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Paul Guedeney, Birgit Vogel, Roxana Mehran
Despite dual antiplatelet therapy (DAPT) including potent P2Y12 inhibitors, recurrent ischaemic events occur in a significant number of patients after acute coronary syndrome (ACS), warranting new antithrombotic strategies. Combinations of non-vitamin K antagonist oral anticoagulant (NOAC) with antiplatelet therapy have been tested in several large phases II and III randomised trials. Overall, current evidence suggests that the use of NOACs on top of DAPT after ACS reduces the rate of recurrent ischaemic events, albeit at the price of increased risk for major bleeding...
May 2018: Interventional Cardiology
Eunice Nc Onwordi, Amr Gamal, Azfar Zaman
Anticoagulation in conjunction with antiplatelet therapy is central to the management of acute coronary syndromes (ACS). When used effectively it is associated with a reduction in recurrent ischaemic events including myocardial infarction and stent thrombosis as well as a reduction in death. Effective ischaemic risk reduction whilst balancing bleeding risk remains a clinical challenge. This article reviews the current available evidence for anticoagulation in ACS and recommendations from the European Society of Cardiology...
May 2018: Interventional Cardiology
Samuel H Kim, Nimesh Patel, Kanika Thapar, Ananda V Pandurangadu, Amit Bahl
Objectives: Greater saphenous vein (GSV) thrombosis is concerning due to its close proximity to the deep femoral vein. This study sought to identify the risk of propagation to deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients with isolated proximal GSV superficial thrombosis and describe provider practice patterns related to treatment. Materials and methods: This is an Institutional Review Board-approved retrospective multi-center study. Patients presented to one of three possible emergency departments in a large health system...
2018: Vascular Health and Risk Management
M Sprynger
Venous thromboembolism is the third cardiovascular disease in Europe. The cornerstone of the treatment of deep vein thrombosis is anticoagulation. It aims at avoiding harmful complications : thrombosis extension and recurrence, pulmonary embolism and post-thrombotic syndrome. Due to low molecular weight heparins, and recently, to direct oral anticoagulants, most of the patients can get treatment as outpatients. Unfortunately, despite guideline publications, the management of these patients may be complicated in real life and not correspond to evidence-based medicine...
May 2018: Revue Médicale de Liège
O Gach, Husseini Z El, P Lancellotti
Acute coronary syndromes represent a major cause of mortality in our country. There is a very wide spectrum of clinical presentation since the actual classification of acute coronary syndromes is based on electrocardiographic presentation, that is to say based on absence or presence of ST segment elevation. When dealing with an acute chest pain, once the probability of acute coronary syndrome is established, the emergency care must follow the scientific guidelines. One of the critical steps is represented by the evaluation of ischaemic and hemorrhagic risk in order to tailor optimally antithrombotic and anticoagulation therapies and revascularization timing...
May 2018: Revue Médicale de Liège
Young-A Heo
Intravenous andexanet alfa [coagulation factor Xa (recombinant), inactivated-zhzo; Andexxa® ] is a first-in-class recombinant modified factor Xa protein that has been developed by Portola Pharmaceuticals as a universal antidote to reverse anticoagulant effects of direct or indirect factor Xa inhibitors. In May 2018, andexanet alfa received its first global approval in the USA for use in patients treated with rivaroxaban and apixaban, when reversal of anticoagulant effects is required in life-threatening or uncontrolled bleeding...
June 20, 2018: Drugs
S M Schellong, H Riess, M Spannagl, H Omran, M Schwarzbach, F Langer, W Gogarten, P Bramlage, R M Bauersachs
Approximately 30% of patients receiving oral anticoagulation using vitamin K antagonists (VKA) require surgery within 2 years. In this context, a clinical decision on the need and the mode of a peri-interventional bridging with heparin is needed. While a few years ago, bridging was almost considered a standard of care, recent study results triggered a discussion on which patients will need bridging at all. Revisiting the currently available recommendations and study results the conclusion can be drawn that the indications for bridging with heparin must nowadays be taken more narrowly and considering the individual patient risk of bleeding and thromboembolism...
June 20, 2018: Der Anaesthesist
Kevin Phan, Declan Lloyd, Ash Wilson-Smith, Vannessa Leung, Marko Andric
BACKGROUND/AIM: To clarify the nature of the relationship between novel oral anticoagulants (NOACs) and traditional anticoagulation in respect to intraocular bleeding. METHODS: A comprehensive literature search up to October 2017 yielded 12 randomised controlled trials. Bayesian Markov chain Monte Carlo analysis was employed to investigate the relationship across multiple trials with varying NOACs. Random effects (informative priors) ORs were applied for the risk of intraocular bleeding due to various treatment measures...
June 20, 2018: British Journal of Ophthalmology
Jian Liu, Meida Fan, Jingjing Zhao, Bingcheng Zhao, Chongyu Zhang, Chen Liu, Yugang Dong
No abstract text is available yet for this article.
June 18, 2018: International Journal of Cardiology
(no author information available yet)
No abstract text is available yet for this article.
June 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Z Y Liu, S Y Zhang
No abstract text is available yet for this article.
June 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
C H Zhou, J L Zhao, X Fang
No abstract text is available yet for this article.
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Zun-Yi Zhang, Ke-Shuai Dong, Er-Lei Zhang, Zhi-Yong Huang, Xiao-Ping Chen, Han-Hua Dong
RATIONALE: Portal vein thrombosis is defined as any thrombosis that develops in the portal vein system. It is considered a very rare and extremely lethal complication of hepatopancreatobiliary surgery. PATIENT CONCERNS: Acute portal vein thrombosis after hepatectomy in patients with hepatolithiasisis very rare. Acute portal vein thrombosis is considered as a dangerous complication after hepatectomy. It is easy to ignore the symptom of acute portal vein thrombosis...
June 2018: Medicine (Baltimore)
AbdAllah Gad, Zakaria Hindi, Talal Zahoor, Rémy Zock À Zock
RATIONALE: Superior mesenteric venous thrombosis (SMVT) is a rare condition that carries high mortality. Very few cases have been reported of SMVT, complicating acute appendicitis. Early recognition requires a high index of suspicion and is crucial in successful treatment of such a life-threatening condition. PATIENT CONCERNS: A 33-year-old male presents with a 4-day history of right lower abdominal pain, nausea and subjective fever. CT scan showed acute appendicitis and a central filling defect in the superior mesenteric vein...
June 2018: Medicine (Baltimore)
Sheng Zhang, Amanda R Guido, Richard G Jones, Benjamin J Curry, Angela S Burke, Melanie E Blaisdell
PURPOSE: The use of cyanoacrylate for intravenous catheter securement is of interest to clinicians and patients, because of the superior adhesive strength and hemostatic effect of cyanoacrylate compared to current securement devices. The purpose of this study is to use novel in vitro and in vivo testing methods to analyze the hemostatic effect of a catheter securement cyanoacrylate (cyanoacrylate). METHODS: An unprecedented in vitro method was performed to determine the effects of a cyanoacrylate on a customized modified activated clotting time assay and blood flow inhibition assay by exposing blood or plasma to either one or three drops of cyanoacrylate...
June 1, 2018: Journal of Vascular Access
Marco Capecchi, Maria Abbattista, Ida Martinelli
The cerebral venous system is an unusual site of thrombosis, with a particularly high incidence in young adults. This incidence has increased in past decades because of the improvement of neuroradiological techniques. Risk factors for cerebral venous sinus thrombosis overlap with those of other venous thromboembolism sites, however, some are specific for this particular anatomical district. Prognosis is favorable in most cases if diagnosis is made rapidly and treatment is promptly initiated, even if acute complications or chronic invalidity still occur in a quarter of patients...
June 19, 2018: Journal of Thrombosis and Haemostasis: JTH
Erica Nishimura, Takeyuki Misawa, Hiroaki Kitamura, Shuichi Fujioka, Tadashi Akiba, Katsuhiko Yanaga
Portal vein thrombosis (PVT) is caused by several conditions including infection, malignancies, surgery, medications, and coagulation disorders. However, PVT caused by low-energy injury is very rare. A 51-year-old man visited a clinic with a 2-day history of abdominal pain following blunt abdominal trauma. Contrast-enhanced computed tomography (CT) revealed thrombosis in both the portal vein and splenic vein, and he was transferred to our hospital with a diagnosis of PVT. Anticoagulant therapy was initiated using unfractionated heparin...
June 19, 2018: Clinical Journal of Gastroenterology
Andreea Farcas, Simona Bataga, Cristina Cijevschi, Mircea Diculescu, Daniela Dobru, Eugen Dumitru, Adrian Goldis, Laurentiu Nedelcu, Alina Popescu, Ioan Sporea, Anca Trifan, Simona Valean, Cristian Gheorghe, Dan Lucian Dumitrascu
Management of patients undergoing endoscopy and under treatment with the newer direct oral anticoagulants (DOACs) is a common and a complex clinical issue that gastroenterologists have to face more and more often these days. The increasing use of DOACs in patients requiring both short- and long-term anticoagulation is mostly due to the advantages these agents offer, among which the lack of monitoring requirements and the reduced need of dose adjustments are perhaps the most important ones. Managing these patients in the peri-endoscopic period implies balancing the risk for thrombosis that a certain patient carries and the bleeding risk associated with the endoscopic procedure itself...
June 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Eric Donn, Ian Atkinson, Andrew McCague
Hemorrhagic cholecystitis is an uncommon form of acute cholecystitis which can be rapidly fatal. It may be hard to detect as it frequently presents with symptoms found in other, more common diagnoses. We report the case of a 63 year old man recently started on anticoagulation for deep vein thrombosis who was found to have hemorrhagic cholecystitis.
April 2018: The surgery journal
Rahul P Patel, Madhur D Shastri, Long Chiau Ming, Syed Tabish R Zaidi, Gregory M Peterson
Lichen planus (LP) is an uncommon mucocutaneous inflammatory condition, that is immunologically mediated, typically pruritic and often recurs. The currently advocated therapies are either not highly effective or associated with severe side effects. Enoxaparin, a widely used anticoagulant, is composed of both anticoagulant and non-anticoagulant fragments. Enoxaparin is reported to have anti-inflammatory properties and it was found to be effective in LP. However, the results from clinical studies have varied substantially and, therefore, the clinical role of enoxaparin in LP remains uncertain...
2018: Frontiers in Pharmacology
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