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https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#1
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28199998/delayed-intraparenchymal-and-intraventricular-hemorrhage-requiring-surgical-evacuation-after-mri-guided-laser-interstitial-thermal-therapy-for-lesional-epilepsy
#2
Sean M Barber, Luke Tomycz, Timothy George, Dave F Clarke, Mark Lee
BACKGROUND: Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). OBJECTIVES: To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). METHODS: An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle...
February 16, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28194291/internal-jugular-and-subclavian-vein-thrombosis-in-a-case-of-ovarian-cancer
#3
Hiroto Moriwaki, Nana Hayama, Shouko Morozumi, Mika Nakano, Akari Nakayama, Yoshiomi Takahata, Yuusuke Sakaguchi, Natsuki Inoue, Toshiki Kubota, Akiko Takenoya, Yoshiko Ishii, Haruka Okubo, Souta Yamaguchi, Tsuyoshi Ono, Toshiaki Oharaseki, Mamoru Yoshikawa
Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT). DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28193123/ventriculoportal-shunt-a-new-transomphalic-extraperitoneal-surgical-technique-in-treatment-of-hydrocephalus
#4
Valentin Titus Grigorean, Aurelia Mihaela Sandu, Mihai Popescu, Victor Strambu
AIM: The aim of this article was to report a new transomphalic extraperitoneal surgical technique for treatment of hydrocephalus, called ventriculoportal shunt. MATERIALS AND METHODS: We performed ventriculoportal shunt on an experimental animal (pig). The particularity of ventriculoportal shunt consists in the fact that the distal end of the catheter is inserted transomphalic extraperitoneally in the portal system through reopened umbilical vein. We present technical details regarding this new surgical technique...
February 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28180915/-nonthrombotic-pulmonary-embolisms
#5
A G Bach, D Schramm, A Surov
The term nonthrombotic pulmonary embolism (NTPE) is defined as embolization of pulmonary arteries caused by foreign bodies (e. g. detached catheter fragments), biological substances (e. g. septic thrombus) or exogenous substances (e. g. gas). The frequency of NTPE is underestimated. Symptoms can cover the spectrum from undetectable to sudden death. In addition to mechanical obstruction of the pulmonary arteries, some NTPEs trigger an inflammatory cascade that causes deterioration of vascular, pulmonary and cardiac function...
February 8, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28178399/evidence-based-implementation-of-peripherally-inserted-central-catheters-piccs-insertion-at-a-vascular-access-care-outpatient-clinic
#6
Xiaoju Zhang, Zhenqi Lu, Yan Hu, Mei Xue, Hongqin Dai
No abstract text is available yet for this article.
February 8, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28169555/aspiration-thrombectomy-and-intracoronary-tirofiban-via-guideliner-%C3%A2-catheter-for-a-thrombosed-aneurysmal-vessel
#7
James Fry, Ali Naqvi, Amit Bahia, Arnold Seto
A 52-year-old Asian male with no traditional risk factors for coronary artery disease presented with acute coronary syndrome. Coronary angiography showed complete thrombotic occlusion of the left circumflex with a large thrombus burden in the setting of diffuse aneurysmal enlargement of the coronary arteries consistent with antecedent Kawasaki disease. Manual thrombectomy with adjunctive intracoronary tirofiban was performed utilizing the GuideLiner catheter. Stent implantation was deferred. Follow-up imaging 48 h later showed preserved coronary flow and decreased thrombus burden...
February 7, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28168512/automated-oscillometric-blood-pressure-and-pulse-wave-acquisition-for-evaluation-of-vascular-stiffness-in-atherosclerosis
#8
Alexander Massmann, Jennifer Stemler, Peter Fries, Reinhard Kubale, Lutz Erwin Kraushaar, Arno Buecker
OBJECTIVE: Evaluation of diagnostic accuracy of an oscillometry-based device (VascAssist) combining fully automated ankle-brachial index (ABI) and pulse-wave velocity (PWV) assessment for detection of peripheral arterial disease (PAD). SUBJECTS AND METHODS: 110 consecutive subjects including symptomatic PAD patients (n = 41) and healthy PAD-free participants (n = 69) were recruited. All subjects underwent standard manual Doppler-based ABI (sABI) and oscillometry-based automated ABI (aABI) measurements (VascAssist)...
February 6, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28165645/prevalence-of-difficult-venous-access-and-associated-risk-factors-in-highly-complex-hospitalized-patients
#9
Victoria Armenteros-Yeguas, Lucía Gárate-Echenique, Maria Aranzazu Tomás-López, Estíbaliz Cristóbal-Domínguez, Breno Moreno-de Gusmão, Erika Miranda-Serrano, Maria Inmaculada Moraza-Dulanto
AIMS AND OBJECTIVES: To estimate the prevalence of difficult venous access in complex patients with multimorbidity and to identify associated risk factors. BACKGROUND: In highly complex patients, factors like ageing, the need for frequent use of irritant medication and multiple venous catheterisations to complete treatment could contribute to exhaustion of venous access. DESIGN: A cross-sectional study was conducted. METHODS: "Highly complex" patients (n = 135) were recruited from March 2013-November 2013...
February 6, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28165583/chlorhexidine-impregnated-transparent-dressings-decrease-catheter-related-infections-in-hemodialysis-patients-a-quality-improvement-project
#10
Ibironke W Apata, John Hanfelt, James L Bailey, Vandana Dua Niyyar
PURPOSE: Central venous catheters (CVC) are associated with increased infection rates, morbidity and mortality compared to other hemodialysis vascular access. Chlorhexidine-impregnated transparent (CHG-transparent) dressings allow for continuous antimicrobial exposure and easy visibility of the CVC insertion site. We conducted a quality improvement project to compare catheter-related infection (CRI) rates in two dressing regimens - CHG-transparent dressings and adhesive dry gauze dressing in hemodialysis patients with tunneled CVCs...
February 4, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28165577/surgical-reconstruction-of-central-venous-obstruction-in-salvaging-upper-extremity-dialysis-accesses
#11
Jurabek Babadjanov, Rick Bernstein, Lee Kirksey
BACKGROUND: Central vein thrombosis or obstruction is a common complication associated with central venous catheters placed for intermittent hemodialysis. The reported outcomes of percutaneous catheter-based interventions reveal high rates of lesion recurrence with varying and frequently limited patency intervals. We present the case of open venous bypass in the treatment of catheter-associated chronic central vein occlusion. METHODS: We report a case of symptomatic arm swelling secondary to central vein stenosis and failed endovascular venous intervention treated by central vein bypass with prosthetic graft through median sternotomy...
February 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#12
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28157642/cervicovaginal-agenesis-treated-with-modified-yang-monti-technique-in-two-steps-case-report-and-literature-review
#13
J Acosta-León, A Pantoja-Rojas, J R Corona-Rivera, E López-Marure, C F Ploneda-Valencia
INTRODUCTION: Müllerian duct anomalies are rare with less than 200 cases published in the literature. Recently, the implementation of the Yang-Monti principle for the creation of the neovagina has been used in 10 previous published cases. Here, we report the first case of cervicovaginal agenesis treated with the modified Yang-Monti technique in two steps in México. PRESENTATION OF CASE: A 14-year-old female presented to the pediatric consult with a history of primary amenorrhea and a chronic-cyclic pelvic pain...
January 19, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28155102/stratification-of-cardiovascular-risk-in-patients-with-atrial-fibrillation-and-obstructive-sleep-apnea-validity-of-the-2mace-score
#14
Anna E Platek, Filip M Szymanski, Krzysztof J Filipiak, Alicja Dudzik-Plocica, Bartosz Krzowski, Grzegorz Karpinski
BACKGROUND: Risk stratification in patients with atrial fibrillation (AF) is critically important because this group is at high risk of mortality and morbidity. One of the comorbidities potentially affecting thromboembolic and total cardiovascular risk is obstructive sleep apnea (OSA). The aim of this study was to determine whether or not patients with atrial fibrillation and concomitant obstructive sleep apnea have a higher predicted cardiovascular risk than those without sleep-disordered breathing...
February 2, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28151887/weight-based-contrast-administration-in-the-computerized-tomography-evaluation-of-acute-pulmonary-embolism-challenges-in-optimizing-imaging-quality
#15
Lisa Laurent, Ina Zamfirova, Suela Sulo, Pesach Baral
Compare individualized contrast protocol, or weight-based protocol, to standard methodology in evaluating acute pulmonary embolism.Retrospective chart review was performed on patients undergoing computed tomography angiography with standard contrast protocol (n = 50) or individualized protocol (n = 50). Computerized tomography images were assessed for vascular enhancement and image quality.Demographics were comparable, however, more patients in the individualized group were admitted to intensive care unit (48% vs 16%, P = 0...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28145907/evaluation-of-reperfusion-pulmonary-edema-by-extravascular-lung-water-measurements-after-pulmonary-endarterectomy
#16
François Stéphan, Aurélien Mazeraud, Florent Laverdure, Julien Camous, Elie Fadel
OBJECTIVES: Reperfusion pulmonary edema is a specific complication of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Extravascular lung water measurement may be valuable for diagnosing reperfusion pulmonary edema. The primary objective of this study was to describe and assess the clinical significance of extravascular lung water variations after pulmonary endarterectomy. DESIGN: Prospective observational study. SETTING: Nineteen-bed cardiothoracic ICU...
January 31, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28135701/catheter-failure-and-mortality-in-hemodialysis-patients-with-tunneled-cuffed-venous-catheters-in-a-single-center
#17
Min Shi, Tianlei Cui, Liang Ma, Li Zhou, Ping Fu
BACKGROUND: As of now, only a few studies have focused on the failure of tunneled cuffed venous catheter (tCVC) and mortality of hemodialysis (HD) patients using tCVC as long-term vascular access, whose vascular condition for arteriovenous fistula was not very satisfactory. In this study, we aimed to provide information about the first tCVC failure and survival rates of patients in this population. METHODS: Fifty-nine patients who used tCVC from January 1, 2009 to December 31, 2014 in our HD center were analyzed in this retrospective study and followed up either until their death or until December 31, 2015...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28133953/successful-renal-transplantation-in-small-children-with-a-completely-thrombosed-inferior-vena-cava
#18
P Verghese, E Minja, V Kirchner, B Chavers, A Matas, S Chinnakotla
In small children with end-stage renal disease, an adult-size kidney transplant is the best option. However, in the face of a completely thrombosed inferior vena cava (IVC), such transplants can be challenging, given the difficulty of achieving adequate renal venous outflow and the risk of graft thrombosis. Using a new technique to anastomose the renal vein to the right hepatic vein/IVC junction, we successfully implanted an adult-size graft in 2 small children (9.8 kg and 14 kg) who had end-stage renal disease and a completely thrombosed IVC...
January 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28132743/factors-associated-with-long-term-outcome-in-191-patients-with-ilio-femoral-dvt-treated-with-catheter-directed-thrombolysis
#19
P Foegh, L P Jensen, L Klitfod, R Broholm, N Bækgaard
OBJECTIVE: To identify factors associated with long-term treatment success after catheter-directed thrombolysis (CDT) for acute deep venous thrombosis (DVT) involving the ilio-femoral vein. MATERIAL AND METHODS: This was a non-randomised observational cohort study. From 1999 to 2013, 191 consecutive patients (203 limbs) attending a tertiary vascular centre at Gentofte University Hospital, Denmark underwent CDT. All patients had ultrasonically verified acute ilio-femoral DVT with open distal popliteal vein and calf veins...
January 26, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28132546/needle-free-devices-keeping-the-system-closed
#20
Linda J Kelly, Tracey Jones, Stephanie Kirkham
Health professionals are under increasing pressure to reduce costs while ensuring patient safety. As the number of vascular access devices (VADs) used in health care continues to increase, there is a need to reduce the complications of infection and occlusion associated with them. Needle-free devices (NFDs), also known as needleless connectors, have been available since the early 1990s and the type and variety of these devices has continued to develop. As well as the original aim of NFDs to maintain a closed system and to reduce the risk of needlestick injuries and blood spillage, NFDs are now designed with the aim of improving clinical outcomes by reducing the common complications of infection and catheter occlusion...
January 26, 2017: British Journal of Nursing: BJN
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