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https://www.readbyqxmd.com/read/29102272/aspiration-thrombectomy-for-treatment-of-acute-massive-and-submassive-pulmonary-embolism-initial-single-center-prospective-experience
#1
Juan José Ciampi-Dopazo, Juan María Romeu-Prieto, Marcelino Sánchez-Casado, Beatriz Romerosa, Alfonso Canabal, María Luisa Rodríguez-Blanco, Carlos Lanciego
PURPOSE: To evaluate the feasibility of aspiration thrombectomy in patients with acute massive or submassive pulmonary embolism (PE). MATERIALS AND METHODS: This prospective study analyzed patient demographic data, procedural details, and outcomes in 18 consecutive patients (8 men and 10 women; mean age, 60.1 y; range, 36-80 y), 10 with acute submassive PE and 8 with massive PE, treated with an Indigo Continuous Aspiration Mechanical Thrombectomy Catheter between January 2016 and February 2017...
October 25, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29074107/risk-factors-for-presence-and-severity-of-pulmonary-embolism-in-patients-with-deep-venous-thrombosis
#2
Nancy Huynh, Wassim H Fares, Kirstyn Brownson, Anand Brahmandam, Alfred I Lee, Alan Dardik, Timur Sarac, Cassius Iyad Ochoa Chaar
OBJECTIVE: The Caprini model estimates patients' risk for venous thromboembolism by 30 different factors. Hemodynamically significant pulmonary embolism (PE), defined as high-risk (massive) or intermediate-risk (submassive) PE, has high morbidity and mortality rates. This study tests whether the Caprini model and deep venous thrombosis (DVT) characteristics correlate with the prevalence of PE and hemodynamically significant PE in patients with DVT. METHODS: A retrospective review of patients diagnosed with DVT between January 2013 and August 2014 in a tertiary care center was performed...
October 23, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29068112/use-of-systemic-bivalirudin-with-catheter-directed-thrombolysis-in-a-patient-with-heparin-induced-thrombocytopenia-a-case-report
#3
Hisham A Badreldin, Jessica Rimsans, Jean M Connors, Stephen D Wiviott
In patients with submassive pulmonary embolism, the use of catheter-directed thrombolysis (CDT), using low-dose alteplase is associated with improvement in overall hemodynamics. The data for use of CDT in patients with heparin-induced thrombocytopenia are limited. We report a case of CDT in a patient with HIT using bivalirudin anticoagulation. Data of the use of bivalirudin and argatroban for systemic anticoagulation with CDT are limited.
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29030065/diuretics-versus-volume-expansion-in-acute-submassive-pulmonary-embolism
#4
Elie Dan Schouver, Olivier Chiche, Priscille Bouvier, Denis Doyen, Pierre Cerboni, Pamela Moceri, Emile Ferrari
BACKGROUND: The benefit of volume expansion (VE) in submassive pulmonary embolism (PE) with right ventricular (RV) dysfunction is unclear. AIM: To compare the effects of diuretic treatment versus VE in patients hospitalized for PE with RV dysfunction. METHODS: We prospectively included 46 consecutive patients with submassive PE treated on admission with a 40mg bolus of furosemide (D group, n=24) or 500mL of saline infusion (VE group, n=22)...
November 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29029714/catheter-directed-therapy-for-acute-submassive-pulmonary-embolism-summary-of-current-evidence-and-protocols
#5
REVIEW
Andrew Kesselman, William T Kuo
Treatment of acute submassive pulmonary embolism (PE) with thrombolytic therapy remains an area of controversy. For patients who fail or who have contraindications to systemic thrombolysis, catheter-directed therapy (CDT) may be offered depending on the patient's condition and the available institutional resources to perform CDT. Although various CDT techniques and protocols exist, the most studied method is low-dose catheter-directed thrombolytic infusion without mechanical thrombectomy. This article reviews current protocols and data on the use of CDT for acute submassive pulmonary embolism...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029713/techniques-and-devices-for-catheter-directed-therapy-in-pulmonary-embolism
#6
REVIEW
Alok Bhatt, Ramsey Al-Hakim, James F Benenati
The clinical presentation of a patient with acute pulmonary embolism (PE) can be classified into 3 categories: low-risk, submassive (presence of right heart strain), and massive (hemodynamic compromise). Massive PE is associated with high morbidity or mortality and typically treated with systemic intravenous thrombolysis. Over the last 2 decades, however, catheter-directed techniques have become an increasingly popular treatment modality for patients with a contraindication to systemic thrombolysis or without clinical improvement after systemic thrombolysis...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029711/surgical-embolectomy-for-massive-and-submassive-pulmonary-embolism-and-pulmonary-thromboendarterectomy-for-chronic-thromboembolic-pulmonary-hypertension
#7
REVIEW
Richard J Shemin
Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029710/systemic-thrombolysis-for-pulmonary-embolism-who-and-how
#8
REVIEW
Victor F Tapson, Oren Friedman
Anticoagulation has been shown to improve mortality in acute pulmonary embolism (PE). Initiation of anticoagulation should be considered when PE is strongly suspected and the bleeding risk is perceived to be low, even if acute PE has not yet been proven. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher when systemic thrombolytic therapy is administered...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029706/pulmonary-embolism-in-2017-how-we-got-here-and-where-are-we-going
#9
REVIEW
Geno J Merli
In the 1970s, both the Urokinase Pulmonary Embolism and Urokinase-Streptokinase Pulmonary Embolism trials began the quest to develop thrombolytic therapy for the treatment of acute massive and submassive pulmonary embolism (PE). The goals of these studies were the immediate reduction in clot burden, restoration of hemodynamic stability, and improved survival. Major bleeding became the major barrier for clinicians to employ these therapies. From 1980s to the present time, a number of studies using recombinant tissue-type plasminogen activator for achieving these same above outcomes were completed but major bleeding continued to remain an adoption barrier...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28993433/management-of-thromboembolism-in-transit-with-pulmonary-embolism
#10
V S Ellensen, S Saeed, T Geisner, R Haaverstad
We present a rare complication of deep venous thrombosis with pulmonary embolism that threatened the patient with systemic embolization. A 36-year-old female was referred to the hospital after five days of progressive shortness of breath and chest pain. Preceding onset of symptoms she had undergone surgery leading to reduced physical activity and had just returned from vacation by a long flight. Investigations with transthoracic and transesophageal echocardiography revealed a thromboembolism-in-transit across a patent foramen ovale...
October 9, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28958757/clinical-characteristics-risk-factors-and-outcomes-of-south-east-asian-patients-with-acute-pulmonary-embolism
#11
Kwang How Mok, Shiun Woei Wong, Yee May Wong, David Foo, Timothy James Watson, Hee Hwa Ho
BACKGROUND: The clinical features of acute PE have not been well studied in South-East Asia. We therefore sought to evaluate the clinical characteristics, risk factors and outcomes of patients diagnosed with acute pulmonary embolism (PE) in our region. METHODS: From January 2008 to March 2013, 343 patients were admitted to our tertiary institution with acute PE. Data were collected retrospectively on baseline clinical characteristics, presenting signs and symptoms, results of electrocardiographic and imaging studies, therapeutic modality and hospital course...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28957940/comparison-of-acute-and-convalescent-biomarkers-of-inflammation-in-patients-with-acute-pulmonary-embolism-treated-with-systemic-fibrinolysis-vs-placebo
#12
Lauren K Stewart, Kristen E Nordenholz, Mark Courtney, Christopher Kabrhel, Alan E Jones, Matthew T Rondina, Deborah B Diercks, James R Klinger, Jeffrey A Kline
: Previous studies have associated biomarkers indicative of acute inflammation with pulmonary embolism, which may amplify coagulation, inhibit fibrinolysis and increase risk of venous thromboembolism (VTE) recurrence. The aim of this study was to measure inflammatory and hemostatic biomarkers in acute submassive pulmonary embolism at diagnosis and 3-month follow-up and to test the impact of treatment with fibrinolysis. Secondary analysis of a multicenter, double-blinded, randomized controlled trial including patients with submassive pulmonary embolism...
September 27, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28956501/express-catheter-directed-therapy-for-submassive-pulmonary-embolism-after-unsuccessful-systematic-thrombolysis
#13
Chang Dong, Shunfen Jiang, Donghua Ji, Yingqun Ji, Zhonghe Zhang
No abstract text is available yet for this article.
January 1, 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28945166/echocardiographic-assessment-with-right-ventricular-function-improvement-following-ultrasound-accelerated-catheter-directed-thrombolytic-therapy-in-submassive-pulmonary-embolism
#14
Charles Doheny, Lorena Gonzalez, Stanley M Duchman, Joseph Varon, Carlos F Bechara, Mathew Cheung, Peter H Lin
Introduction The objective of this study was to evaluate the efficacy of ultrasound-accelerated catheter-directed thrombolytic therapy in patients with submassive pulmonary embolism. Methods Clinical records of 46 patients with submassive pulmonary embolism who underwent ultrasound-accelerated catheter-directed pulmonary thrombolysis using tissue plasminogen activator, from 2007 to 2017, were analyzed. All patients experienced clinical symptoms with computed tomography evidence of pulmonary thrombus burden...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28941516/continuous-aspiration-mechanical-thrombectomy-for-the-management-of-submassive-pulmonary-embolism-a-single-center-experience
#15
Ramsey Al-Hakim, Alok Bhatt, James F Benenati
The Indigo Mechanical Thrombectomy System (Penumbra, Inc, Alameda, California) was used to treat 6 patients with submassive pulmonary embolism (PE) and a contraindication to thrombolysis. Systolic pulmonary artery pressure (58.2 mm Hg vs 43.0 mm Hg, P < .05), right ventricular/left ventricular ratio (1.7 vs 1.1, P < .05), Miller index (15.0 vs 9.8, P < 0.01), and CT obstructive index (60.4% vs 47.0%, P < .01) were significantly reduced after mechanical thrombectomy. There were no procedural or periprocedural complications...
October 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28920554/a-pulmonary-embolism-response-team-s-initial-20-month-experience-treating-87-patients-with-submassive-and-massive-pulmonary-embolism
#16
Akhilesh K Sista, Oren A Friedman, Eda Dou, Brendan Denvir, Gulce Askin, Jamie Stern, Jaclyn Estes, Arash Salemi, Ronald S Winokur, James M Horowitz
Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28906275/vv-ecmo-assisted-high-risk-endobronchial-stenting-as-rescue-for-asphyxiating-mediastinal-mass
#17
Brandon T Nokes, Laszlo Vaszar, Jama Jahanyar, Karen L Swanson
The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) has traditionally been limited to a narrow set of clinical circumstances, such as acute hypoxic respiratory failure, submassive pulmonary embolism, and cardiopulmonary collapse. Within the pediatric population, there have been cases of VV-ECMO in the context of extrinsic airway compression by a mediastinal mass, typically in the setting of either a lymphoma or germ cell tumors. However, the use of VV-ECMO for adults with extrinsic airway compression is comparatively limited...
September 12, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28890217/saddle-vs-nonsaddle-pulmonary-embolism-clinical-presentation-hemodynamics-management-and-outcomes
#18
Bashar Alkinj, Bibek S Pannu, Dinesh R Apala, Aditya Kotecha, Rahul Kashyap, Vivek N Iyer
OBJECTIVE: To understand the clinical significance, hemodynamic presentation, management, and outcomes of patients presenting with saddle pulmonary embolism (PE). METHODS: All patients with saddle PE diagnosed at Mayo Clinic in Rochester, Minnesota, from January 1, 1999, through December 31, 2014, were included in this study. These patients were age and simplified Pulmonary Embolism Severity Index (sPESI) matched (1:1) to a nonsaddle PE cohort. Both groups were then classified into massive, submassive, and low-risk PE based on established criteria and compared for clinical presentation, management, and outcomes...
October 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28864224/catheter-directed-therapy-as-a-treatment-for-submassive-pulmonary-embolism-a-meta-analysis
#19
Xiao-Fang Li, Cheng-Quan Wan, Xue-Gai He, Jia-Yong Qiu, Dan-Yang Li, Yu-Xia Sun, Yi-Min Mao
AIMS: Catheter-directed therapy (CDT) is included in the guidelines for diagnosing and treating massive pulmonary embolism. However, few studies have evaluated the efficacy of CDT as a treatment for submassive pulmonary embolism (SPE). Therefore, we used evidence-based medicine to evaluate the effectiveness and safety of CDT in treating SPE. METHODS: Search terms describing CDT in SPE and patients with intermediate pulmonary embolism were entered into the PubMed, Embase and Cochrane Library databases to identify relevant articles without language restrictions published between January 1990 and December 2016...
November 1, 2017: Life Sciences
https://www.readbyqxmd.com/read/28828935/a-retrospective-review-of-patients-with-massive-and-submassive-pulmonary-embolism-treated-with-angiojet-rheolytic-thrombectomy-with-decreased-complications-due-to-changes-in-thrombolytic-use-and-procedural-modifications
#20
Sundeep Das, Nikhil Das, Harvey Serota, Sriram Vissa
Objectives A retrospective review of treatment of patients with massive or submassive pulmonary embolism (PE) using AngioJet rheolytic thrombectomy (ART) system with procedural modifications to improve on the previously reported outcomes. Materials and Methods Thirteen patients underwent emergent pulmonary artery thrombectomy for massive and submassive PE using ART with pharmacological and procedural modification, in comparison to prior reports. The modifications included the selective use of the Solent Omni AngioJet device in all subjects, distal contrast angiography via the AngioJet catheter before device activation, and limited short run times...
January 1, 2017: Vascular
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