The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform
Prashant Kapoor - One of the best experts on this subject based on the ideXlab platform.
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portal Vein Thrombosis
The American Journal of Medicine, 2010Co-Authors: Sameer A Parikh, Riddhi Shah, Prashant KapoorAbstract:Portal Vein Thrombosis is a condition not infrequently encountered by clinicians. It results from a combination of local and systemic prothrombotic risk factors. The presentation of acute Thrombosis varies widely from an asymptomatic state to presence of life-threatening intestinal ischemia and infarction. In the chronic stage, patients typically present with variceal bleeding or other complications of portal hypertension. Abdominal ultrasound color Doppler imaging has a 98% negative predictive value, and is considered the imaging modality of choice in diagnosing portal Vein Thrombosis. Controlled clinical trials to assist with clinical decision-making are lacking in both acute and chronic portal Vein Thrombosis. Oral anticoagulant therapy is initiated if the risks of bleeding are low, but long-term anticoagulation is generally not recommended in patients with concomitant hepatic cirrhosis. The roles of invasive therapeutic approaches such as thrombolysis and transjugular intrahepatic portosystemic shunt continue to evolve. This review conflates dissenting views into a rational approach of managing patients with portal Vein Thrombosis for the general internist.
Moniek P M De Maat - One of the best experts on this subject based on the ideXlab platform.
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hypercoagulability and hypofibrinolysis and risk of deep Vein Thrombosis and splanchnic Vein Thrombosis similarities and differences
Arteriosclerosis Thrombosis and Vascular Biology, 2011Co-Authors: Jasper H Smalberg, Marieke J H A Kruip, Harry L A Janssen, D C Rijken, Frank W G Leebeek, Moniek P M De MaatAbstract:In this review, we provide an overview of the risk factors for venous thromboembolism, focusing on hypercoagulability and hypofibrinolysis. In the first part of this review, we discuss the risk factors for commonly occurring venous Thrombosis, in particular deep Vein Thrombosis and pulmonary embolism. In the second part, we provide an overview of the risk factors for the Budd-Chiari syndrome and portal Vein Thrombosis. These are rare, life-threatening forms of venous thromboembolism located in the splanchnic Veins. There are many similarities in the risk profiles of patients with common venous Thrombosis and splanchnic Vein Thrombosis. Inherited thrombophilia and hypofibrinolysis increase the risk of both common venous Thrombosis and splanchnic Vein Thrombosis. However, there are also apparent differences. Myeloproliferative neoplasms and paroxysmal nocturnal hemoglobinuria have a remarkably high frequency in patients with Thrombosis at these unusual sites but are rarely seen in patients with common venous Thrombosis. There are also clear differences in the underlying risk factors for Budd-Chiari syndrome and for portal Vein Thrombosis, suggesting site specificity of Thrombosis even within the splanchnic venous system. These clear differences in underlying risk factors provide leads for further research on the site specificity of venous Thrombosis and the development of Thrombosis at these distinct sites.
Harry R. Büller - One of the best experts on this subject based on the ideXlab platform.
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Deep Vein Thrombosis and Pulmonary Embolism - Deep-Vein Thrombosis and pulmonary embolism.
The Lancet, 2016Co-Authors: Marcello Di Nisio, Harry R. BüllerAbstract:Summary Deep Vein Thrombosis and pulmonary embolism, collectively referred to as venous thromboembolism, constitute a major global burden of disease. The diagnostic work-up of suspected deep Vein Thrombosis or pulmonary embolism includes the sequential application of a clinical decision rule and D-dimer testing. Imaging and anticoagulation can be safely withheld in patients who are unlikely to have venous thromboembolism and have a normal D-dimer. All other patients should undergo ultrasonography in case of suspected deep Vein Thrombosis and CT in case of suspected pulmonary embolism. Direct oral anticoagulants are first-line treatment options for venous thromboembolism because they are associated with a lower risk of bleeding than vitamin K antagonists and are easier to use. Use of thrombolysis should be limited to pulmonary embolism associated with haemodynamic instability. Anticoagulant treatment should be continued for at least 3 months to prevent early recurrences. When venous thromboembolism is unprovoked or secondary to persistent risk factors, extended treatment beyond this period should be considered when the risk of recurrence outweighs the risk of major bleeding.
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deep Vein Thrombosis
The Lancet, 1999Co-Authors: Anthonie W A Lensing, Paolo Prandoni, Martin H Prins, Harry R. BüllerAbstract:Summary Deep-Vein Thrombosis is an important complication of several inherited and acquired disorders, but may also occur spontaneously. Prevention of recurrent venous Thrombosis and pulmonary embolism is the main reason for accurate diagnosis and adequate treatment. This seminar discusses only symptomatic deep-Vein Thrombosis. The diagnosis can be confirmed by objective tests in only about 30% of patients with symptoms. Venous thromboembolic complications happen in less than 1% of untreated patients in whom the presence of venous Thrombosis is rejected on the basis of serial ultrasonography or ultrasonography plus either D-dimer or clinical score. Initial anticoagulant treatment (intravenous or subcutaneous heparin) should continue until oral anticoagulant treatment, started concurrently, increases the international normalised ratio above 2·0 for more than 24 h. The optimum duration of oral anticoagulant treatment is unresolved, but may be guided by the presence of temporary or persistent risk factors or presentation with recurrent venous thromboembolism.
Nicos Labropoulos - One of the best experts on this subject based on the ideXlab platform.
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Natural history of deep Vein Thrombosis in children
Phlebology, 2014Co-Authors: Georgios Spentzouris, Antonios P. Gasparis, Richard J. Scriven, Nicos LabropoulosAbstract:ObjectiveTo determine the natural history of deep Vein Thrombosis in children presented with a first episode in the lower extremity Veins.MethodsChildren with objective diagnosis of acute deep Vein Thrombosis were followed up with ultrasound and clinical examination. Risk factors and clinical presentation were prospectively collected. The prevalence of recurrent deep Vein Thrombosis and the development of signs and symptoms of chronic venous disease were recorded.ResultsThere were 27 children, 15 males and 12 females, with acute deep Vein Thrombosis, with a mean age of 4 years, range 0.1–16 years. The median follow-up was 23 months, range 8–62 months. The location of Thrombosis involved the iliac and common femoral Vein in 18 patients and the femoral and popliteal Veins in 9. Only one Vein was affected in 7 children, two Veins in 14 and more than two Veins in 6. Recurrent deep Vein Thrombosis occurred in two patients, while no patient had a clinically significant pulmonary embolism. Signs and symptoms of ...
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Plantar Vein Thrombosis and pulmonary embolism
Phlebology, 2014Co-Authors: Mvl Barros, Is Nascimento, Tls Barros, Nicos LabropoulosAbstract:Plantar Vein Thrombosis is an unusual and under-diagnosed condition that affects the plantar deep venous system. Current ultrasound investigation protocols for deep venous Thrombosis neglect this entity. To our knowledge, there are only seven reports in the literature of 20 patients with plantar Vein Thrombosis detected with sonography without an associated pulmonary embolism. We present a case report of a patient with a plantar Vein Thrombosis associated with pulmonary embolism. Patients who present with pain and/or swelling of the foot should undergo ultrasound examination and careful evaluation for respiratory symptoms.
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Superficial Vein Thrombosis and hypercoagulable states: the evidence.
Perspectives in Vascular Surgery and Endovascular Therapy, 2005Co-Authors: Luis R. Leon, Nicos LabropoulosAbstract:Aim: To assess the demographic features of superficial Vein Thrombosis and its relation with the occurrence of hypercoagulable states.Methods: Data were gathered from pertinent papers using a MEDLINE search and an exhaustive bibliography review. Studies were considered only when they contained material to superficial Vein Thrombosis and hypercoagulable states.Results: The difference among the patients and the methods used made the comparison difficult and did not allow a pool analysis of the data. Superficial Vein Thrombosis is a common condition, and its prevalence is underestimated. Several risk factors are associated with superficial Vein Thrombosis, and a strong relation was seen with certain thrombophilias.Conclusions: Although superficial Vein Thrombosis most often is perceived as benign, it can coexist with hypercoagulable states. In patients with spontaneous onset of superficial Vein Thrombosis, there should be a lower threshold in testing for hypercoagulable states.
I Marie - One of the best experts on this subject based on the ideXlab platform.
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internal jugular Vein Thrombosis outcome and risk factors
QJM: An International Journal of Medicine, 2011Co-Authors: X Gbaguidi, A Janvresse, Jacques Benichou, N Cailleux, H Levesque, I MarieAbstract:Introduction: The aims of this study were to analyse the characteristics of patients with internal jugular venous Thrombosis. We compared the characteristics of patients with internal jugular venous Thrombosis with those of patients exhibiting upper extremity deep venous Thrombosis (UEDVT) without internal jugular Vein involvement. Patients: From 1998 to 2007, 1948 consecutive patients were referred to our Department of Internal Medicine for deep venous Thrombosis. Results: Sixty-four patients exhibited UEDVT. Internal jugular venous Thrombosis was diagnosed in 29 patients. Twenty-three patients had secondary Thrombosis mainly due to cancer, central venous catheter and ovarian hyperstimulation syndrome; three of the four patients with bilateral DVT exhibited cancer. Six patients had primary internal jugular Vein Thrombosis. Complications of internal jugular Vein Thrombosis were pulmonary embolism (10.3%) and post-thrombotic syndrome (41.4%). Under multivariate analysis, significant factors for internal jugular Vein Thrombosis were older patients ( P = 0.0008), female gender ( P = 0.0035) and ovarian hyperstimulation syndrome ( P = 0.0093). Conclusion: Our study underscores that the most common causes of internal jugular Vein Thrombosis are cancer, central venous catheter and ovarian hyperstimulation syndrome; it also underlines that bilateral internal jugular Vein Thrombosis is a significant risk indicator of malignancy Thrombosis led to high morbidity related to pulmonary embolism and post-thrombotic syndrome, principally in patients with secondary DVT. The knowledge of predictive factors of internal jugular Vein Thrombosis seems to be of utmost importance to improve patients’ management.
