Database : MEDLINE
Search on : venous and thrombosis [Words]
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[PMID]: 29309910
[Au] Autor:Wei Z; Xin G; Wang H; Zheng H; Ji C; Gu J; Ma L; Qin C; Xing Z; Niu H; Huang W
[Ad] Address:Laboratory of Ethnopharmacology, West China Hospital, West China Medical School, Sichuan University, Gaoxin District, Chengdu, Sichuan, China.
[Ti] Title:The diosgenin prodrug nanoparticles with pH-responsive as a drug delivery system uniquely prevents thrombosis without increased bleeding risk.
[So] Source:Nanomedicine;14(3):673-684, 2018 Jan 06.
[Is] ISSN:1549-9642
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Thrombosis is the leading cause of death in patients with cardiovascular disease in the world. Current antithrombotic agent aspirin has serious side effects such as higher bleeding risk and serious gastrointestinal ulcers. Diosgenin reported in clinical research could prevent thrombosis without side effects. However, poor bioavailability and low knowledge on its molecular targets limit its clinical application. A novel prodrug with antithrombotic effect was prepared based on conjugating diosgenin derivatives to PEG with Schiff-base bond. The prodrug with long blood circulation time and satisfying safety could self-assemble into micelles in water. The prodrug micelles with pH-responsibility could targetedly release diosgenin in position of thrombus in vivo. The results indicate that the prodrug micelles without bleeding risk and histological damages prevent thrombosis by inhibiting platelet activation and apoptosis. Our studies demonstrate that the prodrug micelles could obviously enhance the efficacy in the prevention of arterial thrombus and venous thrombus than aspirin.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 61815 MEDLINE  
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[PMID]: 29523353
[Au] Autor:Roriz M; Crassard I; Lechtman S; Saadoun D; Champion K; Wechsler B; Chabriat H; Sène D
[Ad] Address:Internal Medicine Department, Lariboisière Hospital, Paris VII University, 2 rue Ambroise Paré, 75475 Paris, France. Electronic address: melanie.roriz@hotmail.fr.
[Ti] Title:Can anticoagulation therapy in cerebral venous thrombosis associated with Behçet's disease be stopped without relapse?
[So] Source:Rev Neurol (Paris);, 2018 Mar 07.
[Is] ISSN:0035-3787
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:There is as yet no consensus on the treatment of cerebral venous thrombosis (CVT) in Behçet's disease, and the place of anticoagulation is also still being debated. This report is of a series of seven patients with Behçet's disease (BD)-associated CVT, for which anticoagulation was stopped, and discusses the possibility of stopping anticoagulation during follow-up while receiving optimal treatment for BD. The diagnosis of BD was established during follow-up, which lasted a median of 120 [range: 60-1490] days after CVT diagnosis. The median duration of anticoagulation therapy was 29.5 months. On stopping anticoagulation, concomitant treatment then included colchicine, steroids and azathioprine, all introduced after BD was diagnosed. With a median follow-up of 25 months after anticoagulation interruption, only one relapse of CVT was observed. No relapse of CVT or other venous thrombosis was observed in the six patients treated by steroids associated with an immunosuppressant or colchicine. Our results emphasize that corticosteroids are essential for the treatment of BD-associated CVT, and that anticoagulant therapy may be safely stopped during follow-up in the presence of optimal BD treatment (steroids alone or with immunosuppressive drugs).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 61815 MEDLINE  
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[PMID]: 29522911
[Au] Autor:Lee YH; Cha SI; Shin KM; Lim JK; Yoo SS; Lee SY; Lee J; Kim CH; Park JY; Lee WK
[Ad] Address:Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
[Ti] Title:Clinical relevance of syncope in patients with pulmonary embolism.
[So] Source:Thromb Res;164:85-89, 2018 Mar 02.
[Is] ISSN:1879-2472
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Syncope is an unusual clinical manifestation of pulmonary embolism (PE), and the clinical significance of syncope in PE patients remains controversial. We investigated the incidence of syncope, examined the clinical factors associated with syncope, and assessed the association between syncope and the short-term outcomes of PE. METHODS: We retrospectively classified patients presenting with PE into 2 groups: patients with syncope and those without syncope. We compared the clinical and computed tomography parameters between the groups. RESULTS: Among 1084 patients diagnosed with PE, 45 (4.2%) presented with syncope. Four patients which presented with cardiac arrest were excluded from the study. The syncope group showed significantly higher blood biomarker levels and higher rates of central PE and right ventricular dilation than the control group. Unprovoked PE (odds ratio [OR] 8.046, 95% confidence interval [CI] 3.073-21.069, p < 0.001), female sex (OR 3.419, 95% CI 1.348-8.675, p = 0.010), central PE (OR 2.854, 95% CI 1.298-6.278, p = 0.009), and troponin I level (OR 2.812, 95% CI 1.765-4.480, p < 0.001) were observed to be independent factors associated with syncope in PE patients. However, multivariate analysis showed that the presence of syncope was not a significant predictor of adverse outcomes and recurrent venous thromboembolism in PE patients. CONCLUSIONS: Although syncope is associated with a more severe form of PE, it does not influence the short-term prognosis of PE. Central PE, blood troponin I level, unprovoked PE, and female sex were observed to be clinical factors related with syncope in patients with PE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 61815 MEDLINE  
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[PMID]: 29522910
[Au] Autor:Delluc A; Ianotto JC; Tromeur C; De Moreuil C; Couturaud F; Lacut K; Le Moigne E; Louis P; Thereaux J; Metges JP; Mottier D
[Ad] Address:EA 3878 (GETBO), Brest University, 29200 Brest, France; Department of Chest Diseases and Internal Medicine, Hôpital de la Cavale Blanche, 29609 Brest Cedex, France. Electronic address: aurelien.delluc@chu-brest.fr.
[Ti] Title:Real-world incidence of cancer following a first unprovoked venous thrombosis: Results from the EPIGETBO study.
[So] Source:Thromb Res;164:79-84, 2018 Mar 02.
[Is] ISSN:1879-2472
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Venous thromboembolism (VTE) can be the first manifestation of cancer; however, the current incidence of malignancy in unselected patients with first unprovoked VTE needs to be confirmed. MATERIAL AND METHODS: Between March 1st, 2013 and February 28th, 2015 we included and followed-up all patients living in the Brest district, France, who were seen in hospitals or the community for a first symptomatic unprovoked VTE event. The primary study outcome was the one-year incidence of cancer. RESULTS: 526 patients, mean age 66.6 ±â€¯18.1 years, 246 (46.8%) men, were included in the study. In the year following VTE, 26 patients were diagnosed with cancer, corresponding to a one-year cumulative incidence of cancer of 5.06% (95% CI 3.47-7.35). Age ≥60, smoking and pulmonary embolism were significantly associated with cancer diagnosis in multivariate analysis. Fifty percent of cancers were patent at the time of VTE diagnosis, mostly detected on CTPA (Computed Tomographic Pulmonary Angiography) performed for pulmonary embolism assessment. After excluding patients with patent cancer at VTE diagnosis, the one-year incidence of cancer was 2.65% (95% CI: 1.55-4.52); in multivariate analysis, only current smoking was independently associated with a significant 5.4-fold increased risk for cancer diagnosis (HR 5.40; 95% CI 1.31-22.27). No cancer was diagnosed in patients aged 50 years or younger. CONCLUSION: The one-year incidence of cancer after a first unprovoked VTE was 5.06%. Half of the cancers were diagnosed during the diagnosis procedure for pulmonary embolism using CTPA.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  5 / 61815 MEDLINE  
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[PMID]: 29522873
[Au] Autor:Mahmoud O; Vikatmaa P; Räsänen J; Peltola E; Sihvo E; Vikatmaa L; Lappalainen K; Venermo M
[Ad] Address:Department of Vascular Surgery, Helsinki University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki, Finland; Department of Vascular Surgery, Assiut University Hospital, Faculty of Medicine, Assiut University, Egypt.
[Ti] Title:Catheter-Directed Thrombolysis vs. Pharmacomechanical Thrombectomy for Upper Extremity Deep Venous Thrombosis: Cost-Effectiveness Analysis.
[So] Source:Ann Vasc Surg;, 2018 Mar 06.
[Is] ISSN:1615-5947
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:BACKGROUND AND AIMS: We compared the immediate and one-year results as well as total hospital costs between catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of symptomatic upper extremity deep venous thrombosis (UEDVT). MATERIAL AND METHODS: From 2006 to 2013, 55 patients with UEDVT were treated with either CDT or PMT at Helsinki University Hospital. Of them, 43 underwent thoracoscopic rib resection later in order to relieve phlebography-confirmed vein compression. This patient cohort was prospectively followed up with repeated phlebographies. CDT was performed to 24 patients and 19 had PMT with a Trellis™ device. Clinical evaluation and vein patency assessment were performed with either phlebography or ultrasound one year after the thrombolysis. Primary outcomes were immediate technical success, one-year vein patency, and costs of the initial treatment. RESULTS: The immediate overall technical success rate, defined as recanalization of the occluded vein and removal of the fresh thrombus, was 91.7% in the CDT group, and 100% in the PMT group (n.s.). The median thrombolytic time was significantly longer in CDT patients than PMT patients (21.1 hours vs. 0.33 hours, P<0.00001). There were no procedure-related complications. The one-year primary assisted patency rate was similar in both groups (91.7% and 94.7%, respectively). There were no recurrences of clinical DVT. The hospital costs for the acute period were significantly lower in the PMT group than the CDT group (medians 11,476 € and 5,975 € in the in the CDT and PMT group, respectively (P<0.00001)). CONCLUSIONS: The clinical results of the treatment of UEDVT with CDT or PMT were similar. However, PMT required shorter hospital stay and less intensive surveillance, leading to lower total costs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  6 / 61815 MEDLINE  
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[PMID]: 29505518
[Au] Autor:Zhang S; Huang Q; Xu B; Ma J; Cao G; Pei F
[Ad] Address:Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Title:Effectiveness and safety of an optimized blood management program in total hip and knee arthroplasty: A large, single-center, retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9429, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B. The primary outcomes were hemoglobin (Hb) drop and calculated total blood loss (TBL). Other outcome measurements such as transfusion rate, postoperative length of stay (PLOS), venous thromboembolism (VTE), and mortality were also compared.From 2014 to 2016, a total of 1907 unilateral THA (986 in group A, 745 in group B, and 176 in group C) and 1505 unilateral TKA (795 in group A, 556 in group B, and 154 in group C) procedures were conducted at our institution. The Hb drop, calculated TBL, and PLOS in group C were significantly lower than those in groups A and B for THA and TKA patients. The transfusion rate in group C was also significantly less than in groups A and B for THA patients, while it was similar in groups A and B for TKA patients. No patients in group C received a transfusion. A significant difference was not detected in the incidence of deep vein thrombosis. No episode of symptomatic pulmonary embolism or all-cause mortality occurred within 30 days postoperatively.The current retrospective study suggests that for patients receiving primary unilateral THA or TKA, multiple boluses of intravenous TXA combined with topical TXA, rHuEPO, and iron supplements can reduce the calculated TBL, Hb drop, transfusion rate, and PLOS without increasing the incidence of VTE or mortality.
[Mh] MeSH terms primary: Anemia/drug therapy
Antifibrinolytic Agents/administration & dosage
Blood Loss, Surgical/prevention & control
Erythropoietin/therapeutic use
Iron/therapeutic use
Trace Elements/therapeutic use
Tranexamic Acid/administration & dosage
[Mh] MeSH terms secundary: Administration, Intravenous
Administration, Topical
Adult
Aged
Anemia/etiology
Arthroplasty, Replacement, Hip/adverse effects
Arthroplasty, Replacement, Knee/adverse effects
Female
Humans
Male
Middle Aged
Recombinant Proteins/therapeutic use
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Antifibrinolytic Agents); 0 (Recombinant Proteins); 0 (Trace Elements); 11096-26-7 (Erythropoietin); 6T84R30KC1 (Tranexamic Acid); E1UOL152H7 (Iron)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009429

  7 / 61815 MEDLINE  
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[PMID]: 29472180
[Au] Autor:Stubbs MJ; Mouyis M; Thomas M
[Ad] Address:University College London Hospital, London, UK m.stubbs@doctors.org.uk.
[Ti] Title:Deep vein thrombosis.
[So] Source:BMJ;360:k351, 2018 02 22.
[Is] ISSN:1756-1833
[Cp] Country of publication:England
[La] Language:eng
[Mh] MeSH terms primary: Leg/blood supply
Venous Thrombosis/diagnosis
[Mh] MeSH terms secundary: Anticoagulants/therapeutic use
Biomarkers/analysis
Fibrin Fibrinogen Degradation Products/analysis
Humans
Risk Factors
Ultrasonography
Venous Thrombosis/blood
Venous Thrombosis/drug therapy
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Anticoagulants); 0 (Biomarkers); 0 (Fibrin Fibrinogen Degradation Products); 0 (fibrin fragment D)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180224
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k351

  8 / 61815 MEDLINE  
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[PMID]: 29277281
[Au] Autor:Alons IME; Goudsmit BFJ; Jellema K; van Walderveen MAA; Wermer MJH; Algra A
[Ad] Address:Department of Neurology, MCH Westeinde, The Hague, The Netherlands. Electronic address: mandaalons@hotmail.com.
[Ti] Title:Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis.
[So] Source:J Stroke Cerebrovasc Dis;27(4):1077-1084, 2018 Apr.
[Is] ISSN:1532-8511
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Patients with acute severe headache, normal neurological examination, and a normal noncontrast head computed tomography (NCCT) may still have subarachnoid hemorrhage, cerebral venous thrombosis (CVT), cervical arterial dissection, or reversible cerebral vasoconstriction syndrome (RCVS). Computed tomography angiography (CTA) is used increasingly in the emergency department for evaluating this, but its added value remains controversial. METHODS: We retrospectively collected data on the diagnostic yield of CTA in patients with acute severe headache, normal neurological examination, and normal NCCT who received additional CTA in the acute phase in 2 secondary referral centers for vascular neurology. We combined data of our patients with those from the literature and performed a meta-analysis. RESULTS: We included 88 patients from our hospital files and 641 patients after literature search. Of 729 patients 54 had a vascular abnormality on CTA (7.4%; 95% confidence interval [CI] 5.5%-9.3%). Abnormalities consisted of aneurysms (n = 42; 5.4%; 95% CI 3.8%-7.0%), CVT (n = 3, .5%), RCVS (n = 4, .5%), Moyamoya syndrome (n = 2, .3%), arterial dissection (n = 2, .3%), and ischemia (n = 1, .1%). Because most of the aneurysms were probably incidental findings, only 12 (1.6%) patients had a clear relation between the headache and CTA findings. The number needed to scan to find an abnormality was 14 overall, and 61 for an abnormality other than an aneurysm. CONCLUSION: Diagnostic yield of CTA in patients with acute headache, normal neurological examination, and normal NCCT is low, but because of the possible therapeutic consequences, its use might be justified in the emergency setting. Prospective studies confirming these results including cost-effectiveness analyses are needed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process

  9 / 61815 MEDLINE  
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[PMID]: 29257737
[Au] Autor:Bartholomew JR
[Ad] Address:Section Head, Department of Vascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. barthoj@ccf.org.
[Ti] Title:Update on the management of venous thromboembolism.
[So] Source:Cleve Clin J Med;84(12 Suppl 3):39-46, 2017 Dec.
[Is] ISSN:1939-2869
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism, is a common cardiovascular disease associated with significant morbidity ranging from painful leg swelling, chest pain, shortness of breath, and even death. Long-term complications include recurrent VTE, postpulmonary embolism syndrome, chronic thromboembolic pulmonary hypertension, and postthrombotic syndrome (PTS). Management of VTE requires immediate anticoagulation therapy based on a risk assessment for bleeding. Direct oral anticoagulants (DOACs) have become an important option for patients as reflected in the most recent American College of Chest Physician treatment guidelines.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.3949/ccjm.84.s3.04

  10 / 61815 MEDLINE  
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[PMID]: 29214793
[Au] Autor:Yoon JK; Kim MD; Lee DY; Han SJ
[Ad] Address:Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Title:Mesocaval Shunt Creation for Jejunal Variceal Bleeding with Chronic Portal Vein Thrombosis.
[So] Source:Yonsei Med J;59(1):162-166, 2018 Jan.
[Is] ISSN:1976-2437
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:The creation of transjugular intrahepatic portosystemic shunt (TIPS) is a widely performed technique to relieve portal hypertension, and to manage recurrent variceal bleeding and refractory ascites in patients where medical and/or endoscopic treatments have failed. However, portosystemic shunt creation can be challenging in the presence of chronic portal vein occlusion. In this case report, we describe a minimally invasive endovascular mesocaval shunt creation with transsplenic approach for the management of recurrent variceal bleeding in a portal hypertension patient with intra- and extrahepatic portal vein occlusion.
[Mh] MeSH terms primary: Esophageal and Gastric Varices/complications
Esophageal and Gastric Varices/therapy
Gastrointestinal Hemorrhage/complications
Gastrointestinal Hemorrhage/therapy
Jejunum/pathology
Portacaval Shunt, Surgical
Portal Vein/pathology
Venous Thrombosis/complications
Venous Thrombosis/therapy
[Mh] MeSH terms secundary: Adolescent
Chronic Disease
Esophageal and Gastric Varices/diagnostic imaging
Female
Gastrointestinal Hemorrhage/diagnostic imaging
Humans
Portal Vein/diagnostic imaging
Portal Vein/surgery
Tomography, X-Ray Computed
Treatment Outcome
Venous Thrombosis/diagnostic imaging
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:171208
[St] Status:MEDLINE
[do] DOI:10.3349/ymj.2018.59.1.162


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