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Sebastiaan T Roos, Leo Timmers, Paul S Biesbroek, Robin Nijveldt, Otto Kamp, Albert C van Rossum, Gerardus P J van Hout, Pieter R Stella, Pieter A Doevendans, Paul Knaapen, Birgitta K Velthuis, Niels van Royen, Michiel Voskuil, Alex Nap, Yolande Appelman
OBJECTIVES: This double blinded, placebo controlled randomized clinical trial studies the effect of exenatide on myocardial infarct size. The glucagon-like peptide-1 receptor agonist exenatide has possible cardioprotective properties during reperfusion after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. METHODS: 191 patients were randomly assigned to intravenous exenatide or placebo initiated prior to percutaneous coronary intervention using 10μg/h for 30min followed by 0...
October 1, 2016: International Journal of Cardiology
Per Lehnert, Christian H Møller, Jørn Carlsen, Peer Grande, Jann Mortensen, Daniel A Steinbrüchel
Acute pulmonary embolism (PE) is a common and potential lifethreatening condition. Nevertheless the advancements in the patient visitation and treatment algorithms have been few and the mortality unchanged high. Acute high risk PE, which is the most serious subtype, is primary treated with trombolysis. This treatment is not always possible or sufficient. Recent studies have shown that surgical embolectomy is a relevant treatment offer with low mortalities of 6-8%. Patients with acute critical PE should be evaluated and treated in a multidisciplinary centre with medical and surgical possibilities...
May 27, 2013: Ugeskrift for Laeger
Marta Martinez Miguez, Coral Carballo-Fernandez, Nilo Mosquera-Arochena
PURPOSE: This case demonstrates the use of carotid stents in off-label emergency condition where standard self-expandable stents doesn't fit to native artery and balloon-expandable stents could not be also recommended. CASE REPORT: 56 years old patient, EVAR therapy performed 2 months before, suffering acute severe abdominal pain; emergency angioCT showed oclusion of superior mesenteric artery (SMA) and no complications related to previous EVAR. A percutaneuos supraselective trombolysis was performed...
January 2012: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Qingke Bai, Zhenguo Zhao, Paul Fu, Haijing Sui, Xiuhai Xie, Juan Chen, Juan Yang
BACKGROUND: It is unknown whether thrombolysis is beneficial in patients with Wake-Up Ischemic Strokes (WUIS). This study compares the clinical outcomes of MRI-based intravenous thrombolysis in patients with hyperacute ischemic stroke presenting within 12 hours of symptom onset against WUIS patients receiving the same therapy. METHODS: Patients presenting within 12 hours of acute stroke symptom onset and those with WUIS confirmed by CT, and without intracranial hemorrhage, were encouraged to perform an emergent brain MRI scan to confirm the diagnosis of hyperacute ischemic stroke [hyper-intense in diffusion-weighted imaging (DWI) and no hypo-intense change in T2-weighted imaging (T2WI) or FLAIR]...
June 2013: Neurological Research
A Halcín, E Kovácová, F Mikla, A Reptová, J Bedeová
Agenesis/atresia ofvena cava inferior is a rare congenital anomaly, caused by an aberrance of embryonal venous system development. This is in most cases asymptomatic, because of well developed collateral venous circulation. However, in some cases, it can be manifested with occurence of deep thrombosis in area of pelvis and lower limbs. In this case report, we repon a 21 year old male with painful swelling of both lower limbs. Ultrasonographic examination revealed a bilateral thrombosis in deep venous system of lower limbs and pelvis...
December 2009: Vnitr̆ní Lékar̆ství
Jaume Figueras, Magda Heras, Francisco Baigorri, Roberto Elosua, Ignacio Ferreira, Miquel Santaló
BACKGROUND AND OBJECTIVE: To analyze the use of reperfusion therapy in patients with ST elevation myocardial infarction (STEMI) in Catalonia in a registry performed in 2006 (IAM CAT III) and its comparison with 2 previous registries PATIENTS AND METHODS: Frequency of reperfusion therapy and time intervals between symptom onset - reperfusion therapy were the principal variables investigated. The IAM CAT I (June-December 2000) included 1,450 patients, the IAM CAT II (October 2002-April 2003) 1,386, and the IAM CAT III (October-December 2006) 367...
November 14, 2009: Medicina Clínica
Piotr Kukla, Leszek Bryniarski, Robert Długopolski, Ewa Krupa, Jacek Nowak, Lukasz Kulak, Ewa Mirek-Bryniarska, Agnieszka Nowicka, Jerzy Hybel, Kazimierz Szczuka
BACKGROUND: Acute pulmonary embolism (APE) is a life-threatening disease. Mortality in APE still remains very high in spite of progress in diagnostic tools. Mortality rate is about 30% in patients with unrecognised APE. APE is one of the main causes of in-hospital mortality. AIM: To asses management of patients with APE in the Małopolska region. METHODS: This registry consists of 205 consecutive patients who were hospitalised in 6 cardiology departments between 1 January 2005 and 30 September 2007, with the mean age of 65...
July 2009: Kardiologia Polska
A Russo
Pulmonary embolism is high letal risk pathology often misdiagnosed, up to 70% cases, more frequent in hospitalized subjects, i. e. geriatric patients with chronic respiratory and circulatory diseases, or orthopaedic, neurosurgical, or neoplastic ones and trombophylic predisposing conditions. Medical pharmacological strategies include anticoagulative regimens (heparines, fibrinolitic drugs), either for prolonged therapeutical schedules or for prophylactic ones; within 30% of timely acquired diagnoses, compared to 70% non diagnosed cases, survival rates is directly related to the first approach, ranging from 60% after 7 days, to 48% survival during the first year, 39% and 34% after five and eight years respectively, considering the progressive relapsing risk...
April 2009: Il Giornale di Chirurgia
L C Alvaro, J Timiraos, F Sádaba
INTRODUCTION: In-hospital strokes have been poorly reported. They provide an opportunity to shorten intervals for thrombolysis. Our proposals were: a) to describe their clinical features and neurological assessment, and b) regarding thrombolysis, to analyze potential candidates and exclusions at a general tertiary hospital, just before its approval/implementation at the center. METHODS: Cases were retrospectively recruited between May 2001-May 2004. They were identified from discharching diagnosis (ICD-9: 430-439; GRD: 14, 15, 16, 17, 532, 810) and from consultations required to the neurology service...
January 2008: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Astrid Juhl Terkelsen, Jens Erik Nielsen-Kudsk, Henning Rud Andersen, Jens Flensted Lassen
Mortality in untreated pulmonary embolism is high and short-term outcome depends on a timely diagnosis. In this case telemedicine involving 12-lead ECG and GSM-based communication between the patient in the ambulance and the telemedical staff resulted in remote pre-hospital suspicion of acute pulmonary embolism. The ambulance was referred directly to the nearest department of cardiology where acute CT and echocardiography confirmed the diagnosis. Acute trombolysis was successful. Telemedicine may be beneficial in other medical emergencies than acute myocardial infarction...
February 25, 2008: Ugeskrift for Laeger
Yvonne Schwammenthal, Rakefet Tsabari, Mati Bakon, David Orion, Oleg Merzeliak, David Tanne
BACKGROUND: Rapid restoration of cerebral blood flow is the principle goal of acute ischemic stroke therapy. Intravenous recombinant tissue plasminogen activator is an effective therapy for acute ischemic stroke. It has been available in the United States for over a decade and was approved for use in Israel at the end of 2004. OBJECTIVES: To assess the implementation of intravenous rt-PA in routine clinical care at our center after its formal approval in Israel, and the therapeutic and logistic implications for reperfusion therapy for acute ischemic stroke in Israel...
November 2006: Israel Medical Association Journal: IMAJ
A De Roeck, J M H Hendriks, F Delrue, P Lauwers, P Van Schil, M De Maeseneer, O François, P Parizel, O d'Archambeau
OBJECTIVES: To evaluate the long-term results of recanalization with primary stenting for long and complex iliac artery occlusions. DESIGN: Retrospective non-randomized study. METHODS: Between 1996 and 2004, 38 patients underwent recanalization of an occluded iliac artery with subsequent stenting for TASC B lesions in 12 patients, TASC C in 10 and TASC D in 16. Thirty-one patients had Fontaine stage 2 B, four patients had stage 3 and one patient had stage 4...
March 2006: Acta Chirurgica Belgica
T Danek, R Janousek, K Havlícek
Authors present their experience with combined trombolytic-surgical treatment of acute ischaemia of low extremity based on trombosis of popliteal artery aneurysm. This treatment was performed in three patients. Authors compare results of intraarterial catheter pharmacological trombolysis of infrapopliteal arteries with indirect surgical trombolysis.
March 2006: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Jaroslaw Zalewski, Krzysztof Zmudka, Piotr Musialek, Wojciech Zajdel, Piotr Pieniazek, Andrzej Kadzielski, Tadeusz Przewlocki
BACKGROUND: In a significant proportion of patients with acute myocardial infarction (AMI), successful opening of the infarct related artery (IRA) does not translate into adequate perfusion at the tissue level. We hypothesised that deterioration of epicardial blood flow in early reperfusion may identify early signs of coronary microvascular injury. METHODS: In 272 consecutive patients (age 56.9+/-10.4 years) with AMI treated by primary angioplasty (PCI), coronary blood flow (Trombolysis in Myocardial Infarction (TIMI) scale and corrected TIMI frame count (cTFC)) was evaluated before [B], immediately after [O] and 15 min after [O15] opening of the IRA...
September 2004: International Journal of Cardiology
I Sahnoun-Trabelsi, M Jimenez, A Choussat, R Roudaut
Pregnancy in women with mechanical prosthetic heart valves carried an increased risk of thromboembolic complications due to changes in haemostasis. Prosthetic valve thrombosis is a serious complication resulting in high mortality. Ten patients from 20 to 38 years of age had 12 thromboses of mechanical heart prostheses during pregnancy. The prosthesis was mitral in 8 cases and aortic in 4 cases. The prosthesis was a ball valve in 1 case, a tilting disc in 3 cases and bi-leaflet in 8 cases. Initial emergency treatment was surgical in 3 cases and medical in 9 cases (thrombolysis in 7 cases and simple heparin therapy in 2 cases)...
April 2004: Archives des Maladies du Coeur et des Vaisseaux
L Carlos Passos, A da Silva Rodrigues, C Leal Costa, S Ledoux, C M de Souza, J Péricles Esteves
PURPOSE: To describe the use of myocardial reperfusion strategies (percutaneous transluminal coronary angioplasty-PTCA and intravenous trombolysis) whenever it is possible to use emergency cinecoronariography in acute myocardial infarction (AMI). METHODS: The records of patients admitted with initial diagnosis of AMI, until six hours after the beginning of symptoms, were reviewed retrospectively, between March/92 and December/93. RESULTS: One hundred forty-three patients were admitted with suspected AMI...
October 1995: Arquivos Brasileiros de Cardiologia
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