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Special Conditions in Venous Thrombembolism - Case Series
(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2019-10-01)
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Klincheva, Milka
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Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management, and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding, renal insufficiency, disseminated malignancy or pregnant patients) have been under-represented in randomized clinical trials. We still need information from real life data (as example RIETE). The paper presents case series with VTE in special conditions, including cancer associated thrombosis, malignant homeopathies, as well in high risk population.
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Clinical Characteristics and Outcomes of Patients with Lung Cancer and Venous Thromboembolism
(2018)
Ruiz-Artacho P,
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Trujillo-Santos J,
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López-Jiménez L,
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Font C,
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Díaz-Pedroche MDC,
Background The natural history of patients with lung cancer and venous thromboembolism (VTE) has not been consistently evaluated. Methods We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the clinical characteristics, time course, and outcomes during anticoagulation of lung cancer patients with acute, symptomatic VTE. Results As of May 2017, a total of 1,725 patients were recruited: 1,208 (70%) presented with pulmonary embolism (PE) and 517 with deep vein thrombosis (DVT). Overall, 865 patients (50%) were diagnosed with cancer <3 months before, 1,270 (74%) had metastases, and 1,250 (72%) had no additional risk factors for VTE. During anticoagulation (median, 93 days), 166 patients had symptomatic VTE recurrences (recurrent DVT: 86, PE: 80), 63 had major bleeding (intracranial 11), and 870 died. The recurrence rate was twofold higher than the major bleeding rate during the first month, and over threefold higher beyond the first month. Fifty-seven patients died of PE and 15 died of bleeding. Most fatal PEs (84%) and most fatal bleeds (67%) occurred within the first month of therapy. Nine patients with fatal PE (16%) died within the first 24 hours. Of 72 patients dying of PE or bleeding, 15 (21%) had no metastases and 29 (40%) had the VTE shortly after surgery or immobility. Conclusion Active surveillance on early signs and/or symptoms of VTE in patients with recently diagnosed lung cancer and prescription of prophylaxis in those undergoing surgery or during periods of immobilization might likely help prevent VTE better, detect it earlier, and treat it more efficiently.
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Acute Pulmonary Thromboembolism – Use of Fibrinolysis to Treat a Hemodynamically Unstable Patient in the Era of the COVID-19 Pandemic: A Case Report
(Medical Publishing, d.o.o., 2021-06)
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Taravari, Hayber
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Beqiri, Ardiana
Pulmonary embolism (PE) is a common and potentially fatal condition. Despite advances in diagnostic procedures, late detection and non-detection of this condition is also not uncommon. In patients with PE, recurrent embolisms and death can be prevented with prompt diagnosis and adequate treatment. Due to presentation with a non-specific clinical picture and symptomatology, unfortunately almost one third of the patients remain undiagnosed and untreated. We know that there is a large difference in outcome between treated and untreated patients with PE (25-30% mortality in untreated and 2-8% in treated patients). We present a case of PE in the era of the COVID-19 pandemic in an adult patient with acute dyspnea, vomiting, presyncope, chest pain, and shock.
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Complications associated with acute pulmonary embolism – data from the registry of patients with venous thrombembolism
(Македонско лекарско друштво = Macedonian Medical Association, 2022)
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Dejan Todevski
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Suzana Arbutina
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Correct estimation of the severity, mortality, and complication risk are crucial for effective treatment of pulmonary embolism (PE). A total of 162 patients hospitalized with acute PE, treated either with standard treatment with heparin and vitamin K antagonists (VKA) or heparins, followed by direct oral anticoagulants (DOAC) were followed for a 90-days period. Demography, clinical and radiologic presentation, smoking status and concomitant comorbidities were analyzed. The mortality risk was estimated by calculating PESI and sPESI score. The results showed uneven utilization of both treatment modalities (93.8% treated with VKA versus 6.17% with DOAC). Smoking as an independent factor was detected in 55.56% of patients, and is greater than the overall smoking prevalence in Macedonia. Central propagation of PE was found in 57.79% of cases and together with the presence of pleural effusion was associated with a greater risk for complications. Estimation of 30-day mortality risk with PESI and sPESI showed their high predictive value, with an advantage of sPESI, in terms of better accuracy and simplicity of performance. Correct estimation of risk for complications and mortality is important for improving the overall safety of patients with PE and has a positive „cost-benefit“ effect for organization of the treatment.
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Acute pulmonary embolism in COVID-19 pandemic: prevalence and intrahospital outcome: a single center experience
(Oxford University Press (OUP), 2022-02-01)
Peovska Mitevska, I
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Busljetik, O
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Grueva, E
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Lazarova, E

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