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Unprovoked pulmonary embolism

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https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#1
Antonio Salsano, Elena Sportelli, Guido Maria Olivieri, Nicola Di Lorenzo, Silvia Borile, Francesco Santini
Patients with submassive pulmonary embolism (PE), although normotensive, are characterized by right ventricular (RV) dysfunction and elevated levels of biomarkers of cardiac damage. The best treatment option in these cases is still a subject of debate and the use of thrombolysis in submassive PE remains controversial. A 57-year-old Caucasian male with unprovoked PE, normal blood pressure, and elevated troponin I values was referred to the cardiovascular department. In view of the presence of a right atrium thrombus, the patient underwent surgical embolectomy under extracorporeal circulation, with the extraction of a huge thrombus together with fragmented thrombi from both pulmonary arteries...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29301920/risk-factors-for-recurrent-venous-thromboembolism-after-unprovoked-pulmonary-embolism-the-padis-pe-randomised-trial
#2
Cécile Tromeur, Olivier Sanchez, Emilie Presles, Gilles Pernod, Laurent Bertoletti, Patrick Jego, Elisabeth Duhamel, Karine Provost, Florence Parent, Philippe Robin, Lucile Deloire, Florent Leven, Fanny Mingant, Luc Bressollette, Pierre-Yves Le Roux, Pierre-Yves Salaun, Michel Nonent, Brigitte Pan-Petesch, Benjamin Planquette, Philippe Girard, Karine Lacut, Solen Melac, Patrick Mismetti, Silvy Laporte, Guy Meyer, Dominique Mottier, Christophe Leroyer, Francis Couturaud
We aimed to identify risk factors for recurrent venous thromboembolism (VTE) after unprovoked pulmonary embolism.Analyses were based on the double-blind randomised PADIS-PE trial, which included 371 patients with a first unprovoked pulmonary embolism initially treated during 6 months who were randomised to receive an additional 18 months of warfarin or placebo and followed up for 2 years after study treatment discontinuation. All patients had ventilation/perfusion lung scan at inclusion (i.e. at 6 months of anticoagulation)...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29297660/overview-of-venous-thromboembolism
#3
Haley M Phillippe
Venous thromboembolism (VTE) describes the diagnoses of deep vein thrombosis (DVT) or pulmonary embolism (PE). DVT is the formation of thrombi in the deep veins, most commonly the large veins of the legs or pelvis. PE develops when thrombi dislodge from clots in vein walls and travel through the heart to pulmonary arteries. In many patients, the presenting manifestation of PE is sudden death. VTE may be categorized as provoked or unprovoked. This categorization influences the risk of recurrent VTE and duration of anticoagulation therapy...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29224973/residual-pulmonary-embolism-as-a-predictor-for-recurrence-after-a-first-unprovoked-episode-results-from-the-reverse-cohort-study
#4
Tony Wan, Marc Rodger, Wanzhen Zeng, Philippe Robin, Marc Righini, Michael J Kovacs, Melanie Tan, Marc Carrier, Susan R Kahn, Philip S Wells, David R Anderson, Isabelle Chagnon, Susan Solymoss, Mark Crowther, Richard H White, Linda Vickars, Sadri Bazarjani, Grégoire Le Gal
BACKGROUND: The optimal duration of oral anticoagulant therapy after a first, unprovoked venous thromboembolism is controversial due to tightly balanced risks and benefits of indefinite anticoagulation. Risk stratification tools may assist in decision making. OBJECTIVES: We sought to determine the relationship between residual pulmonary embolism assessed by baseline ventilation-perfusion scan after completion of 5-7months of oral anticoagulant therapy and the risk of recurrent venous thromboembolism in patients with the first episode of unprovoked pulmonary embolism...
December 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29169908/increased-risk-and-severity-of-unprovoked-venous-thromboembolism-with-clustering-cardiovascular-risk-factors-for-atherosclerosis-results-of-the-remotev-registry
#5
S Gaertner, E-M Cordeanu, C Mirea, A-S Frantz, C Auger, P Bilbault, P Ohlmann, V Schini-Kerth, D Stephan
BACKGROUND: The role of cardiovascular risk factors (CVRF) for atherosclerosis in venous thromboembolic disease (VTE) is controversial. The aim of this study was to evaluate the impact of CVRF and their cumulative effects on the occurrence of unprovoked VTE, severity, recurrence and survival. METHODS AND RESULTS: This is a prospective cohort from the REMOTEV registry including all consecutively hospitalized patients for acute symptomatic VTE. From November 2013 to December 2016, 515 patients with 6months follow-up (FU) were selected for the analysis...
November 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29142803/unprovoked-pulmonary-embolism-in-a-young-patient-with-marfan-syndrome
#6
Stella Pak, Andrew Kilgore, Rosanne Thornhill, Kyle Rako, Ali Meier, Gavriella Pora, Jillian M Costello, Christine Dee
Marfan syndrome is a rare connective tissue disorder with a prevalence of approximately 2 to 3 per 10,000 individuals. There have been some reports of young patients with Marfan syndrome developing arteriovenous thromboembolism. These events were unprovoked and recurrent. Owing to its rarity, hypercoagulopathy and other metabolic derangement in patients with Marfan syndrome remains largely unknown. Herein, we report a case of a young man with Marfan syndrome who had myocardial infarction and pulmonary embolism...
September 5, 2017: Curēus
https://www.readbyqxmd.com/read/29076888/role-of-perfusion-defects-at-follow-up-lung-scan-in-predicting-recurrences-after-a-first-episode-of-symptomatic-pulmonary-embolism-a-retrospective-analysis
#7
Liliana Villari, Roberta Pancani, Ferruccio Aquilini, Letizia Marconi, Laura Carrozzi, Antonio Palla, Alessandro Celi
The optimal duration of anticoagulant therapy after a first episode of unprovoked pulmonary thromboembolism is not fully defined. The identification of patients more prone to recurrence would be useful in this context but is currently relatively unreliable. Perfusion lung scan (PLS) is an established approach for the follow-up of patients with pulmonary embolism to identify recurrences and to help in the diagnosis of chronic thromboembolic pulmonary hypertension. The aim of the study was to investigate the potential role of residual perfusion defects at follow-up perfusion scans in predicting pulmonary embolism recurrences...
October 25, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29027082/factors-associating-with-the-presence-of-residual-thrombosis-after-3-month-treatment-of-acute-pulmonary-embolism
#8
Jingluan Wang, Mingling Xu, Nina Sun, Zhaozhong Cheng, Jingjing Sui
The present study aimed to investigate the factors associating with the presence of residual thrombosis in patients with acute pulmonary embolism (APE) after at least 3-month anticoagulant therapy. Demographic and clinical data of 180 cases in the affiliated hospital of Qingdao University from January 2005 to June 2015 were retrospectively analyzed. APE in all patients were confirmed by computed tomography pulmonary angiography (CTPA). Patients were then detected for the presence of residual thrombosis according to a second CTPA...
October 12, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28925904/factors-associated-with-pulmonary-embolism-recurrence-and-the-benefits-of-long-term-anticoagulant-therapy
#9
Javier Anniccherico, Jose-Luis Alonso-Martinez, Mirem Urbieta, Jorge Rojo Alvaro, Ione Villar-Garcia
BACKGROUND: Venous thromboemboli tend to recur. However, the causative factors underlying pulmonary embolism recurrence are not well defined. AIMS: To explore the factors associated with pulmonary embolism recurrence. PATIENTS AND METHODS: Patients diagnosed with pulmonary emboli between 2004 and 2013 at our institution were enrolled. Duration of anticoagulant therapy, new episodes of venous thromboembolism, and deaths were recorded. RESULTS: Pulmonary embolism was diagnosed in 528 patients (median age: 76 years, interquartile range [IQR]: 16; male: 45%)...
September 18, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28853209/inferior-vena-cava-atresia-predisposing-to-acute-lower-extremity-deep-vein-thrombosis-in-children-a-descriptive-dual-center-study
#10
Cristina Tarango, Riten Kumar, Manish Patel, Anne Blackmore, Patrick Warren, Joseph S Palumbo
PURPOSE: Thrombosis in the healthy pediatric population is a rare occurrence. Little is known about the optimal treatment or outcomes of children with unprovoked acute lower extremity (LE) deep vein thrombosis (DVT) associated with atresia of the inferior vena cava (IVC). METHODS: We retrospectively analyzed the records of patients with acute LE DVT subsequently found to have IVC atresia who presented to two tertiary pediatric institutions between 2008 and 2016...
August 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28832905/effect-of-testing-for-cancer-on-cancer-and-venous-thromboembolism-vte-related-mortality-and-morbidity-in-people-with-unprovoked-vte
#11
REVIEW
Lindsay Robertson, Su Ern Yeoh, Gerard Stansby, Roshan Agarwal
BACKGROUND: Venous thromboembolism (VTE) is a collective term for two conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). A proportion of people with VTE have no underlying or immediately predisposing risk factors and the VTE is referred to as unprovoked. Unprovoked VTE can often be the first clinical manifestation of an underlying malignancy. This has raised the question of whether people with an unprovoked VTE should be investigated for an underlying cancer. Treatment for VTE is different in cancer and non-cancer patients and a correct diagnosis would ensure that people received the optimal treatment for VTE to prevent recurrence and further morbidity...
August 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28780342/e-selectin-and-sicam-1-biomarkers-of-endothelial-function-predict-recurrence-of-venous-thromboembolism
#12
Olga Dzikowska-Diduch, Justyna Domienik-Karłowicz, Elżbieta Górska, Urszula Demkow, Piotr Pruszczyk, Maciej Kostrubiec
BACKGROUND: Risk factors for atherosclerosis and venous thromboembolism (VTE) overlap and are mostly associated with endothelial dysfunction (ED). We hypothesized that ED is present in patients after the first episode of acute pulmonary embolism (APE) and predicts the risk of VTE recurrence. DESIGN AND METHODS: Patients, at least 6months after the first episode of symptomatic, confirmed APE were included in this case-control study. The exclusion criteria were risk factors for cardiovascular diseases and other conditions associated with endothelial dysfunction...
July 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28756076/-anticoagulation-after-an-acute-pulmonary-embolism
#13
Raphael Le Mao, Cécile Tromeur, Francis Couturaud
In order to determine the optimal duration of anticoagulation after an acute pulmonary embolism, the benefit risk balance needs to be analysed based on the risk of recurrent venous thromboembolism in the absence of anticoagulation and the risk of bleeding while on anticoagulant therapy. Such evaluation take in account the frequency and the severity of the risks; clinical variables appear more informative to predict recurrent venous thromboembolism than biochemical or morphological variables. Three major results are now available: (1) the minimal duration of anticoagulation for pulmonary embolism is 3 months; (2) after pulmonary embolism that was provoked by a major transient risk factor, the risk of recurrence is low and does not justify to prolong anticoagulation beyond 6 months; and (3), in patients with an unprovoked pulmonary embolism (high risk of recurrence), the prolongation of anticoagulation up to 1 or 2 years as compared to 3 or 6 months is not associated with a long term reduction in the risk of recurrence and, consequently, these patients should be treated either during 3 to 6 months or indefinitely...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#14
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28680172/direct-oral-anticoagulants-and-vitamin-k-antagonists-for-treatment-of-deep-venous-thrombosis-and-pulmonary-embolism-in-the-outpatient-setting-comparative-economic-evaluation
#15
Abdullah S Al Saleh, Patrick Berrigan, David Anderson, Sudeep Shivakumar
BACKGROUND: To date, there have been few economic evaluations, from a Canadian perspective, of direct oral anticoagulants (DOACs) for the prevention of recurrent venous thromboembolism (VTE) in patients with acute unprovoked VTE. As a result, there is a lack of consensus about which treatment strategy should be adopted in the clinical setting. OBJECTIVES: To assess the cost-effectiveness of currently approved anti-coagulant options, in terms of cost per quality-adjusted life-year (QALY) gained, for the prevention of recurrent VTE in patients with unprovoked events managed on an outpatient basis...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#16
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28546279/impact-of-residual-pulmonary-obstruction-on-the-long-term-outcome-of-patients-with-pulmonary-embolism
#17
Raffaele Pesavento, Lucia Filippi, Antonio Palla, Adriana Visonà, Carlo Bova, Marco Marzolo, Fernando Porro, Sabina Villalta, Maurizio Ciammaichella, Eugenio Bucherini, Giovanni Nante, Sandra Battistelli, Maria Lorenza Muiesan, Giampietro Beltramello, Domenico Prisco, Franco Casazza, Walter Ageno, Gualtiero Palareti, Roberto Quintavalla, Simonetta Monti, Nicola Mumoli, Nello Zanatta, Roberto Cappelli, Marco Cattaneo, Valentino Moretti, Francesco Corà, Mario Bazzan, Angelo Ghirarduzzi, Anna Chiara Frigo, Massimo Miniati, Paolo Prandoni
The impact of residual pulmonary obstruction on the outcome of patients with pulmonary embolism is uncertain.We recruited 647 consecutive symptomatic patients with a first episode of pulmonary embolism, with or without concomitant deep venous thrombosis. They received conventional anticoagulation, were assessed for residual pulmonary obstruction through perfusion lung scanning after 6 months and then were followed up for up to 3 years. Recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension were assessed according to widely accepted criteria...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28522384/usefulness-of-d-dimer-testing-in-predicting-recurrence-in-elderly-patients-with-unprovoked-venous-thromboembolism
#18
MULTICENTER STUDY
Tobias Tritschler, Andreas Limacher, Marie Méan, Nicolas Rodondi, Drahomir Aujesky
BACKGROUND: Whether post-anticoagulation D-dimer levels are useful in predicting recurrence in elderly patients with unprovoked venous thromboembolism is unknown. METHODS: We followed up 157 patients aged ≥65 years with acute symptomatic, unprovoked venous thromboembolism in a prospective, multicenter cohort study. All patients completed 3-12 months of anticoagulation and then underwent quantitative D-dimer testing (enzyme-linked immunosorbent assay) 12 months after the index venous thromboembolism...
October 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28469497/performing-anticoagulation-a-puzzling-case-of-cholesterol-embolization-syndrome
#19
Yusuke Igarashi, Tetsu Akimoto, Takahisa Kobayashi, Yoshitaka Iwazu, Takuya Miki, Naoko Otani-Takei, Toshimi Imai, Taro Sugase, Takahiro Masuda, Shin-Ichi Takeda, Shigeaki Muto, Daisuke Nagata
The avoidance of any form of anticoagulation is advised in cases of cholesterol embolization syndrome (CES). We herein describe a case of CES in a man with a history of unprovoked pulmonary embolism for which warfarinization was performed. Despite anecdotal reports of successful anticoagulation in CES patients with certain indications, irreversible renal failure, which was sufficiently severe to require chronic hemodialysis, eventually developed in our patient. Our results emphasize the pitfalls of this procedure, which imply its limited feasibility and safety...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28447414/review-of-d-dimer-testing-good-bad-and-ugly
#20
REVIEW
L-A Linkins, S Takach Lapner
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays...
May 2017: International Journal of Laboratory Hematology
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