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Pulmonary embolism heparin

Brigitte Pegourie, Lionel Karlin, Lotfi Benboubker, Frédérique Orsini-Piocelle, Mourad Tiab, Sophie Auger-Quittet, Philippe Rodon, Bruno Royer, Xavier Leleu, Benoit Bareau, Manuel Cliquennois, Jean-Gabriel Fuzibet, Eric Voog, Karim Belhadj-Merzoug, Olivier Decaux, Philippe Rey, Bohrane Slama, Cecile Leyronnas, Charles Zarnitsky, Eileen Boyle, Jean Luc Bosson, Gilles Pernod
The risk of venous thromboembolism (VTE) is higher in myeloma patients receiving immunomodulatory compounds. A VTE prophylaxis using low-molecular-weight heparin or aspirin is therefore proposed. Apixaban is an oral direct anti-Xa. Several studies have shown the efficacy and safety of apixaban in VTE prophylaxis compared to enoxaparin. The objective of this prospective phase 2 pilot study was to assess the risk of VTE and bleeding in patients with myeloma treated with immunomodulatory compounds lenalidomide (len) or thalidomide (thal), using apixaban in a preventive scheme...
March 11, 2019: American Journal of Hematology
Maryam Mukhtar, Mohsin Hamid, Muhammad Atique Alam Khan, Waqas Ullah
Venous thromboembolism prophylaxis guidelines are clear for major orthopaedic surgeries, but data regarding ankle surgery are insufficient. Death from pulmonary embolism (PE) after ankle surgery is rare with the frequency of less than 0.037%. 1 We present a case of a fatal PE after ankle surgery to raise awareness about this rare but potentially fatal complication. Our patient had a left ankle fracture status postsurgical fixation and was discharged without venous thromboembolism (VTE) prophylaxis. Twenty days later, she presented with a sudden onset of dyspnoea and palpitations and was diagnosed to have extensive right-sided PE...
March 6, 2019: BMJ Case Reports
Reinhold Kreutz, Lorenzo G Mantovani, Sylvia Haas, Danja Monje, Jonas Schneider, Jörg-Peter Bugge, Martin Gebel, Miriam Tamm, Walter Ageno, Alexander G G Turpie
INTRODUCTION: The prospective, non-interventional XALIA study investigated the safety and effectiveness of rivaroxaban and standard anticoagulation for the treatment of deep vein thrombosis (DVT). XALIA-LEA was conducted in regions not included in XALIA (Latin America, Eastern Europe, the Middle East, Africa, and the Asia-Pacific), and enrolled patients with isolated pulmonary embolism (PE). MATERIALS AND METHODS: Adult patients with acute venous thromboembolism (VTE) indicated for ≥3 months' anticoagulant treatment were eligible; treatment strategies were at the physician's discretion...
February 13, 2019: Thrombosis Research
Lei Zhu, Jiafei Cheng, Peiqing Gu, Yajun Liu, Junlou Liu, Jianhua Wang, Hong Shen
RATIONALE: Inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), is characterized by chronic inflammatory condition and immunological abnormalities, which probably develop into venous thromboembolic events (VTEs). VTE in IBD patients mostly occurs at deep venous thrombosis (DVT) and pulmonary embolism (PE). The complications are extremely important in clinical practice considering the high mortality rate. Hence, an early diagnosis of IBD and the control of complications play an important role in therapy of thromboembolic events (TEEs)...
March 2019: Medicine (Baltimore)
Yaseen M Arabi, Fahad Al-Hameed, Karen E A Burns, Sangeeta Mehta, Sami J Alsolamy, Mohammed S Alshahrani, Yasser Mandourah, Ghaleb A Almekhlafi, Mohammed Almaani, Ali Al Bshabshe, Simon Finfer, Zia Arshad, Imran Khalid, Yatin Mehta, Atul Gaur, Hassan Hawa, Hergen Buscher, Hani Lababidi, Abdulsalam Al Aithan, Sheryl A I Abdukahil, Jesna Jose, Lara Y Afesh, Abdulaziz Al-Dawood
BACKGROUND: Whether adjunctive intermittent pneumatic compression in critically ill patients receiving pharmacologic thromboprophylaxis would result in a lower incidence of deep-vein thrombosis than pharmacologic thromboprophylaxis alone is uncertain. METHODS: We randomly assigned patients who were considered adults according to the local standards at the participating sites (≥14, ≥16, or ≥18 years of age) within 48 hours after admission to an intensive care unit (ICU) to receive either intermittent pneumatic compression for at least 18 hours each day in addition to pharmacologic thromboprophylaxis with unfractionated or low-molecular-weight heparin (pneumatic compression group) or pharmacologic thromboprophylaxis alone (control group)...
February 18, 2019: New England Journal of Medicine
Benedict Kjaergaard, Jens Hedegaard Kristensen, Jesper Eske Sindby, Susanne de Neergaard, Bodil Steen Rasmussen
INTRODUCTION: In massive pulmonary embolism (PE) with circulatory collapse or with cardiac arrest, treatment can be difficult. Often, the diagnosis is unclear, and the time to treatment is crucial. Our institution has had an out-of-hospital team intended for the treatment of accidental hypothermia with extra corporeal membrane oxygenation (ECMO) since 2004. The team has occasionally been involved in patients suffering massive PE. METHODS: We were called to 38 patients with PE, but two were assessed as untreatable...
February 17, 2019: Perfusion
Mette Søgaard, Peter Brønnum Nielsen, Flemming Skjøth, Jette Nordstrøm Kjaeldgaard, Torben Bjerregaard Larsen
BACKGROUND: Rivaroxaban could be an attractive alternative to low molecular weight heparin for the treatment of cancer-associated venous thromboembolism (VTE) but the safety and effectiveness remain unclear. We examined risk of recurrent VTE and major bleeding associated with rivaroxaban treatment of cancer-associated VTE. METHODS: Through linkage of nationwide Danish registries, we identified all adults with cancer-associated VTE initiating treatment with rivaroxaban, 2012-2017...
February 14, 2019: Cancer Medicine
Firouza Dahi, Michael Keese, Thalhammer Axel, Thomas Schmitz-Rixen, Asimakis Gkremoutis
Hughes-Stovin syndrome is a disorder characterized by deep vein thrombosis and pulmonary artery aneurysms with potentially life-threatening complications. The case of a 22-year-old Moroccan male patient, presenting with signs of sepsis of unclear etiology, is presented here. CT scan revealed thrombosis of the inferior vena cava up to the hepatic veins, thrombosis of both common iliac veins and a thrombus in the right atrium. Primarily suspecting septic thrombosis, surgical thrombectomy was performed. The patient recovered uneventfully and was discharged with oral anticoagulants...
February 11, 2019: Annals of Vascular Surgery
Siavash Piran, Sam Schulman
Patients with acute spinal cord injury (SCI) have the highest risk of venous thromboembolism (VTE) among hospitalized patients. The incidence of total deep vein thrombosis ranges from 50 to 100% in untreated patients and pulmonary embolism is the third most common cause of mortality in these patients. The pathophysiology of the increased risk of VTE is explained by venous stasis after injury, endothelial vessel wall injury from surgery, and a hypercoagulable state associated with trauma. The current thromboprophylaxis options are limited, with low-molecular-weight heparin (LMWH) being the current standard of care...
February 11, 2019: Seminars in Thrombosis and Hemostasis
Mie Sakai, Jumpei Ogura, Koji Yamanoi, Takahiro Hirayama, Tsutomu Ohara, Haruka Suzuki, Yoshihide Inayama, Koji Yasumoto, Koh Suginami
Congenital ATIII deficiency is one of the congenital thrombophilia diseases that can cause severe venous thromboembolism (VTE) in pregnant patients. A 30-year-old female, 4 gravida and 2 para, came to the emergency department with a complaint of oedema and pain in the left lower leg at 11 weeks of gestation. An inferior vena cava thrombus and pulmonary embolism were found. Because VTE was very severe, artificial abortion was performed, and VTE disappeared rapidly. She maintained oral administration of edoxaban (NOAC) and got pregnant naturally fifty-five weeks later after the abortion...
2019: Case Reports in Obstetrics and Gynecology
Tomoki Hariu, Yoshito Nako, Akinobu Furutani, Shigeki Yamasaki, Takashi Kitade, Motomi Wakasa, Teruhisa Sonoyama
An 80-year-old woman with peritoneal dissemination after laparoscopic right hemicolectomy for appendicular carcinoma (mucinous adenocarcinoma, pT4aN1M0, stage Ⅲa)underwent CapeOX plus bevacizumab chemotherapy. The patient achieved stable disease over 5 courses of the treatment. Subjective and objective symptoms were not observed; however, chest computed tomography findings revealed a thrombus in the pulmonary artery that was considered to be associated with bevacizumab. Chemotherapy was discontinued, and anticoagulation therapy was initiated with heparin and then switched to apixaban...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Guangwei Sun, Jingjing Wu, Qian Wang, Qiang Liang, Jian Jia, Kai Cheng, Guoliang Sun, Zili Wang
BACKGROUND: The purpose of this study is to perform a meta-analysis to compare outcomes of venous thromboembolism (VTE) prophylaxis with low-molecular-weight heparin (LMWH) vs other anticoagulants in patients who received total knee (TKA) or total hip arthroplasty (THA). METHODS: MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched until June 30, 2017 for eligible randomized controlled studies. RESULTS: Thirty-two randomized controlled studies were included...
December 1, 2018: Journal of Arthroplasty
Clovis Nkoke, Denis Teuwafeu, Alice Mapina, Cyrille Nkouonlack
OBJECTIVE: Our goal was to study the clinical characteristics, risk factors and outcome of patients admitted for venous thromboembolism (VTE) in the medical unit of the Buea Regional Hospital, Cameroon between 1st July 2016 and 30th November 2017. RESULTS: Twenty-two patients were admitted for VTE. There were 12 (54.4%) men. The mean age was 54.9 ± 13.9 years (range: 31-77 years). The main risk factors were immobilization (40.9%), HIV infection (22.7%), tuberculosis (18...
January 18, 2019: BMC Research Notes
M R Kuznetsov, I V Reshetov, B B Orlov, A A Khotinsky, A A Atayan, M A Shchedrinа
PURPOSE: to elucidate predictors of development of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE). MATERIAL AND METHODS: We included in this study 210 patients hospitalized with diagnosis of submassive and massive PTE from 2013 to 2017. In 1 to 3 years after initial hospitalization these patients were invited for control examination. According to results of this examination patients were divided into two groups: with (group 1, n=45) and without (group 2, n=165) signs of CTEPH...
December 25, 2018: Kardiologiia
Marc Carrier, Alon D Altman, Normand Blais, Artemis Diamantouros, Deanna McLeod, Uthaman Moodley, Christine Nguyen, Stephanie Young, Frank Schwenter
BACKGROUND: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Certain abdominopelvic cancer surgeries are associated with a six to 14-fold increased risk of DVT versus surgeries for benign disease, and extended thromboprophylaxis using perioperative LMWHs may further reduce VTE rates over standard duration administration. This review assesses the value of extended low molecular weight heparin (LMWH) thromboprophylaxis as a recommended strategy after abdominopelvic cancer surgery...
December 16, 2018: American Journal of Surgery
Bishav Mohan, Rohit Tandon, Raahat Bansal, Maninder Singh, Bhupinder Singh, Abhishek Goyal, Shibba Takkar Chhabra, Naved Aslam, Gurpreet S Wander
INTRODUCTION: There is limited data regarding in hospital determinants of clinical deterioration and outcome in sub massive pulmonary embolism (PE). We aimed to evaluate these determinants by comparing biomarkers, CT pulmonary angiogram echocardiography, electrocardiography variables. METHODS: 57 patients of sub massive PE diagnosed on CT pulmonary angiogram were included. All patients received UFH on admission and were divided into two groups based on their clinical course...
December 2018: Indian Heart Journal
Zikai Song, Shijie Lv, Ling Qin, Hongyan Cao, Haidi Wu, Dayong Deng
RATIONALE: Venous thrombus embolism (VTE) includes deep-vein thrombosis (DVT) and pulmonary embolism (PE) which may be an initial symptom for patients with cancer. PE has diverse clinical manifestations and is a rare complication of testicular tumor (TT). PATIENT CONCERNS: Here, we report a 21-year-old man admitted to our hospital due to syncope. DIAGNOSES: Clinical examinations upon admission demonstrated PE resulting in syncope. Further, a malignant TT, liver metastasis, and inferior vena cava (IVC) thrombosis were diagnosed...
December 2018: Medicine (Baltimore)
Paul M Reynolds, Edward T Van Matre, Garth C Wright, R Brett McQueen, Ellen L Burnham, P Michael Ho, Marc Moss, R William Vandivier, Tyree H Kiser
BACKGROUND: Venous thromboembolism (VTE) occurs frequently in critically ill patients without heparin prophylaxis. Although heparin prevents VTE, VTEs occur frequently despite prophylaxis. Higher heparin dosage may be more effective for preventing VTE. METHODS: A retrospective study was conducted utilizing the Premier Incorporated Perspective Database to comparatively evaluate the effects of different heparin prophylaxis dosing strategies in the critically ill patient...
December 28, 2018: Pharmacotherapy
Vishesh Khanna, Munis Ashraf, Senthil Nathan Sambandam
Introduction: Retroperitoneal hemorrhage has been sparsely reported with warfarin therapy. In this paper, we describe a case of spontaneous retroperitoneal hematoma causing femoral neuropathy following treatment with low molecular weight heparin. Case Report: A 65-year-old gentleman had presented with acute onset left-sided thigh pain, paraesthesia, and weakness along with lower backache. On deeper introspection, our patient had, in the recent past, been thrombolyzed for pulmonary embolism...
May 2018: Journal of Orthopaedic Case Reports
Magalie Caudron, Tanya Holt, Geoff DE Cuvelier, Jeffrey Dmytrowich, Gregory Hansen
Pediatric ARDS continues to be a management challenge in the ICU with prolonged hospitalizations and high mortality. Thromboembolic pulmonary embolism and in situ pulmonary artery thrombosis might represent underappreciated thrombotic processes for a subset of these patients. Although well described in the adult literature, descriptions of pulmonary thromboses with pediatric ARDS are limited to case reports. However, many risk factors for pulmonary thromboses are present in children with ARDS (eg, coagulopathy, endothelial injury, central venous catheters, concomitant inflammatory diseases), suggesting a much higher incidence is plausible...
December 24, 2018: Respiratory Care
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