scholarly journals A rare clinical form of deep vein thrombosis: Phlegmasia alba dolens

2018 ◽  
Vol 26 (3) ◽  
pp. 111-115
Author(s):  
Hüseyin Şaşkın
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Form ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
Deep Vein

scholarly journals Improvement of Medical Treatment Options of Proximal Deep Vein Thrombosis of Low Extremities Associated with Phlegmasia Alba Dolens

2021 ◽  
Vol 14 (3) ◽  
pp. 193-198
Author(s):  
Boris Sukovatykh ◽  
Aleksey Viktorovich Sereditsky ◽  
Andrey Mikhailovich Azarov ◽  
Vadim Feliksovich Muradyan ◽  
Mikhail Borisovich Sukovatykh ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Conservative Treatment ◽  
Treatment Options ◽  
Proximal Deep Vein Thrombosis ◽  
Venous Outflow ◽  
Partial Restoration ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
Anti Inflammatory ◽  
Deep Vein

The aim of the study was to improve the conservative treatment options for proximal deep vein thrombosis of low extremities associated with phlegmasia alba dolens optimization of anticoagulant therapy and paravascular injection of the anti-inflammatory medical mixture in areas of the most intense inflammatory process.Materials and methods. The results of treatment of two statistically homogeneous groups of patients with proximal deep vein thrombosis of the lower extremities associated with white phlegmasia were compared. In the first group (n = 30), standard conservative treatment was carried out using rivaroxaban as an anticoagulant; in the second group (n = 30), initial heparin therapy was first performed and, additionally, the following mixture was administered in the places of the greatest severity of inflammatory process under ultrasound control: dexamethasone 16 mg, heparin 5 thousand units, 0.25% novocaine solution 20.0 ml. During treatment the incidence of hemorrhagic syndrome was recorded. The results were assessed after one year according to the degree of deep vein lumen restoration and the severity of venous outflow impairment according to the Villalta scale. Results. In patients of both groups, every tenth patient developed some minor manifestations of hemorrhagic syndrome during treatment with rivaroxaban that was corrected by a decrease in the dose of anticoagulant.Complete restoration of the lumen of the veins occurred in 20.0%, patients of the first group and in 40.0%, patients of the second group; partial, in 63.3% and 56.7% of patients, respectively, minimal - in 16.7% and 3.3% of patients, respectively.In the first group, clinical disorders of venous outflow were absent in 20.0% of patients, a weak degree of severity was registered in 23.3%, an average - in 40.0%, and a strong one in 16.7% of patients, and in the second group, in 40 %, 26.7%, 30% and 3.3% of patients, respectively.Different minor hemorrhagic complications after Rivaroxaban intake occurred equally in both groups in each of ten patients. These complications were treated by the reduction of the anticoagulants dose.Complete restoration of the vein lumen occurred in the first group in 20.0%, and in the second group in 40.0% of patients, partial restoration, in 63.3% and 56.7% of patients, minimal - in 16.7% and 3.3% of patients respectively.In patients of the first group clinical venous congestion was absent in 20,0% of patients, mild congestion was manifested in 23,3% of patients, moderate - in 40,0% of patients, and severe was in 16,7% of cases. In the second group, the obtained data was 40%, 26,7%, 30%, and 3,3% of patients, respectively. Conclusion. Starting therapy with heparin and paravascular injection of anti-inflammatory mixture helps improve treatment outcomes.

Evaluation of Catheter Directed Thrombolytic Therapy versus Systemic Anticoagulant Therapy of Acute Ilio-Femoral Deep Vein Thrombosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Samy Gamil Akhnoukh ◽  
Ramez Monuir Wahba ◽  
Nabil Gamal Abd Elnaser Mahmoud
Keyword(s):  
Deep Vein Thrombosis ◽  
Thrombolytic Therapy ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Anticoagulant Therapy ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
Venous Gangrene ◽  
Deep Vein

Abstract Background Deep venous thrombosis (DVT) is a major cause of morbidity and mortality all-over the world. Complications include pulmonary embolism (PE), post-thrombotic syndrome (PTS), phlegmasia alba dolens, phlegmasia cerulea dolens and venous gangrene. The PTS is the most common cause of long-term morbidity and disability among the previous complications. Aim of the Work The aim of this work is evaluation of the regional catheter-directed thrombolytic therapy versus standard systemic anticoagulant therapy in cases of acute ilio-femoral deep vein thrombosis as regard to efficacy, safety as well as complications. Patients and Methods This study was conducted on 30 patients presented to the vascular surgery unit of Ahmed Maher Teaching Hospital between February, 2019 and August, 2019 with acute iliofemoral deep venous thrombosis (less than two weeks duration). Of the 30 patients, 18 were females and 12 were males. The age of the patients ranged between 22 and 55 years. Results The outcome results of early Follow up of the thrombolytic therapy was complete recanalization in 30.7% of the cases, partial re-canalization in 53.8% of the cases and poor recanalization in the remaining cases15.3%.While the follow up results of anticoagulant therapy was complete re-canalization in 6.7% of the cases, partial re-canalization in 60% of cases and poor recanalization in the remaining cases 33.3% Conclusion Catheter directed thrombolytic therapy using streptokinase, as a lytic agent in the treatment of acute ilio-femoral DVT is a safe and efficient technique.

scholarly journals Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Nelson Oliveira ◽  
Emanuel Dias ◽  
Ricardo Lima ◽  
Fernando Oliveira ◽  
Isabel Cássio
Keyword(s):  
Deep Vein Thrombosis ◽  
Vena Cava ◽  
Young Patients ◽  
Iliac Vein ◽  
Definitive Diagnosis ◽  
Systemic Thrombolysis ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
The Right ◽  
Deep Vein

Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging.Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation.Phlegmasia alba dolensinstalled progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy.Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

Feasibility Study of Catheter-directed Thrombolysis with Recombinant Staphylokinase in Deep Venous Thrombosis

1998 ◽  
Vol 79 (03) ◽  
pp. 517-519 ◽  
Author(s):  
Stephane Heymans ◽  
Raymond Verhaeghe ◽  
Luc Stockx ◽  
Désiré Collen
Keyword(s):  
Deep Vein Thrombosis ◽  
Continuous Infusion ◽  
High Speed ◽  
Minor Bleeding ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Long Term Follow Up ◽  
Valve Function ◽  
Rotating Impeller ◽  
Deep Vein

SummaryThe feasibility of catheter-directed thrombolysis with recombinant staphylokinase was evaluated in six selected patients with deep vein thrombosis. The patients underwent intrathrombus infusion of recombinant staphylokinase (2 mg bolus followed by a continuous infusion of 1 mg/h). Heparin was given via the catheter as a bolus (5000 U) and as a continuous infusion (1000 U/h). Complete lyis was obtained in five patients and partial lysis in one patient. Complications consisted of minor bleeding in four subjects. Symptomatic reocclusion occurred in one. Debulking of the thrombus mass by a high speed rotating impeller (n = 1) and stenting (n = 3) were used as additional interventions. An underlying anatomical abnormality was present in two patients. Long term follow up revealed normal patency in all patients and normal valve function in four patients. Symptomatic venous insufficiency with valve dysfunction was present in the two with a second thrombotic episode.Thus catheter-directed infusion of recombinant staphylokinase in patients with deep vein thrombosis appears feasible and may be associated with a high frequency of thrombolysis. Larger studies to define the clinical benefit of this treatment appear to be warranted.

Deep Vein Thrombosis and Fibrinolysis

1991 ◽  
Vol 66 (04) ◽  
pp. 426-429 ◽  
Author(s):  
Marcel Levi ◽  
Anthonie W A Lensing ◽  
Harry R Büller ◽  
Paolo Prandoni ◽  
Gerard Dooijewaard ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Tissue Type ◽  
Controlled Study ◽  
First Episode ◽  
Control Group ◽  
Vein Thrombosis ◽  
Type Plasminogen Activator ◽  
Deep Vein

SummaryIn the present study 57 consecutive patients with a first episode of venographically proven deep vein thrombosis were investigated to evaluate the release of tissue-type plasminogen activator (t-PA) and of urokinase-type plasminogen activator (u-PA) in response to DDAVP stimulation as well as the resting plasminogen activator inhibitor (PAI) concentration, comparing this to the results obtained in 66 similar patients with a clinical suspicion of thrombosis but with a normal venogram. All assays were performed without knowledge of the patient's status.Four patients in the deep vein thrombosis-group (7%) had an absent u-PA antigen response upon DDAVP infusion, while a normal response was observed in all control subjects. Patients and controls showed similar increases in t-PA antigen level upon DDAVP. High resting PAI antigen levels were encountered in 5 patients in the deep vein thrombosis-group (9%) and in 6 subjects in the control group (9%).The results from this controlled study indicate that a defective release of u-PA may occur in patients with deep vein thrombosis and may have pathogenetic significance. Furthermore it is concluded that elevation of PAI levels cannot be considered as a specific risk factor for venous thrombosis.

Acute Deep Vein Thrombosis Treated with Porcine Plasmin

1974 ◽  
Vol 32 (02/03) ◽  
pp. 468-482 ◽  
Author(s):  
O Storm ◽  
P Ollendorff ◽  
E Drewsen ◽  
P Tang
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Initial Dose ◽  
Treated Group ◽  
Allergic Reactions ◽  
Double Blind ◽  
Vein Thrombosis ◽  
Thrombolytic Effect ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

SummaryThe thrombolytic effect of pig plasmin was tested in a double blind trial on patients with deep venous thrombosis in the lower limb. Only patients with not more than three days old thrombi were selected for this study. The diagnosis of deep vein thrombosis was made clinically and confirmed by phlebography. Lysofibrin Novo (porcine plasmin) or placebo (porcine plasminogen) was administered intravenously to the patients. The enzyme and the placebo were delivered as lyophilized powder in labelled bottles - the contents of the bottles were unknown to the doctor in charge of the clinical administration of the trial. An initial dose of plasmin/plasminogen of 30 unit per kg body weight given slowly intravenously (1-1% hours infusion) was followed by a maintenance dosis of 15 per cent the initial dose per hour for the following 5-7 hours. In most cases a similar maintenance dosis was given the next day. In all patients heparin was administered after ending the plasmin/plasminogen infusion. The results of the treatment was evaluated clinically as well as by control phlebo- grams the following days.A statistically significant improvement was found in the plasmin treated group compared with the placebo (plasminogen) treated group. Thrombolysis was obtained clinically and phlebographically in 65 per cent of the plasmin treated group, but only in 15 per cent of the control patients were improvements found.This study has thus demonstrated that plasmin treatment according to a standard scheme was able to induce thrombolysis. There were only a few and insignificant side effects. Allergic reactions have not been seen and only very simple tests are required.

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