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2. The new Italian registry of infantile thrombosis (RITI): A reflection on its journey, challenges and pitfalls

Author

Pelizza MF, Martinato M, Rosati A, Nosadini M, Saracco P, Giordano P, Luciani M, Ilardi L, Lasagni D, Molinari AC, Bagna R, Palmieri A, Ramenghi LA, Grassi M, Magarotto M, Magnetti F, Francavilla A, Indolfi G, Suppiej A, Gentilomo C, Restelli R, Tufano A, Tormene D, Pin JN, Tona C, Meneghesso D, Rota L, Conti M, Russo G, Lorenzoni G, Gregori D, Sartori S, Simioni P, Collaborators of the R. I. T. I. (Italian Registry of Infantile Thrombosis)., Pelizza, Mf, Martinato, M, Rosati, A, Nosadini, M, Saracco, P, Giordano, P, Luciani, M, Ilardi, L, Lasagni, D, Molinari, Ac, Bagna, R, Palmieri, A, Ramenghi, La, Grassi, M, Magarotto, M, Magnetti, F, Francavilla, A, Indolfi, G, Suppiej, A, Gentilomo, C, Restelli, R, Tufano, A, Tormene, D, Pin, Jn, Tona, C, Meneghesso, D, Rota, L, Conti, M, Russo, G, Lorenzoni, G, Gregori, D, Sartori, S, Simioni, P, and Collaborators of the, R. I. T. I. (Italian Registry of Infantile Thrombosis).

Published
2023

3. Systemic Catheter-Related Venous Thromboembolism in Children: Data From the Italian Registry of Pediatric Thrombosis

Author

Lasagni, D., Nosadini, M., Molinari, A. C., Saracco, P., Pelizza, M. F., Piersigilli, F., Putti, M. C., Gaffuri, M., Giordano, P., Lorenzoni, G., Francavilla, A., Trapani, S., Luciani, M., Suppiej, A., Tufano, A., Tormene, D., Martinato, M., Gregori, D., Sartori, S., Simioni, P., Agostini, M., Bassi, B., Bertoni, E., Casani, A., Farinasso, D., Gallo, E., Gentilomo, C., Grassi, M., Lunetta, F., Magarotto, M., Maschio, F., Palmieri, A., Pettenazzo, A., Sangermani, R., Laverda, A., Lasagni, D, Nosadini, M, Molinari, Ac, Saracco, P, Pelizza, Mf, Piersigilli, F, Putti, Mc, Gaffuri, M, Giordano, P, Lorenzoni, G, Francavilla, A, Trapani, S, Luciani, M, Suppiej, A, Tufano, A, Tormene, D, Martinato, M, Gregori, D, Sartori, S, Simioni, P, Systemic Thromboses Working Group of the Italian Registry of Pediatric Thrombosis (RITI Registro Italiano Trombosi, Infantili)., UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service de néonatologie

Subjects
central venous catheter (CVC), pediatric, children, Pediatrics, Perinatology and Child Health, catheter-complications, heparin, registry, thrombosis, Socio-culturale, equipment and supplies
Abstract

BackgroundCentral venous catheters (CVCs) represent one of the main risk factors for venous thrombotic events (VTEs) in children.MethodsWe studied the Italian Registry of Pediatric Thrombosis (RITI) with regard to systemic radiologically confirmed CVC-related VTEs (CVC-VTEs) occurred during 6.5 years in children aged 29 days to 18 years.ResultsA total of 78 CVC-VTEs were included, which occurred in 76 patients (40/76, 53% males). CVC-VTEs comprised 67 non-cardiac VTEs (86%) and 11 intracardiac thrombotic events (ICTEs) (14%); the median age at onset was 19 and 17 months, respectively. The most frequent reason for CVC insertion was supportive therapy. The catheters were placed percutaneously in 85% of cases (56/66) and surgically in the remaining 15% (10/66). Peripherally inserted central catheters (PICCs) were used in 47% (31/66) cases, partially implanted catheters in 42% (28/66), non-implantable catheters in 7% (5/66), and totally implanted catheters (Port) in 2% (1/66). CVC-VTEs were symptomatic in 77% of cases (60/78), while in the remaining 23%, they were incidentally detected on the imaging performed for the underlying condition. The median time between CVC insertion and the onset of symptoms was 10 days in non-cardiac VTEs and 39 days in ICTEs. Doppler ultrasound was the diagnostic technique most frequently used. The venous compartment most frequently affected was the veins of the lower extremities (52%, 43/73). Anti-thrombotic treatment was administered in 96% of CVC-VTEs (75/78). About 2.6% (2/76) of patients experienced a second thrombotic event. At discharge, post-thrombotic syndrome was reported in 13.5% (5/37) events with available data, CVC replacement in 10.8% (4/47), and ischemic necrosis with toe finger amputation in 2.7% (1/37). Three patients died due to an underlying condition; no CVC-VTE-related deaths were reported.ConclusionsWe have carried out a registry-based study on CVC-VTEs in the children in Italy, providing the data that may help improve the detection and management of this CVC-related complication.

Published
2022

39. High vs. low doses of low‐molecular‐weight heparin for the treatment of superficial vein thrombosis of the legs: a double‐blind, randomized trial

Author

Girolami, A., Prandoni, P., Marchiori, A., Bernardi, E., Cogo, A., Cuppini, S., Rudelli, G., Alvino, S., Recchia, G., Stragliotto, E., Zerbini, O., Gonsalvi, M., Morelli, P., Bucherini, E., Tormene, D., Mosena, L., Rosi, G., Lu Priore, A., Ambrosio, G., Parisi, R., Bortoluzzi, C., Contavalli, C., Andreozzi, G. M., Verlato, F., Camporese, G., Aluigi, L., Astorino, G., Pagnan, A., Salsa, F., Bullo, C., Visona, A., Lusiani, L., Bonanome, A., Pesavento, R., Patrassi, G. M., Scarano, L., Marcon, L., Faresin, F., Frausini, G., Francolini, G., Imberti, D., Prati, C., Santonastaso, M., Zanatta, N., Viani, M. P., Malacarne, Z., Pinto, A., Prestipino, F., Ghirarduzzi, A., Iotti, M., Cattabiani, M., Todini, A. R., Paiella, M. L., Allegra, C., Carlizza, A., Venco, A., Dentali, F., Scannapieco, G., Villalta, S., and Di Salvo, M. M.

Subjects
Male, medicine.medical_specialty, Superficial vein thrombosis, medicine.drug_class, Premedication, Deep vein, Low molecular weight heparin, Asymptomatic, law.invention, Double-Blind Method, Randomized controlled trial, law, Thromboembolism, medicine, Humans, Saphenous Vein, Low-molecular-weight heparin, Aged, Venous Thrombosis, Leg, Dose-Response Relationship, Drug, Heparin, business.industry, Incidence, Great saphenous vein, Thrombophlebitis, Venous thromboembolism, Hematology, Heparin, Low-Molecular-Weight, Middle Aged, medicine.disease, Thrombosis, Surgery, Treatment Outcome, medicine.anatomical_structure, Female, medicine.symptom, business, medicine.drug
Abstract

In contrast with extensive information on the management of deep vein thrombosis of the lower extremities, little is known on the most appropriate treatment of the superficial vein thrombosis (SVT). In a multicenter, prospective, controlled, double-blind, double-dummy clinical trial, 164 consecutive patients with acute SVT of the great saphenous vein were randomized to receive the s.c. administration of either fixed prophylactic doses (2850 a-Xa IU) or body-weight adjusted therapeutic doses of nadroparin once daily for 1 month. The main study outcome was to compare the rate of asymptomatic and symptomatic extension of SVT and/or venous thromboembolic (VTE) complications during a 3-month follow-up period. Of the 81 patients randomized to the prophylactic doses, seven [8.6%; 95% confidence interval (CI), 3.5-17.0] developed SVT progression or VTE complications as compared with six of the 83 (7.2%; 95% CI, 2.8-15.1) allocated to the treatment group (absolute difference, 1.4; 96% CI, -6.9 to 9.7; P = 0.74). No patient in either group developed major bleeding. Our findings suggest that therapeutic doses of low-molecular-weight heparin, administered for 1 month in patients with SVT of the greater saphenous vein do not improve results obtained by prophylactic doses, administered for the same period, over a 3-month follow-up period.

Published
2005

40. Aspirin for preventing the recurrence of venous thromboembolism

Author

Agnelli, G, Becattini, C, Prandoni, P, Ageno, W, Cimminiello, C, Eichinger, S, Duranti, M, Radicchia, S, Guercini, F, Vedovati, M, Tormene, D, Perlati, M, Poggio, R, Leischer, L, Bucherini, E, Galimberti, D, Leone, M, Beretta, A, Carugati, A, Braham, S, Romualdi, E, Tiscia, G, Colaizzo, D, Grilli, M, Salvi, R, Miccio, M, Ria, L, Zanatta, N, Poli, D, Camporese, G, Verlato, F, Salvia, A, Nitti, C, Santi, R, Scannapieco, G, Barillari, G, Pasca, S, De Gaudenzi, E, Cappelli, R, Di Minno, G, Tufano, A, Frausini, G, Bova, C, Pogliani, E, Signorelli, S, Alatri, A, Grifoni, S, Lodigiani, C., BARBARO, Salvatore, SIRAGUSA, Sergio, TESTA, Silvia, MANCUSO, Gaetano, Agnelli, G, Becattini, C, Prandoni, P, Ageno, W, Cimminiello, C, Eichinger, S, Duranti, M, Radicchia, S, Guercini, F, Vedovati, M, Tormene, D, Perlati, M, Barbaro, S, Poggio, R, Leischer, L, Bucherini, E, Galimberti, D, Leone, M, Beretta, A, Carugati, A, Braham, S, Romualdi, E, Tiscia, G, Colaizzo, D, Grilli, M, Siragusa, S, Salvi, R, Miccio, M, Ria, L, Zanatta, N, Poli, D, Camporese, G, Verlato, F, Salvia, A, Nitti, C, Santi, R, Scannapieco, G, Barillari, G, Pasca, S, De Gaudenzi, E, Cappelli, R, Di Minno, G, Tufano, A, Frausini, G, Bova, C, Pogliani, E, Signorelli, S, Testa, S, Alatri, A, Mancuso, G, Grifoni, S, and Lodigiani, C

Subjects
aspirin, venous thrombosis
Published
2012

41. Risk for subsequent venous thromboembolic complications in carriers of the prothrombin or the factor V gene mutation with a first episode of deep-vein thrombosis

Author

PAOLO SIMIONI, Prandoni, P., Lensing, A. W. A., Manfrin, D., Tormene, D., Gavasso, S., Girolami, B., Sardella, C., Prins, M., Girolami, A., Infectious diseases, AII - Amsterdam institute for Infection and Immunity, and APH - Amsterdam Public Health

Subjects
Adult, Aged, 80 and over, Male, Venous Thrombosis, Heterozygote, Immunology, Factor V, Cell Biology, Hematology, Middle Aged, Biochemistry, Cohort Studies, Recurrence, Risk Factors, Thromboembolism, Mutation, Prevalence, Humans, Female, Prothrombin, Aged, Follow-Up Studies, Retrospective Studies
Abstract

Carriers of a mutation in the prothrombin (clotting factor II) or factor V gene have a 2- to 4-fold greater risk for venous thromboembolism than subjects without the mutations. Whether both mutations also predispose to recurrent venous thromboembolism is unclear. Outpatients who had a first episode of proven symptomatic deep-vein thrombosis and a long-term follow-up were studied. The outcome measure was the cumulative incidence of confirmed venous thromboembolic complications. Two hundred fifty-one patients were enrolled in the study. Mean duration of follow-up was 8.3 years. The prothrombin gene mutation was demonstrated in 27 patients (prevalence, 10.8%; 95% CI, 6.9 to 14.6), and the factor V gene mutation was demonstrated in 41 patients (prevalence, 16.3%; 95% CI, 11.8 to 20.9). The cumulative incidence of venous thromboembolic complications after 10 years was 61.3% (95% CI, 35.7 to 87.9), and the hazard ratio was 2.4 (95% CI, 1.3 to 4.7; P = .004) in patients with the prothrombin gene mutation); the cumulative incidence of venous thromboembolic complications after 10 years was 55.2% (95% CI, 36.4 to 74.0), and the hazard ratio was 2.4 (95% CI, 1.4 to 4.1;P = .001) in patients with the factor V gene mutation. In comparison, the cumulative incidence of venous thromboembolic complications after 10 years was 23.1% (95% CI, 16.2 to 30.1) in patients without the mutations. Prothrombin and factor V gene mutations occur frequently in patients with venous thrombosis and are associated with an increased risk for recurrent venous thromboembolic complications

Published
2000

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