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At least 19 recordsLinked to original sources
PubMed1992

[Arterial embolism, venous thrombosis, pulmonary embolism: a suggestive triad].

The aim of this study is to present a relatively rare case of paradoxical arterial embolism, found in a patient who was sent to us for serious pulmonary embolism. Taking into account that the foramen ovale, despite being functionally competent, remains anatomically patent in 30% of the adult population, we cannot neglect the possibility of a paradoxical embolism, in the presence of a sudden embolic limb ischemia unless heart pathology or aortic lesions can be held responsible. Furthermore it must not be forgotten that deep venous thrombosis in the lower limbs or in the pelvic plexus may go unobserved on a purely clinical evaluation.

Axillary Artery↗
PubMed2006

An unusual case of Behçet's disease presenting with postpartum ovarian iliac vein thrombosis and pulmonary embolism.

Thrombosis of the ovarian vein is a rare complication which arises classically in the postpartum. We report a case of 24-year-old woman with a history of Behçet's disease, who presented with pelvic and thoracic pain, tachycardia, dyspnea and fever occurring 2 weeks after delivery. Computed tomography revealed an ascending thrombosis of the iliac and right ovarian veins complicated by bilateral pulmonary embolism. The patient responded well to the combination of anticoagulants and immunosuppressive agents. Behçet's disease should also be considered as an etiologic factor for ovarian vein thrombosis.

Journal Article↗
PubMed2006

Economic burden of deep-vein thrombosis, pulmonary embolism, and post-thrombotic syndrome.

PURPOSE: Deep-vein thrombosis (DVT) and pulmonary embolism (PE) are associated with major morbidity and mortality, with their burden often extending to longer-term complications such as event recurrence and post-thrombotic syndrome (PTS). Few data exist on the overall economic burden of DVT and PE and their sequelae. A retrospective observational cohort study was conducted to determine the direct medical costs of a DVT or PE patient across the entire continuum of care. SUMMARY: Administrative claims data for patients with a DVT or PE diagnosis (ICD-9-CM code) and patients with possible evidence of PTS between January 1, 1997, and March 31, 2004, were extracted from the PharMetrics Patient-Centric Database, which comprises fully adjudicated medical and pharmaceutical claims for U.S. health care-plan enrollees. Resource utilization and annualized direct medical costs of care for patients with DVT and/or PE were calculated and compared with matched controls. A total of 26,958 patients met the study inclusion criteria. Of the 17,634 patients evaluable for the PTS cohort, 663 (3.8%) patients experienced PTS. Patients with DVT, PE, or DVT and PE had higher annualized direct medical costs before the index (initial) DVT and/or PE event (median: $7227, $6381, and $6771, respectively) than controls (median: $1045). During and after the DVT/PE event, annualized median costs rose to $17,512, $18,901, and $25,554, respectively, compared with $680 in the control group. Annualized median total costs for the PTS group were $20,569 compared with $15,843 in matched controls with DVT and/or PE and no PTS. CONCLUSION: These data suggest that the initial acute DVT or PE event is associated with high total health care costs and that these costs are further increased by subsequent events such as recurrent DVT or PE and PTS. Early detection and appropriate treatment of this high-risk population have the potential for both clinical and economic benefits.

Cost of Illness↗
PubMed2002

Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism.

Venous thrombosis and pulmonary embolism are commonly viewed as different manifestations of a single disease process, venous thromboembolism. Recent evidence suggests that there may be important differences between patients who manifest these two conditions. Using linked hospital discharge records we analyzed 71,250 patients hospitalized with a principal diagnosis of venous thrombosis alone or pulmonary embolism and analyzed predictors of rehospitalization within 6 months for venous thrombosis or pulmonary embolism. There were 51233 patients diagnosed with venous thrombosis alone and 21,625 diagnosed with pulmonary embolism. Comparing patients initially diagnosed with venous thrombosis alone to patients with pulmonary embolism, the relative risk of being rehospitalized with venous thrombosis within 6 months for venous thrombosis was 2.7. Conversely, when patients with pulmonary embolism were compared to patients with venous thrombosis alone, the relative risk of rehospitalization within 6 months with a diagnosis of pulmonary embolism was 4.2. In multivariate models the strongest predictor of recurrent thromboembolism manifest as pulmonary embolism was an initial diagnosis of pulmonary embolism and the strongest predictor of recurrence as venous thrombosis was an initial diagnosis of venous thrombosis. We conclude that the initial clinical manifestation of thromboembolism strongly predicts the manifestation of a recurrence. Venous thrombosis and pulmonary embolism appear to be distinct, albeit overlapping, clinical entities with different natural histories.

Aged↗
PubMed1996

Deep vein thrombosis, pulmonary embolism, and the white clot syndrome.

Thromboembolic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) are very uncommon in the pediatric age group; even more rare is the white clot syndrome. We present the case of a 13-year-old girl who presented with no known risk factors for thromboembolic disease or cardiopulmonary complaints, yet was found to have extensive lower extremity DVT and PE. This patient also suffered the rare but potentially devastating complication of heparin therapy referred to as the white clot syndrome, resulting in amputation of the lower extremity. Greater awareness of both thromboembolic disease in children and the white clot syndrome may lessen the morbidity and mortality associated with these entities.

Adolescent↗
PubMed1990

Diagnosis of venous thrombosis and pulmonary embolism.

Venous thrombosis and pulmonary embolism are closely related disorders. As many as 70 to 80% of patients with pulmonary embolism have associated proximal deep venous thrombosis. The clinical diagnosis alone of both venous thrombosis and pulmonary embolism is inaccurate because of the insensitivity and nonspecificity of findings, a problem that also occurs with a variety of other disorders. Invasive, objective tests are still the reference standard, but they are not always easy to perform, they cannot be used for a considerable number of very ill patients, and they create some patient discomfort. There is an increasing trend toward using noninvasive methods, either alone or in combination. These methods entail less risk, can be performed more quickly and conveniently, and are usually more cost-effective. Practical approaches to diagnosing venous thrombosis and pulmonary embolism in the clinical setting are discussed.

Algorithms↗
PubMed1985

Deep venous thrombosis, pulmonary embolism and acute surgery in thrombophlebitis of the long saphenous vein.

Twenty-eight consecutive cases of acute superficial thrombophlebitis of the long saphenous vein above the knee were reviewed concerning presence of asymptomatic deep venous thrombosis and pulmonary embolism and early clinical results after surgical treatment. Contrast phlebography of the ipsilateral leg revealed asymptomatic involvement of major deep veins of the thigh or calf in 4 of 21 examined patients. Perfusion lung scanning and chest radiography demonstrated typical segmental perfusion defects consistent with pulmonary embolism in two of ten examined patients. High ligation and stripping of the phlebitic veins gave prompt cure in 19 patients, though in two who were simultaneously treated with anticoagulants there was troublesome bleeding. Simple high ligation was performed in nine patients without complications, but four of them had protracted phlebitic pain. The results indicated that preoperative phlebography and lung scanning are helpful in detecting associated asymptomatic disorders and for planning therapy in patients with clinically isolated, superficial thrombophlebitis of the long saphenous vein. The treatment of choice is acute high ligation with removal of all phlebitic veins. If anticoagulation is indicated because of concomitant deep venous thrombosis or pulmonary embolism, the initial procedure should preferably be limited to high ligation.

Adult↗
PubMed2006

Pathophysiology of venous thrombosis, thrombophilia, and the diagnosis of deep vein thrombosis-pulmonary embolism in the elderly.

This article reviews Virchow's triad to provide clinicians with the pathophysiologic basis for the development of venous thromboembolism (VTE). Armed with these data physicians should be vigilant of the development of VTE when these factors are present. The second clinical point is the appropriate need to evaluate elderly patients for primary or secondary thrombophilia. By using statistical probability and clinical history selected geriatric patients with VTE should be assessed for the etiology of their hypercoagulable state. Finally, evaluating symptomatic patients for VTE should be structured to use the appropriate testing to confirm the diagnosis.

Age Factors↗