Concomitant Venous Thrombosis Research Articles

Concomitant Venous Thrombosis in Cellulitis of the Upper Extremity

Abstract Objectives Concurrent thrombosis is observed in up to 15 % of the patients with cellulitis of the lower extremity. The risk of concomitant venous thrombosis in patients with upper extremity cellulitis has not been investigated, yet. Aim of this study is to examine the frequency of concomitant venous thrombosis in patients with cellulitis of the upper extremity and to identify risk factors, comorbidities, and complications. Materials and Methods From 2014 to 2021, patients with cellulitis of the arm that received duplexsonography of the same limb were included. Files were reviewed for demographic data, comorbidities, and risk factors. Results 53 patients with upper limb cellulitis were included. In 11.3 % of the patients (n = 6), concomitant venous thrombosis of the upper extremity was detected. Three patients had deep arm thrombosis (brachial and subclavian veins), three had superficial vein thrombosis. Conclusion Cellulitis may increase the risk for venous thrombosis. Venous catheters and chronic lymphedema favor the occurrence of both cellulitis and venous thrombosis. Oncological patients are at particular risk for developing concomitant venous thrombosis.

Liver transplantation for cirrhosis complicated by non-tumor thrombosis of mesenteric portal system

Aim. To develop a universal technology of thrombectomy from the veins of the mesenteric portal system and to evaluate the outcomes of liver transplantation for cirrhosis combined with non-tumorous portal vein thrombosis.Materials and methods. Immediate and long-term results of 309 transplantations in patients with liver cirrhosis of various etiologies were studied. In 46 cases (14.9%), transplantation was performed in patients with liver cirrhosis and concomitant thrombosis in the veins of the mesenteric portal system. Results. A versatile method of thrombectomy, depending on the degree of thrombosis in the veins of the mesenteric portal system was proposed (M.A. Yerdel et al., 2000). Mesenteric portal vein thrombosis increased duration of transplantation and volume of intraoperative blood loss as compared to patients without concomitant thrombosis. No statistically significant differences were found in the overall incidence of postoperative complications, hospital mortality and duration of hospitalization of the patients after liver transplantation with concomitant venous thrombosis compared to the patients without thrombosis. The incidence of thrombotic complications, including hepatic artery thrombosis, was significantly higher after liver transplantation supplemented with thrombectomy from the portal vein system. Five-year survival rate of the patients after liver transplantation with concomitant thrombosis in the veins of the mesenteric portal system was 94.9% (median – 40 months), patients without thrombosis in the veins of the mesenteric portal system – 93.2% (median – 60 months).Conclusion. Transplantation in patients with cirrhosis and thrombosis in the veins of the mesenteric-portal system shows good immediate and long-term results in case proper thrombectomy is carried out.

Natural History of Iatrogenic Pediatric Femoral Artery Injury

Iatrogenic femoral artery trauma complicates the course of critically ill neonates and children. Complications from persistent arterial occlusion may include claudication and limb length discrepancies. Data supporting risk factors for such and need for revascularization are lacking. Review of a prospectively maintained database at a tertiary institution of iatrogenic pediatric femoral artery injuries incurred between 2013 and 2014 was performed. Additional injuries were identified by review of pediatric arterial duplex performed between 2008 and 2013. Demographics, risk factors, and outcomes were queried. Data analysis utilized Fischer's exact t-test and logistic regression. Seventy-six patients were identified of which 68 presented with acute limb ischemia (ALI) and 8 with chronic iliofemoral arterial occlusion resulting in claudication (n=6) or limb length discrepancy (n=2). Mean weight at injury was 6.3kg; mean age at injury was 49weeks (50% aged <3months). Mean follow-up was 14months (out to 11years). Six patients required surgery for ALI, and 6 required delayed operation for limb length discrepancy (n=4) or for persistent external iliac artery (EIA) occlusion. Mean age at delayed revascularization was 6years (range: 2-13 years). Vasopressor use, mechanism/location of injury, and concomitant venous thrombosis were not significantly correlated with need for operation; trends suggested that cardiac catheterization and EIA thrombosis may correlate with chronic disease. Increased age at injury was associated with need for operation. Although a majority of children with ALI may be successfully treated medically, 9% will require operation for ALI and 16% ultimately required revascularization during follow-up. Persistent iliofemoral arterial thrombosis is a likely risk factor for limb length discrepancy with growth; identifying risk factors for this and improved methods for surveillance requires ongoing investigation.

ULTRASOUND DIAGNOSIS OF THROMBOSIS IN CANCER PATIENTS

Purpose. To identify the relationship between ultrasonographic signs of progression of venous thrombosis and procoagulant activity of malignant tumors. Material and methods. A total of 225 cancer patients with concomitant venous thrombosis were examined. The study group (143 patients) and the control group (82 patients) were matched for tumor localization, types of venous thrombosis, prevention and treatment of venous thromboembolic complications, age and gender. The patients of the study group underwent palliative, symptomatic and diagnostic surgical procedures, and the patients of the control group underwent radical surgery for cancer. In postoperative period, all patients underwent ultrasound examination of the inferior vena cava, iliac veins and the veins of the lower extremity every 3 days for 12 days. Results. In the study group, the majority of patients had echographic signs of progression of venous thrombosis. For the control group patients, good recanalization of venous thrombosis.

Bronchogenic Carcinoma and Thromboembolic Disease

To the Editor:— In their report (202:1019, 1967) Byrd and his associates discuss the possibility of survival in carcinoma after a concomitant venous thrombosis is discovered. It is true that in my report of 1949 (New Eng J Med240:1031, 1949) I pointed out the usual rapid demise of these patients. Since then, however, I have been able to report encouraging survival of two patients, one with carcinoma of the ovary who lived for at least 2 1/2 years after surgery, and another with carcinoma of the stomach who is now alive and well four years after gastric resection (New Eng J Med274:1389, 1966). This is in line with the moderately encouraging results of Byrd et al and those of Hubay and Holden (Surg Gynec Obstet98:309, 1954) and of Woolling and Shick (Mayo Clin Proc31:277, 1956).