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Pulmonary thrombolysis

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https://www.readbyqxmd.com/read/28818212/national-trends-in-hospitalizations-for-venous-thromboembolism
#1
Anand Brahmandam, Marwan S Abougergi, Cassius Iyad Ochoa Chaar
OBJECTIVE: The management of venous thromboembolism (VTE) has evolved during the last decade. This study sheds light on the national trends in hospital admissions, outcomes, and economic burden for VTE. METHODS: The National Inpatient Sample (NIS) was reviewed between 2003 and 2013 for hospitalizations for VTE, defined as admissions with a principal diagnosis of deep venous thrombosis (DVT) or pulmonary embolism (PE). Outcomes measured were incidence, inpatient mortality, rates of interventions, hospital length of stay (LOS), and charges...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28818211/evaluation-of-thrombolysis-using-tissue-plasminogen-activator-in-lower-extremity-deep-venous-thrombosis-with%C3%A2-concomitant-femoral-popliteal-venous-segment%C3%A2-involvement
#2
Mayin Lin, John C F Hsieh, Mian Hanif, Alan McDaniel, David K Chew
OBJECTIVE: Current guidelines recommend thrombolytic therapy for iliofemoral deep venous thrombosis (DVT). Anticoagulation is the standard treatment for femoral-popliteal and tibial-level DVT. The objective of this study was to evaluate the efficacy of catheter-directed thrombolysis (CDT) using tissue plasminogen activator vs standard anticoagulation alone in patients with lower extremity DVT involving the femoral-popliteal segment. METHODS: A retrospective review was performed of patients referred to the vascular surgery service with lower extremity DVT from 2006 to 2015...
September 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28805341/treatment-options-for-severe-pulmonary-embolism-during-pregnancy-and-the-postpartum-period-a-systematic-review
#3
G Martillotti, F Boehlen, H Robert-Ebadi, N Jastrow, M Righini, M Blondon
BACKGROUND: Massive pulmonary embolism (PE) during pregnancy or the postpartum period is a rare but dramatic event. Our aim was to systematically review the evidence to guide its management. METHODS: We searched Pubmed, Embase, conference proceedings and the RIETE registry for published cases of severe (submassive/massive) PE treated with thrombolysis, percutaneous or surgical thrombectomy and/or with ECMO, occurring during pregnancy or within 6 weeks of delivery...
August 14, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28802551/a-survey-of-submassive-pulmonary-embolism-treatment-preferences-among-medical-and-endovascular-physicians
#4
Bedros Taslakian, Daanish Chawala, Akhilesh K Sista
PURPOSE: To determine treatment preferences among endovascular and medical physicians who manage acute submassive pulmonary embolism (PE). MATERIALS AND METHODS: From July through August 2016, 83 sites across the United States were surveyed, and 60 completed the survey. Endovascular and medical physicians were asked to rate their predilection for catheter-directed thrombolysis (CDT) on a 5-point scale and for systemic thrombolysis (ST) as "yes" or "no" in seven case scenarios of submassive PE...
August 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28777005/predicting-two-year-mortality-from-discharge-after-acute-coronary-syndrome-an-internationally-based-risk-score
#5
Stuart J Pocock, Yong Huo, Frans Van de Werf, Simon Newsome, Chee Tang Chin, Ana Maria Vega, Jesús Medina, Héctor Bueno
BACKGROUND: Long-term risk of post-discharge mortality associated with acute coronary syndrome remains a concern. The development of a model to reliably estimate two-year mortality risk from hospital discharge post-acute coronary syndrome will help guide treatment strategies. METHODS: EPICOR (long-tErm follow uP of antithrombotic management patterns In acute CORonary syndrome patients, NCT01171404) and EPICOR Asia (EPICOR Asia, NCT01361386) are prospective observational studies of 23,489 patients hospitalized for an acute coronary syndrome event, who survived to discharge and were then followed up for two years...
August 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28768671/paget-schroetter-syndrome-complicated-by-an-incidental-pulmonary-embolism
#6
Jakub Kaczynski, Joseph Sathiananthan
A young man presented with the severe right upper limb swelling following a heavy weight lifting that was thought to be caused by a biceps tendon rupture. However, subsequent investigations confirmed the diagnosis of Paget-Schroetter syndrome that was associated with an incidental pulmonary embolism. The patient underwent a successful thrombolysis followed by a surgical thoracic outlet decompression. Overall, the patient has made a good recovery.
August 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28766495/pulmonary-embolism-with-endovascular-thrombolysis-for-thrombosed-hemodialysis-arteriovenous-access%C3%A2
#7
Yogeshwar Singh Rajaram, Thong Le, Maree Ross-Smith, Andrew Owen, Jason Chuen, Peter F Mount
AIMS: Acute thrombosis of hemodialysis (HD) arteriovenous access is an urgent problem for HD patients and is commonly managed by endovascular thrombolysis. Pulmonary embolism (PE) is a recognized complication of HD access thrombosis and thrombolysis but the risk and outcomes are unclear. This study aims to determine the incidence, predictors, and outcomes of PE after endovascular thrombolysis of HD arteriovenous access in patients presenting with acute thrombosis. MATERIALS AND METHODS: A single-center retrospective study was performed for all adult chronic kidney disease patients undergoing arteriovenous access thrombolysis between January 1, 2012, and December 31, 2014...
September 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28743779/treatment-of-pulmonary-embolism-with-argatroban-and-ultrasound-assisted-catheter-directed-thrombolysis-with-alteplase-in-a-patient-with-heparin-induced-thrombocytopenia
#8
Brittany T Bethea, John W Elliot, John B Richardson, Mustafa I Ahmed
PURPOSE: Successful ultrasound-assisted catheter-directed thrombolysis (USAT) with low-dose alteplase and argatroban in a patient with bilateral pulmonary embolism (PE) secondary to heparin-induced thrombocytopenia (HIT) is reported. SUMMARY: HIT is a life-threatening complication associated with a high risk of thromboembolism. Systemic anticoagulation for the treatment of thrombosis may not be sufficient in the presence of PE. Catheter-directed treatment may be indicated in patients with PE and associated right ventricular dysfunction...
August 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28740129/evaluation-of-high-resolution-ultrasound-as-a-tool-for-assessing-the-3d-volume-of-blood-clots-during-in-vitro-thrombolysis
#9
Laurent Auboire, Jean-Michel Escoffre, Damien Fouan, Jean-René Jacquet, Frédéric Ossant, Jean-Marc Grégoire, Ayache Bouakaz
Thrombosis is a major cause of several diseases, i.e. myocardial infarction, cerebral stroke and pulmonary embolism. Thrombolytic therapies are required to induce fast and efficient recanalization of occluded vessels. To evaluate the in vitro efficacy of these thrombolytic strategies, measuring clot dissolution is essential. This study aimed to evaluate and validate high resolution ultrasound as a tool to assess the exact volume of clots in 3D and in real time during in vitro thrombolytic drug testing. This new method was validated by measuring the effects of concentration range of recombinant tissue type plasminogen activator on a blood clot during complete occlusion or 70% stenosis of a vessel...
July 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28739469/acute-venous-iliofemoral-thrombosis-early-surgical-thrombectomy-is-effective-and-durable
#10
Stefan Ockert, Matthias von Allmen, Michaela Heidemann, Juliette Brusa, Jan Duwe, Robert Seelos
BACKGROUND: The first-line recommendation for treatment of acute iliofemoral deep vein thrombosis (IFDVT) is catheter-directed or pharmaco-mechanical thrombolysis (CDT/PCDT). Recent analysis of surgical thrombectomy has shown comparable results. However this procedure is not commonly given as much importance as interventional techniques. We analyzed patient outcome of surgical thrombectomy using modern endovascular techniques in both the short and long term. METHODS: All consecutive patients who underwent surgical thrombectomy at our institution between April 2008 and April 2017 were included...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28734084/thrombolysis-for-pulmonary-embolism-using-the-superficial-veins-of-the-upper-extremity
#11
Joseph Kusick, Judd Salamat, Kintur Sanghvi
This report describes a novel approach of accessing the superficial veins of the upper extremity for the treatment of pulmonary emboli (PE) with an ultrasound enhanced thrombolytic infusion catheter. In a patient suffering from saddle PE and impending right heart failure, separate basilic and cephalic venous access sites in the right arm were utilized to insert EKOS EndoWave Infusion Catheter (EKOS Corporation, Bothell, WA) insertion in each pulmonary artery (PA). This technique could be advantageous, particularly for patients at high risk for access site complications and those unable to lie supine for prolonged duration of infusion therapy...
July 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28697893/mechanical-valves-in-the-pulmonary-position-an-international-retrospective-analysis
#12
Hanna Pragt, Joost P van Melle, Hoda Javadikasgari, Dong Man Seo, John M Stulak, Igor Knez, Jürgen Hörer, Christian Muñoz-Guijosa, Mahyar G Dehaki, Hong Ju Shin, Joseph A Dearani, Maziar G Dehaki, Petronella G Pieper, Christine Eulenburg, Laura Dos, Tjark Ebels
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014...
May 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28690752/-pulmonary-embolism-could-thrombolysis-be-extended-to-patients-with-intermediate-risk-pulmonary-embolism
#13
Abdelmajid Bouzerda, Issam Serghini, Abdenassar El Kharass
No abstract text is available yet for this article.
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28687687/use-of-low-dose-thrombolytics-for-treatment-of-intracardiac-thrombus-and-massive-pulmonary-embolus-after-aborted-liver-transplant-leads-to-recovery-of-right-ventricular-function-and-redo-liver-transplantation
#14
Aarya Kafi, Oren Friedman, Irene Kim
This is a 61-year-old man with end-stage liver disease who experienced cardiac arrest secondary to a massive pulmonary embolus and intracardiac thrombus during cannulation for veno-venous extracorporeal membrane oxygenation (ECMO) in preparation for orthotopic liver transplantation (OLT). Surgery was aborted and the patient was taken back to the intensive care unit in cardiogenic shock on multiple vasopressors. The patient was unresponsive to heparin bolus and too high risk for systemic thrombolytics or embolectomy...
July 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28668312/ultrasound-assisted-catheter-directed-thrombolysis-in-pulmonary-embolism-in%C3%A2-transit
#15
Andrew Boshara, Sushruth Edla, Saroj Neupane, Howard Rosman, Antonious Attallah
No abstract text is available yet for this article.
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#16
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary embolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
June 27, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#17
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28628412/stratification-imaging-and-management-of-acute-massive-and-submassive-pulmonary-embolism
#18
REVIEW
Akhilesh K Sista, William T Kuo, Mark Schiebler, David C Madoff
While pulmonary embolism (PE) causes approximately 100 000-180 000 deaths per year in the United States, mortality is restricted to patients who have massive or submassive PEs. This state of the art review familiarizes the reader with these categories of PE. The review discusses the following topics: pathophysiology, clinical presentation, rationale for stratification, imaging, massive PE management and outcomes, submassive PE management and outcomes, and future directions. It summarizes the most up-to-date literature on imaging, systemic thrombolysis, surgical embolectomy, and catheter-directed therapy for submassive and massive PE and gives representative examples that reflect modern practice...
July 2017: Radiology
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#19
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#20
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
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