33,373 results match your criteria Thrombolytic Therapy


2,5TT genotype of the MMP-9-1562C/T polymorphism may be a risk factor for thrombolytic therapy-induced hemorrhagic complications after acute ischemic stroke.

Pharmacotherapy 2021 May 4. Epub 2021 May 4.

St. Sava Hospital, Belgrade, Serbia.

Introduction: Levels of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) influence recombinant tissue plasminogen activator (rtPA) therapy response in patients with acute ischemic stroke (AIS). Serum levels of MMPs and TIMPs along with the expression of genes coding these proteins are related to the recovery and appearance of adverse effects (AE) after AIS. Consequently, it is important to explore whether polymorphisms in regulatory sequences of MMPs and TIMPs are associated with rtPA response in AIS patients. Read More

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Safety and efficacy of intravenous thrombolytic treatment in wake-up stroke: Experiences from a single center.

Authors:
Adam Wiśniewski

Brain Behav 2021 May 3:e02152. Epub 2021 May 3.

Department of Neurology, Faculty of Medicine, Collegium Medium in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.

Objectives: Wake-up stroke is an important clinical problem that may account for a quarter of all ischemic strokes. This study aimed to establish the safety and efficacy of intravenous thrombolytic treatment of wake-up strokes by comparing it to the standard thrombolysis treatment in strokes with clear onsets and wake-up strokes that did not receive reperfusion therapy.

Methods: This retrospective study enrolled 95 patients with ischemic strokes who underwent thrombolytic treatment with alteplase, including nine patients with wake-up strokes. Read More

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Clinical-CT mismatch defined NIHSS ≥ 8 and CT-ASPECTS ≥ 9 as a reliable marker of candidacy for intravenous thrombolytic therapy in acute ischemic stroke.

PLoS One 2021 30;16(4):e0251077. Epub 2021 Apr 30.

Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China.

Background: Clinical-diffusion mismatch between stroke severity and diffusion-weighted imaging lesion volume seems to identify stroke patients with penumbra. However, urgent magnetic resonance imaging is sometimes inaccessible or contraindicated. Thus, we hypothesized that using brain computed tomography (CT) to determine a baseline "clinical-CT mismatch" may also predict the responses to thrombolytic therapy. Read More

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2020 Guideline for Prehospital Management, Emergency Evaluation and Treatment of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the Taiwan Society of Emergency Medicine and Taiwan Stroke Society.

J Acute Med 2021 Mar;11(1):12-17

National Taiwan University Hospital Stroke Center and Department of Neurology Taipei Taiwan.

To improve the clinical outcomes of patients with acute ischemic stroke, the public, pre-hospital care system, and hospitals should cooperate to achieve quick assessment and management for such patients and to start treatment as soon as possible. To reach the goal, the Consensus Group, including emergency physicians and neurologists in the Taiwan Society of Emergency Medicine and Taiwan Stroke Society, performed an updated review and discussion for the local guidelines. The guidelines consist of 12 parts, including public education program, evaluation and management in the emergency medical system, emergency medical system, assessment of stroke care capability of the hospital by independent parties, stroke team of the hospital, telemedicine, organization, and multifaceted integration, improvement of quality of care process of stroke system, initial clinical and imaging evaluations after arriving at the hospital, imaging evaluation for indications of intravenous thrombolysis, imaging evaluation for indications of endovascular thrombectomy, and other diagnostics. Read More

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Sex-Related Disparities in the Incidence and Outcomes of Ischemic Stroke among Type 2 Diabetes Patients. A Matched-Pair Analysis Using the Spanish National Hospital Discharge Database for Years 2016-2018.

Int J Environ Res Public Health 2021 Apr 1;18(7). Epub 2021 Apr 1.

Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain.

Background: To analyze the incidence, use of therapeutic procedures, and in-hospital outcomes among patients suffering an ischemic stroke (IS) according to the presence of type 2 diabetes mellitus (T2DM) in Spain (2016-2018) and to assess the existence of sex differences.

Methods: Matched-pair analysis using the Spanish National Hospital discharge.

Results: IS was coded in 92,524 men and 79,731 women (29. Read More

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The outcome of isolated calf muscle vein thrombosis after open reduction and internal fixation for closed intra-articular distal femur fractures: a prospective cohort study.

BMC Musculoskelet Disord 2021 Apr 28;22(1):397. Epub 2021 Apr 28.

Department of Nuclear Medicine, the Second Affiliated Hospital of Guangzhou Medicine University, No. 250 Changgang East Road, Guangdong, 510260, Guangzhou, People's Republic of China.

Background: To observe the outcome of isolated calf muscle vein thrombosis (ICMVT) undergoing open reduction and internal fixation (ORIF) for closed intra-articular distal femur fractures (DFFs) and to analyze related factors.

Methods: The study was designed as a prospective clinical cohort study at our hospital. From August 2018 to August 2020,a total of 140 patients with flesh ICMVT after ORIF for closed intra-articular DFFs were collected during hospitalization. Read More

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[Intravenous thrombolytic therapy with Revelisa of ischemic stroke in real-world clinical practice: interim results of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(3. Vyp. 2):33-37

Institute of Cerebrovascular Pathology and Stroke, Federal Center for Brain and Neurotechnology of the Federal Medical and Biological Agency, Moscow, Russia.

Objective: To assess the safety and efficacy of Revelisa in patients with ischemic stroke in real-world clinical practice.

Material And Methods: The interim analysis of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R included 223 patients (50.2% women and 49. Read More

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[Screening of intravenous thrombolysis for eligible patients with ischemic stroke].

Authors:
H Q Qin Y J Wang

Zhonghua Nei Ke Za Zhi 2021 May;60(5):476-482

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases, Beijing 100070, China.

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[Childhood acute promyelocytic leukemia complicated with thrombosis: four cases and literatures review].

Zhonghua Er Ke Za Zhi 2021 May;59(5):407-411

Department of Hematology and Oncology, Children's Hospital, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To investigate the clinical characteristics and prognosis of children with acute promyelocytic leukemia (APL) complicated with thrombosis. The clinical profiles of four APL patients complicated with thrombosis treated at the First Affiliated Hospital of Zhengzhou University between January 2012 and December 2019 were reviewed. Literature search and review covered the China national knowledge infrastructure, Wanfang database, China biology medicine disc and PubMed using the key words of "acute promyelocytic leukemia" and "thrombosis" up to June 2020. Read More

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Bilateral pulmonary embolism without deep venous thrombosis was observed after knee arthroscopy: a case report.

BMC Musculoskelet Disord 2021 Apr 24;22(1):383. Epub 2021 Apr 24.

Department of Orthopaedics, the Affiliated Hospital of Southwest Medical University, Sichuan Provincial Laboratory of Orthopaedic Engineering, Luzhou, Sichuan, 646000, People's Republic of China.

Background: Symptomatic pulmonary embolism (PE) after knee arthroscopy is extremely rare. If the embolism is not treated promptly, the patient may die. Bilateral pulmonary embolism with associated pulmonary infarct without concomitant deep vein thrombosis has never been reported following routine knee arthroscopy. Read More

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Endovascular therapies for pulmonary embolism.

Heliyon 2021 Apr 1;7(4):e06574. Epub 2021 Apr 1.

Service d'imagerie CHU Toulouse, Rangueil, France.

Purpose: The aim of this article is to define the place of new endovascular methods for the management of pulmonary embolisms (PE), on the basis of a multidisciplinary consensus.

Method And Results: Briefly, from the recent literature, for high-risk PE presenting with shock or cardiac arrest, systemic thrombolysis or embolectomy is recommended, while for lowrisk PE, anticoagulation alone is proposed. Normo-tense patients with PE but with biological or imaging signs of right heart dysfunction constitute a group known as "at intermediate risk" for which the therapeutic strategy remains controversial. Read More

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Access to Reperfusion Therapy and Mortality in Women with ST-Segment-Elevation Myocardial Infarction: VICTIM Register.

Arq Bras Cardiol 2021 Apr;116(4):695-703

Universidade Federal de Sergipe - Núcleo de Pós-Graduação em Ciências da Saúde, São Cristóvão, SE - Brasil.

Background: Myocardial reperfusion is a fundamental part of the treatment for ST elevation myocardial infarction (STEMI) and is responsible for reducing morbidity and mortality in affected patients. However, reperfusion rates are usually lower and mortality rates higher in women compared to men.

Objectives: To evaluate the prevalence of the use of reperfusion therapies among women and men with STEMI in hospitals where percutaneous coronary intervention (PCI) is available in the state of Sergipe. Read More

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Stroke-unit care for stroke patients in China: the results from Bigdata Observatory platform for Stroke of China.

J Neurol 2021 Apr 22. Epub 2021 Apr 22.

The General Office of Stroke Prevention Project Committee, National Health Commission of the People's Republic of China, Beijing, China.

Background: To assess whether stroke patients admitted to stroke units (SU) have a better short-term outcome than those treated in conventional wards (CW).

Methods: A total of 20 hospitals from 16 provinces in China were initially selected in this study. Finally, 24,090 consecutive admissions in 2013-2015 treated in CW and 21,332 consecutive entries in 2017-2019 treated in SU were included. Read More

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Acute Ischemic Stroke During the Convalescent Phase of Asymptomatic COVID-2019 Infection in Men.

JAMA Netw Open 2021 04 1;4(4):e217498. Epub 2021 Apr 1.

Division of Neurology, Department of Medicine, National University Health System, Singapore.

Importance: Acute ischemic stroke (AIS) is a known neurological complication in patients with respiratory symptoms of COVID-19 infection. However, AIS has not been described as a late sequelae in patients without respiratory symptoms of COVID-19.

Objective: To assess AIS experienced by adults 50 years or younger in the convalescent phase of asymptomatic COVID-19 infection. Read More

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Thromboelastography-Guided Anticoagulant Therapy for the Double Hazard of Thrombohemorrhagic Events in COVID-19: A Report of 3 Cases.

Am J Case Rep 2021 Apr 1;22:e931080. Epub 2021 Apr 1.

Indiana University School of Medicine South Bend Campus, Notre Dame, IN, USA.

BACKGROUND The novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), often manifests a coagulopathy in severely ill patients, which may cause hemorrhage and/or thrombosis of varying severity. This report comprises the cases of 3 patients with COVID-19-associated coagulopathy who were evaluated with thromboelastography (TEG) and activated partial thromboplastin time (aPTT) to enable personalized anticoagulant therapy. CASE REPORT Three patients presented with COVID-19 pneumonia, confirmed by reverse transcription-polymerase chain reaction, who developed thrombohemorrhagic coagulopathy. Read More

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Neutrophil extracellular traps promote tPA-induced brain hemorrhage via cGAS in mice with stroke.

Blood 2021 Feb 24. Epub 2021 Feb 24.

Fudan University, Shanghai, China.

Intracerebral hemorrhage associated with thrombolytic therapy with tissue plasminogen activator (tPA) in acute ischemic stroke continues to present a major clinical problem. Here, we report that infusion of tPA resulted in a significant increase in markers of neutrophil extracellular traps (NETs) in the ischemic cortex and plasma of mice subjected to photothrombotic middle cerebral artery occlusion. Peptidylarginine deiminase 4 (PAD4), a critical enzyme for NET formation, is also significantly upregulated in the ischemic brains in tPA-treated mice. Read More

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February 2021

Large Cerebellar Stroke in a Young COVID-19-Positive Patient: Case Report.

J Emerg Med 2021 Feb 9. Epub 2021 Feb 9.

UC San Diego Health Sciences, UC San Diego Medical Center, San Diego, California.

Background: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most frequently presents with respiratory symptoms, such as fever, dyspnea, shortness of breath, cough, or myalgias. There is now a growing body of evidence that demonstrates that severe SARS-CoV-2 infections can develop clinically significant coagulopathy, inflammation, and cardiomyopathy, which have been implicated in COVID-19-associated cerebrovascular accidents (CVAs).

Case Report: We report an uncommon presentation of a 32-year-old man who sustained a large vessel cerebellar stroke associated with a severe COVID-19 infection. Read More

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February 2021

A first trimester pregnancy with cerebrovascular accident treated with thrombolytic therapy: A case report.

Am J Emerg Med 2021 Apr 13. Epub 2021 Apr 13.

Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.

Pregnant patients are at increased risk of cerebrovascular accident due to the prothrombotic state of pregnancy. This risk is highest in those with pre-eclampsia and eclampsia as well as those of Asian descent. Despite this increased risk, pregnancy was an exclusion criterion for major stroke intervention trials. Read More

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Thrombolytic therapy for pulmonary embolism.

Cochrane Database Syst Rev 2021 Apr 15;4:CD004437. Epub 2021 Apr 15.

The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.

Background: Thrombolytic therapy is usually reserved for people with clinically serious or massive pulmonary embolism (PE). Evidence suggests that thrombolytic agents may dissolve blood clots more rapidly than heparin and may reduce the death rate associated with PE. However, there are still concerns about the possible risk of adverse effects of thrombolytic therapy, such as major or minor haemorrhage. Read More

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Intravenous Thrombolysis for Acute Ischemic Stroke Due to Cardiac Myxoma.

Basic Clin Neurosci 2020 Nov-Dec;11(6):855-859. Epub 2020 Nov 1.

Department of Neurology, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Myxoma may cause systemic embolization and frequently presents as ischemic stroke.

Case Presentation: There have been debates about whether it is safe to use recombinant tissue plasminogen activator (rt-PA) in patients with cardiac myxoma who referred with ischemic stroke to the hospital's emergency.

Results: The patient was a young case of atrial myxoma with initial presentation of acute cerebral infarction symptoms who was treated with intravenous rt-PA with no complications. Read More

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November 2020

Verapamil as an Adjunct Therapy to Reduce tPA Toxicity in Hyperglycemic Stroke: Implication of TXNIP/NLRP3 Inflammasome.

Mol Neurobiol 2021 Apr 13. Epub 2021 Apr 13.

Department of Anatomy and Neurobiology, College of Medicine, The University of Tennessee Health Science Center, 875 Monroe Avenue, Wittenborg Bldg, Room-231, Memphis, TN, 38163, USA.

Thrombolytic therapy has remained quite challenging in hyperglycemic patients for its association with poor prognosis and increased hemorrhagic conversions. We recently showed that tissue plasminogen activator (tPA)-induced cerebrovascular damage is associated with thioredoxin-interacting protein (TXNIP) upregulation, which has an established role in the detrimental effects of hyperglycemia. In the present work, we investigated whether verapamil, an established TXNIP inhibitor, may provide protection against hyperglycemic stroke and tPA-induced blood-brain barrier (BBB) disruption. Read More

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Multiple arterial and venous thromboembolism in a male patient with hereditary protein C deficiency: A case report.

Medicine (Baltimore) 2021 Apr;100(15):e25575

Department of Vascular Surgery, The Second Xiangya Hospital of Central South University.

Rationale: Hereditary protein C deficiency has a high prevalence in Asian populations, being the important risk factor associated with thrombophilia. Traditionally, conservative medication is the first choice for patients with hereditary protein C deficiency. However, there are few reports on whether aggressive surgical treatment can be performed when patients continue to develop life-threatening ischemic symptoms after adequate anticoagulant and thrombolytic therapy. Read More

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Improvement in plasma D-dimer level in severe SARS-CoV-2 infection can be an indicator of fibrinolysis suppression: Case reports.

Medicine (Baltimore) 2021 Apr;100(15):e25255

Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA.

Rationale: Fibrinolysis shutdown associated with severe thrombotic complications is a recently recognized syndrome that was previously seldom investigated in patients with severe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It presents a unique therapeutic dilemma, as anticoagulation with heparin alone is insufficient to address the imbalance in fibrinolysis. And while the use of fibrinolytic agents could limit the disease severity, it is often associated with bleeding complications. Read More

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DEEP VEIN ULTRASOUND-GUIDED THROMBOLYSIS.

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):65-67. Epub 2021 Apr 8.

Vascular Surgery Department- Hospital da Senhora da Oliveira, Guimarães; Portugal.

Catheter directed thrombolysis is a minimally invasive procedure that results in a significant reduction in venous obstruction after deep vein thrombosis. The technique implies the performance of phlebographies to monitor the thrombolysis progression. The objective of this paper is to describe the use of vascular ultrasound to follow the thrombus lysis and to adjust the catheter position according to the progression of the thrombolysis. Read More

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A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support.

J Rural Med 2021 Apr 1;16(2):119-122. Epub 2021 Apr 1.

Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Japan.

Herein, we report a patient with acute cerebral infarction with a favorable prognosis after being managed by a general physician with support from the telestroke program. An 85-year-old man was transferred to a regional hospital due to sudden onset of dysarthria and left hemiparesis. As no neurosurgeons or neurologists were available in that hospital or area, the patient was examined by a general physician who diagnosed him with cardioembolic stroke on the left middle cerebral artery territory. Read More

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Exercise Self-efficacy, Perceived Benefits, and Barriers to Exercise Among Patients Following Acute Myocardial Infarction.

J Cardiovasc Nurs 2021 Apr 6. Epub 2021 Apr 6.

Abedalmajeed Shajrawi, PhD, MSN, BSN Assistant Professor, Faculty of Nursing, Applied Science Private University, Amman, Jordan. Heba Khalil, PhD, BSN Assistant Professor, Faculty of Health Sciences, Higher Colleges of Technology-Fujairah Women's Campus, Fujairah, United Arab Emirates. Raghad Abdel Qader, PhD, BSN Associate Professor, Faculty of Nursing, Applied Science Private University, Amman, Jordan. Manal Al-Sutry, PhD, BSN Assistant Professor, Faculty of Nursing, Jeddah University, Jeddah, Kingdom of Saudi Arabia. Mohannad Abu Al-Ruz, PhD, BSN Professor, Faculty of Nursing, Applied Science Private University, Amman, Jordan.

Background: Increasing patient adherence to regular exercise post acute myocardial infarction (AMI) is a major goal after hospitalization. It is therefore essential to identify perceived benefits and barriers to exercise and its association with exercise self-efficacy among patients post AMI.

Aims: The purpose of this study was to identify the perceived benefits and barriers to exercise and the predictors of exercise self-efficacy among patients after AMI. Read More

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Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team.

J Am Board Fam Med 2021 Mar-Apr;34(2):402-408

From the Division of Cardiology, Yale University, New Haven, CT (JC); Division of Cardiology, Medical College of Georgia at the Augusta University Medical Center (VA); and the Department of Family Medicine, Medical College of Georgia at the Augusta University Medical Center, Augusta (TW).

Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. Read More

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Treatment challenges in patients with early acute massive pulmonary thrombosis embolism (PTE) after lung cancer surgery: A case report.

Medicine (Baltimore) 2021 Apr;100(14):e25371

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Introduction: Early acute massive pulmonary thrombosis embolism (PTE) after lung cancer surgery is one of the most fatal surgical complications. It is often accompanied by shock and hypotension, with high mortality rate. Due to surgical wounds, patients with early acute massive PTE after lung cancer surgery have a high risk of thrombolytic bleeding, which renders treatment more challenging and there is currently no standard protocol on how to safely and effectively treat these patients in the clinic. Read More

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[Catheter-directed thrombolysis in iliofemoral thrombosis and aplasia of the inferior vena cava].

Angiol Sosud Khir 2021 ;27(1):91-95

Department of Surgery #3, Alexandrovskaya Hospital, Saint Petersburg, Russia.

Demonstrated in the article are the results of catheter-directed thrombolysis in a male patient presenting with bilateral acute iliofemoral venous thrombosis on the background of aplasia of the inferior vena cava. The incidence rate of this pathology is specified, with an emphasis on no recommendations on choosing optimal therapeutic strategy in this cohort of patients. The main causes and complications of the disease are described. Read More

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[Efficacy of apixaban in prevention of haemorrhagic complications in treatment of deep vein thromboses with endovascular techniques].

Angiol Sosud Khir 2021 ;27(1):33-38

Department of X-ray Surgical Methods of Diagnosis and Treatment, Orel Regional Clinical Hospital, Orel, Russia.

Purpose: This study was undertaken to investigate efficacy of apixaban in prevention of haemorrhagic complications during treatment of proximal thromboses of deep veins of the lower extremities using endovascular techniques.

Patients And Methods: We retrospectively studied the results of treating a total of 50 patients presenting with deep vein thromboses at late stages of the pathological process. The patients were subdivided into 2 statistically homogeneous groups. Read More

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