Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.796
Filtrar
1.
Neurosciences (Riyadh) ; 28(1): 48-52, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36617457

RESUMO

A 65-year-old male patient presented with a rare arterio-venous fistula (AFV). The symptoms included congestion, decreased visual acuity, and proptosis. Further investigation revealed a non-traumatic intra orbital AFV with ophthalmic vein thrombosis. The management strategy was craniotomy and the prescription of anticoagulants. The patient recovered 2 months after surgery demonstrating successful resolution of his presenting symptoms and an alternative approach to complicated cases of embolization.


Assuntos
Fístula Arteriovenosa , Embolização Terapêutica , Exoftalmia , Trombose Venosa , Masculino , Humanos , Idoso , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Exoftalmia/complicações , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/cirurgia , Embolização Terapêutica/efeitos adversos
3.
BMJ Case Rep ; 15(11)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36446470

RESUMO

Phlegmasia cerulea dolens is a rare entity that causes critical limb ischaemia, which may lead to amputation of the limb and may be life-threatening. Here, we describe a case of a healthy man in his 50s with multiple trauma who was transferred to the intensive care unit (ICU) of a central hospital for neuromonitoring following splenectomy for the stabilisation of a hypovolaemic shock. On admission to the ICU, the patient developed a swollen and white leg. The condition was caused by early compromised arterial flow secondary to extensive deep vein thrombosis.


Assuntos
Cianose , Trombose Venosa , Masculino , Humanos , Cianose/etiologia , Edema , Extremidades , Unidades de Terapia Intensiva , Trombose Venosa/complicações , Trombose Venosa/cirurgia
4.
Curr Opin Organ Transplant ; 27(4): 312-319, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-36354257

RESUMO

PURPOSE OF REVIEW: To summarize recent evidence in literature regarding liver transplantation in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT) with no extrahepatic disease. In addition, in this review, we have tried to highlight the advances in downstaging with ablative therapies that have made liver transplantation a possibility, and also the key points to focus on when considering liver transplantation in these patients with locally advanced HCC. RECENT FINDINGS: Advances in the understanding of technicalities and effectiveness of ablative therapies, including transarterial chemoembolization, stereotactic body radiotherapy and transarterial radioembolization on PVTT have helped successfully downstage patients with HCC and PVTT to within transplant criteria. This provides the opportunity to offer a curative liver transplantation in these patients who are generally managed with systemic or palliative therapy alone with dismal prognosis. Meticulous patient selection based on tumour biology, documented downstaging based on imaging and decrease in tumour marker levels, an adequate waiting period to demonstrate stable disease, liver transplantation with some technical modifications, and a modified immunosuppression protocol may offer long-term survival in a select group of patients treated with initial downstaging therapies in an intention to treat strategy. SUMMARY: In patients with HCC, presence of PVTT is generally considered the end of the road by many. A multidisciplinary approach combining ablation and a curative liver transplantation may offer the best hope of long-term survival in a select group of patients with favourable tumour biology. Although promising, current evidence is limited, and future studies with larger number of patients, and longer follow-up may pave the way for an elaborate selection algorithm to choose the ideal candidates for such a curative strategy in patients with locally advanced HCC with PVTT.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Transplante de Fígado , Trombose , Trombose Venosa , Humanos , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/efeitos adversos , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia , Trombose/etiologia , Trombose/patologia , Trombose/terapia , Estudos Retrospectivos
5.
BMC Surg ; 22(1): 377, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333708

RESUMO

BACKGROUND: We aimed to compare the oncological outcomes between the oblique occlusion technique and the traditional technique for robot-assisted radical nephrectomy (RARN) with inferior vena cava (IVC) thrombectomy, and to explore the safety and effectiveness of the oblique occlusion technique. METHODS: Overall, 21 patients with renal cell carcinoma (RCC) and IVC tumor thrombus (TT) were admitted to our hospital from August 2019 to June 2020. All the patients underwent RARN with IVC thrombectomy, of which the IVC oblique occlusion technique was used in 11 patients and traditional occlusion technique was used in 10 patients. The oblique occlusion technique refers to oblique blocking from the upper corner of the right renal vein to the lower corner of the left renal vein using a vessel tourniquet or a vessel clamp (left RCC with IVCTT as an example). RESULTS: Compared with patients in the traditional group, those in the oblique group had lower serum creatinine at follow-up (3 month) (95 ± 21.1 vs. 131 ± 30.7 µmol/L, P = 0.03). There was no significant difference in operation time [149 (IQR 143-245) min vs. 148 (IQR 108-261) min, p = 0.86], IVC clamping time [18 (IQR 12-20) min vs. 20 (IQR 14-23) min, p = 0.41], and estimated intraoperative blood loss [300 (IQR 100-800) mL vs. 500 (IQR 175-738) mL, p = 0.51] between both groups. During a 16-month (range, 15-23 months) follow-up period, two cases progressed in the oblique group and three cases progressed in the traditional group. CONCLUSIONS: The modified IVC oblique occlusion technique procedure is relatively safe and effective in RARN with IVC thrombectomy. The IVC oblique occlusion technique may play a role in the protection of renal function.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Robótica , Trombose Venosa , Humanos , Veia Cava Inferior/cirurgia , Veia Cava Inferior/patologia , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/cirurgia , Neoplasias Renais/patologia , Trombectomia/métodos , Nefrectomia/métodos , Trombose Venosa/cirurgia , Trombose Venosa/patologia , Estudos Retrospectivos
6.
J Osteopath Med ; 122(12): 605-608, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36330769

RESUMO

The use of vena cava filters (VCF) is a common procedure utilized in the prevention of pulmonary embolism (PE), yet VCFs have some significant and known complications, such as strut penetration and migration. Deep vein thrombosis (DVT) and PE remain a major cause of morbidity and mortality in the United States. It is estimated that as many as 900,000 individuals are affected by these each year with estimates suggesting that nearly 60,000-100,000 Americans die of DVT/PE each year. Currently, the preferred treatment for DVT/PE is anticoagulation. However, if there are contraindications to anticoagulation, an inferior vena cava (IVC) filter can be placed. These filters have both therapeutic and prophylactic indications. Therapeutic indications (documented thromboembolic disease) include absolute or relative contraindications to anticoagulation, complication of anticoagulation, failure of anticoagulation, propagation/progression of DVT during therapeutic anticoagulation, PE with residual DVT in patients with further risk of PE, free-floating iliofemoral IVC thrombus, and severe cardiopulmonary disease and DVT. There are also prophylactic indications (no current thromboembolic disease) for these filters. These include severe trauma without documented PE or DVT, closed head injury, spinal cord injury, multiple long bone fractures, and patients deemed at high risk of thromboembolic disease (immobilized or intensive care unit). Interruption of the IVC with filters has long been practiced and is a procedure that can be performed on an outpatient basis. There are known complications of filter placement, which include filter migration within the vena cava and into various organs, as well as filter strut fracture. This case describes a 66-year-old woman who was found to have a filter migration and techniques that were utilized to remove this filter.


Assuntos
Embolia Pulmonar , Filtros de Veia Cava , Trombose Venosa , Feminino , Humanos , Idoso , Filtros de Veia Cava/efeitos adversos , Embolia Pulmonar/etiologia , Embolia Pulmonar/prevenção & controle , Trombose Venosa/etiologia , Trombose Venosa/cirurgia , Trombose Venosa/tratamento farmacológico , Unidades de Terapia Intensiva , Anticoagulantes/uso terapêutico
7.
Rozhl Chir ; 101(8): 369-374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36208931

RESUMO

Varicose veins of lower extremities are a common disorder affecting a significant proportion of adult population. Endovenous techniques have been used in clinical practice for more than 20 years for their radical treatment; of these, laser therapy is one of the most widely utilized options. However, this treatment modality, too, has its specific side effects and complications which can be divided into perioperative (difficult venous access, fiber or sheath damage, vasovagal reaction with a drop in blood pressure and bradycardia, cutaneous thermal injury), and postoperative (bruising and hematomas, exceptionally pain, superficial venous thrombosis (phlebitis) and fibrous cord formation or pigmentations). Paresthesias, infections, arteriovenous fistulas, deep venous thrombosis and pulmonary embolism are very rare. The introduction of new generators with higher wavelengths and fibers with radial emission of laser energy has substantially reduced the side effects and complications. Performing the surgery in the outpatient setting using tumescent local anesthesia and under perioperative ultrasound control is an essential condition of the procedure.


Assuntos
Terapia a Laser , Embolia Pulmonar , Varizes , Trombose Venosa , Adulto , Humanos , Terapia a Laser/efeitos adversos , Terapia a Laser/métodos , Extremidade Inferior , Embolia Pulmonar/etiologia , Veia Safena , Resultado do Tratamento , Varizes/cirurgia , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
9.
Transplant Proc ; 54(8): 2217-2223, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36058748

RESUMO

BACKGROUND: Adequate portal flow to the liver graft is the requirement of a successful liver transplant (LT). Historically, portal vein thrombosis (PVT) was a contraindication for LT, especially for living donor LT (LDLT), demanding technically more difficult operations and advanced technique. In this study, the outcomes of patients with and without PVT after LDLT were compared. METHODS: Adult LDLTs performed by 2 centers (n = 335) between 2013 and 2020 were included into this large cohort study. PVT was classified based on Yerdel classification grade 1 to 4. RESULTS: Sixty-two patients with PVT constituted 19% of the study cohort of 335 recipients. While mean platelet count was found to be lower (P = .011) in the PVT group, patient age (P = .035), operation duration (P = .001), and amount of intraoperative blood transfusion (P = .010) were found to be higher. Incidence of PVT was higher in female patients than males (22.7% vs 16.1%, P = .037). There was no significant difference in survival between patients with and without PVT on 30-day (P = .285), 90-day (P = .565), 1-year (P = .777), and overall survival (P = .917). Early thrombosis did not show a better survival rate than Grades 2, 3, or 4 PVT. Thrombosis limited to portal vein was not found to bring a survival advantage compared with Grade 3 and 4 thromboses. Eversion thrombectomy was the most common procedure (66%) to overcome PVT intraoperatively. CONCLUSION: Although technically more challenging, PVT is not a contraindication of LDLT. Similar outcomes can be achieved in LDLT in patients with PVT after proper restoration of portal flow, which eliminates the default survival disadvantage of patients with PVT.


Assuntos
Hepatopatias , Transplante de Fígado , Trombose Venosa , Adulto , Masculino , Humanos , Feminino , Doadores Vivos , Transplante de Fígado/métodos , Estudos de Coortes , Estudos Retrospectivos , Trombose Venosa/etiologia , Trombose Venosa/cirurgia , Hepatopatias/complicações , Resultado do Tratamento
10.
Eur J Gastroenterol Hepatol ; 34(10): 1090-1097, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36062499

RESUMO

BACKGROUND AND AIM: The aim of this study was to evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension caused by schistosomiasis. METHODS: This study included 43 patients with schistosomiasis-induced portal hypertension treated with TIPS in our institution from December 2015 to May 2021. The demographic, imaging, clinical and follow-up data of patients were recorded retrospectively to evaluate the efficacy and safety of the procedure. RESULTS: All patients were successfully implanted with stents to establish shunt, and 90.7% of the patients were in good postoperative condition with no complications. After TIPS, the Yerdel grade of portal vein thrombosis decreased, and the portal pressure gradient decreased from 27.0 ± 4.9 mmHg to 11.3 ± 3.8 mmHg (P < 0.001). Bleeding was effectively controlled, with a postoperative rebleeding rate of 9.3%, which was an 87.9% reduction from the preoperative rate. The cumulative incidence of postoperative refractory ascites, shunt dysfunction, overt hepatic encephalopathy (OHE) and death were all similar to those of TIPS for nonschistosomiasis portal hypertension. There were no differences in liver and kidney function and blood coagulation indexes before and 3 months after TIPS. Albumin was identified as an independent risk factor for mortality after TIPS for schistosomal liver fibrosis. CONCLUSION: TIPS can be used as a well-tolerated and effective treatment for schistosomiasis-induced portal hypertension, effectively reduce portal pressure gradient and improve portal vein thrombosis.


Assuntos
Varizes Esofágicas e Gástricas , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Esquistossomose , Trombose Venosa , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/cirurgia , Hemorragia Gastrointestinal/etiologia , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Estudos Retrospectivos , Esquistossomose/complicações , Esquistossomose/diagnóstico , Esquistossomose/cirurgia , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
11.
Clin Appl Thromb Hemost ; 28: 10760296221124903, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36083157

RESUMO

Objective: This study investigates the safety and efficacy of endovascular treatments on pregnancy-related iliofemoral deep vein thrombosis (DVT). Methods: We retrospectively reviewed data of 46 patients who had symptomatic pregnancy-related iliofemoral DVT and underwent endovascular treatment. The patients treated with catheter-directed thrombolysis (CDT) were classified as the CDT group. In contrast, those treated with CDT combined with pharmacomechanical thrombectomy (PMT) or angioplasty/stenting were classified as the pharmacomechanical catheter-directed thrombolysis (PCDT) group. Results: Based on the immediate post-operative clot burden reduction rate analysis of 46 patients: 22 cases were completely dissolved (lysis grades III), 12 were partially dissolved (lysis grades II), and 12 failed (lysis grades I). There was a statistically significant difference in the rate of clot burden reduction between the CDT group (n = 19) and the PCDT group (n = 27) (p = 0.001). There was no statistically significant difference in the number of bleeding events between the two groups (p = 0.989). At 24 months, cumulative venous patency in the CDT group was 50.0%, compared to 78.2% in the PCDT group. Furthermore, there was a statistically significant difference in Villalta score (p = 0.001) and venous severity scoring (VCSS score) (p = 0.005) between the two groups. Conclusions: CDT treatment combined with PMT or angioplasty/stenting is comparatively safe and effective for pregnant-related DVT patients. PCDT outperforms CDT in terms of immediate efficacy and reduces the incidence of post-thrombotic syndrome with better midterm outcomes.


Assuntos
Veia Ilíaca , Trombose Venosa , Feminino , Veia Femoral/cirurgia , Fibrinolíticos/uso terapêutico , Humanos , Veia Ilíaca/cirurgia , Gravidez , Estudos Retrospectivos , Terapia Trombolítica/efeitos adversos , Resultado do Tratamento , Trombose Venosa/tratamento farmacológico , Trombose Venosa/cirurgia
12.
BMJ Case Rep ; 15(8)2022 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-35953149

RESUMO

Intravascular tumour extension can occur in many different types of cancer. Those with the highest tendency include renal cell carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma. Inferior vena cava (IVC) tumour thrombus in gynaecological malignancy is rarely reported. We present a report on a female patient with extensive IVC tumour thrombus (intravenous leiomyomatosis) with concurrent intrauterine leiomyomatosis. She underwent a single-stage procedure, involving laparotomy and a sternotomy to remove her pelvic tumour, as well as the intracaval and intracardiac thrombus. The clinical presentation and management of this rare tumour will be detailed in this case report.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Leiomiomatose , Neoplasias Hepáticas , Trombose , Doenças Vasculares , Trombose Venosa , Carcinoma de Células Renais/patologia , Feminino , Humanos , Neoplasias Renais/patologia , Leiomiomatose/diagnóstico por imagem , Leiomiomatose/patologia , Leiomiomatose/cirurgia , Neoplasias Hepáticas/patologia , Trombose/patologia , Doenças Vasculares/patologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgia , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
13.
J Invasive Cardiol ; 34(8): E643-E644, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35920736

RESUMO

Patent foramen ovale (PFO) closure is a very common procedure, and unfavorable femoral venous access is not uncommonly encountered. The ability to treat this common condition in a minimally invasive manner via a different access is important in our daily practice. The transjugular venous approach has been successfully reported, with 1 main difficulty when faced with the angulation of the PFO septum primum during the crossing, as well as less operator-friendly in terms of positioning. Hence, we adopted the bilateral transbrachial approach in this patient. We consider this to be the first reported case of intracardiac echocardiography-guided PFO closure via bilateral transbrachial approach. The authors believe their experience serves an important role in the following: (1) steps and equipment needed for bilateral transbrachial PFO closure; (2) tips and tricks for a successful procedure; and (3) safety and feasibility of bilateral transbrachial approach as an alternative approach for minimally invasive PFO closure.


Assuntos
Forame Oval Patente , Acidente Vascular Cerebral , Trombose Venosa , Cateterismo Cardíaco/métodos , Ecocardiografia , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico , Forame Oval Patente/cirurgia , Humanos , Pericárdio , Resultado do Tratamento , Trombose Venosa/diagnóstico , Trombose Venosa/cirurgia
15.
Spine J ; 22(11): 1811-1819, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35878756

RESUMO

BACKGROUND CONTEXT: Unplanned reoperation, a quality indicator in spine surgery, has not been sufficiently investigated in a large-scale, single-center study. PURPOSE: To assess the incidences, causes, and risk factors of unplanned reoperations within 30 days of spine surgeries in a single-center study. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: A cohort of 35,246 patients who underwent spinal surgery in our hospital were included. OUTCOME MEASURES: The rates, chief reasons, and risk factors for unplanned reoperations within 30 days of spine surgery. METHODS: We retrospectively analyzed the data for patients who underwent spine surgeries for degenerative spinal disorders, tumor, or deformity and had subsequent unplanned operations within 30 days at a single tertiary academic hospital from January 2016 to July 2021. Univariate and multivariate analyses were performed to assess the incidences, causes, and risk factors. RESULTS: Out of 35,246 spinal surgery patients, 297 (0.84%) required unplanned reoperations within 30 days of spine surgery. Patients with a thoracic degenerative disease (3.23%), spinal tumor (1.63%), and spinal deformity (1.50%) had significantly higher rates of reoperation than those with atlantoaxial (0.61%), cervical (0.65%), and lumbar (0.82%) degenerative disease. The common causes for reoperation included epidural hematoma (0.403%), wound infections (0.148%), neurological deficit (0.108%), and pedicle screw malposition (0.077%). Unplanned reoperations were classified as hyperacute (45.45%), acute (30.98%), subacute (15.82%), or chronic (7.74%). Univariate analysis indicated that 20 clinical factors were associated with unplanned reoperation (p<.05). Multivariate Poisson regression analysis revealed that anemia (p<.001), osteoporosis (p=.048), ankylosing spondylitis (p=.008), preoperative foot drop (p=.011), deep venous thrombosis (p<.001), and previous surgical history (p<.001) were independent risk factors for unplanned spinal reoperation. CONCLUSIONS: The incidence of unplanned spinal reoperations was 0.84%. The chief common causes were epidural hematoma, wound infections, neurological deficit, and pedicle screw malposition. Anemia, osteoporosis, ankylosing spondylitis, preoperative foot drop, deep venous thrombosis, and previous surgical history led to an increased risk of unplanned reoperation within 30 days of spine surgery.


Assuntos
Hematoma Epidural Espinal , Osteoporose , Neuropatias Fibulares , Espondilite Anquilosante , Trombose Venosa , Infecção dos Ferimentos , Humanos , Reoperação/efeitos adversos , Incidência , Estudos Retrospectivos , Espondilite Anquilosante/cirurgia , Neuropatias Fibulares/cirurgia , Fatores de Risco , Osteoporose/cirurgia , Trombose Venosa/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia
16.
J Med Case Rep ; 16(1): 257, 2022 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-35778762

RESUMO

BACKGROUND: Deep vein thrombosis with arteriovenous fistulas is rare, with few therapeutic options available for chronic-phase deep vein thrombosis. Moreover, the effectiveness of endovascular treatment for chronic-phase deep vein thrombosis with arteriovenous fistulas has not been established. We describe herein a case of successful endovascular treatment for chronic deep vein thrombosis with multiple arteriovenous fistulas. CASE PRESENTATION: We describe the case of a 72-year-old Asian woman who had begun experiencing left leg swelling and intermittent claudication 2 years prior. Enhanced computed tomography revealed left common iliac vein occlusion with vein-to-vein collateral formation and several arteriovenous fistulas. Angiography and ultrasound showed the arteriovenous fistulas to run from the common and internal iliac arteries to the external iliac and superficial femoral veins. We opted against surgical repair for the arteriovenous fistulas due to their complex nature and complicated morphology. Since her condition was progressive, endovascular treatment with a stent graft was performed for the deep vein thrombosis, after which her symptoms gradually improved. Four months following the procedure, enhanced computed tomography confirmed remarkable reduction of the vein-to-vein collaterals and arteriovenous fistulas. CONCLUSIONS: In the present case, enhanced computed tomography with a stent graft was effective in improving symptoms. This strategy may therefore be a treatment option for intractable chronic deep vein thrombosis with arteriovenous fistulas.


Assuntos
Fístula Arteriovenosa , Trombose Venosa , Idoso , Fístula Arteriovenosa/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Feminino , Veia Femoral/cirurgia , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/cirurgia , Stents/efeitos adversos , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
17.
BMC Surg ; 22(1): 269, 2022 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-35831845

RESUMO

OBJECTIVE: Post-thrombotic syndrome (PTS), an important complication of deep venous thrombosis (DVT), adversely affects patients' quality of life. Endovascular intervention in PTS can relieve symptoms rapidly with high therapeutic value. This study mainly focuses on how to improve postoperative stent patency rates and aims to find prognostic factors impacting patency. METHODS: According to the specific inclusion and exclusion criteria, PTS patients who underwent endovascular intervention at the First Affiliated Hospital of Sun Yat-sen University from December 1, 2014, to December 31, 2019, were included in this single-center prospective study. Follow-up data were collected and analyzed regularly over 2 years. RESULTS: Overall, 31 PTS patients were enrolled in the study. The mean age of these patients was 55.39 ± 11.81, including 19 male patients. Stent implantation was successful in 22 PTS patients, with a technical success rate of 70.97%. The average Villalta scores of the stent-implanted group and the non-stent-implanted group were 5.95 ± 2.57 and 5.78 ± 2.95, respectively, with no significant difference observed. In the stent-implanted group, the perioperative patency rate was 81.81% (18/22), and the follow-up patency rates were 68.18% (15/22) within 3 months, 59.09% (13/22) within 6 months, 45.45% (10/22) within 1 year, and 36.36% (8/22) within 2 years. Based on the stent placement segments, the 22 PTS patients were divided into two subgroups: the iliofemoral vein balloon dilation + iliofemoral vein stent implantation (FV-S) subgroup and the iliofemoral vein balloon dilation + iliac vein stent implantation (FV-B) subgroup. In the FV-S subgroup, the perioperative patency rate was 100.00% (14/14), and the follow-up patency rates were 85.71% (12/14), 71.43% (10/14), 57.14% (8/14) and 50.00% (7/14), which were higher than those for overall stent patency of all patients. The postoperative patency rates in the FV-B subgroup were 50.00% (4/8), 37.50% (3/8), 37.50% (3/8), 25.00% (2/8), and 12.50% (1/8). The secondary postoperative patency rates in the FV-B subgroup were 100.00% (8/8), 87.50% (7/8), 75.00% (6/8), 62.50% (5/8) and 50.00% (4/8). CONCLUSIONS: For PTS patients with iliofemoral vein occlusion but patent inflow, iliofemoral vein stent implantation is a more efficient therapeutic option than iliofemoral vein balloon dilation with iliac vein stent implantation for PTS patients.


Assuntos
Procedimentos Endovasculares , Síndrome Pós-Trombótica , Trombose Venosa , Procedimentos Endovasculares/efeitos adversos , Veia Femoral/cirurgia , Humanos , Veia Ilíaca/cirurgia , Masculino , Síndrome Pós-Trombótica/etiologia , Síndrome Pós-Trombótica/cirurgia , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Stents/efeitos adversos , Resultado do Tratamento , Grau de Desobstrução Vascular , Trombose Venosa/complicações , Trombose Venosa/cirurgia
18.
Transplant Proc ; 54(6): 1654-1656, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35840433

RESUMO

One of the crucial steps of liver transplantation is to provide the portal inflow. Portal vein thrombosis is the most challenging factor to achieve. Using a pericholedochal varix for portal inflow in a patient with complete portal vein thrombosis in living donor liver transplantation (LDLT) is a rare technique. We present our experience of a LDLT with PVT.


Assuntos
Hepatopatias , Transplante de Fígado , Varizes , Trombose Venosa , Humanos , Hepatopatias/complicações , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Doadores Vivos , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Varizes/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
19.
J Int Med Res ; 50(6): 3000605221100134, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35650686

RESUMO

OBJECTIVE: May-Thurner syndrome (MTS) is an anatomic stenotic variation associated with deep vein thrombosis (DVT) of the left leg. The classical DVT treatment strategy is medical treatment without thrombus removal. This study was performed to assess the clinical outcomes of the combination of AngioJet™ rheolytic thrombectomy and stenting for treatment of MTS-related DVT. METHODS: We conducted a retrospective cohort study of patients treated for MTS-related DVT from January 2017 to June 2020 at a single institution. RESULTS: Fourteen patients (nine women) underwent AngioJet™ rheolytic thrombectomy for MTS-related DVT during the study period. The median DVT onset time was 8 days (interquartile range (IQR), 3-21 days). The median procedure time was 130 minutes (IQR, 91-189 minutes), and the median hospital stay was 7 days (IQR, 5-26 days). One patient had a residual thrombus and occluded iliac stent and underwent adjuvant catheter-directed thrombolysis for revascularization. The primary patency rate for the iliac stent was 92.9% at 12 months. CONCLUSION: Concomitant AngioJet™ rheolytic thrombectomy and stenting of MTS-induced lesions may be beneficial for patients with MTS-related DVT.


Assuntos
Síndrome de May-Thurner , Trombose Venosa , Feminino , Humanos , Síndrome de May-Thurner/complicações , Síndrome de May-Thurner/terapia , Estudos Retrospectivos , Trombectomia , Terapia Trombolítica/métodos , Resultado do Tratamento , Grau de Desobstrução Vascular , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
20.
Arab J Gastroenterol ; 23(3): 159-164, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35688682

RESUMO

BACKGROUND AND STUDY AIMS: Portal vein thrombosis (PVT) is no longer an absolute contraindication for living donor liver transplantation (LDLT). This study aimed to assess the short-term outcomes of LDLT and compare the 1-year survival rates between patients with and without preoperative PVT. PATIENTS AND METHODS: This combined prospective and retrospective cohort study was conducted on patients who underwent LDLT at Ain Shams Centre for Organ Transplantation (ASCOT) between 2008 and 2020. The study included 60 patients with PVT and 60 patients without PVT. The two groups were compared in terms of preoperative data, operative details, postoperative complications, and 1-year survival. RESULTS: Most patients with PVT were Child C (65%) and had higher model for end stage liver disease scores (16.23 ± 4.03) compared to the non-PVT group (13.9 ± 4.5). The PVT group showed longer cold ischemic time (CIT), hospital stay, and intensive care unit stay and significantly shorter 1-year survival rate (63.3%) compared to the non-PVT group (86.7%) (P = 0.003). Those with PVT grades I, II, and III had 1-year survival rates of 72.5%, 50%, and 40%, respectively. CONCLUSION: Preoperative PVT reduces the 1-year survival after transplantation, with patients with higher PVT grades exhibiting lower 1-year survival. LDLT for PVT still remains challenging and requires further studies.


Assuntos
Doença Hepática Terminal , Hepatopatias , Transplante de Fígado , Trombose Venosa , Criança , Doença Hepática Terminal/etiologia , Humanos , Hepatopatias/complicações , Transplante de Fígado/efeitos adversos , Doadores Vivos , Veia Porta/cirurgia , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Trombose Venosa/complicações , Trombose Venosa/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...