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https://www.readbyqxmd.com/read/29329472/impact-of-thrombus-sidedness-on-presentation-and-outcomes-of-patients-with-proximal-lower-extremity-deep-vein-thrombosis
#1
Behnood Bikdeli, Babak Sharif-Kashani, Bavand Bikdeli, Reina Valle, Conxita Falga, Antoni Riera-Mestre, Lucia Mazzolai, Peter Verhamme, Philip S Wells, Juan Francisco Sánchez Muñoz Torrero, Luciano Lopez-Jiménez, Manuel Monreal
Small studies have suggested differences in demographics and outcomes between left- and right-sided deep vein thrombosis (DVT), and also unilateral versus bilateral DVT. We investigated the clinical presentation and outcomes of patients with DVT based on thrombus sidedness. The authors used the data from the Registro Informatizado Enfermedad TromboEmbólica (RIETE) database (2001-2016) to identify patients with symptomatic proximal lower-extremity DVT. Main outcomes included cumulative 90-day symptomatic pulmonary embolism (PE) and 1-year mortality...
January 12, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29321337/associations-between-collateral-status-and-thrombus-characteristics-and-their-impact-in-anterior-circulation-stroke
#2
Heitor C Alves, Kilian M Treurniet, Bruna G Dutra, Ivo G H Jansen, Anna M M Boers, Emilie M M Santos, Olvert A Berkhemer, Diederik W J Dippel, Aad van der Lugt, Wim H van Zwam, Robert J van Oostenbrugge, Hester F Lingsma, Yvo B W E M Roos, Albert J Yoo, Henk A Marquering, Charles B L M Majoie
BACKGROUND AND PURPOSE: Thrombus characteristics and collateral score are associated with functional outcome in patients with acute ischemic stroke. It has been suggested that they affect each other. The aim of this study is to evaluate the association between clot burden score, thrombus perviousness, and collateral score and to determine whether collateral score influences the association of thrombus characteristics with functional outcome. METHODS: Patients with baseline thin-slice noncontrast computed tomography and computed tomographic angiography images from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands) were included (n=195)...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29310958/increased-left-ventricular-filling-pressure-and-arterial-occlusion-in-stroke-related-to-atrial-fibrillation
#3
Wi-Sun Ryu, Eun-Kee Bae, Soo-Hyun Park, Sang-Wuk Jeong, Dawid Schellingerhout, Matthias Nahrendorf, Dong-Eog Kim
BACKGROUND: We investigated whether left ventricular filling pressure is associated with arterial occlusion in patients with ischemic stroke related to atrial fibrillation (AF). METHODS: Ninety-nine patients with AF-related stroke were included. Left ventricular filling pressure was assessed by E (early mitral inflow velocity)/e' (early diastolic velocity of the mitral valve annulus velocity) ratio based on tissue Doppler echocardiography. Arterial occlusion was evaluated by computed tomography or magnetic resonance angiography...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29248881/three-vessel-coronary-artery-aneurysmal-disease-complicated-by-multivessel-thrombosis-and-cardiogenic-shock-the-saving-role-of-intracoronary-thrombolysis
#4
Luis Pablo Roldan, Chris Rowan, Mark Sheldon, Carlos A Roldan
The benefit of intracoronary thrombolytics in ST-elevation myocardial infarction (STEMI) is not well established. Mainstays of STEMI management include intravenous thrombolytics, percutaneous coronary interventions and surgical revascularisation. However, in cases of STEMI secondary to coronary artery aneurysmal disease (CAAD), standard treatment options may not be suitable due to high thrombus burden, perioperative risk and factors unique to each patient. Thus, STEMI management in CAAD can represent a therapeutically challenging clinical scenario...
December 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29248101/design-and-rationale-of-a-randomized-trial-comparing-standard-versus-ultrasound-assisted-thrombolysis-for-submassive-pulmonary-embolism
#5
Efthymios D Avgerinos, Abhisekh Mohapatra, Belinda Rivera-Lebron, Catalin Toma, Christopher Kabrhel, Larry Fish, Joan Lacomis, Iclal Ocak, Rabih A Chaer
BACKGROUND: Catheter-directed interventions for the treatment of patients with submassive pulmonary embolism (sPE) have shown promise in rapidly improving right-sided heart strain and preventing decompensation to massive pulmonary embolism. Among various catheter interventions, ultrasound-assisted thrombolysis (USAT) has attracted interest as potentially having more efficient lytic effect that could achieve thrombolysis faster and with a reduced lytic dose. However, based on clinical evidence, it is unclear whether USAT is superior to standard catheter-directed thrombolysis (SCDT)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29246206/the-association-between-hiv-and-atherosclerotic-cardiovascular-disease-in-sub-saharan-africa-a-systematic-review
#6
Emily P Hyle, Bongani M Mayosi, Keren Middelkoop, Mosepele Mosepele, Emily B Martey, Rochelle P Walensky, Linda-Gail Bekker, Virginia A Triant
BACKGROUND: Sub-Saharan Africa (SSA) has confronted decades of the HIV epidemic with substantial improvements in access to life-saving antiretroviral therapy (ART). Now, with improved survival, people living with HIV (PLWH) are at increased risk for non-communicable diseases (NCDs), including atherosclerotic cardiovascular disease (CVD). We assessed the existing literature regarding the association of CVD outcomes and HIV in SSA. METHODS: We used the PRISMA guidelines to perform a systematic review of the published literature regarding the association of CVD and HIV in SSA with a focus on CVD surrogate and clinical outcomes in PLWH...
December 15, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29234445/bioactivity-guided-fractionation-of-the-traditional-chinese-medicine-resina-draconis-reveals-loureirin-b-as-a-pai-1-inhibitor
#7
Yu Jiang, Guangping Zhang, Dong Yan, Hong Yang, Zuguang Ye, Tonghui Ma
Thrombotic diseases have become a global burden due to morbidity, mortality, and disability. Traditional Chinese medicine has been proven effective in removing blood stasis and promoting blood circulation, but the exact mechanisms remain unclear. Plasminogen activator inhibitor-1 (PAI-1) is a natural inhibitor of tissue-type and urokinase-type plasminogen activators. In this study, we screened four fractions of Resina Draconis (a traditional Chinese medicine) extract for PAI-1 inhibitory activity. Bioactivity-guided purification and chromogenic substrate-based assay led to the identification of loureirin B as the major PAI-1 inhibitor, with an IC50 value of 26...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#8
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#9
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29212126/thrombus-burden-of-deep-vein-thrombosis-and-its-association-with-thromboprophylaxis-and-d-dimer-measurement-insights-from-the-apex-trial
#10
Gerald Chi, Samuel Z Goldhaber, Russell D Hull, Adrian F Hernandez, Mathieu Kerneis, Fahad Al Khalfan, Alexander T Cohen, Robert A Harrington, C Michael Gibson
No abstract text is available yet for this article.
December 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29193382/prediction-of-no-reflow-and-major-adverse-cardiovascular-events-with-a-new-scoring-system-in-stemi-patients
#11
Adil Bayramoğlu, Hakan Taşolar, Ahmet Kaya, İbrahim Halil Tanboğa, Mehmet Yaman, Osman Bektaş, Zeki Yüksel Günaydın, Vecih Oduncu
BACKGROUND: No-reflow is associated with a poor prognosis in STEMI patients. There are many factors and mechanisms that contribute to the development of no-reflow, including age, reperfusion time, a high thrombus burden, Killip class, long stent use, ejection fraction ≤40, and a high Syntax score. In this study, we aimed to evaluate the parameters associated with no-reflow prediction by creating a new scoring system. METHODS: The study included 515 consecutive STEMI patients who underwent PCI; 632 STEMI patients who had undergone PCI in another center were included in the external validation of the scoring system...
November 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29191641/vena-cavoscopy-in-the-assessment-of-intraluminal-vena-caval-tumor-involvement
#12
Jeffrey Loh-Doyle, Sumeet Bhanvadia, Mukul B Patil, Hooman Djaladat, Siamak Daneshmand
OBJECTIVE: To improve confirmation of complete tumor thrombus removal in advanced malignancy, we report on our experience using intraoperative vena cavoscopy using a flexible cystoscope to confirm complete thrombus resection. Patients with renal cell carcinoma (RCC) or testicular cancer (TC) associated with inferior vena caval tumor involvement benefit from surgical resection of the primary tumor and tumor thrombus. Intraoperative assessment of the vena cava represents a technical challenge, particularly when the thrombus is friable, involves the hepatic veins, or there is caudal extension of thrombus towards the bifurcation...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29174781/utilization-of-veno-arterial-extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism
#13
Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat these patients. METHODS: All patients with a massive pulmonary embolism who were placed on VA-ECMO, as an initial intervention determined by protocol, were retrospectively reviewed...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29155385/local-low-dose-urokinase-thrombolysis-for-the-management-of-hemodynamically-stable-pulmonary-embolism-with-right-ventricular-dysfunction
#14
Sara Alcántara Carmona, Marina Pérez Redondo, Luis Nombela Franco, Rocío González Costero, Bárbara Balandín Moreno, Miguel Valdivia de la Fuente, Santiago Méndez Alonso, Agustín García Suárez, Ana Royuela
AIMS: To evaluate the effectiveness of local low-dose urokinase thrombolysis (LLDUT) in hemodynamically stable pulmonary embolism with right ventricular dysfunction (RVD). METHODS AND RESULTS: Prospective study. LLDUT with a 200,000 IU bolus followed by a 100,000 IU/h infusion. Treatment duration was determined through radiological control performed 48-72h into treatment. Follow-up echocardiogram was performed within seven days after LLDUT completion. Evolution of thrombus burden, pulmonary artery pressures (PAP) and RVD were studied, and hemorrhagic complications and mortality were recorded...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29141786/intraluminal-thrombus-is-associated-with-early-rupture-of-abdominal-aortic-aneurysm
#15
Stephen J Haller, Jeffrey D Crawford, Katherine M Courchaine, Colin J Bohannan, Gregory J Landry, Gregory L Moneta, Amir F Azarbal, Sandra Rugonyi
BACKGROUND: The implications of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA) are currently unclear. Previous studies have demonstrated that ILT provides a biomechanical advantage by decreasing wall stress, whereas other studies have associated ILT with aortic wall weakening. It is further unclear why some aneurysms rupture at much smaller diameters than others. In this study, we sought to explore the association between ILT and risk of AAA rupture, particularly in small aneurysms...
November 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29130316/correlation-of-leukocyte-and-coronary-lesion-severity-of-acute-myocardial-infarction
#16
Yunting Liang, Hui Chen, Ping Wang
Leukocytes play a pivotal role in the onset and progression of acute myocardial infarction (AMI). We evaluated the relationship between leukocyte count and coronary lesion severity of AMI. We carried out a retrospective study involving 815 patients with AMI undergoing primary percutaneous coronary intervention from 2005 to 2014 at a cardiovascular center. We recorded their risk factors, routine blood parameters, and cardiovascular events during hospitalization. When thrombus and nonthrombus burden groups were compared, leukocyte count (9...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29100817/edoxaban-improves-acute-venous-thromboembolism-while-preserving-protein-c-and-protein-s-levels
#17
Hiromu Yamazaki, Shusuke Yagi, Yuta Torii, Rie Amano, Yasuyuki Oomichi, Teruaki Sangawa, Daiju Fukuda, Muneyuki Kadota, Takayuki Ise, Rie Ueno, Tomoya Hara, Kenya Kusunose, Tomomi Matsuura, Takeshi Tobiume, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata
BACKGROUND: It is well known that warfarin inhibits the synthesis of vitamin K-dependent anticoagulants, including thrombin, protein C and S, and factor Xa, leading, paradoxically, to an initial hypercoagulable state. Edoxaban, a direct inhibitor of activated factor X is widely used for the treatment of acute venous thromboembolism (VTE). However, the effect of edoxaban on circulating coagulation factors, in patients with acute VTE, remains unknown. METHODS AND RESULTS: We enrolled 57 patients with acute VTE with/without pulmonary embolism treated with edoxaban (n=37) or warfarin (n=20) in a clinical setting...
October 31, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29096903/-management-of-high-thrombus-burden-in-primary-pci
#18
L Mangin, M Lotfi, P Puie, K Yayehd, A Ispas, L Belle
A large thrombus burden is not uncommon in primary percutaneous coronary intervention, and is associated with more frequent complications. The role of intracoronary thrombolysis and glycoprotein IIb/IIIa inhibitors in the management of a large thrombus burden is discussed. The use of thromboaspiration must follow a particular logic and used with rigorous manipulations; the capacities of the protective filters are often exceeded. Stents dedicated to thrombus management can be used. Interest and limits of these stents are developed...
October 30, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29084042/a-comparison-of-intracoronary-treatment-strategies-for-thrombus-burden-removal-during-primary-percutaneous-coronary-intervention-a-coctail-ii-substudy
#19
Laura Gatto, Alessio Di Landro, Enrico Romagnoli, Valeria Marco, Chiara Russo, Tomasz Pawlowski, Francesco Versaci, Ugo Limbruno, Fausto Castriota, Luca Di Vito, Antonio Trivisonno, Francesco Prati
BACKGROUND: Manual thrombus aspiration and local drug delivery of abciximab have been proposed as a strategy to reduce thrombus burden during percutaneous coronary intervention in patients with ST elevation myocardial infarction; however, the effectiveness of these approaches, is uncertain. In this COCTAIL II substudy, we compared the effect of these strategies on prestenting and poststenting thrombus burden assessed by optical coherence tomography. PATIENTS AND METHODS: COCTAIL II trial enrolled patients with ST elevation myocardial infarction randomized to intralesion (IL, by the ClearWay catheter) versus intracoronary (IC, by the guide catheter) abciximab bolus with or without aspiration thrombectomy (AT)...
October 27, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29067927/observational-study-comparing-pharmacoinvasive-strategy-with-primary-percutaneous-coronary-intervention-in-patients-presenting-with-st-elevation-myocardial-infarction-to-a-tertiary-care-centre-in-india
#20
A G Alex, A Lahiri, T Geevar, O K George
OBJECTIVE: The objective was to study whether the incidence of composite end points (mortality, cardiogenic shock and re-myocardial infarction [re-MI]) in pharmacoinvasive strategy was noninferior to primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). METHODS: This was an observational study which included 138 patients. The study included patients admitted with a diagnosis of STEMI within 24 h of symptom onset, who underwent primary PCI or pharmacoinvasive therapy in a single center over a 9-month period...
October 23, 2017: Journal of Postgraduate Medicine
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