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Quinn T, Cholette JM, Pinto MG, Schreiber H, Madden MA, Bennett E, Kolmar A, Poole A, Silva CT, Ehrlich L, Navarro OM, Faustino EVS. Antithrombin activity and central venous catheter-associated thrombosis in critically ill children at high risk of bleeding. J Thromb Haemost 2024; 22:213-224. [PMID: 37797693 DOI: 10.1016/j.jtha.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Normalization of antithrombin activity may prevent catheter-associated thrombosis in critically ill children at high risk of bleeding. OBJECTIVES To characterize the temporal pattern of antithrombin activity, assess its association with catheter-associated thrombosis and clinically relevant bleeding, and evaluate its relationship with thrombin generation in these children. METHODS In this prospective cohort study, critically ill children <18 years old at high risk of bleeding with central venous catheter were eligible. Antithrombin activity and thrombin generation were measured from platelet-poor plasma and after in vitro antithrombin supplementation. Systematic surveillance ultrasound was performed to diagnose thrombosis. Children were followed for bleeding. RESULTS We enrolled 8 infants (median age: 0.2 years, IQR: 0.2, 0.3 years) and 72 older children (median age: 14.3 years, IQR: 9.1, 16.1 years). Mean antithrombin on the day of catheter insertion was 64 IU/dL (SD: 32 IU/dL) in infants and 83 IU/dL (SD: 35 IU/dL) in older children. Antithrombin normalized by the day of catheter removal. Thrombosis developed in 27 children, while 31 children bled. Thrombosis (regression coefficient: 0.008, 95% CI: -0.01, 0.03) and bleeding (regression coefficient: -0.0007, 95% CI: -0.02, 0.02) were not associated with antithrombin. Antithrombin was not correlated with in vivo change in endogenous thrombin potential (correlation coefficient: -0.07, 95% CI: -0.21, 0.08). In vitro supplementation reduced endogenous thrombin potential (correlation coefficient: -0.78; 95% CI: -0.95, -0.23). CONCLUSION These findings may not support normalization of antithrombin activity to prevent catheter-associated thrombosis in critically ill children at high risk of bleeding.
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Affiliation(s)
- Tyler Quinn
- Pediatric Intensive Care Unit, Yale-New Haven Children's Hospital, New Haven, Connecticut, USA
| | - Jill M Cholette
- Department of Pediatrics, University of Rochester Golisano Children's Hospital, Rochester, New York, USA
| | - Matthew G Pinto
- Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital, Valhalla, New York, USA
| | - Hilary Schreiber
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Maureen A Madden
- Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Erin Bennett
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Amanda Kolmar
- Department of Pediatrics, Washington University in St Louis, St Louis, Missouri, USA
| | - Alan Poole
- Division of Critical Care, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Cicero T Silva
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lauren Ehrlich
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Oscar M Navarro
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Narvaez EG, Freischlag JA. A Standardised Surgical Approach for Improved Outcomes in Paget-Schroetter Syndrome: Insights From A Comprehensive Meta-Analysis. Eur J Vasc Endovasc Surg 2023; 66:876. [PMID: 37832912 DOI: 10.1016/j.ejvs.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023]
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Liu Z, Chen X, Tao S, You J, Ma H, Huang C. Published trends and research hotspots of central venous catheter-associated thrombosis from 1973 to 2022: A scientometric analysis. Medicine (Baltimore) 2023; 102:e36111. [PMID: 37986369 PMCID: PMC10659629 DOI: 10.1097/md.0000000000036111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/02/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
This study aims to explore the intellectual landscape and research hotspots in the central venous catheter-related thrombosis (CVC-RT) research field. Studies discussing CVC-RT published from 1973 to 2022 in the Web of Science Core Collection database were retrieved on February 24th, 2022. Citespace was used to perform a scientometric analysis to identify the intellectual landscape and research hotspots in the research fields of CVC-RT. A total of 4358 studies were retrieved, with an ascending trend in publication numbers. The United States of America was the most influential country. The Journal of Vascular Access published the most studies, and McMaster University was the most prolific institution. The results showed that the focus population of CVC-RT research has changed from pediatric patients to cancer patients, the management of CVC-RT has become more formal and standardized, and the focused CVC type has shifted to port and peripherally inserted central catheters. In addition, seventeen active burst keywords were detected, such as patient safety, clinical practice guidelines, and postthrombotic syndrome. This study comprehensively reviewed publications related to CVC-RT. The research topics on patient safety, clinical practice guidelines, and postthrombotic syndrome related to CVC-RT may be future hotspots.
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Affiliation(s)
- Zuoyan Liu
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xinxin Chen
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Shiqi Tao
- West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Thoracic Oncology Ward, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiuhong You
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Hui Ma
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Cheng Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Kocoglu Barlas U, Ozel A, Yenice Bal M, Ozturk S. The Effect of Serum Electrolyte Levels and Infusion Treatments on the Development of Femoral Central Venous Catheter-Associated Deep Vein Thrombosis in Pediatric Intensive Care Unit. Clin Pediatr (Phila) 2023; 62:1277-1284. [PMID: 36856119 DOI: 10.1177/00099228231157956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
In this study, we aimed to determine the frequency of symptomatic central venous catheters-associated deep vein thrombosis (CVC-a DVT) among critically ill children with femoral vein implantation in our pediatric intensive care unit (PICU), and to compare the demographic factors, serum electrolyte levels, and types of the infusion treatments performed. A total of 215 patients aged 1 month to 18 years who had femoral CVC implanted between 2019 and 2021 were included in this study. The cases that were clinically symptomatic and had thrombosis diagnosed ultrasonography were accepted as CVC-a DVT (+), and the other cases were considered as CVC-a DVT (-). Of the total 215 cases, 57.2% (n = 123) were female and 42.8% (n = 92) were male. Catheters-associated deep vein thrombosis diagnosis were made in 9.8% of the cases (n = 21). The mean time to diagnose thrombosis in CVC-a DVT (+) cases was 8.33 ± 5.65 days. With regard to gender, age, blood type, intubation status, length of stay on mechanical ventilator, presence of extra hemodialysis catheter, acute and chronic disease status, number of days of PICU hospitalization, and Pediatric Risk of Mortality-3 scoring, no significant differences between CVC-a DVT (-) and CVC-a DVT (+) cases were observed (P > .05). The incidence of thrombosis in refugee cases was found to be significantly higher than in Turkish cases (P = .047; P < .05). There was no statistically significant difference between the groups in baseline, mean, and peak glucose, sodium, and magnesium values and who received magnesium, blood product, inotrope, and 3% hypertonic saline (HTS) infusion (P > .05). No effect of serum glucose, sodium, and magnesium levels on the development of CVC-a DVT was found. Magnesium, blood product, inotrope, and 3% HTS infusion treatments have not been shown to have an effect on the development of CVC-a DVT.
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Affiliation(s)
- Ulkem Kocoglu Barlas
- Pediatric Intensive Care Unit, Bagcılar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Abdulrahman Ozel
- Department of Pediatrics, Bagcılar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Merve Yenice Bal
- Department of Pediatrics, Bagcılar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Samet Ozturk
- Department of Radiology, Bagcılar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Avila ML, Bentley RF, Bastas D, Brandão LR, Schneiderman JE, Ward L, Wong G, Stephens S, Liu K, Thomas S. Unraveling the pathophysiology of lower-limb postthrombotic syndrome in adolescents: a proof-of-concept study. Blood Adv 2023; 7:2784-2793. [PMID: 36763520 PMCID: PMC10275697 DOI: 10.1182/bloodadvances.2022009599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
A better understanding of the pathophysiology of pediatric postthrombotic syndrome (PTS) is needed to develop strategies to treat this condition. We investigated calf pump function, exercise capacity, balance in power output, and changes in limb muscle oxygen saturation (SmO2) and fluid content during exercise in 10 pediatric patients with unilateral lower-limb PTS, and in age- and sex-matched controls (1:1-1:2 ratio). Outcomes were investigated using bioimpedance spectroscopy, torque-sensing pedals, and near-infrared spectroscopy during incremental- and constant-load cycling tests. The median age at participation was 17 years (25th-75th percentile, 15-18 years); 68% of participants were females. The median CAPTSure score in the affected leg of affected participants was 35 points (25th-75th percentile, 24-46 points), indicating moderate/severe PTS; 20% of patients had a history of central venous catheter-related thrombosis. Increasing PTS severity was associated with higher calf pump venous volume and higher ejection volume, leading to compensated calf pump performance. We found no evidence of PTS impact on exercise capacity. Leg contribution to power output was similar in affected and unaffected legs. However, the PTS-affected legs showed lower SmO2 during active cycling and recovery with increasing PTS severity, indicating impaired microvascular function in the muscle. These findings suggest that PTS severity is associated with impaired blood flow, presumably from elevated venous pressure during and after exercise. The fact that microvascular function is impaired in young patients with PTS underscores the relevance of developing strategies to mitigate the effects of this chronic vascular disease to minimize its deleterious effects as children grow older.
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Affiliation(s)
- M. Laura Avila
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert F. Bentley
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Denise Bastas
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leonardo R. Brandão
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jane E. Schneiderman
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Clinical Research Services, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leigh Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Australia
| | - Gina Wong
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Samantha Stephens
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Kuan Liu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Scott Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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Perek S, Khatib A, Izhaki N, Khalaila AS, Brenner B, Horowitz NA. A prediction model for central venous catheter-related thrombosis in patients with newly-diagnosed acute myeloid leukemia: A derivation cohort analysis. Eur J Intern Med 2022; 101:68-75. [PMID: 35527180 DOI: 10.1016/j.ejim.2022.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Catheter-related thrombosis (CRT) is a common complication in cancer patients, that may lead to chemotherapy deferral, elevated risk for systemic infections and pulmonary embolism. This study aimed to assess CRT incidence and risk factors in newly-diagnosed acute myeloid leukemia (AML) patients and create predictive models potentially allowing to decrease CRT occurrence in this population. METHODS This retrospective single-center analysis included all AML patients treated at the Rambam Health Care Campus between 2006 and 2019. Patient clinical and laboratory data were collected to evaluate thrombosis occurrence and time from AML diagnosis to CRT development. Multivariate classification models were created using logistic regression (LR) and competing risk analyzes. RESULTS The final analysis included 632 newly-diagnosed AML patients (mean age 54 ± 15 years). CRT incidence was 10.1% [confidence interval (CI) 7.7-12.9%], median time from AML diagnosis to CRT was 12.5 days [interquartile range 6-30]. In an LR multivariate model, prior history of venous thromboembolism [adjusted odds ratio (AOR) 12.046, p < 0.0001], acute promyelocytic leukemia (APL) (AOR 2.824, p = 0.015), a high body mass index and initial platelet counts <100 × 10E9/L (AOR 1.059 and 0.546; p = 0.011 and 0.040, respectively) were significantly associated with high CRT risk. Analysis of 587 non-APL patients demonstrated comparable results, with CRT incidence of 9.3% (CI 7.0%-12.1%) and emergence of chronic obstructive pulmonary disease (COPD) as a novel significant co-factor (AOR 34.491, p = 0.004). In both models, the area under curve (AUC) was ≥70%. CONCLUSIONS Significant CRT risk factors defined using the created model could be used for identification of high-risk newly-diagnosed AML patients requiring CRT prophylaxis.
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Affiliation(s)
- Shay Perek
- Department of Internal Medicine A, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel; Department of Emergency Medicine, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, 1, Efron St, Haifa 3109601, Israel
| | - Alaa Khatib
- Department of Emergency Medicine, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel
| | - Niv Izhaki
- Department of Internal Medicine A, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel
| | - Ali Sleman Khalaila
- Department of Internal Medicine, Nazareth Hospital EMMS, 1611, Al Wadi Al Jawani, Nazareth 16100, Israel
| | - Benjamin Brenner
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, 1, Efron St, Haifa 3109601, Israel; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel
| | - Netanel A Horowitz
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, 1, Efron St, Haifa 3109601, Israel; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, 8, Ha'Aliya Street, Haifa 3109601, Israel.
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Sharp R, Carr P, Childs J, Scullion A, Young M, Flynn T, Kirker C, Jackson G, Esterman A. Catheter to vein ratio and risk of peripherally inserted central catheter (PICC)-associated thrombosis according to diagnostic group: a retrospective cohort study. BMJ Open 2021; 11:e045895. [PMID: 34226216 PMCID: PMC8258560 DOI: 10.1136/bmjopen-2020-045895] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Determine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group. DESIGN Retrospective cohort study. SETTING 4 tertiary hospitals in Australia and New Zealand. PARTICIPANTS Adults who had undergone PICC insertion. PRIMARY OUTCOME MEASURE Symptomatic thrombus of the limb in which the PICC was inserted. RESULTS 2438 PICC insertions were included with 39 cases of thrombosis (1.6%; 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30; 95% CI 1.202 to 4.383; p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions. CONCLUSIONS Adherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.
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Affiliation(s)
- Rebecca Sharp
- Clinical and Health Sciences/Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia
| | - Peter Carr
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
- Alliance for Vascular Access Teaching and Research (AVATAR), Griffith University, Nathan, Queensland, Australia
| | - Jessie Childs
- Clinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Andrew Scullion
- Vascular Access Team, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Mark Young
- Peri-Operative Services, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Tanya Flynn
- Cancer Services, St George Hospital, Sydney, New South Wales, Australia
| | - Carolyn Kirker
- Department of Anaesthesia and Pain Management, Capital and Coast District Health Board, Wellington, New Zealand
| | - Gavin Jackson
- Medical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Adrian Esterman
- Clinical and Health Sciences/Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia
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Elder NM, Yee J. Venous Thoracic Outlet Syndrome in a Young Student. J Emerg Med 2020; 59:e69-e71. [PMID: 32471745 DOI: 10.1016/j.jemermed.2020.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Venous thoracic outlet syndrome (VTOS) results from compression and thrombosis of the axillosubclavian vein. In primary effort thrombosis, a subtype of VTOS, chronic repetitive compression injury of the axillosubclavian vein leads to scarring, stenosis, and eventually, thrombosis. This is a rare manifestation of an upper extremity deep vein thrombosis. CASE REPORT A 23-year-old male student without significant past medical history presented to our Emergency Department with a complaint of intermittent swelling and discoloration of his upper right arm. His symptoms had been present for the past year and had worsened over the past few weeks. Swelling was associated with overhead use of the arm. There is no family history of clotting disorders. A computed tomography angiogram of the chest with upper extremity runoff showed findings consistent with VTOS. The patient was discharged with an urgent referral to Vascular Surgery. Within 2 weeks, he underwent multiple surgical procedures and was initiated on anticoagulation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: VTOS usually presents in patients who do not have commonly recognized prothrombotic risk factors. Emergency physicians should include this diagnosis in their differential because good functional outcomes rely on early diagnosis and prompt initiation of treatment. In addition, emergency physicians must refer these patients to vascular surgeons, as most will require surgical management.
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Affiliation(s)
- Natalie Mira Elder
- Department of Emergency Medicine, The Ohio State University, Columbus, Ohio
| | - Jennifer Yee
- Department of Emergency Medicine, The Ohio State University, Columbus, Ohio
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Kameyama H, Yamazaki T, Maeda C, Akamatsu M, Yokoyama N, Kuwabara S, Otani T, Katayanagi N. [Central venous access port devices (CVAPD) - related complications in colorectal cancer patients]. Gan To Kagaku Ryoho 2010; 37:453-455. [PMID: 20332682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Frequency of CVAPD-related complications in colorectal cancer patients is investigated to clarify the relationship to the clinical factors. METHODS The subjects were 57 patients with unresectable or recurrent colorectal cancer who received interposition operation of CVAPD during the period from February 2006 to April 2009. The clinical factors including the insertion sites, the indwelling period of time, surgical operators, and the types of CVAPD products were analyzed in relation to the complications. RESULTS The patients were 42 males and 15 females in the median age of 67 (28-82) years at insertion of CVAPD. The reasons for the introduction of CVAPD were liver metastasis in 25 patients, peritoneal metastasis in 12 patients, recurrent lymph node metastasis in 7 patients, lung metastasis in 18 patients, local factors in 8 patients, and other in 4 patients (multiple response). For CVAPD-related troubles, a total of 10 patients (17.5%) postponed the therapeutical treatment; for occurrence of infection in 4 patients (7.0%), thrombosis in 5 (8.8%), and fracture of a catheter in 1 (1.8%). The CV port device was removed in 9 patients. Analytical results showed that the frequency of CV port device-related complications was not affected by the puncture sites, surgical operators, indwelling period of time, and types of CVAPD products. CONCLUSION Some troubles are often observed which require CVAPD removal, regardless of surgical operators and indwelling period of time, though the frequency of CVAPD-related complications is relatively lower. Review of the operational procedures of the CVAPD insertion and the types of the product to be used, early detection of the complications, and also understanding of the potential risks by the medical staff and patient are important for management of such clinical troubles related to CVAPD.
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SAVELEV VS, DUMPE EP. [THROMBECTOMY IN PAGET-SCHROETTER SYNDROME]. Khirurgiia (Mosk) 1964; 40:94-8. [PMID: 14338169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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PEGOBUSTO A. [PAGET-VON SCHROETTER SYNDROME]. Med Clin (Barc) 1964; 42:122-5. [PMID: 14163685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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MASONI A, TOMASI AM, ANTONIOLI G. [PAGET-SCHROETTER SYNDROME OR PRIMARY THROMBOSIS OF THE SUBCLAVIAN VEIN]. Minerva Med 1963; 54:3644-8. [PMID: 14127698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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13
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SAVELEV VS, DYMPE EP. [PAGET-SCHROETTER SYNDROME. (CLINICAL ASPECTS AND TREATMENT)]. Grudn Khir 1963; 5:60-6. [PMID: 14142847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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14
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PAPLINSKI Z, SMAJKIEWICZ L, KLAMUT K. [Paget-Schroetter syndrome. Report of 4 cases]. Pol Tyg Lek 1963; 18:104-8. [PMID: 13941317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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15
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LASHCHEVKER VM. [On thrombosis of the axillary and subclavian vein (Paget-Schroetter syndrome)]. Novyi Khirurgicheskii Arkhiv 1962; 3:30-3. [PMID: 14462591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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16
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SOKOLOVSKII BF. [Paget-Schroetter syndrome]. Khirurgiia (Mosk) 1961; 37:72-7. [PMID: 13914892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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FERUGLIO GA. [On primary occlusion of the axillo-subclavian venous trunk (effort venous thrombosis or Paget-Schroetter syndrome)]. Friuli Med 1961; 16:825-34. [PMID: 13892622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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MACHADO E, de MORAIS J, MARQUES V, AZOUBEL E. [Axillary-subclavian primary thrombosis (Paget-Schroetter syndrome)]. Rev Bras Med 1961; 18:87-91. [PMID: 14467860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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PAWLUK W. [Paget-Schroetter syndrome (effort thrombosis of the subclavian and axillary veins)]. Pol Tyg Lek 1960; 15:1808-11. [PMID: 13733644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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PAPAGEORGIOU A. [Subclavian-axillary venous occlusion (Paget- von Schroetter syndrome)]. Med Klin 1960; 55:1312-5. [PMID: 14430261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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CROWELL DL. Effort thrombosis of the subclavian and axillary veins: review of the literature and case report with two-year follow-up with venography. Ann Intern Med 1960; 52:1337-43. [PMID: 13813044 DOI: 10.7326/0003-4819-52-6-1337] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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BELLMANN G, SIEBER F. [A contribution to subclavian-axillary vein occlusion (Paget-v. Schroetter syndrome)]. Med Monatsschr 1960; 14:248-51. [PMID: 13798594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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Abstract
A case is reported of primary venous obstruction in the upper extremity, the Paget-Schroetter syndrome. The literature of this unusual condition is reviewed and the mechanism of its development and its treatment is discussed.
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RAINIE RC. Effort thrombosis of the axillary and subclavian veins; case report and review of the literature. Conn State Med J 1957; 21:104-6. [PMID: 13397172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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KARSAY G, KORANYI A. [Anticoagulant therapy in Paget-Schroetter syndrome]. Orv Hetil 1956; 97:1027-8. [PMID: 13388322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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FOTI D. [Anatomo-histological study of the etiology and pathogenesis of the Paget-Schroetter syndrome]. MINERVA CHIR 1955; 10:1263-70. [PMID: 13308931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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DREWES J. [Phlebographical findings in venous obstruction of the upper extremities (Paget-von Schroetter syndrome)]. Fortschr Geb Rontgenstr 1954; 80:341-54. [PMID: 13173727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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CIATTO G. [Effort phlebo-thrombosis of the axillary vein]. Folia Cardiol 1954; 13:92-3. [PMID: 13162017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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BALAS A, STEFANICS J, RANKY L, GORGO P. [Pathology and treatment of the Paget-Schroetter syndrome]. Chirurg 1953; 24:241-8. [PMID: 13082620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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JENNINGS PB, JONES CR. Axillary vein thrombosis in a blood donor. J Am Med Assoc 1953; 151:642-3. [PMID: 13011066 DOI: 10.1001/jama.1953.02940080042009b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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ZISS RC. Paget-Schroetter's syndrome. U S Armed Forces Med J 1953; 4:127-9. [PMID: 13005869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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TOWNSEND SR. Primary or effort thrombosis of the axillary vein. Can Med Assoc J 1952; 66:585-6. [PMID: 14945037 PMCID: PMC1822496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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BALAS A, RANKY L. [Non-thrombotic obstruction of the venous circulation of the upper arm; therapeutic value of venolysis and perivenous sympathectomy; Paget-Schroetter syndrome]. Chirurg 1952; 23:11-4. [PMID: 14916438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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de la BARREDA P, CASTRO FARINAS E. [Effort thrombosis of the lower extremity]. Angiologia 1951; 3:64-7. [PMID: 14819702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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GLASER JL. "Effort" thrombosis of the axillary vein. Rocky Mt Med J 1950; 47:523-4. [PMID: 15430925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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HUGHES ESR. Venous obstruction in the upper extremity; Paget-Schroetter's syndrome; a review of 320 cases. Surg Gynecol Obstet 1949; 88:89-127. [PMID: 18108679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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FICARRA BJ. Primary thrombosis of the axillary vein. N Y State J Med 1948; 48:1287. [PMID: 18864511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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