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Pulmonary Thromboembolism

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https://www.readbyqxmd.com/read/29791520/use-of-direct-oral-anticoagulants-for-chronic-thromboembolic-pulmonary-hypertension
#1
Francisca Alexandra Gavilanes-Oleas, Jose Leonidas Alves, Caio Julio Cesar Fernandes, Luis Felipe Lopes Prada, William Salibe Filho, Mario Terra Filho, Luciana Morinaga, Susana Hoette, Carlos Jardim, Rogerio Souza
OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of direct oral anticoagulants for acute pulmonary embolism treatment has provided a viable and effective alternative for treating this condition. However, little is known about the efficacy of this new class of drugs for treating chronic thromboembolic pulmonary hypertension...
May 17, 2018: Clinics
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#2
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789046/management-of-venous-thromboembolism-in-the-elderly-a-review-of-the-non-vitamin-k-oral-anticoagulants
#3
Laressa Bethishou, Tania Gregorian, Kimberly Won, Kristina Lopez, Laura V Tsu
Objective To provide an up-to-date review of the available evidence regarding pharmacotherapeutic management of venous thromboembolic events in the geriatric population. Data Sources A PubMed search of articles published through August 2017 was performed using a combination of the following words: apixaban, betrixaban, dabigatran, edoxaban, enoxaparin, geriatric, heparin, idaricizumab, rivaroxaban, and venous thromboembolism. Study Selection/data Extraction Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with venous thromboembolism (VTE)...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29788694/long-term-rivaroxaban-for-the-treatment-of-acute-venous-thromboembolism-in-patients-with-active-cancer-in-a-prospective-multicenter-trial
#4
Ho-Young Yhim, Won-Il Choi, Sung-Hyun Kim, Seung-Hyun Nam, Kyoung Ha Kim, Yeung-Chul Mun, Doyeun Oh, Hun-Gyu Hwang, Keun-Wook Lee, Eun-Kee Song, Yong Shik Kwon, Soo-Mee Bang
Background/Aims: Limited data are available regarding the efficacy of rivaroxaban for the treatment of cancer-associated venous thromboembolism (VTE). The aim of this study was to evaluate the effectiveness and safety of rivaroxaban for the treatment of VTE in active cancer patients. Methods: In this prospective, multicenter, open-label trial (NCT01989845), we enrolled patients with active cancer and objectively diagnosed lower-extremity deep vein thrombosis, pulmonary embolism (PE), or both from November 2013 to June 2016...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29784123/endovascular-interventions-for-venous-disease
#5
REVIEW
Paul O'Connor, Robert Lookstein
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784118/acute-lower-extremity-deep-venous-thrombosis-the-data-where-we-are-and-how-it-is-done
#6
Raja S Ramaswamy, Olaguoke Akinwande, Joseph D Giardina, Pavan K Kavali, Christina G Marks
The incidence of venous thromboembolism, including both deep vein thrombosis and pulmonary embolism, is estimated at 300,000-600,000 per year. Although thrombosis may occur anywhere, it is thrombosis of the deep veins of the lower extremities that is of interest as this is where thrombosis occurs most often within the venous system. This article discusses the evaluation and interventions, including endovascular catheter-direct treatments, for patients with acute deep venous thrombosis.
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29781388/hospitalization-metrics-associated-with-hospital-level-variation-in-inferior-vena-cava-filter-utilization-for-patients-with-venous-thromboembolism-in-the-united-states-implications-for-quality-of-care
#7
Ming Chen, Amie Goodin, Hong Xiao, Qiong Han, Driss Raissi, Joshua Brown
Variation in the use of inferior vena cava filters (IVCFs) across hospitals has been observed, suggesting differences in quality of care. Hospitalization metrics associated with venous thromboembolism (VTE) patients have not been compared based on IVCF utilization rates using a national sample. We conducted a descriptive retrospective study using the Nationwide Readmissions Database (NRD) to delineate the variability of hospitalization metrics across the hospital quartiles of IVCF utilization for VTE patients...
May 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29780621/thromboembolism-prophylaxis-in-orthopaedics-an-update
#8
Dimitrios A Flevas, Panayiotis D Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, Andreas F Mavrogenis
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death.Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%.VTE prophylaxis methods are divided into mechanical and pharmacological...
April 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29780248/incidence-of-symptomatic-venous-thromboembolism-in-2372-knee-and-hip-replacement-patients-after-discharge-data-from-a-thromboprophylaxis-registry-in-montreal-canada
#9
Andréa Senay, Milanne Trottier, Josée Delisle, Andreea Banica, Benoit Benoit, G Yves Laflamme, Michel Malo, Hai Nguyen, Pierre Ranger, Julio C Fernandes
Background: Low-molecular-weight heparin (LMWH) is a recommended anticoagulant for thromboprophylaxis after major orthopedic surgery. Dabigatran etexilate is an oral anticoagulant recognized as noninferior to LMWH. We aimed to assess the incidence of symptomatic venous thromboembolic events (VTEs) after discharge in patients who underwent joint replacement, using a hospital registry. Patients and methods: Patients who underwent total knee and hip arthroplasty between September 2011 and March 2015 were selected...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29778034/early-discharge-of-patients-with-pulmonary-embolism-in-daily-clinical-practice-a-prospective-observational-study-comparing-clinical-gestalt-and-clinical-rules
#10
Simone Vanni, Cecilia Becattini, Peiman Nazerian, Carlo Bova, Valerio Teodoro Stefanone, Ludovica Anna Cimini, Gabriele Viviani, Cosimo Caviglioli, Michela Sanna, Giuseppe Pepe, Stefano Grifoni
OBJECTIVES: To estimate the efficiency and safety of clinicians' gestalt in the identification of patients with pulmonary embolism (PE) candidates for early discharge and to compare the efficiency and safety of clinical gestalt with that of the Pulmonary Embolism Severity Index (PESI), the simplified PESI (sPESI) and the Hestia criteria (HC). METHODS: Consecutive adult patients presenting to the emergency department of four Italian hospitals with confirmed diagnosis of PE were included...
May 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29776563/chronic-thromboembolic-pulmonary-hypertension-reversal-of-pulmonary-hypertension-but-not-sleep-disordered-breathing-following-pulmonary-endarterectomy
#11
Maria Teresa La Rovere, Francesco Fanfulla, Anna Eugenia Taurino, Claudio Bruschi, Roberto Maestri, Elena Robbi, Rita Maestroni, Caterina Pronzato, Maurizio Pin, Andrea M D'Armini, Gian Domenico Pinna
BACKGROUND: It has been hypothesized that pre-capillary pulmonary hypertension (PH) may trigger sleep disordered breathing (SDB). In patients with chronic thromboembolic PH (CTEPH), pulmonary endarterectomy (PEA) is potentially effective to improve PH. We assessed the pre- and post-operative prevalence of SDB in CTEPH patients submitted to PEA and the relationship between SDB and clinical, pulmonary and hemodynamic factors. METHODS: Unattended cardiorespiratory recording was performed the night before and one month after elective PEA in 50 patients...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29774484/effect-of-post-filter-anticoagulation-on-mortality-in-patients-with-cancer-associated-pulmonary-embolism
#12
Jieun Kang, Seon Ok Kim, Yeon-Mok Oh, Sang-Do Lee, Jae Seung Lee
BACKGROUND: Malignancy is associated with an increased risk of venous thromboembolism. Inferior vena cava filters are a viable alternative when anticoagulation is infeasible because of the risk of bleeding. Although the current guidelines recommend that all patients with a vena cava filter be treated with anticoagulation treatment when the risk of bleeding is reduced, studies concerning the role of concomitant anticoagulation after vena cava filter insertion in high-risk patients are scarce...
May 17, 2018: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29770793/pulmonary-embolism
#13
REVIEW
Menno V Huisman, Stefano Barco, Suzanne C Cannegieter, Gregoire Le Gal, Stavros V Konstantinides, Pieter H Reitsma, Marc Rodger, Anton Vonk Noordegraaf, Frederikus A Klok
Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can be fatal. Acute PE is associated with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Furthermore, individuals who survive PE can develop post-PE syndrome, which is characterized by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and/or chronic functional limitations...
May 17, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29770766/histogram-pattern-analysis-of-the-lung-perfused-blood-volume-for-assessment-of-pulmonary-thromboembolism
#14
Munemasa Okada, Takafumi Nomura, Yoshiteru Nakashima, Yoshie Kunihiro, Shoji Kido
PURPOSE: We aimed to evaluate the usefulness of histograms of lung perfused blood volume (HLPBV) based on the presence of pulmonary thromboembolism (PTE) and the pulmonary embolic burden. METHODS: A total of 168 patients (55 males; mean age, 62.9 years) underwent contrast-enhanced dual-energy computed tomography (DECT) between January 1 2012 and October 31 2014. Initial DECT images were three-dimensionally reconstructed, and the HLPBV patterns were divided into three types, including the symmetric type (131 patients, 78...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29762047/imaging-of-suspected-pulmonary-embolism-and-deep-venous-thrombosis-in-obese-patients
#15
Vincent Cascio, Man Hon, Linda B Haramati, Animesh Gour, Peter Spiegler, Sanjeev Bhalla, Douglas Katz
Obesity is a growing problem around the world, and radiology departments frequently encounter difficulties related to large patient size. Diagnosis and management of suspected venous thromboembolism, in particular deep venous thrombosis (DVT) and pulmonary embolism (PE), are challenging even in some lean patients, and can become even more complicated in the setting of obesity. Many obstacles must be overcome to obtain imaging examinations in obese patients with suspected PE and/or DVT, and to ensure that these examinations are of sufficient quality to diagnose or exclude thromboembolic disease, or to establish an alternative diagnosis...
May 15, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29760849/acute-pulmonary-embolism-in-emergency-department-patients-despite-therapeutic-anticoagulation
#16
Michelle Y Liu, Dustin W Ballard, Jie Huang, Adina S Rauchwerger, Mary E Reed, Sean C Bouvet, David R Vinson
Introduction: Emergency department (ED) patients with acute pulmonary embolism (PE) despite therapeutic anticoagulation at the time of diagnosis are uncommonly encountered and present a diagnostic and management challenge. Their characterization and outcomes are poorly described. We sought to describe the prevalence and characteristics of therapeutically anticoagulated patients among a population of patients with acute PE in a community setting and to describe treatment changes and 30-day outcomes...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757786/management-of-venous-thromboembolism-with-non-vitamin-k-oral-anticoagulants-a-review-for-nurse-practitioners-and-pharmacists
#17
Michelle Schmerge, Sally Earl, Carol Kline
BACKGROUND AND PURPOSE: Venous thromboembolism (VTE), comprising deep-vein thrombosis and pulmonary embolism, is associated with significant morbidity and mortality. Non-vitamin K oral anticoagulants (NOACs), including apixaban, betrixaban, dabigatran, edoxaban, and rivaroxaban, are as effective and safe as vitamin K antagonists (VKAs) for primary prophylaxis, treatment, and/or secondary prevention of VTE and present significant advantages in convenience of use. This review provides guidance to nurse practitioners (NPs) and pharmacists on NOAC usage for the management of VTE and examines how traditional anticoagulation clinics can adapt to cater to patients on NOACs...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29757489/emergency-department-discharge-of-pulmonary-embolus-patients
#18
W Frank Peacock, Craig I Coleman, Deborah Diercks, Samuel Francis, Christopher Kabrhel, Catherine Keay, Jeffery Kline, Jacob Manteuffel, Peter Wildgoose, Jim Xiang, Adam J Singer
BACKGROUND: Hospitalization for low risk pulmonary embolism (PE) is common, expensive, and of questionable benefit. OBJECTIVE: Determine if low-risk PE patients discharged from the emergency department (ED) on rivaroxaban require fewer hospital days compared to standard of care (SOC). METHODS: Multicenter, open label randomized trial in low risk PE defined by Hestia criteria. Adult subjects were randomized to early ED discharge on rivaroxaban, or SOC...
May 14, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29754426/venous-thromboembolism-in-cancer-patients-receiving-neoadjuvant-chemotherapy-a-systematic-review-and-meta-analysis
#19
M Di Nisio, M Candeloro, A W S Rutjes, E Porreca
BACKGROUND: Venous thromboembolism (VTE) is a frequent complication in cancer patients receiving adjuvant treatment. The risk of VTE during neoadjuvant chemo-radiotherapy remains unclear. OBJECTIVES: This systematic review evaluated the incidence of VTE in patients with cancer receiving neoadjuvant treatment. METHODS: MEDLINE and EMBASE databases were searched from inception to October 2017. Search results were supplemented with screening of conference proceedings of the American Society of Clinical Oncology (2009-2016) and the International Society of Thrombosis and Haemostasis (2003-2016)...
May 13, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29753308/rivaroxaban-for-thromboprophylaxis-among-patients-recently-hospitalized-for-acute-infectious-diseases-a-subgroup-analysis-of-the-magellan-study
#20
Kevin P Cohoon, Yoriko De Sanctis, Lloyd Haskell, Robert D McBane, Theodore E Spiro
BACKGROUND: Despite the well-established association between infection and venous thromboembolism (VTE), there are few data specifically assessing the efficacy and safety of the VTE prophylaxis strategies for patients hospitalized for acute infectious diseases. OBJECTIVES: Estimate incidence of VTE and bleeding outcomes comparing prolonged prophylaxis with rivaroxaban 10 mg daily for 35 days with enoxaparin 40 mg daily for 10 days. PATIENTS/METHODS: A subgroup analysis of patients hospitalized for acute infectious diseases in the MAGELLAN trial was performed...
May 12, 2018: Journal of Thrombosis and Haemostasis: JTH
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