• Vascular Specialist International
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• v.34 no.4
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.381-386
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• 2020

Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.999-1010
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• 2023

This case report shows the effect of Korean medicine treatment in a patient with deep vein thrombosis (DVT) after cerebral infarction who is suspected of having post-thrombotic syndrome (PTS) due to the loss of thrombus after receiving new oral anticoagulant (NOAC) treatment. The patient was treated with Korean medicine (Boyanghwano-tang and Hyulbuchuko-tang) three times a day. Acupuncture, moxibustion, infrared, and extra-physical therapy were given to the patient for 24 days. Clinical assessment - grading of edema and circumference of the left lower extremity were observed twice a week until the end of the treatment. NOAC treatment was continued for 24 days. After treatment, the patient's edema grade and circumference of the extremity improved. On the 24th day, the patient's chief complaints improved, and she requested termination of treatment. The results suggest that Korean medicine treatments, including Boyanghwano-tang, Hyulbuchuko-tang, and acupuncture therapy, can be effective in improving the clinical symptoms of DVT and PTS.

• Journal of Gastric Cancer
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• v.14 no.2
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• pp.142-146
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• 2014

Pulmonary tumor thrombotic microangiopathy (PTTM) causing fatal pulmonary hypertension is a rare presentation of malignancy. In general, patients with PTTM rapidly succumb to death due to severe hypoxia. To date, very few cases of PTTM have been reported in the literature; and most of these cases were from gastric cancer and were diagnosed on post mortem autopsy, as it is extremely challenging to make an ante mortem diagnosis. We here report on a case of undiagnosed diffuse gastric cancer, presenting as worsening hypoxia. The clinical, radiographic, and echocardiographic features, and laboratory and pathological results were consistent with PTTM from gastric cancer. The patient was started on anticoagulation therapy, corticosteroids, and high-flow oxygen. However, her hypoxia worsened to the extent that she required ventilator support, and she died soon after intubation due to cardiac arrest. Since diffuse gastric cancer is associated with hereditary diffuse gastric cancer syndrome, cadherin 1 gene mutation analysis was performed to estimate the risk to her daughters. The test came back negative.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.266-272
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• 2010

Background: Deep vein thrombosis (DVT) is a serious disease that causes life-threatening pulmonary embolism and chronic venous insufficiency. Anticoagulation is the standard therapy for DVT. However, the results of standard anticoagulation for treating DVT have been disappointing, so endovascular treatment is commonly performed nowadays. The aim of this study was to evaluate the efficacy of an endovascular procedure for treating patients with DVT. Material and Method: We retrospectively evaluated the clinical data of 29 DVT patients who underwent an endovascular procedure between December 2006 and July 2008. We compared the results of the 29 patients with the results of another 45 patients who were treated with only aspirin and heparin. Result: The patient’s mean age was 55.4 years in the intervention group and 53.7 years in the control group. DVT occurred more frequently in the females. Catheter-directed thrombolysis was performed in 22 patients (75.8%). Aspiration thrombectomy was performed in 18 patients (62%) and a endovascular stent was placed in 25 patients (86.2%). Fifteen patients (51.7%) underwent percutaneous insertion of a retrievable IVC filter for the prevention of pulmonary embolism. In the control group, thirty nine patients (86.7%) were treated with low-molecular heparin, and seven patients (15.6%) who were contraindicated for warfarin were treated with aspirin. No bleeding complications occurred during thrombolysis or anticoagulation. We analyzed the statistical data according to recurrence of DVT and the incidence of post-thrombotic syndrome (PTS) during the follow-up period. The intervention group had a significantly lower incidence of PTS (p-value=0.008), but they had the same result as the control group for the recurrence of DVT. In addition, death from the DVT did not occur in the intervention group. Thus, we obtained better clinical outcomes in the intervention group as compared to those in the anticoagulation only group. Conclusion: Endovascular procedures are effective alternative modalities, as compared to systemic anticoagulation, for the treatment of DVT. But more studies are needed to determine the specific indications and to validate the long-term efficacy of endovascular procedures for the treatment of DVT.