Factors influencing recanalization of thrombotic venous occlusions.

Factors influencing recanalization of thrombotic venous occlusions. Vasa. 2019 May 28;:1-6 Authors: Poredoš P, Poredoš P, Jezovnik MK Abstract The outcome of a thrombotic vessel occlusion is related to the resolution of thrombus and restitution of blood flow. Thrombus formation simultaneously activates an enzymatic process that mediates endogenous fibrinolysis to maintain vessel patency. The balance between coagulation and fibrinolysis determines the extent of thrombus formation, its resolution, and clinical outcome. Endogenic fibrinolysis is frequently unable to overcome coagulation and to resolve the thrombus. Therefore, for a complete resolution of thrombus in an acute phase, exogenic fibrinolytic agents are needed. Currently, tissue plasminogen activator (tPA) is most frequently used for therapeutic thrombolysis. Also, heparins, particularly low-molecular-weight heparins and direct oral anticoagulants which are known as anticoagulant drugs, have some pro-fibrinolytic properties. Besides the extent and age of a clot, different other factors influence the lysis of thrombus. Thrombus structure is one of the most important determinants of thrombus lysis. The concentration of thrombolytic agent (tPA) around and inside of thrombus importantly determines clot lysis velocity. Further, flow-induced mechanical forces which stimulate the transport of thrombolytic agent into the clot influence thrombolysis. Inflammation most probably represents a ...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - Category: Surgery Authors: Tags: Vasa Source Type: research

Related Links:

Authors: Boucly A, Savale L, Vuillard C, Turpin M, Jaïs X, Montani D, Humbert M, Sitbon O Abstract Right ventricular failure (RVF) is a common cause of admission to the intensive care unit and its presence is a major prognostic factor in acute pulmonary embolism (PE) and chronic pulmonary hypertension (PH). RVF results from an incapacity of the RV to adapt to an increase in afterload so it can become critical in acute PE and chronic PH. The presence of RVF in cases of acute PE with haemodynamic instability is an indication for thrombolytic therapy. RVF represents the most common cause of death in chronic PH. F...
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
Publication date: Available online 17 February 2020Source: Surgery (Oxford)Author(s): Tristan E. McMillan, Timothy Gardner, Alan J. JohnstoneAbstractTourniquets have been around for many years, providing surgeons with a bloodless operative field and saving lives in the pre-hospital care of major limb trauma. However, their use does come with risk. It is therefore extremely important that we, as surgeons, fully understand the physiological influence they impose on patients, the complications associated with their use and, moreover, how to minimize the incidence of these complications. Most tourniquets are now electronically...
Source: Surgery (Oxford) - Category: Surgery Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0039-1701018Traumatic-induced coagulopathy (TIC) is often associated with significant bleeding, transfusion requirements, inflammation, morbidity, and mortality. This review considers TIC as a systems failure, not as a single-event manifestation of trauma. After briefly reviewing the meaning of TIC and the bewildering array of fibrinolysis phenotypes, we will discuss the role of platelets and fibrinogen in coagulopathy. Next, we will review the different TIC hypotheses and drill down to a single mechanistic domain comprising (1) thrombin's differential binding to thrombomodulin, (2) the e...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0040-1702170It has long been known that the fibrinolytic system becomes activated following trauma. At first glance, this is not at all surprising and would appear to be in response to coagulation and the apparent need to remove blood clots and restore blood flow. However, in a bleeding patient, the opposite is what is actually needed. Therefore, one may ask why the fibrinolytic system gets activated in the first place or is there another purpose? Or is it that the waxing and waning of hemostasis in such severely injured patients creates a “moving target” such that the fibrino...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting.Materials and methodsThis is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Radiation exposure (dose area product [DAP], air KERMA (AK) and fluoroscopy time [FT]), technical success, clinical success, complications and survival were analyzed.ResultsIn total, 29 patients had CPV...
Source: La Radiologia Medica - Category: Radiology Source Type: research
We report the case of a patient with acute CVST, showing perfusion abnormalities on computed tomography perfusion with perfusion defect in the relevant hemisphere. The defect was found in a region adjacent to the occluded sinus and was not corresponding to an arterial territory. To the best of our knowledge this is the first ever report on CT perfusion abnormalities few hours after acute symptom onset in CVST.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Tags: Case Report Source Type: research
An 85-year-old man presented with left hemiparesis, too late for any intervention. Brain computed tomography (CT) revealed a right hemispheric infarct. He had a history of diabetes mellitus (on metformin, statin), hypertension (on losartan/lercanidipine), past smoking, COPD (on inhalers) and peripheral artery disease (on aspirin).
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
Atrial fibrillation (AF) is the most common arrhythmia and is associated with increased morbidity and mortality. Its prevalence is increasing with the aging of the population and there is a clear need for more reliable diagnosis and improved therapy. Current therapeutic approaches for AF have only moderate efficacy, substantial side effects and eminent limitations due to the complex treatment of concomitant thromboembolism, cardiac ischemia and heart failure [1,2]. Sex-related differences in the prevalence, presentation, associated co-morbidities and therapy outcomes further complicate the management of this important clinical condition [3].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
This study aims to investigate the utility of TTE as part of AIS workup.Methods: We collected data on consecutive patients with AIS who were admitted to our institution between 07/01/2016 and 09/30/2017. Patients were included based on neuroimaging-documented AIS, age>18 and neuroimaging studies. Primary endpoint was the proportion of cases in which TTE yielded relevant finding, defined as Atrial Septa Defect or Patent Foramen Ovale, left atrial enlargement, left ventricular thrombus or ejection fraction of
Source: Frontiers in Neurology - Category: Neurology Source Type: research
More News: Surgery | Thrombosis