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Thrombus burden

Sunil Kr Verma
A 62-year-old male was undergoing treatment of NHL with bone marrow involvement with thrombocytopenia. After 15min of starting of IV infusion of rituximab, he started having severe retrosternal chest pain, diagnosed as acute ST elevation inferior wall MI. Patient was pre-loaded with dual anti platelets. Coronary angiogram showed 100% occlusion of proximal RCA. Thrombosuction of this culprit RCA revealed underlying 90% stenosis. After that, PCI with balloon angioplasty of RCA was done. The procedure was terminated in the view of successful balloon angioplasty with good TIMI flow...
September 2016: Indian Heart Journal
Alberto Francesco Cereda, Patrizia Pedrotti, Lucio De Capitani, Cristina Giannattasio, Alberto Roghi
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis characterized by hypereosinophilia. EGPA typically develops in three clinical phases, beginning with asthma, followed by tissue eosinophilia and finally systemic vasculitis. Cardiac involvement is the most important predictor of mortality; it occurs in approximately 15-60% of EGPA patients, a significant proportion of whom are asymptomatic and have normal electrocardiogram (ECG) and echocardiogram...
October 7, 2016: European Journal of Internal Medicine
Filip K Swirski, Matthias Nahrendorf, Peter Libby
Inflammation furnishes a series of pathogenic pathways that couple the risk factors for atherosclerosis with altered behavior of the intrinsic cells of the arterial wall, endothelium, and smooth muscle and promote the disease and its complications. Myeloid cells participate critically in all phases of atherosclerosis from initiation through progression, and ultimately the thrombotic consequences of this disease. Foam cells, lipid-laden macrophages, constitute the hallmark of atheromata. Much of the recent expansion in knowledge of the roles of myeloid cells in atherosclerosis revolves around the functional contributions of subsets of monocytes, precursors of macrophages, the most abundant myeloid cells in the atheroma...
August 2016: Microbiology Spectrum
Yu Shrike Zhang, Farideh Davoudi, Philipp Walch, Amir Manbachi, Xuan Luo, Valeria Dell'Erba, Amir K Miri, Hassan Albadawi, Andrea Arneri, Xiaoyun Li, Xiaoying Wang, Mehmet Remzi Dokmeci, Ali Khademhosseini, Rahmi Oklu
Pathologic thrombosis kills more people than cancer and trauma combined; it is associated with significant disability and morbidity, and represents a major healthcare burden. Despite advancements in medical therapies and imaging, there is often incomplete resolution of the thrombus. The residual thrombus can undergo fibrotic changes over time through infiltration of fibroblasts from the surrounding tissues and eventually transform into a permanent clot often associated with post-thrombotic syndrome. In order to understand the importance of cellular interactions and the impact of potential therapeutics to treat thrombosis, an in vitro platform using human cells and blood components would be beneficial...
October 18, 2016: Lab on a Chip
Eric R Powers
No abstract text is available yet for this article.
October 10, 2016: JACC. Cardiovascular Interventions
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
B Ajlani, G Gibault-Genty, G Cherif, E Blicq, S Azzaz, P Schiano, M Brami, L Sarfati, C Charbonnel, R Convers-Domart, B Livarek, J-L Georges
BACKGROUND: Massive intracoronary thrombus is associated with adverse procedural results including failed aspiration and unfavourable reperfusion. We aim to evaluate the effect of the intracoronary administration of antithrombotic agents via a perfusion catheter in patients with ST-segment elevation myocardial infarction (STEMI) presenting with a large thrombus burden and failed aspiration. METHODS: We retrospectively analyzed the thrombus burden, the TIMI grade flow, and the myocardial Blush in 25 consecutive STEMI patients with a large thrombus burden and failed manual aspiration, who received intracoronary infusion of glycoprotein IIb/IIIa inhibitors (N=17) or bivalirudine (N=8) via a 6F-infusion catheter (ClearWay™ RX) RESULTS: Mean age was 67±14 years, 16 patients (64 %) presented with anterior STEMI, and 7 (28 %) with cardiogenic shock...
September 29, 2016: Annales de Cardiologie et D'angéiologie
José A Páramo, Fernando Civeira
As it is well-known, a thrombus evolving into a disrupted/eroded atherosclerotic plaque causes most acute coronary syndromes. Plaque stabilization via reduction of the lipid core and/or thickening of the fibrous cap is one of the possible mechanisms accounted for the clinical benefits displayed by different anti-atherosclerotic strategies. The concept of plaque stabilization was developed to explain how lipid-lowering agents could decrease adverse coronary events without substantial modifications of the atherosclerotic lesion ('angiographic paradox')...
September 27, 2016: Clínica e Investigación en Arteriosclerosis
Y Pan, J Zhao, J Mei, M Shao, J Zhang, H Wu
OBJECTIVE: The incidence of thrombus was investigated within retrievable filters placed in trauma patients with confirmed DVT at the time of retrieval and the optimal treatment for this clinical scenario was assessed. A technique called "filter retrieval with manual negative pressure aspiration thrombectomy" for management of filter thrombus was introduced and assessed. METHODS: The retrievable filters referred for retrieval between January 2008 and December 2015 were retrospectively reviewed to determine the incidence of filter thrombus on a pre-retrieval cavogram...
September 27, 2016: European Journal of Vascular and Endovascular Surgery
Susan M Hastings, Shriprasad Deshpande, Scott Wagoner, Kevin O Maher, David N Ku
Extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support of critically ill patients is used frequently in the pediatric population. ECMO is burdened by complications, including thrombosis and hemorrhage. Here we demonstrate the focused location of clots, their histological composition, and the relationship of in situ thrombus to local hemodynamics in ECMO circuits.Pediatric ECMO circuits from Children's Healthcare of Atlanta, Emory University (Atlanta, GA) were obtained following removal from extracorporeal support over a 2...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Faxin Ren, Nan Mu, Xia Zhang, Jinxi Tan, Liudong Li, Chuanhuan Zhang, Mei Dong
OBJECTIVE: We aimed to investigate the association between platelet-leukocyte aggregates (PLA) levels on admission and the risk of myocardial no-reflow in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: A total of 83 patients with STEMI undergoing primary PCI were included in the current study. Platelet-leukocyte conjugates (PLA), including platelet-monocyte aggregates (PMA), platelet-neutrophil aggregates (PNA) and platelet-lymphocyte aggregates were studied by flow cytometry in peripheral venous blood...
September 2016: American Journal of the Medical Sciences
Maxim Mokin, Elad I Levy, Adnan H Siddiqui, Mayank Goyal, Raul G Nogueira, Dileep R Yavagal, Vitor M Pereira, Jeffrey L Saver
BACKGROUND: The clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown. OBJECTIVE: To evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial...
September 15, 2016: Journal of Neurointerventional Surgery
Mohamed Teleb, Mateo Porres-Aguilar, Belinda Rivera-Lebron, Kyari Sumayin Ngamdu, Gehan Botrus, Javier E Anaya-Ayala, Debabrata Mukherjee
Intermediate-risk pulmonary embolism (PE), also known as submassive PE, occurs in a substantial group of patients and carries a significant mortality risk. With adequate risk stratification, catheter-directed techniques could be used as a therapeutic approach in the intermediate-risk PE. Ultrasound-assisted catheter-directed thrombolysis (UCDT) represents a novel endovascular technique with good clinical and safety outcomes. Ultrasound-assisted catheter-directed thrombolysis can achieve reduction in the thrombus burden and improvement of pulmonary hemodynamics and right ventricular (RV) dysfunction and/or dilatation, without major procedure-related complications, major bleeding, or hemorrhagic strokes...
September 7, 2016: Angiology
De-Jia Huang, Yan-Hao Li, Yao-Chang Luo, Jun-Zhen Huang, Hai-Yuan He
Advanced hepatocellular carcinoma (HCC) with tumor thrombi invading the portal vein and extending into the right atrium (RA) through the hepatic vein is regarded as a terminal-stage condition. Intracardiac tumor thrombus and treatment via liver resection has been reported in the current literature, but results from this therapeutic approach remain unsatisfactory. The present study describes a rare case of HCC with metastatic portal vein, middle hepatic vein, inferior vena cava (IVC) and RA tumor thrombi, and pulmonary metastases...
September 2016: Oncology Letters
Lara El Khoury, Nabil Zeineddine, Richard Felix, Mark Goldstein
Levamisole is an antihelminthic drug banned by the US Food and Drug Administration (FDA) in 2000 because of its dangerous side effects. Over the past few years, it has been identified as an adulterant in cocaine and reported to cause cutaneous vasculitis in cocaine users. The health burden of levamisole is serious since it is estimated that over 5 million Americans use cocaine and that 70% of the cocaine used in the USA contains levamisole. In this paper we report the case of a 23-year-old female cocaine user that presented with purpuric rash and skin necrosis, found to have positive c-ANCA and anti-proteinase 3 antibodies...
2016: Case Reports in Rheumatology
Slaven Pikija, Vladimir Trkulja, Johannes Sebastian Mutzenbach, Mark R McCoy, Patricia Ganger, Johann Sellner
BACKGROUND: Understanding the underlying mechanism of thrombus formation and its components is critical for effective prevention and treatment of ischemic stroke. The generation of thrombotic clots requires conversion of soluble fibrinogen to an insoluble fibrin network. Quantitative features of intracranial clots causing acute ischemic stroke can be studied on non-contrast enhanced CT (NECT). Here, we evaluated on-admission fibrinogen and clot burden in relation to stroke severity, final infarct volume and in-hospital mortality...
2016: Journal of Translational Medicine
Arif Arısoy, Fatih Altunkaş, Kayıhan Karaman, Metin Karayakalı, Ataç Çelik, Köksal Ceyhan, Çağrı Zorlu
Intracoronary thrombus burden is associated with some adverse events and poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Identifying predictors of the intracoronary thrombus burden may contribute to the management of STEMI. In this study, we evaluated whether monocyte count to high-density lipoprotein cholesterol ratio (MHR) is a predictor of intracoronary thrombus burden in patients with STEMI. The study population consisted of 414 patients with STEMI who underwent primary percutaneous coronary intervention (PCI)...
August 16, 2016: Clinical and Applied Thrombosis/hemostasis
Lachlan J Kelsey, Janet T Powell, Paul E Norman, Karol Miller, Barry J Doyle
Aneurysms of the common iliac artery (CIAA) are most commonly seen in association with an abdominal aortic aneurysm (AAA). Isolated CIAAs, in the absence of an AAA, are uncommon. Similar to AAAs, CIAA may develop intraluminal thrombus (ILT). As isolated CIAAs have a contralateral common iliac artery for comparison, they provide an opportunity to study the haemodynamic mechanisms behind ILT formation. In this study, we compared a large isolated CIAA and the contralateral iliac artery using computational fluid dynamics (CFD) to determine if haemodynamic metrics correlate with the location of ILT...
August 10, 2016: International Journal for Numerical Methods in Biomedical Engineering
Anselm Angermaier, Patrik Michel, Alexander V Khaw, Michael Kirsch, Christof Kessler, Soenke Langner
BACKGROUND: Patient selection for endovascular revascularization treatment (ERT) in acute ischemic stroke depends on the expected benefit-risk ratio. As rapid revascularization is a major determinant of good functional outcome, we aimed to identify its predictors after ERT. METHODS: Consecutive stroke patients from a single stroke center with distal internal carotid artery-, proximal middle cerebral artery- or T-occlusions treated with ERT were retrospectively selected...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fuyu Qiu, Gary S Mintz, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Rupa Parvataneni, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
OBJECTIVES: The aim of this study was to evaluate the prevalence and long-term clinical impact of tissue protrusion (TP) after stent implantation. BACKGROUND: Stent implantation may be associated with tissue (plaque or thrombus) protrusion, especially in unstable lesions, but its clinical impact is unknown. METHODS: ADAPT-DES (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) was a prospective multicenter study of 8,663 patients undergoing percutaneous coronary intervention (PCI) using drug-eluting stents...
July 25, 2016: JACC. Cardiovascular Interventions
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