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https://www.readbyqxmd.com/read/28525548/computational-fluid-dynamics-characterization-of-pulsatile-flow-in-central-and-sano-shunts-connected-to-the-pulmonary-arteries-importance-of-graft-angulation-on-shear-stress-induced-platelet-mediated-thrombosis
#1
Robert Ascuitto, Nancy Ross-Ascuitto, Martin Guillot, Carey Celestin
OBJECTIVES: Central (aorta) and Sano (right ventricle)-to-pulmonary artery (PA) shunts, palliative operations for infants with complex heart defects, can develop life-threatening thrombosis. We employed computational fluid dynamics (CFD) to study pulsatile flow in these shunts, with the goal to identify haemodynamic characteristics conducive to thrombus formation. METHODS: CFD, using the finite volume method with cardiac catheterization data, and computer simulations, based on angiography, were employed to determine flow-velocity field, wall shear stress (WSS) profile and oscillatory shear index (OSI)...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28480772/cross-circulation-thrombectomy-with-use-of-a-stent-retriever-a-case-report
#2
Ali Sultan-Qurraie, Gregory Rozansky, John Andrew Cox, Marc Lazzaro
Introduction The efficacy of the endovascular treatment of acute ischemic stroke has been substantiated by several recent randomized clinical trials. While intra-arterial therapy has significantly evolved in recent years, anatomic cerebrovascular variants and disease burden can present challenges to timely recanalization. We present the first reported case of anterior-to-posterior mechanical clot retrieval with use of a stent retriever. Case description A 53-year-old man presented with basilar artery thrombosis...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28470135/a-decade-of-health-assessments-in-appalachia
#3
E Scott Sills, Xiang Li
Purpose The purpose of this paper is to describe standardized clinical process of care and quality performance metrics at Roane Medical Center (RMC) and compare data from 2005 to 2015. Design/methodology/approach Information was extracted from a nationwide sample of short-term acute care hospitals using the Hospital Quality Alliance (HQA) database, evaluating multiple parameters measured at RMC. HQA data from RMC were matched against state and national benchmarks; findings were also compared with similar reports from the same facility in 2005...
May 8, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28432262/quantitative-imaging-of-cerebral-thromboemboli-in-vivo-the-effects-of-tissue-type-plasminogen-activator
#4
Dong-Eog Kim, Jeong-Yeon Kim, Dawid Schellingerhout, Ju Hee Ryu, Su-Kyoung Lee, Sangmin Jeon, Ji Sung Lee, Jiwon Kim, Hee Jeong Jang, Jung E Park, Eo Jin Kim, Ick Chan Kwon, Cheol-Hee Ahn, Matthias Nahrendorf, Kwangmeyung Kim
BACKGROUND AND PURPOSE: Quantitative imaging for the noninvasive assessment of thrombolysis is needed to advance basic and clinical thrombosis-related research and tailor tissue-type plasminogen activator (tPA) treatment for stroke patients. We quantified the evolution of cerebral thromboemboli using fibrin-targeted glycol chitosan-coated gold nanoparticles and microcomputed tomography, with/without tPA therapy. METHODS: We injected thrombi into the distal internal carotid artery in mice (n=50)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28411920/neoadjuvant-targeted-molecular-therapy-before-renal-surgery
#5
REVIEW
Sumi Dey, Henry N Peabody, Sabrina L Noyes, Brian R Lane
Neoadjuvant targeted molecular therapy may benefit select patients with metastatic renal cell carcinoma. The primary use of this therapy in patients with metastatic disease is to reduce tumor burden, prevent distant metastasis, and increase overall survival. Neoadjuvant therapy may reduce tumor size and tumor complexity, facilitate partial nephrectomy rather than radical nephrectomy, downstage tumor thrombus facilitating thrombectomy, and make unresectable tumors resectable when applied to selected patients...
May 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28400037/predictors-of-no-reflow-during-primary-angioplasty-for-acute-myocardial-infarction-from-medical-college-hospital-trivandrum
#6
Padmajan Sabin, Alummoottil George Koshy, Prabha Nini Gupta, Pattu Valappil Sanjai, Kunjukrishanpilla Sivaprasad, Praveen Velappan, Radhakrishnan Vellikat Velayudhan
BACKGROUND: Primary angioplasty (PCI) for acute myocardial infarction is associated with no-reflow phenomenon, in about 5-25% of cases. Here we analysed the factors predicting no reflow . METHODS: This was a case control study of consecutive patients with acute myocardial infarction who underwent Primary PCI from August 2014 to February 2015. RESULTS: Of 181 patients who underwent primary PCI, 47 (25.9%) showed an angiographic no-reflow phenomenon...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28398633/intracranial-hemorrhage-in-a-patient-with-sub-massive-pulmonary-embolism-treated-with-ekosonic-endovascular-system-directed-thrombolysis
#7
Sarju Ganatra, Arjun Majithia, Yun-Ting Eric Yeh, Michael S Levy
Ultrasound-assisted catheter-directed thrombolysis therapy has emerged more recently as a management strategy for patients with intermediate risk pulmonary embolism and has shown promising results in clinical trials by early reversal of right ventricle dilation, reduced pulmonary hypertension, and decreased anatomic thrombus burden. This therapeutic strategy requires a small fraction of the systemic fibrinolytic dose and is therefore associated with a reduced bleeding risk. Although intracranial hemorrhage has not been reported in clinical trials, it is a possible complication...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28396618/apixaban-for-the-treatment-of-saphenous-vein-graft-thrombosis-presenting-as-unstable-angina-a-case-report
#8
Makoto Saigan, Tsuyoshi Isawa, Tatsushi Ootomo
BACKGROUND: Saphenous vein graft thrombosis can present as unstable angina. However, percutaneous coronary intervention for saphenous vein graft lesions poses a high risk of slow flow related to the procedure. Here we present the utilization of the novel oral anticoagulant, apixaban, in the treatment of unstable angina with extensive saphenous vein graft thrombus, leading to considerable thrombus resolution and eliminating the need of percutaneous coronary intervention. CASE PRESENTATION: A 72-year-old man with 3-vessel coronary artery bypass graft surgery using a saphenous vein graft and a left internal mammary artery, performed 25 years earlier, presented at our hospital with recurrent chest tightness...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28381215/a-case-of-successful-reperfusion-through-a-combination-of-intracoronary-thrombolysis-and-aspiration-thrombectomy-in-st-segment-elevation-myocardial-infarction-associated-with-an-ectatic-coronary-artery
#9
Yonggu Lee, Eunjin Kim, Bae Keun Kim, Jeong-Hun Shin
BACKGROUND: Large thrombus burdens in ectatic coronary arteries that remain after aspiration thrombectomy can negatively impact outcomes following percutaneous coronary interventions in patients with acute myocardial infarction. CASE PRESENTATION: A 53-year-old man presented with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed an ectatic right coronary artery (RCA) that was completely occluded in the mid portion by a large amount of thrombus...
April 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28344684/splenic-vein-thrombosis-as-a-rare-complication-of-disseminated-tuberculosis-imaging-diagnosis-and-case-report
#10
Satarupa Roy, Shuchi Bhatt, Rajesh Rawal, Anupama Tandon, Neha Meena
BACKGROUND: Venous thromboembolism is a known but rare complication associated with Mycobacterium tuberculosis infection. The reported incidence of venous thromboembolism is 1.5-3.4% of infected patients, and it occurs due to a hypercoagulable state induced by the associated inflammation. CASE REPORT: A young woman with pulmonary tuberculosis was found to have disseminated tuberculosis and a clinically unsuspected partial thrombus in the splenic vein on imaging...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28318137/plaque-erosion-delays-vascular-healing-after-drug-eluting-stent-implantation-in-patients-with-acute-coronary-syndrome-an-in-vivo-optical-coherence-tomography-study
#11
COMPARATIVE STUDY
Sining Hu, Chao Wang, Chunyang Zhe, Yinchun Zhu, Taishi Yonetsu, Haibo Jia, Jingbo Hou, Shaosong Zhang, Ik-Kyung Jang, Bo Yu
OBJECTIVES: To compare vascular healing after drug-eluting stent (DES) implantation between plaque rupture (PR) and plaque erosion (PE). BACKGROUND: Vascular response after stent implantation in patients with PR has been extensively studied. Little is known about vascular healing after stent implantation in PE. METHODS: Sixty-five ACS patients who received optical coherence tomography (OCT) imaging of the culprit lesions both before and after stent implantation at baseline as well as at 6 months were included in this study...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28265127/management-of-cavoatrial-deep-venous-thrombosis-incorporating-new-strategies
#12
REVIEW
Mohamed A Zayed, Gayan S De Silva, Raja S Ramaswamy, Luis A Sanchez
Cavoatrial deep venous thrombosis (DVT) is diagnosed with increasing prevalence. It can be managed medically with anticoagulation or with directed interventions aimed to efficiently reduce the thrombus burden within the target venous segment. The type of management chosen depends greatly on the etiology and chronicity of the thrombosis, existing patient comorbidities, and the patient's tolerance to anticoagulants and thrombolytic agents. In addition to traditional percutaneous catheter-based pharmacomechanical thrombolysis, other catheter-based suction thrombectomy techniques have emerged in recent years...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28256347/right-coronary-dissection-and-left-anterior-descending-thrombus-dual-dilemma-in-a-young-cardiac-arrest-survivor
#13
Holly Morgan, Michael McCann, Alan Whelan, Richard Clugston
BACKGROUND: ST-elevation myocardial infarction (STEMI) leading to cardiac arrest is an exceptionally rare occurrence in young adults. Those affected tend to abuse sympathomimetic drugs, have strong family histories, or have a significant burden of cardiac risk factors. Another uncommon cause of STEMI is coronary artery dissection, which overwhelmingly affects middle- and older-aged women with few cardiac risk factors. CASE REPORT: A 22-year-old athlete with no medical history was admitted to our institution post-cardiac arrest with an anterior STEMI and concomitant right coronary dissection...
February 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28246560/saddle-pulmonary-embolism-with-thrombus-in-transit-across-a-patent-foramen-ovale
#14
Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28242585/at-least-7-days-delayed-stenting-using-minimalist-immediate-mechanical-intervention-mimi-in-st-segment-elevation-myocardial-infarction-the-super-mimi-study
#15
Petru Mester, Helene Bouvaist, Nicolas Delarche, Frédéric Bouisset, Mohamed Abdellaoui, Pierre-Yves Petiteau, Olivier Dubreuil, Ziad Boueri, Mohamed Chettibi, Géraud Souteyrand, Hend Madiot, Loic Belle
AIMS: To ascertain whether a minimalist immediate mechanical intervention (MIMI) aiming to restore an optimal Thrombolysis In Myocardial Infarction (TIMI) flow in the culprit artery, followed ≥7 days later by a second percutaneous coronary intervention with intentional stenting is safe in patients with ST- segment elevation myocardial infarction and large thrombotic burden. METHODS AND RESULTS: SUPER-MIMI was a prospective, observational trial conducted between January 2014 and April 2015 in 14 French centres...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28228577/the-basilar-artery-on-computed-tomography-angiography-prognostic-score-for-basilar-artery-occlusion
#16
Fana Alemseged, Darshan G Shah, Marina Diomedi, Fabrizio Sallustio, Andrew Bivard, Gagan Sharma, Peter J Mitchell, Richard J Dowling, Steven Bush, Bernard Yan, Carlo Caltagirone, Roberto Floris, Mark W Parsons, Christopher R Levi, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND PURPOSE: Basilar artery occlusion is associated with high risk of disability and mortality. This study aimed to assess the prognostic value of a new radiological score: the Basilar Artery on Computed Tomography Angiography (BATMAN) score. METHODS: A retrospective analysis of consecutive stroke patients with basilar artery occlusion diagnosed on computed tomographic angiography was performed. BATMAN score is a 10-point computed tomographic angiography-based grading system which incorporates thrombus burden and the presence of collaterals...
March 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28223279/distinct-contributions-of-complement-factors-to-platelet-activation-and-fibrin-formation-in-venous-thrombus-development
#17
Saravanan Subramaniam, Kerstin Jurk, Lukas Hobohm, Sven Jäckel, Mona Saffarzadeh, Kathrin Schwierczek, Philip Wenzel, Florian Langer, Christoph Reinhardt, Wolfram Ruf
Expanding evidence indicates multiple interactions between the hemostatic system and innate immunity, and the coagulation and complement cascades. Here we show in a tissue factor (TF)-dependent model of flow restriction-induced venous thrombosis that complement factors make distinct contributions to platelet activation and fibrin deposition. Complement factor 3 (C3) deficiency causes prolonged bleeding, reduced thrombus incidence, thrombus size, fibrin and platelet deposition in the ligated inferior vena cava, and diminished platelet activation in vitro...
April 20, 2017: Blood
https://www.readbyqxmd.com/read/28216061/outcomes-after-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-caused-by-ectatic-infarct-related-arteries
#18
Vimalraj Bogana Shanmugam, Peter J Psaltis, Dennis T L Wong, Ian T Meredith, Yuvaraj Malaiapan, Wally Ahmar
BACKGROUND: There is minimal published data on outcomes of patients presenting with ST elevation myocardial infarction (STEMI) due to an ectatic infarct-related artery (EIRA). The aim of this study was to analyse the clinical characteristics and outcomes of these patients presenting for primary percutaneous coronary intervention (P-PCI) in comparison with non-EIRA. METHODS: Of the 1834 patients who presented at our institution for P-PCI between February 2008 and November 2013, 25 (1...
February 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28191743/manual-thrombectomy-efficiency-in-relationship-to-the-area-at-risk-in-patients-with-myocardial-infarction-with-timi-0-1-coronary-flow-insights-from-an-all-comers-registry
#19
André Luz, Inês Silveira, Bruno Brochado, Patrícia Rodrigues, Maria João Sousa, Raquel Santos, Maria Trêpa, Mário Santos, João Silveira, Severo Torres, Adelino F Leite-Moreira, Henrique Carvalho
OBJECTIVES: To review the effectiveness of manual thrombectomy (MT) in a series of patients with ST-elevation myocardial infarction (STEMI) exclusively presenting with TIMI 0-1 flow undergoing percutaneous coronary intervention (PCI), in accordance to the angiographically estimated area at risk (AAR). Second, to assess major in-hospital clinical events, emphasizing neurological outcomes. BACKGROUND: The routine utilization of MT in STEMI is not recommended. However, in recent trials, a significant proportion of patients had neither large thrombus burden nor a totally occluded coronary segment, neutralizing the expected benefits of MT...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28178411/computed-tomography-based-thrombus-imaging-for-the-prediction-of-recanalization-after-reperfusion-therapy-in-stroke
#20
REVIEW
Ji Hoe Heo, Kyeonsub Kim, Joonsang Yoo, Young Dae Kim, Hyo Suk Nam, Eung Yeop Kim
The prediction of successful recanalization following thrombolytic or endovascular treatment may be helpful to determine the strategy of recanalization treatment in acute stroke. Thrombus can be detected using noncontrast computed tomography (CT) as a hyperdense artery sign or blooming artifact on a T2(*)-weighted gradient-recalled image. The detection of thrombus using CT depends on slice thickness. Thrombus burden can be determined in terms of the length, volume, and clot burden score. The thrombus size can be quantitatively measured on thin-section CT or CT angiography/magnetic resonance angiography...
January 2017: Journal of Stroke
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