Current management of isolated soleal and gastrocnemius vein thrombosis

Elfandi, Ali; Anghel, Sharen; Sales, Clifford M.

doi:10.1016/j.jvsv.2015.02.002

Cited by 18 publications

(13 citation statements)

References 20 publications

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“…However, the treatment options for ICMVT remains controversial in regard to the use of controversies monitoring with duplex examinations versus therapeutic anticoagulation. Despite the multiple trials that showed the potential benefit of anticoagulation use in the treatment of ICMVT [ 16 , 35 ], a latest meta-analysis demonstrated insignificant outcomes of anticoagulation use in decreasing the rate of thrombosis progression, as well as increasing the rate of complete recanalization when compared with the no anticoagulation [ 36 ] (Table 4 ). The present study provided novel findings on the assessment of efficacy and safety of therapeutic anticoagulation for ICMVT in patients after femoral neck fracture.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment and management of preoperative venous thromboembolism following femoral neck fracture

et al. 2018

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BackgroundLimited studies are available to investigate the prevalence of preoperative venous thromboembolism (VTE) in elderly patients with femoral neck fractures. Our primary aim was to determine the incidences of VTE and its risk or protective factors in such patient population. The secondary objective was to evaluate the need of therapeutic anticoagulation for isolated calf muscular venous thrombosis (ICMVT) prior to femoral neck fracture surgery.MethodsThis is a retrospective case-control study, including 301 femoral neck fracture patients who were admitted to our institution between January 2014 and March 2017. Bilateral Doppler ultrasonography was performed in each of the patients as a preoperative VTE screening. The event rate of VTE was calculated, and significant risk or protective factors were determined by using a multivariate logistic regression model. Patients with ICMVT were divided into anticoagulation and no anticoagulation groups to assess the efficacy and safety of preoperative therapeutic anticoagulation. Intraoperative blood loss, drainage volume, blood transfusion, perioperative hemoglobin change, and rate of thrombosis extension were compared between the two groups.ResultsThe overall preoperative incidence of VTE in patients with femoral neck fracture was 18.9% (57/301), in which deep vein thrombosis (DVT) was 18.9% and pulmonary embolism (PE) was 1%. Among the DVT cases, 77.2% (44/57) were ICMVTs. Multiple fractures (odds ratio [OR] = 9.418; 95% confidence interval [CI] = 2.537 to 34.96), coexisting movement disorder (OR = 3.862; 95% CI = 1.658 to 8.993), bed rest for more than 7 days (OR = 2.082; 95% CI = 1.011 to 4.284) as well as elevated levels of D-dimer (OR = 1.019; 95% CI = 1.002 to 1.037) and fibrinogen (OR = 1.345; 95% CI = 1.008 to 1.796) led to an increase in the risk of VTE, while the recent use of antiplatelet drug (OR = 0.424; 95% CI = 0.181 to 0.995) and prophylactic anticoagulation (OR = 0.503; 95% CI = 0.263 to 0.959) decreased the risk of VTE. For the 39 patients with ICMVT undergoing femoral neck fracture surgery, there were no significant differences in the rate of thrombosis extension between anticoagulation and no anticoagulation groups, but significantly decreased postoperative hemoglobin was observed in the anticoagulation group.ConclusionOur findings showed a high prevalence of preoperative VTE in elderly patients with femoral neck fracture, with risk factors identified. We found that the most detected VTE were ICMVTs. Our study suggested that a direct surgery without preoperative use of therapeutic anticoagulation for ICMVT would not reduce the risk of thrombus extension, and the therapeutic use of anticoagulation may worsen postoperative anemia.

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Section: Discussionmentioning

confidence: 99%

Risk assessment and management of preoperative venous thromboembolism following femoral neck fracture

et al. 2018

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“…Routine scanning was performed for the femoral common vein, superficial and deep femoral vein, popliteal vein, posterior and anterior tibial vein, and peroneal vein of bilateral lower extremities. Superficial or intermuscular vein thrombosis (soleal or gastrocnemius vein thrombosis) was excluded, due to their relatively less clinical significance [16,17].…”

Section: Diagnosis Of Dvtmentioning

confidence: 99%

Incidence of deep venous thrombosis (DVT) of the lower extremity in patients undergoing surgeries for ankle fractures

Zixuan

Chen

et al. 2020

J Orthop Surg Res

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Objective: To investigate the incidence of postoperative deep venous thrombosis (DVP) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. Methods: This was a retrospective study. A total of 1451 patients undergoing surgery of ankle fractures from January 2016 to June 2019 were included. The inpatient medical record system was inquired for data collection, including demographics, comorbidities, injury, and surgery-related data, and laboratory biomarkers. DVT of the lower extremity was diagnosed by routine Doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Results: Among the 1451 patients, DVT was confirmed in 38 cases, indicating an incidence of 2.6%. DVT involved both the operated and non-operated limbs in 8 patients (21.1%). DVT involved superficial femoral vein in 4 cases (6.6%), deep femoral vein in 2 (3.3%), popliteal vein in 5 (8.2%), posterior tibial vein in 11 (18.0%), and peroneal vein in 39 (63.9%). The median interval between operation and diagnosis of DVT was 7 days. Six risk factors were identified to be independently associated with DVT, including age (10-year increase) (OR, 1.44), preoperative stay (delay of each day) (OR, 1.11), anesthesia (general vs regional) (OR, 3.51), lower hemoglobin level (OR, 2.02), total cholesterol > 5.2 mmol/L (OR, 3.20), and reduced lymphocyte count (OR, 3.16). Conclusion: These identified factors, although not easily modifiable, do help counsel patients about the risk of DVT and help individualized assessment of the risk factors and accordingly the risk stratification.

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“…Routine scanning was performed for the femoral common vein, super cial and deep femoral vein, popliteal vein, posterior and anterior tibial vein, and peroneal vein of bilateral lower extremities. Super cial or intermuscular vein thrombosis (soleal or gastrocnemius vein thrombosis) was excluded, due to their relatively less clinical signi cance [16,17].…”

Section: Diagnosis Of Dvtmentioning

confidence: 99%

Incidence of deep venous thrombosis (DVT) of lower extremity in patients undergoing surgeries for ankle fractures

Luo¹,

Chen²,

Li³

et al. 2020

Preprint

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Objective To investigate the incidence of postoperative deep venous thrombosis (DVP) in patients undergoing surgeries for ankle fractures and identify the associated risk factors. Methods This was a retrospective study. A total of 1451 patients undergoing surgery of ankle fractures from January 2016 to June 2019 were included. The inpatient medical record system was inquired for data collection, including demographics, comorbidities, injury and surgery-related data and laboratory biomarkers. DVT of lower extremity was diagnosed by routine doppler examination. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors.Results Among the 1451 patients, DVT was confirmed in 38 cases, indicating an incidence of 2.6%. DVT involved both the operated and non-operated limbs in 8 patients (21.1%). DVT involved superficial femoral vein in 4 cases (6.6%), deep femoral vein in 2 (3.3%), popliteal vein in 5 (8.2%), posterior tibial vein in 11 (18.0%) and peroneal vein in 39 (63.9%). The median interval between operation and diagnosis of DVT was7 days. Six risk factors were identified to be independently associated with DVT, including age (10-year increase) (OR, 1.44), preoperative stay (delay of each day) (OR, 1.11), anesthesia (general vs regional) (OR, 3.51), lower hemoglobin level (OR, 2.02), total cholesterol >5.2mmol/L (OR, 3.20) and reduced lymphocyte count (OR, 3.16). Conclusion These identified factors, although not easily modifiable, do help counsel patients about the risk of DVT and help individualized assessment of the risk factors and accordingly the risk stratification.

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Current management of isolated soleal and gastrocnemius vein thrombosis

Cited by 18 publications

References 20 publications

Risk assessment and management of preoperative venous thromboembolism following femoral neck fracture

Risk assessment and management of preoperative venous thromboembolism following femoral neck fracture

Incidence of deep venous thrombosis (DVT) of the lower extremity in patients undergoing surgeries for ankle fractures

Incidence of deep venous thrombosis (DVT) of lower extremity in patients undergoing surgeries for ankle fractures

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