Iliofemoral Thrombosis Research Articles

Intramuscular pressure in the lower leg in deep vein thrombosis and phlegmasia cerulae dolens.

The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than 0.001) higher in the thrombosed leg than in the contralateral leg (0-16 mmHg). The increase in intramuscular pressure was related to the extension of the thrombus. Iliofemoral thrombosis caused a significantly (p less than 0.001) higher pressure (17-28 mmHg) than calf thrombosis (16-23 mmHg). A compartment syndrome was found to be a part of the entity phlegmasia cerulea dolens (rest pressure 47-56 mmHg). In the treatment of phlegmasia cerulea dolens, fasciotomy is suggested additional to other therapeutic procedures.

Controlled Multicenter Pilot Study of Urokinase – Heparin and Streptokinase in Deep Vein Thrombosis

Thirty-three patients with acute iliofemoral thrombosis were randomly assigned to three treatment groups in a pilot dose-ranging study of thrombolytic therapy in deep vein thrombosis. One group received tissue culture urokinase in a dose of 2,200 I.U./kg/hr, and a second group in a dose of 1,100 I.U./kg/hr following a loading dose of 4,400 I.U./kg given in ten min. Urokinase was administered for 12 hr periods, alternating with 12 hr periods of heparin. A third group received an initial dose of 250,000 I.U. of streptokinase in 20 min, followed by 100,000 I.U./hr. Treatment of all patients continued for three days. At the end of this period little improvement, evaluated by "blinded" interpretation of pre- and post-treatment phlebograms, was found in five out of ten of the higher-dose urokinase patients, seven out of eleven of lower-dosage urokinase patients, and six out of ten of streptokinase patients. Optional treatment for another three days showed little further improvement of urokinase-patients and moderate further improvement in the streptokinase-patients. Neither of the 2 dosage schemes at intermittent application of urokinase appeared to be advantageous. Urokinase treated patients experienced fewer adverse reactions.

Percutaneous wire-guided balloon pumping

A percutaneous wire-guided double lumen intraaortic balloon pump was tested in 44 patients, 15 with cardiogenic shock. The balloon volume is 40 ml, the material is Avcothane, and the central lumen will pass a 0.035 inch (0.889 mm) wire guide. Standard Seldinger technique was followed by successful insertion in 40 patients (90 percent) with no recognized vascular trauma. Counterpulsation was excellent and central pressure monitoring through the balloon lumen showed good fidelity. Iliofemoral thrombosis occurred in 5 percent of patients. The overguide technique is simple, successful and atraumatic.

Reliability of Doppler ultrasound in the diagnosis of acute venous thrombosis both above and below the knee

We have found the Doppler examination to be accurate in 92 per cent of limbs with suspected iliofemoral thrombosis and in 86 per cent of limbs with suspected calf vein thrombosis. Above the knee, the sensitivity was 94 per cent and the specificity, 90 per cent. Below the knee, the sensitivity was 91 per cent and the specificity, 84 per cent. In the hands of a skilled examiner, Doppler ultrasound is a reliable noninvasive technique for evaluating patients with suspected deep venous thrombosis and one on which therapy can safely be based.

Renal Allograft Rupture With Iliofemoral Thrombophlebitis

Spontaneous rupture of a renal allograft in the early posttransplant period is associated with tachycardia, hypotension, oliguria, swelling, pain, a falling hematocrit level, and tenderness at the transplant site. Occasionally, the ruptured allograft can be saved by control of the hemorrhage. Deep vein thrombophlebitis, a common occurrence after prolonged surgery and cortocosteroid therapy, is less common in renal allograft transplantation, but may be associated with renal vein thrombosis. The simultaneous occurrence of deep vein thrombophlebitis, renal vein thrombosis, and allograft rupture contraindicates anticoagulent therapy. We present a patient in whom ipsilateral deep vein thrombophlebitis developed eight days after a cadaveric renal allograft, followed in two days by hypotension, a falling hematocrit level, oliguria, and a painfall mass at the allograft site. Surgical exploration revealed a ruptured allograft with iliofemoral and renal vein thrombosis and profuse hemorrhage. A transplant nephrectomy was performed.

Spontaneous Venous Ilio-Femoral Thrombosis in an Infant

Spontaneous Venous Ilio-Femoral Thrombosis in an Infant

Incidence of early post-operative iliofemoral thrombosis.

The doppler ultrasound probe was used to study 138 patients after major surgery to assess the incidence of iliofemoral thrombosis in the early postoperative period. The patients were simultaneously studied with the 125-I-fibrinogen uptake test. The accuracy of the ultrasonic technique was assessed concurrently by comparing its results with those of ascending phlebography in a separate group of patients. The ultrasound probe detected thrombus proximal to the calf but was inaccurate in locating its exact site. Of the 138 patients studied postoperatively 28 developed calf vein thrombosis detected istopically, but there was no evidence of iliofemoral thrombosis in any patient. Thus, spontaneous iliofemoral thrombosis in the early postoperative period is rare.

Total disappearance of a fatal pulmonary embolus during streptokinase therapy of an iliofemoral thrombosis.

During streptokinase treatment of an iliofemoral thrombosis, a formerly healthy man developed clinical signs of major pulmonary embolism. In spite of all attempts at resuscitation, the patient died after 1.5 hours. The autopsy showed no signs of remaining thrombus or emboli. The probable explanation is that the thrombus had partially been lysed and that the remaining parts formed an embolus large enough to cause considerable haemodynamic changes which could not be influenced. Lysis continued pre- and postmortally and was complete at the time of autopsy.

Evaluation of Doppler test for venous thrombosis in obstetrics and gynecology

The use of the ultrasonic Doppler test to diagnose venous thrombosis was evaluated in an obstetric and gynecological unit. Both asymptomatic postoperative patients and those with suspected venous thrombosis were studied. Detection of ilio-femoral thrombosis was possible, but the incidence in unselected gynecological patients was low. The technique was of greater value in clarifying the diagnosis in suspected venous thrombosis.

Traumatic renal vein thrombosis associated with renal artery occlusion.

Traumatic renal vein thrombosis is rare. There are 13 cases of this injury described after direct trauma to the abdomen or the loin (Barney and Mintz, 1933; Chait et al., 1968; Colliez, 1959; Gruber, 1919; Gyepes et al., 1967; Hamburger, et al., 1968; Lang et al., 1971; March and Halpern, 1963; Meriel et al., 1959; Ney and Friedenberg, 1966; Vallery-Radot et al., 1949; Pisani, 1925–1926), although the renal vein may also be involved by proximal extension from a traumatic ilio-femoral vein thrombosis (Bayley et al., 1965). In the only case with occlusion of both renal vein and artery after direct trauma (Barney and Mintz, 1933), the correct diagnosis was made at necropsy and few clinical details were given. We are reporting a patient with this combination of injuries, diagnosed during life, to emphasize the clinical and radiological features of renal vein thrombosis in the presence of traumatic renal artery occlusion. A 25-year-old man entered the hospital with abdominal pain, hypotension, and anuria after...

ILIO-FEMORAL VENOUS THROMBOSIS AFTER OPERATIONS ON THE HIP

1. In a prospective controlled trial in patients undergoing hip operations, six out of thirty-three patients receiving prophylactic Dextran 70, and five out of thirty-three patients receiving only dextrose, were shown by ascending phlebography to have ilio-femoral thrombosis. Oedema was the only consistent clinical finding. 2. This study does not therefore support the conclusion of other reports that Dextran 70 is of value in preventing ilio-femoral thrombosis after operations on the hip joint. 3. It is suggested that patients needing operation on the hip joint are especially prone to major vein thrombosis and it may be that higher dosage of Dextran 70 is indicated. 4. This controlled investigation of sixty-six patients, now submitted as a preliminary report, is continuing.

Iliofemoral phlebography in pulmonary embolism.

Abstract Iliofemoral venous thrombosis is a common condition which, in the great majority of patients, occurs primarily in the iliofemoral segment and not as a result of proximal propagation of distal thrombus. In addition to the common femoral and external iliac veins the common iliac is an important primary site of thrombosis. Non-occlusive iliofemoral thrombus is common and is usually symptomless and unsuspected. Whether clinical signs are present or not iliofemoral thrombosis is frequently bilateral. Pulmonary embolism of a degree likely to endanger life occurs only from the iliofemoral segment, and thrombus there constitutes a serious threat to the patient. Iliofemoral phlebography is the only accurate method of examining these veins and should be carried out as a matter of urgency in patients who have a history of pulmonary embolism or who have clinical evidence of iliofemoral thrombosis or of persistent or recurrent peripheral deep vein thrombosis. Direct puncture of the common femoral vein under l...

The ultrasonic velocity detector in a clinical study of venous disease.

THE CLINICAL evaluation of diseases involving the venous system has been hampered somewhat by the lack of ancillary diagnostic aids. Aside from the history and physical examination, the only readily available methods of study are venography and venous pressure measurements. These techniques have not generally been accepted with the same enthusiasm as arteriography or plethysmography have in arterial disease because it is only in special circumstances that the findings directly influence the type of therapy to be employed. While it is certainly true that there are entities such as varicose veins, superficial thrombophlebitis, and iliofemoral thrombosis which are often simple to diagnose, there are many situations in which additional information would be desirable. The recent introduction of the ultrasonic velocity detector has provided us with a new method of obtaining qualitative information relative to venous dynamics hitherto unavailable. Because of its simplicity of operation and versatility, the detector is proving

Patency after Thrombectomy for Iliofemoral Thrombosis

Patency after Thrombectomy for Iliofemoral Thrombosis

Surgical treatment of iliofemoral thrombosis.

Surgical treatment of iliofemoral thrombosis.

Iliac vein compression.--Its relation to iliofemoral thrombosis and the post-thrombotic syndrome.

Summary The treatment of haemorrhoids by conservative methods has been examined. Injection therapy with the use of phenol in almond oil was effective in controlling bleeding, but with almond oil alone it was not. A comparison between the results of injection therapy and the technique of rubber ring ligation showed objectively better results after six months with ligations. However, ligation was sometimes followed by pain, and a few patients refused to continue with this form of treatment. These preliminary alternatives indicate that phenol in oil is still the best treatment for early first-degree piles. The results of ligation for second-degree piles are encouraging, but further evaluation is required.

Thrombectomy for acute iliofemoral venous thrombosis

1. 1. Four patients successfully treated by thrombectomy for acute progressive iliofemoral or inferior vena caval thrombosis are presented. 2. 2. General anesthesia and temporary occlusion of the inferior vena cava or common iliac veins were employed in each patient. 3. 3. Our experience suggests that early thrombectomy for thrombosis of major veins is a valuable procedure which deserves wide-spread adoption.

Vascular manifestations of idiopathic retroperitoneal fibrosis

1. 1. A case of retroperitoneal fibrosis presenting with acute iliofemoral vein thrombosis is reported. 2. 2. Smooth tapering constrictive stenosis seen on arteriogram, although not diagnostic, should suggest the possibility of retroperitoneal fibrosis. 3. 3. A ten minute total urogram is recommended after all angiographic studies. It was an aid in the diagnosis of this case. 4. 4. Early planned intervention by a team of surgeons including a urologist is recommended.