PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Postphlebitic Syndrome”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

[The trophic venous ulcer. The physiopathological, microbiological and pharmacological aspects].

The ulcus cruris is an ulcerative lesions caused by chronic venous stasis and chronic venous hypertension. Every pathologic obstacle to venous return can cause ulcus cruris. Ulcus could be brought back to 3 situations: postphlebitic syndrome, chronic venous insufficiency and primitive varicosities. The common denominator is always the increase in venous pressure, the appearance of reflux and venous stasis. Venous ulcers are possibly characterized by tissue degeneration and by bacterial superinfection. A particular bacterial flora is found in these injuries, it is qualitatively different from that of healthy skin. The therapy of ulcus cruris cannot leave out by its etiopathogenesis: the first treatment always consists in the stasis suppression to arrive quickly to a complete cicatricial would repair. In it three moments are recognizable: ulcus abstersion, disinfection and cicatrization. The venous ulcer is not cured when it is closed, but when it has no recurrency: the cicatrization is obtainable treating the principal causes, eliminating the venous stasis and anticipating the relapses.

Bacteria↗
PubMed1994

Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE.

Deep vein thrombosis (DVT) and pulmonary embolism (PE) occur in pediatric patients; however, the incidence, associated morbidity, and mortality are unknown. A Canadian registry of DVT and PE in children (ages 1 month to 18 years) was established July 1, 1990 in 15 tertiary-care pediatric centers. One-hundred thirty-seven patients were identified prospectively and are the subject of this report. The incidence of DVT/PE was 5.3/10,000 hospital admissions or 0.07/10,000 children in Canada. Infants under 1 year old and teenagers predominated with equal numbers of both sexes. DVT were located in the upper (n = 50) and lower (n = 79) venous system, or as PE alone (n = 8). Central venous lines (CVLs) were present in approximately 33% of children with DVT (n = 45). Associated conditions were present in 96% of children and 90% of children had two or more associated conditions for DVT. DVT was diagnosed by venography (n = 83), duplex ultrasound (n = 37), and other combinations (n = 17). Twenty-two of the 31 ventilation/perfusion scans performed were interpreted as high-probability scans for PE. Therapy consisted of heparin (n = 115), thrombolysis (n = 15), surgical removal of a CVL or thrombus (n = 22), and oral anticoagulant therapy (n = 103). Significant bleeding complications did not occur. However, three (2.2%) children died as a direct consequence of their thromboembolic disease; DVT reoccurred in 23 children and postphlebitic syndrome (PPS) occurred in 26. In conclusion, DVTs occur in a significant number of hospitalized children with a mortality of 2.2%. Complications are not hemorrhagic, but thrombotic, and characterized by PE, recurrent disease, and PPS. In contrast to adults, the upper venous system is frequently affected because of the use of CVLs. The frequency of DVT/PE justifies controlled trials of primary prophylaxis in high-risk groups, and therapeutic trials to determine optimal treatment.

Administration, Oral↗
PubMed1993

[Blunt trauma with combined femoral arterial and venous occlusion].

Blunt trauma to common femoral artery is rare, and it is frequently unrecognized. A 61-year-old man who fell while carrying a log and struck on his right groin, presented right leg edema and intermittent claudication one month later. Both right femoral arterial and venous occlusion was suspected by Doppler flowmeter, confirmed by venography and arteriography which showed concomitant external iliac arterial occlusion. He underwent prosthetic bypass grafting from common iliac artery to common femoral artery and embolectomy of femoral vein. Circulation to the right leg was restored, but postphlebitic syndrome had remained which was ameliorated by wearing the elastic stocking.

Femoral Artery↗
PubMed1996

[Ultrasonographic evaluation of pelvis minor and lower extremity veins during pregnancy and puerperium].

Thrombophlebitis of iliac and lower extremity veins is still an actual diagnosis problem in obstetrics and gynaecology. Classical ultrasonography and color doppler usefulness were compared. High efficacy of both methods in early diagnosis was concluded. The color doppler method is more effective in postphlebitic syndrome recognition. Spread out of veins ultrasonography with compression test gives a possibility of early diagnosis of thrombophlebitis in the course of pregnancy and puerperium.

Adolescent↗
PubMed1996

[Surgical treatment of deep venous thrombosis--indications, possibilities and limitations in venous thrombectomy].

Venous thrombectomy as a treatment of deep venous thrombosis is discussed extremely controversial. Occasionally, however, surgical technique, goal of the therapy, indications and limitations are not really known. Indication for surgical treatment is an extensive acute deep vein thrombosis with clinical symptoms of less than 7 days. Goal of the therapy is the preservation of valve function and prevention of a postphlebitic syndrome. Further indications are an embolizing venous thrombosis, a floating thrombus and an ischemic thrombosis. In these cases the single goal of the treatment is to reduce the individual risk of the patient. The best long term results can be achieved in young patients (below 40 years of age) with no preexisting venous lesion and an acute iliofemoral thrombosis. Advantages, drawbacks and results of venous thrombectomy are discussed.

Adult↗
PubMed1996

Catheter-directed thrombolysis for iliofemoral venous thrombosis.

The combination of catheter-directed thrombolytic therapy and endovascular stenting is a new and promising approach for treating acute and chronic thrombotic iliofemoral venous occlusions on the basis of the authors' initial experience in a small group of patients. In acute DVT, catheter-directed techniques provide more complete lysis than systemic infusions and early, aggressive interventional therapy may spare the patient from the life-long disability associated with the postphlebitic syndrome, by preserving valve function and eliminating the venous outflow obstruction. Immediate postthrombolysis venography can evaluate the underlying vein and assess the need for adjunctive treatment with angioplasty and/or stents. Urokinase has a high degree of safety with few complications when a catheter-directed approach rather than systemic infusion is used. Even patients with chronic DVT can benefit by reducing the obstruction to venous outflow if the occlusion is limited to the iliac vein and/or the inferior vena cava. Long-term follow-up studies are necessary to evaluate patency rates of the treated veins, determine whether successfully treated limbs have a lower frequency of recurrent DVT, and ascertain the frequency of chronic venous insufficiency compared with that in patients treated with anticoagulation alone. Based on our initial experience, a National Venous Thrombosis Registry was established in October 1994. The purpose of this multidisciplinary Registry is to prospectively document the long-term results of catheter-directed thrombolytic therapy for patients with iliofemoral DVT, with data now being collected from 40 leading medical centers around the United States. We hope that endovascular techniques for iliofemoral DVT will significantly reduce the immediate and long-term complications commonly associated with this difficult and often misunderstood clinical problem.

Acute Disease↗
PubMed1996

[Thrombophlebitis of the lower limbs: a convenient diagnosis?].

Venous thrombosis may expose the patient to short (pulmonary embolism) or long term complications (postphlebitic syndrome), invalidating and onerous for society. The main point is identifying or excluding this pathology by anamnesis, clinical findings and bloodless diagnostics as Doppler c.w. and vascular duplex scanner. We suggest a decision flow chart helpful for diagnosis and therapeutics.

Adult↗
PubMedDate not supplied

Diagnostic imaging in deep vein thrombosis of the limbs.

The clinically suspected deep vein thrombosis (DVT) should always be confirmed by instrumental procedures. In fact, about 70% of patients with clinically suspected DVT are shown to be negative on instrumental investigations. Phlebography is still the gold standard in the diagnosis of peripheral DVT. Main phlebographic findings are: persistent filling defect; abrupt interruption of contrast in a vein; lack of opacification in all or some deep veins; flow diversion with opacification of collateral branches. At present, peripheral phlebography is performed when the other noninvasive exams (Color Doppler US and Duplex Doppler) are doubtful, technically limited or when thrombosis of innominate veins or superior vena cava, is suspected. Real-time US enables direct visualization of the limb proximal veins. The venous wall, the venous valves, the thrombus and its development, the anatomic variants, the perivenous structures which may impact on the normal physiology of venous return, are depicted. However, the distal veins of the leg and arm and deep veins (the iliac veins, the superficial femoral vein in the adductor canal) are not accurately visualized. The US findings in DVT include: the presence of echoes within the vascular lumen; the veins in axial scans are not compressible. Pulsed Doppler and duplex Doppler combine the morphologic and functional study. Injury caused by DVT at the valvular level (postphlebitic syndrome) is visualized. Primary deep vein thrombosis caused by valvular disorders (valvular aplasia) is identified. Inadequate superficial and perforating veins to be treated with surgery are mapped. Color Doppler US depicts directly superficial and deep limb veins combining the morphologic with the functional assessment represented by the visualization of the map of flow velocity and direction. Recently, a new diagnostic procedure, the color Doppler Energy (CDE) or Power Doppler has been introduced. Together with mean flow velocity and spectral variance, the signal energy or power is also analyzed. The CDE is independent of the US incidence angle, it does not shows the flow direction, detects particularly slow flows, early canalization of thrombi and non occlusive thrombosis. Color Doppler diagnosis of thrombosis is prompt because an area with absence of color is visualized. Collateral vessels and flow direction within them, is well depicted. Beside the site and extension of thrombosis, color Doppler US is able to directly visualize the distal end of the thrombus, which when floating is at high risk for embolism. CT allows an adequate study of the iliocaval axis and is useful if phlebography or color Doppler US are not diagnostic. Iliocaval thrombosis represents a not infrequent finding during abdominal CT. The thrombus appears as a hypodense mass encircled by the hyperdense rim of contrast medium.

Humans↗
PubMedDate not supplied

Treatment of deep vein thrombosis.

At present, most common initial treatment of deep vein thrombosis is anticoagulant therapy with i.v. heparin. Recently, some reports in literature suggest the efficacy of low molecular weight heparin fractions administered also to outpatients. Thrombolytic therapy as compared to heparin seems to be favorable as for the valvular integrity and function with minor postphlebitic sequels. It is however burdened with a higher incidence of hemorrhagic complications. Probably, it should be reserved for those patients with massive phlebothrombosis or phlebothrombosis associated with relevant clinical signs. At present, it has not definitely been proved that one of the commonly used drugs, streptokinase, urokinase and r-TPA affords substantial advantages in terms of efficacy and safety. Locoregional administration by a catheter inserted into the thrombus with the protection of a caval filter enhances the efficacy of thrombolytic agents, even if data on long-term results of this method are still lacking. Discordant opinions exist on the validity of thrombectomy. As a prophylaxis of pulmonary embolism, thrombus removal has been replaced by caval filters. At present it is commonly indicated for phlegmasia coerulea dolens. In the other forms, even if the vascular patency is restored in a good percentage of cases, it is not similarly effective in preventing the postphlebitic syndrome. For these reasons it should be applied in selected cases.

Anticoagulants↗
PubMed1997

Diagnostic imaging of lower limb deep venous thrombosis.

Lower limb deep venous thrombosis is a common clinical disorder that can lead to fatal pulmonary emboli and postphlebitic syndrome. The clinical evaluation for deep venous thrombosis has been found to be useful in nonhospitalized patients, but a low-cost, easily available technique to confirm the presence of lower limp thrombi is still needed. Doppler ultrasound examination with compression has emerged as the diagnostic imaging study of choice for most patients. Contrast venography, magnetic resonance imaging or radionuclide scintigraphy may be useful in selected patients.

Algorithms↗
PubMed1997

[Recurrent thrombophlebitis and ulcera crurum as manifestations of hereditary blood coagulation disorders and Klinefelter syndrome. Discussion based on 4 case examples].

Recurrent phlebothromboses in young patients with subsequent severe postthrombotic syndrome and chronic venous leg ulcers may be caused by underlying hereditary disorders of hemostasis or may occur as part of other congenital syndromes. The most common hereditary disorders of hemostasis in this respect appear to be deficiencies of antithrombin III, protein C, and protein S, and activated protein C resistance (mutations of factor V). Less frequently, dysfibrinogenemia, increased plasminogen activator inhibitor levels, or deficiencies of tissue plasminogen activator or heparin cofactor II may be found. Klinefelter's syndrome and homocystinuria are prime examples of those rare congenital disorders indirectly associated with an elevated risk of thrombosis in young individuals. Early diagnosis of these disorders will allow timely treatment, preventive care and counselling of patients as well as family members.

Adult↗