Objective
: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE affects all races, age groups, and genders. The objective of this registry was to analyze the patient characteristics, clinical outcomes, management strategies, and temporal trends in VTE at a single center.
Materials and Methods
: Consecutive medical records of inpatients between January 2007 and March 2018, meeting the inclusion criteria (confirmed diagnosis of DVT by Doppler ultrasound scan and/or PE by chest computed tomography) were identified and collected. A total of 1,024 patients were reviewed.
Results
: Eight hundred and twelve patients with VTE were enrolled into the study; 37.4% were referrals from outside hospitals, 33.1% of the total patients had no risk factors, hence classified as unprovoked VTE and the rest of the patients had single or multiple risk factors which may have provoked the VTE, 68.8% presented with swelling and pain, and 88.5% had proximal DVT.
Conclusion
: VTE is no longer a rare phenomenon in the Indian population, as believed earlier. The knowledge of VTE, prophylaxis, and treatment strategies is minimal among small institutes, nursing homes, and among general practitioners who are not affiliated with teaching institutes. Therefore, educating primary care physicians/surgeons on VTE is paramount, as this would reduce the incidence of VTE in India as well as associated morbidity and mortality rates.
Pseudoaneurysm (PA) of posterior tibial artery (PTA) is not very common and that of middle one-third of PTA is rare. Endovascular treatment of symptomatic PAs has become a viable less invasive option compared to open repair. In this case report, a 64-year-old gentleman came with acute thrombosis of superficial femoral artery which was treated successfully by embolectomy. He later presented to us with increasing pain over the calf region which on duplex scan revealed us a PA of middle one-third of PTA. It was successfully managed by endovascular stenting without compromising the distal blood flow. An extensive review of the literature has also been performed.
Background To maintain the patency and longevity of arteriovenous fistula, the availability of a venous segment with adequate diameter is important. In Indian population, many chronic kidney disease patients have poor caliber veins. The study aimed to evaluate the efficacy of hydrostatic dilatation versus Primary balloon angioplasty of small caliber cephalic veins of (≤2.5 mm) preoperatively in terms of patency rate and maturation time of arteriovenous fistula. Methods Patients ( n = 80) with an end-stage renal disease requiring arteriovenous access surgery for hemodialysis with small caliber cephalic veins were randomized into two groups, i.e., hydrostatic dilatation and primary balloon angioplasty, each with 40 patients. All patients underwent a thorough clinical examination as well as duplex ultrasound vein mapping of both upper extremities. Patients were followed up for six months and primary patency, maturation time, and complications were noted. Results Immediate technical success with good palpable thrill was achieved in 97.5% of patients in the primary balloon angioplasty group and 87.5% in the hydrostatic dilatation group. The fistula maturation time in the primary balloon angioplasty group was 34.41 days and 46.18 days in the hydrostatic dilatation group. In the primary balloon angioplasty group, the primary patency of the fistula was 97.5% and 87.5% in the hydrostatic dilatation group, at six months. The arteriovenous fistula functioning rate was 77.5% in the hydrostatic dilatation group as compared to 92.5% in the primary balloon angioplasty group at six months. The incidence of surgical site infection was 5% in the primary balloon angioplasty group as compared to 10% in the hydrostatic dilatation group. Conclusion Primary balloon angioplasty of small caliber cephalic veins (≤2.5 mm) performed prior to arteriovenous fistula creation for hemodialysis is a beneficial procedure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.