Postthrombotic Syndrome

Vazquez,; Kahn, Jeffrey D.

doi:10.1161/circulationaha.109.925651

Cited by 21 publications

(12 citation statements)

References 15 publications

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“…A common complication of DVT is post-thrombotic syndrome (PTS), which is estimated to occur in more than one-third of all patients diagnosed with DVT [ 17 ]. Symptoms of PTS include recurrent pain/swelling in the legs, skin changes and recurrent leg ulcers [ 10 , 18 ].…”

Section: Decision Problemmentioning

confidence: 99%

The geko™ Electro-Stimulation Device for Venous Thromboembolism Prophylaxis: A NICE Medical Technology Guidance

Summers

Clinch

Radhakrishnan

et al. 2014

Appl Health Econ Health Policy

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The geko™ device is a single-use, battery-powered, neuromuscular electrostimulation device that aims to reduce the risk of venous thromboembolism (VTE). The National Institute for Health and Care Excellence (NICE) selected the geko™ device for evaluation, and invited the manufacturer, Firstkind Ltd, to submit clinical and economic evidence. King’s Technology Evaluation Centre, an External Assessment Centre (EAC) commissioned by the NICE, independently assessed the evidence submitted. The sponsor submitted evidence related to the geko™ device and, in addition, included studies of other related devices as further clinical evidence to support a link between increased blood flow and VTE prophylaxis. The EAC assessed this evidence, conducted its own systematic review and concluded that there is currently limited direct evidence that geko™ prevents VTE. The sponsor’s cost model is based on the assumption that patients with an underlying VTE risk and subsequently treated with geko™ will experience a reduction in their baseline risk. The EAC assessed this cost model but questioned the validity of some model assumptions. Using the EACs revised cost model, the cost savings for geko™ prophylaxis against a ‘no prophylaxis’ strategy were estimated as £197 per patient. Following a second public consultation, taking into account a change in the original draft recommendations, the NICE medical technologies guidance MTG19 was issued in June 2014. This recommended the adoption of the geko™ for use in people with a high risk of VTE and when other mechanical/pharmacological methods of prophylaxis are impractical or contraindicated in selected patients within the National Health Service in England.

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Section: Decision Problemmentioning

confidence: 99%

The geko™ Electro-Stimulation Device for Venous Thromboembolism Prophylaxis: A NICE Medical Technology Guidance

Summers

Clinch

Radhakrishnan

et al. 2014

Appl Health Econ Health Policy

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“…PTS is an often-overlooked complication of DVT, which is caused by the injury of endothelium and low venous flow. It leads to the distension of collateral vessels and general swelling of the tissue, which may result in pain and cramping [ 3 ]. DVT is also frequently observed after ECMO decannulation [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Compartment syndrome was initially suspected. We clinically ruled out compartment syndrome [3], since the patient was negative for Homan's sign and had good distal pulsation with warm circulation. The patient had burning sensation and Grade 3 weakness in hip and knee flexion motions with no deep tendon reflex.…”

Section: Case Presentationmentioning

confidence: 99%

Femoral neuropathy following venoarterial-extracorporeal membrane oxygenation therapy: a case report

Jang

Lee

et al. 2020

BMC Cardiovasc Disord

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Background Although life-threatening complications of extracorporeal membrane oxygenation (ECMO) are well described, non-life threatening complications are less known. Herein, we report a case of femoral neuropathy (FN) due to nerve compression caused by cannula compression and deep vein thrombosis (DVT) after successful ECMO therapy, which seriously undermined one’s quality of life. Case presentation A 70-year old male presented to the emergency department for chest pain. The patient had cardiac arrest before percutaneous coronary intervention (PCI) and was inserted with ECMO. Although he was successfully weaned from ECMO 4 days after PCI, he consistently complained swelling, abnormal sensation, and weakness in his right lower extremity, where the cannulas were inserted. Imaging studies showed deep vein thrombosis (DVT) in his right leg, which was further treated with anticoagulants. Symptoms, however, remained after the regression of DVT. Nerve conduction study revealed femoral neuropathy, which may have been caused by ECMO cannula compression and tissue swelling. Conclusion The current case proposes that non-life threatening complications of ECMO therapy can seriously affect quality of life. Venous drainage distant from the arterial cannula may prevent such complications.

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“…[1,2] After an initial DVT, post-thrombotic syndrome (PTS) occurs in 20%-50% of patients. [3] PTS is more common in patients with DVT proximal to the knee, are overweight and in those who do not take their anticoagulants or are not within therapeutic levels on anticoagulation. PTS is manifested by venous ulcers, venous insufficiency and discoloration.…”

Section: Discussionmentioning

confidence: 99%