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Language: search.filters.language.EnglishSubject: search.filters.subject.deep vein thrombosis

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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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    Special Conditions in Venous Thrombembolism – Case Series
    (Macedonian Academy of Sciences and Arts, 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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    Sex Differences in Patients With Occult Cancer After Venous Thromboembolism.
    (2018)
    Jara-Palomares L,
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    Otero R,
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    Jiménez D,
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    Praena-Fernández JM,
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    Rivas A,
    In patients with venous thromboembolism (VTE), male sex has been associated with an increased risk of occult cancer. The influence of sex on clinical characteristics, treatment, cancer sites, and outcome has not been thoroughly investigated yet. We used the Registro Informatizado Enfermedad TromboEmbólica registry to compare the clinical characteristics, treatment strategies, cancer sites, and clinical outcomes in patients with VTE having occult cancer, according to sex. As of June 2014, 5864 patients were recruited, of whom 444 (7.6%; 95% confidence interval: 6.8-8.2) had occult cancer. Of these, 246 (55%) were men. Median time elapsed from VTE to occult cancer was 4 months (interquartile range: 2-8.4), with no sex differences. Women were older, weighed less, and were less likely to have chronic lung disease than men. The most common cancer sites were the lung (n = 63), prostate (n = 42), and colorectal (n = 29) in men and colorectal (n = 38), breast (n = 23), uterine (n = 18), hematologic (n = 17), or pancreas (n = 15) in women. Men were more likely to have lung cancer than women (2.18% vs 0.30%; P < .01) and less likely to have pancreatic cancer (0.17% vs 0.5%; P = .03). Interestingly, breast cancer was more likely found in women aged ≥50 years than in those aged <50 years (0.97% vs 0.14%; P = .03). This study highlights the existence of sex differences in patients with VTE having occult cancer. One in every 2 men had lung, prostate, or colorectal cancer. In women, there is a heterogeneity of cancer sites, increasing risk of breast cancer in those aged >50 years.
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    CTPA beyond pulmonary embolism- the pulmonary arterial obstruction index
    (2023-10)
    Pulmonary thromboembolism (PTE) and deep vein thrombosis (DVT) are different manifestations of the same condition, venous thromboembolism (VTE), which is the third most common cardiovascular disease after the ischemic heart and cerebrovascular diseases. Thus, we have to be mindful that acute pulmonary embolism (APE) is a medical emergency and a very serious clinical manifestation of VTE, that occurs due to discharge of emboli in the pulmonary arterial system which leads in subsequent arterial occlusion and an increase in the pulmonary vascular resistance, an increase in the right heart afterload and acute right ventricular failure, which is a life- threatening condition. Taking into account the fact that patients with right heart dysfunction have a high mortality rate, timely diagnosis and prompt management are the basis for the reversibility of the condition. The significantly improved image quality and upgraded diagnostic performance of CT pulmonary angiography are essential in acknowledging this diagnostic modality as the imaging technique of choice in suspected pulmonary embolism. The last decade has shown a dramatic improvement in the CTPA depiction quality of the pulmonary vasculature, and through additional enabling of the PAOI calculation, offers a quantitative value to the severity of APE, as well as detailed assessment of RV function. The objective of this lecture is not only to confirm the importance of CTPA in the prompt diagnosis of APE, but also to help radiologists conduct a detailed assessment of the CTPA’s in patients with APE, and by evaluating the relationship between the pulmonary arterial obstruction index (PAOI) and several CT cardiovascular markers of right heart dysfunction, to determine its prognostic value in the risk stratification of potential RHD. Besides confirming the prognostic value of CTPA in predicting possible complications, we also want to make a meaningful contribution into the decision making of the APE management, in forming an interdisciplinary consensus regarding follow up CTPA protocols in patients with PTE, and through the evaluation of PAOI and PAOI- associated right ventricular dysfunction, to optimize the duration of therapy and avoid unnecessary imaging examinations, i.e., over- diagnosis.
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    Prevalence and risk factors for Pulmonary Embolism (PE) and Deep Vein Thrombosis (DVT) during Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
    (VM Media SP. zo.o VM Group SK, 2020-06-15)
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    Trajkovska, Ivana
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    Kuzmanovska Dimitrovska, Melina
    Introduction: COPD patients are at high risk for PE and DVT due to immobility, inflammation, comorbidities. Prevalence of PE during AECOPD is uncertain and often under-diagnosed. Material and methods: Single-center, prospective, an observational trial of 100 hospitalized patients with AECOPD, diagnosed according to GOLD criteria, 40–75 years, stratified according to airflow limitation (I–IV), divided into subgroups (PE-diagnosed/non-PE and with known/ undetermined exacerbation etiology). Investigations: clinical risk assessment, electrocardiogram (ECG), laboratory, spirometry, gas-analysis, D-dimer (DD), chest X-ray, thoracic ultrasonography (TUS), Doppler-ultrasonography of deep-veins of lower-extremities (DULE). Patients with high DD and DVT or high DD and abnormal TUS underwent computed-tomography pulmonary-angiography (CTPA). Results: PE was diagnosed in 26 (26.0%), DVT in 5 (5.0%) of hospitalized AECOPD patients. There was a positive correlation between COPD-severity and PE. Frequencies of PE in GOLD-stages I, IV, were 0 (0.0%), 3 (11.5%), 8 (30.7%), 15 (57.7%) respectively. Patients with pleuritic chest-pain, TUS abnormality, phlebitis and high DD were more likely to develop PE. Localization was subsegmental in 9 (34.6%), in one of the main pulmonary arteries 7 (26.9%), lobar and interlobar arteries in 10 (38.5%). DD was significantly higher among patients with PE than those without (3.34 ± 1.1 μg/mL vs. 2.2 ± 0.8μg/mL, P < 0.0001). There was positive correlation between the presence of PE and elevated DD > 2.0 μg/mL (P = 0.02). There was no statistically significant difference between patients with PE and without, according to age, gender and comorbidities (P > 0.05). Immobility and obesity were significantly higher among PE patients, P = 0.032 and P < 0.0001 respectively. Conclusion: AECOPD associated with pleuritic chest pain, immobility, high DD, should be considered for PE. Chest-ultrasound, as a low-cost and safe procedure, can be a very helpful investigation.