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Bistervels IM, Buchmüller A, Tardy B. Inferior vena cava filters in pregnancy: Safe or sorry? Front Cardiovasc Med 2022; 9:1026002. [DOI: 10.3389/fcvm.2022.1026002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
BackgroundPotential hazards of vena cava filters include migration, tilt, perforation, fracture, and in-filter thrombosis. Due to physiological changes during pregnancy, the incidence of these complications might be different in pregnant women.AimTo evaluate the use and safety of inferior vena cava filters in both women who had an inferior vena cava filter inserted during pregnancy, and in women who became pregnant with an inferior vena cava filter in situ.MethodsWe performed two searches in the literature using the keywords “vena cava filter”, “pregnancy” and “obstetrics”.ResultsThe literature search on women who had a filter inserted during pregnancy yielded 11 articles compiling data on 199 women. At least one filter complication was reported in 33/177 (19%) women and included in-filter thrombosis (n = 14), tilt (n = 6), migration (n = 5), perforation (n = 2), fracture (n = 3), misplacement (n = 1), air embolism (n = 1) and allergic reaction (n = 1). Two (1%) filter complications led to maternal deaths, of which at least one was directly associated with a filter insertion. Filter retrieval failed in 9/149 (6%) women. The search on women who became pregnant with a filter in situ resulted in data on 21 pregnancies in 14 women, of which one (6%) was complicated by uterine trauma, intraperitoneal hemorrhage and fetal death caused by perforation of the inferior vena cava filter.ConclusionThe risks of filter complications in pregnancy are comparable to the nonpregnant population, but could lead to fetal or maternal death. Therefore, only in limited situations such as extensive thrombosis with a contraindication for anticoagulants, inferior vena filters should be considered in pregnant women.
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Management of venous thromboembolism in pregnancy. Thromb Res 2022; 211:106-113. [DOI: 10.1016/j.thromres.2022.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 11/23/2022]
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Rottenstreich A, Kalish Y, Elchalal U, Klimov A, Bloom AI. Retrievable inferior vena cava filter utilization in obstetric patients. J Matern Fetal Neonatal Med 2018; 32:3045-3053. [PMID: 29562788 DOI: 10.1080/14767058.2018.1456521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives: The objective of this study is to evaluate patterns of use and outcomes of retrievable inferior vena cava filters (rIVCF) in obstetric patients. Methods: A single center review of consecutive patients who underwent rIVCF placement during pregnancy/postpartum in 2005-2016. A pooled analysis of the relevant cases in the English literature was conducted. Results: The current cohort comprised 24 women, median age 27 [interquartile range 24-30] years. Among 10 filters placed during pregnancy, the most common indication (n = 4) was the need to withhold anticoagulation therapy before delivery, in the presence of acute thrombosis. In the postpartum period, most filters (64%, 9/14) were an adjunct to catheter-directed thrombolytic therapy. Inferior vena cava filters (IVCF)-related complications occurred in seven (29.2%). Retrieval was attempted in 21 patients (87.5%), and was technically successful in 19 (90.5%), for an overall removal rate of 79.1%. Pooled analysis of the literature (n = 98) showed comparable rates for filter removal and complications (81.6%, p = .78 and 24.2%, p = .60, respectively). Suprarenal placement (p = .12) and elective cesarean section (p = .19) did not reduce overall complication and retrieval rates. The estimated radiation dose among pregnant patients who underwent rIVCF placement without adjunct catheter directed thrombolysis (CDT) (mean 695 Gy cm2) was significantly lower than the radiation dose used in postpartum patients (1863 Gy cm2) or in pregnant patients in whom adjunct CDT was utilized (4059 Gy cm2) (p = .001 for both comparisons). Conclusions: Frequent rIVCF-related complications, radiation exposure, and removal failure call for their cautious utilization in obstetric patients. The role of suprarenal placement and elective cesarean section to improve outcomes has yet to be established.
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Affiliation(s)
- Amihai Rottenstreich
- a Department of Obstetrics and Gynecology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel
| | - Yosef Kalish
- b Department of Hematology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel
| | - Uriel Elchalal
- a Department of Obstetrics and Gynecology , Hadassah-Hebrew University Medical Center , Jerusalem , Israel
| | - Alexander Klimov
- c Department of Radiology , Interventional Radiology Section, Hadassah-Hebrew University Medical Center , Jerusalem , Israel
| | - Allan I Bloom
- c Department of Radiology , Interventional Radiology Section, Hadassah-Hebrew University Medical Center , Jerusalem , Israel
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Crosby DA, Ryan K, McEniff N, Dicker P, Regan C, Lynch C, Byrne B. Retrievable Inferior vena cava filters in pregnancy: Risk versus benefit? Eur J Obstet Gynecol Reprod Biol 2018; 222:25-30. [DOI: 10.1016/j.ejogrb.2017.12.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/12/2017] [Accepted: 12/18/2017] [Indexed: 11/27/2022]
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Takahashi N, Isoda K, Hiki M, Fujimoto S, Daida H. Thrombolytic Therapy and Aspiration of Clots were Effective in the Removal of a Transient Inferior Vena Cava (IVC) Filter that Captured a Large Thrombus. Intern Med 2017; 56:1369-1373. [PMID: 28566600 PMCID: PMC5498201 DOI: 10.2169/internalmedicine.56.8175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 37-year-old woman presented at 37 weeks of gestation with a history of heaviness in her left leg. Enhanced computed tomography revealed a left extensive ileofemoral thrombus, and we employed a transient inferior vena cava (IVC) filter (t-IVCF) before delivery. Although we attempted to remove the t-IVCF on the day after delivery, a large thrombus was captured in the filter. We therefore performed thrombolytic therapy for one week, but a few small clots remained within the t-IVCF. We were ultimately able to remove the t-IVCF under constant negative pressure by aspiration from a side-hole of the sheath. We herein describe the effectiveness of this aspiration technique in our case.
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Affiliation(s)
- Norihito Takahashi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Masaru Hiki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Shinichiro Fujimoto
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan
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Dueppers P, Grabitz K, Li Y, Schelzig H, Wagenhäuser MU, Duran M. Surgical management of iliofemoral vein thrombosis during pregnancy and the puerperium. J Vasc Surg Venous Lymphat Disord 2016; 4:392-9. [PMID: 27638991 DOI: 10.1016/j.jvsv.2016.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 06/30/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The risk of deep venous thrombosis is elevated during pregnancy and the puerperium. Therapy is usually limited to conservative measures as invasive thrombus removal is feared because of possible complications. However, leg- or life-threatening situations require fast thrombus removal, and the long-term rate of post-thrombotic syndrome (PTS) may be reduced by venous recanalization. Our center's experience may give support to surgical venous thrombectomy (VT). METHODS Between 1996 and 2016, all women who received VT for pregnancy-related deep venous thrombosis in our department were included. Retrospective data were combined with a current follow-up. RESULTS The study included 82 women with a mean age of 29 years (17-38 years). An additional arteriovenous fistula was performed in 79 and planned simultaneous cesarean section in 13 patients. Neither pulmonary emboli nor fetal complications occurred during surgery, and perioperative and postoperative mortality was 0%. Operative revision was required in 38% mainly for rethrombosis (24%) and bleeding (12%). One fetus died 2 months after VT of unrelated causes. After a mean of 83 months, complete venous recanalization was seen in 88%, venous valve sufficiency in 90%, and PTS in 31% without any ulcers. At 10 years, PTS incidence rose to reach 50% with limited statistical significance because of the number of patients reaching long-term follow-up. CONCLUSIONS Iliofemoral venous recanalization during pregnancy can be performed safely in a specialized center, with lower PTS rates than in historical controls.
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Affiliation(s)
- Philip Dueppers
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Klaus Grabitz
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - You Li
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Hubert Schelzig
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Markus Udo Wagenhäuser
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Mansur Duran
- Department of Vascular and Endovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Germany.
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Du Plessis LE, Mol BW, Svigos JM. The use of retrievable inferior vena cava filters in pregnancy: Another successful case report, but are we actually making a difference? Obstet Med 2016; 9:102-5. [PMID: 27630744 DOI: 10.1177/1753495x16648026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/09/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pregnant women with venous thromboembolism are traditionally managed with anticoagulation, but inferior vena cava filters are an alternative. We balanced risks and benefits of an inferior vena cava filter in a decision analysis. METHODS We constructed a decision model to compare in pregnant women with VTE the outcome of (1) inferior vena cava filter and anticoagulant treatment versus (2) anticoagulant treatment only. RESULTS Assuming a 63% risk reduction from an inferior vena cava filter (baseline mortality rate of venous thromboembolism of 0.5%), 318 women would need to be treated with inferior vena cava filters to prevent one venous thromboembolism related maternal death. Sensitivity analyses indicated that at a mortality rate of 0.5% the risk reduction from inferior vena cava filters needed to be 80%, while at a mortality rate of 2% a risk reduction of 20% would justify inferior vena cava filters. CONCLUSIONS In view of their potential morbidity, inferior vena cava filters should be restricted to pregnant woman at strongly increased risk of recurrent venous thromboembolism.
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Affiliation(s)
- Lodewyk E Du Plessis
- Women's and Babies Division, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Ben W Mol
- Discipline of Obstetrics and Gynaecology, University of Adelaide, SA, Australia; The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, SA, Australia
| | - John M Svigos
- Women's and Babies Division, Women's and Children's Hospital, North Adelaide, SA, Australia; Discipline of Obstetrics and Gynaecology, University of Adelaide, SA, Australia
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Mitchell-Jones N, McEwan M, Johnson M. Management of venous thromboembolism secondary to ovarian hyperstimulation syndrome: A case report documenting the first use of a superior vena caval filter for upper limb venous thromboembolism in pregnancy, and the difficulties and complications relating to anticoagulation in antenatal and peri-partum periods. Obstet Med 2016; 9:93-5. [PMID: 27512501 DOI: 10.1177/1753495x16640072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/24/2016] [Indexed: 01/14/2023] Open
Abstract
The management of venous thromboembolism and subsequent pulmonary embolism in pregnancy remains hugely challenging. In this case, we report the first use of a superior vena caval filter in pregnancy as an adjunct to pharmacological anticoagulation. This is the first reported use of a superior vena caval filter in pregnancy. We discuss the complexities of managing thromboembolism in pregnancy and the peri-partum period.
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Affiliation(s)
- Nicola Mitchell-Jones
- Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - Michael McEwan
- Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
| | - Mark Johnson
- Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK
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Harris SA, Velineni R, Davies AH. Inferior Vena Cava Filters in Pregnancy: A Systematic Review. J Vasc Interv Radiol 2016; 27:354-60.e8. [DOI: 10.1016/j.jvir.2015.11.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/31/2015] [Accepted: 11/01/2015] [Indexed: 11/15/2022] Open
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Konishi H, Miyoshi T, Neki R, Fukuda T, Ishibashi-Ueda H, Ogo T, Nakanishi N, Yoshimatsu J. Intrapartum temporary inferior vena cava filters are rarely indicated in pregnant women with deep venous thromboses. J Vasc Surg Venous Lymphat Disord 2015; 3:370-375. [DOI: 10.1016/j.jvsv.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/28/2015] [Indexed: 11/24/2022]
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Sherer DM, Dalloul M, Behar HJ, Salame G, Holland R, Zinn H, Abulafia O. Peripartum Primary Prophylaxis Inferior Vena Cava Filter Placement in a Patient with Stage IV B-Cell Lymphoma Presenting with a Pathologic Femur Fracture. AJP Rep 2015; 5:e129-31. [PMID: 26495170 PMCID: PMC4603859 DOI: 10.1055/s-0035-1551675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 03/10/2015] [Indexed: 12/02/2022] Open
Abstract
Background Pulmonary embolus (PE) remains a leading etiology of maternal mortality in the developed world. Increasing utilization of retrievable inferior vena cava (IVC) filter placement currently includes pregnant patients. Case A 22-year-old woman at 27 weeks' gestation was diagnosed with Stage IV high-grade malignant B cell lymphoma following pathologic femur fracture. Significant risk factors for PE led to placement of primary prophylaxis IVC filter before cesarean delivery, open reduction and internal fixation of the fractured femur, and chemotherapy. Conclusion This case supports that primary prophylaxis placement of IVC filters in highly selected pregnant patients may assist in decreasing PE-associated maternal mortality.
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Affiliation(s)
- David M Sherer
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Mudar Dalloul
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Henry James Behar
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Ghadir Salame
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Roy Holland
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Harry Zinn
- Department of Radiology, State University of New York, Downstate Medical Center, Brooklyn, New York
| | - Ovadia Abulafia
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, New York
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González-Mesa E, Azumendi P, Marsac A, Armenteros A, Molina N, Narbona I, Herrera J, Artero I, Rodríguez-Mesa JM. Use of a temporary inferior vena cava filter during pregnancy in patients with thromboembolic events. J OBSTET GYNAECOL 2015; 35:771-6. [PMID: 25692613 DOI: 10.3109/01443615.2015.1007928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There are circumstances in the management of thromboembolic events during pregnancy when anticoagulant therapy is either contraindicated or not advisable, such as when pulmonary embolism (PE) or deep venous thrombosis is diagnosed close to term, given the risk of bleeding during delivery. In these cases, the thromboembolic risk can be controlled using temporary inferior vena cava filters (T-IVCFs). We present the case of a pregnant woman with thrombophilia who remained at rest for eight weeks due to an amniotic prolapse and for whom the placement of a T-IVCF was decided at 32 weeks' gestation after anticoagulant therapy had failed. An emergency caesarean section was performed at 33 weeks' gestation due to placental abruption following the spontaneous onset of preterm labour. The risk of bleeding during delivery when high doses of heparin are used, and the risk of PE when the heparin dose is decreased, needs to be evaluated versus the risks related to T-IVCF placement procedure and, as such, a review of the published experience in this field is warranted. We have concluded that T-IVCFs can be a safe alternative treatment for pregnant women in whom anticoagulation therapy is either contraindicated or not advisable.
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Affiliation(s)
- E González-Mesa
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - P Azumendi
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - A Marsac
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - A Armenteros
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - N Molina
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - I Narbona
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - J Herrera
- a Obstetrics and Gynecology Department, Regional University Hospital , Málaga , Spain
| | - I Artero
- b Vascular Radiology Department, Regional University Hospital , Málaga , Spain
| | - J M Rodríguez-Mesa
- b Vascular Radiology Department, Regional University Hospital , Málaga , Spain
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Bilger A, Pottecher J, Greget M, Boudier E, Diemunsch P. Extensive pulmonary embolism after severe postpartum haemorrhage: management with an inferior vena cava filter. Int J Obstet Anesth 2014; 23:390-3. [DOI: 10.1016/j.ijoa.2014.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/18/2014] [Accepted: 06/08/2014] [Indexed: 11/28/2022]
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Debska M, Debski R, Muzyka K, Kurzyna M, Dabrowski M. An unexpected complication with the use of a retrievable vena cava filter in late pregnancy. Eur J Obstet Gynecol Reprod Biol 2014; 180:205-6. [PMID: 25087189 DOI: 10.1016/j.ejogrb.2014.06.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Marzena Debska
- II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland.
| | - Romuald Debski
- II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Katarzyna Muzyka
- II Department of Obstetrics and Gynaecology, The Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Marcin Kurzyna
- Department of Pulmonary Circulation and Thromboembolic Diseases, The Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Marek Dabrowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, The Medical University, Warsaw, Poland
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Harvey J, Hopkins J, McCafferty I, Jones R. Inferior vena cava filters: What radiologists need to know. Clin Radiol 2013; 68:721-32. [DOI: 10.1016/j.crad.2013.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 01/02/2013] [Accepted: 01/03/2013] [Indexed: 10/27/2022]
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Conti E, Zezza L, Ralli E, Comito C, Sada L, Passerini J, Caserta D, Rubattu S, Autore C, Moscarini M, Volpe M. Pulmonary embolism in pregnancy. J Thromb Thrombolysis 2013; 37:251-70. [DOI: 10.1007/s11239-013-0941-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Wadajkar AS, Santimano S, Rahimi M, Yuan B, Banerjee S, Nguyen KT. Deep vein thrombosis: current status and nanotechnology advances. Biotechnol Adv 2012; 31:504-513. [PMID: 22940402 DOI: 10.1016/j.biotechadv.2012.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 08/13/2012] [Accepted: 08/14/2012] [Indexed: 12/12/2022]
Abstract
Deep vein thrombosis (DVT) affects up to 2 million people in the United States, and worldwide incidence is 70 to 113 cases per 100,000 per year. Mortality from DVT is often due to subsequent pulmonary embolism (PE). Precise diagnosis and treatment is thereby essential for the management of DVT. DVT is diagnosed by a thorough history and physical examination followed by laboratory and diagnostic tests. The choice of laboratory and diagnostic test is dependent on clinical pretest probability. Available laboratory and diagnostic techniques mainly involve D-dimer test, ultrasound, venography, and magnetic resonance imaging. The latter two diagnostic tools require high doses of contrast agents including either radioactive or toxic materials. The available treatment options include lifestyle modifications, mechanical compression, anticoagulant therapy, inferior vena cava filter, and thrombolysis/thrombolectomy. All of these medical and surgical treatments have serious side effects including improper clot clearance and increased risk of hemorrhage occurrence. Therefore, research in this field has recently focused on the development of non-invasive and accurate diagnostics, such as ultrasound enhanced techniques and molecular imaging methods, to assess thrombus location and its treatment course. The frontier of nanomedicine also shows high prospects in tackling DVT with efficient targeted drug delivery. This review describes the pathology of DVT along with successive medical problems such as PE and features a detailed listing of various diagnostic and therapeutic modalities that have been in use and are under development.
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Affiliation(s)
- Aniket S Wadajkar
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA
- Joint Biomedical Engineering Program between The University of Texas at Arlington and The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Sonia Santimano
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA
- Joint Biomedical Engineering Program between The University of Texas at Arlington and The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Maham Rahimi
- Department of Vascular Surgery, University of Cincinnati, OH 45267, USA
| | - Baohong Yuan
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA
- Joint Biomedical Engineering Program between The University of Texas at Arlington and The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Subhash Banerjee
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Kytai T Nguyen
- Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA
- Joint Biomedical Engineering Program between The University of Texas at Arlington and The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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