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https://www.readbyqxmd.com/read/29333796/upper-extremity-deep-vein-thrombosis-symptoms-diagnosis-and-treatment
#1
REVIEW
Jaber Mustafa, Ilan Asher, Zev Sthoeger
Upper extremity deep vein thrombosis (UEDVT) is defined as thrombosis of the deep venous system (subclavian, axillary, brachial, ulnar, and radial veins), which drains the upper extremities. It can be caused by thoracic outlet anatomic obstruction, such as Paget-Schroetter syndrome, (primary) or by central intravenous catheters (secondary). UEDVT may be asymptomatic or present with acute severe pain and arm swelling. Clinical suspicion should be confirmed by diagnostic imaging procedures such as duplex ultrasound, computed tomography scan, or magnetic resonance imaging...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29326820/a-case-of-intra-arterial-thrombolysis-with-alteplase-in-a-patient-with-hypothenar-hammer-syndrome-but-without-underlying-aneurysm
#2
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29322817/endovascular-coil-embolization-and-stenting-for-the-treatment-of-iatrogenic-right-internal-mammary-artery-injury-a-case-report
#3
Zhen Jiang, JinXiu Yang, XingXiang Wang
A 54-year-old Chinese woman presented with a 10-year history of repeated paroxysmal palpitations. She was diagnosed with paroxysmal supraventricular tachycardia by 12-lead electrocardiogram and was advised to undergo catheter-based radiofrequency ablation. During the procedure, a rare complication occurred that was diagnosed as a right internal mammary artery penetrating injury. After appropriate emergency treatment with arterial embolization and membrane-covered stent implantation, the patient was out of immediate danger of haemorrhaging...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29322547/improvement-of-the-salvage-rate-of-flap-after-venous-thrombosis-with-intraparenchymatous-venous-pressure-monitoring
#4
Hajime Matsumine, Mariko Mogami, Osamu Fujiwara, Masahiro Hasegawa, Hiroshi Ito, Hiroyuki Sakurai
PURPOSE: Intraparenchymatous venous pressure (IVP) monitoring in flap can measure venous pressure with catheter placement. Among patients with IVP monitoring, this study reviewed postoperative microvascular complications for investigating the transplanted-tissue salvage-rate. PATIENTS AND METHODS: Two hundred and seventy-one patients (male, 132; female, 139; mean age, 52.3 years; age range, 9-82 years) underwent free flap transfer and postoperative continuous IVP monitoring, which performed as follows; a venous catheter was connected to a transducer, and venous pressure in the flap was recorded for three consecutive days postoperatively...
January 11, 2018: Microsurgery
https://www.readbyqxmd.com/read/29322352/supraclavicular-catheterization-of-the-brachiocephalic-vein-a-way-to-prevent-or-reduce-catheter-maintenance-related-complications-in-children
#5
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
January 10, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29295847/how-i-use-catheter-directed-interventional-therapy-to-treat-patients-with-venous-thromboembolism
#6
Suresh Vedantham, Akhilesh K Sista
Patients who present with severe manifestations of acute venous thromboembolism (VTE) are at higher risk for premature death and long-term disability. In recent years, catheter-based interventional procedures have shown strong potential to improve clinical outcomes in selected VTE patients. However, physicians continue to be routinely faced with challenging decisions that pertain to the utilization of these risky and costly treatment strategies, and there is a relative paucity of published clinical trials with sufficient rigor and directness to inform clinical practice...
January 2, 2018: Blood
https://www.readbyqxmd.com/read/29289933/study-protocol-for-a-multicentre-randomised-controlled-trial-to-assess-the-effectiveness-of-antimicrobial-central-venous-catheters-versus-ordinary-central-venous-catheters-at-reducing-catheter-related-infections-in-critically-ill-chinese-patients
#7
Minming Wu, Yao Chen, Bin Du, Yan Kang
INTRODUCTION: Catheter use is associated with many complications and is an iatrogenic source of morbidity and mortality in intensive care units (ICU). The catheter being studied (Certofix Protect) was developed to reduce the risk of catheter related infections. This clinical trial will compare the safety and efficiency of Certofix Protect with that of an ordinary Certofix catheter. METHODS AND ANALYSIS: In this multicentre trial, we will randomly assigned dual lumen central venous catheterisation (≥5 ds) in patients in the adult ICU to the antimicrobial central venous catheter (CVC) group or the ordinary CVC group...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29286452/esophageal-heat-transfer-for-patient-temperature-control-and-targeted-temperature-management
#8
Melissa I Naiman, Maria Gray, Joseph Haymore, Ahmed F Hegazy, Andrej Markota, Neeraj Badjatia, Erik B Kulstad
Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time...
November 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284881/postoperative-chylothorax-of-unclear-etiology-in-a-patient-with-right-sided-subclavian-central-venous-catheter-placement
#9
Samie Asghar, Faisal Shamim
A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29280123/-complications-analysis-of-subcutaneous-venous-access-port-for-chemotherapy-in-patients-with-gastrointestinal-malignancy
#10
Huashe Wang, Yonghe Chen, Aihong Liu, Jun Xiang, Yijia Lin, Yue'e Wen, Xiaobin Wu, Junsheng Peng
OBJECTIVE: To describe and analyze the complications of subcutaneous venous access port for patients with gastrointestinal malignancy. METHODS: Data of 1 912 patients with gastrointestinal malignancy who accepted chemotherapy in our department via subcutaneous venous access ports, including 127 cases in upper arm, 865 cases in subclavicular vein and 920 cases in internal jugular vein, from June 2007 to April 2016 were analyzed retrospectively. Associated complications and risk factors were emphatically investigated...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29249865/heparin-induced-thrombocytopenia-and-thrombosis-preventing-your-thrombolysis-practice-from-taking-a-hitt
#11
REVIEW
Eric Wannamaker, Kimi Kondo, D Thor Johnson
Heparin-induced thrombocytopenia and thrombosis (HITT) is an under-recognized cause of deep venous thrombosis treatment failure and of complications during catheter-directed thrombolysis. After a review of HITT pathophysiology, diagnosis, and management, three different cases are presented in this article. Each case highlights subtleties and challenges of HITT diagnosis and management. An example of a practical approach to the diagnosis of HITT is presented.
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29249170/occult-catheter-rupture-causing-episodic-symptoms-in-a-patient-treated-with-epoprostenol
#12
Barbara L LeVarge, Anica C Law, Blanche Murphy
Infection, thrombosis, and catheter dislodgment are well-recognized potential complications of chronic intravenous prostanoid therapy for pulmonary arterial hypertension. As long-term outcomes of pulmonary hypertension patients improve, novel adverse events are likely to arise. We describe the sudden development of unexplained hypotension and lightheadedness in a patient receiving intravenous epoprostenol for several years, ultimately determined to be due to an unusual catheter complication, not previously described in this population...
January 2018: Pulmonary Circulation
https://www.readbyqxmd.com/read/29242058/endovascular-cooling-versus-standard-femoral-catheters-and-intravascular-complications-a-propensity-matched-cohort-study
#13
Olivier Andremont, Damien du Cheyron, Nicolas Terzi, Cedric Daubin, Amélie Seguin, Xavier Valette, Flore-Anne Lecoq, Jean-Jacques Parienti, Bertrand Sauneuf
BACKGROUND: Targeted temperature management (TTM) contributes to improved neurological outcome in adults who have been successfully resuscitated after cardiac arrest with shockable rhythm. Endovascular cooling catheters are widely used to induce and maintain targeted temperature in the ICU. The aim of the study was to compare the risk of complications with cooling catheters and standard central venous catheters. MATERIALS AND METHODS: In this prospective single-centre cohort study, we included all patients admitted to an intensive care unit for successfully resuscitated cardiac arrest that required endovascular TTM (Coolgard®, Zoll™ Medical corporation, MA, USA), between August 2012 and November 2014, inclusive...
December 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29239263/percutaneous-mechanical-thrombectomy-combined-with-catheter-directed-thrombolysis-in-the-treatment-of-acute-pulmonary-embolism-and-lower-extremity-deep-venous-thrombosis-a-novel-one-stop-endovascular-strategy
#14
Bing Liu, MingYuan Liu, LiHong Yan, JunWei Yan, Jiang Wu, XueFei Jiao, MingJin Guo
Objective This study was performed to evaluate the efficacy and feasibility of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in patients with acute pulmonary embolism (APE) and lower extremity deep venous thrombosis (LEDVT). Methods In total, 20 consecutive patients with APE and LEDVT were prospectively selected for PMT combined with CDT. Mechanical thrombus fragmentation and aspiration using a pigtail rotation catheter followed by CDT was performed in each patient...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29224434/percutaneous-intervention-to-correct-central-venous-port-catheter-malposition
#15
Yen-Hsiang Wang, Chieh-Shou Su, Keng-Hao Chang, Chi-Jen Went, Wen-Lieng Lee, Chih-Hung Lai
The use of central venous port access is increasing due to the requirements of multimodal intravenous therapy.1 However, catheter malposition in smaller veins can lead to vein thrombosis, phlebitis and pain. Herein, we report our experience with the use of percutaneous interventions to correct migrated port catheter malposition. Minimally invasive percutaneous interventional correction of malposition could be an alternative to extraction and re-implantation of malpositioned port catheters.
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29224047/magnetic-resonance-imaging-of-cardiovascular-thrombi-in-children
#16
Pablo Caro-Dominguez, Shi-Joon Yoo, Mike Seed, Lars Grosse-Wortmann
Cardiovascular thrombosis is rare in children and usually occurs in the presence of predisposing conditions, such as indwelling vascular catheters, tumors, aneurysms, ventricular dysfunction, or after surgery. Clots can occur in the cardiac chambers, arteries or veins, or inside conduits. Detection of thrombi is feasible with a variety of magnetic resonance imaging (MRI) techniques, including unenhanced methods but also contrast-enhanced MR angiography. In this essay we illustrate the MRI appearance of cardiovascular thrombosis in children and suggest an imaging protocol based on our clinical experience...
December 9, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29222321/thrombectomy-and-thrombolysis-for-the-prevention-and-treatment-of-postthrombotic-syndrome
#17
REVIEW
Suresh Vedantham
Postthrombotic syndrome (PTS) is a frequent complication of lower-extremity deep vein thrombosis (DVT), occurring in approximately 40% of patients despite the use of anticoagulant therapy. PTS causes significant impairment of patients' health-related quality of life, and no evidence-based therapies have been consistently effective. Catheter-directed thrombolysis and thrombectomy have been shown to remove acute thrombus, and it has been hypothesized they could prevent or reduce PTS. However, because these procedures can be associated with complications, mainly bleeding, randomized trial data are needed to determine when they should be used...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221746/clinical-and-neuroimaging-characteristics-of-cerebral-sinovenous-thrombosis-in-neonates-undergoing-cardiac-surgery
#18
Nathalie H P Claessens, Selma O Algra, Nicolaas J G Jansen, Floris Groenendaal, Esther de Wit, Alexander A Wilbrink, Felix Haas, Antonius N J Schouten, Rutger A J Nievelstein, Manon J N L Benders, Linda S de Vries
OBJECTIVES: Neonates with congenital heart disease may have an increased risk of cerebral sinovenous thrombosis, but incidence rates are lacking. This study describes the clinical and neuroimaging characteristics of cerebral sinovenous thrombosis in neonates undergoing cardiac surgery. METHODS: Forty neonates (78% male) requiring neonatal univentricular or biventricular cardiac repair using cardiopulmonary bypass were included. All underwent preoperative (median postnatal day 7) and postoperative (median postoperative day 7) magnetic resonance imaging of the brain, including venography, to detect cerebral sinovenous thrombosis...
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29214504/postmarketing-experience-with-neutrolin%C3%A2-taurolidine-heparin-calcium-citrate-catheter-lock-solution-in-hemodialysis-patients
#19
Bruce E Reidenberg, Christoph Wanner, Bruce Polsky, Mariana Castanheira, Alla Shelip, Dirk Stalleicken, Antony E Pfaffle
Catheter-related bloodstream infections (CRBSI) are major complications for patients with life-threatening conditions requiring chronic vascular catheterization. The wide range of etiologic microbes and the ongoing development of resistance to antimicrobials with specific mechanisms of action make this an appropriate target for applying a nonspecific antimicrobial therapeutic. Taurolidine hydrolyzes into two antimicrobial moieties, formaldehyde and methylene glycol, which react with microbial surfaces. Neutrolin® (taurolidine, heparin, calcium citrate) was recently introduced in Germany as an antimicrobial catheter lock solution...
December 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29211671/pharmacomechanical-catheter-directed-thrombolysis-for-deep-vein-thrombosis
#20
RANDOMIZED CONTROLLED TRIAL
Suresh Vedantham, Samuel Z Goldhaber, Jim A Julian, Susan R Kahn, Michael R Jaff, David J Cohen, Elizabeth Magnuson, Mahmood K Razavi, Anthony J Comerota, Heather L Gornik, Timothy P Murphy, Lawrence Lewis, James R Duncan, Patricia Nieters, Mary C Derfler, Marc Filion, Chu-Shu Gu, Stephen Kee, Joseph Schneider, Nael Saad, Morey Blinder, Stephan Moll, David Sacks, Judith Lin, John Rundback, Mark Garcia, Rahul Razdan, Eric VanderWoude, Vasco Marques, Clive Kearon
BACKGROUND: The post-thrombotic syndrome frequently develops in patients with proximal deep-vein thrombosis despite treatment with anticoagulant therapy. Pharmacomechanical catheter-directed thrombolysis (hereafter "pharmacomechanical thrombolysis") rapidly removes thrombus and is hypothesized to reduce the risk of the post-thrombotic syndrome. METHODS: We randomly assigned 692 patients with acute proximal deep-vein thrombosis to receive either anticoagulation alone (control group) or anticoagulation plus pharmacomechanical thrombolysis (catheter-mediated or device-mediated intrathrombus delivery of recombinant tissue plasminogen activator and thrombus aspiration or maceration, with or without stenting)...
December 7, 2017: New England Journal of Medicine
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