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https://www.readbyqxmd.com/read/28733124/left-upper-lung-lobectomy-is-an-embolic-risk-factor-for-cerebral-infarction
#1
Yuya Kobayashi, Hiroyuki Yahikozawa, Ryota Takamatsu, Rie Watanabe, Kenichi Hoshi, Wataru Ishii, Shunichi Sato
Cerebral embolism is typically caused by a cardiogenic thrombus. The patent foramen ovale is a well-known cause of paradoxical embolism. However, some idiopathic cases of stroke have been reported. Such strokes are designated as embolic stroke of undetermined sources. Among them, lung lobectomy may be a new embolic risk factor for cerebral embolism. The risk of thrombus formation is high at the pulmonary vein stump after lung lobectomy, especially in the left upper lobe. Interestingly, the risk remains several years after surgery...
July 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28726017/retrosternal-reconstruction-can-be-a-risk-factor-for-upper-extremity-deep-vein-thrombosis-after-esophagectomy
#2
Takamasa Takahashi, Masahide Fukaya, Kazushi Miyata, Yayoi Sakatoku, Masato Nagino
BACKGROUND: Upper extremity deep vein thrombosis (UEDVT) is a rare but important complication because it can cause pulmonary embolism. The aim of this study was to investigate the incidence of UEDVT after esophagectomy and the risk factors related to UEDVT. METHODS: This study included 88 patients who underwent esophagectomy with retrosternal or posterior mediastinal reconstruction using gastric tube. The incidence of UEDVT and the diameter of left brachiocephalic vein were measured using postoperative contrast-enhanced computed tomography (CT)...
July 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28723742/liver-transplantation-using-the-otherwise-discarded-partial-liver-resection-graft-with-hepatic-benign-tumor-analysis-of-a-preliminary-experience-on-15-consecutive-cases
#3
Guoqiang Li, Xiaoxin Mu, Xinli Huang, Xiaofeng Qian, Jianjie Qin, Zhongming Tan, Wenjie Zhang, Xiaoliang Xu, Shanbai Tan, Zhijun Zhu, Wei Li, Xuan Wang, Xuehao Wang, Beicheng Sun
RATIONALE: The shortage of available donor organs limits the development of liver transplantation. This case-serial study presents a novel way to expand the donor pool by using the other-wise discarded partial liver resection graft with hepatic benign tumor. PATIENT CONCERNS: From 2012 to 2016, 15 patients with hepatic lesions were admitted to our hospital. 12 patients suffered from right epigastric discomfort and 3 patients worried about uncertain diagnosis. INTERVENTIONS: Regular hepatic lobectomy was performed for all patients and after back-table management the resected partial liver grafts were used for patients with end-stage liver disease for liver transplantation...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721321/correlation-of-ventilation-perfusion-v-q-scan-results-as-compared-with-clinical-probability-of-pulmonary-embolism-in-african-american-population
#4
Fasil Tiruneh, Ahmad Awan, Nicole Hunt, Nahom Tegegn, Daniel Larbi
Introduction Current guidelines suggest the use of the more specific Wells' score could safely reduce the number of unnecessary scans. There is a lack of research to support whether these guidelines apply to the African American population. This study aims to evaluate the correlation of clinical pretest probability of pulmonary embolism (PE) with ventilation-perfusion (V/Q) scan results in a predominantly African American population and to test whether current guidelines based on studies conducted in other populations hold true in this group...
June 14, 2017: Curēus
https://www.readbyqxmd.com/read/28720746/-a-rare-case-of-ruptured-internal-carotid-posterior-communicating-artery-aneurysm-associated-with-contralateral-delayed-oculomotor-nerve-palsy
#5
Chika Somagawa, Yutaka Fukuda, Shota Yoshimura, Kei Satoh, Takeshi Hiu, Tomonori Ono, Ryujirou Ushijima, Keisuke Toda, Keisuke Tsutsumi
A 55-year-old man presented with difficulty breathing, chest pain, and disturbance of consciousness, and was transferred to our hospital. Initial whole body CT revealed a diffuse subarachnoid hemorrhage(SAH)with severe pulmonary edema that was considered neurogenic in origin. He received controlled ventilation under sedation and conservative care for the SAH. One day after the onset of the SAH, his left pupil suddenly became dilated to 6mm, with no reaction to light. Head CT showed no new bleeding. Subsequent CT angiogram revealed a right internal carotid-posterior communicating artery aneurysm(IC-PC AN)with a posterior-lateral projection; however, no vessel abnormality was observed in the left anterior or posterior circulations...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28708723/preliminary-results-can-dual-energy-computed-tomography-help-distinguish-cardiogenic-pulmonary-edema-and-acute-interstitial-lung-disease
#6
Hitoshi Takeuchi, Shigeru Suzuki, Haruhiko Machida, Takuya Ishikawa, Eiko Ueno
OBJECTIVE: We compared iodine concentration in pulmonary ground-glass opacity on iodine density images of contrast-enhanced chest dual-energy computed tomography (DECT) between patients with cardiogenic pulmonary edema (CPE) and acute interstitial lung disease (AILD). METHODS: Five of 12 patients who underwent contrast-enhanced chest DECT to exclude pulmonary embolism were clinically diagnosed with CPE and 7, with AILD. We compared the mean CT value on monochromatic images at 65 keV and iodine concentration on iodine density images between the affected and normal areas...
July 13, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28708470/safety-and-efficacy-of-an-absorbable-filter-in-the-inferior-vena-cava-to-prevent-pulmonary-embolism-in-swine
#7
Steven Y Huang, Mitchell Eggers, Mark J McArthur, Katherine A Dixon, Amanda McWatters, Stephen Dria, Lori R Hill, Marites P Melancon, Joseph R Steele, Michael J Wallace
Purpose To evaluate the immediate and long-term safety as well as thrombus-capturing efficacy for 5 weeks after implantation of an absorbable inferior vena cava (IVC) filter in a swine model. Materials and Methods This study was approved by the institutional animal care and use committee. Eleven absorbable IVC filters made from polydioxanone suture were deployed via a catheter in the IVC of 11 swine. Filters remained in situ for 2 weeks (n = 2), 5 weeks (n = 2), 12 weeks (n = 2), 24 weeks (n = 2), and 32 weeks (n = 3)...
July 14, 2017: Radiology
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#8
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28705345/-multiple-abdominal-venous-aneurysms-revealed-by-pulmonary-embolism
#9
N Saddoud, B Gmiha, I Bouktif, I Jebali, F Boussema, M H Daghfous
Venous aneurysms are rare lesions, they have been reported in most venous territories. Abdominal location is unusual. A 61-year-old man presented with chest pain and dyspnea attributed to pulmonary embolism. Computed tomography of the abdomen showed multiple thrombosed venous aneurysms of the left external iliac vein and the inferior vena cava. There were no signs of rupture. The patient received anticoagulant treatment. He had no surgical treatment.
July 2017: J Med Vasc
https://www.readbyqxmd.com/read/28700484/cardiac-metastasis-of-tongue-squamous-cell-carcinoma-complicated-by-pulmonary-embolism-a-case-report
#10
Sonaz Malekzadeh, Alexandra Platon, Pierre-Alexandre Poletti
RATIONALE: Cardiac metastasis is known as a rare complication of head and neck malignancy. PATIENT CONCERNS: We present a 58-year-old woman patient with a history of tongue carcinoma who was admitted in emergency department for sudden chest pain. Imaging work-up by computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) diagnosed a cardiac metastasis complicated by intraventricular thrombus and pulmonary embolism. DIAGNOSIS: Cardiac metastasis from tongue carcinoma complicated by pulmonary embolism...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700164/-the-evolution-of-imaging-techniques-for-the-diagnosis-of-pulmonary
#11
Helia Robert-Ebadi, Frédéric Glauser, Sara Manzocchi Besson, Marc Blondon, Fatima Mahhou-Sennouni, Marc Righini
Modern diagnostic strategies for pulmonary embolism (PE) rely on the sequential use of clinical probability assessment, D-dimer and thoracic imaging when necessary. Computed tomography pulmonary angiography (CTPA) has become the imaging modality of choice. Diagnostic strategies using CTPA are very safe for the diagnosis of PE and have been well validated in large prospective management outcome studies. With the widespread use of CTPA, concerns regarding radiation and overdiagnosis of PE have paved the way for investigating new diagnostic modalities...
December 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28698421/-tricuspid-valve-repair-in-a-patient-with-isolated-tricuspid-valve-infective-endocarditis-with-pulmonary-embolism-report-of-a-case
#12
Hiroyuki Hara, Kenji Minakata, Kazuhisa Sakamoto, Yuki Kuroda, Toshio Harada, Taro Nakatsu, Tomohiro Nakata, Kyokun Uehara, Kazuhiro Yamasaki, Tadashi Ikeda
We report a case of 39-year-old man who developed tricuspid valve infective endocarditis with a complication of pulmonary embolism. He was transferred to our institution because of intermittent fever and enlargement of the vegetation of the tricuspid valve in spite of optimal antibiotics treatment. Computed tomography revealed pulmonary embolism, and transesophageal echocardiography showed a large and mobile vegetation (22×10 mm) on the tricuspid valve with moderate regurgitation. In addition, Streptococcus agalactiae was identified in blood cultures...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698417/-intravenous-ablation-for-lower-extremity-varices-to-prevent-recurrent-pulmonary-embolism-in-klippel-trenaunay-syndrome-report-of-a-case
#13
Ikutaro Kigawa, Masahiro Aiba, Atsushi Ito
Klippel-Trenaunay syndrome( KTS) is a complex congenital anomaly characterized by lower extremity varix and venous malformations, port-wine stains, and soft tissue and bone hypertrophy. We present a case of a 35-year-old man of KTS with pulmonary embolism (PE). The patient was referred to our hospital complaining of the leg pain and sudden onset of dyspnea. Enhanced computed tomography (CT) showed lower extremity varices, superficial thrombophlebitis and bilateral pulmonary thrombi. No venous malformations except for varicose veins were revealed in the limbs or pelvis...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28695478/the-prognostic-impact-of-additional-intrathoracic-findings-in-patients-with-cancer-related-pulmonary-embolism
#14
P Jiménez-Fonseca, A Carmona-Bayonas, C Font, J Plasencia-Martínez, D Calvo-Temprano, R Otero, C Beato, M Biosca, M Sánchez, M Benegas, D Varona, L Faez, M Antonio, I de la Haba, O Madridano, M P Solis, A Ramchandani, E Castañón, P J Marchena, M Martín, F Ayala de la Peña, V Vicente
AIM: To assess the prevalence and prognostic significance of additional intrathoracic findings (AIFs) in patients with cancer and pulmonary embolism (PE). AIFs were considered alterations other than the characteristic ones intrinsic to PE or changes in cardiovascular morphology. METHODS: Subjects have been taken from a Spanish national multidisciplinary and multicenter study of PE and cancer who were treated between 2004 and 2015. The endpoint was the appearance of serious complications or death within 15 days...
July 10, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28683951/diagnosis-and-exclusion-of-pulmonary-embolism
#15
Jeffrey A Kline
BACKGROUND: Failure to test for pulmonary embolism (PE) can be a lethal mistake, but PE and produces symptoms similar to many other diseases. Overtesting for PE has negative consequences. OBJECTIVES: Use published evidence to create a rationale and safe diagnostic approach for ambulatory and emergency patients with suspected PE in 2017. FINDINGS: Pulmonary embolism need not be pursued in patients with no symptoms of PE in the present or recent history (dyspnea, chest pain, cough or syncope), and always normal vital signs...
June 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28679334/syncope-in-a-patient-with-minimal-change-disease-without-nephrotic-range-proteinuria
#16
Wen-Fang Chiang, Jenq-Shyong Chan, Pauling Chu, Chia-Chao Wu
Introduction Pulmonary embolism is a potentially life-threatening complication of nephrotic syndrome. Syncope is rarely reported as an initial presentation of pulmonary embolism in nephrotic patients. Case presentation We describe a 35-year-old man who was taking steroids and diuretics for relapse of minimal change disease who presented after a syncopal event. The patient was hypotensive and had distended neck veins. The major laboratory findings were hypoalbuminemia with mild proteinuria. The findings on electrocardiography, chest radiography, and echocardiography and the elevated plasma D-dimer level raised suspicion of pulmonary embolism...
May 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28677845/detection-of-peripheral-embolic-consolidations-using-contrast-enhanced-ultrasonography-in-patients-with-no-evidence-of-pulmonary-embolism-on-computed-tomography-a-pilot-study
#17
C Trenker, J C Apitzsch, S Pastor, S Bartelt, A Neesse, C Goerg
AIM: To investigate the value of B-mode imaging and contrast-enhanced ultrasonography (CEUS) in patients with clinically suspected pulmonary embolism (PE) but no evidence of central PE on CT. METHODS: Between May 2004 and February 2015, we included in this retrospective study 19 patients with a risk profile for PE according to their Wells' score, sonographic patterns of peripheral embolic consolidations (EC) on B-mode-imaging and CEUS (ie, missing or inhomogeneous enhancement of the pleural lesions), and exclusion of central PE by CT within 1 week of CEUS...
July 5, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#18
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28673674/is-ct-angiography-of-the-pulmonary-arteries-indicated-in-patients-with-high-clinical-probability-of-pulmonary-embolism
#19
L Martínez Montesinos, J M Plasencia Martínez, J M García Santos
When a diagnostic test confirms clinical suspicion, the indicated treatment can be administered. A problem arises when the diagnostic test does not confirm the initially suspected diagnosis; when the suspicion is grounded in clinically validated predictive rules and is high, the problem is even worse. This situation arises in up to 40% of patients with high suspicion for acute pulmonary embolism, raising the question of whether CT angiography of the pulmonary arteries should be done systematically. This paper reviews the literature about this issue and lays out the best evidence about the relevant recommendations for patients with high clinical suspicion of acute pulmonary embolism and negative findings on CT angiography...
June 30, 2017: Radiología
https://www.readbyqxmd.com/read/28673474/new-developments-and-future-challenges-of-nuclear-medicine-and-molecular-imaging-for-pulmonary-embolism
#20
Pierre-Yves Le Roux, Philippe Robin, Pierre-Yves Salaun
Although widely validated, current tests for pulmonary embolism (PE) diagnosis, i.e. computed tomography pulmonary angiography (CTPA) and V/Q planar scintigraphy, have some limitations. Drawbacks of CTPA include the radiation dose, some contra indications and a rising concern about a possible overdiagnosis/overtreatment of PE. On the other hand, V/Q planar scintigraphy has a high rate of non-diagnostic tests responsible for complex diagnostic algorithms. Since the PIOPED study, imaging equipment and radiopharmaceuticals have greatly evolved allowing the introduction of techniques that improve imaging of lung ventilation and perfusion...
June 27, 2017: Thrombosis Research
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