| Phlegmasia cerulea dolens: the role of non-operative therapy. | |
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MedLine Citation:
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PMID: 8076089 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Thrombectomy and thrombolysis are often advocated in the treatment of phlegmasia cerulea dolens, but frequently result in incomplete clot removal, recurrence of thrombosis, local and systemic hemorrhagic complications and chronic venous stasis; this state is associated with a rate of major amputation and death of up to 50%. Non-operative therapy includes elevation, hydration and heparinization and excludes all methods aimed at surgical removal or chemical lysis of the thrombus. In 1982 it was decided to use non-operative therapy as the first line of treatment for phlegmasia cerulea dolens. In the last 9 years seven extremities in six patients with this condition have been treated. One patient had advanced gangrene on presentation and one underwent emergency thrombectomy. Five extremities (in five patients) were treated with non-operative therapy. Ischemia was rapidly corrected in all five patients. Edema resolved completely after 3-4 days in four patients. There were no complications attributable to the therapy. Two of six (33%) patients died from terminal disease. Non-operative therapy appears to be effective in preventing limb loss and avoiding the risks of thrombectomy and thrombolysis in critically ill patients. |
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Authors:
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K R Patel; C N Paidas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular surgery (London, England) Volume: 1 ISSN: 0967-2109 ISO Abbreviation: Cardiovasc Surg Publication Date: 1993 Oct |
Date Detail:
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Created Date: 1994-10-06 Completed Date: 1994-10-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9308765 Medline TA: Cardiovasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 518-23 Citation Subset: IM |
Affiliation:
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Department of Surgery (12A3), Metropolitan Hospital Center, New York 10029. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amputation Combined Modality Therapy Female Follow-Up Studies Foot / blood supply Gangrene Heparin / administration & dosage Humans Ischemia / etiology, mortality, therapy* Leg / blood supply* Male Middle Aged Survival Rate Thrombophlebitis / etiology, mortality, therapy* Vena Cava Filters |
| Chemical | |
Reg. No./Substance:
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9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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