ABSTRACT
Purpose@#Isolated distal deep vein thrombosis (IDDVT) is a localized lesion; nonetheless, the risk of proximal vein propagation makes it difficult to decide on the treatment protocol—that is, whether immediate anticoagulation after diagnosis or surveillance via serial imaging should be employed. This study aimed to investigate the appropriate treatment protocol for IDDVT in kidney transplant recipient (KTR). @*Methods@#Surveillance for venous thromboembolism (VTE) was performed using duplex ultrasonography (DUS) before transplant surgery and at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year after transplant surgery. Dual mechanical prophylaxis was administered to prevent VTE. @*Results@#In total, 60 out of 829 patients (7.2%) developed VTE, with 49 cases (81.6%) of IDDVT. Among IDDVT patients, 15 patients were treated using anticoagulation-first strategy, whereas the remaining 34 patients were treated using surveillance-first strategy. No patient in either group exhibited thrombus extension into the proximal vein or recurrence within 1 year from transplant surgery. @*Conclusion@#In Korean KTR, extension of IDDVT into the proximal vein could be prevented safely and effectively by serial DUS surveillance along with the maintenance of mechanical prophylaxis. However, the patients who have high thrombus burden or are difficult to get repeated DUS require the use of anticoagulation in early stages.
ABSTRACT
Purpose@#Isolated distal deep vein thrombosis (IDDVT) is a localized lesion; nonetheless, the risk of proximal vein propagation makes it difficult to decide on the treatment protocol—that is, whether immediate anticoagulation after diagnosis or surveillance via serial imaging should be employed. This study aimed to investigate the appropriate treatment protocol for IDDVT in kidney transplant recipient (KTR). @*Methods@#Surveillance for venous thromboembolism (VTE) was performed using duplex ultrasonography (DUS) before transplant surgery and at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year after transplant surgery. Dual mechanical prophylaxis was administered to prevent VTE. @*Results@#In total, 60 out of 829 patients (7.2%) developed VTE, with 49 cases (81.6%) of IDDVT. Among IDDVT patients, 15 patients were treated using anticoagulation-first strategy, whereas the remaining 34 patients were treated using surveillance-first strategy. No patient in either group exhibited thrombus extension into the proximal vein or recurrence within 1 year from transplant surgery. @*Conclusion@#In Korean KTR, extension of IDDVT into the proximal vein could be prevented safely and effectively by serial DUS surveillance along with the maintenance of mechanical prophylaxis. However, the patients who have high thrombus burden or are difficult to get repeated DUS require the use of anticoagulation in early stages.
ABSTRACT
PURPOSE: This study aims to figure out the changes of the prevalence and management of carotid arterial occlusive diseases (CAOD), abdominal aortic diseases (AAA), and arterial diseases of the lower extremities (LAOD) in Korea over the past 5 years. METHODS: Data were extracted from the Health Insurance Review and Assessment Service during the period from 2008 to 2012. RESULTS: The number of patients with CAOD increased by about 30% every year. From the year 2008, the number of open surgeries (OS) and endovascular treatments (ET) increased by more than 20% during each of the first 2 years and by 10% every year for 3 years thereafter for CAOD. ET was preferred to OS and occupied 77%-79% of the total number of procedures. The number of patients with AAA increased by 11%-17% every year. ET for AAA occupied 52% of the total number of procedures in 2008 and gradually increased to 70% in 2012. The number of patients who were diagnosed with LAOD fluctuated over the five years. The total number of procedures to treat LAOD increased each year by 20%-25%. ET for LAOD constantly increased by 18%-24% each year and occupied 80%-95% of the total number of procedures. CONCLUSION: It is evident that the incidence of vascular diseases will be increasing as our society ages, not to mention its care costs. The need for long-range plans and guidelines are urgent.