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Concept: Deep vein

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Patients with iliac deep vein thrombosis (DVT) have a poor prognosis and high incidence of postthrombotic syndrome (PTS). We evaluated the effect of low-molecular-weight heparin (LMWH; tinzaparin) versus usual care (tinzaparin plus warfarin for ā‰„12 weeks at home) in the development of PTS according to DVT location (iliac/noniliac) by retrospective analysis of the Home-LITE cohort (480 patients with proximal DVT). Patients with iliac DVT had an overall odds ratio of 0.53 (95% confidence interval [CI] 0.33, 0.83; P = .0079) for PTS (including ulcer data) in favor of tinzaparin. Patients with noniliac DVT had a similar odds ratio (0.79 [95% CI 0.67, 0.93], P = .0046) to that reported in the overall Home-LITE population (0.76 [95% CI 0.66, 0.89], P = .0004; including ulcer data), both in favor of tinzaparin. Long-term LMWH may be a suitable alternative for the prevention of PTS in patients with iliac DVT who are unlikely to undergo invasive thrombolysis.

Concepts: Stroke, Thrombosis, Pulmonary embolism, Vein, Low molecular weight heparin, Anticoagulant, Deep vein thrombosis, Deep vein

26

Patients with suspected deep vein thrombosis (DVT) of the lower limb represent a diagnostic dilemma for general practitioners. Compression ultrasonography (US) is universally recognized as the best test of choice. We assessed the diagnostic accuracy of compression US performed by general practitioners given short training in the management of symptomatic proximal DVT.

Concepts: Thrombosis, Physician, Hematology, Vein, Low molecular weight heparin, Deep vein thrombosis, Deep vein, Human leg

26

Whether compression stockings are effective in the prevention of post thrombotic syndrome in patients with deep vein thrombosis remains unknown. Since the recently published SOX trial, no meta-analysis has been done to re-evaluate the available literature on whether compression stockings are beneficial in these patients. We aimed to determine the effectiveness of elastic compression stockings on preventing post thrombotic syndrome in patients with deep vein thrombosis.

Concepts: Clinical trial, Effect, Randomized controlled trial, Effectiveness, Vein, Deep vein thrombosis, Deep vein, Compression stockings

26

Venous catheters provide access for hemodialysis (HD) when patients do not have functioning access device. Obstruction of jugular, femoral or even external iliac vessels further depletes options. Subclavian approach is prohibited. Catheterization of inferior vena cava requires specialized equipment and skills.

Concepts: Central venous catheter, Femoral artery, External iliac artery, Inferior vena cava, Deep vein thrombosis, Deep vein, Superior vena cava, External iliac vein

26

Duplex ultrasound scanning (DUS) is the method of choice for diagnosis of deep vein thrombosis (DVT). However, only a few studies have performed prospective serial DUS after an acute episode of DVT to assess its evolution. This study aimed to report our experience using DUS combined with a thrombosis score (TS) and a newly proposed vein diameter variation index (VDVI) to evaluate the rate of resolution of DVT by assessing and quantifying the early stages of vein recanalization in proximal vein segments within 6 months after an episode of acute lower extremity DVT.

Concepts: Thrombosis, Hematology, Vein, Medical ultrasonography, Low molecular weight heparin, Deep vein thrombosis, Deep vein

26

Central venous catheters and peripherally inserted central catheters are widely used in children with serious chronic diseases. In this report, data about catheters and venous thromboembolic disease (VTE) in children will be reviewed, and the experience of a single academic children’s hospital will be described. Two separate data sets that examine overlapping subpopulations will be reported: (1) the proportion of pediatric patients with catheters who develop VTE and (2) the proportion of patients referred to pediatric hematology for VTE who have catheters. The limitations of current pilot data and the authors' approach to better define this problem and its prevention are discussed.

Concepts: Medicine, Blood, Medical terms, Hospital, Thrombosis, Vein, Central venous catheter, Deep vein

26

Deep venous thrombosis treatment using catheter-directed thrombolysis is advocated over systemic thrombolysis because it reduces bleeding complications. With the development of a catheter that combines ultrasound vibrations and the local delivering of thrombolytics, new and safer treatments appear that are suitable for more complex problems.

Concepts: Blood, Thrombosis, Vein, Inferior vena cava, Deep vein thrombosis, Deep vein, Thrombolysis, Superior vena cava

26

Polymorphisms of coagulation factor XIII, an A2B2 tetramer, have been reported in correlation with venous and arterial thrombotic events. As there were limited data on these polymorphisms from Iranian population, we studied the correlation of factor XIIIA-Val34Leu and factor XIIIB-His95Arg with venous thromboembolism (VTE) in central Iran. Venous blood was collected from 102 unrelated VTE patients, diagnosed as pulmonary embolism, deep vein thrombosis (DVT), and pulmonary embolism/DVT and 165 healthy persons as control group. Genotyping was performed from DNA for FXIIIA-V34L and FXIIIB-H95R by polymerase chain reaction-restriction fragment length polymorphism and data were analyzed using Statistical Package for the Social Services software. There was no difference in age among the three groups of patients and between male and female participants. 41.02% of patients versus 42.04% of controls were carriers of FXIIIA-V34L as homozygous or heterozygous. Homozygosity of 34LL was significantly lower in patients compared with control participants (OR: 0.107, 95% CI: 0.14-0.83, Pā€Š=ā€Š0.01) with only one homozygous in patients compared with 14 in the control group. Factor XIIIB-H95R was observed in 26.5% of patients versus 17.6% of control participants with no significant difference. There was no significant difference between patients and control group in homozygosity. Our findings on the frequency of FXIIIA-V34L is compatible with Caucasians. The significantly higher existence of homozygous 34LL in control participants is comparable with those who found it as protective against VTE. It may help to recognize risk factors or may contribute to prophylaxis in family members. We found FXIIIB-H95R polymorphism neutral. As there are different ethnicities in Iran, it may be beneficial to study other populations.

Concepts: Blood, Thrombosis, Warfarin, Hematology, Vein, Deep vein thrombosis, Deep vein, Iran

25

Abdominoplasty is a common plastic surgery procedure and has a higher rate of postoperative deep venous thrombosis (DVT) than any other such surgery. DVT prevention remains an important topic in the plastic surgery community. Many surgeons avoid DVT chemoprophylaxis, because they are concerned about the risk of postoperative bleeding.

Concepts: Hospital, Surgery, Hematology, Vein, Plastic surgery, Deep vein thrombosis, Deep vein, General surgery

25

Reported studies have showed that Thrombin Activatable Fibrinolysis Inhibitor (TAFI) may be associated with an increased risk of venous thromboembolism. But the relation of VT with TAFI gene SNPs could not be clearly demonstrated. Thus, we conducted a meta-analysis to analyze the associations between three TAFI variants -438G/A, 505G/A and 1040C/T and the risk of venous thrombosis.

Concepts: Genetics, Blood, Thrombosis, Warfarin, Hematology, Vein, Deep vein, Thrombin-activatable fibrinolysis inhibitor