Document Detail


Association of localized intravascular coagulopathy with venous malformations.
MedLine Citation:
PMID:  18645138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine which venous malformations (VMs) are at risk for coagulopathy. Venous malformations are slow-flow vascular malformations present at birth, and localized intravascular coagulopathy (LIC) causes pain and thrombosis within a lesion and severe bleeding during surgical procedures. DESIGN: Prospective convenience sample accrued from 2 multidisciplinary sites in Brussels, Belgium, and Caen, France. PARTICIPANTS: The study population comprised 140 patients with clinical data and coagulation parameters. Magnetic resonance imaging was performed for 110 patients. MAIN OUTCOME MEASURE: Measurement of D-dimer levels. RESULTS: Of the 140 participants, 59 (42%) showed high D-dimer levels, 36 (61%) of whom had levels higher than 1.0 microg/mL. Six of the participants had low fibrinogen levels. In univariate analysis, large surface, presence of palpable phleboliths, and truncal localization were associated with high D-dimer levels. In the multivariate analysis, only large surface area and presence of phleboliths remained independently associated with high D-dimer levels. Severe LIC, characterized by concomitant low fibrinogen level, was associated with extensive venous malformations of the extremities. CONCLUSIONS: Localized intravascular coagulopathy is statistically significantly associated with large and/or deep venous malformations that affect any location, which can have a palpable phlebolith. These patients are at risk of local pain due to thrombosis. Lesions with elevated D-dimer levels associated with low fibrinogen levels (severe LIC) commonly affect an extremity and have a high risk of hemorrhage. Low-molecular-weight heparin can be used both to treat the pain caused by LIC and to prevent decompensation of severe LIC to disseminated intravascular coagulopathy.
Authors:
Anne Dompmartin; Aurélie Acher; Pascal Thibon; Sébastien Tourbach; Cédric Hermans; Véronique Deneys; Ben Pocock; Agnès Lequerrec; Daniel Labbé; Marie-Thérèse Barrellier; Romain Vanwijck; Miikka Vikkula; Laurence M Boon
Related Documents :
17898948 - Clinical study on the treatment of premature ejaculation by uighur medicine gu-jing-mai...
14524738 - Bemiparin: a review of its use in the prevention of venous thromboembolism and treatmen...
17597288 - Multi-institutional study of symptomatic deep venous thrombosis and pulmonary embolism ...
1538888 - Clinical and hemodynamic sequelae of lower-extremity, deep-vein thrombosis after total ...
18638588 - Bivalirudin with provisional glycoprotein iib/iiia inhibitors in patients undergoing pr...
2957418 - The effects of reverse sequential anti-androgen therapy (cyproterone acetate and ethiny...
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of dermatology     Volume:  144     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-08-14     Revised Date:  2009-03-31    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  873-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Dermatology, Université de Caen Basse Normandie, Centre Hospitalier Universitaire Caen, Caen, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Belgium / epidemiology
Blood Coagulation Disorders / blood,  complications,  epidemiology*,  pathology
Child
Child, Preschool
Female
Fibrin Fibrinogen Degradation Products / metabolism
France / epidemiology
Humans
Infant
Male
Middle Aged
Pain Measurement
Prospective Studies
Risk Factors
Severity of Illness Index
Sex Factors
Vascular Malformations / blood,  complications,  epidemiology*,  pathology,  ultrasonography
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D
Comments/Corrections
Comment In:
Arch Dermatol. 2008 Jul;144(7):922-6   [PMID:  18645144 ]
Arch Dermatol. 2009 Feb;145(2):210; author reply 210-1   [PMID:  19221279 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Coagulation disorders in patients with venous malformation of the limbs and trunk: a case series of ...
Next Document:  Motivation for contemporary tattoo removal: a shift in identity.