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https://www.readbyqxmd.com/read/27914131/the-role-of-pharmacomechanical-endovascular-intervention-for-iliofemoral-vein-thrombosis-compared-to-conventional-anticoagulation-therapy
#1
In Sub Kim, Won Min Jo
Although anticoagulation therapy is the primary treatment for deep vein thrombosis (DVT), it has not been associated with the rapid recanalization of the venous occlusion. Moreover, it is associated with long-term disability due to post-thrombotic syndrome (PTS). In contrast, pharmacomechanical endovascular intervention (PMI) results in more rapid clinical improvement in DVT patients, but there are few reports on its long-term outcomes. This retrospective study evaluated the clinical effectiveness of PMI compared to conventional anticoagulation therapy (ACA) for acute and subacute iliofemoral DVT...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27909276/-closure-of-ascending-aortic-entry-by-debranching-endovascular-management-in-an-elderly-patient-with-acute-stanford-type-a-dissection
#2
Munehiro Saiki, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Gaku Uchino, Takuya Kawabata, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty. A couple of days later, her condition became stabilized with antihypertensive therapy. Since the dissection was limited within the ascending aorta, closure of the entry with the stentgraft was considered appropriate and much less invasive as compared with an open surgery...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27909202/prediction-of-blood-brain-barrier-disruption-and-intracerebral-hemorrhagic-infarction-using-arterial-spin-labeling-magnetic-resonance-imaging
#3
Takeya Niibo, Hajime Ohta, Shirou Miyata, Ichiro Ikushima, Kazuchika Yonenaga, Hideo Takeshima
BACKGROUND AND PURPOSE: Arterial spin-labeling magnetic resonance imaging is sensitive for detecting hyperemic lesions (HLs) in patients with acute ischemic stroke. We evaluated whether HLs could predict blood-brain barrier (BBB) disruption and hemorrhagic transformation (HT) in acute ischemic stroke patients. METHODS: In a retrospective study, arterial spin-labeling was performed within 6 hours of symptom onset before revascularization treatment in 25 patients with anterior circulation large vessel occlusion on baseline magnetic resonance angiography...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27908309/an-unrecognised-presentation-of-takayasu-arteritis-superficial-femoral-artery-involvement
#4
Hui Dong, Wuqiang Che, Xiongjing Jiang, Meng Peng, Yubao Zou, Huimin Zhang, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: Superficial femoral artery (SFA) involvement in Takayasu arteritis (TA) has rarely been reported. The purpose of this study was to investigate the clinical characteristic and clinical outcomes of endovascular therapy in such patients. METHODS: We analysed the data collected from 105 consecutive patients with TA, who were diagnosed from January 2011 to December 2013. All patients underwent ankle brachial index (ABI) measurements and angiography. Nine patients with an ABI <0...
November 18, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27906754/management-of-acute-stroke-in-patients-on-oral-anticoagulants
#5
Jan C Purrucker, Thorsten Steiner
PURPOSE OF REVIEW: An increasing number of patients are receiving oral anticoagulants. Since non-vitamin K antagonist oral anticoagulants (NOACs) were approved, primary prevention of ischemic stroke has become simpler. However, managing ischemic stroke and intracerebral hemorrhage while on oral anticoagulation (OAC) has become more complex. This review covers the latest developments in managing ischemic and hemorrhagic stroke in patients receiving vitamin K antagonists (VKA) and NOACs...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27906117/carotid-artery-stenting-versus-no-stenting-assisting-thrombectomy-for-acute-ischaemic-stroke-protocol-for-a-systematic-review-of-randomised-clinical-trials-with-meta-analyses-and-trial-sequential-analyses
#6
Henrik Steglich-Arnholm, Markus Holtmannspötter, Christian Gluud, Derk Wolfgang Krieger
BACKGROUND: In patients with intracranial large vessel arterial occlusion, ipsilateral extracranial carotid artery occlusions or near-occlusions pose a significant hurdle in endovascular management of acute ischaemic stroke. Stenting of the carotid lesion may be beneficial in this situation to provide a stable access for introducing catheters through the carotid lesion into the intracranial vasculature and the target occlusion. Furthermore, carotid stenting may ensure ample blood flow for wash-out of clot material and reperfusion of the ischaemic penumbral tissue...
December 1, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27904110/infected-aortic-aneurysm-mimicking-anti-proteinase-3-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#7
Kenta Hachiya, Kazuaki Wakami, Atsuhiro Yoshida, Hisao Suda, Nobuyuki Ohte
We herein report an unusual case of an infected descending aortic pseudoaneurysm with luminal pathognomonic oscillating vegetation with serological findings and clinical features mimicking anti-proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis. The positive blood cultures and imaging findings, including a pseudoaneurysm and vegetations in the aorta, suggested the presence of an infected aortic aneurysm. The patient was successfully treated with antibiotics and endovascular aortic repair...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27903484/loss-of-kidney-function-after-endovascular-treatment-of-peripheral-arterial-disease
#8
T A Sigterman, L J J Bolt, A G Krasznai, M G Snoeijs, R Heijboer, G W H Schurink, L H Bouwman
BACKGROUND: Administration of radiocontrast during endovascular procedures for peripheral arterial disease may cause acute kidney injury, which generally recovers with supportive treatment. Long-term effects of endovascular procedures on renal function remain to be investigated. METHOD: This retrospective observational cohort study includes all patients who newly presented to the vascular surgery outpatient clinic with rutherford class II or III peripheral arterial disease and who were treated with either supervised exercise therapy or endovascular interventions...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903474/functional-assessment-and-evaluation-of-outcome-after-endovascular-therapy-with-coverage-of-the-left-subclavian-artery-in-case-of-blunt-thoracic-aortic-injury
#9
A Gombert, D Kotelis, U M Griepenkerl, G Fraedrich, J Klocker, B Glodny, M J Jacobs, A Greiner, J Grommes
OBJECTIVE: Patients suffering blunt thoracic aortic injury (BTAI) can be treated by use of thoracic endovascular aortic repair (TEVAR). In this setting, the coverage of the left subclavian artery (LSA) is frequently necessary. Nevertheless, the functionality of the upper left extremity after TEVAR had been rarely analyzed. Thus this study intends to underline the safety of TEVAR as well as to determine the functionality of the left arm after coverage of the LSA. METHODS: All patients suffering from BTAI treated by endovascular means in three centers (Aachen [Germany], Maastricht [Netherlands] and Innsbruck [Austria]) between 1996 and 2009 were retrospectively analyzed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903022/-recanalization-techniques-for-venous-outflow-obstruction
#10
Michael K W Lichtenberg, Houman Jalaie
Deep vein thrombosis (DVT) is associated with a high cost burden for health care systems because of secondary cost intensive complications like pulmonary embolism and especially the post thrombotic syndrome (PTS). The current standard therapy of anticoagulation for DVT therapy has not changed through the years leaving patients especially with iliofemoral vein thrombus on a high-risk situation for developing PTS. Current study situation for endovascular treatment of iliofemoral DVT treatment gives a rationale for active thrombus removal using catheter directed therapy (CDT) or pharmacomechanical thrombectomy (PMT) which improves valvular vein function and luminal patency reducing the potential complication of PTS...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27900415/-management-of-anesthesia-in-endovascular-interventions
#11
T Rössel, R Paul, T Richter, S Ludwig, T Hofmockel, A R Heller, T Koch
Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27895242/availability-of-endovascular-therapies-for-cerebrovascular-disease-at-primary-stroke-centers
#12
Mark J Alberts, Jean Range, William Spencer, Vicki Cantwell, M J Hampel
BACKGROUND: Endovascular therapies (EVTs) are useful for treating cerebrovascular disease. There are few data about the availability of such services at primary stroke centers (PSCs). Our hypothesis was that some of these services may be available at some PSCs. METHODS: We conducted an internet-based survey of hospitals certified as PSCs by the Joint Commission. The survey inquired about EVTs such as intra-arterial (IA) lytics, IA mechanical clot removal, coiling of aneurysms, and cervical arterial stenting, physician training, coverage models, hospital type, and outcomes...
November 28, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#13
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27890835/acute-kidney-injury-after-open-repair-of-intact-abdominal-aortic-aneurysms
#14
REVIEW
Charles Dariane, Raphaël Coscas, Celia Boulitrop, Isabelle Javerliat, Eve Vilaine, Olivier Goeau-Brissonniere, Marc Coggia, Ziad A Massy
BACKGROUND: These last years, considerable attention has been given to renal issues following endovascular aortic repair (EVAR) but acute kidney injury (AKI) also remains one of the most frequent complications following open repair (OR). OBJECTIVES: Since AKI definition has evolved, our aim was to review the aetiology, incidence, classifications and consequences of AKI after OR for intact abdominal aortic aneurysm (AAA). METHODS: A review of the English language literature published between 2004 and 2016 was conducted according to the PRISMA criteria...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27889194/usefulness-of-thromboelastography-in-the-detection-and-management-of-tissue-plasminogen-activator-associated-hyperfibrinolysis
#15
Francesca Rosafio, Laura Vandelli, Guido Bigliardi, Francesco Cavallieri, Maria Luisa Dell'Acqua, Livio Picchetto, Andrea Zini
Rotation thromboelastometry is a viscoelastometric method that provides a rapid assessment of a patient's hemostatic processes in emergency settings, allowing prompt identification of specific coagulation abnormalities. Its results thus might guide targeted replacement therapy in hemorrhagic conditions, in case of platelet or coagulation factor deficiency, or hyperfibrinolysis, which is difficult to identify otherwise. Although currently used in emergency and traumatic surgery, there are limited data about thromboelastometry in ischemic stroke, particularly in monitoring the coagulative response to recombinant tissue plasminogen activator after intravenous thrombolysis (IVT)...
November 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27888081/bow-hunter-s-syndrome-from-a-tortuous-v1-segment-vertebral-artery-treated-with-stent-placement
#16
Rouzbeh Motiei-Langroudi, Christoph J Griessenauer, Abdulrahman Alturki, Nimer Adeeb, Ajith J Thomas, Christopher S Ogilvy
Bow Hunter's syndrome is a dynamic and reversible occlusion of the vertebral artery occurring after rotation or extension of the neck. The V3 segment is the most common site of compression, especially at the atlanto-axial joint. Surgical decompression with or without cervical fusion has been the mainstay of therapy and endovascular intervention such as placement of stents is rarely performed. We report a patient with Bow Hunter's Syndrome from tortuosity of the V1 segment of the VA treated with a self-expanding biliary stent placement...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27887687/comparison-of-lower-extremity-endovascular-intervention-outcomes-in-women-versus-men
#17
Haekyung Jeon-Slaughter, Shirling Tsai, Preeti Kamath, Nicolas W Shammas, Emmanouil S Brilakis, Subhash Banerjee
This study examined a gender difference in 12-month patient outcomes after endovascular intervention for symptomatic peripheral artery disease (PAD) utilizing propensity score-matched Excellence in Peripheral Artery Disease registry data. Mortality and repeat intervention outcomes after endovascular treatment in women compared with men in the existing literature are inconsistent and confounded by other risk factors. The study included 1,084 patients who underwent 1,702 endovascular procedures, at 8 non-Veterans Administration hospitals from January 2005 to October 2015...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27882189/successful-treatment-of-resistant-hypertension-by-means-of-chronic-renal-artery-occlusion-revascularization-in-a-fragile-patient
#18
Laura Spezia, Simone Perandini, Raffaele Augelli, Giovanni Puppini, Stefania Montemezzi
BACKGROUND: Renal artery stenosis is a common cause of secondary hypertension refractory to medical therapy. Percutaneous angioplasty along with metallic stent placement has been described as an effective treatment for revascularization of the renal artery. CASE REPORT: A 54-year-old woman affected by paranoid schizophrenia with a history of hypertension and chronic renal failure due to renal artery occlusion was treated by endovascular recanalization and stent placement that resulted in improvement of renal function and control of hypertension...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27878794/varicosities-of-the-lower-extremity-new-approaches-cosmetic-or-therapeutic-needs
#19
Luca Spinedi, Heiko Uthoff, Sasan Partovi, Daniel Staub
Varicose veins of the lower extremity (VVLE) are a frequently encountered vascular disorder in the general population. The general view that VVLE are a non-serious disease with primarily aesthetic impact is a common misconception, as the disease can have a significant negative impact on generic and disease-specific quality of life. Further, VVLE may be associated with potentially threatening clinical conditions, such as chronic venous ulceration, venous thromboembolism and haemorrhage from ruptured varicose veins...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27873124/carotid-and-vertebral-dissection-imaging
#20
REVIEW
Hakeem J Shakir, Jason M Davies, Hussain Shallwani, Adnan H Siddiqui, Elad I Levy
Carotid or vertebral artery dissection is the result of a tear in the vessel lining wherein the intima separates the media. This creates a false or pseudo lumen, often accompanied by hemorrhage into the arterial wall. Dissection of these craniocervical vessels often manifests with pain alone but, if untreated, may result in severe neurologic compromise. The causes of dissection are multifactorial, including spontaneous, iatrogenic, and traumatic insults. Regardless of etiology, treatment consists primarily of anticoagulation, whereas endovascular therapy is reserved for cases with persistent thrombus or flow limitation...
December 2016: Current Pain and Headache Reports
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