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Pulmonary thrombolysis

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https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#1
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28279597/inferior-vena-cava-filters-in-pulmonary-embolism-a-historic-controversy
#2
Carlos Jerjes-Sanchez, David Rodriguez, Aline Navarrete, Carolina Parra-Cantu, Jorge Joya-Harrison, Eduardo Vazquez, Alicia Ramirez-Rivera
OBJECTIVE: Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. METHODS: Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table...
March 6, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28265129/deep-vein-thrombosis-interventions-in-cancer-patients
#3
REVIEW
Resmi Ann Charalel, Suresh Vedantham
The presence of cancer increases the risk of deep vein thrombosis (DVT), DVT recurrence, and treatment-related bleeding, and therefore offers distinctive clinical considerations when planning treatment. Anticoagulation with a low-molecular-weight heparin is the preferred initial and long-term therapy in cancer patients. Inferior vena cava filters may be used judiciously for patients with cancer-related DVT who have contraindications to anticoagulation or who exhibit breakthrough pulmonary embolism (PE) despite anticoagulation, but should be removed when the PE risk is felt to subside...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28262244/risk-adapted-management-of-pulmonary-embolism
#4
Stefano Barco, Stavros V Konstantinides
The presence and severity of right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of pulmonary embolism (PE). Risk-adapted treatment strategies continue to evolve, tailoring initial management to the clinical presentation and the functional status of the RV. Beyond pharmacological and, if necessary, mechanical circulatory support, systemic thrombolysis remains the mainstay of treatment for hemodynamically unstable patients; in contrast, it is not routinely recommended for intermediate-risk PE...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28246560/saddle-pulmonary-embolism-with-thrombus-in-transit-across-a-patent-foramen-ovale
#5
Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28228310/comparison-of-pesi-echocardiogram-ctpa-and-nt-probnp-as-risk-stratification-tools-in-patients-with-acute-pulmonary-embolism
#6
A Vamsidhar, D Rajasekhar, V Vanajakshamma, A Y Lakshmi, K Latheef, C Siva Sankara, G Obul Reddy
OBJECTIVE: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients. METHODS: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28214483/systemic-thrombolysis-increases-hemorrhagic-stroke-risk-without-survival-benefit-compared-with-catheter-directed-intervention-for-the-treatment-of-acute-pulmonary-embolism
#7
Nathan L Liang, Efthymios D Avgerinos, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Systemic thrombolysis (ST) and catheter-directed intervention (CDI) are both used in the treatment of acute pulmonary embolism (PE), but the comparative outcomes of these two therapies remain unclear. The objective of this study was to compare short-term mortality and safety outcomes between the two treatments using a large national database. METHODS: Patients presenting with acute PE were identified in the National Inpatient Sample (NIS) from 2009 to 2012...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#8
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#9
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28208201/catheter-based-approaches-for-the-treatment-of-acute-pulmonary-embolism
#10
Victor F Tapson, David Jimenez
Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher with thrombolytic therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#11
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28206731/thrombus-resolution-and-right-ventricular-functional-recovery-using-ultrasound-accelerated-thrombolysis-in-acute-massive-and-submassive-pulmonary-embolism
#12
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28193193/observation-management-of-pulmonary-embolism-and-agreement-with-claims-based-and-clinical-risk-stratification-criteria-in-united-states-patients-a-retrospective-analysis
#13
Elaine Nguyen, Craig I Coleman, W Frank Peacock, Philip S Wells, Erin R Weeda, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Thomas J Bunz, Gregory J Fermann
BACKGROUND: Guidelines suggest observation stays are appropriate for pulmonary embolism (PE) patients at low-risk for early mortality. We sought to assess agreement between United States (US) observation management of PE and claims-based and clinical risk stratification criteria. METHODS: Using US Premier data from 11/2012 to 3/2015, we identified adult observation stay patients with a primary diagnosis of PE, ≥1 PE diagnostic test claim and evidence of PE treatment...
February 13, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28186234/surgical-embolectomy-compared-to-thrombolysis-in-acute-pulmonary-embolism-morbidity-and-mortality
#14
Per Lehnert, Christian H Møller, Jann Mortensen, Jesper Kjaergaard, Peter Skov Olsen, Jørn Carlsen
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28179706/massive-pulmonary-embolism-presenting-as-seizures
#15
Shahrukh Hashmani, Fateh Ali Tipoo Sultan, Murtaza Kazmi, Ammarah Yasmeen
Pulmonary embolism can present in various ways, though seizure activity has been rarely reported. We report a 38 years old male who had met a road traffic accident, underwent surgery, presented a month later with seizures, chest pain, shortness of breath and low blood pressure. Massive pulmonary embolism was diagnosed on CTPA, with classical features on ECG and echocardiogram and the patient was successfully managed with thrombolysis. Massive pulmonary embolism (MPE) should be kept in mind in patients who present with seizures, chest pain and haemodynamic instability...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28159824/novel-thrombolytic-drug-based-on-thrombin-cleavable-microplasminogen-coupled-to-a-single-chain-antibody-specific-for-activated-gpiib-iiia
#16
Thomas Bonnard, Zachary Tennant, Be'Eri Niego, Ruchi Kanojia, Karen Alt, Shweta Jagdale, Lok Soon Law, Sheena Rigby, Robert Lindsay Medcalf, Karlheinz Peter, Christoph Eugen Hagemeyer
BACKGROUND: Thrombolytic therapy for acute thrombosis is limited by life-threatening side effects such as major bleeding and neurotoxicity. New treatment options with enhanced fibrinolytic potential are therefore required. Here, we report the development of a new thrombolytic molecule that exploits key features of thrombosis. We designed a recombinant microplasminogen modified to be activated by the prothrombotic serine-protease thrombin (HtPlg), fused to an activation-specific anti-glycoprotein IIb/IIIa single-chain antibody (SCE5), thereby hijacking the coagulation system to initiate thrombolysis...
February 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28154761/pathogenesis-of-thromboembolism-and-endovascular-management
#17
REVIEW
Sasan Behravesh, Peter Hoang, Alisha Nanda, Alex Wallace, Rahul A Sheth, Amy R Deipolyi, Adnan Memic, Sailendra Naidu, Rahmi Oklu
Venous thromboembolism (VTE), a disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with high mortality, morbidity, and costs. It can result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US. The current standard of care for VTE is anticoagulation, though thrombolysis may be performed in patients with PE and threatened limb...
2017: Thrombosis
https://www.readbyqxmd.com/read/28150371/venous-thromboembolism-management-practices-and-knowledge-of-guidelines-a-survey-of-australian-haematologists-and-respiratory-physicians
#18
Rory Wallace, Mary-Ann Anderson, Katharine See, Ms Alexandra Gorelik, A/Prof Louis Irving, Renee Manser
BACKGROUND: Current international clinical practice guidelines do not adequately address all clinical scenarios in the management of venous thromboembolism (VTE) and no comprehensive Australian guidelines exist. We aimed to identify areas of uncertainty in VTE management and whether self-reported practice is consistent with guidelines. METHODS: We conducted an Australian cross-sectional online survey consisting of 53 questions to investigate doctors' VTE management practices...
February 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28145042/safety-of-catheter-directed-thrombolysis-for-massive-and-submassive-pulmonary-embolism-results-of-a-multicenter-registry-and-meta-analysis
#19
Tyler L Bloomer, Georges E El-Hayek, Michael C McDaniel, Breck C Sandvall, Henry A Liberman, Chandan M Devireddy, Gautam Kumar, Pete P Fong, Wissam A Jaber
OBJECTIVES: To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) in the treatment of acute pulmonary embolism (PE). BACKGROUND: The use of CDT for the treatment of acute submassive and massive PE is increasing in frequency. However, its safety and efficacy have not been well elucidated. METHODS: This study is made of two parts: one is a two-center registry of acute PE patients treated with CDT. The safety outcome evaluated was any major complication including fatal, intracranial (ICH), intraocular, or retroperitoneal hemorrhage or any overt bleeding requiring transfusion or surgical repair...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28133174/-a-case-of-pulmonary-embolism-developed-during-combination-chemotherapy-with-s-1-and-cisplatin-in-a-young-female-patient-with-type-4gastric-cancer
#20
Noboru Kobayashi, Kazuyoshi Yamamoto, Kiyotaka Hagihara, Kazuhiro Nishikawa, Motohiro Hirao, Sakae Maeda, Mamoru Uemura, Masakazu Miyake, Naoki Hama, Atsushi Miyamoto, Michihiko Miyazaki, Masataka Ikeda, Shoji Nakamori, Mitsugu Sekimoto
We report a case of a 23-year-old womanwho developed pulmonary embolism(PE)during chemotherapy for advanced gastric cancer following total gastrectomy(R1). She presented with type 4 gastric cancer with peritoneal dissemination and positive washing cytology. Palliative total gastrectomy was performed(R1)and first-line chemotherapy with S-1(80mg/m2, days 1 to 21) plus CDDP(60mg/m2, day 8)(SP; every 35 days)was administered. PE occurred on day 15 of the 3rd courses of SP. Computed tomography(CT)revealed massive PE in both the pulmonary arteries, and ultrasonography indicated an increase in right-sided pressure...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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