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Embolization, Therapeutic

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https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#1
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
March 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28328524/paramagnetic-micro-particles-as-a-tool-for-rapid-quantification-of-apixaban-dabigatran-edoxaban-and-rivaroxaban-in-human-plasma-by-uhplc-ms-ms
#2
Martin H J Wiesen, Cornelia Blaich, Thomas Streichert, Guido Michels, Carsten Müller
BACKGROUND: Assessment of the anticoagulant activity of direct oral anticoagulants (DOACs) is justified in special clinical situations. Here, we evaluated two independent extraction methods and developed a multi-analyte ultra-high performance liquid chromatography tandem mass (UHPLC-MS/MS) method for the quantification of apixaban, dabigatran, edoxaban and rivaroxaban in human plasma. METHODS: Routine extraction based on protein precipitation with acetonitrile and subsequent centrifugation was compared to sample clean-up using commercial paramagnetic micro-particles and subsequent magnetic depletion...
March 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28323763/prospective-randomized-clinical-trial-investigating-the-effect-of-the-reamer-irrigator-aspirator-on-the-volume-of-embolic-load-and-respiratory-function-during-intramedullary-nailing-of-femoral-shaft-fractures
#3
Jeremy A Hall, Michael D McKee, Milena R Vicente, Zachary A Morison, Niloofar Dehghan, Christine E Schemitsch, Hans J Kreder, Brad Petrisor, Emil H Schemitsch
OBJECTIVES: We sought to determine whether the use of the Reamer-Irrigator-Aspirator (RIA) device resulted in a decreased amount of fat emboli compared with standard reaming (SR) when performing intramedullary (IM) nailing of femoral shaft fractures. DESIGN: Prospective randomized clinical trial. SETTING: Multi-centered trial, level I trauma centers. PATIENTS/PARTICIPANTS: All eligible patients who presented to participating institutions with an isolated femoral shaft fracture amenable to fixation with antegrade IM nailing...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28318365/effects-of-tgf-%C3%AE-on-uterine-fibroids-of-women-of-childbearing-age-and-uterine-artery-embolization
#4
Tao Shen, Hongjian Shi, Qiang Xu, Qian Song, Yuanfen Xu, Youhua Huang
PURPOSE: To evaluate the effects of transforming growth factor-β (TGF-β) on uterine fibroids of women of childbearing age and uterine artery embolization (UAE) using Embosphere microspheres. MATERIAL AND METHODS: A total of 128 eligible women were randomly divided into an experimental group and a control group (n = 64) who received UAE using Embosphere microspheres and panhysterectomy, respectively. Another 128 healthy women receiving physical examination in the same period were also enrolled...
March 20, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28316870/dural-arteriovenous-fistula-manifested-as-rapid-progressive-dementia-successfully-treated-by-endovascular-embolization-only
#5
Heewon Hwang, Yun Kyung La, Min Seok Baek, Kyoungwon Baik, Sang Hyun Suh, Won-Joo Kim
A 43-year-old male presented with daytime sleepiness at work and indifferent behavior like never before. Two weeks prior to hospital admission, he had episodic memory loss with well preserved remote memory. Brain MRI showed a dural arteriovenous fistula (DAVF) in the right lateral transverse sinus with a bilateral thalamic venous infarction. Cerebral angiography confirmed a right transverse sigmoid dural arteriovenous fistula with a feeding artery of the right occipital artery and left posterior meningeal artery...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28316124/anticoagulation-in-patients-with-isolated-distal-deep-vein-thrombosis-a-meta-analysis
#6
Laura Franco, Michela Giustozzi, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: The optimal management of patients with isolated distal deep vein thrombosis (IDDVT) concerning both the need for anticoagulation and its duration is undefined. OBJECTIVES: We performed a meta-analysis of randomized and cohort studies in patients with IDDVT to assess the clinical benefit of i) anticoagulation versus no anticoagulation and ii) anticoagulant treatment for 6 weeks vs. more than 6 weeks. METHODS: The primary outcome of this analysis was recurrent venous thromboembolism (proximal propagation, recurrence of deep vein thrombosis and pulmonary embolism)...
March 17, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28303857/research-progress-on-the-risk-factors-and-outcomes-of-human-carotid-atherosclerotic-plaques
#7
REVIEW
Xiang-Dong Xiong, Wei-Dong Xiong, Shang-Shen Xiong, Gui-Hai Chen
OBJECTIVE: Atherosclerosis is an inflammatory process that results in complex lesions or plaques that protrude into the arterial lumen. Carotid atherosclerotic plaque rupture, with distal atheromatous debris embolization, causes cerebrovascular events. This review aimed to explore research progress on the risk factors and outcomes of human carotid atherosclerotic plaques, and the molecular and cellular mechanisms of human carotid atherosclerotic plaque vulnerability for therapeutic intervention...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28302764/-18-f-gp1-a-novel-fluorine-18-labeled-tracer-designed-for-pet-imaging-of-thrombi-with-high-detection-sensitivity-and-low-background
#8
Jessica Lohrke, Holger Siebeneicher, Markus Berger, Michael Reinhardt, Mathias Berndt, Andre Mueller, Marion Zerna, Norman Koglin, Felix Oden, Marcus Bauser, Matthias Friebe, Ludger M Dinkelborg, Joachim Huetter, Andrew W Stephens
Thromboembolic diseases such as myocardial infarction, stroke, transient ischemic attacks and pulmonary embolism are major causes of morbidity and mortality worldwide. GPIIb/IIIa is the key receptor involved in platelet aggregation and is a validated target for therapeutic approaches and diagnostic imaging. The aim of this study was to develop and characterize a specific small molecule tracer for positron emission tomography (PET) imaging that binds with high affinity to GPIIb/IIIa receptors and has suitable pharmacokinetic properties to overcome limitations of previous approaches...
March 16, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28299645/new-concepts-in-embolotherapy-of-hcc
#9
REVIEW
F Pesapane, N Nezami, F Patella, J F Geschwind
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related deaths worldwide with rapidly growing incidence rates in the USA and Europe. Despite improving surveillance programs, most patients are diagnosed at intermediate to advanced stages and are no longer amenable to curative therapies, such as ablation, surgical resection and liver transplantation. For such patients, catheter-based image-guided embolotherapies such as transarterial chemoembolization (TACE) represent the standard of care and mainstay therapy, as recommended and endorsed by a variety of national guidelines and staging systems...
April 2017: Medical Oncology
https://www.readbyqxmd.com/read/28293407/thrombocytopenia-in-patients-with-chronic-hepatitis-c-virus-infection
#10
REVIEW
Sumit Dahal, Smrity Upadhyay, Rashmi Banjade, Prajwal Dhakal, Nabin Khanal, Vijaya Raj Bhatt
Thrombocytopenia in patients with chronic hepatitis C virus (HCV) infection is a major problem. The pathophysiology is multifactorial, with auto-immunogenicity, direct bone marrow suppression, hypersplenism, decreased production of thrombopoietin and therapeutic adverse effect all contributing to thrombocytopenia in different measures. The greatest challenge in the care of chronic HCV patients with thrombocytopenia is the difficulty in initiating or maintaining IFN containing anti-viral therapy. Although at present, it is possible to avoid this challenge with the use of the sole Direct Antiviral Agents (DAAs) as the primary treatment modality, thrombocytopenia remains of particular interest, especially in cases of advanced liver disease...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#11
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28289598/massive-hemoptysis-in-a-patient-with-pulmonary-embolism-a-real-therapeutic-conundrum
#12
Yiolanda Herodotou, Andriana I Papaioannou, Anna Karakatsani, Lazaros Reppas, Effrosyni D Manali, Vasiliki Apollonatou, Ioannis Tomos, Elias Brountzos, Spyros Papiris
Massive Hemoptysis and pulmonary embolism are two very severe and potentially fatal pulmonary emergencies requiring completely different treatments. We present the case of a 45-year old male transmitted to our Hospital for massive hemoptysis who at the same time was found to suffer from pulmonary embolism. Hemoptysis was treated with bronchial artery embolization which resulted in cessation of haemorrhage and allowed the administration of anticoagulant therapy a few days later. This case report gives an answer on how to manage a real therapeutic conundrum which is the coexistence of a massive hemoptysis and a concomitant pulmonary embolism...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28289527/left-atrial-appendage-occlusion-a-better-alternative-to-anticoagulation
#13
REVIEW
Ibrahim Akin, Christoph A Nienaber
Non-valvular atrial fibrillation is associated with a significantly increased risk of embolic stroke due to blood clot forming predominantly in the left atrial appendage (LAA). Preventive measures to avoid embolic events are permanent administration of anticoagulants or surgical closure of the LAA. Various clinical trials provide evidence about safety, effectiveness and therapeutic success of LAA occlusion using various cardiac occluder devices. The use of such implants for interventional closure of the LAA is likely to become a valuable alternative for stroke prevention, especially in patients with contraindication for oral anticoagulation as safety, clinical benefit and cost-effectiveness of LAA occlusion has recently been demonstrated...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28289497/interventional-therapy-for-pulmonary-embolism
#14
Alan B Lumsden, Erik Suarez
Patients with pulmonary embolism (PE) present with highly variable clinical symptoms and often have accompanying comorbidities. Timely diagnosis and treatment are critical to help prevent recurrence and increased morbidity/mortality. While open surgical thrombectomy was once reserved only for those with massive PE and hemodynamic compromise, it has been reevaluated with a focus on careful patient selection and early intervention. Lately, there has been increased interest in catheter-based interventions and in combining these with an open surgical component to decrease the magnitude of the intervention-for example, direct placement of large-bore thrombectomy devices directly into the right ventricle via sternotomy or subxiphoid approaches...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28286755/aneurysms-of-peripancreatic-arterial-arcades-coexisting-with-celiac-trunk-stenosis-or-occlusion-single-institution-experience
#15
Robert Antoniak, Laretta Grabowska-Derlatka, Ireneusz Nawrot, Andrzej Cieszanowski, Olgierd Rowiński
Introduction. True aneurysms of peripancreatic arterial arcades (PAAAs) are rare. Most of them coexist with celiac axis stenosis/occlusion due to median arcuate ligament (MAL) compression or atherosclerosis. The aim of this study was to evaluate the cause of celiac axis lesion and characterize the anatomy of the aneurysms. These findings may have important management implications. Material and Methods. A retrospective analysis of 15 patients with true PAAAs was performed. The diagnosis was established by contrast-enhanced CT, using a 64-MDCT scanner...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28286654/it-s-better-to-be-lucky%C3%A2-%C3%A2-%C3%A2-successful-management-of-an-acute-endobronchial-tumour-embolism-in-the-icu-a-case-report-and-review-of-the-literature
#16
Christopher J Walsh, Ron Olivenstein, Eric Forget, Anne V Gonzalez
Endobronchial tumour embolism is a rare cause of acute central airway obstruction. It is primarily reported during pneumonectomy, and the outcome is frequently fatal. Successful management requires the urgent removal of tumour with rigid or flexible bronchoscopy. We present the case of a 62-year-old woman with poorly differentiated non-small cell lung cancer (NSCLC), referred to our institution for Nd:YAG laser photoresection of endobronchial tumour completely obstructing the right mainstem bronchus (RMSB)...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28285949/considerations-in-cardio-oncology-multiple-mobile-left-sided-cardiac-thrombi-in-chemotherapy-induced-cardiomyopathy
#17
Toshinori Minamishima, Kenichi Matsushita, Hiromu Morikubo, Aoi Isaka, Noriko Matsushita, Hidehito Endo, Hiroshi Kubota, Konomi Sakata, Toru Satoh, Hideaki Yoshino
With advances in cancer chemotherapy, the importance of the new clinical discipline of cardio-oncology, which is concerned with the cardiac effects of chemotherapy, is increasing. Herein we describe the case of a 48-year-old woman with a history of breast cancer who presented with symptoms of heart failure due to chemotherapy-induced cardiomyopathy. Treatment for the patient's breast cancer had included surgery and chemotherapy with anthracyclines and trastuzumab. Echocardiography revealed multiple mobile thrombi in the left ventricle and atrium...
March 10, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28283902/what-is-the-ideal-route-of-administration-of-tranexamic-acid-in-tka-a-randomized-controlled-trial
#18
Sung Yup Lee, Suri Chong, Dhanasekaraprabu Balasubramanian, Young Gon Na, Tae Kyun Kim
BACKGROUND: TKA commonly involves substantial blood loss and tranexamic acid has been used to reduce blood loss after TKA. Numerous clinical trials have documented the efficacy and safety of intravenous (IV) or intraarticular (IA) use of tranexamic acid. Combined administration of tranexamic acid also has been suggested; however, there is no consensus regarding the ideal route of tranexamic acid administration. QUESTIONS/PURPOSES: (1) To compare the efficacy of tranexamic acid in terms of total blood loss and the allogeneic transfusion rate among three routes of administration: IV alone, IA alone, and combined IV and IA...
March 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28281739/cerebral-micro-embolization-during-pulmonary-vein-isolation-relation-to-post-ablation-silent-cerebral-ischemia
#19
Edina Nagy-Baló, Mihran Martirosyan, Gábor Sándorfi, Orsolya Hajas, Levente Lánczi, Ervin Berényi, Lilla Ladányi, Alexandra Kiss, István Édes, Zoltán Csanádi
BACKGROUND: High incidences of silent cerebral ischemia (SCI) have been revealed by diffusion-weighted magnetic resonance imaging (DW MRI) after pulmonary vein isolation (PVI) for atrial fibrillation. A high number of mostly gaseous micro-embolic signals (MESs) was detected by transcranial Doppler (TCD) during PVI. In this investigation the possible relationship between MESs detected intraoperatively by TCD and new SCI on DW MRI post-ablation is reported. METHODS: 27 consecutive atrial fibrillation patients (6 female, age median: 64 interquartile range: 13...
March 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#20
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
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