Association Between Thrombin Generation Parameters and the Risk of Bleeding in Patients Treated With Anticoagulants for Cancer Associated Thrombosis (CAT) (a Multicenter Study)

Pulmonary embolism, the second leading cause of death in cancer patients, is effectively treated with anticoagulants. In patients with cancer-associated thrombosis (CAT), the use of anticoagulants is associated with 10 to 15% of bleeding in the first 6 months. Most of the guidelines propose to integrate the bleeding risk in the choice of therapies. Thrombin generation assay (TGA) reflects an overall hemostatic response and could be a useful biomarker. Proven on the thrombotic side in the CAT population, useful in the assessment of the bleeding risk of hemophiliac patients, the TGA is emerging as a tool. The investigators to measure TGA in cancer patients included prospectively, having recently developed a CAT and to evaluate the association between the measurement and the risk of hemorrhagic complication under anticoagulant during the first 6 month of treatment.

Start Date01 Jun 2025

Sponsor / Collaborator

Centre Hospitalier Universitaire de Saint-Etienne

[+3]

NCT06906250

/ Not yet recruitingNot Applicable

European Venous Registry

The European Venous Registry (EVeR) is an international repository of data on the treatments and outcomes of people with deep venous disease. The registry is designed to evaluate the outcomes of venous interventions over a ten-year period, with the ultimate goal to inform clinical decision making through the delivery of scientific evidence.

Start Date01 Jun 2025

Sponsor / Collaborator-

ChiCTR2500101395

/ SuspendedNot ApplicableIIT

A randomized controlled trial of single anticoagulant therapy before hepatectomy for the prevention of ultra-early postoperative deep venous thrombosis of lower limbs

Start Date01 May 2025

Sponsor / Collaborator

The First Hospital of Jilin University

100 Clinical Results associated with Acute deep vein thrombosis of lower limb

100 Translational Medicine associated with Acute deep vein thrombosis of lower limb

0 Patents (Medical) associated with Acute deep vein thrombosis of lower limb

445

Literatures (Medical) associated with Acute deep vein thrombosis of lower limb

01 May 2025·Journal of Vascular Surgery: Venous and Lymphatic Disorders

Plasma D-dimer changes and clinical value in acute lower extremity deep venous thrombosis treated with catheter-directed thrombolysis

Article

Author: Wang, Jixu ; Zheng, Yide ; Fan, Xiaowen ; Yu, Yongzhong ; Xu, Shaofei

OBJECTIVEThis study sought to investigate the changes in plasma D-dimer levels during catheter-directed thrombolysis (CDT) in patients with acute lower extremity deep venous thrombosis (DVT), analyze imaging results, and assess their clinical implications.METHODSWe retrospectively analyzed 62 patients diagnosed with acute lower extremity DVT who underwent CDT between March 2019 and December 2022. Plasma D-dimer levels were measured before CDT, at regular intervals after CDT, and at the end of CDT. Lower limb venography was performed every 2 days during CDT to assess the thrombus clearance rate and level of thrombus dissolution. Statistical analyses were conducted to observe the D-dimer concentration changes and analyze the correlation between D-dimer concentration and thrombus clearance rate. Additionally, a receiver operating characteristic curve was constructed to determine the diagnostic performance of D-dimer in assessing the efficacy of thrombolysis, including the calculation of the area under the curve, sensitivity, specificity, and optimal cut-off value.RESULTSDuring CDT for acute lower extremity DVT, plasma D-dimer levels rapidly increased, peaking on CDT day 1, and then gradually decreased, followed by a rapid decline, but remained slightly elevated compared with normal levels. There was a positive correlation between D-dimer levels and thrombolysis efficacy (r = 0.809; P = .00). The linear regression equation for this correlation was Y = 0.161 + 0.028X. The area under the curve of D-dimer was 0.95, with a cut-off value of 9.935 mg/L (sensitivity, 93.2%; specificity, 95.4%).CONCLUSIONSPlasma D-dimer concentration can serve as an indicator for evaluating the efficacy of thrombolysis during CDT in acute lower extremity DVT.

25 Apr 2025·Circulation Journal

Association Between White Blood Cell Counts at Diagnosis and Clinical Outcomes in Venous Thromboembolism　― From the COMMAND VTE Registry-2 ―

Article

Author: Kobayashi, Yohei ; Nakai, Hisato ; Ogihara, Yoshito ; Otsui, Kazunori ; Morimoto, Takeshi ; Sakamoto, Jiro ; Takabayashi, Kensuke ; Kim, Kitae ; Yamashita, Yugo ; Inoko, Moriaki ; Takase, Toru ; Mabuchi, Hiroshi ; Chatani, Ryuki ; Tsuyuki, Yoshiaki ; Chen, Po-Min ; Koitabashi, Norimichi ; Ikeda, Nobutaka ; Hiramori, Seiichi ; Tsuji, Shuhei ; Dohke, Tomohiro ; Ikeda, Shinya ; Takada, Takuma ; Usami, Shunsuke ; Nishikawa, Ryusuke ; Oi, Maki ; Murata, Koichiro ; Kaneda, Kazuhisa ; Togi, Kiyonori ; Nishimoto, Yuji ; Ono, Koh ; Sueta, Daisuke ; Inoue, Takeshi ; Shioyama, Wataru ; Ikeda, Satoshi ; Doi, Kosuke ; Kimura, Takeshi

BACKGROUNDWhite blood cell (WBC) counts were reported to be a risk factor for acute adverse events in patients with venous thromboembolism (VTE). However, there are limited data on VTE patients without active cancer.METHODS AND RESULTSThe COMMAND VTE Registry-2 was a multicenter study enrolling 5,197 consecutive patients with acute symptomatic VTE. We divided 3,668 patients without active cancer into 4 groups based on WBC count quartiles (Q1-Q4) at diagnosis: Q1, ≤5,899 cells/μL; Q2, 5,900-7,599 cells/μL, Q3, 7,600-9,829 cells/μL; and Q4, ≥9,830 cells/μL. Patients in Q4 more often presented with pulmonary embolism (PE) than patients in Q1, Q2, and Q3 (68% vs. 37%, 53%, and 61%, respectively; P<0.001). The proportion of massive PEs among all PEs was higher in Q4 than in Q1, Q2, and Q3 (21% vs. 3.4%, 5.8%, and 11%, respectively; P<0.001). Compared with Q1, Q2, and Q3, patients in Q4 had a higher cumulative 5-year incidence of all-cause death (17.0%, 15.2%, 16.1%, and 22.8%, respectively; P<0.001) and major bleeding (10.9%, 11.0%, 10.3%, and 14.4%, respectively; P=0.002). The higher mortality risk of Q4 relative to Q2 was consistent regardless of the presentations of VTEs.CONCLUSIONSAn elevated WBC count on VTE diagnosis was associated with a higher risk of mortality and major bleeding regardless of VTE presentation, suggesting the potential usefulness of WBC counts for further risk stratification.

15 Mar 2025·Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery

[Effectiveness of guide plate with mortise-tenon joint structure combined with off-axis fixation in treatment of Pauwels type Ⅲ femoral neck fractures].

Article

Author: Jia, Yudong ; Zhu, Yingjie ; Cui, Lijuan ; Zhu, Xuanye ; Zhang, Leilei ; Liu, Youwen

ObjectiveTo investigate the effectiveness of using 3 hollow compression screws combined with 1 screw off-axis fixation under the guidance of three-dimensional (3D) printed guide plate with mortise-tenon joint structure (mortise-tenon joint plate) for the treatment of Pauwels type Ⅲ femoral neck fractures.MethodsA clinical data of 78 patients with Pauwels type Ⅲ femoral neck fractures, who were admitted between August 2022 and August 2023 and met the selection criteria, was retrospectively analyzed. The operations were assisted with mortise-tenon joint plates in 26 cases (mortise-tenon joint plate group) and traditional guide plates in 28 cases (traditional plate group), and without guide plates in 24 cases (control group). There was no significant difference in the baseline data of gender, age, body mass index, cause of injury, and fracture side between groups ( P>0.05). The operation time, intraoperative blood loss, frequency of intraoperative fluoroscopy, incision length, incidence of postoperative deep vein thrombosis of lower extremity, pain visual analogue scale (VAS) score at 1 week after operation, and Harris score of hip joint at 3 months after operation were recorded and compared. X-ray re-examination was taken to check the quality of fracture reduction, fracture healing, and the shortening length of the femoral neck at 3 months after operation, and the incidences of internal fixation failure and osteonecrosis of the femoral head during operation.ResultsCompared with the control group, the operation time, intraoperative blood loss, and frequency of intraoperative fluoroscopy reduced in the two plate groups, and the quality of fracture reduction was better, but the incision was longer, and the differences were significant ( P<0.05). The operation time and intraoperative blood loss were significantly higher in the traditional plate group than in the mortise-tenon joint plate group ( P<0.05), the incision was significantly longer ( P<0.05); and the difference in fracture reduction quality and the frequency of intraoperative fluoroscopy was not significant between two plate groups ( P>0.05). There was 1 case of deep vein thrombosis of lower extremity in the traditional plate group and 1 case in the control group, while there was no thrombosis in the mortise-tenon joint plate group. There was no significant difference in the incidence between groups ( P>0.05). All patients were followed up 12-15 months (mean, 13 months). There was no significant difference in VAS score at 1 week and Harris score at 3 months between groups ( P>0.05). Compared with the control group, the fracture healing time and the length of femoral neck shortening at 3 months after operation were significantly shorter in the two plate groups ( P<0.05). There was no significant difference between the two plate groups ( P>0.05). There was no significant difference in the incidences of non-union fractures, osteonecrosis of the femoral head, or internal fixation failure between groups ( P>0.05).ConclusionFor Pauwels type Ⅲ femoral neck fractures, the use of 3D printed guide plate assisted reduction and fixation can shorten the fracture healing time, reduce the incidence of postoperative complications, and be more conducive to the early functional exercise of the affected limb. Compared with the traditional guide plate, the mortise-tenon joint plate can reduce the intraoperative bleeding and shorten the operation time.

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