Trombosis venosa profunda: Factores de riesgo y profilaxis / Deep vein thrombosis: Risk factors and prophylaxis

Antecedentes: La enfermedad tromboembólica venosa (ETV) es catalogada como la causa prevenible más frecuente de muerte hospitalaria y la tercer causa de morbilidad se ha calculado que en EEUU pueden existir 600,000 casos anuales. Metodología: Estudio descriptivo transversal con el objetivo de identificar pacientes con factores de riesgo para desarrollar ETV y no tienen profilaxis en servicios de medicina interna, ortopedia y cirugía del Hospital Roosevelt en agosto, 2016. Resultados: Se incluyeron 124 pacientes, 75/124 (60.4%) son de sexo masculino. El promedio de la edad fue de 44 años, rango de 14 ­ 87, 40/124 (32.2%) tenían indicación de reposo absoluto, 80/124 (64.5%) eran pacientes quirúrgicos, 16/124 (12.9%) tenían cáncer, 110/124 (88.7%) pacientes no recibieron profilaxis. Doce de 124 pacientes (9.6%) tenían al menos un factor de riesgo, 8/124 (6.4%) tenían 2 factores de riesgo, 16/124 (12.9%) tenían 3 factores de riesgo y 80/124 (64.5%) tenían 4 o más factores de riesgo. Conclusiones: Todos los pacientes encuestados poseen al menos un factor de riesgo para ETV, de los cuales 88.7% no recibe profilaxis...(AU)

Background: Venous thromboembolic disease (VTE) is listed as the most frequent preventable cause of hospital death and the third cause of morbidity has been estimated that in the US there may be 600,000 cases per year. Methodology: Cross-sectional descriptive study with the objective of identifying patients with risk factors to develop VTE and have no prophylaxis in services of internal medicine, orthopedics and surgery of the Roosevelt Hospital in August, 2016. Results: 124 patients were included, 75/124 ( 60.4%) are male. The average age was 44 years, range of 14 - 87, 40/124 (32.2%) had absolute rest indication, 80/124 (64.5%) were surgical patients, 16/124 (12.9%) had cancer, 110/124 (88.7%) patients did not receive prophylaxis . Twelve of 124 patients (9.6%) had at least one risk factor, 8/124 (6.4%) had 2 risk factors, 16/124 (12.9%) had 3 risk factors and 80/124 (64.5%) had 4 or more risk factors. Conclusions: All the patients surveyed have at least one risk factor for VTE, of which 88.7% do not receive prophylaxis ... (AU)

Interrupción de la vena cava inferior mediante filtros de inserción percutánea: Indicaciones y resultados en 287 pacientes / Percutaneous inferior vena cava filters: Indications and results in 287 patients

Background: Anticoagulation is the treatment of choice for deep vein thrombosis (DVT) and pulmonary embolism (PE). Occasionally this treatment is contraindicated or fails to prevent PE. In these patients, inferior vena caval (IVC) interruption is indicated and insertion of a filter is the most commonly performed procedure. Aim: To report the experience with IVC filters. Material and methods: Retrospective review of all medical records and operative protocols of patients subjected to IVC filter implantations. Follow up was performed by telephone contact with the patient, relatives or primary physicians, ambulatory consultation or by death certificates. Results: During the period 1993-2005 we implanted IVC filters on 287 patients, 55.4 percent male, average age: 62.1 yrs (17-99). Indications for the procedure were DVT or PE and contraindication of anticoagulation in 141 patients (49.1 percent), DVT or PE and complication of anticoagulation in 65 patients (22.6 percent), prophylaxis in 39 patients (13.6 percent), massive PE or poor respiratory function in 31 patients (10.8 percent), paradoxal emboli in 4 patients (1.4 percent) and other causes in seven patients. All percutaneous devices were successfully inserted. There was no morbidity or mortality related to the procedure. The most frequent access site was the internal jugular vein (66.6 percent). In 24 patients (8.4 percent) the filter was intentionally deployed above the renal veins. Six patients (2.1 percent) were lost to follow up after discharge. A mean follow up of 41.5 months was achieved. Ninety one patients died, with a 5 years survival of 64.7 percent. Symptomatic recurrent PE occurred in 6 patients (2.1 percent) and was the cause of death on 3 of them (1 percent), DVT has been detected in 22 patients (7.7 percent) during the follow up period. Conclusions: IVC filter implantation is a safe and effective short and long term measure to prevent PE and its consequences.

Trombose venosa profunda na gravidez / Deep venous thrombosis in pregnancy

A trombose venosa profunda pode ocorrer na gravidez. A síndrome pós-flebítica e a hipertensão venosa crônica são sequelas da trombose venosa profunda. Assim, a prevenção e o tratamento da trombose venosa profunda são importantes na redução da morbi-mortalidade materna. Este artigo revisa a patogênese, aspectos clínicos, diagnóstico e tratamento da trombose venosa profunda na gravidez