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https://www.readbyqxmd.com/read/29331855/retrievable-inferior-vena-cava-filters-in-pregnancy-risk-versus-benefit
#1
REVIEW
David A Crosby, Kevin Ryan, Niall McEniff, Patrick Dicker, Carmen Regan, Caoimhe Lynch, Bridgette Byrne
OBJECTIVE: Venous thromboembolism remains one of the leading causes of maternal mortality in the developed world. Retrievable inferior vena cava (IVC) filters have a role in the prevention of lethal pulmonary emboli when anticoagulation is contraindicated or has failed [1]. It is unclear whether or not the physiological changes in pregnancy influence efficacy and complications of these devices. The decision to place an IVC filter in pregnancy is complex and there is limited information in terms of benefit and risk to the mother...
December 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29330629/giant-left-atrial-myxoma-causing-acute-ischemic-stroke-in-a-child
#2
Hayato Ise, Natsuya Ishikawa, Sentaro Nakanishi, Hiroyuki Kamiya
Ischemic stroke is uncommon in pediatric populations and is sometimes caused by cardiac myxoma. In such cases, neurological deficits initially present in ischemic stroke due to emboli or thrombi of the myxoma. Echocardiography is helpful to diagnose myxoma in a timely manner and allows urgent surgical resection of the myxoma. We report a successful case of myxoma in a 7-year-old boy who initially presented with left-sided hemiparesis.
January 12, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29323823/atrioesophageal-fistula-a-rare-complication-of-radiofrequency-ablation
#3
Inbar Saporta, Adithya Chennamadhavuni, Michael J Dolan
75-year-old woman was admitted with fever, chills, altered mentation, and right-sided weakness. A month earlier, she had undergone catheter radiofrequency ablation for treatment of chronic atrial fibrillation. A magnetic resonance imaging scan of her brain revealed septic emboli with multiple bilateral cerebral and cerebellar infarcts, as well as extensive bilateral leptomeningeal enhancement. Blood cultures were positive for Streptococcus mitis, Rothia mucilaginosa, Streptococcus pneumonia, and Candida albicans, which suggested a connection between gastrointestinal and cardiovascular systems...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#4
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29320313/acute-radiologic-manifestations-of-america-s-opioid-epidemic
#5
David D B Bates, Katherine Gallagher, HeiShun Yu, Jennifer Uyeda, Akira M Murakami, Bindu N Setty, Stephan W Anderson, Mariza O Clement
The United States is in the midst of an opioid use epidemic, which has severe medical, social, and economic consequences. Addictions to and abuse of prescription and illicit opioids are increasing, and emergency department radiologists are increasingly being faced with the task of examining patients who present with opioid-related complications. These complications may be the result of direct drug toxicity or nonsterile injection of the drugs. Neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal complications may be evident at diagnostic imaging in emergent settings...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29315509/carotid-plaque-volume-in-patients-undergoing-carotid-endarterectomy
#6
S Ball, S Rogers, K Kanesalingam, R Taylor, E Katsogridakis, C McCollum
BACKGROUND: The main indication for carotid endarterectomy (CEA) is severity of carotid artery stenosis, even though most strokes in carotid disease are embolic. The relationship between carotid plaque volume (CPV) and symptoms of cerebral ischaemia, and the measurement of CPV by minimally invasive tomographic ultrasound imaging, were investigated. METHODS: The volume of the endarterectomy specimen was measured using a validated saline suspension technique in patients undergoing CEA...
January 8, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29314704/use-of-a-novel-embolic-filter-in-carotid-artery-stenting-30-day-results-from-the-embolden-clinical-study
#7
William A Gray, Manish Mehta, Firas Alani, Karthikeshwar Kasirajan, Richard J Begg, J Michael Bacharach, Peter A Soukas
OBJECTIVES: The EMBOLDEN study was conducted to test the safety and efficacy of a novel emboli protection filter design for use in carotid artery stenting (CAS) in patients with severe carotid stenosis who were at high risk of operative complications from carotid endarterectomy (CEA). BACKGROUND: General considerations for filter design usually involve trade-offs between trackability/profile and wall apposition/capture efficiency. The GORE® Embolic Filter (GEF) is intended to address these design goals via a hybrid construction...
January 3, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314391/emboli-shower-beware-of-the-catastrophe
#8
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29314390/emboli-shower-beware-of-the-catastrophe
#9
Gurinder Kumar, Nitin Airon, Aman Ps Sohal
No abstract text is available yet for this article.
January 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29307005/effect-of-cerebral-embolus-size-on-the-timing-of-cardiac-surgery-for-infective-endocarditis-in-patients-with-neurological-complications
#10
Yong Kyun Kim, Choong Gon Choi, Jiwon Jung, Shi Nae Yu, Ju Young Lee, Yong Pil Chong, Sung-Han Kim, Sang-Oh Lee, Sang-Ho Choi, Jun Hee Woo, Yang Soo Kim
The optimal timing of cardiac surgery remains unclear for patients with neurological complications of infective endocarditis (IE). However, neuroimaging findings may allow more refined clinical decision-making. We analyzed clinical and advanced neuroimaging data for 135 patients with IE who had preoperatively diagnosed ischemic cerebral complications (86 patients) or hemorrhagic complications (49 patients), between January 1997 and May 2013. The effect of early surgery (within 3 and 7 days of ischemic and hemorrhagic complications respectively) on in-hospital mortality and 1-year adverse outcomes (mortality, relapse, or new embolic events) was estimated...
January 6, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29306522/visceral-thromboses-in-pancreas-adenocarcinoma-systematic-review
#11
REVIEW
Angel Mier Hicks, Antonio DeRosa, Michael Raj, Richard Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes...
December 12, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29303459/multimodal-treatment-approach-in-a-patient-with-multiple-intracranial-myxomatous-aneurysms
#12
David L Penn, Arianna B Lanpher, Jennifer M Klein, Harry P W Kozakewich, Kristopher T Kahle, Edward R Smith, Darren B Orbach
The most common primary cardiac tumor is myxoma, typically originating in the left atrium. Emboli to the central nervous system can cause cerebral infarction or, rarely, seed tumor growth within vessel walls, causing myxomatous aneurysms. Fewer than 60 myxomatous aneurysms have been reported, including 2 cases in children. Here, the authors describe 2 different growing myxomatous aneurysms in a child successfully managed using a combined multidisciplinary approach. A 12-year-old boy developed a sudden headache, diplopia, gait instability, and speech difficulty...
January 5, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29302305/lemierre-syndrome-a-diagnostic-dilemma-in-paediatric-patients
#13
Fatemeh Rafati, Vishal Bhalla, Varun Chillal, Mani Thyagarajan
Lemierre's syndrome is a rare disease of the head and neck, characterized by an initial infection, usually within the oropharynx, which can develop into a septic thrombophlebitis. It can involve the jugular vein, facial veins and respiratory tract. A 7-year-old child attended our institution with a 1-week history of fever and cough. Initial imaging demonstrated a large left sided empyema with multiple cavitating lung lesions and persisting pneumothoraces secondary to the development of a bronchopleural fistula...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29302121/use-of-a-modified-cardiopulmonary-bypass-circuit-for-suction-embolectomy-with-the-angiovac-device
#14
Cara M Michelson, Cornelius M Dyke, Douglas J Wick, Rory Guenther, Dylan Dangerfield, Matthew E Wiisanen
The AngioVac suction cannula and circuit were designed for the percutaneous removal of soft thrombus and emboli in procedures requiring extracorporeal circulatory support. We describe a modification of the AngioVac suction catheter and cardiopulmonary bypass (CPB) circuit to effectively remove thrombus while maintaining the ability to rapidly initiate full CPBs during a medical crisis. This article will discuss the design concepts of the modified circuit as well as procedural protocols and considerations. The design modifications of incorporating an oxygenator, reservoir, and bridge allow for an increased flexibility that allows adaption to veno-venous extracorporeal membrane oxygenation or full CPB support when required for oxygenation or hemodynamic support...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302117/an-in-vitro-study-comparing-the-gme-handling-of-two-contemporary-oxygenators
#15
Carl J Gisnarian, Angela Hedman, Kenneth G Shann
Gaseous microemboli (GME) are a potential complication of cardiopulmonary bypass (CPB). Though it is difficult to prove that GME is the only major cause of neurological deficits, it may increase the chance of post-operative cognitive dysfunction if not removed. The objectives of this research were to compare LivaNova-Sorin Inspire (Inspire) oxygenator with a Medtronic arterial filter to the Medtronic Fusion (Fusion) oxygenator with and without a Medtronic arterial filter based on each system's ability to handle GME...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29298792/lemierre-s-syndrome-a-pain-in-the-neck-with-far-reaching-consequences
#16
Thomas James Stubington, Paul James
Lemierre's syndrome is a potentially life-threatening consequence of oropharyngeal and ear infections and often results in critical care admission and even intubation. Due to the multisystem manifestation, multiple teams may initially be involved in the care, some of which may be unfamiliar with the features and usual clinical course. This report describes a case in a 36-year-old woman with the classic features of internal jugular vein thrombosis and septic emboli to the lungs secondary to an oropharyngeal infection...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29298459/embolisation-for-pulmonary-arteriovenous-malformation
#17
REVIEW
Charlie C-T Hsu, Gigi Nc Kwan, Hannah Evans-Barns, Mieke L van Driel
BACKGROUND: Pulmonary arteriovenous malformations are abnormal direct connections between the pulmonary artery and pulmonary vein which result in a right-to-left shunt. They are associated with substantial morbidity and mortality mainly from the effects of paradoxical emboli. Potential complications include stroke, cerebral abscess, pulmonary haemorrhage and hypoxaemia. Embolisation is an endovascular intervention based on the occlusion of the feeding arteries the pulmonary arteriovenous malformations thus eliminating the abnormal right-to-left-shunting...
January 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29290408/pulmonary-emboli-and-deep-venous-thrombosis-during-adolescence
#18
Celeste Schultz, Rebecca Doran
Pulmonary emboli (PE) and deep venous thrombus (DVT) are two conditions considered to affect primarily adults. These conditions, however, can and do affect neonates, toddlers, school-age children, and adolescents. Factors contributing to the development of PE and DVT are often associated with genetic mutations in Antithrombin III, Protein C, and Protein S. This article presents a primary care case study of an adolescent who was diagnosed with and underwent treatment for bilateral PE and a DVT, and reviews the underlying primary genetic mutations, diagnostic workup, and management of his clinical condition...
December 28, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29276710/use-of-tachycardia-in-patients-with-submassive-pulmonary-emboli-to-risk-stratify-for-early-initiation-of-thrombolytic-therapy-a-case-series-comparing-early-versus-late-thrombolytic-initiation
#19
Jordana Cheta, Ashleigh Long, Paul Marik
Pulmonary embolism (PE) represents a prevalent cause of morbidity and mortality in the United States, with approximately 600 000 cases diagnosed annually. The mortality rate for untreated PE is as high as 30%. Right ventricular (RV) dysfunction is a sign of possible adverse outcomes with right-sided heart failure being the usual cause of death from PE. There is a spectrum of clinical presentations associated with PE diagnoses, from incidental and asymptomatic to rapid hemodynamic collapse. Despite successes in identifying patients with "high-risk" PEs for aggressive thrombolytic interventions and "low-risk" PEs for outpatient anticoagulation, a significant lack of consensus exists regarding intervention modalities for PEs identified as "intermediate risk" or "submassive," defined as normotensive (systolic blood pressure ≥90 mm Hg) with acute RV dysfunction and myocardial injury...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29251634/the-clinical-implication-of-transcranial-doppler-detection-of-microembolic-signals-in-patients-with-heartmate-ii
#20
Kazuki Fukuma, Osamu Seguchi, Kozue Saito, Kensuke Kuroda, Seiko Nakajima, Takuma Sato, Masanobu Yanase, Yorihiko Matsumoto, Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi, Kazuyuki Nagatsuka, Norihide Fukushima
We aimed to elucidate the clinical relevance of transcranial Doppler (TCD) in the detection of microembolic signals in patients with Heartmate II (HM-II). Twenty patients with HM-II underwent TCD examinations, and microembolic signals were rarely detected in stable patients. However, they were detected in patients with hemolysis and/or thromboembolic events. Further, TCD examination under oxygen inhalation revealed that, both, solid emboli and gaseous emboli exist in patients with HM-II.
December 14, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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