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Luo N, Liang XY, Li L, Zhang X, Zang CM, Liu X, Fan XZ. Foreign body accompanied with thrombosis in the right internal jugular vein: A case report. Clin Hemorheol Microcirc 2024; 86:451-455. [PMID: 38007641 DOI: 10.3233/ch-231988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
A rare foreign body accompanied by thrombosis in the right internal jugular vein was accidentally observed. We collected the medical history of this special patient, analyzed the causes and characteristics of the foreign body and thrombosis formation, and subsequently observed the changes in thrombosis. Finally, we discussed the diagnostic value of ultrasound for such rare intravascular lesions.
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Affiliation(s)
- Nan Luo
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
- Anhui Medical University Fifth Clinical Medical College, Anhui, China
| | - Xiao-Yu Liang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Lu Li
- Department of Outpatients, the 26th Rest Center for Retired Cadres, Beijing, China
| | - Xiao Zhang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Chun-Mei Zang
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xi Liu
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Xiao-Zhou Fan
- Department of Ultrasound, Air Force Medical Center, Air Force Medical University, Beijing, China
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Idei M, Seino Y, Sato N, Saishu Y, Goto S, Namekawa M, Moriwaki S, Ishikawa J, Kamei D, Nakagawa M, Ichiba S, Nomura T. Catheter-related thrombosis after cardiac surgery in patients with both central venous and pulmonary artery catheters inserted into the right internal jugular vein: a single-center, prospective, observational study. Heart Vessels 2021; 37:691-696. [PMID: 34618188 DOI: 10.1007/s00380-021-01955-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
Central venous catheters (CVCs) and pulmonary artery catheters (PACs) are widely used in intensive care and perioperative management. The detection and prevention of catheter-related thrombosis (CRT) are important because CRT is a complication of catheter use and can cause pulmonary embolism and bloodstream infection. Currently, there is no evidence for CRT in patients using both CVC and PAC. We conducted a single-center, prospective, observational study to identify the incidence, timing, and risk factors for CRT in patients undergoing cardiovascular surgery and using a combination of CVC and PAC through the right internal jugular vein (RIJV). Out of 50 patients, CRT was observed using ultrasonography in 39 patients (78%), and the median time of CRT formation was 1 day (interquartile range: 1-1.5) after catheter insertion. The mean duration of PAC placement was 3 days (interquartile range: 2-5), and the maximum diameter of CRT was 12 mm (interquartile range: 10-15). In short-axis images, CRT occupied more than half of the cross-sectional area of the RIJV in five patients (10%), and CRT completely occluded the RIJV in one patient (2%). Platelet count, duration of PAC placement, and intraoperative bleeding amount were found to be high-risk indicators of CRT. In conclusion, patients who underwent cardiovascular surgery and using both CVC and PAC had a high incidence of CRT. Avoiding unnecessary PAC placement and early removal of catheters in patients at high risk of developing CRT may prevent the development of CRT.
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Affiliation(s)
- Masafumi Idei
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Yusuke Seino
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan.
| | - Nobuo Sato
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Yumi Saishu
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Shunsaku Goto
- Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Motoki Namekawa
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Shota Moriwaki
- Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Junya Ishikawa
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Daigo Kamei
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Masashi Nakagawa
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Shingo Ichiba
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
| | - Takeshi Nomura
- Department of Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, Japan
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Qiu C, Li T, Wei G, Xu J, Yu W, Wu Z, Li D, He Y, Chen T, Zhang J, He X, Hu J, Fang J, Zhang H. Hemorrhage and venous thromboembolism in critically ill patients with COVID-19. SAGE Open Med 2021; 9:20503121211020167. [PMID: 34104439 PMCID: PMC8170290 DOI: 10.1177/20503121211020167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/03/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: The majority of patients with COVID-19 showed mild symptoms. However,
approximately 5% of them were critically ill and require intensive care unit
admission for advanced life supports. Patients in the intensive care unit
were high risk for venous thromboembolism and hemorrhage due to the
immobility and anticoagulants used during advanced life supports. The aim of
the study was to report the incidence and treatments of the two
complications in such patients. Method: Patients with COVID-19 (Group 1) and patients with community-acquired
pneumonia (Group 2) that required intensive care unit admission were
enrolled in this retrospective study. Their demographics, laboratory
results, ultrasound findings and complications such as venous
thromboembolism and hemorrhage were collected and compared. Results: Thirty-four patients with COVID-19 and 51 patients with community-acquired
pneumonia were included. The mean ages were 66 and 63 years in Groups 1 and
2, respectively. Venous thromboembolism was detected in 6 (18%) patients
with COVID-19 and 18 (35%) patients with community-acquired pneumonia
(P = 0.09). The major type was distal deep venous thrombosis. Twenty-one
bleeding events occurred in 12 (35%) patients with COVID-19 and 5 bleeding
events occurred in 5 (10%) patients with community-acquired pneumonia,
respectively (P = 0.01). Gastrointestinal system was the most common source
of bleeding. With the exception of one death due to intracranial bleeding,
blood transfusion with or without surgical/endoscopic treatments was able to
manage the bleeding in the remaining patients. Multivariable logistic
regression showed increasing odds of hemorrhage with extracorporeal membrane
oxygenation (odds ratio: 13.9, 95% confidence interval: 4.0–48.1) and
COVID-19 (odds ratio: 4.7, 95% confidence interval: 1.2–17.9). Conclusion: Venous thromboembolism and hemorrhage were common in both groups. The
predominant type of venous thromboembolism was distal deep venous
thrombosis, which presented a low risk of progression. COVID-19 and
extracorporeal membrane oxygenation were risk factors for hemorrhage. Blood
transfusion with or without surgical/endoscopic treatments was able to
manage it in most cases.
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Affiliation(s)
- Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tong Li
- Department of Emergency, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Guoqing Wei
- Department of Hematology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Xu
- Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenqiao Yu
- Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yangyan He
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tianchi Chen
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jingchen Zhang
- Department of Emergency, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xujian He
- Department of Emergency, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jia Hu
- Department of Emergency, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Junjun Fang
- Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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