Identificação pelo eco-Doppler colorido de fístula arteriovenosa na trombose venosa profunda

Barros, Fanilda Souto; Pontes, Sandra Maria; Silva, Wanderley de Paula e; Prezotti, Bruno Bourguinon; Sandri, João Luiz

doi:10.1590/s1677-54492006000300012

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…A recanalização da trombose venosa é um processo complexo, envolvendo mecanismos de fibrinólise intrínseca e extrínseca, fragmentação periférica, neovascularização e retração do trombo. 134,143,144 Tais dados têm sido confirmados por estudos por meio do uso da USV, que demonstraram a regressão do trombo nos três primeiros meses, podendo ocorrer recanalização completa na metade dos pacientes dentro de 6 a 9 meses após o episódio de TVP. 8,145 A recanalização parcial e a persistência do segmento ocluído ocorrem em cerca de 20% e 5% dos casos, respectivamente 146 (Figura 21A).…”

Section: Recanalizaçãounclassified

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Diretriz Conjunta sobre Tromboembolismo Venoso – 2022

Albricker¹,

Freire²,

Santos³

et al. 2022

Arquivos Brasileiros De Cardiologia

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Section: Recanalizaçãounclassified

“…A observação de imagens de pequenos vasos tortuosos identificados pelo mapeamento de fluxo em cores e Doppler pulsado, no interior do trombo e adjacente à parede venosa, sugerem a presença de neovascularização no complexo processo de recanalização 134,143 (Figura 21B).…”

Section: Recanalizaçãounclassified

Diretriz Conjunta sobre Tromboembolismo Venoso – 2022

Albricker¹,

Freire²,

Santos³

et al. 2022

Arquivos Brasileiros De Cardiologia

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“…Labropoulos et al studied the remodeling process in veins of the calf and found that length, lysis patterns and the location of thrombi are all factors that affect this process 31 . Furthermore, Labropoulos et al, and Barros et al have observed flow patterns that fit the profile of arteriovenous fistulae (AVF) in the thrombus interior as part of neovascularization after acute DVT episodes 32,33 . The spontaneous arterial flow that can be identified by color duplex mapping of thrombosed veins during the first weeks after an acute event appears to be secondary to the inflammation and neovascularization that occur after formation and remodeling of a thrombus 32 .…”

Section: Recanalization and Neoangiogenesismentioning

confidence: 98%

Recanalization after acute deep vein thrombosis

2013

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The process of recanalization of the veins of the lower limbs after an episode of acute deep venous thrombosis is part of the natural evolution of the remodeling of the venous thrombus in patients on anticoagulation with heparin and vitamin K inhibitors. This remodeling involves the complex process of adhesion of thrombus to the wall of the vein, the inflammatory response of the vessel wall leading to organization and subsequent contraction of the thrombus, neovascularization and spontaneous lysis of areas within the thrombus. The occurrence of spontaneous arterial flow in recanalized thrombosed veins has been described as secondary to neovascularization and is characterized by the development of flow patterns characteristic of arteriovenous fistulae that can be identified by color duplex scanning. In this review, we discuss some controversial aspects of the natural history of deep vein thrombosis to provide a better understanding of its course and its impact on venous disease.Keywords: venous thrombosis; ultrasonography Doppler color; review literature as topic. ResumoO processo de recanalização das veias dos membros inferiores, após um episódio de trombose venosa profunda aguda em pacientes anticoagulados com heparina e inibidores da vitamina K, faz parte da evolução natural da remodelagem do trombo venoso. Esse complexo processo de remodelagem envolve a adesão do trombo à parede da veia, à resposta inflamatória da parede do vaso, levando à organização e subsequente contração do trombo, à neovascularização e à lise espontânea de áreas no interior do trombo. A presença de fluxo arterial espontâneo em veias com trombose recanalizada tem sido descrita como secundária à neovascularização e se caracteriza pelo desenvolvimento de fluxo com padrão de fístulas arteriovenosas, identificadas por meio de mapeamento dúplex colorido. Nesta revisão, são discutidos alguns aspectos controversos da história natural da trombose venosa profunda, para uma melhor compreensão da sua evolução e do seu impacto sobre a doença venosa.Palavras-chave: trombose venosa; ultrassonografia Doppler em cores; literatura de revisão como assunto.

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“…23 Sasajima et al studied deep venous arterialization in mice, showing that rupture of the valves at the level of the femoral vein was accompanied by an increase in skin temperature in the region of the hip and thigh and at the knee joint. They also showed that hyperthermia of the distal extremity only occurred when the valves in the popliteal vein were ruptured.…”

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confidence: 99%

Isquemia e reperfusão por circulação retrógrada: estudo comparativo experimental

et al. 2017

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Background: There are few options for treating critical ischemia in limbs with no distal patency. Diverting flow through the venous circulation is an option supported by evidence from numerous published studies. Objectives: To compare the behavior of clinical and laboratory variables between the hind limbs of pigs subjected to ischemia and to ischemia with reperfusion by retrograde circulation and between these intervention groups and a control group. Methods: Ten pigs were divided into 2 groups. In group 1 (n=5), controls, patterns of physiological variables such as flow according to Doppler ultrasound, temperature, blood gas analysis results, lactate, creatine kinase, and blood pressure were evaluated. In group 2 (n=5), after an initial ischemia period with mean duration of 27 minutes and 30 seconds, provoked by interrupting flow through the femoral arteries, the animals were subjected to venous arterialization of the left hind limb while the right hind limb was maintained in ischemia. Variables were analyzed separately for each hind leg at 0, 2, 3, 4, and 6 hours after reperfusion and compared against each other and the control group. Results: Analysis of variables from both procedures showed decreases in BE and PO 2 and significant increases in lactate and creatine kinase, in relation to the control group. In arterialized ischemic limbs, we observed flow on Doppler ultrasound, and arterial pressures and temperatures were higher than in the ischemic limbs. Conclusions: Comparative analysis of the extremities in ischemia and arterialized ischemia showed, in relation to the control group, metabolic acidosis with significant increases in lactate and creatine kinase, suggesting cellular damage, and there were signs of retrograde reperfusion in arterialized extremities.

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Identificação pelo eco-Doppler colorido de fístula arteriovenosa na trombose venosa profunda

Cited by 3 publications

References 6 publications

Diretriz Conjunta sobre Tromboembolismo Venoso – 2022

Diretriz Conjunta sobre Tromboembolismo Venoso – 2022

Recanalization after acute deep vein thrombosis

Isquemia e reperfusão por circulação retrógrada: estudo comparativo experimental

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