• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• Journal of Korean Academy of Nursing
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• v.42 no.3
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• pp.396-404
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• 2012

Purpose: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. Methods: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. Results: The mean age was 62.24 (${\pm}17.28$) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(${\pm}2.94$) and they had on average 4.01(${\pm}1.35$) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. Conclusion: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.221-225
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• 2009

Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.572-579
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• 2019

Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

• Tuberculosis and Respiratory Diseases
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• v.77 no.6
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• pp.274-278
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• 2014

Antiphospholipid syndrome (APS) is an acquired systemic autoimmune disorder characterized by a combination of clinical criteria, including vascular thrombosis or pregnancy morbidity and elevated antiphospholipid antibody titers. It is one of the causes of deep vein thrombosis and pulmonary embolism that can be critical due to the mortality risk. Overall recurrence of thromboembolism is very low with adequate anticoagulation prophylaxis. The most effective treatment to prevent recurrent thrombosis is long-term anticoagulation. We report on a 17-year-old male with APS, who manifested blue toe syndrome, deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction despite adequate long-term anticoagulation therapy.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.858-861
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• 1994

Prosthetic valve thrombosis is rare but it is one of fatal complication after heart valve surgery. Improvements of the valve design and the material have decreased the frequency of thrombosis but have not eliminated completely. And some cases of prosthetic valve thrombosis during pregnancy were reported inspite of adequate anticoagulation therapy.Urgent surgical intervention is indicated for prosthetic valve thrombosis but it is associated with high operative risk, therefore medical thrombolytic therapy such as urokinase or streptokinase therapy is regarded as an alternative therapy. This is a case report of the successful thrombolytic therapy for valve thrombosis in a pregnant patient after mechanical mitral valve replacement.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.315-321
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• 2016

Objective: This study reports on the clinical effects of combinatorial Hyulbuchuko-tang on a deep-vein thrombosis patient.Method: The deep-vein thrombosis patient was treated using combinatorial Hyulbuchuko-tang and pharmacopuncture (water-soluble carthami flos, WCF) three times a day for 33 days. The effects of deep-vein thrombosis were measured using a 0-10 numerical rating scale (NRS) and external appearance.Result: Improvements in the NRS from 7 to 2 were observed after the combinatorial Hyulbuchuko-tang treatment.Conclusions: From these results, combinatorial Hyulbuchuko-tang may be considered to show improvement for patients with deep-vein thrombosis.

• Journal of Yeungnam Medical Science
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• v.35 no.2
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• pp.227-231
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• 2018

Left main coronary artery (LMCA) thrombosis is rare and the cause should be determined. A previously healthy young man presented with severe chest pain and dyspnea. The electrocardiogram showed typical ST-segment elevation myocardial infarction with clinical instability. Emergency coronary angiography revealed complete LMCA occlusion by thrombosis. After reperfusion, the patient was admitted to the cardiac care unit. He was diagnosed with hemolytic anemia and tested positive for antinuclear antibodies. Systemic lupus erythematosus (SLE) and LMCA disease due to systemic thrombosis were diagnosed. Steroids were started and the patient was discharged without complications. We report this rare case of LMCA thrombosis as an initial presentation of SLE.

• Journal of the Korean Society of Radiology
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• v.79 no.5
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• pp.282-285
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• 2018

Acute scrotal pain is a common clinical symptom of urinary system and there are various causes. Among them, thrombosis of testicular vein is rare, but one of the causes of acute scrotal pain. Thrombosis is a common disease that can occur anywhere in our body. But thrombosis of testicular vein has not been reported in Korea. We report a case of thrombosis of testicular vein in a 26-years-old man with acute scrotal pain.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.125-129
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• 2022

Patients with nephrotic syndrome (NS) are generally known to be at greater risk for thrombosis, with arterial thrombosis-related complications being relatively rare compared to venous thrombosis-related complications. This report describes a 46-year-old male with historically proven minimal change disease (MCD) complicated by acute aortoiliac thrombosis. He had been diagnosed with MCD 8 months previously and was treated successfully with steroids. He was prescribed a second course of high-dose steroids (prednisolone 1 mg/kg/day) due to a relapse of MCD at the outpatient clinic 8 days before the emergency department visit. The patient presented with severe pain in both lower limbs and was diagnosed with aortoiliac thrombosis that developed during high-dose steroid treatment. He subsequently underwent surgical thromboembolectomy. Hypoalbuminemia has the strongest association with the risk of thromboembolism. According to international clinical practice guidelines, anticoagulant therapy is recommended when serum albumin is ≤2-2.5 g/dL. However, as serum albumin levels may be relatively high in the early phase of NS, as in this case report, an individualized anticoagulation strategy for each patient should be considered, regardless of serum albumin levels.