scholarly journals Treatment of Varicose Veins Affects the Incidences of Venous Thromboembolism and Peripheral Artery Disease

2021 ◽  
Author(s):  
Shyue-Luen Chang ◽  
Sindy Hu ◽  
Yau-Li Huang ◽  
Mei-Ching Lee ◽  
Wen-Hung Chung ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Health Insurance ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Peripheral Artery Disease ◽  
National Health Insurance ◽  
Varicose Veins ◽  
Research Database ◽  
Peripheral Artery ◽  
Artery Disease

Background: Varicose veins are a common problem worldwide. Although it was reported that varicose veins have cosmetic and symptomatic effects and can also lead to an increased risk of incident deep venous thrombosis, pulmonary embolism, and peripheral artery disease, whether varicose vein treatment prevents those serious complications is unknown. Methods: This retrospective cohort study used claims data extracted from the Chang Gung Research Database and National Health Insurance Research Database in Taiwan. The study subjects were patients aged ≥20 years who underwent endovenous thermal ablation (ETA) from 2005 to 2016 and a group of untreated subjects who were matched by sex and year of birth. All patients were followed from the index date to the earliest occurrence of peripheral artery disease, deep venous thrombosis, or pulmonary embolism or death or the end of the study. To avoid possible selection bias, 1:4 propensity score matching was implemented and a Cox proportional-hazards model was applied while controlling for potential confounders. We also collected data on complications within 28 days of ETA. Results: In total, data on 1323 ETA-treated patients with varicose veins were extracted from the Chang Gung Research Database, while data on 149 586 untreated patients with varicose veins were extracted from the National Health Insurance Research Database. Compared with the untreated group, ETA-treated patients had decreased risks of deep venous thrombosis and peripheral artery disease (adjusted hazard ratio, 0.49 [95% CI, 0.32–0.75] and 0.64 [95% CI, 0.49–0.85]). The incidence rates of deep venous thrombosis and pulmonary embolism after ETA (≤28 days) were 0.296% and 0.074%, respectively. Conclusions: ETA treatment of varicose veins was associated with a substantial decrease in the subsequent incidence of thromboembolism and peripheral artery disease compared with that in the absence of treatment. In addition, the incidence rate of postprocedural thromboembolic complications after ETA was low in the Asian population. We suggest that improved disease awareness and appropriate early treatment may help reduce the risk of serious complications.

scholarly journals Microvascular Complications, Peripheral Artery Disease and Mortality in Patients with Type 2 Diabetes Mellitus, in Two Counties of Southern Lithuania over 13 Years: Analysis Using a Cohort Database of the National Health Insurance

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1380
Author(s):  
Laima Piliponienė ◽  
Džilda Veličkienė ◽  
Rima Kregždytė
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Insurance ◽  
Peripheral Artery Disease ◽  
National Health Insurance ◽  
Microvascular Complications ◽  
Peripheral Artery ◽  
Artery Disease

Background and Objectives: People living with diabetes mellitus are at risk of developing many serious and life-threatening complications. The present study aimed to determine the occurrence of microvascular complications, peripheral artery disease, and mortality in patients with type 2 diabetes mellitus (T2DM), in 2 Lithuanian counties. Materials and Methods: The data on residents aged ≥ 18 years, who were diagnosed for the first time in 2004 with uncomplicated T2DM, were obtained from the National Health Insurance Fund database. The occurrence of T2DM microvascular complications, peripheral artery disease, and mortality during the period from 2004 to 2016 were assessed by gender and age groups (<65 and ≥65 years). Results: During the 13 years, 46.9% of the patients developed T2DM complications. More men than women developed at least 1 T2DM complication (50.8% vs. 44.8%, p = 0.035). The mean time for developing any T2DM complication was 9.2 years. The probability of occurrence of any complication was 0.07 in the second year and increased to 0.59 in the thirteenth year of living with diabetes. Within the 13 years, 38.2% of the patients died. More men (43.1%) than women (35.5%) died during the analysis period (p = 0.036). Mortality was higher among older patients (60.7%) than among younger patients (22.2%) (p < 0.001). Conclusions: The results of this study provide a comprehensive picture of microvascular complications, peripheral artery disease, and mortality among patients with T2DM of two Lithuanian counties. Information about the occurrence of T2DM complications and mortality will assist further studies in estimating the burden of T2DM and in performing economic evaluations of T2DM prevention and treatment in Lithuania.

scholarly journals Rivaroxaban: Expanded Role in Cardiovascular Disease Management—A Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Muhammad Ajmal ◽  
Jacob Friedman ◽  
Qurat Ul Ain Riaz Sipra ◽  
Tom Lassar
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Factor Xa ◽  
Evidence Based ◽  
Peripheral Artery ◽  
Nonvalvular Atrial Fibrillation ◽  
Artery Disease ◽  
Hip And Knee Surgery

Direct oral anticoagulants (DOACs) are widely used for the prevention of stroke in nonvalvular atrial fibrillation, treatment of deep venous thrombosis and pulmonary embolism, and as prophylaxis after hip and knee surgery after approval by the Food and Drug Administration. In the last decade, DOACs were studied for various indications; this review is focused on rivaroxaban, a factor Xa inhibitor, which is used in an expanded evidence-based fashion for coronary artery disease, peripheral artery disease, heart failure, malignancy, and prophylaxis of deep venous thrombosis in acute medical illnesses.

scholarly journals Major adverse cardiovascular and limb events in patients with diabetes and concomitant peripheral artery disease treated with sodium glucose cotransporter 2 inhibitor versus dipeptidyl peptidase-4 inhibitor

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Hsin-Fu Lee ◽  
Shao-Wei Chen ◽  
Jia-Rou Liu ◽  
Pei-Ru Li ◽  
Lung-Sheng Wu ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Study Groups ◽  
Dipeptidyl Peptidase ◽  
Research Database ◽  
Peripheral Artery ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Artery Disease

Abstract Background Whether sodium glucose co-transporter 2 inhibitors (SGLT2i) are associated with a lower risk of cardiovascular as well as adverse lower limb events in patients with type-2 diabetes mellitus (T2DM) and concomitant peripheral artery disease (PAD) is unclear. We aimed to evaluate the risk of cardiovascular and limb events, and death associated with the use of SGLT2i compared with dipeptidyl peptidase-4 inhibitors (DPP4i) among a longitudinal and national cohort of patients with T2DM. Methods In this nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database, we identified a total of 11,431 and 93,972 consecutive T2DM patients with PAD taking SGLT2i and DPP4i, respectively, from May 1, 2016, to December 31, 2017. We used 1:1 propensity score matching (PSM) to balance covariates across study groups. Patients were followed from the drug index date until the occurrence of clinical outcomes, death, discontinuation of the index drug, or the end of the study period, whichever occurred first. Results Overall, 56% and 44% of the patients were treated with dapagliflozin and empagliflozin, respectively. The use of SGLT2i had comparable risks of ischemic stroke and acute myocardial infarction, and was associated with lower risks of congestive heart failure (CHF) [hazard ratio (HR): 0.66; 95% confidence interval (CI) 0.49–0.89; p = 0.0062], lower limb ischemia requiring revascularization (HR: 0.73; 95% CI 0.54–0.98; p = 0.0367) or amputation (HR: 0.43; 95% CI 0.30–0.62; p < 0.0001), and cardiovascular death (HR: 0.67; 95% CI 0.49–0.90; p = 0.0089) when compared with the DDP4i group after PSM. The subgroup analysis revealed consistent results for CHF and major adverse limb outcomes for SGLT2i versus DPP4i among patients aged ≥ 75 years, the presence of chronic kidney disease and established cardiovascular disease was consistent with the main analysis. Conclusions SGLT2i were associated with lower risks of CHF and adverse lower limb events compared with DPP4i among patients with T2DM and PAD in real-world practice.

scholarly journals Association of Varicose Veins With Incident Venous Thromboembolism and Peripheral Artery Disease

JAMA ◽  
2018 ◽  
Vol 319 (8) ◽  
pp. 807 ◽  
Author(s):  
Shyue-Luen Chang ◽  
Yau-Li Huang ◽  
Mei-Ching Lee ◽  
Sindy Hu ◽  
Yen-Chang Hsiao ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Peripheral Artery Disease ◽  
Varicose Veins ◽  
Peripheral Artery ◽  
Artery Disease

Deep Venous Thrombosis and Pulmonary Embolism as Rare Complications After Hallux Valgus Surgery

2013 ◽  
Vol 103 (2) ◽  
pp. 145-148 ◽  
Author(s):  
Faik Altintaş ◽  
Turhan Özler ◽  
Melih Güven ◽  
Afşar Timuçin Özkut ◽  
Çağatay Uluçay
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Hallux Valgus ◽  
Varicose Veins ◽  
Early Mobilization ◽  
Thromboembolic Disease ◽  
Foot And Ankle ◽  
Ankle Surgery ◽  
Life Threatening

The incidence and life-threatening complications of thromboembolic disease after major orthopedic surgical procedures have been extensively defined in the medical literature. However, there are few studies concerning the incidence of thromboembolic disease after foot and ankle surgery. We describe a 57-year-old female patient who underwent surgery for bilateral hallux valgus deformities and was diagnosed as having deep venous thrombosis and pulmonary embolism after the surgery despite early mobilization and mechanical prohylaxis. Her preoperative physical examination revealed varicose veins in both cruris. She was treated for pulmonary embolism with low-molecular-weight heparin and an oral anticoagulant in the postoperative period. Although venous thromboembolism is more commonly described after proximal lower-extremity procedures, it can occur after foot and ankle surgery, particularly if the patient has certain risk factors. Therefore, in addition to mechanical prophylaxis, pharmacologic prophylaxis should be kept in mind in such patients. (J Am Podiatr Med Assoc 103(2): 145–148, 2013)

Associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm – a grin without a cat!

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Hisato Takagi ◽  
Takuya Umemoto
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Peripheral Artery Disease ◽  
Literature Search ◽  
Systematic Literature Search ◽  
Peripheral Artery ◽  
Epidemiological Evidence ◽  
Abdominal Aortic ◽  
Artery Disease ◽  
Meta Analyses

Abstract. Both coronary and peripheral artery disease are representative atherosclerotic diseases, which are also known to be positively associated with presence of abdominal aortic aneurysm. It is still controversial, however, whether coronary and peripheral artery disease are positively associated with expansion and rupture as well as presence of abdominal aortic aneurysm. In the present article, we overviewed epidemiological evidence, i. e. meta-analyses, regarding the associations of coronary and peripheral artery disease with presence, expansion, and rupture of abdominal aortic aneurysm through a systematic literature search. Our exhaustive search identified seven meta-analyses, which suggest that both coronary and peripheral artery disease are positively associated with presence of abdominal aortic aneurysm, may be negatively associated with expansion of abdominal aortic aneurysm, and might be unassociated with rupture of abdominal aortic aneurysm.

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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