• Title/Summary/Keyword: Deep Vein Thrombus

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Pulmonary Thromboembolectomy of Chronic Pulmonary Thromboembolism (만성 폐전색증의 전색 제거술 치험 -1례 보고-)

  • 문석환
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.911-917
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    • 1988
  • Pulmonary thromboembolism originated most commonly from the venous thrombus, especially deep vein thrombus in the leg, which migrated to and occluded the pulmonary vasculatures. The failure of clot lysis and repeated embolic episodes resulted in the hemodynamic compromise -that is- in the increasing in the pulmonary vascular resistance, which would cause the right ventricle failure[Car Pulmonale]. Under the cardiopulmonary bypass, 20 year old male patient was treated successfully by thromboembolectomy of pulmonary thromboembolism with pulmonary hypertension, which originated from the deep vein thrombus in the leg. The results of radiologic studies and clinical evaluations were excellent in that the postoperative lung perfusion scan showed the newly increased perfusion of post-embolectomy territories and in the arterial blood gas finding of 76 from 66[mmHg] in PaO2. The patient was uneventful and discharged on postop. $ 14 days with anticoagulant continued.

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A Case of Deep Vein Thrombosis Associated with Myositis due to Streptococcus pyogenes (Streptococcus pyogenes 근염에 심부 정맥 혈전증이 동반한 1례)

  • Lee, Jae Sook;Jang, Tae Young;Ahn, Young Min
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.87-91
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    • 2009
  • A 5-year-old boy was admitted to the hospital with a high fever and abnormal gait. Magnetic resonance imaging showed extensive swelling of the quadriceps and adductor muscles around the right hip and anterior thigh. A duplex scan demonstrated a thrombus from the external iliac vein to below the popliteal vein. The blood culture revealed Streptococcus pyogenes. The patient was immediately treated with antibiotics and anticoagulants. Follow-up sonography demonstrated complete disappearance of the venous thrombosis. We report a case of streptococcal myositis complicated by deep vein thrombosis.

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Salvage of late flap compromise in deep inferior epigastric perforator flaps: To revise or not to revise

  • Hong, Seung Heon;Lee, Kyeong-Tae;Pyon, Jai-Kyong
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.97-101
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    • 2020
  • Although the success rate of deep inferior epigastric perforator (DIEP) flaps has increased, late flap failures still occur and have a low salvage rate. The present article describes a case of salvage of a case of late flap failure using the pedicle vein as a vein graft source. A 50-yearold woman underwent a bilateral DIEP free flap procedure. On postoperative day 6, she experienced flap compromise and underwent emergency flap revision. In the flap revision, flap venous drainage and the superficial inferior epigastric vein were completely obstructed. A Fogarty catheter was used to remove a thrombus from the completely obstructed pedicle vein, and this pedicle vein was used as a graft source and was ligated in retrograde fashion to the flap vein stump. After injection of urokinase into the arterial branch, venous flow to the flap was restored. At a 6-month follow-up visit in the outpatient clinic, only partial fat necrosis at the flap was noted. By dissecting various perforators in the initial operation, decisions regarding immediate revision can be made with more confidence. Additionally, the combined procedures performed in this case may be helpful even for practitioners treating cases of late flap compromise.

Pharmaco-mechanical Thrombectomy and Stent Placement in Patients with May-Thurner Syndrome and Lower Extremity Deep Venous Thrombosis (May-Thurner 증후군과 동반된 하지 심부정맥혈전환자에서 혈전제거술과 스텐트삽입술)

  • Jeon, Yonh-Sun;Kim, Yong-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Baek, Wan-Ki;Kim, Kwang-Ho;Kim, Joung-Taek
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.757-762
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    • 2009
  • Background: Compression of the left common iliac vein by the overriding common iliac artery is frequently combined with acute deep vein thrombosis in patients with May-Thurner Syndrome. We evaluate the results of treatment with thrombolysis and thrombectomy followed by stenting in 34 patients with May-Thurner Syndrome combined with lower extremity deep venous thrombosis. Material and Method: The authors retrospectively reviewed the records of 34 patients (mean age: $65{\pm}14$ year old) who had undergone stent insertion for acute deep vein thrombosis that was caused by May-Thurner syndrome. After thrombectomy and thrombolysis, insertion of a wall stent and balloon angioplasty were performed to relieve the compression of the left common iliac vein. Urokinase at a rate of 80,000 to 120,000 U/hour was infused into the thrombosed vein via a multi-side hole thrombolysis catheter. A retrieval inferior vena cava (IVC) filter was placed to protect against pulmonary embolism in 30 patients (88%). Oral anticoagulation with warfarin was maintained for 3 months, and follow-up Multi Detector Computerized Tomography (MDCT) angiography was done at the date of the patients' hospital discharge and at the 6 months follow-up. Result: The symptoms of deep venous thrombosis disappeared in two patients (4%), and there was clinical improvement within 48 hours in twenty eight patients (82%), but there was no improvement in four patients (8%). The MDCT angiography at discharge showed no thrombus in 9 patients (26%) and partial thrombus in 21 (62%), whereas the follow-up MDCT at $6.4{\pm}5.5$ months (32 patients) revealed no thrombus in 23 patients (72%), and partial thrombus in 9 patients (26%). Two patients (6%) had recurrence of DVT, so they underwent retreatment. Conclusion: Stent insertion with catheter-directed thrombolysis and thrombectomy is an effective treatment for May-Thurner syndrome combined with acute deep vein thrombosis in the lower extremity.

Surgical Treatment of Renal Cell Carcinoma with IVC Tumor Extension Using Deep Hypothermic Circulatory Arrest - A Case Report - (심도 저체온 순환 정지를 이용한 하대정맥에 파급된 신세포암의 수술적 치료 -1례 보고-)

  • Kang, Shin-Kwang;Kim, Si-Wook;Won, Tae-Hee;Ku, Kwan-Woo;Na, Myung-Hoon;Yu, Jae-Hyun;Lim, Seung-Pyung;Lee, Young;Sul, Jong-Goo
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.755-759
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    • 2002
  • A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

The Effect of Urokinase Infusion Regimens on Thrombolysis - a Numerical Study

  • Jeong, Woo-Won;Jang, An-Sik;Rhee, Kye-Han
    • Journal of Biomedical Engineering Research
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    • v.27 no.5
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    • pp.267-273
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    • 2006
  • Numerical analysis was performed on the enzyme transport and the flow fields in order to predict the effectiveness of urokinase injection regimens in clot dissolution. The species and momentum transport equations were numerically solved for the case of uniform perfusion of enzyme into a fibrin clot for an arterial thrombus and a deep vein thrombus models. In order to predict the thrombus lysis efficiency of continuous and forced intermittent injections, enzyme perfusion and clot lysis were simulated for the different injection velocities. Intermittent injection showed faster clot lysis compared to continuous perfusion, and lysis efficiency was increased as injection velocity increased.

Pulmonary Embolectomy for Acute massive Pulmonary Embolism - 1 case -

  • 이형교
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.804-810
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    • 1990
  • Pulmonary thromboembolism originated mostly from the venous thrombus, especially deep vein thrombosis in the lower extremities, which migrated upward and lodged the pulmonary vasculatures, Massive pulmonary thromboembolism usually leads to in \ulcornerhospital mortality if the patient was not treated properly. Under the cardiopulmonary bypass, a 49-year old man was treated successfully by emergent pulmonary embolectomy of pulmonary thromboembolism, which originated from the deep vein thrombosis in the right leg. Ligation or filtering device insertion of the inferior vena cava was not performed. The patient’s postoperative course was uneventful and discharged on postoperative 15th day He continued to receive oral anticoagulation with aspirin and persantin, which had been started on the third postoperative day. And he was well till recent days through the outpatient follow-up. The clinical courses of this patient are described, and massive pulmonary embolism and its management are discussed.

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Case of Deep Vein Thrombosis Patient Treated by Korean Medicine (한의학적 치료로 호전된 심부 정맥혈전증 치험 1례)

  • Kim, Hyun Tae;Choi, Koh Eun;Oh, Jeong Min;Heo, Jong Won;Eom, Tae Min;Cho, Min Kyoung;Cho, Hyun Kyoung;Yoo, Ho Ryong;Seol, In Chan;Kim, Yoon Sik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.6
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    • pp.503-509
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    • 2015
  • This is a case report on a deep vein thrombosis(DVT) patient whose pain, numbness, and swelling in the left leg have been decreased with Korean Medicine. The 59 year-old male patient who was diagnosed with DVT and showed the classic symptoms of DVT(pain, numbness and swelling in the left leg). Although he was treated with medication(100mg of aspirin, 20mg of rivaroxaban) for five weeks, his symptoms did not improved. Then, he was gaven Sunkihwalhyul-tang three times a day and Jungsongouhyul pharmacopuncture once a day for two months. Conservative therapy including leg elevation and an elastic stocking was co-administered. During our treatment period, the size of the thrombus in the left external iliac vein was decreased according to sonography compared with the pre-hospital's sonography, and the patient felt his symptoms had improved. This case report suggests Korean Medicine may play a role in improving the deep vein thrombosis symptoms.