Thrombosis and Embolism: from Research to Clinical Practice

Name: Thrombosis and Embolism: from Research to Clinical Practice | Volume 1
Brand: Springer
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Volume 1

Md. Shahidul Islam(Herausgeber*in)

Springer (Verlag)

1. Auflage

Erschienen am 25. November 2016

IX, 429 Seiten

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978-3-319-22108-3 (ISBN)

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Inhalt

Intro
Preface
Contents
The Prevention of Venous Thromboembolism in Surgical Patients
1 Introduction
2 Pharmacological Thromboprophylaxis
3 Low-Molecular Weight Heparin (LMWH)
4 Fondaparinux
5 Low Dose Un-Fractioned Heparin (UFH)
6 Dabigatran
7 Rivaroxaban
8 Apixaban
9 Mechanical Thromboprophylaxis
10 Graduated Compression Garments
11 Intermittent Pneumatic Compression Devices (IPC)
12 Electrical Stimulation
13 Surgical Specialities and Optimal Duration of VTE Prophylaxis
14 Summary
References
Thromboembolic Prophylaxis for Morbidly Obese Patients Undergoing Bariatric Surgery
1 Introduction
2 Morbid Obesity as Risk Factor
3 Laparoscopic Bariatric Surgery
4 Clinical Manifestations and Diagnosis
5 Antithromboembolic Prophylaxis (Primary Prophylaxis)
6 Screening for Asymptomatic Venous Thromboembolism (Secondary Prophylaxis)
7 Summary and Recommendations
References
The Use of Surgical Care Improvement Projects in Prevention of Venous Thromboembolism
1 Introduction
2 The World Health Organization Surgical Safety Checklist
3 The American College of Surgeons National Surgical Quality Improvement Program
4 The Surgical Care Improvement Project
5 The Surgical Patient Safety System
6 The NICE Guideline
7 Comments and Conclusion
References
The Diagnosis and Management of Early Deep Vein Thrombosis
1 Introduction
2 Pathophysiology
3 Diagnosis of DVT
3.1 The Wells Score
3.2 Duplex Ultrasound
3.3 D-Dimer Test
3.4 Venography
4 Management of Early DVT
4.1 Anticoagulation
4.2 Post Thrombotic Syndrome
4.3 Severe or Complicated DVT
4.4 Unprovoked DVT
5 Alternative Causes of Acute leg Swelling
5.1 Chronic Venous Insufficiency (CVI)
5.2 Lymphedema
5.3 Cellulitis
5.4 Musculo-Skeletal
6 Conclusion
References
Symptomatology, Clinical Presentation and Basic Work up in Patients with Suspected Pulmonary Embolism
1 Introduction
2 Identification of the Patient with Possible Pulmonary Embolism
2.1 Overall Clinical Presentation
2.2 Symptoms
2.3 Clinical Findings
2.4 Differential Diagnosis
2.5 Risk Factors for PE
2.6 PE in Different Medical Specialties
3 Basic Work Up
3.1 Arterial Gas Analysis
3.2 Chest X-Ray
3.3 ECG
3.4 Biochemical Analyses
4 Compilation of History, Symptoms, Clinical Findings and Basic Workup
4.1 The Wells Score
4.2 The Geneva and Revised Geneva Score
4.3 Practical Impact of the Clinical Probability Scoring Systems
4.4 Limitations of the Clinical Probability Scores
4.5 Risk Stratification
5 Conclusions
References
Radionuclide Diagnosis of Pulmonary Embolism
1 Introduction
1.1 Tracers and Imaging Technique
2 The Value of Planar V/Q-Scan in Suspected Pulmonary Embolism
2.1 Later Modifications of Planar V/Q Scan Interpretations
2.2 Additional Interpretive Pitfalls
3 The Value of SPECT V/Q-Scan in Suspected Pulmonary Embolism
3.1 Controversies
4 Radionuclide Molecular Imaging of Pulmonary Embolism
4.1 Positron Emission Tomography/Computer Tomography (PET/CT)
5 Concluding Summary
References
Thrombolytic Therapy by Tissue Plasminogen Activator for Pulmonary Embolism
1 Introduction
2 Indications for Systemic Treatment by Thrombolytic Agents in PE
3 Contraindications for Thrombolysis
4 Benefits of Thrombolytic Therapy and the Risks of Bleeding Complications
5 Thrombolytic Drugs
6 Administration of Thrombolytic Drugs
7 Care of the Patients During and After Thrombolysis
8 Treatment After Thrombolysis
9 Thrombolysis for PE During Pregnancy
10 Complications of Thrombolysis
11 Unsuccessful Thrombolytic Therapy
12 Final Remarks
References
Surgical Treatment of Acute Massive Pulmonary Embolism
1 Definition
2 History
3 Epidemiology
4 Pathology, Physiology and Pathogenesis
5 Natural History
6 Clinical Presentation
7 Diagnosis
8 Surgical Indications
9 Embolectomy
10 Technique of Operation
10.1 Preoperative Management
10.2 Surgery
10.3 Postoperative Management
10.4 Mechanical Circulatory Support in PE
10.5 Inferior Vena Cava Filters
11 Results
12 Summary
References
The Optimal Duration of Anticoagulation in Patients with Unprovoked Venous Thromboembolism
1 Baseline Risk Factors for VTE Recurrence
1.1 Provoked Versus Unprovoked VTE
1.2 Clinical Characteristics
1.3 Modality of VTE Presentation
2 Inherited Thrombophilia and Family History
3 Post-Baseline Factors
3.1 D-Dimer
3.2 Post-Thrombotic Syndrome
3.3 Residual Vein Thrombosis
4 Risk Stratification Models
5 Duration of Treatment in Patients with Unprovoked VTE: Old and New Scenarios
6 New Opportunities
6.1 New Oral Anticoagulants
6.2 Low-Dose Aspirin
6.3 Statins
7 Conclusions
References
Anticoagulation Therapy in Patients with Chronic Kidney Disease
1 Introduction
2 Definition and Stages of CKD
3 Heparin-Induced Thrombocytopenia in CKD
4 Indirect Thrombin Inhibitors
4.1 Unfractionated Heparin
4.1.1 Structure and Mechanism of Action
4.1.2 Pharmacokinetics
4.1.3 Dosing
4.1.4 Monitoring
4.1.5 Clinical Practice
4.2 Low-Molecular-Weight Heparin
4.2.1 Structure and Mechanism of Action
4.2.2 Pharmacokinetics
4.2.3 Dosing
4.2.4 Monitoring
4.2.5 Clinical Practice
4.3 Fondaparinux
4.3.1 Structure and Mechanism of Action
4.3.2 Pharmacokinetics
4.3.3 Dosing
4.3.4 Monitoring
4.3.5 Clinical Practice
5 Parenteral Direct Thrombin Inhibitors
6 Oral Anticoagulants
6.1 Warfarin
6.1.1 Structure and Mechanism of Action
6.1.2 Pharmacokinetics
6.1.3 Clinical Practice
7 Novel Oral Anticoagulants
8 Summary and Recomendations
References
Cancer-Associated Thrombosis: Regulatory Mechanisms and Emerging Directions
1 Introduction
2 Cancer-Associated Thrombus Formation
2.1 Clinical and Future Perspectives
3 Cancer-Associated Thrombus Resolution
3.1 Clinical and Future Perspectives
4 Conclusions
References
The Treatment of Venous Thromboembolism in Patients with Cancer
1 Introduction
2 Initial Treatment
2.1 Intracaval Filters
2.2 Thrombolytic Treatment
2.3 Anticoagulant Therapy
3 Long-Term Anticoagulation
4 Treatment of Challenging Situations
4.1 Management of Recurrent VTE Despite Anticoagulation
4.2 Management of Cancer-Associated VTE in Patients with Thrombocytopenia
4.3 Management of Cancer-Associated VTE in Patients Who Are Bleeding
5 The Potential of the New Oral Anticoagulants
6 Management of Incidentally Detected Isolated PE
7 Treatment of Catheter-Related Thrombosis
8 Impact of Antithrombotic Drugs on Cancer Evolution
9 Conclusions
References
The Role of New Oral Anticoagulants (NOACs) in Cancer Patients
1 Introduction
2 Cancer Related VTE Risk Factors
3 Challenges of Anticoagulation in Patients with VTE
4 Current Management of VTE
5 New Oral Anticoagulants (NOACs)
6 Treatment of Acute VTE in Patients with Cancers
6.1 Acute Management of Cancer Related VTE
6.2 Extended Treatment of Cancer Related VTE
6.3 Anticoagulant Therapy in Patients with Recurrence of VTE
7 Venous Thromboprophylaxis in Patients with Cancers
7.1 Ambulatory Cancer Patients Undergoing Chemotherapy
7.2 Cancer Patients Undergoing Surgery
7.3 Extended Thromboprophylaxis in Cancer Patients Undergoing Surgery
7.4 Hospitalised Non-Surgical Patients
7.5 Cancer Patients with Indwelling Central Venous Catheter
8 Future Perspectives of NOACs in the Prevention and Treatment of VTE in Cancer Patients
9 Conclusion
References
Venous Thromboembolic Disease in Children and Adolescents
1 Venous Thrombosis
2 Epidemiology
3 Developmental Hemostasis
4 Risk Factors
5 Clinical Presentation
6 Evaluation of Suspected Thrombosis
7 Diagnostic Laboratory Studies
8 Evaluation of Inherited Thrombophilia
9 Therapy
10 Anticoagulant Therapy
11 Anticoagulant Medications
12 Newer Anticoagulants
13 Thrombolysis
14 Inferior Vena Cava (IVC) Filters
14.1 Thrombectomy
15 VTE Prophylaxis
16 Infancy
17 Central Venous Catheter (CVC) Use in Children
18 Pediatric Malignancy
19 Pulmonary Embolism
20 Conclusions
Literature Cited
Deep Vein Thrombosis in Intensive Care
1 How Many Deep Vein Thrombosis in ICU?
2 The Difference Between Prevalence and Incidence of DVT in ICU
3 Criticism About Clinical and Ultrasound Diagnosis of DVT in ICU
4 Does Differentiating Between Symptomatic and Asymptomatic DVT in ICU Have Sence?
5 What About CVC-Related Thrombosis?
6 What Is Important to Know About DVT Incidence in ICU?
6.1 Risk Factors for DVT in ICU
7 DVT Risk Assessment Model in ICU-One for Each ICU?
7.1 DVT Prophylaxis in ICU
8 Heparin Thromboprophylaxis in High Risk Subgroups
8.1 Sepsis
8.2 Renal Failure
9 What About Obesity?
10 When the Bleeding Risk Is Not Acceptable for Prophylaxis-Major Bleeding
11 Only Heparin as Anticoagulant for DVT Prophylaxis in ICU?
12 Doubts on the Role of Mechanical Thromboprophylaxis in ICU Patients
13 Strategies to Improve Thromboprophylaxis Compliance in ICU
14 Additional Problems Due to the Increased Dosage of Heparin from Prophylaxis to Therapy
15 Key Messages
References
Cerebral Venous Thrombosis
1 Introduction
2 Objectives
3 Epidemiology
4 Anatomy and Pathophysiology
5 Risk Factors
6 Symptoms and Signs
7 Diagnosis
8 Treatment
8.1 Anticoagulation
8.2 Endovascular Treatment
8.3 Decompressive Surgery
8.4 Steroids
9 Complications
9.1 Seizures
9.2 Hydrocephalus
9.3 Intracranial Hypertension
10 Prognosis
11 Conclusion
References
Endovascular Treatment of Thrombosis and Embolism
1 Endovascular Treatment of Deep Venous Thrombosis
1.1 Endovascular Interventional Options for Deep Vein Thrombosis
1.1.1 Catheter-Directed Thrombolysis (CDT) for DVT
1.1.2 Pharmacomechanical Catheter-Directed Thrombolysis
1.1.3 Percutaneous Mechanical Thrombectomy
1.1.4 Percutaneous Aspiration Thrombectomy
2 Endovascular Treatment of Acute Stroke
2.1 Primary Management of Acute Stroke Patients
2.2 Endovascular Therapy
2.2.1 Intraarterial Fibrinolysis
2.2.2 Mechanical Thrombectomy
3 Endovascular Treatment Cerebral Venous and Sinus Thrombosis
3.1 Radiological Work-up
3.2 Medical Management
3.3 Endovascular Treatment
References
Venous Thromboembolism in Brain Tumor Patients
1 Introduction
2 Epidemiology of VTE
3 Pathogenesis of VTE in Patients with Brain Tumors
4 Presenting Signs and Symptoms
5 Prophylaxis and Treatment
5.1 Pharmacological Prophylaxis
5.2 Mechanical Prophylaxis
5.3 Combined Prophylaxis
5.4 Timing of Prophylaxis
5.5 Treatment for VTE
5.6 Clinical Recommendations for VTE Prophylaxis
6 Conclusion
7 Key Points
References
Portal Vein Thrombosis: Recent Advance
1 Introduction
2 Epidemiology
3 Etiology
4 Prevention
5 Treatment
5.1 Anticoagulation in Non-Cirrhotic Patients with PVT
5.2 Anticoagulation in Cirrhotic Patients With PVT
5.3 Thrombolysis
5.4 Transjugular Intrahepatic Portosystemic Shunt
5.5 Percutaneous Transhepatic/Transsplenic Balloon Angioplasty and Stent-Placement
5.6 Rex Shunt Surgery
6 Prognosis
7 Conclusion
References
Portal Vein Thrombosis After Splenic and Pancreatic Surgery
1 Introduction
2 Portal Vein Thrombosis After Splenic Surgery
2.1 Epidemiology
2.2 Risk Factors
2.3 Clinical Manifestations and Diagnosis
2.4 Prophylaxis
3 Portal Vein Thrombosis After Pancreatic Surgery and Pancreatic Diseases
3.1 Pancreas Transplantation
3.1.1 Thrombosis
Diagnosis
Treatment of Venous Thrombosis
3.2 Pancreatoduodenectomy (Whipple Procedure)
3.3 Distal Pancreatectomy
3.4 Pancreatitis
3.4.1 Splenic Thrombosis
3.4.2 Splenoportal Thrombosis
3.4.3 Mesenteric Thrombosis
References
Genetic Risk Factors in Venous Thromboembolism
1 Introduction
2 Historical Perspective
3 Classification
4 Factor V Leiden
4.1 Gene Mutation (Gene Symbol/Chromosome Locus: Factor V Leiden: F5
1q23)
4.2 Prevalence in Healthy Population and VTE
4.3 Clinical Implication
4.4 Practical Aspects
5 Prothrombin G20210A
5.1 Gene Mutation (Gene Symbol/ Chromosome Locus: Factor II: F2
11p11-q12)
5.2 Prevalence in Healthy Populations and VTE
5.3 Clinical Implication
5.4 Practical Aspects
6 Protein C (PC) Deficiency
6.1 Gene Mutations
6.2 Prevalence in General Population and VTE
6.3 Clinical Implication
6.4 Practical Aspects
7 PS Deficiency
7.1 Gene Mutations
7.2 Prevalence in Healthy Populations and VTE
7.3 Clinical Implications
7.4 Practical Aspects
8 Antithrombin Deficiency (or AT III Deficiency)
8.1 Gene Mutations
8.2 Prevalence in Healthy Populations and VTE
8.3 Clinical Implications
8.4 Practical Aspects
9 MTHFR Polymorphisms
9.1 Gene Mutations
9.2 Prevalence in Healthy Population and VTE
9.3 Clinical Implication
9.4 Practical Aspects
10 Antiphospholipidic Syndrome
10.1 Gene Mutations
10.2 Prevalence in Healthy Populations and VTE
10.3 Clinical Implications
10.4 Practical Aspects
11 Guidelines Regarding Thrombophilia
References
Venous and Arterial Thrombosis: Is There a Link?
1 Introduction
2 Generation of the Hypothesis
3 Association Between VTE and Atherosclerosis
4 Risk Factors of Atherosclerosis and Venous Thromboembolism
5 Nature of the Association
6 Is Atherosclerosis Predictive of VTE?
7 Is VTE Predictive of Arterial Cardiovascular Events?
8 Implications of the Association
References
Thrombosis and von Willebrand Factor
1 Introduction
2 VWF Gene
3 VWF Biosynthesis
3.1 Synthesis of vWF in Endothelial Cells
3.2 Synthesis of vWF in Platelet
4 VWF Structure
5 VWF Function
5.1 VWF and Neutrophil Extracellular Traps (NETs)
6 Factors Influencing vWF Levels and Activity
6.1 VWF and Blood Group
6.1.1 Updated and Theoretical Rationale for vWF and ABO Interaction
6.2 VWF and Aging
6.3 The Role of a Disintegrin-Like and Metalloprotease with ThromboSpondin Type I Repeats-13 (ADAMTS13)
7 Plasma vWF Versus Platelet vWF
8 VWF and Shear Stress
9 Von Willebrand Factor and Thrombosis
9.1 Von Willebrand Factor and Thrombotic Thrombocytopenic Purpura (TTP)
9.1.1 TTP Pathological Mechanisms and Recent Insights
9.1.2 TTP Subgroups
Congenital TTP
Drug-Related TTP
TTP and Pregnancy
9.1.3 TTP Diagnosis Based on the Patient´s History and Following Parameters
Management and Treatment
10 Von Willebrand Disease (vWD)
10.1 Von Willebrand Disease and Thrombosis
10.2 History, Signs, and Symptoms
10.3 The Laboratory Diagnosis of vWD
10.4 VWD Treatment
11 VWF Multimers and Thrombotic Events
12 How to Manage vWF Fluctuations
12.1 Effectors and Inhibitors of vWF
12.1.1 Inhibiting the vWF Activity as a Novel Treatment
13 Summary
Uncategorized References
Role of P2Y12 Receptor in Thrombosis
1 Introduction of Platelet P2Y Receptors: P2Y1 and P2Y12
2 Molecular Mechanisms and Effects of P2Y12 Receptor Signaling
2.1 Biochemistry Structure
2.2 Agonists and Antagonists
2.3 Signal Transductions
2.3.1 Major Pathways
2.3.2 Pathways in Platelet Activation
Platelet Aggregation
Platelet Shape Change
Platelet Granule Release
Thrombus Growth and Stability
2.3.3 Pathways in Platelet Apoptosis
2.3.4 Pathways in Inflammation and Immunity
3 Abnormalities of P2Y12 Receptors
3.1 P2Y12 Gene Polymorphisms
3.2 Congenital Deficiency of P2Y12 Receptor
3.3 P2Y12 Receptor Abnormal Expression in Diseases
3.3.1 Diabetes Mellitus
3.3.2 Chronic Kidney Disease
4 Antiplatelet Drugs Targeting P2Y12 Receptor
4.1 Thienopyridines
4.1.1 Ticlopidine
Pharmacodynamics and Pharmacokinetics
Side Effect
Clinical Application
4.1.2 Clopidogrel
Pharmacodynamics and Pharmacokinetics
Clinical Application
Side Effects
4.1.3 Prasugrel
Pharmacodynamics and Pharmacokinetics
Clinical Application
Side Effects
4.2 P2Y12 Receptor Direct Antagonists
4.2.1 Ticagrelor
Pharmacodynamics and Pharmacokinetics
Clinical Application
Side Effects
4.2.2 Cangrelor
Pharmacodynamics and Pharmacokinetics
Clinical Application
Side Effects
4.2.3 Elinogrel
Pharmacodynamics and Pharmacokinetics
Clinical Application
Side Effects
4.3 P2Y12 Receptor Inverse Agonists
4.4 New Dual Antiplatelet Agent
5 Conclusion and Prospective
References
Proton Pump Inhibitors in Cardiovascular Disease: Drug Interactions with Antiplatelet Drugs
1 Introduction
2 Aspirin: Pharmacology and Clinical Use
2.1 Pharmacology
2.2 Clinical Use
3 ADP Receptor Antagonists: Pharmacology and Clinical Use
3.1 Pharmacology
3.2 Clinical Use
4 Antiplatelet Treatment and Gastrointestinal Bleeding
5 Proton Pump Inhibitors: Pharmacology and Clinical Use
6 Biochemical Background for Putative Drug Interactions Between Proton Pump Inhibitors and Antiplatelet Drugs
7 Interactions Between Proton Pump Inhibitors and Aspirin
8 Interaction Between Proton Pump Inhibitors and Clopidogrel
8.1 Pharmacological Studies
8.2 Clinical Studies
9 Interaction Between Proton Pump Inhibitors and Prasugrel or Ticagrelor
10 Discussion
11 Conclusion
References
The Risk of Thromboembolism in Users of Antidepressants and Antipsychotics
1 Introduction
2 Antidepressants and Arterial Thromboembolism
3 Potential Mechanisms Between Antidepressants and Arterial Atherothrombotic Events
4 Clinical Implications
5 Antipsychotics and Arterial Events
6 Potential Mechanisms Between Antipsychotics and Arterial Atherothrombotic Events
7 Clinical Implications
8 Antidepressants and Venous Thromboembolic Events
9 Clinical Implications
10 Antipsychotics and Venous Thromboembolism
11 Potential Mechanisms Between Antipsychotics and Venous Thromboembolism
12 Clinical Implications
13 Conclusion
References
Post Thrombotic Syndrome
Abbreviations
1 Introduction
2 Pathophysiology of PTS
3 Incidence
4 Clinical Presentation of PTS
5 Investigations
6 Severity Scores for PTS
7 Quality of Life
8 Treatment
8.1 Lifestyle Changes and Conservative Treatment
8.2 Compression
8.3 Pharmacological Agents
8.4 Endovascular Intervention
8.5 Deep Venous Surgery
8.6 Venous Bypass Procedures
8.7 Valve Transposition
8.8 Venous Valvuloplasty
8.9 Deep Venous Valve Substitutes
8.9.1 Risk Factors for the Development of PTS
9 Prevention Strategies
9.1 Anticoagulation
9.2 Early Thrombus Removal
9.3 Compression
10 On-Going Trials
11 Conclusions
References
A Review of the Evidence to Support Neuromuscular Electrical Stimulation in the Prevention and Management of Venous Disease
1 Introduction
2 Methods
3 Results
4 Physical Parameters
4.1 Effect of Electrical Parameters on Venous Haemodynamics
4.1.1 Direct Stimulation of the Muscle
4.1.2 Indirect Stimulation
4.2 Comparison of NMES to Other Medical Devices
5 Efficacy of Clinical Application
5.1 Electrical Stimulation as a Method of Thromboprophylaxis
5.2 Effect of Electrical Stimulation on leg Oedema/Chronic Venous Disease
5.3 The Effect of Electrical Stimulation in Patients with Impaired Calf Muscle Pump
6 Discussion
References
Non-Invasive Management of Peripheral Arterial Disease
1 Background
2 Methods
3 Results
4 Devices
4.1 Intermittent Pneumatic/External Compression
4.2 Electrical Stimulators
5 Evidence by Indication
5.1 Intermittent Claudication (Also Described as ``Stable Claudicants´´, or Fontaine Stage 2)
5.2 Critical Limb Ischaemia
5.3 Post Revascularisation
5.4 Galvanic stimulation - a special mention
6 Discussion
7 Conclusion
References
Medico-Legal Aspects of Pulmonary Thromboembolism
1 Introduction
2 Macroscopic Examination of Pulmonary Thromboembolism
3 Microscopic Examination of Pulmonary Thromboembolism
4 Immunoistochemestry of Pulmonary Thromboembolism
5 New Postmortem Diagnostic Tools in Pulmonary Thromboembolism
6 Discussion
7 Conclusions
References
Index

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