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The Use of Radioisotopic Tests for Diagnosing Lower Limb Venous Thrombosis – Own Research

100%

Janczak D., Janczak P., Skóra J., Dorobisz K., Merenda M., Litarski A., Szyber P.

Polish Journal of Surgery

2012

vol. 84

issue 12

605-612

Inflammatory mediators play an important role in thrombosis etiopathology. Diagnostic radioisotopic tests can be used to assess the activity of thrombo-inflammatory process. The aim of the study was to assess the suitability of Tc-99m HMPAO labelled leukocyte scintigraphy in the diagnostics of deep vein thrombosis. Material and methods. The study covered 45 patients with lower limb deep vein thrombosis treated in 2009 at the Department of Vascular, General and Transplantological Surgery of the Wrocław Medical University. Scintigraphic test were performed during the first few days after the onset of symptoms and 8 weeks later. Results. All patients with active deep vein thrombosis had higher levels of TC-99m-HMPAO markers in sick limbs. After 8 weeks, 93% of patients still had elevated levels of radioisotope in limbs with an active thrombosis process. However, the levels of markers were clearly lower than in the acute phase of thrombosis. Conclusions. 1. In the chronic phase of thrombosis, 93% of patients still have higher levels of radioisotopic markers, which indicates an active inflammatory process. 2. Tc-99m HMPAO labelled leukocyte scintigraphy demonstrates high sensitivity in the diagnostics of deep vein thrombosis.

Patients with Upper Extremity Deep Vein Thrombosis in a Clinical Material of Warsaw Medical University

80%

Jeleńska M., Romanowski Ł.

Polish Journal of Surgery

2010

vol. 82

issue 11

603-609

The aim of the study was to analyze causes, location and signs and symptoms of the upper extremity deep vein thrombosis (UEDVP) in twelve patients who were referred for tests for trombophilia; these patients were treated from 2002 to 2009 in various Clinics of Warsaw Medical University.Material and methods. Retrospective analysis involved collection of clinical data of hospitalized patients related to signs and symptoms and location of the thrombosis, antithrombotic treatment and results of tests for thrombophilia. Patients with thrombosis caused by dialysis catheter, chemotherapy or paranteral nutrition and cardiac pacemaker electrode were excluded from the study.Results. Eight of the study subjects had a primary thrombosis: in as many as five of them this was an exercise-induced thrombosis. Secondary thrombosis was diagnosed in four patients, two of whom had a malignancy, the third one used oral contraceptives while the fourth, pregnant patient, had UEDVP associated with ovarian hyperstimulation syndrome.Conclusions. Pulmonary embolism (PE) without lower extremity thrombosis should prompt the search for UEDVT that can be asymptomatic. One of the study subjects underwent imaging studies that confirmed presence of thrombosis of the left brachiocephalic vein only after PE was detected.The study group contained many relatively young patients (five patients) with exercise-induced UEDVT, indicating possible thrombotic complications following too vigorous physical exercise.UEDVT that occurred in a pregnant patient was a complication of hormonal stimulation of ovaries used in the treatment of infertility. Pain and edema of the neck in such patients should prompt their attending physician to perform imaging studies. Should UEDVT be detected, antithrombotic heparin therapy should be started.

Standardy badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego – aktualizacja. Badanie żył kończyn dolnych

51%

Małek G., Nowicki A.

Journal of Ultrasonography

2014

vol. 14

issue 58

287-296

This article has been prepared on the basis of the Ultrasonography Standards of the Polish Ultrasound Society (2011) and updated based on the latest findings and reports. Ultrasound examination of the lower extremity veins is relatively easy and commonly used to confirm or rule out venous thrombosis. However, a relatively easy compression test frequently requires experience, particularly in situations when imaging is difficult (due to lymphedema, dressing or thick tissues). The technique is time-consuming and requires assessment of each deep vein every 1 cm. Lesions in the deep veins cannot be ruled out when the vessels are assessed in only 2–3 points – a full examination is needed. The value of the method is the highest when the proximal section is assessed and the lowest when crural veins are evaluated. Doppler sonography is the basic method used when patients are prepared for a surgery of varicose veins. The assessment of the superficial veins prior to this procedure is tedious and requires knowledge of anatomy together with numerous variants. A considerable challenge is posed by re-assessment of recurrent varicose veins following a previous surgery. The Standards include anatomic nomenclature proposed by the Polish Society for Vascular Surgery and Polish Society of Phlebology, which should facilitate communication with clinicians. The most beneficial patient positions have been thoroughly discussed in terms of safety and effectiveness of the examination. Sometimes during such an examination, no venous pathology is found, but other changes with symptoms that suggest deep thrombophlebitis are detected. In such a situation, it is necessary to conduct an initial (or complete, if possible) assessment of lesions as well as provide recommendations connected with further, more detailed diagnosis.

Pracę przygotowano na podstawie Standardów badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego (2011) i zaktualizowano, opierając się na najnowszych doniesieniach z piśmiennictwa. Badanie ultradźwiękowe żył kończyn dolnych jest metodą względnie prostą i powszechnie stosowaną do rozpoznawania lub wykluczania zakrzepicy żylnej. Z założenia prosta w wykonaniu próba uciskowa bardzo często wymaga dużego doświadczenia, zwłaszcza w sytuacjach utrudniających obrazowanie (obrzęk chłonny, opatrunek czy duża grubość tkanek). Technika badania jest pracochłonna i wymaga oceny każdej żyły głębokiej co 1 cm. Nie można więc wykluczyć zmian w układzie żył głębokich, oceniając naczynia tylko w 2–3 punktach – konieczne jest pełne badanie. Wartość metody jest największa w ocenie żył odcinka proksymalnego, najmniejsza zaś w ocenie żył podudzia. Ultrasonografia dopplerowska stanowi podstawową metodę w przygotowaniu pacjenta do operacji żylaków. Ocena żył powierzchownych przed tym zabiegiem jest żmudna i wymaga znajomości anatomii wraz z licznymi odmianami. Dużym wyzwaniem bywa ocena żylaków nawrotowych, po wykonanej wcześniej operacji. W standardzie uwzględniono mianownictwo anatomiczne zaproponowane przez Polskie Towarzystwo Chirurgii Naczyniowej i Polski Towarzystwo Flebologiczne, co powinno ułatwić komunikację z klinicystami. Szczegółowo omówiono proponowane podczas badania pozycje, najbardziej korzystne ze względu na bezpieczeństwo pacjenta i efektywność wyniku. Wielokrotnie podczas tego badania nie znajduje się patologii żylnej, ale inną, dającą objawy sugerujące zapalenie zakrzepowe żył głębokich. W takiej sytuacji konieczna jest wstępna ocena zmian (lub gdy to możliwe – pełna) i dalsze ukierunkowanie bardziej szczegółowej diagnostyki.

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2 Polish Journal of Surgery

1 Journal of Ultrasonography

1 2014

1 2012

1 2010

1 Dorobisz K.

1 Janczak D.

1 Janczak P.

1 Jeleńska M.

1 Litarski A.

1 Małek G.

1 Merenda M.

1 Nowicki A.

1 Romanowski Ł.

1 Skóra J.

1 Szyber P.

Search results

The Use of Radioisotopic Tests for Diagnosing Lower Limb Venous Thrombosis – Own Research

Patients with Upper Extremity Deep Vein Thrombosis in a Clinical Material of Warsaw Medical University

Standardy badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego – aktualizacja. Badanie żył kończyn dolnych