Venous Thromboembolism

Otoya, Jorge; Nemcek, Albert A.

doi:10.1378/chest.96.5.1169

Chest

1989

DOI: 10.1378/chest.96.5.1169

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Venous Thromboembolism

Jorge Otoya

Albert A. Nemcek

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1993

2005

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Cited by 3 publications

References 19 publications

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Recurrent Pulmonary Embolism Despite Inferior Vena Cava Filter Placement in Patients With the Antiphospholipid Syndrome

Cherian

Gertner

2005

JCR: Journal of Clinical Rheumatology

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In patients at risk for pulmonary emboli, consideration is often given to placement of an inferior vena cava (IVC) filter to prevent propagation of a distal thrombus. However, long-term benefits remain controversial, and deep venous thrombosis and IVC thrombosis may result from the procedure itself. Whether a filter if beneficial or even detrimental in patients with the antiphospholipid syndrome (APS) is unclear. We reviewed clinical outcomes in 2 patients who had IVC filter placement years before the diagnosis of the APS and 1 who had a contraindication to anticoagulation. Recurrent pulmonary emboli were seen despite the presence of the filter. IVC pathology sometimes revealed thrombus both proximal and distal to the IVC filter. Pulmonary emboli in the APS may be secondary to deep venous thrombosis (DVT). They may also occur secondary to a cardiac source or in situ thrombosis in the pulmonary vessels. An IVC filter will not be of benefit if the heart or the lungs are the primary source for the emboli. It may also not protect against propagation of a more distal thrombus if collateral vessels develop around the filter or a thrombus is present on the proximal side of the filter. Recurrence of pulmonary emboli after a filter placement should alert the clinician to the possibility of a hypercoagulable state such as APS. Clinicians need to assess risks and benefits carefully before placing a permanent IVC filter in patients with APS. Whether a temporary or retrievable filter is safer in APS and more effective is unknown at the present time.

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Recurrent Pulmonary Embolism Despite Inferior Vena Cava Filter Placement in Patients With the Antiphospholipid Syndrome

Cherian

Gertner

2005

JCR: Journal of Clinical Rheumatology

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Pulmonary Thromboembolism in Dogs

Keyes

Rush

Knowles

1993

J Vet Emergen Crit Care

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Pulmonary thromboembolism (PTE) is an infrequently diagnosed complication of many systemic diseases including heartworm disease, glomerulopathy leading to the nephrotic syndrome, immune‐mediated hemolytic anemia, hyperadrenocorticism, pancreatitis, neoplasia, and sepsis. Acute, unexplained dyspnea in a patient with minimal abnormalities on thoracic radiographs should prompt consideration of this diagnosis. Confirmation requires ventilation‐perfusion radionuclide scanning or selective pulmonary angiography. Treatment includes cage rest, anticoagulant therapy with heparin and warfarin, correction of the underlying disorder, and supportive care. Clinicians should be prepared to treat hemorrhage associated with anticoagulant therapy. Recombinant tissue plasminogen activator may prove useful as a thrombolytic in the treatment of animals suffering massive PTE, but is, at present, expensive.

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Lethal Pulmonary Embolism in a Patient With Primary Antiphospholipid Syndrome and a Vena Caval Filter

Lee

Laya

1994

Chest

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Venous Thromboembolism

Cited by 3 publications

References 19 publications

Recurrent Pulmonary Embolism Despite Inferior Vena Cava Filter Placement in Patients With the Antiphospholipid Syndrome

Recurrent Pulmonary Embolism Despite Inferior Vena Cava Filter Placement in Patients With the Antiphospholipid Syndrome

Pulmonary Thromboembolism in Dogs

Lethal Pulmonary Embolism in a Patient With Primary Antiphospholipid Syndrome and a Vena Caval Filter

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