PMID- 30522332 OWN - NLM STAT- MEDLINE DCOM- 20190710 LR - 20200225 IS - 1938-2723 (Electronic) IS - 1076-0296 (Print) IS - 1076-0296 (Linking) VI - 25 DP - 2019 Jan-Dec TI - Management of Extremity Venous Thrombosis in Neonates and Infants: An Experience From a Resource Challenged Setting. PG - 1076029618814353 LID - 10.1177/1076029618814353 [doi] LID - 1076029618814353 AB - We aimed to evaluate the outcome of different treatment modalities for extremity venous thrombosis (VT) in neonates and infants, highlighting the current debate on their best tool of management. This retrospective study took place over a 9-year period from January 2009 to December 2017. All treated patients were referred to the vascular and pediatric surgery departments from the neonatal intensive care unit. All patients underwent a thorough history-taking as well as general clinical and local examination of the affected limb. Patients were divided into 2 groups: group I included those who underwent a conservative treated with the sole administration of unfractionated heparin (UFH), whereas group II included those who were treated with UFH plus warfarin. Sixty-three patients were included in this study. They were 36 males and 27 females. Their age ranged from 3 to 302 days. Forty-one (65%) patients had VT in the upper limb, whereas the remaining 22 (35%) had lower extremity VT. The success rate of the nonsurgical treatment was accomplished in 81% of patients. The remaining 19% underwent limb severing, due to established gangrene. The Kaplan-Meier survival method revealed a highly significant increase in both mean and median survival times in those groups treated with heparin and warfarin compared to heparin-only group ( P < .001). Nonoperative treatment with anticoagulation or observation (ie, wait-and-see policy) alone may be an easily applicable, effective, and a safe modality for management of VT in neonates and infants, especially in developing countries with poor or highly challenged resource settings. FAU - Mousa, Ahmed AU - Mousa A AUID- ORCID: 0000-0002-0840-4080 AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. AD - 2 Divisions of Vascular Surgery, Pediatric Surgery, General Surgery, Emergency Medicine; Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. FAU - Zakaria, Ossama M AU - Zakaria OM AD - 2 Divisions of Vascular Surgery, Pediatric Surgery, General Surgery, Emergency Medicine; Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. AD - 3 Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. FAU - Hanbal, Ibrahim AU - Hanbal I AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - Nasr, Mohammed A AU - Nasr MA AD - 4 Division of Vascular Surgery, Department of Surgery, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt. FAU - Sultan, Tamer A AU - Sultan TA AD - 5 Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt. FAU - El-Hamid, Mohamed Abd AU - El-Hamid MA AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - El-Gibaly, Amr M AU - El-Gibaly AM AD - 6 Department of General, Visceral, Thoracic and Vascular Surgery, Hanse Klinikum Stralsund, University Medicine of Greifswald, Stralsund, Germany. FAU - Al-Arfaj, Haytham AU - Al-Arfaj H AD - 2 Divisions of Vascular Surgery, Pediatric Surgery, General Surgery, Emergency Medicine; Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. FAU - Daha, Ahmed S AU - Daha AS AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - Buhalim, Mohammed A AU - Buhalim MA AD - 2 Divisions of Vascular Surgery, Pediatric Surgery, General Surgery, Emergency Medicine; Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. FAU - Zakaria, Mohamed Y AU - Zakaria MY AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - Metwally, Dina E El AU - Metwally DEE AD - 7 Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. FAU - Bosat, Bosat E AU - Bosat BE AD - 8 Department of General Surgery, Al-Zahraa University Hospital, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. FAU - Sharabi, Alaa AU - Sharabi A AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - Nienaa, Mohamed AU - Nienaa M AD - 2 Divisions of Vascular Surgery, Pediatric Surgery, General Surgery, Emergency Medicine; Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. FAU - Amin, Mahsoub M AU - Amin MM AD - 1 Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt. FAU - Rashed, Khaled A AU - Rashed KA AD - 9 Department of Pediatrics, Al-Hussain University Hospital, Faculty of Medicine for Male, Al-Azhar University, Cairo, Egypt. LA - eng PT - Journal Article DEP - 20181206 PL - United States TA - Clin Appl Thromb Hemost JT - Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis JID - 9508125 RN - 0 (Anticoagulants) RN - 0 (Heparin, Low-Molecular-Weight) SB - IM MH - Anticoagulants/pharmacology/*therapeutic use MH - Female MH - Heparin, Low-Molecular-Weight/pharmacology/*therapeutic use MH - Humans MH - Infant MH - Infant, Newborn MH - Male MH - Retrospective Studies MH - Venous Thrombosis/*drug therapy/pathology PMC - PMC6714954 OTO - NOTNLM OT - anticoagulants OT - heparins OT - pediatric thrombosis OT - thrombosis OT - venous thromboembolism COIS- Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2018/12/14 06:00 MHDA- 2019/07/11 06:00 PMCR- 2018/12/06 CRDT- 2018/12/08 06:00 PHST- 2018/12/14 06:00 [pubmed] PHST- 2019/07/11 06:00 [medline] PHST- 2018/12/08 06:00 [entrez] PHST- 2018/12/06 00:00 [pmc-release] AID - 10.1177_1076029618814353 [pii] AID - 10.1177/1076029618814353 [doi] PST - ppublish SO - Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029618814353. doi: 10.1177/1076029618814353. Epub 2018 Dec 6.