Efficacy of modified pressure cuff for thrombolytic treatment on lower extremity deep venous thrombosis.

ABSTRACT: To compare the effectiveness and patient comfort between two methods that block superficial venous blood flow during the thrombolytic treatment of lower extremity deep venous thrombosis (DVT) to provide evidence that informs clinical choice.One hundred twenty patients with lower extremity DVT were randomly divided into sphygmomanometer (group A, n = 40), tourniquet (group B, n = 40), and control group (no blocking, n = 40). All the patients were treated with a daily dosage of urokinase using a dial sphygmomanometer cuff and tourniquet to block lower extremity superficial vein blood flow. The pressure of the dial sphygmomanometer blocking lower extremity superficial vein blood flow was measured during lower extremity venography. Leg swelling reduction rate, venous patency, thrombus removal rate, and average comfort index were observed during the blocking process.The average pressure value for group A was 70  ±â€Š10 mm Hg. The differences in the swelling reduction rate and venous patency were significant between the groups. Comparing the two groups at different time points, the average thrombus clearance rate of group A was higher than that of group B and control group. The leg pain scores of group A were lower than those of group B and control group. The postoperative comfort ratio of group A was higher than that of group B, and the proportion of severe discomfort in group A was lower than that in group B.Compared with the tourniquet, using a dial sphygmomanometer cuff to block lower extremity superficial vein blood flow achieved a better thrombolytic effect on DVT and provided higher patient comfort during treatment.

Manual aspiration thrombectomy for acute and subacute inferior vena cava thrombosis and lower extremity deep venous thrombosis.

Deep vein thrombosis (DVT), which can lead to pulmonary embolism (PE), is a major contributor to the global disease burden and is the third most common cardiovascular pathology after coronary artery disease and stroke. Venous thromboembolic disease, which encompasses the disease entities of DVT and PE, affects up to 10 million cases every year and represents a serious and potentially life-threatening condition. Standard anticoagulation therapy alone is ineffective at promoting deep venous system thrombus removal. Many patients develop postthrombotic syndrome (PTS) despite being on adequate anticoagulation therapy. Aggressive therapy for rapid thrombus removal is important to prevent the development of PTS. Besides impeding the onset of PTS, rapid clearance of the thrombus is also required in the treatment of phlegmasia cerulea dolens, an uncommon but life-threatening complication of acute DVT that can lead to arterial insufficiency, compartment syndrome, venous gangrene, and limb amputation. Manual aspiration thrombectomy (MAT) can provide rapid and effective therapy that could be compared to the open surgical thrombectomy approach with minimal risk of morbidity, mortality, or recurrence after surgery. Though many devices have been developed to date for pharmacomechanical thrombolysis, the cost of the treatment using these devices is very expensive. MAT is simple to perform, easy to learn, inexpensive, and rapid. This review will outline and dissect several studies and case reports, sourced from the PubMed database, on the subject of the use of MAT in treating inferior vena cava thrombosis and lower extremity DVT, including in patients with compression of the iliac vein and phlegmasia cerulea dolens.

Prostate Cancer Magnetic Resonance Spectroscopy Imaging at 1.5 and 3.0 T: A Meta-Analysis.

OBJECTIVE: We sought to assess the value of 1.5-T and 3-T magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer by meta-analysis. METHODS: Prospective studies were selected from MEDLINE, PubMed, Science Direct, OVID, and Springer between January 2004 and June 2014. Studies were reviewed based on Quality Assessment of Diagnostic Accuracy Studies criteria. Any publication bias was assessed using Deek funnel plot asymmetry test. Pooled sensitivities, specificities, positive likelihood ratios, negative likelihood ratios, and 95% confidence intervals were calculated. Summary receiver-operating characteristic curves were used to assess the results. RESULTS: A total of 17 articles were included in this study. The area under the curve values of 1.5-T magnetic resonance spectroscopy imaging with the use of an endorectal coil, 1.5-T magnetic resonance spectroscopy imaging without the use of an endorectal coil, and 3.0-T magnetic resonance spectroscopy imaging without the use of an endorectal coil were 0.90 ± 0.03, 0.75 ± 0.03, and 0.93 ± 0.02, respectively. CONCLUSION: Three-tesla magnetic resonance spectroscopy imaging without the use of an endorectal coil and 1.5-T magnetic resonance spectroscopy imaging with the use of an endorectal coil both had similar applied values compared to the lower applied value of 1.5-T magnetic resonance spectroscopy imaging without the use of an endorectal coil.

Lobular capillary hemangioma of the trachea.

As a polypoid form of capillary hemangioma, lobular capillary hemangioma (LCH) most commonly occurs on the cutaneous and mucosal surfaces and is frequently benign in children. Tracheal LCH is a rare benign tumor in adults, with hemoptysis being one of the most serious forms of presentation. A definite diagnosis of LCH depends on its histopathology. In clinical practice, however, radiological characteristics are an important component for making a suggestive diagnosis. We present a case of tracheal LCH and describe its features on computed tomography, pathology, and differential diagnosis. A review of the relevant literature is also provided.