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Pulmonary Thromboembolism

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https://www.readbyqxmd.com/read/28317330/long-term-risk-of-venous-thromboembolism-recurrence-after-isolated-superficial-vein-thrombosis
#1
Jean-Philippe Galanaud, Marie-Antoinette Sevestre, Gilles Pernod, Susan R Kahn, Céline Genty, Hugo Terrisse, Dominique Brisot, Jean-Luc Gillet, Isabelle Quéré, Jean-Luc Bosson
BACKGROUND: Isolated superficial vein thrombosis (iSVT) (without concomitant deep vein thrombosis (DVT) or pulmonary embolism (PE)) is a frequent event but available data on long-term outcomes are scarce and retrospective. Therefore, we aimed to determine prospectively the risk and type of venous thromboembolic (VTE) recurrence after iSVT and compare it with that of proximal DVT. METHODS: Using data from the prospective, multicentre, observational, OPTIMEV study, we assessed at three years and after anticoagulants were stopped, the incidence and the type of VTE recurrence (iSVT/DVT/PE) of patients with a first objectively confirmed iSVT without cancer (n=285) and compared this to patients with a first proximal DVT without cancer (n=262)...
March 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28316124/anticoagulation-in-patients-with-isolated-distal-deep-vein-thrombosis-a-meta-analysis
#2
Laura Franco, Michela Giustozzi, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: The optimal management of patients with isolated distal deep vein thrombosis (IDDVT) concerning both the need for anticoagulation and its duration is undefined. OBJECTIVES: We performed a meta-analysis of randomized and cohort studies in patients with IDDVT to assess the clinical benefit of i) anticoagulation versus no anticoagulation and ii) anticoagulant treatment for 6 weeks vs. more than 6 weeks. METHODS: The primary outcome of this analysis was recurrent venous thromboembolism (proximal propagation, recurrence of deep vein thrombosis and pulmonary embolism)...
March 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28316030/a-new-ct-score-as-index-of-hemodynamic-changes-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#3
Maria Barbara Leone, Marica Giannotta, Massimiliano Palazzini, Mariano Cefarelli, Sofia Martìn Suàrez, Enrico Gotti, Maria Letizia Bacchi Reggiani, Maurizio Zompatori, Nazzareno Galiè
PURPOSE: The aim of this study was to retrospectively assess the relationship between radiological and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We introduced a new CT-score to evaluate hemodynamic changes, only employing CT-pulmonary angiography (CTPA). MATERIALS AND METHODS: 145 patients affected by CTEPH underwent hemodynamic and CTPA evaluation. Among these 145 patients, 69 underwent pulmonary endarterectomy (PEA) and performed a CTPA evaluation even after surgery...
March 18, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28314981/time-trends-in-incidence-rates-of-venous-thromboembolism-in-a-large-cohort-recruited-from-the-general-population
#4
Nadia Arshad, Trond Isaksen, John-Bjarne Hansen, Sigrid K Brækkan
Changes in the incidence of venous thromboembolism (VTE) during the last two decades have not been extensively studied. Therefore, we studied time trends in the incidence rates (IRs) of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a cohort of 26,855 subjects, aged 25-97 years, enrolled in the Tromsø study in 1994/1995. The subject were followed-up throughout 2012, and all symptomatic, objectively confirmed, incident VTEs were identified using multiple sources (hospital discharge-, radiology procedure- and autopsy registry) and validated by review of medical records...
March 17, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28314711/validating-the-herdoo2-rule-to-guide-treatment-duration-for-women-with-unprovoked-venous-thrombosis-multinational-prospective-cohort-management-study
#5
Marc A Rodger, Gregoire Le Gal, David R Anderson, Jeannot Schmidt, Gilles Pernod, Susan R Kahn, Marc Righini, Patrick Mismetti, Clive Kearon, Guy Meyer, Antoine Elias, Tim Ramsay, Thomas L Ortel, Menno V Huisman, Michael J Kovacs
Objective To prospectively validate the HERDOO2 rule (Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years), which states that women with none or one of the criteria can safely discontinue anticoagulants after short term treatment.Design Prospective cohort management study.Setting 44 secondary or tertiary care centres in seven countries.Participants Of 3155 consecutive eligible participants with a first unprovoked venous thromboembolism (VTE, proximal leg deep vein thrombosis or pulmonary embolism) who completed 5-12 months of short term anticoagulant treatment, 370 declined to participate, leaving 2785 enrolled participants...
March 17, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28302764/-18-f-gp1-a-novel-fluorine-18-labeled-tracer-designed-for-pet-imaging-of-thrombi-with-high-detection-sensitivity-and-low-background
#6
Jessica Lohrke, Holger Siebeneicher, Markus Berger, Michael Reinhardt, Mathias Berndt, Andre Mueller, Marion Zerna, Norman Koglin, Felix Oden, Marcus Bauser, Matthias Friebe, Ludger M Dinkelborg, Joachim Huetter, Andrew W Stephens
Thromboembolic diseases such as myocardial infarction, stroke, transient ischemic attacks and pulmonary embolism are major causes of morbidity and mortality worldwide. GPIIb/IIIa is the key receptor involved in platelet aggregation and is a validated target for therapeutic approaches and diagnostic imaging. The aim of this study was to develop and characterize a specific small molecule tracer for positron emission tomography (PET) imaging that binds with high affinity to GPIIb/IIIa receptors and has suitable pharmacokinetic properties to overcome limitations of previous approaches...
March 16, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28302503/the-giessen-pulmonary-hypertension-registry-survival-in-pulmonary-hypertension-subgroups
#7
Henning Gall, Janine F Felix, Franziska K Schneck, Katrin Milger, Natascha Sommer, Robert Voswinckel, Oscar H Franco, Albert Hofman, Ralph T Schermuly, Norbert Weissmann, Friedrich Grimminger, Werner Seeger, Hossein A Ghofrani
BACKGROUND: Pulmonary hypertension (PH) is a severe, progressive disease. Although 5 PH subgroups are recognized, reports on survival have focused mainly on pulmonary arterial hypertension (PAH). METHODS: Long-term transplant-free survival and its determinants were investigated in patients with PH (diagnosed by right heart catheterization) within a prospective registry at a single referral center in Giessen, Germany. RESULTS: In total, 2,067 patients were enrolled (PAH, 685 patients [33...
February 17, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28302245/amniotic-fluid-embolism
#8
Tayyab Mohyuddin, Shahbaz Sarwar, Dawar Ayyaz
We report a case of 34-year patient who had uncomplicated elective caesarean-section. Postoperatively, she developed sudden hypotension, bradycardia, dyspnea and disseminated intravascular coagulation (DIC), all signs associated with amniotic fluid embolism (AFE). Echocardiogram showed signs of acutely increased right ventricular after load including McConell's sign, i.e. right ventricular dilatation, segmental hypokinesia (mid-right ventricular) and hypercontractile right ventricular apex and overall right ventricular dysfunction...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28300866/thrombotic-risk-according-to-serpinc1-genotype-in-a-large-cohort-of-subjects-with-antithrombin-inherited-deficiency
#9
Martine Alhenc-Gelas, Genevieve Plu-Bureau, Justine Hugon-Rodin, Véronique Picard, Marie-Helene Horellou
Inherited quantitative (type I) or qualitative (type II) antithrombin deficiency (ATD) due to mutations in the SERPINC1 gene is a well-known risk factor for venous thromboembolism. ATD may also increase risk for arterial thrombosis. Few studies have investigated risk for thrombosis according to mutations. We addressed this topic in a large retrospective cohort study of 540 heterozygous carriers of SERPINC1 mutations and compared risk for first venous or arterial thrombosis associated with carrying of different type II or type I mutations...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28298559/the-risk-of-deep-venous-thrombosis-and-pulmonary-embolism-in-primary-sj%C3%A3-gren-syndrome-a-general-population-based-study
#10
J Antonio Aviña-Zubieta, Michael Jansz, Eric C Sayre, Hyon K Choi
OBJECTIVE: To estimate the future risk and time trends of venous thromboembolism (VTE) in individuals with newly diagnosed primary Sjögren syndrome (pSS) in the general population. METHODS: Using a population database that includes all residents of British Columbia, Canada, we created a study cohort of all patients with incident SS and up to 10 controls from the general population matched for age, sex, and entry time. We compared incidence rates (IR) of pulmonary embolism (PE), deep vein thrombosis (DVT), and VTE between the 2 groups according to SS disease duration...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28298388/pulmonary-endarterectomy-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#11
REVIEW
David Jenkins, Michael Madani, Elie Fadel, Andrea Maria D'Armini, Eckhard Mayer
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension, resulting from fibrotic transformation of pulmonary artery clots causing chronic obstruction in macroscopic pulmonary arteries and associated vascular remodelling in the microvasculature.Pulmonary endarterectomy (PEA) offers the best chance of symptomatic and prognostic improvement in eligible patients; in expert centres, it has excellent results. Current in-hospital mortality rates are <5% and survival is >90% at 1 year and >70% at 10 years...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28298387/diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#12
REVIEW
Deepa Gopalan, Marion Delcroix, Matthias Held
Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of pulmonary hypertension. Rapid and accurate diagnosis is pivotal for successful treatment. Clinical signs and symptoms can be nonspecific and risk factors such as history of venous thromboembolism may not always be present. Echocardiography is the recommended first diagnostic step. Cardiopulmonary exercise testing is a complementary tool that can help to identify patients with milder abnormalities and chronic thromboembolic disease, triggering the need for further investigation...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28294875/-efficiency-of-operation-trombendarterektomy-from-pulmonary-artery-branches-depending-on-the-degree-of-pulmonary-hypertension-and-duration-of-disease
#13
A M Chernyavskiy, A G Edemskiy, M A Chernyavskiy, V G Efimenko, A R Tarkova, S N Ivanov
AIM: to assess effect of thromboendarterectomy from pulmonary artery branches on clinical functional state of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in dependence on degree of pulmonary hypertension and disease duration. MATERIAL: Patients (n=152) were divided into 3 groups: (1) with systolic pulmonary artery pressure (SPAP) less or equal 50 mm Hg (n=20), (2) with SPAP>50- less or equal 80mm Hg (n=46), (3) with SPAP >80mm Hg (n=86)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28293147/a-case-of-pulmonary-thromboembolism-due-to-coagulation-factor-v-leiden-in-japan%C3%A2-%C3%A2-usefulness-of-next-generation-sequencing
#14
Daisuke Sueta, Miwa Ito, Mitsuhiro Uchiba, Kenji Sakamoto, Eiichiro Yamamoto, Yasuhiro Izumiya, Sunao Kojima, Koichi Kaikita, Satoru Shinriki, Seiji Hokimoto, Hirotaka Matsui, Kenichi Tsujita
BACKGROUND: Because the venous thromboembolisms (VTEs) due to the coagulation factor V R506Q (FV Leiden) mutation is often seen in Caucasians, the VTE onset in Japan has not been reported. CASE PRESENTATION: A 34-year-old man from north Africa experiencing sudden dyspnea went to a hospital for advice. The patient had pain in his right leg and a high plasma D-dimer level. A contrast-enhanced computed tomography scan revealed a contrast deficit in the bilateral pulmonary artery and in the right lower extremity...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28291667/medical-therapy-versus-balloon-angioplasty-for-cteph-a-systematic-review-and-meta-analysis
#15
Kevin Phan, Helen E Jo, Joshua Xu, Edmund M Lau
BACKGROUND: A significant number of chronic thromboembolic pulmonary hypertension (CTEPH) patients will have an inoperable disease. Medical therapy and balloon pulmonary angioplasty (BPA) have provided alternate therapeutic options for patients with inoperable CTEPH, although there are a limited number of published studies examining the outcomes. Thus, our study aims to evaluate and compare the efficacy of medical therapy and BPA in patients with inoperable CTEPH. METHODS: An electronic search of six databases was performed and the search results were screened against established criteria for inclusion into this study...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#16
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28289496/surgical-treatment-of-chronic-thromboembolic-pulmonary-hypertension-pulmonary-thromboendarterectomy
#17
Michael M Madani
Pulmonary thromboendarterectomy (PTE), also referred to as pulmonary endarterectomy, is the definitive treatment for chronic thromboembolic pulmonary hypertension (CTEPH). The true incidence of CTEPH is unknown and difficult to ascertain; however, most experts agree that approximately 4% to 5% of all patients who have an acute episode of pulmonary embolism (PE) will continue to develop CTEPH. Based on an incidence rate of about 0.1% for acute PE, this translates into a CTEPH incidence of approximately 10,000 to 15,000 annually in the United States alone...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28289495/treatment-of-chronic-thromboembolic-pulmonary-hypertension-the-role-of-medical-therapy-and-balloon-pulmonary-angioplasty
#18
Timothy M Fernandes, David S Poch, William R Auger
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable disease when treated with pulmonary thromboendarterectomy (PTE). However, even at experienced surgical centers, nearly one-third of patients with CTEPH will be deemed inoperable for reasons including distal disease, comorbidities, or out-of-proportion pulmonary hypertension. It is in these patients with inoperable CTEPH that pulmonary hypertension (PH)-targeted medical therapy and balloon pulmonary angioplasty have potential therapeutic value...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28289494/chronic-thromboembolic-pulmonary-hypertension-pearls-and-pitfalls-of-diagnosis
#19
Humna Abid Memon, C Huie Lin, Ashrith Guha
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic obstruction of major pulmonary arteries by organized thromboembolic material. Untreated CTEPH can result in pulmonary hypertension and eventually right heart failure, yet it is the only form of pulmonary hypertension that is potentially curable with surgical or catheter-based intervention. While early diagnosis is key to increasing the likelihood of successful treatment, CTEPH remains largely underdiagnosed. This article reviews the role of echocardiogram, ventilation/perfusion scan, and other available modalities in the diagnosis of CTEPH...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28289493/epidemiology-and-pathophysiology-of-chronic-thromboembolic-pulmonary-hypertension-risk-factors-and-mechanisms
#20
Sarah Medrek, Zeenat Safdar
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when thromboemboli travel to the pulmonary vasculature, fail to resolve, and cause elevated pulmonary arterial pressure. Untreated, this disease leads to progressive right heart failure and death. It develops in approximately 1% to 5% of patients who suffer an acute pulmonary embolism (PE) and has an overall incidence of 3 to 30 per million in the general population. While it is not entirely evident why most but not all people are able to clear this clot burden, there are known risk factors for the development of CTEPH...
October 2016: Methodist DeBakey Cardiovascular Journal
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