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https://www.readbyqxmd.com/read/29155385/local-low-dose-urokinase-thrombolysis-for-the-management-of-hemodynamically-stable-pulmonary-embolism-with-right-ventricular-dysfunction
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/29054179/the-impact-of-systems-of-care-on-pharmacoinvasive-management-with-streptokinase-the-subgroup-analysis-of-the-tn-stemi-programme
#8
Deep Chandh Raja, Vijayakumar Subban, Suma M Victor, George Joseph, Viji Samuel Thomson, Kumaresan Kannan, Justin Paul Gnanaraj, Ganesh Veerasekar, Jose G Thenpally, Nandhini Livingston, Brahmajee K Nallamothu, Thomas Alexander, Ajit S Mullasari
OBJECTIVES: We evaluated the impact of implementation of the TN-STEMI programme on various characteristics of the pharmacoinvasive group by comparing clinical as well as angiographic outcomes between the pre- and post-implementation groups. METHODS: The TN-STEMI programme involved 2420 patients of which 423 patients had undergone a pharmacoinvasive strategy of reperfusion. Of these, 407 patients had a comprehensive blinded core-lab evaluation of their angiograms post-lysis and clinical evaluation of various parameters including time-delays and adverse cardio- and cerebro-vascular events at 1year...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29049090/pharmacomechanical-thrombolysis-for-deep-vein-thrombosis-in-may-thurner-syndrome
#9
Mayank Roy, Morris Sasson, Armando Rosales-Velderrain, Savannah Moon, Mark Grove, Terry King
OBJECTIVE: Patients with May-Thurner syndrome presenting with acute deep vein thrombosis benefit from early lysis of clot and endovascular treatment. We evaluated the outcome of patients with May-Thurner syndrome who presented with deep vein thrombosis, managed with pharmacomechanical thrombolysis as the primary mode of intervention, in combination with angioplasty and stent placement. METHODS: We reviewed all patients with May-Thurner syndrome managed in our institution between January 2009 to December 2015...
October 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29042400/thrombus-aspiration-for-st-segment-elevation-myocardial-infarction-in-modern-era-still-an-issue-of-debate
#10
REVIEW
Junhua Ge, Andreas Schäfer, Georg Ertl, Peter Nordbeck
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment-elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia] and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) do not supply evidence supporting the routine use of TA in patients with ST-segment-elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29029074/multimodality-imaging-evaluation-of-chagas-disease-an-expert-consensus-of-brazilian-cardiovascular-imaging-department-dic-and-the-european-association-of-cardiovascular-imaging-eacvi
#11
Maria Carmo P Nunes, Luigi Paolo Badano, J Antonio Marin-Neto, Thor Edvardsen, Covadonga Fernández-Golfín, Chiara Bucciarelli-Ducci, Bogdan A Popescu, Richard Underwood, Gilbert Habib, Jose Luis Zamorano, Roberto Magalhães Saraiva, Ester Cerdeira Sabino, Fernando A Botoni, Márcia Melo Barbosa, Marcio Vinicius L Barros, Eduardo Falqueto, Marcus Vinicius Simões, André Schmidt, Carlos Eduardo Rochitte, Manoel Otávio Costa Rocha, Antonio Luiz Pinho Ribeiro, Patrizio Lancellotti
Aims: To develop a document by Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI) to review and summarize the most recent evidences about the non-invasive assessment of patients with Chagas disease, with the intent to set up a framework for standardized cardiovascular imaging to assess cardiovascular morphologic and functional disturbances, as well as to guide the subsequent process of clinical decision-making. Methods and results: Chagas disease remains one of the most prevalent infectious diseases in Latin America, and has become a health problem in non-endemic countries...
September 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29025425/prognostic-utility-of-differential-tissue-characterization-of-cardiac-neoplasm-and-thrombus-via-late-gadolinium-enhancement-cardiovascular-magnetic-resonance-among-patients-with-advanced-systemic-cancer
#12
Angel T Chan, Andrew J Plodkowski, Shawn C Pun, Yuliya Lakhman, Darragh F Halpenny, Jiwon Kim, Samantha R Goldburg, Mathew J Matasar, Chaya S Moskowitz, Dipti Gupta, Richard Steingart, Jonathan W Weinsaft
BACKGROUND: Late gadolinium enhancement (LGE-) cardiovascular magnetic resonance (CMR) is well-validated for cardiac mass (CMASS) tissue characterization to differentiate neoplasm (CNEO) from thrombus (CTHR): Prognostic implications of CMASS subtypes among systemic cancer patients are unknown. METHODS: CMASS + patients and controls (CMASS -) matched for cancer diagnosis and stage underwent a standardized CMR protocol, including LGE-CMR (IR-GRE) for tissue characterization and balanced steady state free precession cine-CMR (SSFP) for cardiac structure/function...
October 12, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#13
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28984758/expression-of-matrix-metalloproteinases-12-in-st-segment-elevation-myocardial-infarction-a-case-control-study
#14
Jing Wang, Guoqing Wei, Wei Hu, Linhua Li, Yujia Ye, Huawei Wang, Wen Wan, Rui Li, Longjun Li, Linling Ma, Zhaohui Meng
Matrix metalloproteinases-12 (MMP12) can lead to degradation of elastin resulting in plaque destabilization and rupture. MMP12 also facilitates platelet aggregation, adhesion, and granule secretion. However, evidence in the literature related to the function of MMP12 in ST-segment elevation myocardial infarction (STEMI) is little. This study investigated the expression of MMP12 in human coronary thrombus and examined the relationship between plasma MMP12 and STEMI.Arterial plasma was obtained from 46 STEMI patients and 52 stable angina pectoris (SAP) patients and 30 controls with angiographically normal coronary arteries...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28979905/the-role-of-intracoronary-imaging-in-acute-coronary-syndromes-oct-in-focus
#15
REVIEW
Ahmad Samir, Ahmed ElGuindy
Optical coherence tomography (OCT) has emerged as a powerful intravascular imaging modality in recent years. The introduction of frequency-domain OCT has simplified the procedure and enabled its safe utilisation in different clinical settings including acute coronary syndromes, where it can determine the mechanism of plaque disruption, thrombus burden, and guide percutaneous coronary intervention. In patients presenting with stent failure (stent thrombosis and instent restenosis), OCT can also be very useful in determining the underlying mechanism and guiding therapy thereafter...
December 30, 2016: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/28974667/intracoronary-administration-of-thrombolysis-for-severe-coronary-artery-ectasia-presenting-as-an-acute-inferior-st-segment-elevation-myocardial-infarction
#16
Avadhesh Saraswat, Atifur Rahman, Ravinder Batra
We present a 75-year-old male with acute inferior ST-elevation myocardial infarction, severe coronary artery ectasia, and large thrombus burden in the right coronary artery to support the use of intracoronary thrombolysis as a second-line therapy for a large thrombus burden in primary percutaneous coronary intervention.
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28945166/echocardiographic-assessment-with-right-ventricular-function-improvement-following-ultrasound-accelerated-catheter-directed-thrombolytic-therapy-in-submassive-pulmonary-embolism
#17
Charles Doheny, Lorena Gonzalez, Stanley M Duchman, Joseph Varon, Carlos F Bechara, Mathew Cheung, Peter H Lin
Introduction The objective of this study was to evaluate the efficacy of ultrasound-accelerated catheter-directed thrombolytic therapy in patients with submassive pulmonary embolism. Methods Clinical records of 46 patients with submassive pulmonary embolism who underwent ultrasound-accelerated catheter-directed pulmonary thrombolysis using tissue plasminogen activator, from 2007 to 2017, were analyzed. All patients experienced clinical symptoms with computed tomography evidence of pulmonary thrombus burden...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28941516/continuous-aspiration-mechanical-thrombectomy-for-the-management-of-submassive-pulmonary-embolism-a-single-center-experience
#18
Ramsey Al-Hakim, Alok Bhatt, James F Benenati
The Indigo Mechanical Thrombectomy System (Penumbra, Inc, Alameda, California) was used to treat 6 patients with submassive pulmonary embolism (PE) and a contraindication to thrombolysis. Systolic pulmonary artery pressure (58.2 mm Hg vs 43.0 mm Hg, P < .05), right ventricular/left ventricular ratio (1.7 vs 1.1, P < .05), Miller index (15.0 vs 9.8, P < 0.01), and CT obstructive index (60.4% vs 47.0%, P < .01) were significantly reduced after mechanical thrombectomy. There were no procedural or periprocedural complications...
October 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28938239/absence-of-a-correlation-between-the-abo-blood-group-and-thrombus-burden-in-patients-with-st-segment-elevation-myocardial-infarction
#19
Lutfu Askin, Mustafa Cetin, Serdar Turkmen
OBJECTIVE: ABO antigens are highly abundant in many human cell types, including platelets, vascular endothelium, and red blood cells. The presence of a thrombus is associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). We reviewed the relationship between ABO blood groups and thrombus burden in patients with STEMI. PATIENTS AND METHODS: We carried out a retrospective study of 396 patients with STEMI who did not have an ABO blood group or thrombus burden...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28919630/deep-vein-thrombosis-in-a-post-coronary-artery-bypass-grafting-patient-successful-conservative-management
#20
S H Sarker, A K Miraj, M A Hossain, M Aftabuddin
Deep vein thrombosis is an alarming medical emergency. Deep vein thrombosis or deep venous thrombosis (DVT) is the formation of a blood clot (thrombus) within a deep vein predominantly in the legs. Post-Coronary Artery Bypass Grafting deep vein thrombosis is a very rare medical condition relatively in Asian. Approximately 80% of deep vein thrombosis (DVTs) is clinically asymptomatic, 20% of those that actually demonstrate signs and symptoms can be easily confused with symptoms of other commonly presenting musculoskeletal disorders...
July 2017: Mymensingh Medical Journal: MMJ
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