Invasive approaches to treatment of venous thromboembolism.

نویسندگان

  • Peter Augustinos
  • Kenneth Ouriel
چکیده

Deep vein thrombosis (DVT) occurs in one-quarter of a million individuals annually in the United States and results in significant disability from pulmonary embolism and chronic venous insufficiency, especially when the proximal iliofemoral is involved. Treatment has centered on early institution of adequate anticoagulation to prevent thrombus propagation and embolism, but anticoagulation alone does not always restore venous patency and many patients are left with venous outflow obstruction and valvular incompetence-the anatomic underpinnings of the postthrombotic syndrome. Various strategies have been used to restore patency of thrombosed veins, including open surgical thrombectomy, pharmacological thrombolysis, and percutaneous mechanical thrombectomy. Each modality has benefits and shortcomings. Surgical thrombectomy had previously been abandoned secondary to poor long-term results. More recently, with improved techniques and better patient selection, surgical thrombectomy has regained a therapeutic role in treating acute DVT in young patients with short segment occlusions. The advent of percutaneous techniques has allowed thrombolysis, percutaneous mechanical thrombectomy, and stenting to be used in conjunction with each other-allowing for better resolution of venous clot burden than when an individual modality is used alone. Practitioners who treat patients with DVT should be familiar with all the options available to restore venous patency, preserve valvular function, and thereby minimize the risk of late postthrombotic complications.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Recurrent Venous Thromboembolism as the Initial Clinical Presentation of Gastric Cancer: A Case Report

Pulmonary thromboembolism (PTE) is a clinically critical disease, misdiagnosis or delayed diagnosis of which can lead to increased rate of mortality. For prevention of recurrence of PTE, recognition of its risk factors or underlying diseases is of great importance. PTE is common in patients with cancer and has high morbidity and mortality rates. Although cancer is a lethal condition, PTE accele...

متن کامل

Evaluation of the Frequency of Risk Factors in Venous Thromboembolic Patients Admitted to Ekbatan and Farshchian Hospitals in Hamadan from 2012 to 2017

Background and Objective: Venous thromboembolism is one of the major causes of mortality worldwide. Various environmental and genetic factors are known as risk factors for this disease. Therefore, this study aimed to investigate the frequency of risk factors in patients with venous thromboembolism admitted to Ekbatan and Farshchian hospitals in Hamadan from 2012 to 2017. Materials and Methods:...

متن کامل

Rivaroxaban versus enoxaparin for treatment of patients with nonhematologic cancer with venous thromboembolism a randomized clinial trial

Background: Low-Molecular-Weight Heparin (LMWH) is recommended as the first-line treatment in patients with active cancer and venous thromboembolism (VTE), but many patients prefer to take oral anticoagulants and non-injectable forms with more reasonable price. Venous thromboembolism is a very common comorbidity in patients with cancer. Therefore, the aim of this study was to evaluate the effic...

متن کامل

Treatment of Venous Thromboembolism in Pediatric Patients

Given the increased incidence of venous thromboembolism (VTE) in pediatric patients, which has been associated with increased survival of medically complex patients and increased use of invasive supportive measures, it is important to understand treatment options and unique aspects of anticoagulant use in children. The objective of this mini-review is to outline the goals of treatment, treatmen...

متن کامل

Venous Thromboembolism Following Travel

International travel has become increasingly common and accessible, hence, about two billion passengers undertake international and domestic air travel each year. Venous thromboembolism (VTE) is a serious public health disorder which may occur following prolonged travel, especially after air travel. A direct relation between VTE development and prolonged travels has been documented, while some ...

متن کامل

Management of antithrombotic therapy in patients undergoing invasive procedures.

Copyright © 2013 Massachusetts Medical Society. More than 6 million patients in the United States receive long-term anticoagulation therapy for the prevention of thromboembolism due to atrial fibrillation, placement of a mechanical heart-valve prosthesis, or venous thromboembolism.1 In addition, dual antiplatelet therapy (combination treatment with aspirin and a thienopyridine) after the placem...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation

دوره 110 9 Suppl 1  شماره 

صفحات  -

تاریخ انتشار 2004