Upper extremity deep venous thrombosis and pulmonary embolism after transvenous lead replacement or upgrade procedures

2020 ◽  
Vol 43 (5) ◽  
pp. 495-502 ◽  
Author(s):  
Caio Marcos de Moraes Albertini ◽  
Katia Regina da Silva ◽  
Marta Fernandes Lima ◽  
Joaquim Maurício da Motta Leal Filho ◽  
Martino Martinelli Filho ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity

scholarly journals Upper extremity deep venous thrombosis: risk factors, diagnosis, treatment

2016 ◽  
Vol 11 (1) ◽  
pp. 28-32
Author(s):  
Camelia C. DIACONU ◽  
◽  
Mădălina ILIE ◽  
Mihaela Adela IANCU ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Brachiocephalic Vein ◽  
Risk Of Death ◽  
Thrombosis Risk ◽  
Effort Thrombosis

Upper extremity deep venous thrombosis is a condition with increasing prevalence, with high risk of morbidity and mortality, due to embolic complications. In the majority of the cases, thrombosis involves more than one venous segment, most frequently being affected the subclavian vein, followed by internal jugular vein, brachiocephalic vein and basilic vein. Upper extremity deep venous thrombosis in patients without risk factors for thrombosis is called primary deep venous thrombosis and includes idiopathic thrombosis and effort thrombosis. Deep venous thrombosis of upper extremity is called secondary when there are known risk factors and it is encountered mainly in older patients, with many comorbidities. The positive diagnosis is established only after paraclinical and imaging investigations, ultrasonography being the most useful diagnostic method. The most important complication, with high risk of death, is pulmonary embolism. Treatment consists in anticoagulant therapy, for preventing thrombosis extension and pulmonary embolism.

Upper Extremity Deep Venous Thrombosis: Reassessing the Risk for Subsequent Pulmonary Embolism

2011 ◽  
Vol 25 (4) ◽  
pp. 442-447 ◽  
Author(s):  
Mark M. Levy ◽  
Christopher Bach ◽  
Ruth Fisher-Snowden ◽  
Justin D. Pfeifer
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity

Upper-Extremity Deep Venous Thrombosis and Pulmonary Embolism

CHEST Journal ◽  
1991 ◽  
Vol 99 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Manuel Monreal ◽  
Elena Lafoz ◽  
Joan Ruiz ◽  
Rafael Valls ◽  
Antoni Alastrue
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity

scholarly journals Development of a Computable Phenotype for Hospital-Acquired Venous Thrombosis: The Medical Inpatient Thrombosis and Hemostasis (MITH) Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 40-41
Author(s):  
Ryan M Thomas ◽  
Insu Koh ◽  
Katherine Wilkinson ◽  
Nicholas Roetker ◽  
Nicholas L Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Sensitivity And Specificity ◽  
Survey Methodology ◽  
Imaging Studies ◽  
Icd Codes ◽  
Hospital Acquired

Introduction Electronic health records (EHRs), allow use of large clinical databases to inform the practice of medicine. The impact of EHRs on research has been modest due to the lack of validated computable phenotypes for risk factors and outcomes. We developed and validated a computable phenotype for hospital-acquired (HA) venous thrombosis (VTE) to aid future studies about of HA-VTE. Methods The study population consisted of all admissions to the medical services (general medicine, cardiology, intensive care unit, and hematology / oncology) between 2010-19 at the University of Vermont (UVM) Medical Center, a 540-bed tertiary acute care hospital. HA-VTE was defined as a deep vein thrombosis of a lower or upper extremity or pulmonary embolism. Data used to develop the computable phenotype include International Classification of Disease (ICD) 9 or 10 discharge codes with the present on admission (POA) flag and current procedure terminology (CPT) codes with dates/times (which include imaging studies). We divided VTE into three groups; upper extremity deep venous thrombosis, lower extremity deep venous thrombosis, and pulmonary embolism, and selected CPT codes which could have diagnosed each VTE group. Our final definition consisted of a VTE ICD code not POA with a VTE site-specific CPT code (but not on the day of admission). We validated the algorithm by randomly abstracting 110 charts in 6 groups; 1) no VTE ICD codes, 2) VTE ICD code POA, 3) VTE ICD code not POA and no CPT code, 4) VTE ICD code not POA and with a CPT code on day 1 of admission, 5) VTE ICD code not POA with a CPT code on day 1 of admission and another 1+ day of admission (this group was incidentally discovered during our initial chart abstraction and validation) and 6) VTE ICD code not POA and with a CPT code after day 1 of admission (our computable phenotype of HA-VTE). We used survey methodology to determine the sensitivity and specificity of our computable phenotype for HA-VTE. Results Figure 1 shows our methodology and the results from the computable phenotype including how many admissions were analyzed and the total number of HA-VTE identified. For validation we abstracted 110 hospitalizations from the 6 identified groups using a standardized form. The results of the validation by abstraction group are presented in the Table. Using survey methodology, we estimate the incidence of HA-VTE to be 4.9 per 1000 admissions. Among the 20 patients with no VTE ICD code, there were no VTE events. Among the hospitalizations with VTE ICD codes which did not meet our computable phenotype definition of HA-VTE, 5 of 91 individuals had a HA-VTE. One individual had an incorrect POA flag, another had a non-vascular ultrasound which diagnosed the HA-VTE, and 3 admissions with HA-VTE were excluded due to having an imaging study on day 1. Among the 19 patients abstracted for our computable phenotype for HA-VTE, 16 had a HA-VTE. Among the three failures of our HA-VTE computable phenotype, 1 individual had a HA-superficial venous thrombosis (miscoded), the second individual had multiple imaging studies due to a high clinical suspicion, and the third had a VTE on admission (erroneous POA flag). The sensitivity and specificity of our computable phenotype for HA-VTE was 84.2% (CI 78.7-88.9%) and 99.8% (CI 99.77-99.84%). Conclusions We developed a computable phenotype for HA-VTE with adequate specificity and excellent sensitivity. This phenotype will be used to assess risk factors for HA-VTE and with appropriate validation to estimate the rates of HA-VTE at other institutions. Disclosures No relevant conflicts of interest to declare.

Perforation of inferior vena cava during filter placement

VASA ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Piecuch ◽  
Wiewiora ◽  
Nowowiejska-Wiewiora ◽  
Szkodzinski ◽  
Polonski
Keyword(s):  
Pulmonary Embolism ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Retroperitoneal Hematoma ◽  
Ivc Filter ◽  
Filter Placement ◽  
Therapeutic Method

The placement of an inferior vena cava (IVC) filter is a therapeutic method for selected patients with deep venous thrombosis and pulmonary embolism. However, insertion and placement of the filter may be associated with certain complications. For instance, retroperitoneal hematoma resulting from perforation of the wall by the filter is such a very rare but serious complication. We report the case of a 64-year-old woman with perforation of the IVC wall and consecutive hematoma caused by the filter who was treated surgically.

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