Anticoagulants ; therapeutic use ; Humans ; Venous Thrombosis ; drug therapy

External beam radiotherapy, transarterial chemoembolization and sorafenib are currently standard treatments for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. However, hepatic arterial infusion chemotherapy has been applied to advanced stage HCC with a view to improving the therapeutic effect. We experienced a case of advanced HCC with clinical complete response after hepatic artery infusion chemotherapy and radiation therapy and report that.
Carcinoma, Hepatocellular* ; Chemoradiotherapy ; Drug Therapy* ; Hepatic Artery* ; Portal Vein* ; Radiotherapy* ; Thrombosis* ; Venous Thrombosis

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The majority of patients with HCC are diagnosed at advanced disease stages with vascular invasion, where curative approaches are often not feasible. Currently, sorafenib is the only available standard therapy for HCC with portal vein tumor thrombosis (PVTT). However, in many cases, sorafenib therapy fails to achieve satisfactory results in clinical practice. We present a case of advanced HCC with PVTT that was treated with hepatic arterial infusion chemotherapy (HAIC) followed by liver transplantation. Three cycles of HAIC treatment resulted in necrotic changes in most of the tumors, and PVTT was reduced to an extent at which liver transplantation was possible. Further studies are required to determine the treatment strategies for advanced HCC with PVTT that can improve prognosis.
Carcinoma, Hepatocellular ; Drug Therapy ; Humans ; Liver Transplantation ; Liver ; Portal Vein ; Prognosis ; Thrombosis ; Venous Thrombosis

Acute superior mesenteric venous thrombosis is rare. With advance in CT venography, angiography and diagnostic laparoscopy, the incidence of acute superior mesenteric venous thrombosis has increased worldwide with more access to early diagnosis. The use of anticoagulation medication, interventional radiology, and damage control approach has resulted in better clinical outcomes. At present, the new step-up approach for acute superior mesenteric venous thrombosis includes CT venography as the main diagnostic technique, anticoagulation as the cornerstone of therapy, local transcatheter thrombolytic therapy as the key recanalization method, and adjunctive use of arterial spasmolysis and various endovascular manipulation and damage control surgery by intestinal resection plus jejunostomy and ileostomy or open abdomen. This strategy may further improve clinical outcomes. This review will present the most recent advance in this strategy.
Acute Disease ; Humans ; Mesenteric Veins ; Thrombolytic Therapy ; Venous Thrombosis ; diagnosis ; therapy

A kind of intermittent pneumatic compression (IPC) apparatus is developed to prevent deep vein thrombosis (DVT),which is based on the theory of occurrence and prevention of the DVT and AT89C52 micro-controller. This paper introduces its principle, composition of electromechanical system and the software design. The apparatus has showed its characteristics of easy operation, high intelligence and high reliability.
Equipment Design ; Physical Therapy Modalities ; instrumentation ; Software ; Thrombolytic Therapy ; instrumentation ; Venous Thrombosis ; prevention & control

PURPOSE: The purpose of this study is to evaluate treatment outcomes in patients with symptomatic deep vein thrombosis (DVT) who had undergone a catheter-directed thrombolysis with conventional aspiration thrombectomy for the treatment of lower extremity deep vein thrombosis. MATERIALS AND METHODS: The authors retrospectively reviewed the records of 74 patients (mean age 61 +/- 15) that underwent a catheter-directed thrombolysis with conventional aspiration thrombectomy. A retrieval inferior vena cava (IVC) filter was placed to protect against a pulmonary embolism in 60 patients (81%). Stenting and balloon angioplasty were performed in 37 patients (50%) under the left common iliac vein compression. RESULTS: Sixty-seven patients (91%) showed a clinical improvement within 48 hours, but seven patients (9%) showed no improvement. Multi detector computerized tomographic venography (MDCT venography) at discharge showed no thrombus in 15 patients (20%) and partial thrombus in 52 (70%). Twenty-eight patients (38%) developed post-thrombotic syndrome at 3.0 +/- 4.2 months postoperatively. Six patients (8%) were admitted due to DVT recurrence at a mean of 5.6 +/- 7.4 months postoperatively. Sixty-nine patients underwent follow up MDCT venography at 5.7 +/- 5.6 months. fifty (72%) of these showed no thrombus, 15 (22%) partial thrombus, and 4 (6%) showed obstruction. Twentyeight of 61 (46%) were asymptomatic, twentyeight (46%) had moderate improvement, and four (6%) were mildly improved by a telephone interview (81%) at 22.8 +/- 10.7 months postoperatively. CONCLUSION: Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results.
Aged ; *Catheterization ; Female ; Humans ; Male ; Middle Aged ; Thrombectomy/*methods ; Thrombolytic Therapy/*methods ; Venous Thrombosis/*therapy

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, is an important cause of morbidity and mortality. The aim of this review is to summarize the findings from clinically important publications over the last year in the area of VTE. In this review, we discuss 11 randomized controlled trials published from March 2013 to April 2014. The COAG and the EU-PACT trials indicate that pharmacogenetic testing has either no usefulness in the initial dosing of vitamin K antagonists or marginal usefulness in the Caucasian population. Recent clinical trials with novel oral anticoagulants (NOACs) have demonstrated that the efficacy and safety of rivaroxaban, apixaban, edoxaban, and dabigatran are not inferior to those of conventional anticoagulants for the treatment of VTE. The PEITHO and ULTIMA trials suggested that rescue thrombolysis or catheter-directed thrombolysis may maximize the clinical benefits and minimize the bleeding risk. Lastly, riociguat has a proven efficacy in treating chronic thromboembolic pulmonary hypertension. In the future, NOACs, riociguat, and catheter-directed thrombolysis have the potential to revolutionize the management of patients with VTE.
Anticoagulants ; Hemorrhage ; Humans ; Hypertension, Pulmonary ; Mortality ; Pharmacogenetics ; Pulmonary Embolism* ; Thrombolytic Therapy ; Venous Thromboembolism ; Venous Thrombosis ; Vitamin K ; Rivaroxaban ; Dabigatran

Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.
Angioplasty, Balloon ; Arteries ; Edema ; Humans ; Iliac Vein ; Leg ; May-Thurner Syndrome* ; Phlebography ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

May-Thurner syndrome (iliac vein compression syndrome) is an uncommon condition in which the right common iliac artery compresses the left common iliac vein against the pelvic rim, resulting in left iliofemoral deep vein thrombosis and severe leg edema. Serious vascular sequelae to the leg can result if this condition is not recognized and corrected in a timely fashion. Several new interventions for treating May-Thurner syndrome have emerged over the past several years. Catheter-directed thrombolysis and stenting have been advocated as effective for the treatment of acute thrombosis and the underlying stenosis of May-Thurner syndrome. We report two cases of May-Thurner syndrome that were treated with catheter-directed thrombolysis and stent implantation.
Constriction, Pathologic ; Edema ; Iliac Artery ; Iliac Vein ; Leg ; May-Thurner Syndrome ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Veins ; Venous Thrombosis

A paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt, and is commonly related to patent foramen ovale (PFO). However, coexisting pulmonary embolisms, deep vein thromboses (DVT), and multipe systemic arterial embolisms, associated with PFO, are rare. Here, we report a patient who had a cryptogenic ischemic stroke, associated with PFO, which is complicated with a massive pulmonary thromboembolism, DVT, and renal infarctions, and subsequently, the patient was treated using a thrombolytic therapy.
Embolism ; Embolism, Paradoxical ; Foramen Ovale, Patent ; Humans ; Infarction ; Kidney Diseases ; Pulmonary Embolism ; Renal Artery ; Stroke ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis