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Venous Thromboembolism and Anticoagulation
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Venous thromboembolism (VTE) refers to a condition in which blood clots inappropriately, and includes deep vein thrombosis ([DVT], when a clot forms in the deep veins of the body; 75–80% of VTE cases), and pulmonary embolism ([PE] when a clot in the deep veins breaks free and is carried to the arteries of the lung; 20–25% of VTE cases). Approximately 50% occur during pregnancy, and 50% occur during the postpartum period [1].
Antepartum Haemorrhage
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Compression stockings should be used as prophylaxis against venous thromboembolism (VTE). The decision to administer low molecular weight heparin in the postpartum period after haemostasis has been achieved should be made by a consultant after considering the patient’s risk profile for VTE.
Transfusion products
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
Hereditary deficiencies of this plasma constituent lead to recurrent venous thromboembolism. Antithrombin III is stable in stored blood, but concentrates are needed if clinically significant deficiencies are to be treated effectively. Heat-treated antithrombin III concentrates are available, and are indicated for the prevention and treatment of patients with hereditary antithrombin III deficiency.
Current evidence on the use of direct oral anticoagulants in patients with myeloproliferative neoplasm: a systematic review
Published in Expert Review of Hematology, 2023
Mehmet Baysal, Meltem Bayrak, Ahmet Emre Eşkazan
Low-dose aspirin is the standard of care for primary prophylaxis in most patients [6]. According to the disease and risk classification, phlebotomy and/or cytoreductive treatments are applied to keep the hematocrit below 45% [6,7]. Vitamin K antagonists (VKAs) are preferred in patients who have had an attack of thrombosis or present with thrombosis despite prophylaxis and treatments [8]. In recent years, innovations have occurred in the treatment of venous thromboembolism with changes in the treatments used in the interventions of venous thromboembolism (VTE). Direct oral anticoagulants (DOACs) have begun to be used effectively in the treatment of VTE and are included in the guidelines because of the results found in studies in the treatment of cancer-associated thrombosis (CAT) [9–12]. However, the data regarding the usage of DOACs in MPNs are scarce. The utility of DOACs in VTE and atrial fibrillation (AF) is very well established according to randomized controlled studies, but MPN patients were underrepresented in those reports [13–16]. The data regarding the practice of DOACs in MPNs patients mostly come from retrospective or observational studies [17–19].
Pharmacological venous thromboembolism prophylaxis in elective cranial surgery: a systematic review of time of initiation, regimen and duration
Published in British Journal of Neurosurgery, 2022
Ian Tan, Anand S. Pandit, Shivani Joshi, Mehdi Khan, Zara Sayar, John-Paul Westwood, Hannah Cohen, Ahmed K. Toma
All studies included VTE and ICH as outcomes of interest. Wilhelmy et al.38 performed routine surveillance to detect postoperative ICH using computed tomography (CT) imaging, whereas the confirmation of ICH in all other studies either relied on the identification of clinical symptoms or were not specified. VTE was detected using clinical symptoms alone,37 or with further confirmation by imaging39; Wilhelmy et al.38 did not specify their method of measuring VTE occurrence. Whilst our review is focused on venous thromboembolism in the form of deep vein thrombosis and pulmonary embolism, Wilhelmy et al.38 also included patients who experienced non-venous thromboembolic events, including two patients who developed ischaemic stroke. None of the studies investigated the association between the interventions and mortality.
Helix Thigh Lift. A Novel Approach to Severe Deformities in Massive Weight Loss Patients
Published in Journal of Investigative Surgery, 2022
Luigi Losco, Ana Claudia Roxo, Carlos Weck Roxo, Alessandro de Sire, Alberto Bolletta, Roberto Cuomo, Luca Grimaldi, Emanuele Cigna, Carlos del Pino Roxo
The incidence of deep venous thromboembolism, pulmonary embolism and revisional surgery due to a complication was zero. In our series, five patients (36%) experienced at least one complication related to the thigh lift. They were minor complications including four seromas (29%) treated with multiple percutaneous aspirations, one dehiscence (7%) and one hematoma (7%) treated in an outpatient setting, and one case of cellulitis (7%) that responded to oral antibiotics. No skin necrosis was reported. Four patients (29%) required surgical revision for scar irregularity; they were all minor revisions performed under local anesthesia, and advocated for esthetic purpose. We reported one case of transient edema (7%) that resolved within three months (Table 2). The mean follow-up time was 14.8 ± 3.2 months.