Deep Vein Thrombosis Research Today is a free monthly online journal that collates and summarizes the latest research about Deep Vein Thrombosis, including details on dvt, prevention, effects, causes, air travel, blood clots. | ||||||
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Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial., Dennis M, Sandercock PA, Reid J, Graham C, Murray G, Venables G, Rudd A, Bowler G Division of Clinical Neurosciences, University of Edinburgh, Bramwell Dott Building, Western General Hospital, Edinburgh EH4 2XU, UK. martin.dennis@ed.ac.uk BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism are common after stroke. In small trials of patients undergoing surgery, graduated compression stockings (GCS) reduce the risk of DVT. National stroke guidelines extrapolating from these trials recommend their use in patients with stroke despite insufficient evidence. We assessed the effectiveness of thigh-length GCS to reduce DVT after stroke. METHODS: In this outcome-blinded, randomised controlled trial, 2518 patients who were admitted to hospital within 1 week of an acute stroke and who were immobile were enrolled from 64 centres in the UK, Italy, and Australia. Patients were allocated via a central randomisation system to routine care plus thigh-length GCS (n=1256) or to routine care plus avoidance of GCS (n=1262). A technician who was blinded to treatment allocation undertook compression Doppler ultrasound of both legs at about 7-10 days and, when practical, again at 25-30 days after enrolment. The primary outcome was the occurrence of symptomatic or asymptomatic DVT in the popliteal or femoral veins. Analyses were by intention to treat. This study is registered, number ISRCTN28163533. FINDINGS: All patients were included in the analyses. The primary outcome occurred in 126 (10.0%) patients allocated to thigh-length GCS and in 133 (10.5%) allocated to avoid GCS, resulting in a non-significant absolute reduction in risk of 0.5% (95% CI -1.9% to 2.9%). Skin breaks, ulcers, blisters, and skin necrosis were significantly more common in patients allocated to GCS than in those allocated to avoid their use (64 [5%] vs 16 [1%]; odds ratio 4.18, 95% CI 2.40-7.27). INTERPRETATION: These data do not lend support to the use of thigh-length GCS in patients admitted to hospital with acute stroke. National guidelines for stroke might need to be revised on the basis of these results. FUNDING: Medical Research Council (UK), Chief Scientist Office of Scottish Government, Chest Heart and Stroke Scotland, Tyco Healthcare (Covidien) USA, and UK Stroke Research Network. Published 8 June 2009 in Lancet, 373(9679): 1958-65. Articles on Deep Vein Thrombosis published 2 June 2009: The role of thrombosis as a mechanism of exacerbation in venous and combined venous lymphatic vascular malformations of the orbit. Ophthalmology, 116(6): 1216-24. PURPOSE: To describe venous thrombosis as a mechanism of clinical change in venous and combined venous lymphatic malformations of the orbit and to attempt histopathologically to distinguish the various vascular components of these lesions using immunohistochemistry with CD31 and D2-40 antibodies. DESIGN: Retrospective, comparative, interventional case series. PARTICIPANTS: Twelve patients with clinically and radiologically well-documented episodes of thrombosis in venous malformations (n = 7; ... [Abstract] [Full-text] Articles on Deep Vein Thrombosis published 29 May 2009: Cancer and thrombosis: back to the future renewed interest in an old problem. Cancer Invest, 27(5): 472-3. Cancer patients are at increased risk for thromboembolic complications due to the release of procoagulants, compression or invasion of blood vessels and the reduced mobility associated with cancer and cancer treatment. This has led to recommendations for thromboprophylaxis in hospitalized medical and surgical cancer patients and extended prophylaxis in cancer patients experiencing a venous thromboembolism. Routine prophylactic anticoagulation is not currently recommended in ambulatory cancer ... [Abstract] [Full-text] Articles on Deep Vein Thrombosis published 27 May 2009: The presence of JAK2V617F mutation in the liver endothelial cells of patients with Budd-Chiari syndrome. Blood, 113(21): 5246-9. Patients with myeloproliferative disorders are at a high risk of developing thrombotic events. Several investigators have hypothesized that endothelial cell (EC) abnormalities might contribute to this prothrombotic state. Budd-Chiari syndrome (BCS) and portal vein thrombosis have been reported to be associated with JAK2V617F-positive hematopoiesis. We explored whether JAK2V617F was present in ECs in the vessels of polycythemia vera (PV) patients with BCS using laser capture microdissection ... [Abstract] [Full-text] Retinal vein occlusion and the risk of acute myocardial infarction (correction of infraction): a 3-year follow-up study. Br J Ophthalmol, 93(6): 717-20. AIM: Using a nationwide population-based dataset, this study investigated the relationship between retinal vein occlusion (RVO) and subsequent acute myocardial infarction (AMI). METHODS: This study is based on a nationwide database released by the Taiwan National Health Research Institute. The study cohort consisted of all ambulatory care patients who were diagnosed as having RVO during 2000 approximately 2003 (n = 591), while the control cohort comprised 2955 randomly selected patients ... [Abstract] [Full-text] Selective testing for thrombophilia in patients with first venous thrombosis: results from a retrospective family cohort study on absolute thrombotic risk for currently known thrombophilic defects in 2479 relatives. Blood, 113(21): 5314-22. Thrombophilia screening is controversial. In a retrospective family cohort, where probands had thrombosis and a thrombophilic defect, 2479 relatives were tested for thrombophilia. In antithrombin-, protein C-, and protein S-deficient relatives, annual incidences of venous thrombosis were 1.77% (95% CI, 1.14-2.60), 1.52% (95% CI, 1.06-2.11), and 1.90% (95% CI, 1.32-2.64), respectively, at a median age of 29 years and a positive family history of more than 20% symptomatic relatives. In relatives ... [Abstract] [Full-text] Articles on Deep Vein Thrombosis published 26 May 2009: "A forgotten disease": a case of Lemierre syndrome. ScientificWorldJournal, 9: 331-2. Lemierre's syndrome is a rare but a life threatening condition which affects young healthy individuals, was first described by Dr.Andre Lemierre in 1936. Incidence rates are between 0.6 and 2.3 per million population. It is found more commonly in males, with a male to female ratio of approximately 2:1. Its pathogenesis consists of the development of infectious thrombophlebitis in the internal jugular vein or one of its branches caused by a focal sepsis, mostly localized in the oropharynx, ... [Abstract] [Full-text] Asymptomatic lower extremity deep venous thrombosis resulting in fibula free flap failure. Laryngoscope, 119(6): 1085-7. OBJECTIVES/HYPOTHESIS: The successful harvest and transplant of a fibular flap depends on many factors, including healthy inflow and outflow systems. A contraindication to harvesting a fibular flap is disease of the lower extremity arterial system; therefore, preoperative evaluation of the arterial system is routine. Preoperative evaluation of the venous system is not routine, unless there is clinical suspicion of venous disease. METHODS: Retrospective chart review. RESULTS: Two cases of occult ... [Abstract] [Full-text] Articles on Deep Vein Thrombosis published 21 May 2009: Inferior vena cava ligation rapidly induces tissue factor expression and venous thrombosis in rats. Arterioscler Thromb Vasc Biol, 29(6): 863-9. OBJECTIVE: Although stasis is important in the pathogenesis of deep vein thrombosis (DVT), how it contributes to thrombogenesis is largely unknown. To gain mechanistic insight, we used a rat model of inferior vena cava (IVC) ligation. METHODS AND RESULTS: Rats were subjected to IVC ligation for 15 to 60 minutes. Ligation resulted in rapid IVC dilatation and by 60 minutes, thrombi were detected in all rats. Small thrombi were detected in the IVC of most rats after 15 minutes of ligation. Thrombi ... [Abstract] [Full-text] © 2004-2009 Deep Vein Thrombosis Research Today. 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