Tag Archives: Pulmonary Embolism

High Prevalence and Mortality Associated with Upper Extremity Deep Venous Thrombosis in Hospitalized Patients at a Tertiary Care Center

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“Venous thromboembolism (VTE), which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is the third most common cardiovascular disorder with an annual incidence of 0.1%, affecting approximately 5% of the population.1 Upper extremity DVT (UEDVT) has been thought to account for 4e10% of all cases of DVT and may involve the radial, ulnar, brachial, axillary, subclavian, brachiocephalic, or internal jugular veins.
Historically, UEDVT has been considered a relatively benign event. However, as the incidence of UEDVT increases, so do its subsequent complications including PE, venous access difficulties, superior vena cava syndrome, postthrombotic syndrome, and bleeding on therapeutic anticoagulation therapy, suggesting an insufficient understanding and management of UEDVT.
Management guidelines, with the exception of those for thoracic outlet syndrome, are largely
extrapolated from lower extremity DVT (LEDVT) and PE management.”

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Symptomatic perioperative venous thromboembolism is a frequent complication inpatients with a history of deep vein thrombosis

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“Perioperative venous thromboembolism (VTE) is a frequent complication in patients who undergo major surgical procedures. The risk for thromboembolism is increased in patients with advancing age, malignancy, inherited and acquired thrombophilic conditions, and in those patients who undergo certain higher-risk surgical procedures (for example: total hip arthroplasty, total knee arthroplasty, and abdominal cancer operations). A history of deep vein thrombosis (DVT) or pulmonary embolism (PE) frequently is cited as a risk factor for subsequent recurrence around the time of surgery. However, the incidence of perioperative VTE recurrence in patients with a history of lower extremity deep vein thrombosis is not well studied.”

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Immune-mediated inflammatory diseases and risk of venous thromboembolism:

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“Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), affects ~10 million people worldwide every year, representing the third most
common cardiovascular disease globally. The 30-day case fatality rate after VTE diagnosis is 10.6%, with about 30% to 50% of survivors developing long-term complications that increase
the burden of this disease.”

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Risk of postoperative deep vein thrombosis and pulmonary embolism in patients with inflammatory bowel disease

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“An increased risk of DVT and PE in patients with IBD has been evident for the past 75 years. Most work in this area has not looked specifically at patients undergoing surgery. Patients with IBD frequently require surgical intervention, and an understanding of their risk of venous thromboembolism is therefore an important issue. This study aimed to examine rates of DVT and PE in patients with IBD undergoing surgery using data from the NSQIP.”

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Optimev study. Clinical presentation and mortality in pulmonary embolism

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“Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common clinical problem associated with significant mortality and life-long morbidity among hospitalized patients and outpatients. The diagnosis of VTE is challenging because of the non specific signs and symptoms of this disease.”

“The aim of this study was to investigate the clinical presentation and 3-month mortality associated with some forms of VTE: PE with DVT, and PE without DVT.”

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Systemic Thrombolysis for Pulmonary Embolism

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Tapson VF, Friedman O. Systemic Thrombolysis for Pulmonary Embolism: Who and How. Tech Vasc Interv Radiol. 2017 Sep;20(3):162-174.

Full-text for Emory users.

PE screenshot

“For several decades, clinicians and clinical trialists have worked toward a more aggressive, yet safe solution for patients with intermediate-risk PE. Standard-dose thrombolysis, low-dose systemic thrombolysis, and catheter-based therapy which includes a number of devices and techniques, with or without low-dose thrombolytic therapy, have offered potential solutions and this area has continued to evolve. On the basis of heterogeneity within the category of intermediate-risk as well as within the high-risk group of patients, we will focus on the use of systemic thrombolysis in carefully selected high- and intermediate-risk patients. In certain circumstances when the need for aggressive therapy is urgent and the bleeding risk is acceptable, this is an appropriate approach, and often the best one.”

More PubMed results on systemic thrombolysis.