Ileofemoral Thrombosis Research Articles

Group A beta-haemolytic streptococcal toxic shock syndrome presenting as suspected ileo-femoral thrombosis in the puerperium

Group A beta-haemolytic streptococcal toxic shock syndrome presenting as suspected ileo-femoral thrombosis in the puerperium

Long-term infusion in cancer chemotherapy with the Groshong catheter via the inferior vena cava.

Vascular access through a vein draining into the superior vena cava is commonly used for long-term infusion of drugs inr cancer chemotherapy; prolonged cannulation of the inferior vena cava is generally considered as having an excessively high complication rate. Prolonged cisplatin infusion via the inferior vena cava by means of a Groshong catheter was evaluated in 20 consecutive patients with thoracic malignancies showing evidence of superior vena cava infiltration or obstruction. We achieved 1,291 catheter days for our survey with a mean duration of vascular access of 64.5 days per patient and a mean duration of infusion time of 40 days. There were 2 complications, a catheter obstruction after a 7-day rest period and an ileo-femoral thrombosis 6 days after catheter placement. Our experience compared favourably with the results obtained by long-term central venous access via the supraumbilical route, and demonstrated the reliability and safety of this approach in cases where the superior vena cava cannulation is technically difficult or impossible.

Bilateral pelvic lymphadenectomy, iridium 192 template, and external beam therapy for localized prostatic carcinoma: complications and results.

Thirty-five patients with prostatic adenocarcinoma were treated by bilateral pelvic lymphadenectomy and temporary implantation of iridium 192 strands with adjuvant external beam radiotherapy. With the implant the prostate received between 3,200 and 3,500 gray (Gy) followed in two weeks by small-field external beam irradiation for an additional dose of approximately 3,400 Gy. Morbidity included an ileofemoral thrombosis in one patient, and transient radiation proctitis in four patients; one patient required transurethral prostatic resection for obstruction at one year. Local response of the primary tumor was dramatic in every case at three-month follow-up. In 11 of 15 patients (73%), biopsy at one year showed no evidence of disease.

Vascular complications in renal transplantation: The Johannesburg experience

The aim of this retrospective study, involving 909 renal transplants in 773 patients, was to determine the incidence of vascular complications. Four patients had isolated calf vein thrombosis (0.4%), 13 had ileofemoral thrombosis (1.4%), 3 had superficial vein thrombosis (0.3%), 10 developed pulmonary emboli (1.1%), 6 had renal vein thrombosis (0.66%), 3 had renal artery thrombosis (0.3%), 3 had renal artery stenosis, 2 patients developed anastomotic aneurysms and a further patient ruptured his arterial anastomosis. Cyclosporine has not increased the incidence of thrombosis since its introduction to the unit.

Lungenembolien im Kindesalter

The frequency of pulmonary embolism was investigated in a 10-year period from 1971 to 1982. During this time approximately 30 000 operations in 60 000 surgical and medical patients were performed. In seven patients, six boys and one girl, pulmonary embolism was diagnosed. This includes six patients with septic embolism, arising in three cases from subacute endocarditis, in two from osteomyelitis of the humerus and in one from coxitis. Only in one patient, a boy who was operated for perforated appendicitis, pulmonary embolism resulted as a complication of left-sided ileofemoral thrombosis. In three boys with osteomyelitis and coxitis, staph. aureus was found locally as well as in blood culture and in sputum. Prophylactic anticoagulation is recommended by the authors in all children over 10 years who were immobilized due to a septic process.

The Role of Fasciotomy for Limb Salvage in Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens, a complication of ileofemoral thrombosis, fre quently results in venous gangrene and limb loss.1,2,3 The ischemia associated with phlegmasia cerulea dolens is secondary to venous occlusion, increased pressure in muscle compartments and diminished capillary perfusion. 1,2,3 Fas ciotomy should theoretically be a logical adjunct to therapy when anticoagula tion or venous thrombectomy is contraindicated or ineffective. Benefits attri buted to compartment decompression have been reported.2,4 Nevertheless, publicized failures of fasciotomy to reverse the ischemia of phlegmasia cerulea dolens have discouraged its use.5,1

Practical Role for Ultrasound in Diagnosis of Deep Venous Thrombosis of Lower Extremities

The Doppler Ultrasonic Velocity Detector has been shown to be of significant value in the evaluation of patients with suspected deep venous thrombosis. Our experience in 121 patients demonstrates a false-negative rate of 10% for "minimal" thrombophlebitis and 3.2% for ileofemoral thrombosis when the Doppler was used as a diagnostic aid. Since ileofemoral thrombosis represents the greatest threat to the patient in terms of pulmonary embolism, this appears to be a sensitive and specific technic for the detection of ileofemoral thrombosis.

The iliac compression syndrome.

The iliac compression syndrome is a condition of venous congestion in the pelvis starting at the confluence area and radiating to 1 of the legs. It is usually left-sided. Venous drainage from the leg is obstructed and thrombosis may result. Where the right common iliac artery crosses the left common iliac vein compression at the level of the promontory may occur with a chronic inflammatory condition of the vein caused by arterial pulsations. Endothelial proliferation then causes narrowing of the venous lumen. This condition has been found in 7 patients all women. Pelvic phlebography was used to demonstrate the obstruction. Case histories are given. Oral contraceptives may play a role by increasing the tendency to blood thrombus formation and of intimal thickening of the vein. In 1 patient ileofemoral thrombosis developed shortly after administration of oral contraceptives. The disorder can be successfully treated surgically.

Systemic reaction after intravenous fibrinolysin therapy.

A 39-year-old man had a number of abdominal operations, including cholecystectomy and subtotal gastrectomy. During his most recent period of hospitalization he suffered an ileofemoral thrombosis and was treated by intravenous injection of 100 mg. of heparin and 200,000 units of fibrinolysin. Fever and shock appeared within 3 hours after the injection, but all tenderness disappeared from the patient's ileofemoral region in approximately 10 hours. Recovery from the thrombosis and from the side-effects of the treatment was complete within three days. Immunological studies led to the hypothesis that the patient's circulation carried antibodies for streptokinase and fibrinolysin. It is suggested that fibrinolysin be used with caution until its mode of action is better understood.