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Submassive pulmonary embolism

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https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#1
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28045672/catheter-directed-fibrinolysis-of-submassive-pulmonary-embolism-after-ivc-filter-migration-to-renal-veins
#2
Kershaw V Patel, Jeffrey A Leef, John E Blair, Atman P Shah, Sandeep Nathan, Jonathan D Paul
A 76-year-old male presented with a submassive pulmonary embolism despite having an inferior vena cava (IVC) filter. Imaging demonstrated pulmonary artery emboli and a deep vein thrombosis in the left common femoral vein. Venography revealed the IVC filter with struts extending into the left and right renal veins. A new IVC filter was deployed below the prior filter. This case demonstrates IVC filter migration complicated by a submassive pulmonary embolism.
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27990080/systemic-thrombolysis-for-pulmonary-embolism-a-review
#3
Colleen Martin, Kristine Sobolewski, Patrick Bridgeman, Daniel Boutsikaris
The authors review the evidence behind the use of thrombolytic therapy in patients with massive or submassive pulmonary embolism. Concurrent heparin therapy and the management of bleeding episodes are also discussed.
December 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27970176/tct-790-cardiac-arrest-triage-score-best-predicts-mortality-after-intervention-in-patients-with-massive-and-submassive-pulmonary-embolism
#4
Taishi Hirai, DeShon Jones, Steven Tate, Kathryn Dryer, Lyn Santiago, Dana Edelson, Janet Friant, Sandeep Nathan, Atman Shah, Jonathan Paul, John Blair
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27938515/do-patients-with-submassive-pulmonary-embolism-benefit-from-thrombolytic-therapy
#5
REVIEW
Ali Ataya, Jessica Cope, Abbas Shahmohammadi, Hassan Alnuaimat
Despite growing interest in thrombolytic agents to treat submassive pulmonary embolism, their role in this scenario remains controversial. Needed is a way to identify patients with this condition who are at risk of clinical deterioration and who would benefit from thrombolytic therapy. Here, we review the use of thrombolytic agents in submassive pulmonary embolism to help distinguish the risk and benefits of this therapy.
December 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27938512/thrombolysis-in-submassive-pulmonary-embolism-finding-the-balance
#6
EDITORIAL
Carlos L Alviar, Gustavo A Heresi
No abstract text is available yet for this article.
December 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27913777/risk-factors-for-major-bleeding-in-the-seattle-ii-trial
#7
Immad Sadiq, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure...
December 1, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27666802/initial-experiences-with-endovascular-management-of-submassive-pulmonary-embolism-is-it-safe
#8
Timothy J Fuller, Christopher M Paprzycki, Muhammad H Zubair, Lala R Hussain, Brian A Kuhn, Matthew H Recht, Patrick E Muck
BACKGROUND: Interventional strategies for massive and submassive pulmonary embolism (smPE) have historically included either systematic intravenous thrombolytic alteplase or surgical embolectomy, both of which are associated with significant morbidity and mortality. However, with the advent of endovascular techniques, recent studies have suggested that an endovascular approach to the treatment of acute smPE may be both safe and effective with excellent outcomes. The purpose of this study was to evaluate the outcomes of patients who have undergone catheter-directed thrombolysis (CDT) for smPE at our institution in an effort to determine the safety of the procedure...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27630267/comparative-outcomes-of-ultrasound-assisted-thrombolysis-and-standard-catheter-directed-thrombolysis-in-the-treatment-of-acute-pulmonary-embolism
#9
Nathan L Liang, Efthymios D Avgerinos, Luke K Marone, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVES: The objective of this study was to compare the outcomes of patients undergoing ultrasound-accelerated thrombolysis (USAT) and standard catheter-directed thrombolysis (CDT) for the treatment of acute pulmonary embolism (PE). METHODS: The records of all patients in our institution having undergone CDT or USAT for massive or submassive PE from 2009 to 2014 were retrospectively reviewed. Standard statistical methods were used to compare characteristics and to assess for longitudinal change in outcomes...
August 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27609936/ultrasound-assisted-catheter-directed-thrombolysis-a-novel-and-promising-endovascular-therapeutic-modality-for-intermediate-risk-pulmonary-embolism
#10
Mohamed Teleb, Mateo Porres-Aguilar, Belinda Rivera-Lebron, Kyari Sumayin Ngamdu, Gehan Botrus, Javier E Anaya-Ayala, Debabrata Mukherjee
Intermediate-risk pulmonary embolism (PE), also known as submassive PE, occurs in a substantial group of patients and carries a significant mortality risk. With adequate risk stratification, catheter-directed techniques could be used as a therapeutic approach in the intermediate-risk PE. Ultrasound-assisted catheter-directed thrombolysis (UCDT) represents a novel endovascular technique with good clinical and safety outcomes. Ultrasound-assisted catheter-directed thrombolysis can achieve reduction in the thrombus burden and improvement of pulmonary hemodynamics and right ventricular (RV) dysfunction and/or dilatation, without major procedure-related complications, major bleeding, or hemorrhagic strokes...
September 7, 2016: Angiology
https://www.readbyqxmd.com/read/27503757/interobserver-and-intraobserver-agreement-on-qualitative-assessments-of-right-ventricular-dysfunction-with-echocardiography-in-patients-with-pulmonary-embolism
#11
Anthony J Weekes, Laura Oh, Gregory Thacker, Angela K Johnson, Michael Runyon, Geoffrey Rose, Thomas Johnson, Megan Templin, H James Norton
OBJECTIVES: To evaluate observer agreement using qualitative goal-directed echocardiographic criteria for right ventricular (RV) dysfunction prognostication in submassive pulmonary embolism (PE). METHODS: Two emergency physicians and 2 cardiologists independently reviewed 31 packets of goal-directed echocardiographic video clips consisting of at least 3 windows obtained by emergency physicians from normotensive patients with PE. Nine packets were repeated to assess for intraobserver agreement...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27423976/surgical-pulmonary-embolectomy-experience-in-a-series-of-37-consecutive-cases
#12
J J Edelman, N Okiwelu, K Anvardeen, P Joshi, B Murphy, L H Sanders, M A Newman, J Passage
BACKGROUND: Massive pulmonary embolism is a poorly tolerated condition. Treatment options in this condition include anticoagulation and primary reperfusion therapy - systemic thrombolysis, catheter based treatments or surgical embolectomy. There is little data on the relative efficacy of each treatment. METHODS: The preoperative characteristics and outcomes of patients referred for surgical embolectomy between 2000-2014 was reviewed. Echocardiography was performed in the majority of patients before and after surgery...
December 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27318043/improved-early-right-ventricular-function-recovery-but-increased-complications-with-catheter-directed-interventions-compared-with-anticoagulation-alone-for-submassive-pulmonary-embolism
#13
Efthymios D Avgerinos, Nathan L Liang, Omar M El-Shazly, Catalyn Toma, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: The purpose of this study was to determine the short-term and midterm outcomes of catheter-directed intervention (CDI) compared with anticoagulation (AC) alone in patients with submassive pulmonary embolism (sPE). METHODS: This was a retrospective review of all patients treated for sPE between January 2009 and October 2014. Two groups were identified on the basis of the therapy: AC and CDI. End points included complications, mortality, and change in echocardiographic parameters...
July 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27170484/mean-platelet-volume-and-mean-platelet-volume-platelet-count-ratio-in-risk-stratification-of-pulmonary-embolism
#14
Turker Yardan, Murat Meric, Celal Kati, Yildiray Celenk, Atilla Guven Atici
BACKGROUND AND OBJECTIVE: Recently, some of the hemogram parameters were reported to predict early death in acute pulmonary embolism (PE). The aim of this study was to investigate the role of mean platelet volume (MPV) and MPV/platelet count ratio (MPV/P), WBC and red cell distribution width (RDW) in risk stratification of patients with acute PE. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients with acute PE admitted to the Emergency Department...
2016: Medicina
https://www.readbyqxmd.com/read/27139009/resolution-of-a-mobile-right-atrial-thrombus-complicating-acute-pulmonary-embolism-with-low-dose-tissue-plasminogen-activator-in-a-patient-with-recent-craniotomy
#15
Amisha K Patel, Aarya Kafi, Antonio Bonet, Shelly M Shapiro, Scott S Oh, Michelle R Zeidler, Jaime Betancourt
Right heart thrombus in transit (RHTT) is a rare, severe form of venous thromboembolism that carries a high mortality rate. The optimal treatment for RHTT has not been well established. Thrombolysis is a therapeutic modality for RHTT but carries the risk of bleeding complications including intracranial hemorrhage. Low-dose thrombolysis has been shown to be effective in treating submassive pulmonary emboli without an increased risk in bleeding complications, but it has not been studied in patients with RHTT...
October 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27081754/catheter-directed-therapy-in-acute-pulmonary-embolism-with-right-ventricular-dysfunction-a-promising-modality-to-provide-early-hemodynamic-recovery
#16
Asli Gorek Dilektasli, Ezgi Demirdogen Cetinoglu, Nilufer Aylin Acet, Cuneyt Erdogan, Ahmet Ursavas, Guven Ozkaya, Funda Coskun, Mehmet Karadag, Ercument Ege
BACKGROUND Catheter-directed therapy (CDT) for pulmonary embolism (PE) is considered as an alternative to systemic thrombolysis (ST) in patients with hemodynamically unstable acute PE who are considered at high bleeding risk for ST. We aimed to evaluate the efficacy and safety of CDT in the management of acute PE with right ventricular dysfunction (RVD). The primary outcomes were mortality, clinical success, and complications. Secondary outcomes were change in hemodynamic parameters in the first 24 hours following the procedure...
April 15, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27071316/current-controversies-in-thrombolytic-use-in-acute-pulmonary-embolism
#17
Brit Long, Alex Koyfman
BACKGROUND: Acute pulmonary embolism (PE) has an annual incidence of 100,000 cases in the United States and is divided into three categories: nonmassive, submassive, and massive. Several studies have evaluated the use of thrombolytics in submassive and massive PE. OBJECTIVE: Our aim was to provide emergency physicians with an updated review of the controversy about the use of thrombolytics in submassive and massive PE. DISCUSSION: Nonmassive PE is defined as PE in the setting of no signs of right ventricular strain (echocardiogram or biomarker) and hemodynamic stability...
July 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27033736/comparison-between-systemic-and-catheter-thrombolysis-in-patients-with-pulmonary-embolism
#18
Jung-Wan Yoo, Ho Cheol Choi, Seung Jun Lee, Yu Ji Cho, Jong Deog Lee, Ho Cheol Kim
BACKGROUND: Although systemic thrombolysis (ST) or catheter-directed therapy (CDT) is performed in patients with acute massive or submassive pulmonary embolism (PE), clinical data comparing between both therapies remain limited. We compared clinical outcomes between ST and CDT in patients with acute massive and submassive PE. METHODS: From January 2005 to June 2015, clinical outcomes of patients with acute massive or submassive PE receiving ST or CDT were evaluated and compared retrospectively...
June 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27006156/a-multidisciplinary-pulmonary-embolism-response-team-initial-30-month-experience-with-a-novel-approach-to-delivery-of-care-to-patients-with-submassive-and-massive-pulmonary-embolism
#19
Christopher Kabrhel, Rachel Rosovsky, Richard Channick, Michael R Jaff, Ido Weinberg, Thoralf Sundt, David M Dudzinski, Josanna Rodriguez-Lopez, Blair A Parry, Savanah Harshbarger, Yuchiao Chang, Kenneth Rosenfield
BACKGROUND: Integrating newly developed tests and treatments for severe pulmonary embolism (PE) into clinical care requires coordinated multispecialty collaboration. To meet this need, we developed a new paradigm: a multidisciplinary Pulmonary Embolism Response Team (PERT). In this report, we provide the first longitudinal analysis of patients treated by a PERT. METHODS: Our PERT includes specialists in cardiovascular medicine and surgery, emergency medicine, hematology, pulmonary/critical care, and radiology, and is organized as a rapid response team...
August 2016: Chest
https://www.readbyqxmd.com/read/26923384/systemic-full-dose-half-dose-and-catheter-directed-thrombolysis-for-pulmonary-embolism-when-to-use-and-how-to-choose
#20
Mohsen Sharifi
Treatment of pulmonary embolism (PE) is variable amongst different and even the same institutions. With the introduction of different forms of thrombolysis, catheter based interventions, and new oral anticoagulants, the treatment and decision-making process has become more complex. The different forms of classification of PE into massive, submassive, severe, moderate, intermediate high risk, intermediate low risk, and low risk have only added to this complexity. The main two reasons for such classifications have been to aid in assessment of patient prognosis and in the intent to carefully select patients who are high risk and would benefit from thrombolysis...
May 2016: Current Treatment Options in Cardiovascular Medicine
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