UTR) involved in the post-transcriptional regulation of factor VII (FVII) gene has been recently identified, a two adenine insertion/deletion at nucleotide 11293. In this study, we investigated its effect on the risk of thrombosis in the frame of two case-control studies, including patients suffering from peripheral arterial disease (PAD) or venous thromboembolic (VTE) disease. The 3’UTR FVII gene polymorphism was investigated i) in 181 patients who had symptomatic atherosclerotic disease of the lower limbs, ii) in 178 patients who had had at least one episode of objectively diagnosed deep venous thrombosis and iii) in controls matched for age and sex. Plasma FVII antigen (FVII:Ag) levels were lower in the presence of the 3’UTR 2A insertion (68.4 ± 12.3%, 81.3 ± 14.5% and 89.5 ± 13.7% in 2A/2A, 2A/0 and 0/0 subjects respectively, p<0.0001). No significant relationship was found with VTE disease. In the contrary we observed a lower risk of PAD for the 2A/2A compared to the 0/0 genotype after adjustment for traditional risk factors (hypercholesterolemia, smoking status, diabetes and hypertension), with an OR of 0.24 [95% CI 0.06–0.99]. In conclusion, the 2 adenine insertion in the 3’UTR of FVII gene, related to lower plasma FVII levels, is a genetic variation that may contribute to reduce the risk of PAD.

scholarly journals Differences in Clinical Presentation, Rate of Pulmonary Embolism, and Risk Factors Among Patients With Deep Vein Thrombosis in Unusual Sites

2019 ◽  
Vol 25 ◽  
pp. 107602961987255 ◽  
Author(s):  
Angelo Porfidia ◽  
Enrica Porceddu ◽  
Daniela Feliciani ◽  
Marzia Giordano ◽  
Fabiana Agostini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
University Hospital ◽  
Cerebral Vein ◽  
Jugular Vein Thrombosis ◽  
Unusual Site ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Deep Vein

Unusual site deep vein thrombosis (USDVT) is an uncommon form of venous thromboembolism with heterogeneous signs and symptoms, unknown rate of pulmonary embolism (PE), and poorly defined risk factors. We conducted a retrospective analysis of 107 consecutive cases of USDVTs, discharged from our University Hospital over a period of 2 years. Patients were classified based on the site of thrombosis and distinguished between patients with cerebral vein thrombosis, jugular vein thrombosis, thrombosis of the deep veins of the upper extremities, and abdominal vein thrombosis. We found statistically significant differences between groups in terms of age ( P < .0001) and gender distribution ( P < .05). We also found that the rate of symptomatic patients was significantly different between groups ( P < .0001). Another interesting finding was the significant difference between groups in terms of rate of PE ( P < .01). Finally, we found statistically significant differences between groups in terms of risk factors for thrombosis, in particular cancer ( P < .01). Unprovoked cases were differently distributed among groups ( P < .0001). This study highlights differences between patients with USDVT, which depend on the site of thrombosis, and provides data which might be useful in clinical practice.

Quality of life and the duration of treatment with vitamin K antagonists in patients with deep venous thrombosis

2003 ◽  
Vol 90 (07) ◽  
pp. 101-107 ◽  
Author(s):  
Mirjam Sprangers ◽  
Hanneke de Haes ◽  
Harry Büller ◽  
Martin Prins ◽  
Mirjam Locadia
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Venous Thrombosis ◽  
Vitamin K ◽  
Treatment Duration ◽  
Vitamin K Antagonists ◽  
Great Influence ◽  
Duration Of Treatment ◽  
Study Centre

SummaryIn clinical practice, decisions on the duration of treatment with vitamin K antagonists are usually based on the presence of persistent risk factors, the risk of bleeding and centre policy. Little is known about the influence of patients’ experienced quality of life. The objectives of this study were: 1) to explore the course of quality of life in patients with venous thrombosis treated for 3 months versus patients treated for 6 months with vitamin K antagonists; 2) to investigate the factors that were associated with the duration of treatment with vitamin K antagonists. The study sample comprised patients participating in a multi-centre clinical trial. Quality of life was assessed at study entry, after 10-14 days,3 and 6 months in 360 patients. Overall, no dif-ferences in quality of life were found between the 2 patient groups. An interaction effect between group and time was found for physical functioning. Regression analyses indicated that the presence of one or more permanent risk factors, duration of hospitalisation, mobility prior to deep-vein thrombosis and study centre were associated with the duration of treatment with vitamin K antagonists. Interestingly, quality of life was not associated with treatment duration. Since study centre was the most important factor associated with treatment duration, local policy appears to have a great influence on decisions regarding the duration of treatment with vitamin K antagonists.Part of this manuscript has been included in a poster presentation at the International Society for Quality of Life Research in Amsterdam, The Netherlands, November 8, 2001.

scholarly journals Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis

2017 ◽  
Vol 27 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Brad E. Zacharia ◽  
Sweena Kahn ◽  
Evan D. Bander ◽  
Gustav Y. Cederquist ◽  
William P. Cope ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Spinal Metastasis ◽  
Univariate Analysis ◽  
Previous History ◽  
Vena Cava ◽  
Spinal Metastases ◽  
Multivariate Logistic Regression Model ◽  
Histopathological Classification

OBJECTIVEThe authors of this study aimed to identify the incidence of and risk factors for preoperative deep venous thrombosis (DVT) in patients undergoing surgical treatment for spinal metastases.METHODSUnivariate analysis of patient age, sex, ethnicity, laboratory values, comorbidities, preoperative ambulatory status, histopathological classification, spinal level, and surgical details was performed. Factors significantly associated with DVT univariately were entered into a multivariate logistic regression model.RESULTSThe authors identified 314 patients, of whom 232 (73.9%) were screened preoperatively for a DVT. Of those screened, 22 (9.48%) were diagnosed with a DVT. The screened patients were older (median 62 vs 55 years, p = 0.0008), but otherwise similar in baseline characteristics. Nonambulatory status, previous history of DVT, lower partial thromboplastin time, and lower hemoglobin level were statistically significant and independent factors associated with positive results of screening for a DVT. Results of screening were positive in only 6.4% of ambulatory patients in contrast to 24.4% of nonambulatory patients, yielding an odds ratio of 4.73 (95% CI 1.88–11.90). All of the patients who had positive screening results underwent preoperative placement of an inferior vena cava filter.CONCLUSIONSPatients requiring surgery for spinal metastases represent a population with unique risks for venous thromboembolism. This study showed a 9.48% incidence of DVT in patients screened preoperatively. The highest rates of preoperative DVT were identified in nonambulatory patients, who were found to have a 4-fold increase in the likelihood of harboring a DVT. Understanding the preoperative thrombotic status may provide an opportunity for early intervention and risk stratification in this critically ill population.

scholarly journals Bilateral Deep Vein Thrombosis Associated with Inferior Vena Cava Agenesis in a Young Patient Manifesting as Low Back Pain

2017 ◽  
Vol 30 (4) ◽  
pp. 333 ◽  
Author(s):  
Felipe Langer ◽  
Daiane Dos Santos ◽  
Gustavo Suertegaray ◽  
Carlos Jesus Pereira Haygert
Keyword(s):  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Young Patients ◽  
Young Male ◽  
Vascular Anomaly ◽  
Lower Limbs ◽  
Increased Risk

Congenital absence of the inferior vena cava is a rare vascular anomaly, and most cases are asymptomatic. Nevertheless, patients with inferior vena cava malformations may have increased risk of deep venous thrombosis. Particularly, cases of bilateral deep venous thrombosis may arise owing to an insufficient collateral venous drainage from the lower limbs. We hereby describe a case of a previously healthy young male patient presenting with bilateral lower limb deep venous thrombosis as the initial clinical manifestation of congenital inferior vena cava agenesis. We conclude that in young patients presenting with deep venous thrombosis, especially when thrombosis occurs spontaneously, bilaterally, or recurrently, inferior vena cava anomalies should be thoroughly investigated and ruled out as appropriate.

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