• Title/Summary/Keyword: Vein thrombosis

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Diagnosis and Endovascular Treatment of May-Thurner Syndrome (May-Thurner 증후군의 진단과 혈관내 치료)

  • 허균;이재욱;신화균;원용순
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.911-917
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    • 2004
  • Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

Development of a Measurement System of the Transferred Pressure from Intermittent Pneumatic Compression Device (간헐적공기압박장치의 전달압력 측정시스템 개발)

  • Lee, Wonhee;Seo, Jong Hyun;Kim, Jun;Kang, Seung Ho;Kim, Gook Han;Chung, Seung Hyun;Kim, Kwang Gi;Kang, Hyun Guy
    • Journal of Biomedical Engineering Research
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    • v.37 no.1
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    • pp.39-45
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    • 2016
  • A pressure measurement system was developed to verify magnitude and position of transferred pressure on the body surface during the intermittent pneumatic compression (IPC) which is one of the most well-known methods for the prevention of deep vein thrombosis (DVT). Eighty force sensing resistors (FSR) were arranged on a mannequin leg and a hardware controller sensed, digitized, and transferred pressure data every second while IPC was being applied. Finally, sensed pressure data were color coded and visualized on the 3D model with lab-developed software. The pressure data were also saved to files for further analysis. Using this measurement system, the changing pattern of pressure was measured on the mannequin leg by changing both chamber pressure and cuff tightness. As a result, net pressure transferred onto the body surface is dependent on chamber pressure and cuff tightness. Under the same chamber pressure, the tighter a cuff was worn, the wider compressed area was and the shorter compression cycle was. Also transferred pressure was proportional to both chamber pressure and cuff tightness.

Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

  • Li, Nan;Hu, Wen-Jun;Shi, Jie;Xue, Jie;Guo, Wei-Xing;Zhang, Yang;Guan, Dong-Xian;Liu, Shu-Peng;Cheng, Yu-Qiang;Wu, Meng-Chao;Xie, Dong;Liu, Shan-Rong;Cheng, Shu-Qun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3509-3514
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    • 2013
  • The prognostic value of the fibroblast growth factor-inducible 14 (Fn14) expression in hepatocellular carcinoma (HCC) is unknown. Real-time PCR (RT-PCR), western blot assays and immunohistochemistry analysis were here performed in order to compare Fn14 expressios in paired liver samples of HCC and normal liver tissue. Most of the tumor tissues expressed significantly higher levels of Fn14 compared to adjacent non-tumor tissues, with Fn14High accounting for 54.6% (142/260) of all patients. The Pearson ${\chi}^2$ test indicated that Fn14 expression was closely associated with serum alpha fetal protein (AFP) (P=0.002) and tumor number (p=0.019). Univariate and multivariate analyses revealed that along with tumor diameter and portal vein tumor thrombosis (PVTT ) type, Fn14 was an independent prognostic factor for both overall survival (OS) (HR=1.398, p=0.008) and recurrence (HR=1.541, p=0.001) rates. Fn14 overexpression HCC correlated with poor surgical outcome, and this molecule may be a candidate biomarker for prognosis as well as a target for therapy.

Pulmonary Thromboembolism after Post-menopause Hormonal Replacement Therapy (폐경기 호르몬 대체요법 후 발생한 폐 색전증)

  • Kim, Sun Young;Park, Jong Hyeok;Lee, Hyun Kyung;Lee, Hyuk Pyo;Lee, Hye Kyung;Choi, Soo Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.362-367
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    • 2007
  • Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.

Incidence of Venous Thromboembolic Complications in Instrumental Spinal Surgeries with Preoperative Chemoprophylaxis

  • Hamidi, Saeed;Riazi, Mahdieh
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.114-118
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    • 2015
  • Objective : Venous thromboembolism (VTE) after spinal surgery affects a patients' postoperative recovery and also carries a mortality risk. Some studies recommended chemical prophylaxis for high-risk patients and for those after complex spinal surgeries. However, chemoprophylaxis for VTE in spinal surgery is underemployed and there is no agreement on the use of VTE prophylaxis in spinal surgery. The aim of this study was to document the incidence of VTE after an elective instrumental spinal surgery, among those receiving preoperative chemoprophylaxis as compared with patients who did not receive it. Methods : This study was carried out on eighty-nine patients allocated randomly to receive either low molecular weight heparin (LMWH) or no prophylaxis before elective instrumental spinal surgery. All patients received postoperative compression stockings. A compression Doppler ultrasonography was performed for all patients to detect postoperative deep vein thrombosis. In addition, further imaging studies were performed for patients suspected of VTE. Results : Three (3.3%) patients were diagnosed with VTE. One of them had received preoperative chemoprophylaxis. There were no significant difference in incidence of VTE between the two groups (p>0.95; 95% confidence interval, 0.06-8.7). Laterality of gender and postsurgical recumbence duration were all independent predictors of VTE (p=0.01 and p<0.001, respectively). Conclusion : The difference in the incidence of thromboembolic complications between the two groups was not significant. Moreover, we found that preoperative prophylactic LMWH injection has no major bleeding complications altering postoperative course; still, the issue concerning the initiation time of chemoprophylaxis in spinal surgery remains unclear.

Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • 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 Incidence of Venous Thromboembolism Following Shoulder Surgery: A Pilot Study

  • Cho, Chul-Hyun;Jang, Hyung-Gyu;Park, Ui-Jun;Kim, Hyoung Tae
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.18-23
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    • 2017
  • Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

The Safety Management for Compression Medical Device through the Quality Improvement Activities (질 향상 활동을 통한 사지압박순환장치의 안전관리)

  • An, Young-Jae;Kim, Kyu-Sung;Shin, Jeong-Ae;Lee, Hye-Ryun;Hwang, Kyu-Jung;Park, Ji-Young;Kim, Sae-Rom;Kang, Su-Kyung;Kwon, Dae-Gyu
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.2
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    • pp.125-132
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    • 2017
  • Intermittent pneumatic compression is frequently used for prophylaxis of deep vein thrombosis, however there is a lot of complains by frequent adverse event. In this paper, we analyzed the cause of adverse event and we tried to improve for the cause of machine, nurses, patients, system by diverse strategy. And we could improve the index of each cause, the rate of error was decreased finally. The proactive activity of quality improvement for medical device can contribute to decrease the error, that will improve the quality of medical service and achieve the safe medial culture.

A Case of Pulmonary Thromboembolism Due to Congenital Antithrombin III Deficiency (선천성 Antithrombin III 결핍증에서 발생한 폐색전증 1 예)

  • Park, Hyeong-Kwan;Park, Chang-Min;Ko, Kyoung-Haeng;Rim, Myung-Soo;Kim, Yu-Il;Hwang, Jun-Hwa;Lim, Sung-Chul;Kim, Young-Chul;Park, Kyung-Ok
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.394-399
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    • 1999
  • We report a case of congenital and familial antithrombin III deficiency developing massive pulmonary thromboembolism. A 44-year-old man was admitted to our hospital because of sudden chest pain and severe dyspnea. Five years ago, he was operated due to a mesenteric vein thrombosis of unknown cause. On admission, radioisotopic venogram showed deep vein thrombosis and lung scintigram showed multiple segmental perfusion defects. His plasma antithrombin III level was 10.5 mg/dL which was less than 50% of normal and those of a son and two daughters were also decreased. After treatment with tissue plasminogen activator, heparin and coumadin, his symptom and lung scintigram were significantly improved. As far as we reviewed, there were very rare reports with congenital antithrombin III deficiency presenting as pulmonary thromboembolism in Korea.

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Microvascular Anastomosis with Non-penetrating Vascular Clips in Head and Neck Free Flap Surgery (두경부 유리피판 수술에 있어서의 비천공성 혈관 클립을 이용한 미세혈관 문합술)

  • Chang, Hak;Minn, Kyung-Won;Kim, Woo-Ram;Shin, Hyun-Woo;Koh, Kyung-Suck
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.57-62
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    • 2005
  • Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

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