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https://www.readbyqxmd.com/read/28430541/a-comprehensive-approach-to-hepatic-vascular-disease
#1
Khaled M Elsayes, Akram M Shaaban, Sarah M Rothan, Sanaz Javadi, Beatrice L Madrazo, Rosa P Castillo, Victor J Casillas, Christine O Menias
The liver has a complex vascular supply, which involves the inflow of oxygenated blood through the hepatic artery (systemic circulation) and deoxygenated blood through the portal vein (portal circulation), as well as the outflow of deoxygenated blood through the hepatic veins to the inferior vena cava. A spectrum of vascular variants can involve the liver. Some of these variants may result in areas of enhancement that can mimic more serious pathologic conditions. In this article, the authors discuss a spectrum of variants and pathologic conditions that may involve the liver vasculature...
April 21, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#2
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28420633/fibrin-sheath-associated-endovascular-infection-of-the-heart-the-trojan-horse-of-indwelling-central-venous-catheters
#3
Muhammad Adil Sheikh, Mohamed Shokr, Walid Ibrahim, Shaun Cardozo
Chronic indwelling central venous catheters can result in formation of fibrin sheaths increasing risk of occlusion, thrombosis and infection. Endovascular infection of right-sided heart structures induced by such sheaths is very rare. A 48-year-old woman with end-stage renal disease initially treated for diabetic ketoacidosis developed persistent Staphylococcus epidermidis bacteraemia without an identifiable source. Although transthoracic echocardiography was unremarkable, transoesophageal echocardiography revealed a fibrin sheath and vegetations in superior vena cava-right atrium junction, which was the site of the tip of a central catheter that had been removed 2 months prior, consistent with fibrin sheath-associated endovascular infection...
April 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28419986/hypodysfibrinogenemia-with-a-heterozygous-mutation-of-%C3%AE-cys326ser-by-the-novel-transversion-of-tgt-to-tct-in-a-patient-with-pulmonary-thromboembolism-and-right-ventricular-thrombus
#4
Akiko Ushijima, Taichi Komai, Atsuko Masukawa, Keiko Oikawa, Norishige Morita, Satomi Asai, Saki Mukai, Nobuo Okumura, Yoshinori Kobayashi, Hayato Miyachi
We encountered a 45-year-old Japanese man who suffered from pulmonary thromboembolism and huge right ventricular thrombus after inferior vena cava (IVC) filter implantation without apparent thrombus in either the deep veins or inside the IVC filter. The biochemical data showed a discrepancy in the level of fibrinogen between the immunological and thrombin time methods, suggesting hypodysfibrinogenemia. The sequencing of the fibrinogen γ-chain gene (FGG) revealed a novel heterozygous missense mutation in exon 8 - a TGT to TCT transversion in codon 326 - resulting in an amino acid substitution of serine for cysteine (γCys326Ser)...
April 19, 2017: Cardiology
https://www.readbyqxmd.com/read/28413581/robotic-assisted-inferior-vena-cava-filter-retrieval
#5
Shahin Owji, Tony Lu, Thomas M Loh, Adeline Schwein, Alan B Lumsden, Jean Bismuth
Although anticoagulation remains the mainstay of therapy for patients with venous thromboembolism, guidelines recommend the use of inferior vena cava (IVC) filters in those who fail anticoagulation or have contraindications to its use. Short-term use of filters has proven effective in reducing the rate of pulmonary embolism. However, their extended use is associated with a variety of complications such as thrombosis, filter migration, or caval perforation, thus making a case for timely filter retrieval. This is the case of a 68-year-old female with a history of chronic oral anticoagulation use for multiple deep venous thrombi (DVT) and pulmonary emboli (PE) who required cervical and thoracic spinal intervention for spondylosis and foramina stenosis...
January 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28380473/successful-management-of-a-patient-with-autoimmune-hemorrhaphilia-due-to-anti-factor-xiii-13-antibodies-complicated-by-pulmonary-thromboembolism
#6
Yoshiyuki Ogawa, Kunio Yanagisawa, Masayoshi Souri, Masahiro Mihara, Chiaki Naito, Makiko Takizawa, Takuma Ishizaki, Takeki Mitsui, Hiroshi Handa, Tsukasa Osaki, Yoshihisa Nojima, Akitada Ichinose
Autoimmune hemophilia-like disease (hemorrhaphilia) due to anti-factor XIII (FXIII) antibodies (AH13) is a very rare, life-threatening bleeding disorder. A 77-year-old woman developed macrohematuria and a right renal pelvic hematoma. The coagulation times were not prolonged, but FXIII activity and antigen levels were severely and moderately reduced to 9 and 29% of normal values, respectively. Accordingly, the FXIII-specific activity turned out to be low. FXIII inhibitor and anti-FXIII-A subunit autoantibodies were detected by a 1:1 crossmixing test and immunoblot and immunochromatographic assays...
April 6, 2017: Acta Haematologica
https://www.readbyqxmd.com/read/28373261/how-we-treat-central-venous-access-device-related-upper-extremity-dvt
#7
Anita Rajasekhar, Michael B Streiff
Central venous access device (CVAD)-related thrombosis (CRT) is a common complication among patients requiring central venous access as part of their medical care. Complications of CRT include pulmonary embolism, recurrent deep venous thrombosis, loss of central venous access and post-thrombotic syndrome. Patient, device and treatment-related factors can influence the risk of CRT. Despite numerous randomized controlled trials, the clinical benefit of pharmacologic thromboprophylaxis for prevention of CRT remains to be established...
April 3, 2017: Blood
https://www.readbyqxmd.com/read/28372458/hepatocellular-carcinoma-presenting-with-budd-chiari-syndrome-right-atrial-thrombus-and-pulmonary-emboli
#8
Luís C Lourenço, David V Horta, Sara F Alberto, Jorge Reis
A 47-year-old patient presented with a two-week history of right upper quadrant pain, abdominal distention and new onset of shortness of breath. He had a history of intravenous drug abuse, no alcohol consumption and denied any known liver disease. On physical examination, he was tachypneic and had dullness in the flanks. His blood analysis at admission was as follows: hemoglobin, 12.9 g/dL; leukocyte count, 6,800/uL; platelet count, 63,000/uL; INR, 2.1; serum creatinine, 1.27 mg/dL; liver biochemistry tests were notable for marginal derangement, HBsAg was negative, anti-HCV was positive, HCV RNA was 367,498 IU/ml and alpha-fetoprotein was 992 mg/dL...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28368881/patent-foramen-ovale-closure-through-inferior-vena-cava-filter-in-a-patient-with-deep-venous-thrombosis-and-recurrent-ischemic-events
#9
Damiano Regazzoli, Marco B Ancona, Antonio Mangieri, Akihito Tanaka, Vittorio Romano, Pier P Leone, Moreno Tresoldi, Giuseppe Lanzillo, Eustachio Agricola, Azeem Latib, Antonio Colombo, Matteo Montorfano
Here reported a case of successful patent foramen ovale (PFO) occlusion from femoral vein access passing through a caval filter. Vena cava filters are broadly implanted and this case suggests that procedures that require large delivery systems to be passed through filters are safe and feasible.
March 31, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28367009/trauma-patients-warrant-upper-and-lower-extremity-venous-duplex-ultrasound-surveillance
#10
Alonso Andrade, Alan H Tyroch, Susan F McLean, Jody Smith, Alex Ramos
BACKGROUND: Due to the high incidence of thromboembolic events (deep venous thrombosis [DVT] and pulmonary embolus [PE]) after injury, many trauma centers perform lower extremity surveillance duplex ultrasounds. We hypothesize that trauma patients are at a higher risk of upper extremity DVTs (UEDVTs) than lower extremity DVTs (LEDVTs), and therefore, all extremities should be evaluated. MATERIALS AND METHODS: A retrospective chart and trauma registry review of Intensive Care Unit trauma patients with upper and LEDVTs detected on surveillance duplex ultrasound from January 2010 to December 2014 was carried out...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28355402/budd-chiari-syndrome-secondary-to-catheter-associated-inferior-vena-cava-thrombosis
#11
Gustavo N Araujo, Luciane M Restelatto, Carlos A Prompt, Cristina Karohl
INTRODUCTION: Patients with chronic kidney disease (CKD) are at increased risk for thrombotic complications. The use of central venous catheters as dialysis vascular access additionally increases this risk. We describe the first case of Budd-Chiari syndrome (BCS) secondary to central venous catheter misplacement in a patient with CKD. CASE REPORT: A 30-year-old female patient with HIV/AIDS and CKD on hemodialysis was admitted to the emergency room for complaints of fever, prostration, and headache in the last six days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/28348475/giant-intrahepatic-portal-vein-aneurysm-leave-it-or-treat-it
#12
Amit Shrivastava, Jagdeesh S Rampal, D Nageshwar Reddy
Portal vein aneurysm (PVA) is a rare vascular dilatation of the portal vein. It is a rare vascular anomaly representing less than 3% of all visceral aneurysms and is not well understood. Usually, PVA are incidental findings, are asymptomatic, and clinical symptoms are proportionally related to size. Patients present with nonspecific epigastric pain or gastrointestinal bleeding with underlying portal hypertension. PVA may be associated with various complications such as biliary tract compression, portal vein thrombosis/rupture, duodenal compression, gastrointestinal bleeding, and inferior vena cava obstruction...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28341513/impact-of-inferior-vena-cava-filter-placement-on-short-term-outcomes-in-patients-with-acute-pulmonary-embolism
#13
Nathan L Liang, Elizabeth A Genovese, Efthymios D Avgerinos, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Inferior vena cava filters (IVCF) have been associated with improved survival in patients with acute pulmonary embolism (PE) in some studies. However, without randomization, those with early mortality who did not receive an IVCF may have died prior to treatment decision about filter placement, falsely contributing a survival advantage to those receiving IVCF and biasing the results of previous observational studies. The objective of this study is to evaluate the impact of IVCF on in-hospital mortality after adjusting for this survivor treatment selection...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341503/endovascular-repair-of-a-large-abdominal-aortic-aneurysm-in-a-patient-presenting-with-lower-extremity-edema-as-a-result-of-inferior-vena-cava-thrombosis
#14
Nan Li, Ming Xue, Deng-Ke Hong, Xing-Sheng Chen
PURPOSE: Abdominal aortic aneurysm (AAA) can present with symptoms because of aneurysmal compression of adjacent organ systems. This condition has always been treated by open surgical repair. Here, we report a case of an AAA complicated by inferior vena cava (IVC) thrombosis and deep venous thrombosis (DVT) due to IVC compression by aneurysm successfully treated by endovascular aneurysm repair (EVAR). CASE REPORT: A 50-year-old man presented with three-day right lower extremity edema...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28334639/inferior-vena-cava-filters-in-patients-with-cancer-and-venous-thromboembolism-vte-does-not-improve-clinical-outcomes-a-population-based-study
#15
Ann Brunson, Gwendolyn Ho, Richard White, Ted Wun
BACKGROUND: There are few studies that have determined clinical outcomes following inferior vena cava filter (IVCF) insertion in cancer patients hospitalized for acute deep-vein-thrombosis (DVT) or pulmonary embolism (PE). METHODS AND RESULTS: We analyzed hospital discharge records of all patients with active cancer who were admitted to a California hospital specifically for acute DVT or PE between 2005 through 2009. Propensity and competing risk methodology were used to determine if IVCF-use lowered either 30-day mortality or the risk of recurrent PE, DVT, and major bleeding within 180days...
March 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28332376/pathological-significance-of-tissue-trapped-in-retrieved-optease-vena-cava-filter-at-18th-day-after-installation-in-patient-with-deep-vein-thrombosis
#16
Sang Min Park, Jung Woo Son, Kyung Soon Hong, Kyung Chan Choi
The retrievable type of inferior vena cava filter has been widely used to prevent pulmonary thromboembolism in patients with deep vein thrombosis and contraindication of anticoagulation. Physicians make considerable efforts to remove the filter according to the manufacturer and US Food and Drug Administration safety advisory recommendation. However, forced filter retrieval might cause vascular injury within 3 weeks. Herein, we report pathologic and angiographic findings to suggest filter associated vascular injury during forced retrieval just within recommended period in a patient with deep vein thrombosis...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28319522/a-numerical-simulation-comparing-a-cavopulmonary-assist-device-and-va-ecmo-for-failing-fontan-support
#17
Po-Lin Hsu, Dongfang Wang, Cherry Ballard-Croft, Dawei Xiao, Joseph B Zwischenberger
A cavopulmonary assist device (CPAD) has been developed for failing Fontan support. This CPAD pumps blood from superior/inferior vena cavae to pulmonary artery. In this study, we compared failing Fontan support with CPAD versus VA ECMO in silico. A numerical lumped-parameter circulatory system model was used to simulate Fontan circulation. Failing Fontan was simulated by increased pulmonary resistance. Central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), left atrial pressure (LAP), and univentricular outflow (CO) were simulated and compared to published clinical data...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28316856/giant-splenorenal-shunt-in-a-young-patient-with-autoimmune-hepatitis-primary-biliary-cholangitis-overlap-syndrome-and-portal-vein-thrombosis
#18
F Chegai, A U Cavallo, M Forcina, V Giuricin, F Castellani, L Greco, M Manuelli, T M Manzia, G Sergiacomi
We present a case of giant Splenorenal Shunt (SRS) associated with portal vein thrombosis in a 37-year-old woman with a twelve-year history of autoimmune hepatitis/primary biliary cholangitis overlap syndrome. At the moment of the CT examination laboratory tests showed creatinine 1.5 mg/dl, bilirubin 1.5 mg/dl, INR 3, and Na 145 mmol/l and the Model End-Stage Liver Disease score was 24. Extensive calcified thrombosis causing complete occlusion of the portal vein lumen and partially occluding the origin of the superior mesenteric vein was present and a small calcified thrombus in the Splenic Vein lumen was also evident...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/28316327/obstructive-primary-cardiac-t-cell-lymphoma-a-case-report-from-senegal
#19
Simon Antoine Sarr, Abdou Majib Gaye, Fatou Aw, Jean de Dieu Nzambaza, Malick Bodian, Kana Babaka, Mouhamadou Bamba Ndiaye, Adama Kane, Maboury Diao, Serigne Abdou Ba
BACKGROUND Cardiac lymphoma is a rare entity, defined by the non-extra cardiac location at diagnosis. CASE REPORT Our patient was a 32-year-old female with no particular medical history, who presented with right heart failure with recurrent ascites and pleural effusion. There was a progressive worsening exertional dyspnea. On admission, examination revealed an irregular tachycardia at 170 beats per minute (bpm) and congestive heart failure. The electrocardiogram scored full tachyarrhythmia by atrial fibrillation with an average ventricular rate of 179 cycles per minute...
March 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28315498/primitive-neuroectodermal-tumour-of-kidney-with-thrombosis-of-the-inferior-vena-cava-and-good-responsive-to-surgical-and-medical-treatment-description-of-a-case-and-revision-of-literature
#20
Giovanni L Giliberto, Carmelo A Di Franco, Bruno Rovereto
Primitive neuroectodermal tumour (PNET) of kidney is a rare cancer typical of young adults with few cases described in the literature. We report a case of renal PNET in a 31-year-old man who presented to our department with a computed tomographic (CT)-scan revealing a large renal mass of 20 cm, massive thrombosis of the inferior vena cava (IVC). The patient underwent radical nephrectomy with contextual retroperitoneal lymphadenectomy and resection of IVC needing Dacron prosthesis substitution. Definitive histopathological examination showed PNET of kidney infiltrating ipsilateral adrenal gland, massive cava thrombosis with infiltration of vena cava wall and one lymph nodal metastasis...
March 15, 2017: Urologia
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