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Ultrasound Pulmonary embolism

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https://www.readbyqxmd.com/read/29322296/catheter-directed-ultrasound-facilitated-fibrinolysis-in-obese-patients-with-massive-and-submassive-pulmonary-embolism
#1
Brett J Carroll, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Obesity is a well-established risk factor for pulmonary embolism (PE). However, treatment of PE in obese patients is challenging because of limited outcomes data, especially with advanced therapies such as catheter-based fibrinolysis. We assessed the efficacy and safety of ultrasound-facilitated, catheter-directed fibrinolysis in obese patients with submassive and massive PE enrolled in the SEATTLE II Trial. Eligible patients had a right ventricular-to-left ventricular (RV/LV) diameter ratio ≥ 0.9 on chest computed tomography (CT)...
January 10, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29310336/removal-of-a-subdermal-contraceptive-implant-implanon-nxt-that-migrated-to-the-axilla-by-c-arm-guidance-a-case-report-and-review-of-the-literature
#2
Ji Ung Park, Han Sol Bae, Seung Mi Lee, Jaehoon Bae, Jeong Woo Park
RATIONALE: To report the distant migration of a subdermal contraceptive implant and to suggest that C arm-guided technique is one of the feasible options for removal of the device migrated to the axilla. PATIENT CONCERNS: A 41-year-old multipara with tingling sensation in the left axilla was referred for removal of an Implanon NXT which could not be palpated by physical examination or detected by ultrasound scanning. Finally, the device was detected by computed tomography and found migrating to the left axilla...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29301470/risk-of-complications-of-ultrasound-guided-renal-biopsy-for-adult-and-pediatric-patients-with-systemic-lupus-erythematosus
#3
Y S Sun, I T Sun, H K Wang, A H Yang, C Y Tsai, C J Huang, D F Huang, C C Lai
Objective The objective of this paper is to identify the risk of complications of real-time ultrasound-guided renal biopsy in adult and pediatric patients with systemic lupus erythematosus (SLE). Materials and methods This retrospective study examined outcomes of 296 renal biopsy procedures in 275 SLE patients. Imaging-confirmed symptomatic hematoma was regarded as a major complication when intervention (blood transfusion, angiographic embolization, or surgery) was required or as a minor complication otherwise...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29275595/-clinical-efficacy-of-rivaroxaban-in-prevention-and-treatment-of-postoperative-deep-vein-thrombosis-for-severe-traumatic-brain-injury
#4
Z L Zhang, W M Liu, Y Zhang, G H Wang, C Yan, H Q Wang, Q B Huang
Objective: To explore the clinical efficacy of rivaroxaban in the prevention and treatment of postoperative deep vein thrombosis (DVT) for severe traumatic brain injury (sTBI). Methods: Patients with sTBI who met the inclusion criteria were enrolled in this study, including 119 males (75.8%) and 38 females (24.2%), aged (38.75 ± 11.98) years old. DVT was prevented and treated according to the DVT screening and anticoagulation regimen. Intermittent venous compression was used on all of the patients to prevent DVT, and D-dimer dynamic monitoring and regular ultrasound were performed to screen for DVT...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29248101/design-and-rationale-of-a-randomized-trial-comparing-standard-versus-ultrasound-assisted-thrombolysis-for-submassive-pulmonary-embolism
#5
Efthymios D Avgerinos, Abhisekh Mohapatra, Belinda Rivera-Lebron, Catalin Toma, Christopher Kabrhel, Larry Fish, Joan Lacomis, Iclal Ocak, Rabih A Chaer
BACKGROUND: Catheter-directed interventions for the treatment of patients with submassive pulmonary embolism (sPE) have shown promise in rapidly improving right-sided heart strain and preventing decompensation to massive pulmonary embolism. Among various catheter interventions, ultrasound-assisted thrombolysis (USAT) has attracted interest as potentially having more efficient lytic effect that could achieve thrombolysis faster and with a reduced lytic dose. However, based on clinical evidence, it is unclear whether USAT is superior to standard catheter-directed thrombolysis (SCDT)...
January 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29229465/diverse-management-of-isolated-calf-deep-venous-thrombosis-in-a-university-hospital
#6
Raudel Garcia, Kristan Probeck, Doreen M Elitharp, Antonios P Gasparis, Nicos Labropoulos
BACKGROUND: The management of patients with isolated deep venous thrombosis (DVT) is controversial, leading to overtreatment and undertreatment with several complications and increased cost. The aim of this study was to describe the management of isolated calf DVT (ICDVT) in a university hospital. METHODS: Data on patients with acute DVT in our hospital are prospectively entered in a database through our venous thromboembolism team. All patients had an objective diagnosis with duplex ultrasound (DU) in our accredited vascular laboratory...
December 8, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29226957/pilot-multi-centre-randomised-trial-of-the-impact-of-pre-operative-focused-cardiac-ultrasound-on-mortality-and-morbidity-in-patients-having-surgery-for-femoral-neck-fractures-echonof-2-pilot
#7
D J Canty, J Heiberg, Y Yang, A G Royse, S Margale, N Nanjappa, D Scott, A Maier, D I Sessler, A Chuan, A Palmer, A Bucknill, C French, C F Royse
Hip fracture surgery is common, usually occurs in elderly patients who have multiple comorbidities, and is associated with high morbidity and mortality. Pre-operative focused cardiac ultrasound can alter diagnosis and management, but its impact on outcome remains uncertain. This pilot study assessed feasibility and group separation for a proposed large randomised clinical trial of the impact of pre-operative focused cardiac ultrasound on patient outcome after hip fracture surgery. Adult patients requiring hip fracture surgery in four teaching hospitals in Australia were randomly allocated to receive focused cardiac ultrasound before surgery or not...
December 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29222260/should-we-diagnose-and-treat-distal-deep-vein-thrombosis
#8
REVIEW
Helia Robert-Ebadi, Marc Righini
Ultrasound series report that isolated distal deep vein thrombosis (DVT), also known as calf DVT, represents up to 50% of all lower-limb DVTs and, therefore, is a frequent medical condition. Unlike proximal DVT and pulmonary embolism, which have been studied extensively and for which management is well standardized, much less is known about the optimal management of isolated calf DVT. Recent data arising from registries and nonrandomized studies have suggested that most distal DVTs do not extend to the proximal veins and have an uneventful follow-up when left untreated...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29214507/comparison-of-once-daily-bemiparin-with-twice-daily-enoxaparin-for-acute-deep-vein-thrombosis-a-multicenter-open-label-randomized-controlled-trial
#9
Igor A Suchkov, Javier Martinez-Gonzalez, Sebastian M Schellong, Toni Garbade, Michela Falciani
BACKGROUND: Individuals with deep vein thrombosis (DVT) have an increased risk of pulmonary embolism (PE), death, and long-term thrombotic complications. OBJECTIVES: To evaluate the efficacy and safety of bemiparin once daily versus enoxaparin twice daily in the treatment of acute DVT, and to establish therapeutic non-inferiority of bemiparin. PATIENTS AND METHODS: This multicenter, randomized, open-label, active-controlled phase III clinical trial enrolled patients with acute proximal DVT confirmed by complete compression ultrasound (CCUS)...
December 6, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29174452/diagnosing-centrally-located-pulmonary-embolisms-in-the-emergency-department-using-point-of-care-ultrasound
#10
Kristin H Dwyer, Joshua S Rempell, Michael B Stone
OBJECTIVE: The study objective was to investigate the combined accuracy of right heart strain on focused cardiac ultrasound (FOCUS) and deep vein thrombosis (DVT) on compression ultrasound (CUS) for identification of centrally located pulmonary embolism (PE) diagnosed on computed tomography pulmonary angiography (CTPA). METHODS: This was a prospective observational study using a convenience sample of patients undergoing CTPA in the emergency department (ED) for evaluation of PE...
November 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29143222/quantitative-analysis-of-the-level-of-readability-of-online-emergency-radiology-based-patient-education-resources
#11
David R Hansberry, Michael D'Angelo, Michael D White, Arpan V Prabhu, Mougnyan Cox, Nitin Agarwal, Sandeep Deshmukh
PURPOSE: The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. METHODS: Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales...
November 15, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#12
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29100817/edoxaban-improves-acute-venous-thromboembolism-while-preserving-protein-c-and-protein-s-levels
#13
Hiromu Yamazaki, Shusuke Yagi, Yuta Torii, Rie Amano, Yasuyuki Oomichi, Teruaki Sangawa, Daiju Fukuda, Muneyuki Kadota, Takayuki Ise, Rie Ueno, Tomoya Hara, Kenya Kusunose, Tomomi Matsuura, Takeshi Tobiume, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masashi Akaike, Masataka Sata
BACKGROUND: It is well known that warfarin inhibits the synthesis of vitamin K-dependent anticoagulants, including thrombin, protein C and S, and factor Xa, leading, paradoxically, to an initial hypercoagulable state. Edoxaban, a direct inhibitor of activated factor X is widely used for the treatment of acute venous thromboembolism (VTE). However, the effect of edoxaban on circulating coagulation factors, in patients with acute VTE, remains unknown. METHODS AND RESULTS: We enrolled 57 patients with acute VTE with/without pulmonary embolism treated with edoxaban (n=37) or warfarin (n=20) in a clinical setting...
October 31, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29096931/st-elevation-in-massive-acute-pulmonary-embolism-during-hemodynamic-instability
#14
Riccardo Scagliola
Electrocardiogram (ECG) is one of the first procedures performed in the initial assessment of patients with suspected pulmonary embolism (PE), although one of its main advantages is in suspecting alternative clinical conditions, including acute coronary syndrome (ACS). ST-elevation remains an uncommon ECG pattern in PE. Cardiac ultrasound can help to the differential diagnosis from ACS and to a fast detection of acute right ventricle (RV) overload. In the presence of hemodynamic instability, with ECG signs of RV strain and concomitant ST-elevation, massive PE should be suspected as shown in the present case report...
October 19, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29073366/catheter-directed-thrombolysis-for-intermediate-risk-pulmonary-embolism
#15
David Furfaro, R Scott Stephens, Michael B Streiff, Roy Brower
Intermediate risk pulmonary embolism is common and carries a risk of progression to hemodynamic collapse and death. Catheter directed thrombolysis is an increasingly utilized treatment option, based largely on the assumptions that it is more efficacious than anticoagulation alone, and safer than systemic thrombolysis. In this review, we critically analyze the published data regarding catheter directed thrombolysis for the treatment of intermediate risk pulmonary embolism. Catheter directed thrombolysis reduces right heart strain and lowers pulmonary artery pressures more quickly than anticoagulation alone...
October 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29050117/-pediatric-idiopathic-hypereosinophilic-syndrome-with-pulmonary-embolism-a-case-report-and-review-of-literature
#16
N Dong, X Y Dong
Objective: To explore clinical features of idiopathic hypereosinophilic syndrome combined with pulmonary embolism. Method: A retrospective analysis of a patient with idiopathic hypereosinophilic syndrome and pulmonary embolism diagnosed and treated in the Respiratory Department of Shanghai Children's Hospital in September 2016 was performed. A literature search was performed with"Eosinophils increased, thrombosis"as the Chinese keywords in Wanfang database and"idiopathic hypereosinophilic syndrome, deep vein thrombosis"as the English key words in PubMed database...
October 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29029777/-management-of-high-risk-pulmonary-embolism-with-pulmonary-artery-trunk-mobile-thrombus
#17
A Rougé, L Perriollat, M Abdellaoui, B Faurie, J Monségu
The presence of a right intraventricular thrombus is a marker of severity of pulmonary embolism (PE), and is associated with high mortality. We report the case of a young patient with a PE postoperative of patellar tendon surgery. The cardiac echocardiography at its admission revealed a voluminous mobile thrombus of 1.7cm diameter located on the pulmonary trunk. Systemic thrombolysis was performed because of respiratory deterioration allowing a rapid disappearance of the thrombus and recovery. Our case emphasizes the value of a complete ultrasound analysis centered on the pulmonary trunk in the case of intermediate-risk PE...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29019812/venous-thromboembolism-after-adult-lung-transplantation-a-frequent-event-associated-with-lower-survival
#18
Manuel L Ribeiro Neto, Marie Budev, Daniel A Culver, C Randall Lane, Marcelo Gomes, Xiao-Feng Wang, Paulo Novis Rocha, Mitchell A Olman
BACKGROUND: The incidence of venous thromboembolism (VTE) after lung transplantation (LTX) varies significantly across studies. Two studies have suggested that these thrombotic events are associated with a lower posttransplant survival. Herein, we sought to determine the incidence, predictors and impact of VTE on survival after LTX at a quaternary referral center. METHODS: This was a large cohort study of LTX recipients. Key outcome parameters were time to VTE after transplant and survival...
October 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28994575/thrombin-activatable-microbubbles-as-potential-ultrasound-contrast-agents-for-the-detection-of-acute-thrombosis
#19
Jacques Lux, Alexander M Vezeridis, Kenneth Hoyt, Stephen R Adams, Amanda M Armstrong, Shashank R Sirsi, Robert F Mattrey
Acute deep vein thrombosis (DVT) is the formation of a blood clot in the deep veins of the body that can lead to fatal pulmonary embolism. Acute DVT is difficult to distinguish from chronic DVT by ultrasound (US), the imaging modality of choice, and is therefore treated aggressively with anticoagulants, which can lead to internal bleeding. Here we demonstrate that conjugating perfluorobutane-filled (PFB-filled) microbubbles (MBs) with thrombin-sensitive activatable cell-penetrating peptides (ACPPs) could lead to the development of contrast agents that detect acute thrombosis with US imaging...
November 1, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28984662/rapid-cardiothoracic-ultrasound-protocol-for-diagnosis-of-acute-heart-failure-in-the-emergency-department
#20
Jonas Öhman, Veli-Pekka Harjola, Pasi Karjalainen, Johan Lassus
OBJECTIVES: The aim of this study was to evaluate the performance of a rapid cardiothoracic ultrasound protocol (CaTUS), combining echocardiographically derived E/e' and lung ultrasound (LUS), for diagnosing acute heart failure (AHF) in patients with undifferentiated dyspnea in an emergency department (ED). PATIENTS AND RESULTS: We enrolled 100 patients with undifferentiated dyspnea from a tertiary care ED, who all had CaTUS done immediately upon arrival in the ED...
October 3, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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