Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Dec 2010
Randomized Controlled Trial Multicenter StudyComparison of tinzaparin and acenocoumarol for the secondary prevention of venous thromboembolism: a multicentre, randomized study.
The objective of the present study was to evaluate the efficacy, safety and healthcare resource utilization of long-term treatment with tinzaparin in symptomatic patients with acute pulmonary embolism as compared to standard therapy. In this open-label trial, 102 patients with objectively confirmed pulmonary embolism were randomized to receive, after initial treatment with tinzaparin, either tinzaparin (175 IU/kg/day) or international normalized ratio-adjusted acenocoumarol for 6 months. Clinical endpoints were assessed during the 6 months of treatment. ⋯ Median hospital length of stay was shorter in the tinzaparin group compared to the acenocoumarol group (7 versus 9 days; P = 0.014). When all the direct and indirect cost components were combined for the entire population, we found a slight, nonstatistically significant (mean difference €345; 95% CI 1382-2071; P = 0.69) reduction in total cost with tinzaparin. Symptomatic acute pulmonary embolism treatment with full therapeutic doses of tinzaparin for 6 months is a feasible alternative to conventional treatment with vitamin K antagonists.
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Blood Coagul. Fibrinolysis · Dec 2010
Targeted ultrasound is the procedure of choice for detecting rudimentary branchial cysts causing jugular and subclavian vein thrombosis.
The aim of this study was to facilitate the imaging diagnosis of branchial cysts leading to combined jugular and subclavian vein thrombosis during ovarian hyperstimulation syndrome (OHSS). Three women developed combined jugular and subclavian vein thrombosis following OHSS related to assisted reproductive technologies. The imaging modalities used for diagnosis were a bimode Doppler ultrasound, MRI of the neck in two women, computed tomography (CT) angiography and venography in one. ⋯ Venography was performed in one patient; it demonstrated the thrombosed vein possibly with some extrinsic compression, but it could not define a cyst. Targeted ultrasound is the simplest and best imaging modality for discerning rudimentary cysts in pregnant women with OHSS who present with jugular and subclavian vein thrombosis following assisted reproductive technology. A search for the cyst at the time of OHSS is important, as early detection could decrease the risk of developing thrombosis.