Cerebral venous thrombosis (CVT) rarely recurs, and the factors associated with a recurrence remain unclear. Recently, however, elevated plasma coagulation factor VIII has been considered a factor related to recurrent venous thromboembolism. Here we report a patient who had recurrent CVT associated with significantly elevated levels of factor VIII despite the chronic use of an antiplatelet agent. Factor IX was also elevated in this patient. These findings suggest that elevated factor VIII is a factor underlying the recurrence of CVT, and that prolonged anticoagulation therapy may have to be considered in patients with elevated coagulation factor levels.
Blood Coagulation Factors ; Factor IX ; Factor VIII* ; Humans ; Plasma ; Recurrence ; Venous Thromboembolism ; Venous Thrombosis*

Pulmonary embolism is a common clinical problem in patients with immobilization, cancer, indwelling central venous catheter and surgery. However, although rare, it may occur in patients with inherited thrombophilia. Protein S deficiency is known to increase the risk of venous thrombosis and pulmonary embolism. There are many reports of venous thrombosis with protein S deficiency, but there are few reports of arterial thrombosis, especially recurrent acute pulmonary embolism. Here, we report a case of recurrent pulmonary embolism associated with type II protein S deficiency.
Blood Coagulation Disorders, Inherited ; Central Venous Catheters ; Humans ; Immobilization ; Protein S ; Protein S Deficiency ; Pulmonary Embolism ; Thrombophilia ; Thrombosis ; Venous Thrombosis

Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis. Concurrently, there are safety concerns regarding the risk of bleeding from anticoagulants in people with advanced liver disease. Further prospective studies are required to determine not only if cirrhotic patients benefit from receiving anticoagulation therapy for preventing thrombotic complications, but also to determine which prophylactic regimen is most appropriate.
Anticoagulants ; Blood Coagulation Factors ; Fibrosis ; Hemorrhage ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Prospective Studies ; Thrombocytopenia ; Thrombosis ; Venous Thromboembolism ; Venous Thrombosis

PURPOSE: Venous thromboembolism (VTE) is a common life-threatening illness with significant morbidity and mortality rates. In recent years, the incidence of VTE has gradually increased in Korea. In this study, we evaluated the current trends in the management of acute deep vein thrombosis (DVT) in Korea. MATERIALS AND METHODS: A 20-item questionnaire was prepared and sent to 48 members of the Korean Society for Vascular Surgery. Each member worked in a different hospital. Twenty-two members participated in this study. RESULTS: The vascular surgery departments were primarily responsible for managing DVT. Ultrasound and computed tomography (CT) venography were chosen as the most common initial diagnostic tools. Eighty-two percent of participants routinely used the coagulation factor assay. Thrombolysis and inferior vena cava (IVC) filter insertion were performed mainly in the radiology departments. Seventy-seven percent of participants performed thrombolysis only if the thrombus age was less than 21 days. During thrombolysis, IVC filter was routinely inserted by 50% of respondents and removed within 14 days by 64% of respondents. Nearly all participants followed the 2012 American College of Chest Physicians guidelines for anticoagulation therapy. CONCLUSION: The majority of Korean vascular surgeons followed the guidelines. However, CT was frequently used. Thrombolysis and IVC filter insertion were more frequently performed than recommended by the guidelines.
Blood Coagulation Factors ; Surveys and Questionnaires ; Incidence ; Korea ; Mortality ; Phlebography ; Thorax ; Thrombosis ; Ultrasonography ; Veins ; Vena Cava, Inferior ; Venous Thromboembolism ; Venous Thrombosis*

A thromboembolic event in patients later given a diagnosis of cancer is the result rather than the cause of the cancer. The risk of hidden cancer is significantly higher for patients with recurrent idiopathic thromboembolism compared to those with secondary deep vein thrombosis. Microemboli from hepatic or adrenal metastases and large-sized emboli from the great veins invaded by the tumor are the sources of tumor embolization. The intraarterial tumor emboli less likely invade the arterial wall. Thrombus formation and organization may be capable of destroying tumor cells within pulmonary blood vessels. Therefore, all tumor emboli are not true metastases. The treatment of deep vein thrombosis and pulmonary embolism in patients with cancer consists of anticoagulation with heparin and warfarin, venacaval filters, appropriate anti-neoplastic agents, and surgical methods(embolectomy, thromboendarterectomy). However, considerable literatures suggest that oral anticoagulant such as warfarin is ineffective in the treatment of those. We report a case of primary unknown squamous cell carcinoma incidentally found in the thrombus after pulmonary embolectomy.
Blood Vessels ; Carcinoma, Squamous Cell* ; Diagnosis ; Embolectomy* ; Heparin ; Humans ; Neoplasm Metastasis ; Pulmonary Embolism ; Thromboembolism ; Thrombosis* ; Veins ; Venous Thrombosis ; Warfarin

Cerebrovascular disease refers to disorder of one or more blood vessels of the brain, and the majority of lesions that arise from these are from arterial diseases. The occurrence of cerebral venous thrombosis is clearly linked to the puerperal state, and pregnancy may increase the risk of subarachnoid hemorrhage. The most common cause is rupture of arterial aneurism. Hemodynamic, hormonal or other physiological changes of pregnancy may play a role in aneurysmal rupture. We report two cases of cerebrovascular diseases in the puerperium with a brief review of concerned literatures
Aneurysm ; Blood Vessels ; Brain ; Hemodynamics ; Postpartum Period* ; Pregnancy ; Rupture ; Subarachnoid Hemorrhage ; Venous Thrombosis

Humans ; Lower Extremity ; blood supply ; May-Thurner Syndrome ; etiology ; Venous Thrombosis ; etiology

Deep venous thrombosis (DVT) is one of the most common complications after total joint replacement, which is also one of the most concerned problems for clinicians. Domestic research data shows that the incidence of DVT in patients without thrombotic prophylaxis after joint replacement surgery are 20.6%-40.0%. The occurrence mechanism of DVT is explained by the Virchow theory, that is blood stasis, the blood vessel wall damage and blood coagulation state. The diagnostic rate of DVT is not satisfactory. The diagnosis of symptomatic DVT depends mainly on clinical symptoms and auxiliary examination. The diagnosis of asymptomatic DVT is mainly based on the auxiliary examination. The prevention and treatment of DVT after artificial joint replacement is currently mainly concentrated in the aspects of new oral anticoagulant agents, drug prevention method, and time limit.
Anticoagulants ; therapeutic use ; Arthroplasty, Replacement ; adverse effects ; Blood Coagulation ; Humans ; Incidence ; Venous Thrombosis ; diagnosis ; therapy

Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, diffuse dural thickening, and enhancement in magnetic resonance imaging. Cerebral venous thrombosis (CVT) has been reported to be a rare complication of SIH. There is no consensus in anticoagulation treatment of CVT secondarily caused by SIH. We report a female patient with SIH complicated by CVT and spontaneously regressed CVT not by anticoagulation but by epidural blood patch.
Blood Patch, Epidural ; Consensus ; Female ; Headache ; Humans ; Intracranial Hypotension ; Magnetic Resonance Imaging ; Venous Thrombosis

PURPOSE: To investigate the difference in blood loss between two injection methods, intravenous (IV) and intra-articular (IA) methods via drain tube. MATERIALS AND METHODS: A total of 183 patients who underwent total knee arthroplasty between October 2013 and March 2016 were included. The method of tranexamic acid (TXA) administration was intravenously injected before August 2015, and it was applied thereafter to the joint through a drainage tube post intra-articular suture. Our subjects were divided into the following groups: The intravenous unilateral (IVU), intravenous bilateral (IVB), intra-articular unilateral (IAU), and intra-articular bilateral (IAB) groups. Hemoglobin and hematocrit, drainage amount, transfusion frequency, mean transfusion volume, and blood loss, as well as complications were compared between the groups. RESULTS: Drainage amount was 558.08±296.29 ml in IVU, and 498.39±199.70 ml in IAU; there was less drainage in IAU than in IVU, but without significance (p=0.262). Moreover, the drainage amount was 1,110.39±396.23 ml in IVB and 827.14±282.47 ml in IAB, which was significantly lower in IAB (p=0.000). Transfusion frequency was 5 patients (10.0%) in IVU and 2 patients (4.5%) in IAU, but without significant difference (p=0.442). Moreover, the frequency was 16 patients (29.6%) in IVB and 1 patient (2.9%) in IAB, which was significantly lower in the IAB group (p=0.002). Mean transfusion volume was 44.80±144.71 ml in IVU and 21.80±106.86 ml in IAU, but without significant difference (p=0.389); the volume was 177.80±321.00 ml in IVB and 18.30±108.18 ml in IAB, with statistical significance (p=0.001). Blood loss was 1,318.70±724.20 ml in IVU and 963.28±454.03 ml in IAU, which was significantly lower in the IAU (p=0.006); blood loss was 1,837.40±699.70 ml in IVB, and 1,337.60±382.20 ml in IAB and it was significantly lower in IAB (p=0.000). Complications included deep vein thrombosis in one case in IVU. CONCLUSION: In TKA, IA injection of TXA significantly reduced blood loss compared with IV injection, especially in bilateral TKA.
Arthroplasty, Replacement, Knee* ; Blood Transfusion ; Drainage ; Hematocrit ; Humans ; Joints ; Methods ; Sutures ; Tranexamic Acid* ; Venous Thrombosis