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Hemorrhage and thrombosis

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https://www.readbyqxmd.com/read/29790286/vascular-reconstruction-technique-of-a-perforated-portal-vein-during-a-pediatric-total-pancreatectomy-and-islet-autotransplant
#1
Kent J Peterson, Oscar K Serrano, Siobhan Flanagan, Srinath Chinnakotla
Hereditary pancreatitis (HP) is a progressive disease that can manifest in childhood with debilitating, relapsing pain. A total pancreatectomy and islet autotransplant (TPIAT) is a surgical option to relieve chronic pain while preserving the available beta-cell mass. The clinical course of HP is fraught with pancreatitis-related sequelae that can both necessitate and complicate a TPIAT. We describe a child with HP who developed a pancreatic pseudocyst-portal vein (PV) fistula. Active hemorrhage of the perforated PV into the pseudocyst and PV thrombosis complicated the planned TPIAT procedure and, preoperatively, required urgent image-guided stenting...
May 22, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29789969/identification-of-risk-factors-for-toxicity-in-patients-with-hormone-receptor-positive-advanced-breast-cancer-treated-with-bevacizumab-plus-letrozole-a-calgb-40503-alliance-correlative-study
#2
Daneng Li, Linda M McCall, Olwen M Hahn, Clifford A Hudis, Harvey J Cohen, Hyman B Muss, Aminah Jatoi, Jacqueline M Lafky, Karla V Ballman, Eric P Winer, Debu Tripathy, Bryan Schneider, William Barry, Maura N Dickler, Arti Hurria
BACKGROUND: In hormone receptor-positive advanced breast cancer, a progression-free survival benefit was reported with addition of bevacizumab to first-line letrozole. However, increased toxicity was observed. We hypothesized that functional age measures could be used to identify patients at risk for toxicity while receiving letrozole plus bevacizumab for hormone receptor-positive advanced breast cancer. METHODS: CALGB 40503 was a phase III trial that enrolled patients with hormone receptor-positive advanced breast cancer randomized to letrozole with or without bevacizumab...
May 22, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29788836/intracranial-hemorrhage-in-adults-on-ecmo
#3
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29786890/thrombotic-and-hemorrhagic-complications-during-visceral-transplantation-risk-factors-and-association-with-intraoperative-disseminated-intravascular-coagulation-like-thromboelastographic-qualities-single-center-retrospective-study
#4
Yehuda Raveh, Yiliam Rodriguez, Ernesto Pretto, Fouad Souki, Vadim Shatz, Behrouz Ashrafi, Vinaya Manmohansigh, Michael Demos, Joshua Livingstone, Georges Nasrallah, David Andrews, Thiago Beduschi, Rodrigo Vianna, Ramona Nicolau-Raducu
This study describes the risk of thrombotic and hemorrhagic complications, both intraoperatively, and up to 1-month following visceral transplantation. Data from 48 adult visceral transplants performed between 2010-2017 were retrospectively studied (32 multivisceral (MVTx); 10 isolated intestine; 6 modified-MVTx). Intraoperatively, intracardiac thrombosis (ICT)/pulmonary embolism (PE) occurred in 25%, 0% and 0% of MVTx, isolated intestine and modified MVTx, respectively, and was associated with 50% (4/8) mortality...
May 22, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29778342/one-year-outcomes-associated-with-a-novel-stented-bovine-pericardial-aortic-bioprosthesis
#5
Joseph F Sabik, Vivek Rao, Rüdiger Lange, A Pieter Kappetein, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Neil J Weissman, Himanshu J Patel, Michael J Reardon, Federico M Asch, Cathy Zeng, Robert J M Klautz
OBJECTIVES: The study objectives were to evaluate the safety, effectiveness, and hemodynamic performance of a new stented bovine pericardial aortic valve. METHODS: This trial enrolled patients with symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. We assessed death, valve-related adverse events, functional recovery, and hemodynamic performance at discharge, 3 to 6 months, and 1 year, as required by the US Food and Drug Administration for regulatory approval...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29772320/predictive-factors-of-silent-brain-infarcts-after-asymptomatic-carotid-endarteriectomy
#6
Rémy Pascot, Benjamin Parat, Yann Le Teurnier, Gilles Godet, Jean-Yves Gauvrit, Yann Gouëffic, Eric Steinmetz, Alain Cardon, Adrien Kaladji
BACKGROUND: The optimization of medical treatment regularly challenges the role of carotid surgery for asymptomatic patients. Current research seeks to determine which of these patients will benefit most from surgery. The goal of this study was to identify in a multi-center study, using MRI, the risk factors for postoperative silent cerebral ischemic lesions after carotid surgery for asymptomatic stenosis METHODS: The multicenter, retrospective study included patients with asymptomatic severe carotid stenosis suitable for surgical treatment and who did not have a history of cerebral ischemia...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29768323/efficacy-and-risks-of-anticoagulation-for-cerebral-venous-thrombosis
#7
Weilin Xu, Liansheng Gao, Tao Li, Anwen Shao, Jianmin Zhang
BACKGROUND AND PURPOSE: Cerebral venous thrombosis (CVT) is a rare but life-threatening disease. Timely and proper treatments are the keys in saving patients' life and preventing from permanent neurological deficits. We performed this network meta-analysis to evaluate the role of anticoagulation in CVT, especially for the patients accompanied with hemorrhagic stroke. METHODS: PubMed, Embase, Web of Science, Cochrane Database, and Chinese Biomedical (CBM) databases were searched comprehensively to select eligible articles (up to 30 June 2017)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767734/electrical-burns-and-late-spontaneous-artery-ruptures-about-three-cases
#8
C Reinbold, K Serror, M Mimoun, M Chaouat, O Marco, D Boccara
Electrical burns are responsible for arterial and venous thrombosis, as well as weakening of the arteries. Immediate or delayed arterial occlusions, secondary to the aggression of the intima, or aneurysms, secondary to the aggression of the media, sometimes lead to artery ruptures without any warning signs. Such ruptures may trigger a hemorrhagic shock whose period of onset is variable and unpredictable. We are presenting here three cases treated in our department for electrical burns, whose complications were marked by hemorrhagic shock, secondary to late artery ruptures, sometimes occurring several months following the event...
May 15, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29766943/brain-stem-hemangioblastomas-the-seemingly-innocuous-lesion-in-a-perilous-location
#9
Jeena Joseph, Sanjay Behari, Shruti Gupta, Kamlesh Singh Bhaisora, Anish Gandhi, Arun Srivastava, Awadhesh K Jaiswal
Introduction: Hemangioblastomas [75% sporadic, 25% with Von Hippel Lindau (VHL) disease] are highly vascular, benign lesions. The surgical nuances, management, and complication avoidance in brain-stem hemangioblastomas (BHs) have been studied. Material and Methods: Over 18 years, 27(mean age: 29 years; range 15-60 years) consecutive cases of BH underwent microsurgical excision. All patients were assessed clinico-radiologically for neurological deficits and screened for VHL disease...
May 2018: Neurology India
https://www.readbyqxmd.com/read/29765391/abciximab-reopro-dosing-strategy-for-the-management-of-acute-intraprocedural-thromboembolic-complications-during-pipeline-flow-diversion-treatment-of-intracranial-aneurysms
#10
Li-Mei Lin, Bowen Jiang, Jessica K Campos, Narlin B Beaty, Matthew T Bender, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon
Background: Flow diversion with the Pipeline embolization device (PED) is an effective neuro-endovascular method and increasingly accepted for the treatment of cerebral aneurysms. Acute in situ thrombosis is a known complication of PED procedures. There is limited experience in the flow diversion literature on the use of abciximab (ReoPro) for the management of acute thrombus formation in PED cases. Methods: Data were collected retrospectively on patients who received intra-arterial (IA) ReoPro with or without subsequent intravenous (IV) infusion during PED flow diversion treatment of intracranial aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29757897/coagulation-defects-in-the-cirrhotic-patient-undergoing-liver-transplantation
#11
Arabesque Parker, Constantine J Karvellas
Patients with cirrhosis undergoing liver transplantation have unique challenges with regard to the prevention and management of thrombosis and hemorrhage. Patients with cirrhosis have an unstable balance of the coagulation system due to defects in both prothrombotic and antithrombotic components. These changes make laboratory monitoring challenging, prophylaxis against bleeding and thrombosis controversial, and therapy for the same uncertain. When cirrhotic patients undergo liver transplantation they frequently have significant transfusion requirements...
May 7, 2018: Transplantation
https://www.readbyqxmd.com/read/29756168/transsplenic-splenoportography-and-portal-venous-interventions-in-pediatric-patients
#12
Eric J Monroe, Ethan J Speir, C Matthew Hawkins, Giri Shivaram, Kevin S H Koo, Anne E Gill
BACKGROUND: Data regarding transsplenic portal venous access for diagnostic imaging and endovascular intervention in children are limited, possibly due to concerns regarding high bleeding risks and resultant underutilization. OBJECTIVE: To investigate the safety and utility of transsplenic splenoportography and portal venous interventions in children. MATERIALS AND METHODS: A retrospective review was performed of all pediatric patients undergoing percutaneous transsplenic portal venous access and intervention at two large tertiary pediatric institutions between January 2012 and April 2017 was performed...
May 13, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29754725/-time-in-therapeutic-range-ttr-and-follow-up-of-patients-on-vitamin-k-antagonist-a-cohort-analysis
#13
E Valdelièvre, I Quéré, B Caré, J P Laroche, J F Schved
INTRODUCTION: Despite the increasing utilization of direct oral anticoagulant (DOAC) prescriptions, vitamin K antagonists (VKAs) remain the treatment of choice for treating and preventing thromboembolic events. The morbidity and mortality of VKAs are partly due to the difficulty of keeping the patient within the therapeutic range. For patients treated by VKA, time in therapeutic range (TTR) is a quality parameter of treatment, widely used in clinical trials but rarely by prescribers. It is well established that its use correlates with the risk of hemorrhage, thrombosis or mortality...
May 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29752489/cerebral-venous-thrombosis-state-of-the-art-diagnosis-and-management
#14
REVIEW
Adam A Dmytriw, Jin Soo A Song, Eugene Yu, Colin S Poon
PURPOSE: This review article aims to discuss the pathophysiology, clinical presentation, and neuroimaging of cerebral venous thrombosis (CVT). Different approaches for diagnosis of CVT, including CT/CTV, MRI/MRV, and US will be discussed and the reader will become acquainted with imaging findings as well as limitations of each modality. Lastly, this exhibit will review the standard of care for CVT treatment and emerging endovascular options. METHODS: A literature search using PubMed and the MEDLINE subengine was completed using the terms "cerebral venous thrombosis," "stroke," and "imaging...
May 11, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29751198/price-to-pay-portal-vein-arterialization-for-hepatic-artery-thrombosis-after-living-donor-liver-transplantation-a-case-report
#15
Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-Iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can't be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son...
May 2, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29745356/noninfectious-hospital-adverse-events-decline-after-elimination-of-contact-precautions-for-mrsa-and-vre
#16
Elise M Martin, Brandy Bryant, Tristan R Grogan, Zachary A Rubin, Dana L Russell, David Elashoff, Daniel Z Uslan
OBJECTIVETo evaluate the impact of discontinuing routine contact precautions (CP) for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) on hospital adverse events.DESIGNRetrospective, nonrandomized, observational, quasi-experimental study.SETTINGAcademic medical center with single-occupancy rooms.PARTICIPANTSInpatients.METHODSWe compared hospital reportable adverse events 1 year before and 1 year after discontinuation of routine CP for endemic MRSA and VRE (preintervention and postintervention periods, respectively)...
May 10, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29743845/a-case-of-ulcerative-colitis-presenting-with-cerebral-venous-thrombosis
#17
Junghwan Lee, Sung Wook Hwang, Jinhee Lee, Kyung Hwa Jung, Ha Il Kim, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Patients with inflammatory bowel disease (IBD) have been reported to have an increased risk of thromboembolism. Cerebral venous thrombosis (CVT) is a rare but serious extraintestinal manifestation of IBD. Due to its highly variable manifestation and low incidence, CVT is not usually readily recognized by physicians. Herein, we report a case of a 35-year-old male presenting with CVT associated with ulcerative colitis (UC). The patient was admitted with chief complaints of bloody diarrhea that had started 3 days prior...
April 2018: Intestinal Research
https://www.readbyqxmd.com/read/29742000/haemoproteus-parahaemoproteus-spp-in-captive-bred-bobwhite-quail-colinus-virginianus-in-southern-utah-usa
#18
E Jane Kelly, Thomas J Baldwin, David D Frame, April L Childress, James F X Wellehan
A captive-bred Bobwhite Quail ( Colinus virginianus) ranch in southern Utah experienced high mortality rates in the late summer and fall of 2012. Nine juvenile birds were necropsied at the Utah Veterinary Diagnostic Laboratory. Gross lesions included pale skeletal muscle with multifocal hemorrhages and petechiae in the air sacs and serosal surfaces of most organs. Histologically there was moderate to severe, multifocal, degenerative myositis with intramyofiber schizonts and minimal lymphoplasmacytic infiltrates in the proventriculus, ventriculus, heart, and skeletal muscle...
May 9, 2018: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/29739085/cerebral-venous-sinus-thrombosis-with-cerebral-hemorrhage-presenting-with-status-epilepticus-in-early-pregnancy
#19
Xuemin Feng, Teng Zhao, Jingyao Liu, Chunkui Zhou
BACKGROUND: CVST is an important cause of stroke during late pregnancy and in the puerperium, but it is seldom encountered during early pregnancy. We report a case of a 34-year-old woman presenting with convulsive status epilepticus in early pregnancy. METHODS: In this case, the cranial computed tomography detected hemorrhage. Magnetic resonance imaging revealed a bilateral hypointense signal involving the frontal lobes and a hyperintense lesion on the right temporal lobe on T1-weighted imaging, and a large bilateral hyperintense area involving the frontal lobes on T2-weighted and fluid-attenuated inversion recovery imaging...
April 1, 2018: Clinical Laboratory
https://www.readbyqxmd.com/read/29738377/proton-pump-inhibition-in-patients-treated-with-novel-antithrombotic-drugs-should-we-worry-about-thrombosis
#20
Tomáš Bolek, Matej Samoš, Ingrid Škorňová, Frantisek Kovář, Peter Galajda, Ján Stasko, Peter Kubisz, Marián Mokáň
Proton pump inhibition (PPI) administrated together with antiplatelet and anticoagulant agents reduces the risk of gastrointestinal hemorrhage. Several novel antithrombotic agents have been recently introduced for acute coronary syndrome patients (prasugrel, ticagrelor), or for patients requiring long-term anticoagulation (dabigatran, rivaroxaban, apixaban, edoxaban, betrixaban). In fact, these agents might offer even stronger inhibition of platelets or coagulation compared with older agents; and therefore, the need for gastroprotection might be even stronger when these new agents are used for long-term antithrombotic therapy...
April 24, 2018: Journal of Cardiovascular Pharmacology
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