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https://www.readbyqxmd.com/read/28654852/adductor-canal-compression-syndrome-in-an-18-year-old-female-patient-leading-to-acute-critical-limb-ischemia-a-case-report
#1
Yi Zhou, Evan J Ryer, Robert P Garvin, Jeremy L Irvan, James R Elmore
BACKGROUND: Adductor canal compression syndrome is a rare non-atherosclerotic cause of arterial occlusion and limb ischemia. PRESENTATION OF CASE: The patient is an 18-year-old healthy female who presented to the emergency department with acute left lower extremity ischemia. Her symptoms began as sudden onset mild foot pain approximately two months ago. Over the 72h prior to presentation, she developed severe pain, pallor, paralysis, loss of pedal pulses, paresthesia, and poikilothermia...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28652952/fibromuscular-dysplasia-with-spontaneous-coronary-artery-disease-presenting-as-acute-myocardial-infarction
#2
Ali Farooq, Waseem Amjad, Ata Ur Rahim Bajwa, Hassaan Yasin, Rizwan Ali, Muhammad Pervaiz
A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0...
May 23, 2017: Curēus
https://www.readbyqxmd.com/read/28649477/the-importance-of-catheter-angiography-in-computed-tomography-angiography-negative-subarachnoid-hemorrhage
#3
Ali S Haider, Caleb Gottlich, Anadjeet Khahera, Steven Vayalumkal, Umair Khan, Eliel N Arrey, Jacob Campbell, Richa Thakur, Sam Finn, Kennith F Layton
Computed tomography angiography (CTA) has become an effective tool in the evaluation of patients with subarachnoid hemorrhage (SAH), but it still has limitations. Up to 15% of non-traumatic SAH cases are negative on CTA. The benefits of catheter angiography in the evaluation of certain cases of CTA-negative SAH have been previously demonstrated. Here, we present the case of a 48-year-old female who presented with headache and right-sided hemiparesis, who later became apneic and required intubation. A computed tomography (CT) scan of the head demonstrated a diffuse SAH...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28649087/acute-hemodynamic-and-tissue-effects-of-cryoballoon-ablation-on-pulmonary-vessels-the-ivus-cryo-study
#4
Jakub Baran, Paweł Lewandowski, Krzysztof Smarż, Agnieszka Sikorska, Beata Zaborska, Piotr Kułakowski
BACKGROUND: Cryoballoon-based pulmonary vein isolation (CB-PVI) has been widely used for the treatment of atrial fibrillation. Although generally safe and effective, the procedure may be associated with pulmonary vein (PV) stenosis and bronchial or esophageal injury. The mechanisms leading to these complications have not been studied in detail. Our aim was to examine acute effects of cryoballoon on the pulmonary vessel and right heart pressures as well as PV wall morphology. METHODS AND RESULTS: In 8 patients (5 men, mean age 55±14 years) undergoing CB-PVI, pressure in each PV was measured by catheter located inside the PV directly before and after CB-PVI...
June 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28647632/axillary-artery-to-right-atrial-graft-for-dialysis-access-using-an-autologous-femoropopliteal-vein
#5
Yusuf Chauhan, M Mujeeb Zubair, Sashi Inkollu, Eric K Peden
Patients with prolonged history of central venous catheters can develop central venous occlusion. We report the creation of an axillary artery to right atrial graft using the femoropopliteal vein for dialysis access in a patient with end stage renal disease (ESRD) on hemodialysis with history of central venous occlusion. The patient had previously developed steal syndrome following a right brachial artery to right atrial polytetrafluoroethylene (PTFE) graft requiring revision to a left axillary artery inflow which subsequently thrombosed...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647627/endovascular-retrieval-of-migrated-distal-end-of-vp-shunt-from-bilateral-pulmonary-arteries-a-technical-note
#6
Rimal Hanif Dossani, Tanmoy Kumar Maiti, Devi Prasad Patra, Anil Nanda, Hugo Cuellar
Ventriculoperitoneal (VP) shunting of cerebrospinal fluid is one of the most common procedures performed by neurosurgeons around the world. Migration of distal VP shunt catheter into bilateral segmental pulmonary arteries is an extremely rare complication of VP shunt placement. In present case, a 30-year-old male underwent VP shunting complicated by migration of distal VP shunt catheter into the bilateral pulmonary arteries. Despite manual attempt at externalizing the distal VP shunt catheter at the level of the clavicle, a small piece of distal VP shunt catheter in bilateral pulmonary arteries was noted on CT chest obtained following manual externalization...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647197/characterizing-tissue-perfusion-after-lower-extremity-intervention-using-two-dimensional-color-coded-digital-subtraction-angiography
#7
Ann H Kim, Andrew J Shevitz, Katherine L Morrow, Daniel E Kendrick, Karem Harth, Henry Baele, Vikram S Kashyap
OBJECTIVE: Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients. METHODS: Between March 2015 and June 2016, patients (N = 31) underwent lower extremity angiography using a two-dimensional perfusion (2DP) imaging protocol (Philips Healthcare, Andover, Mass)...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28646466/effects-of-catheter-based-renal-denervation-on-heart-failure-with-reduced-ejection-fraction-a-systematic-review-and-meta-analysis
#8
REVIEW
Hidekatsu Fukuta, Toshihiko Goto, Kazuaki Wakami, Nobuyuki Ohte
Despite the recent advances in the management of heart failure, the mortality of heart failure patients remains high. It is of urgent need to develop new therapy for heart failure. Heart failure is characterized by increased sympathetic activity, and chronic sympathetic activation is involved in the maintenance of the pathological state. Catheter-based renal denervation (RDN) has emerged as an invasive but safe approach that can reduce sympathetic activation. Studies have reported inconsistent results regarding the effect of RDN in heart failure patients due to limited power with small sample sizes...
June 24, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28646330/-imaging-of-vessels-supplying-the-brain
#9
REVIEW
S M Schellong, N Abolmaali, B Voigts, C Stelzner
Nowadays, several technically validated modalities are available for imaging both the extracranial and intracranial segments of arteries supplying blood to the brain. In the acute stroke setting, computed tomography (CT) angiography is of utmost importance because it provides the key diagnostic criteria indicative for the use of catheter-based recanalization techniques. Ultrasound imaging of extracranial arteries is most suitable for detecting an underlying stenosis of the internal carotid artery (ICA) in patients with stroke, transient ischemic attacks (TIA), retinal vessel occlusion and amaurosis fugax...
June 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28644311/hemobilia-an-uncommon-but-notable-cause-of-upper-gastrointestinal-bleeding
#10
Scott Cathcart, John W Birk, Michael Tadros, Micheal Schuster
GOAL AND BACKGROUND: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. STUDY: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. RESULTS: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28644058/air-embolism-diagnosis-and-management
#11
Neera Malik, Paul L Claus, Jeffery E Illman, Seth J Kligerman, Michael R Moynagh, David L Levin, David A Woodrum, Arvin Arani, Shivaram P Arunachalam, Philip A Araoz
Air embolism is an uncommon, but potentially life-threatening event for which prompt diagnosis and management can result in significantly improved patient outcomes. Most air emboli are iatrogenic. Arterial air emboli may occur as a complication from lung biopsy, arterial catheterization or cardiopulmonary bypass. Immediate management includes placing the patient on high-flow oxygen and in the right lateral decubitus position. Venous air emboli may occur during pressurized venous infusions, or catheter manipulation...
June 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28642298/does-acid-base-equilibrium-correlate-with-remnant-liver-volume-during-stepwise-liver-resection
#12
Mohammad Golriz, Sepehr Abbasi, Parham Fathi, Ali Majlesara, Thorsten Brenner, Arianeb Mehrabi
Small for size and flow syndrome (SFSF) is one of the most challenging complications following extended hepatectomy (EH). After EH, hepatic artery flow decreases and portal vein flow increases per 100 gram remnant liver volume (RLV). This causes hypoxia followed by metabolic acidosis. A correlation between acidosis and post-hepatectomy liver failure has been postulated, but not studied systematically in a large animal model or clinical setting. In our study, we performed stepwise liver resections on nine pigs to defined SFSF limits as follows: step 1: segment II/III resection, step 2: segment IV resection, step 3: segment V/VIII resection (RLV: 75%, 50% and 25% respectively)...
June 22, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28640781/hydrogen-gas-inhalation-inhibits-progression-to-the-irreversible-stage-of-shock-after-severe-hemorrhage-in-rats
#13
Tadashi Matsuoka, Masaru Suzuki, Motoaki Sano, Kei Hayashida, Tomoyoshi Tamura, Koichiro Homma, Keiichi Fukuda, Junichi Sasaki
BACKGROUND: Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival. METHODS: Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mmHg. After 60 minutes of shock, the rats were resuscitated with a volume of normal saline equal to four times the volume of shed blood...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28639773/-paradigm-shift-in-the-treatment-of-atrial-fibrillation-the-importance-of-risk-factor-management
#14
Stefania Aur, Patrizio Pascale
The prevalence of atrial fibrillation (AF) is constantly rising. Different studies have underlined the correlation between AF and modifiable risk factors such as obesity, obstructive sleep apnea, hypertension and sedentary lifestyle. Treatment of these comorbidities could significantly reduce the AF burden and the recurrence rate after cardioversion or ablation. These data should therefore lead to a paradigm shift in the management of AF. A strategy limited to catheter ablation or to the prescription of an antiarrhythmic drug is not sufficient...
May 24, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28639746/acute-changes-in-histopathology-and-intravascular-imaging-after-catheter-based-renal-denervation-in-a-porcine-model
#15
Atsushi Sakaoka, Akiyuki Takami, Yuji Onimura, Hitomi Hagiwara, Hisako Terao, Fumiaki Kumagai, Kiyoshi Matsumura
OBJECTIVES: We first aimed to identify the histopathological changes occurring immediately after renal denervation (RDN) with radiofrequency energy, and then to assess the feasibility of determining procedural success using currently available clinical intravascular imaging techniques. BACKGROUND: Catheter-based RDN has been used as an alternative therapy for hypertension. However, no practical endpoint to determine procedural success during treatment has been established...
June 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28636165/a-feasibility-and-safety-study-of-intracoronary-hemodilution-during-primary-coronary-angioplasty-in-order-to-reduce-reperfusion-injury-in-myocardial-infarction
#16
Michael McGarvey, Omar Ali, M Bilal Iqbal, Charles Ilsley, Joyce Wong, Carlo Di Mario, Simon Redwood, Tiffany Patterson, Dudley J Pennell, Paula Rogers, Miles Dalby
OBJECTIVES: We designed a pilot study to evaluate safety and feasibility of an inexpensive and simple approach to intracoronary hemodilution during primary angioplasty (PPCI) to reduce reperfusion injury. INTRODUCTION: Early revascularization in acute myocardial infarction decreases infarct size and improves outcomes. However, abrupt restoration of coronary flow results in myocardial reperfusion injury and increased final infarct size. Dilution of coronary blood during revascularization may help reduce this damage...
June 21, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28633268/surgical-interventional-hybrid-concept-in-a-newborn-with-borderline-left-heart
#17
Stefan Rupp, Josef Thul, Kerstin Gummel, Markus Khalil, Hakan Akintuerk, Dietmar Schranz
Through a series of complex surgical and interventional procedures including downsizing of an unrestricted atrial septal defect, aortic arch reconstruction, pulmonary artery banding, reversed Potts shunt, and Melody valve in a mitral position, biventricular conversion was successfully achieved in a patient with a distinct borderline left ventricle. By use of these interventional steps, flow-mediated and load-mediated growth of a small left ventricle was observed, highlighting the plasticity of hearts in growing children...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28632583/incremental-balloon-deflation-following-complete-resuscitative-endovascular-balloon-occlusion-of-the-aorta-results-in-steep-inflection-of-flow-and-rapid-reperfusion-in-a-large-animal-model-of-hemorrhagic-shock
#18
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Jeremy W Cannon, Todd E Rasmussen, Lucas P Neff, M Austin Johnson, Timothy K Williams
INTRODUCTION: To avoid potential cardiovascular collapse after resuscitative endovascular balloon occlusion of the aorta (REBOA), current guidelines recommend methodically deflating the balloon for 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#19
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28625402/comparison-between-catheter-based-delivery-of-paclitaxel-after-bare-metal-stenting-and-drug-eluting-stents-in-coronary-artery-disease-patients-at-high-risk-for-in-stent-restenosis
#20
Mostafa El-Mokadem, Mohamed El-Ramly, Amr Hassan, Hesham Boshra, Amir AbdelWahab
BACKGROUND: Drug eluting stents reduce the risk of in-stent restenosis but delay healing of the vascular wall. Recent data on late and very late stent thrombosis after drug-eluting stent (DES) implantation have raised concerns about the long-term safety. High lipophilicity of paclitaxel promotes rapid cellular uptake and prolongs its action. This makes paclitaxel a very promising candidate for local drug therapy intended to inhibit the proliferative and migratory processes involved in restenosis following PCI...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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