PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “PULMONARY EMBOLISM AND THROMBOSIS”

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 685 records · Page 38Linked to original sources
PubMed2004

[Interpretation of increased D-dimer values].

BACKGROUND: The determination of D-dimer concentration is an essential part in the diagnostic procedure of thromboembolic diseases, e.g. deep vein thrombosis, pulmonary embolism. D-dimers are the products of fibrin hydrolysis with elevated levels in fibrinolytic processes. QUESTION: In the clinical practice problems exist in the interpretation of increased D-dimer concentrations, especially without thromboembolic disease. Before starting further expensive imaging diagnostics other reasons (i.e. pregnancy, neoplasma, systemic inflammatory disease, advanced arteriosclerosis) should be considered in differential diagnosis. CONCLUSION: The determination of the concentration of D-dimers is involved in the diagnostic strategy in thromboembolic diseases. However, this parameter is not suited for routine screening. Its high predictive-negative value is proved for the exclusion of thrombosis or pulmonary embolism in case of negative test result. Since a range of diseases and physiological conditions lead to increased D-dimer values, a positive D-dimer result does not verify the diagnosis of thromboembolism.

Antifibrinolytic Agents↗
PubMed2001

Automated detection of the G20210A prothrombin mutation using the LCx microparticle enzyme immunoassay.

BACKGROUND: The prothrombin mutation, a G/A transition at position 20210 in the 3' untranslated region of the prothrombin gene, is associated with an increased risk of deep venous thrombosis and obstetrical complications. Several methods have been developed to detect the mutation; however, given the increased demand for this test in risk factor assessment, the development of simple and efficient screening methods has become necessary. METHODS: We have used a rapid, sensitive, and precise method developed by Abbott Laboratories to detect the prothrombin mutation. The method employs a polymerase chain reaction (PCR) amplification and the Abbot LCx microparticle enzyme immunoassay (MEIA) for detection. This method is able to detect and identify both homozygous and heterozygous genotypes. RESULTS: Two hundred ninety-six patients with a history of deep venous thrombosis, pulmonary embolism, preeclampsia, or cardiovascular disease and 163 control patients were included in this study. The prevalence of the mutation was 5.74% in the high-risk group and 3.06% in the control group. There was complete agreement between the results from the MEIA detection with those obtained using other detection methodologies, namely standard PCR and restriction fragment length polymorphism (RFLP) analysis. CONCLUSIONS: The MEIA detection method of the prothrombin mutation represents a simple, fast, and reliable alternative to standard methods of detection and is well suited for use in routine clinical laboratories. The results of our study confirm others' studies showing a greater incidence of G20210A prothrombin gene mutation in patients with an increased risk of venous thrombosis and pulmonary embolism as well as patients with cardiovascular disease and pregnant women with preeclampsia. It reinforces the necessity of including the screening for prothrombin mutation in populations at risk.

3' Untranslated Regions↗
PubMed1992

[Right atrial thrombosis and severe pulmonary embolism].

Two cases of severe pulmonary embolism associated with right atrial thrombosis are reported. In the first case, fibrinolytic therapy was administered and was thought to be a causative factor in the death of the patient due to massive pulmonary embolism. In the second case, the patient was referred for surgery and two enormous thrombi were extracted. Unfortunately, the outcome was fatal. These two cases were confronted with the results of the literature. They strongly suggest that echocardiography should be a first-line investigation in severe pulmonary embolism. The detection of right atrial thrombosis modifies the clinical strategy and orientates treatment towards surgical referral when the patient's condition allows it.

Adult↗
PubMed2006

Thrombolytic therapy in pregnancy.

Pregnancy due to its physiological changes is a procoagulant state. The rate of cardiac valve prosthesis thrombosis, deep venous thrombosis and pulmonary embolism are all increased. Thrombolytic therapy with tissue plasminogen activator (rt-PA) is an approved therapy for ischemic stroke, myocardial infarction, pulmonary embolism and thrombosis of cardiac valve prosthesis. However, there are no data from controlled randomized trials in pregnant patients. Thrombolytic therapy has been rarely used in pregnancy with only 28 cases of rt-PA thrombolysis reported in the literature so far. Indications for rt-PA thrombolysis were stroke (n = 10), thrombosis of cardiac valve prosthesis (n = 7), pulmonary embolism (n = 7), deep venous thrombosis (n = 3), and myocardial infarction (n = 1). Remarkably, all thrombosis of cardiac valve prostheses occurred after switching from warfarin to heparin in order to prevent teratogenicity and fetal loss. Two patients died (7%) and three suffered from complications that were managed conservatively (11%). In another three patients thrombolysis was not successful. Thrombolysis complication rates were similar compared to non-pregnant patients for the above mentioned indications. Six out of the 26 fetus from surviving mothers died (23%), three of them after induced abortion for maternal reasons (12%). A likely causal relation to the prior thrombolysis could only be established in two fetal fatalities (8%). None of the live born children suffered a permanent deficit. Considering that rt-PA does not cross the placenta and taking into account that the complication rates do not exceed those of large randomised controlled trials thrombolytic therapy should not be withheld in pregnant patients in case of life-threatening or potentially debilitating thrombembolic disease.

Adult↗
PubMed2002

Effectiveness and safety of bemiparin versus low-molecular weight heparins in orthopaedic surgery.

OBJECTIVE: To evaluate the effectiveness and safety of bemiparin in the prophylaxis of thromboembolism in orthopaedic surgery with respect to other low-molecular-weight heparins. METHODS: A meta-analysis of effectiveness and safety of low-molecular weight heparins versus standard heparin in orthopaedic surgery was performed. A literature search was done of Medline and Excerpta Medica from 1988 to 1998. Only controlled clinical trials were selected for meta-analysis. Differences between groups were expressed as odds ratios and these were combined by the Mantel-Haenszel method. MAIN OUTCOME MEASURES: Rates of deep vein thrombosis, pulmonary embolism and wound haematoma. RESULTS: Twenty-one studies involving 4605 patients were included in the meta-analysis. Bemiparin significantly reduces the rates of deep vein thrombosis (OR; 95% CI = 0.38, 0.15-0.90). No significant differences were found in pulmonary embolism and wound haematoma. The incidence of deep vein thrombosis is also lower with enoxaparin than with unfractionated heparin. However, only nadroparin reduced the incidence of pulmonary embolism (ORs = 0.24, 95% CI = 0.05-0.94). In any case, the incidence of wound haematoma was not significant. CONCLUSION: Bemiparin seems to be as effective and safe as the other low-molecular-weight heparins in the prevention of thromboembolic complications in orthopaedic surgery.

Confidence Intervals↗
PubMed2004

Early pacemaker lead thrombosis leading to massive pulmonary embolism.

Clinically apparent pulmonary embolism is a rare complication of permanent transvenous pacing catheters. Here we report an unusual case of a 71-year-old man who developed massive pulmonary embolism 12 hours after a permanent transvenous pacemaker implantation in the absence of any patient-related predisposing factor. Transesophageal echocardiography showed a large thrombus within the right atrium closely attached to the pacemaker lead. Anticoagulation with heparin, followed by warfarin therapy, led to a complete resolution of the thrombus.

Aged↗
PubMed2002

Randomized trial of different regimens of heparins and in vivo thrombin generation in acute deep vein thrombosis.

Low-molecular-weight and unfractionated heparins are frequently used to treat venous thromboembolism, but it is not known whether they are equally effective in inhibiting in vivo generation of thrombin. In this multicenter trial, 1048 patients were randomized to intravenous unfractionated heparin (group A), twice daily low-molecular-weight heparin (reviparin) for 1 week (group B), or once daily reviparin for 4 weeks (group C). All patients received vitamin K antagonists. Blood samples withdrawn at the baseline and at weeks 1 and 3 were analyzed using markers of in vivo thrombin generation and other coagulation parameters. During the first 3 weeks symptomatic recurrent deep vein thrombosis-pulmonary embolism (DVT/PE) occurred in 17 (4.5%) of 375 patients in group A compared with 4 (1.0%) of 388 patients in group B, and 9 (2.4%) of 374 patients in group C. Forty percent of patients in group A, 53.4% in group B, and 53.5% in group C showed 30% or greater reduction in thrombus size assessed by venography. Patients in group B had significantly greater reduction in D-dimer, prothrombin fragments 1 and 2 (F1 + 2), endogenous thrombin potential (ETP), and thrombin-antithrombin (TAT) complexes compared to groups A and C. Greater release of tissue factor pathway inhibitor (TFPI) and reduction in levels of thrombin activatable fibrinolysis inhibitor (TAFI) and fibrinogen were significantly more pronounced in group C patients. Reviparin administered twice daily plus vitamin K antagonist is more effective in inhibiting in vivo thrombin generation compared to intravenous unfractionated heparin plus vitamin K antagonist, and reviparin once daily produced significantly higher TFPI release and greater reduction in TAFI and fibrinogen levels.

Acute Disease↗
PubMedDate not supplied

[Anticoagulation in thrombolytic therapy: importance and future perspectives].

The present overview describes the mode of action of direct and indirect anticoagulants. Furthermore it presents well-accepted and potential indications for the different anticoagulants as concomitant treatment during thrombolysis of deep vein thrombosis, pulmonary embolism and myocardial infarction. The new antithrombotics dermatansulfate, hirudine, synthetic peptide thrombin inhibitors, activated protein C, inhibitors of glycoprotein IIb/IIIa are reviewed. Many small and large studies on the thrombolytic treatment of myocardial infarction demonstrate the benefit of simultaneous application of heparins.

Anticoagulants↗
PubMed2003

Heparin-induced thrombocytopenia with pulmonary embolism and disseminated intravascular coagulation associated with low-molecular-weight heparin.

Heparin-induced thrombocytopenia (HIT) is a severe adverse effect of heparin therapy. Although most cases occur in patients receiving unfractionated heparin, HIT can arise in venous thrombosis prophylaxis with a low-molecular-weight heparin (LMWH). We report an uncommon case of HIT in a postoperative orthopedic patient associated with LMWH (nadroparin), complicated by deep venous thrombosis, pulmonary embolism, and disseminated intravascular coagulation, treated successfully with recombinant hirudin and immunoglobulin therapy.

Arthroplasty, Replacement, Hip↗
PubMed1996

Deep venous thrombosis with pulmonary embolus after selective embolization of an internal iliac artery aneurysm.

A 69-year-old man with an isolated right internal iliac artery aneurysm measuring 5.6 cm in diameter was treated with percutaneous embolization inducing thrombosis of the aneurysm. Four months later, he was seen with thrombosis of the right common iliac vein and pulmonary embolus. He subsequently underwent ligation of the aneurysm and repair of the right common iliac artery. Computed tomographic and operative findings suggested that the iliac vein thrombosis was the result of direct compression by the aneurysm itself, as well as perianeurysmal inflammation that encased the right common iliac vein. This report summarizes this case and presents a new potential long-term complication after successful selective embolization of an internal iliac artery aneurysm.

Aged↗
PubMed2000

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials.

OBJECTIVES: To obtain reliable estimates of the effects of neuraxial blockade with epidural or spinal anaesthesia on postoperative morbidity and mortality. DESIGN: Systematic review of all trials with randomisation to intraoperative neuraxial blockade or not. STUDIES: 141 trials including 9559 patients for which data were available before 1 January 1997. Trials were eligible irrespective of their primary aims, concomitant use of general anaesthesia, publication status, or language. Trials were identified by extensive search methods, and substantial amounts of data were obtained or confirmed by correspondence with trialists. MAIN OUTCOME MEASURES: All cause mortality, deep vein thrombosis, pulmonary embolism, myocardial infarction, transfusion requirements, pneumonia, other infections, respiratory depression, and renal failure. RESULTS: Overall mortality was reduced by about a third in patients allocated to neuraxial blockade (103 deaths/4871 patients versus 144/4688 patients, odds ratio=0.70, 95% confidence interval 0.54 to 0.90, P=0. 006). Neuraxial blockade reduced the odds of deep vein thrombosis by 44%, pulmonary embolism by 55%, transfusion requirements by 50%, pneumonia by 39%, and respiratory depression by 59% (all P<0.001). There were also reductions in myocardial infarction and renal failure. Although there was limited power to assess subgroup effects, the proportional reductions in mortality did not clearly differ by surgical group, type of blockade (epidural or spinal), or in those trials in which neuraxial blockade was combined with general anaesthesia compared with trials in which neuraxial blockade was used alone. CONCLUSIONS: Neuraxial blockade reduces postoperative mortality and other serious complications. The size of some of these benefits remains uncertain, and further research is required to determine whether these effects are due solely to benefits of neuraxial blockade or partly to avoidance of general anaesthesia. Nevertheless, these findings support more widespread use of neuraxial blockade.

Anesthesia, Epidural↗