Journal of vascular surgery. Venous and lymphatic disorders
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J Vasc Surg Venous Lymphat Disord · Mar 2019
Statin therapy associated with improved thrombus resolution in patients with deep vein thrombosis.
Statin therapy has been associated with a decreased incidence of venous thromboembolism (VTE) in clinical trials and enhanced thrombus resolution in animal models. The effect of statins on thrombus resolution has not been reported clinically. This study investigates the association of statins with thrombus resolution or improvement in patients with deep venous thrombosis (DVT). ⋯ Statin therapy is associated with greater thrombus resolution or improvement in patients with DVT. However, statin therapy in this study was not associated with different clinical outcomes of VTE recurrence or mortality.
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J Vasc Surg Venous Lymphat Disord · Mar 2019
Case ReportsDirect contrast-enhanced magnetic resonance lymphangiography in the diagnosis of persistent occult chylous effusion leak after thoracic duct embolization.
Thoracic duct embolization (TDE) is currently the technique of choice for chylothorax refractory to medical management. Diagnosis and treatment of persistent lymphatic leakage after an initially successful TDE are complicated by inadequate imaging to localize the nidus of the lymphatic leak. Traditional imaging modalities including nuclear medicine lymphoscintigraphy, magnetic resonance lymphangiography, and fluoroscopic lymphangiography lack spatial resolution and dynamic physiologic real-time evaluation. We report a contemporary imaging technique using direct contrast-enhanced magnetic resonance lymphangiography to diagnose an occult chylous leak after TDE.
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J Vasc Surg Venous Lymphat Disord · Mar 2019
Case ReportsEndovascular treatment of a penetrating injury of the suprarenal inferior vena cava.
In this case, a 22-year-old man sustained multiple gunshot wounds to the abdomen, which required in extremis surgical exploration with damage control laparotomy and hemostatic resuscitation in the surgical intensive care unit. Diagnostic angiography was negative and an inferior vena cava (IVC) injury was suspected. He was returned to the operating room, where the infrarenal IVC was accessed by direct puncture and venography demonstrated active extravasation of the suprarenal vena cava. ⋯ He made a full recovery and was discharged home on hospital day 20. Outpatient follow-up computed tomography at 2 months revealed a patent stent with preserved branches. Stent graft repair of penetrating IVC injury can be lifesaving and warrants further investigation.