| Association of localized intravascular coagulopathy with venous malformations. | |
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MedLine Citation:
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PMID: 18645138 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Archives of dermatology Volume: 144 ISSN: 1538-3652 ISO Abbreviation: Arch Dermatol Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-07-22 Completed Date: 2008-08-14 Revised Date: 2009-03-31 |
Medline Journal Info:
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Nlm Unique ID: 0372433 Medline TA: Arch Dermatol Country: United States |
Other Details:
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Languages: eng Pagination: 873-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Dermatology, Université de Caen Basse Normandie, Centre Hospitalier Universitaire Caen, Caen, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D |
| Comments/Corrections | |
Comment In:
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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
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