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https://www.readbyqxmd.com/read/28228977/transient-hemi-lower-limb-ischemia-in-the-newborn-arterial-thrombosis-or-persistent-sciatic-artery
#1
Makiko Kirino, Masayuki Ochiai, Masako Ichiyama, Hirosuke Inoue, Takeshi Kusuda, Tadamune Kinjo, Masataka Ishimura, Shouichi Ohga
Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28228620/a-case-of-intracranial-arterial-dolichoectasia-with-4-repeated-cerebral-infarctions-in-6-months-and-enlargement-of-basilar-artery
#2
Hideyuki Moriyoshi, Soma Furukawa, Mai Iwata, Junichiro Suzuki, Noriyoshi Nakai, Suguru Nishida, Yasuhiro Ito
A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy...
February 22, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28228323/evaluation-of-the-role-of-susceptibility-weighted-imaging-in-thrombolytic-therapy-for-acute-ischemic-stroke
#3
Guangjian Zhao, Ling Sun, Ziran Wang, Liquan Wang, Zhongrong Cheng, Hongyan Lei, Daiqun Yang, Yansen Cui, Shirui Zhang
We inspected low-intensity venous signals and microbleeds in patients with acute ischemic stroke (AIS) using susceptibility-weighted imaging (SWI) before and after administration of within-thrombolytic-time-window thrombolytic therapies, and observed their prognosis and safety, in order to guide individualized thrombolytic therapies. Patients with AIS were divided into groups A or B according to the presence of symmetric or asymmetric veins on SWI, and were re-inspected by SWI after intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA)...
February 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28227899/peripheral-sensory-stimulation-is-neuroprotective-in-a-rat-photothrombotic-ischemic-stroke-model
#4
Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor, Aishwarya Bandla, Chua Le Teng Sherry, Frances Lim, Chan Kim Chuan, Lun-De Liao, Nitish V Thakor, Lun-De Liao, Nitish V Thakor, Frances Lim, Chua Le Teng Sherry, Aishwarya Bandla, Chan Kim Chuan
Ischemic stroke is one of the leading causes of death and disability in the world. Thrombolytic therapy using recombinant tissue plasminogen activator (rtPA), the only FDA-approved drug for acute ischemia, is limited by a narrow therapeutic time window and risk of hemorrhage. There is a serious need for a neuroprotective therapy which is clinically viable. We earlier demonstrated that peripheral sensory stimulation (PSS) is a potential therapeutic intervention for hyperacute ischemia resulting in recovery of neurovascular functions when administered immediately following ischemia onset in a rat model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28222238/thrombolysis-with-intravenous-recombinant-tissue-plasminogen-activator-during-early-postpartum-period-a-review-of-the-literature
#5
Munetoshi Akazawa, Makoto Nishida
Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. We performed a computerized MEDLINE and EMBASE search. We collected data for 13 cases of systemic thrombolytic therapy during the early postpartum period, when limiting the early postpartum period to 48 hours after delivery...
February 21, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28217292/oxygen-or-cooling-to-make-a-decision-after-acute-ischemia-stroke
#6
REVIEW
Wen-Cao Liu, Xin-Chun Jin
The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA), which remains the only United States Food and Drug Administration (FDA) approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT)...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28214484/hybrid-operative-thrombectomy-is-noninferior-to-percutaneous-techniques-for-the-treatment-of-acute-iliofemoral-deep-venous-thrombosis
#7
Limael E Rodríguez, Aihab Aboukheir-Aboukheir, Ricardo Figueroa-Vicente, Hiram Soler-Bernardini, Guillermo Bolanos-Avila, Luis J Torruella-Bartolomei, Anthony J Comerota, Jorge L Martinez-Trabal
OBJECTIVE: Hybrid operative thrombectomy (HOT) is a novel technique for the treatment of acute iliofemoral deep venous thrombosis (IFDVT) and is an alternative to percutaneous techniques (PTs) that use thrombolytics. In this study, we compare perioperative and intermediate outcomes of HOT vs PT as interventions for early thrombus removal. METHODS: From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb IFDVT...
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/28213478/endovascular-mechanical-thrombectomy-for-cerebral-venous-sinus-thrombosis-a-systematic-review
#9
REVIEW
Adeel Ilyas, Ching-Jen Chen, Daniel M Raper, Dale Ding, Thomas Buell, Panogiotis Mastorakos, Kenneth C Liu
BACKGROUND: Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke that, when severe, can be a therapeutic challenge. Endovascular mechanical thrombectomy (EMT) techniques have significantly evolved over the past decade, but data regarding the efficacy and safety of EMT for CVST are poorly defined. OBJECTIVE: To summarize the large number of case series on this relatively rare condition and establish trends in the outcomes of EMT for CVST. METHODS: A literature review was performed using PubMed and Medline to identify reports of three or more patients with CVST treated with EMT...
February 17, 2017: Journal of Neurointerventional Surgery
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/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#11
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
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
#12
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/28208194/risk-stratification-for-proven-acute-pulmonary-embolism-what-information-is-needed
#13
Deisy Barrios, Roger D Yusen, David Jiménez
Classification of risk drives treatment decisions for patients with acute symptomatic pulmonary embolism (PE). High-risk patients with acute symptomatic PE have hemodynamic instability (i.e., shock or hypotension present), and treatment guidelines suggest systemically administered thrombolytic therapy in this setting. Normotensive PE patients at low risk for early complications (low-risk PE) might benefit from treatment at home or early discharge, while normotensive patients with preserved systemic arterial pressure deemed as having a high risk for PE-related adverse clinical events (intermediate-high-risk PE) might benefit from close observation and consideration of escalation of therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28195884/interventional-treatment-of-lvad-outflow-graft-stenosis-by-introduction-of-bare-metal-stents
#14
Dominik Wiedemann, Thomas Schlöglhofer, Thomas Haberl, Julia Riebandt, Kamen Dimitrov, Heinrich Schima, Johannes Kastner, Wolfgang Matzek, Günther Laufer, Daniel Zimpfer
LVAD outflow graft stenosis is a rare but life-threatening complication of MCS-therapy. Current treatment modalities (pump exchange or systemic thrombolytic therapy) are associated with significant mortality and morbidity.Implantation of bare metal stents within the stenosed outflow graft is an alternative. Herein we describe a series of 3-cases with successful stent placement. This seems to be safe and successful however correct and early diagnosis of outflow stenosis can be challenging. Information provided by the HeartWare HVAD logfiles are extremely helpful for diagnosis...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28194291/internal-jugular-and-subclavian-vein-thrombosis-in-a-case-of-ovarian-cancer
#15
Hiroto Moriwaki, Nana Hayama, Shouko Morozumi, Mika Nakano, Akari Nakayama, Yoshiomi Takahata, Yuusuke Sakaguchi, Natsuki Inoue, Toshiki Kubota, Akiko Takenoya, Yoshiko Ishii, Haruka Okubo, Souta Yamaguchi, Tsuyoshi Ono, Toshiaki Oharaseki, Mamoru Yoshikawa
Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT). DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28188404/-direct-oral-anticoagulants-and-acute-stroke-insights-into-translational-research-studies
#16
C Foerch, J H Schäfer, W Pfeilschifter, F Bohmann
In recent years a considerable number of translational research studies on intracerebral hemorrhage and ischemic stroke have been published, which are characterized by a particular proximity to practical clinical questions. Animal research has provided insights into the pathophysiological processes and therapy effects, which have so far only been insufficiently investigated in clinical studies. This includes the effectiveness of a rapid reversal of anticoagulation in cases of anticoagulation-associated intracerebral hemorrhage and the safety of thrombolytic treatment in ischemic stroke occurring during treatment with anticoagulants...
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28185942/the-effects-of-pharmaceutical-thrombolysis-and-multi-modal-therapy-on-patients-with-acute-posterior-circulation-ischemic-stroke-results-of-a-one-center-retrospective-study
#17
Yang Yang, Chunyang Liang, Chunsen Shen, Hao Tang, Shang Ma, Qiang Zhang, Mou Gao, Qin Dong, Ruxiang Xu
BACKGROUND: The treatment method for acute ischemic stroke is rapidly developing, and the effects of endovascular modalities, when used alone or in combination, needs to be studied. We aimed to identify the difference between pharmaceutical thrombolysis and multi-modal therapy (MMT) used in acute posterior circulation ischemic stroke (APCIS) patients and also to detect the predictors for successful recanalization and favorable outcomes. METHODS: A retrospective analysis of patients with APCIS who received thrombolytic pharmaceuticals and MMT from 2011 to 2016 was performed at the stroke center...
February 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28183857/coexistent-sickle-cell-disease-has-no-impact-on-the-safety-or-outcome-of-lytic-therapy-in-acute-ischemic-stroke-findings-from-get-with-the-guidelines-stroke
#18
Robert J Adams, Margueritte Cox, Shelly D Ozark, Julie Kanter, Phillip J Schulte, Ying Xian, Gregg C Fonarow, Eric E Smith, Lee H Schwamm
BACKGROUND AND PURPOSE: The recommended treatment for ischemic stroke is tPA (tissue-type plasminogen activator). Although sickle cell disease (SCD) represents no known contraindication to tPA, National Heart Lung and Blood Institute of the National Institutes of Health recommended acute exchange transfusion for stroke in SCD, not tPA. Data on safety and outcomes of tPA in patients are needed to guide tPA use in SCD. METHODS: We matched patients from the American Heart Association and American Stroke Association Get With The Guidelines-Stroke registry with SCD to patients without SCD and compared usage, complications, and discharge outcomes after tPA...
February 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28182117/fibrin-sheaths-in-central-venous-port-catheters-treatment-with-low-dose-single-injection-of-urokinase-on-an-outpatient-basis
#19
De-Hua Chang, Kamal Mammadov, Tilman Hickethier, Jan Borggrefe, Martin Hellmich, David Maintz, Christoph Kabbasch
PURPOSE: Evaluation of the efficacy of single-shot, low-dose urokinase administration for the treatment of port catheter-associated fibrin sheaths. METHODS: Forty-six patients were retrospectively evaluated for 54 episodes of port catheter dysfunction. The presence of a fibrin sheath was detected by angiographic contrast examinations. On an outpatient basis, patients subsequently received thrombolysis consisting of a single injection of urokinase (15.000 IU in 1...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28179050/cerebral-amyloid-angiopathy-in-stroke-medicine
#20
Frank Block, Manuel Dafotakis
BACKGROUND: Cerebral amyloid angiopathy (CAA) is a degenerative vasculopathy that is classically associated with lobar intracerebral or sulcal hemorrhage. Its prevalence is estimated at 30% in the seventh decade and 50% in the eighth and ninth decades. In this review, we summarize the risks linked to CAA with respect to the treatment and prevention of stroke. METHODS: This review is based on pertinent publications retrieved by a selective search employing the terms "amyloid cerebral angiopathy," "stroke," "intra - cerebral bleeding," and "acute stroke therapy...
January 20, 2017: Deutsches Ärzteblatt International
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