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Venous thrombolysis

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https://www.readbyqxmd.com/read/27917948/association-of-cortical-vein-filling-with-clot-location-and-clinical-outcomes-in-acute-ischaemic-stroke-patients
#1
Sonu Bhaskar, Andrew Bivard, Peter Stanwell, John R Attia, Mark Parsons, Michael Nilsson, Christopher Levi
Delay in cortical vein filling during the late-venous phase (delayed-LCVF) is characterized by opacification of cerebral veins despite contrast clearance from contralateral veins on dynamic computed tomography angiography (dCTA) in acute ischemic stroke (AIS) patients. The aim of the study was to investigate the associations of delayed-LCVF with clot location, reperfusion status at 24 hours, and 90-days functional outcome in AIS patients who received reperfusion therapy. A prospective cohort of AIS patients treated with intravenous thrombolysis was studied...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27913777/risk-factors-for-major-bleeding-in-the-seattle-ii-trial
#2
Immad Sadiq, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure...
December 1, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27879533/the-angiovac-device-understanding-the-failures-on-the-road-to-success
#3
Berhane Worku, Arash Salemi, Marcus D DʼAyala, Robert F Tranbaugh, Leonard N Girardi, Iosif M Gulkarov
OBJECTIVE: Current percutaneous thromboembolectomy techniques may obviate surgical intervention in high-risk patients with iliocaval thrombus or thrombus of the right side of the heart, but typically require thrombus fragmentation and thrombolysis with associated bleeding and thromboembolic complications. The AngioVac (Angiodynamics, Latham, NY USA) device uses a percutaneous venovenous bypass circuit to aspirate intact thrombus. A review of the literature was performed with regard to the AngioVac device to determine the factors correlating with successful thrombus extraction...
November 22, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#4
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27867284/ekosonic-thrombolysis-as-a-therapeutic-adjunct-in-venous-occlusive-disease
#5
D S Zaghlool, R W Franz, J Jenkins
The use of ultrasound waves in conjunction with local thrombolysis may accelerate clot resolution and serve as an important therapeutic adjunct in the treatment of venous occlusive disease. Our goal was to provide a larger sample population over a 5-year period to evaluate our experience with the EkoSonic endovascular system (EKOS, EKOS Corporation, Bothell, WA). We suspected that ultrasound-accelerated thrombolysis (UAT) using EKOS would provide excellent thrombolysis and midterm patency rates with minimal thrombolytic complications...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27860129/the-postthrombotic-syndrome-current-evidence-and-future-challenges
#6
REVIEW
A Rabinovich, S R Kahn
Post thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT), which develops in 20%-50 % of patients. PTS manifests as a spectrum of symptoms and signs of chronic venous insufficiency that can impose significant morbidity and have a negative impact on quality of life. Chronic venous hypertension caused by a combination of residual venous obstruction and valvular reflux is believed to play a major role in the pathophysiology of PTS. The Villalta scale is the most widely applied clinical scale used to diagnose and define PTS...
November 18, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27849513/venous-thoracic-outlet-syndrome-the-role-of-early-rib-resection
#7
Vienna G Katana, Jeffrey S Weiss
The upper extremity is an uncommon site for deep vein thrombosis and, although most of these thrombotic events are secondary to catheters or indwelling devices, venous thoracic outlet syndrome is an important cause of primary thrombosis. Young, active, otherwise healthy individuals that engage in repetitive upper extremity exercises, such as those required by a military vocation, may be at an increased risk. We present the case of a Naval Officer diagnosed with venous thoracic outlet syndrome whereby a multimodal approach with early surgical decompression was used...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27830895/thrombolysis-for-acute-deep-vein-thrombosis
#8
REVIEW
Lorna Watson, Cathryn Broderick, Matthew P Armon
BACKGROUND: Standard treatment for deep vein thrombosis aims to reduce immediate complications. Use of thrombolysis or clot dissolving drugs could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the third update of a review first published in 2004. OBJECTIVES: To assess the effects of thrombolytic therapy and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function...
November 10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27829970/local-intrasinus-thrombolysis-for-cerebral-venous-sinus-thrombosis
#9
Lakshmi Sudha Prasanna Karanam, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Ramatharaknath Vemuri, Sravanthi Byrapaneni, Raghavasarma Polavarapu
BACKGROUND: Cerebral venous strokes due to cerebral venous sinus thrombosis (CVST) have varied presentation and clinical outcome. Despite aggressive medical treatment with optimal anticoagulation, some patients develop progressive neurologic deterioration causing significant morbidity and mortality. The aim of the present series is to analyze the safety and efficacy of in situ thrombolysis in patients with cerebral venous sinus thrombosis in severe clinical grade and refractory to conventional medical management...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27818112/endovascular-management-of-may-thurner-syndrome-in-adolescents-a-single-center-experience
#10
Roger E Goldman, Victoria A Arendt, Nishita Kothary, William T Kuo, Daniel Y Sze, Lawrence V Hofmann, Matthew P Lungren
PURPOSE: To report a single-center experience in regard to the technique, safety, and clinical outcomes of endovascular therapy for treatment of May-Thurner syndrome (MTS) in adolescent patients. MATERIALS AND METHODS: A retrospective review identified 10 patients (6 female; mean age, 16 y; range, 12-18 y; mean weight, 73 kg; range, 50-116 kg) treated by endovascular therapy for MTS from 1998 to 2015. Clinical presentations consisted of acute thrombotic MTS (n = 6) and nonthrombotic MTS (n = 4)...
November 3, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27816347/cerebral-venous-thrombosis
#11
José Manuel Ferro, Patrícia Canhão, Diana Aguiar de Sousa
Cerebral venous thrombosis (CVT) has an incidence of 1.32/100,000/years in high-income countries, and higher in middle- and low-income countries. CVT is more frequent in infants and children young adults and females, especially during pregnancy/puerperium. CVT are now being diagnosed with increasing frequency because of the increased awareness and higher use of magnetic resonance imaging (MR) for investigating patients with acute and subacute headaches and new onset seizures. CVT rarely present as a stroke syndrome...
November 2, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27814432/pharmacomechanical-thrombectomy-for-iliofemoral-deep-vein-thrombosis
#12
REVIEW
Lindsay Robertson, Olivia McBride, Anne Burdess
BACKGROUND: Deep venous thrombosis (DVT) occurs in approximately one in 1000 adults every year, and has an annual mortality of 14.6%. In particular, iliofemoral DVT can lead to recurrent thrombosis and post-thrombotic syndrome (PTS), a painful condition which can lead to chronic venous insufficiency, oedema, and ulceration. It causes significant disability, impaired quality of life, and economic burden. Early thrombus removal techniques have been advocated in patients with an iliofemoral DVT in order to improve vein patency, prevent valvular dysfunction, and reduce future complications, such as post-thrombotic syndrome and venous ulceration...
November 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27798328/cerebral-venous-sinuses-thrombosis-in-both-transverse-sinus-and-torcula-multistep-endovascular-treatment-and-stenting
#13
G Cabral de Andrade, A Lesczynsky, V M Clímaco, E R Pereira, P O Marcelino, Aoc Franco, D F De Almeida
PURPOSE: Cerebral venous sinus thrombosis (CVST) is an unusual and potentially life-threatening condition with variable and nonspecific clinical symptoms and high morbimortality rates. Standard therapy consists of systemic anticoagulation; although there is no clear evidence about the best choice for treatment, intravenous heparin is used as the first-line treatment modality. Intravenous sinus thrombolysis can be an effective and relatively safe treatment for acutely deteriorating patients who have not responded to conventional therapy...
October 26, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27774968/-ultrasound-assisted-catheter-directed-thrombolysis-of-acute-pulmonary-embolism-via-the-subclavian-vein-alternative-access-path
#14
Veysel Özgür Barış, Evren Özçınar, Özgür Ulaş Özcan, Mustafa Şırlak
Routinely, the femoral vein is used for access in ultrasound-assisted, catheter-directed thrombolysis (USAT). Presently described is a case of bilateral femoral venous occlusion caused by chronic thrombosis, successfully treated with USAT, using subclavian vein for access.
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#15
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27738902/decision-making-in-a-patient-with-cardiac-arrest-due-to-venous-thromboembolism-within-24%C3%A2-h-after-glioblastoma-resection
#16
D Dubinski, S-Y Won, M Bruder, M-T Forster, V Seifert, C Senft, J Berkefeld, J Mersmann
In the fulminant VTE form with cardiac arrest, systemic thrombolysis remains the most effective therapy. However, several contraindications restrict the use such as intracranial neoplasm or a recent history of intracranial surgery. Here, we report the case of a 59-year-old man who underwent glioblastoma resection and suffered from a fulminant pulmonary embolism with cardiac arrest. After CPR, continuous tPA infusion via an endovascularly placed pulmonary catheter was maintained over a period of 8 h. In this case, we report on our decision-making process and the use of local thrombolysis as a successful therapy in a patient with multiple contraindications...
October 14, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27722126/venous-thromboembolism-in-pediatric-patients-a-single-institution-experience-in-korea
#17
Hyoung Soo Choi, Chang Won Choi, Heon Min Kim, Hye Won Park
BACKGROUND: While venous thromboembolism (VTE) is uncommon, its incidence is increasing in children. We aimed to evaluate the incidence, risk factors, treatment, and outcome of pediatric VTE cases at a single tertiary hospital in Korea. METHODS: We retrospectively analyzed the records of consecutive pediatric VTE patients admitted to the Seoul National University Bundang Hospital between April 2003 and March 2016. RESULTS: Among 70,462 hospitalizations, 25 pediatric VTE cases were identified (3...
September 2016: Blood Research
https://www.readbyqxmd.com/read/27664152/endovascular-treatment-of-thrombosis-and-embolism
#18
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
September 24, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27659895/significance-of-echocardiographically-detected-central-venous-catheter-tip-associated-thrombi
#19
Jeffrey Forris Beecham Chick, Shilpa N Reddy, Ruchika D Bhatt, Benjamin J Shin, James N Kirkpatrick, Scott O Trerotola
PURPOSE: To explore significance, management, and outcomes of central venous catheter (CVC) tip-associated thrombi incidentally detected on echocardiography. MATERIALS AND METHODS: Echocardiogram data from all patients with CVCs from October 2009 to June 2011 were reviewed (N = 170). Patients with CVC tip-associated thrombi were selected (n = 49). Echocardiograms were reviewed for ejection fraction, presence of patent foramen ovale (PFO), presence of other intracardiac shunts, and mean thrombus size...
December 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27650230/increased-platelet-leukocyte-aggregates-are-associated-with-myocardial-no-reflow-in-patients-with-st-elevation-myocardial-infarction
#20
Faxin Ren, Nan Mu, Xia Zhang, Jinxi Tan, Liudong Li, Chuanhuan Zhang, Mei Dong
OBJECTIVE: We aimed to investigate the association between platelet-leukocyte aggregates (PLA) levels on admission and the risk of myocardial no-reflow in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: A total of 83 patients with STEMI undergoing primary PCI were included in the current study. Platelet-leukocyte conjugates (PLA), including platelet-monocyte aggregates (PMA), platelet-neutrophil aggregates (PNA) and platelet-lymphocyte aggregates were studied by flow cytometry in peripheral venous blood...
September 2016: American Journal of the Medical Sciences
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