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Ultrasound Pulmonary embolism

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https://www.readbyqxmd.com/read/28625110/ultrasound-facilitated-catheter-directed-low-dose-fibrinolysis-in-elderly-patients-with-pulmonary-embolism-a-seattle-ii-sub-analysis
#1
Brett J Carroll, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Elderly patients with acute pulmonary embolism (PE) have higher mortality than non-elderly patients, but receive systemic fibrinolysis less frequently. In this sub-analysis of the SEATTLE II trial, we evaluated the efficacy and safety of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis in elderly patients with submassive and massive PE. We compared patients ⩾65 years old with those <65 years old. Eligible patients had proximal PE and a right ventricular-to-left ventricular (RV/LV) diameter ratio ⩾0...
June 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28620429/novel-approaches-to-ultrasonography-of-the-lung-and-pleural-space-where-are-we-now
#2
REVIEW
Daniel Lichtenstein
This review article is an update of what should be known for practicing basic lung ultrasound in the critically ill (LUCI) and is also of interest for less critical disciplines (e.g. pulmonology). It pinpoints on the necessity of a professional machine (not necessarily a sophisticated one) and probe. It lists the 10 main signs of LUCI and some of the main protocols made possible using LUCI: the BLUE protocol for a respiratory failure, the FALLS protocol for a circulatory failure, the SESAME protocol for a cardiac arrest and the investigation of a ventilated acute respiratory distress syndrome patient, etc...
June 2017: Breathe
https://www.readbyqxmd.com/read/28615428/increased-rate-of-venous-thrombosis-may-be-associated-with-inpatient-dihydroergotamine-treatment
#3
Amy R Tso, Irene R Patniyot, Amy A Gelfand, Peter J Goadsby
OBJECTIVE: To review whether the incidence of catheter-associated venous thromboses was higher in patients receiving IV dihydroergotamine compared to lidocaine. METHODS: We retrospectively reviewed all admissions at the University of California, San Francisco Headache Center from February 25, 2008, through October 31, 2014, for age, sex, diagnosis, aura, treatment dose, type of IV line used, days with line, superficial (SVT) or deep venous thrombosis (DVT), and pulmonary embolism (PE)...
June 14, 2017: Neurology
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#4
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of acute cardiovascular mortality and long-term morbidity. Right ventricular (RV) dysfunction is the key determinant of prognosis in the acute phase of PE, and residual RV dysfunction is associated with the development of post-PE functional impairment, chronic thromboembolic disease, and higher costs of treatment over the long term. Patients with clinically overt RV failure, i.e. hemodynamic collapse at presentation (high-risk PE), necessitate immediate thrombolytic treatment to relieve the obstruction in the pulmonary circulation; surgical or catheter-directed removal of the thrombus can be an alternative option...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28585792/-endovascular-embolization-in-the-treatment-of-the-pulmonary-intralobar-sequestration
#5
S Santiago-Martínez, G Guillén, A Laín, S López-Fernández, M Pérez, J Lloret
INTRODUCTION: Up to date the classical therapeutic approach for intralobar sequestrations (IS) has been surgical excision. However, systemic arteries embolization is presented as an alternative, and even constitutes the first line of treatment in some centers. We summarize our experience in selected cases with the aim of preserving the maximum lung parenchyma. MATERIAL AND METHODS: Retrospective study of IS who underwent endovascular embolization at our institution between 2013 and 2014...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28555810/reduced-right-ventricular-diameter-during-cardiac-arrest-caused-by-tension-pneumothorax-a-porcine-ultrasound-study
#6
P Caap, R Aagaard, E Sloth, B Løfgren, A Granfeldt
INTRODUCTION: Advanced life support (ALS) guidelines recommend ultrasound to identify reversible causes of cardiac arrest. Right ventricular (RV) dilatation during cardiac arrest is commonly interpreted as a sign of pulmonary embolism. The RV is thus a focus of clinical ultrasound examination. Importantly, in animal studies ventricular fibrillation and hypoxia results in RV dilatation. Tension pneumothorax (tPTX) is another reversible cause of cardiac arrest, however, the impact on RV diameter remains unknown...
May 28, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28541021/predictors-of-active-cancer-thromboembolic-outcomes-mortality-associated-with-calf-deep-vein-thrombosis
#7
Juan P Salazar Adum, Harry E Fuentes, Benjamin B Lind, Alfonso J Tafur, Joseph A Caprini
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of mortality in patients with cancer. Outcomes, including mortality data, in the cancer population are limited in those with calf deep vein thrombosis (CDVT) compared to individuals with proximal deep vein thrombosis. AIM: To assess the prognosis among patients with active cancer and CDVT. METHODS: Single institution inception cohort of cancer-associated CDVT patients who presented with thrombosis distal to popliteal level confirmed objectively by ultrasound...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28540661/diagnostic-accuracy-of-focused-cardiac-and-venous-ultrasound-examinations-in-patients-with-shock-and-suspected-pulmonary-embolism
#8
Peiman Nazerian, Giovanni Volpicelli, Chiara Gigli, Alessandro Lamorte, Stefano Grifoni, Simone Vanni
Evaluating the diagnostic performance of focused cardiac ultrasound (US) alone and combination with venous US in patients with shock and suspected pulmonary embolism (PE). Consecutive adult patients with shock and suspected PE, presenting to two Italian emergency departments, were included. Patients underwent cardiac and venous US at presentation with the aim of detecting right ventricular (RV) dilatation and proximal deep venous thrombosis (DVT). Final diagnosis of PE was based on a second level diagnostic test or autopsy...
May 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28538271/pulmonary-transplant-salvage-using-ultrasound-assisted-thrombolysis-of-subacute-occlusive-main-pulmonary-artery-embolus
#9
John R Spratt, Prashant Shrestha, Gabriel Loor, Jagadish M Patil, Marshall I Hertz, Gosta B Pettersson, Michael S Rosenberg
A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28498107/ultrasound-assisted-thrombolysis-of-an-occluded-transjugular-portosystemic-shunt
#10
Nicholas Hilliard, Teik Choon See, Nadeem Shaida
Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Ultrasound-assisted thrombolysis has been shown to be successful for treatment of pulmonary embolism, deep vein thrombosis, and peripheral arterial thromboembolism, but has not been described before for TIPS occlusion...
May 12, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28480751/ct-pulmonary-angiography-in-young-women
#11
Paul D Stein, Fadi Matta, Kate E Hughes, Mary J Hughes
The purpose was to determine whether young women in the emergency department who received computed tomographic (CT) pulmonary angiograms were evaluated to receive lower dose imaging or no imaging, recognizing that the risks of radiation are particularly high in young women. This was a retrospective cohort investigation of women aged 18 to 29 years seen for suspected acute pulmonary embolism in emergency departments of 5 regional hospitals from May 1, 2015 to April 30, 2016. Computed tomographic (CT) pulmonary angiograms were obtained in 379 young women...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28473076/acr-appropriateness-criteria-%C3%A2-acute-chest-pain-suspected-pulmonary-embolism
#12
Jacobo Kirsch, Richard K J Brown, Travis S Henry, Cylen Javidan-Nejad, Clinton Jokerst, Paul R Julsrud, Jeffrey P Kanne, Christopher M Kramer, Jonathon A Leipsic, Kalpesh K Panchal, James G Ravenel, Amar B Shah, Tan-Lucien Mohammed, Pamela K Woodard, Suhny Abbara
Pulmonary embolism (PE) remains a common and important clinical condition that cannot be accurately diagnosed on the basis of signs, symptoms, and history alone. The diagnosis of PE has been facilitated by technical advancements and multidetector CT pulmonary angiography, which is the major diagnostic modality currently used. Ventilation and perfusion scans remain largely accurate and useful in certain settings. Lower-extremity ultrasound can substitute by demonstrating deep vein thrombosis; however, if negative, further studies to exclude PE are indicated...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28471148/clinical-imaging-in-patients-experiencing-chest-pain
#13
Angelo Silverio, Rodolfo Citro
Non-invasive imaging modalities integrate the clinical and laboratory diagnostic work-up of patients admitted in emergency department for chest pain. Transthoracic echocardiography is the first-line imaging tool because it is rapidly and widely available, bedside feasible and cost-effective. Even when a comprensive exam is not feasible, a fast focused ultrasound exam should be performed. Contrast enhanced computed tomography is an easily accessible tool with specific application in patients suspected for pulmonary embolism (PE) and acute coronary syndrome (ACS) according to the pre-test risk assessment and to the clinical status...
May 3, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28457630/non-invasive-thrombolysis-using-microtripsy-in-a-porcine-deep-vein-thrombosis-model
#14
Xi Zhang, Jonathan J Macoskey, Kimberly Ives, Gabe E Owens, Hitinder S Gurm, Jiaqi Shi, Matthew Pizzuto, Charles A Cain, Zhen Xu
Histotripsy is a non-invasive therapeutic technique that uses ultrasound generated from outside the body to create controlled cavitation in targeted tissue, and fractionates it into acellular debris. We have developed a new histotripsy approach, termed microtripsy, to improve targeting accuracy and to avoid collateral tissue damage. This in vivo study evaluates the safety and efficacy of microtripsy for non-invasive thrombolysis in a porcine deep vein thrombosis model. Acute thrombi were formed in left femoral veins of pigs (∼35 kg) by occluding the vessel using two balloon catheters and infusing with thrombin...
July 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28443595/evaluation-of-the-diagnostic-role-of-bedside-lung-ultrasonography-in-patients-with-suspected-pulmonary-embolism-in-the-emergency-department
#15
Hüseyin Acar, Serkan Yılmaz, Elif Yaka, Nurettin Özgür Doğan, Asım Enes Özbek, Murat Pekdemir
BACKGROUND: Despite the existence of detailed consensus guidelines, challenges continue to exist regarding efficient, appropriate and safe imaging methods for the diagnosis of suspected pulmonary embolism. AIMS: This study was conducted to investigate the role of wedge sign, B-lines and pleural effusion seen on bedside lung ultrasound in the diagnosis of pulmonary embolism. STUDY DESIGN: Diagnostic accuracy study. METHODS: During the first evaluation of patients with suspected pulmonary embolism, bedside lung ultrasound was performed, and the B-lines, wedge sign, and pleural effusion were investigated...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28435782/thoracic-ultrasound-what-non-radiologists-need-to-know
#16
REVIEW
Jonathan P Williamson, Chris Grainge, Ahilan Parameswaran, Scott H Twaddell
PURPOSE OF REVIEW: The aim of this review is to provide the theoretical and practical knowledge essential for non-radiologists to develop the skills necessary to apply thoracic ultrasound as an extension of clinical assessment and intervention. RECENT FINDINGS: Issues relating to training and competence are discussed and a library of thoracic ultrasound videos is provided to illustrate artefacts, pleural, parenchymal and pneumothorax pathology as well as important pitfalls to consider...
2017: Current Pulmonology Reports
https://www.readbyqxmd.com/read/28430698/the-right-ventricle-is-dilated-during-resuscitation-from-cardiac-arrest-caused-by-hypovolemia-a-porcine-ultrasound-study
#17
Rasmus Aagaard, Asger Granfeldt, Morten T Bøtker, Troels Mygind-Klausen, Hans Kirkegaard, Bo Løfgren
OBJECTIVES: Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e., ventricular fibrillation). DESIGN: Thirty pigs were anesthetized and then randomized to cardiac arrest induced by three diffrent methods...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28417266/guided-longer-pulses-from-a-diagnostic-ultrasound-and-intraclot-microbubble-enhanced-catheter-directed-thrombolysis-in-vivo
#18
Shunji Gao, Qiong Zhu, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28411699/outcomes-of-a-single-center-experience-with-classification-and-treatment-of-endothermal-heat-induced-thrombosis-after-endovenous-ablation
#19
Lindsey M Korepta, Jennifer J Watson, M Ashraf Mansour, Christopher M Chambers, Robert F Cuff, Jason D Slaikeu, Peter Y Wong
OBJECTIVE: Endothermal heat-induced thrombosis (EHIT) is a known complication of endothermal venous ablation procedures. EHIT can lead to deep vein thrombosis/pulmonary embolism, which cause significant disability and, rarely, death. Other studies have evaluated risk factors for EHIT. There is an accepted grading system for EHIT, but there is no consensus on treatment type, duration, or follow-up. We retrospectively evaluated all cases of EHIT after radiofrequency ablation or endovenous laser ablation at our institution during a 7-year period, focusing on classification, treatment, and outcomes of EHIT...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#20
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Elizabeth Genovese, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This study aimed to identify factors associated with CDI failure and to describe anticipated complications. METHODS: Consecutive patients who underwent CDI for massive or submassive PE between 2009 and 2015 were identified; outcomes and complications were retrospectively collected...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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