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https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#1
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28432665/systemic-and-microcirculatory-effects-of-blood-transfusion-in-experimental-hemorrhagic-shock
#2
Gonzalo Ferrara, Vanina S Kanoore Edul, Héctor S Canales, Enrique Martins, Carlos Canullán, Gastón Murias, Mario O Pozo, Juan F Caminos Eguillor, María G Buscetti, Can Ince, Arnaldo Dubin
BACKGROUND: The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification of anaerobic metabolism is elusive. The venoarterial PCO2 to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2) might be a surrogate for respiratory quotient, but this has not been validated. Therefore, our goal was to characterize sublingual and intestinal (mucosal and serosal) microvascular injury after blood resuscitation in hemorrhagic shock and its relation with O2 and CO2 metabolism...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28432428/tranexamic-acid-for-treatment-and-prophylaxis-of-bleeding-and-hyperfibrinolysis
#3
Ingrid Pabinger, Dietmar Fries, Herbert Schöchl, Werner Streif, Wolfgang Toller
Uncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e...
April 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#4
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28426578/plasma-transfusion-as-bleeding-prophylaxis-in-the-critically-ill
#5
Eric A Gehrie, Aaron A R Tobian
No abstract text is available yet for this article.
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28425090/determinants-of-the-post-pericardiotomy-syndrome-a-systematic-review
#6
REVIEW
Dirk van Osch, Hendrik M Nathoe, Kirolos A Jacob, Pieter A Doevendans, Diederik van Dijk, Willem J Suyker, Jan M Dieleman
BACKGROUND: Post Pericardiotomy Syndrome (PPS) is a common complication following cardiac surgery, however the exact pathogenesis remains uncertain. Identifying risk factors of PPS might help to better understand the syndrome. The aim of this study was to provide an overview of existing literature around determinants of PPS in adult cardiac surgery patients. MATERIAL AND METHODS: Two independent investigators performed a systematic search in MEDLINE, EMBASE and the Cochrane Central Register...
April 20, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28424132/outcomes-of-recreational-activity-associated-trauma-in-elderly-persons-on-blood-thinning-medications
#7
Zachary M DeBoard, Jonathan Grotts, Lisa Ferrigno
With increasing life expectancy, the elderly are participating in recreational activities traditionally pursued by younger persons. Elderly patients have many reasons for worse outcomes after trauma, one of which may be the rising use of anticoagulant and/or antiplatelet medications. This study aimed to determine whether preinjury use of these agents yielded worse outcomes in geriatric patients injured during high-impact recreational activities. The National Trauma Data Bank was reviewed from 2007 to 2010 for patients ≥65 years admitted to Level I or II trauma centers with ICD-9 E-codes for specific mechanisms of injury...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28420804/contemporary-trends-and-outcomes-associated-with-the-preprocedural-use-of-oral-p2y12-inhibitors-in-patients-undergoing-percutaneous-coronary-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#8
Devraj Sukul, Milan Seth, Simon R Dixon, Akshay Khandelwal, Thomas A LaLonde, Hitinder S Gurm
OBJECTIVES: We sought to describe trends in the use of preprocedural P2Y12 inhibitors and their clinical impact in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Oral P2Y12 inhibitors are ubiquitously used medications; however, the specific timing of initial P2Y12 inhibitor administration remains intensely debated. METHODS: Our study population comprised 74,053 consecutive patients undergoing PCI at 47 hospitals in Michigan from January 2013 through June 2015...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28420645/association-between-chronic-kidney-disease-and-rates-of-transfusion-and-progression-to-end-stage-renal-disease-in-patients-undergoing-transradial-versus-transfemoral-cardiac-catheterization-an-analysis-from-the-veterans-affairs-clinical-assessment-reporting
#9
Amit N Vora, Maggie Stanislawski, Gary K Grunwald, Mary E Plomondon, John S Rumsfeld, Thomas M Maddox, Mladen I Vidovich, Walter Woody, Brahmajee K Nallamothu, Hitinder S Gurm, Sunil V Rao
BACKGROUND: Patients with chronic kidney disease (CKD) are at increased risk for bleeding, transfusion, and dialysis after cardiac catheterization. Whether rates of these complications are increased in this high-risk population undergoing transradial access compared with transfemoral access is unknown. METHODS AND RESULTS: From the Veterans Affairs (VA) Clinical Assessment Reporting and Tracking program, we identified 229 108 patients undergoing cardiac catheterization between 2007 and 2014, of which 48 155 (21...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28420512/managing-vulvovaginal-hematoma-by-arterial-embolization-as-first-line-hemostatic-therapy
#10
Kenjiro Takagi, Keiko Akashi, Isao Horiuchi, Eishin Nakamura, Koki Samejima, Junko Ushijima, Tomohisa Okochi, Kohei Hamamoto, Keisuke Tanno
OBJECTIVE: A puerperal vulvovaginal hematoma may continue to grow after a surgical procedure and may require blood transfusion. Thus, we selected arterial embolization for hemostasis as the first-line management in two cases of large vulvovaginal hematoma. MATERIALS AND METHODS: Case 1 was a 32-year-old pregnant woman. After delivery, a 10-cm vulvar hematoma developed. An enhanced computed tomography (CT) scan revealed active bleeding. Arterial embolization was performed and complete hemostasis was obtained...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28417594/real-world-supported-unprotected-left-main-percutaneous-coronary-intervention-with-impella-device-data-from-the-uspella-registry
#11
Theodore Schreiber, Wah Wah Htun, Nimrod Blank, Tesfaye Telila, Nestor Mercado, Alexandros Briasoulis, Amir Kaki, Ashok Kondur, Ahmad Munir, Cindy Grines
BACKGROUND: Patients with left main (LM) coronary artery disease are increasingly being treated with percutaneous revascularization (PCI). The safety, feasibility, and efficacy of unprotected LM intervention (ULMI) with hemodynamic support by Impella device have not been evaluated previously. OBJECTIVE: Using a large retrospective single center database from the USpella registry, we evaluated the safety, feasibility, and potential benefits of periprocedural left ventricular assist with axial flow Impella 2...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28416739/tki-rotation-induced-persistent-deep-molecular-response-in-multi-resistant-blast-crisis-of-ph-cml
#12
Peter Valent, Susanne Herndlhofer, Mathias Schneeweiß, Bernd Boidol, Anna Ringler, Stefan Kubicek, Karoline V Gleixner, Gregor Hoermann, Emir Hadzijusufovic, Leonhard Müllauer, Wolfgang R Sperr, Giulio Superti-Furga, Christine Mannhalter
In chronic myeloid leukemia (CML) resistance against one or more BCR-ABL1 tyrosine kinase inhibitors (TKI) remains a clinical challenge. Preclinical data suggest that TKI combinations may overcome resistance. We report on a heavily pre-treated 78 year-old female patient with CML who developed multi-resistant blast crisis with bone marrow fibrosis and a Ph- clone. Treatment with ponatinib resulted in blast cell clearance, decrease in fibrosis, and disappearance of BCR-ABL1, but also in severe thrombocytopenia with bleedings requiring platelet transfusions...
April 4, 2017: Oncotarget
https://www.readbyqxmd.com/read/28414116/the-largest-european-single-center-experience-300-laparoscopic-pancreatic-resections
#13
Safi Dokmak, Fadhel Samir Ftériche, Béatrice Aussilhou, Philippe Lévy, Philippe Ruszniewski, Jérome Cros, Marie Pierre Vullierme, Linda Khoy Ear, Jacques Belghiti, Alain Sauvanet
BACKGROUND: Although laparoscopic pancreatic resection (LPR) has become a routine, large single center series are still lacking. Our aim was to analyze the results of a large European single center series of LPR. STUDY DESIGN: Between January 2008 and September 2015, 300 LPR were performed and studied prospectively including 165 (55%) distal pancreatectomies, 68 (23%) pancreatoduodenectomies (PD), 30 (10%) enucleations, 35 (11%) central pancreatectomies and 2 (1%) total pancreatectomies...
April 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28413658/subcutaneous-metastasis-arising-from-gastric-cancer-a-case-report
#14
Tsutomu Namikawa, Eri Munekage, Masaya Munekage, Hiromichi Maeda, Tomoaki Yatabe, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki
A 59-year-old man was referred to the Kochi Medical School Hospital due to left shoulder pain. Physical examination revealed a nodular, painful mass lesion in the subcutaneous tissue of the right chest wall, with a diameter of ~2 cm. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower gastric body near the lesser curvature, and biopsy specimens of the gastric and humeral lesions revealed poorly differentiated adenocarcinoma. Abdominal computed tomography revealed multiple low-density lesions in the liver and a well-defined, 2...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28410562/superior-vena-cava-reconstruction-under-the-left-internal-jugular-vein-to-left-femoral-vein-bypass-support
#15
Jun Ba, Runsheng Peng, Hui Shi, Chunsheng Wang
The complete surgical resection of malignant thymoma is recommended. We present a rare case of tumor resection and superior vena cava (SVC) reconstruction under veno-venous bypass support from the left internal jugular vein to the left femoral vein. The full amount of systemic heparinization (3 mg/kg) was avoided. The surgical pathology revealed thymic squamous cell carcinoma. No complications such as fatal extensive bleeding, coagulopathy, thromboembolism or transfusion reaction were found postoperatively...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#16
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28407297/short-term-complications-associated-with-the-use-of-transvaginal-mesh-in-pelvic-floor-reconstructive-surgery-results-from-a-multi-institutional-prospectively-maintained-dataset
#17
Maxx Caveney, Devin Haddad, Catherine Matthews, Gopal Badlani, Majid Mirzazadeh
AIMS: Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. METHODS: Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding...
April 13, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28405037/the-effect-of-different-dose-regimens-of-tranexamic-acid-in-reducing-blood-loss-during-hip-surgery
#18
Anil Kumar Thipparampall, Indira Gurajala, R Gopinath
BACKGROUND AND AIMS: Antifibrinolytics may help bleeding in orthopaedic surgeries. The present study was undertaken to compare two dose regimens of tranexamic acid (TA) on perioperative blood loss in patients undergoing hip surgeries. METHODS: In a prospective, randomised, controlled study, 59 patients scheduled for hip surgery were divided into Group C: receiving normal saline (n - 20), Group B: receiving single dose of TA (10 mg/kg) (n - 21), and Group I: receiving a bolus (10 mg/kg) plus infusion (1 mg/kg/h) of TA up to 4 h postoperatively (n - 18)...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#19
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28397699/restrictive-versus-liberal-blood-transfusion-for-gastrointestinal-bleeding-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#20
Ayodele Odutayo, Michael J R Desborough, Marialena Trivella, Adrian J Stanley, Carolyn Dorée, Gary S Collins, Sally Hopewell, Susan J Brunskill, Brennan C Kahan, Richard F A Logan, Alan N Barkun, Michael F Murphy, Vipul Jairath
BACKGROUND: Acute upper gastrointestinal bleeding is a leading indication for red blood cell (RBC) transfusion worldwide, although optimal thresholds for transfusion are debated. METHODS: We searched MEDLINE, Embase, CENTRAL, CINAHL, and the Transfusion Evidence Library from inception to Oct 20, 2016, for randomised controlled trials comparing restrictive and liberal RBC transfusion strategies for acute upper gastrointestinal bleeding. Main outcomes were mortality, rebleeding, ischaemic events, and mean RBC transfusion...
May 2017: Lancet. Gastroenterology & Hepatology
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