Journal of vascular surgery. Venous and lymphatic disorders
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J Vasc Surg Venous Lymphat Disord · Jul 2016
The next frontier of office-based inferior vena cava filter placement.
There is an increasing number of procedures that traditionally were performed in the inpatient setting that are now becoming office-based procedures. These include peripheral endovascular procedures such as angiograms, angioplasties, dialysis access interventions, and treatment for venous insufficiency. We chose to evaluate the feasibility, safety of inferior vena cava (IVC) filter placement in the office-based setting. ⋯ Our preliminary experience suggests that placement of IVC filters for treatment of venous thrombotic events in an office-based facility is safe and efficacious with basic endovascular equipment. Long-term outcome cannot be determined at this point.
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J Vasc Surg Venous Lymphat Disord · Jul 2016
Improved early right ventricular function recovery but increased complications with catheter-directed interventions compared with anticoagulation alone for submassive pulmonary embolism.
The purpose of this study was to determine the short-term and midterm outcomes of catheter-directed intervention (CDI) compared with anticoagulation (AC) alone in patients with submassive pulmonary embolism (sPE). ⋯ CDI for sPE can result in faster restoration of right ventricular function and shorter intensive care unit stay, but at the cost of a higher complication rate, with similar midterm outcomes compared with AC alone. A potential effect of CDI on mortality and pulmonary hypertension needs further investigation through larger studies.
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J Vasc Surg Venous Lymphat Disord · Apr 2016
Validation of the Caprini risk assessment model for venous thromboembolism in high-risk surgical patients in the background of standard prophylaxis.
We used the Caprini venous thromboembolism risk assessment score to prospectively evaluate if there was a correlation between the Caprini scores and the incidence of postoperative deep vein thrombosis (DVT) in high-risk surgical patients. A second objective was to determine whether patients at extremely high risk need a more effective prophylactic regimen. ⋯ There was a significant correlation between Caprini scores and the incidence of postoperative DVT in high-risk surgical patients. A Caprini score of ≥ 11 can identify a subgroup of patients at extremely high risk. These patients need a more effective prophylactic regimen.
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J Vasc Surg Venous Lymphat Disord · Apr 2016
Lymph proteins may access peripheral blood without entering thoracic duct in patients with lymphatic dysfunction.
The objective was to investigate the hypothesis that lymphovenous communications, which allow lymph proteins to access peripheral blood without first entering the thoracic duct, open in patients with abnormal lymphatic function. ⋯ Lymphovenous communications exist in about one-third of patients with abnormalities detected on lymphoscintigraphy. The timings of tracer arrival in the liver and lymph nodes is consistent with lymphovenous communication within lymph nodes themselves.
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J Vasc Surg Venous Lymphat Disord · Oct 2015
ReviewThe additional benefit of graduated compression stockings to pharmacologic thromboprophylaxis in the prevention of venous thromboembolism in surgical inpatients.
The evidence base supporting the use of graduated compression stockings (GCS) for venous thromboembolism (VTE) prevention has been challenged, and there appears to be a lack of evidence for the additional benefit of GCS to pharmacologic thromboprophylaxis. This study aimed to summarize and quality assess the existing evidence concerning whether GCS offer a significant benefit in addition to pharmacologic thromboprophylaxis in surgical inpatients. ⋯ The additional benefit of GCS to pharmacologic thromboprophylaxis in surgical inpatients is not clear on the basis of existing data. Further clinical trials directly evaluating this clinical question are recommended.