D-dimer level correlation with treatment response in children with venous malformations
| Autor: | Man-Yee Tang, Hon-Shing Fung, M. W. Y. Leung, Lap-Yan Chung, Clarence S.W. Liu, Wai-lun Poon, Kelvin K.W. Liu, Nicholas S.Y. Chao, Shi-Da Yam, Yvonne C.L. Leung, Judy Hung |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Vascular Malformations medicine.medical_treatment Veins Fibrin Fibrinogen Degradation Products 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Median follow-up Sclerotherapy D-dimer medicine Coagulopathy Humans Prospective Studies Child Prospective cohort study business.industry Infant General Medicine Perioperative Blood Coagulation Disorders medicine.disease Surgery Treatment Outcome Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Cohort Female business Venous malformation Biomarkers Follow-Up Studies |
| Zdroj: | Journal of Pediatric Surgery. 53:289-292 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2017.11.030 |
| Popis: | Localized intravascular coagulopathy is present in children with venous malformations (VMs) as evidenced by elevated D-dimer levels. Few studies have looked into the changes in D-dimer after sclerotherapy and its correlation with treatment outcome and complications. Our study aims to investigate changes in D-dimer in children with VMs undergoing alcohol sclerotherapy.A prospective cohort study from 2014 to 2016, which included children (18years) with VM undergoing alcohol sclerotherapy, was completed. Demographics and lesion characteristics were recorded. Perioperative D-dimer levels were collected 2weeks prior to treatment (baseline) and on postoperative days 1, 2, 5, and 14, respectively. A raised postoperative D-dimer was defined as a peak level of at least 50% increase of baseline D-dimer. Children were followed up with documentation of lesional size at 6months and long-term recurrence beyond 6months of treatment.Eighteen children were identified (10 females, 8 males) with a median follow up of 21months. Overall, 15 patients (83%) had a satisfactory outcome. Baseline D-dimer levels were high in 8 patients (44%). Postoperative D-dimer level was raised in 12 patients irrespective of their baseline levels, with 92% peaking on postoperative day one (n=11). In the elevated D-dimer group, 11 patients had a satisfactory outcome, and 10 patients did not have long-term recurrence. We did not encounter any complications in our cohort.Changes in perioperative D-dimer levels may predict early treatment response and long-term recurrence after alcohol sclerotherapy. With a standardized protocol, alcohol sclerotherapy for venous malformation is safe with minimal complications.Prognosis study.IV. |
| Databáze: | OpenAIRE |
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