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https://www.readbyqxmd.com/read/29457113/pulmonary-embolism-caused-by-ovarian-vein-thrombosis-during-cesarean-section-a-case-report
#1
Yutaka Oda, Michie Fujita, Chika Motohisa, Shinichi Nakata, Motoko Shimada, Ryushi Komatsu
Background: Ovarian vein thrombosis is a rare complication of pregnancy. The representative complaints of patients with ovarian vein thrombosis are abdominal pain and fever. In some cases, however, fatal pulmonary embolism may develop. We report a case of pulmonary embolism presenting with severe hypotension and loss of consciousness during cesarean section possibly caused by ovarian vein thrombosis. Case presentation: A 25-year-old woman at 38 weeks 4 days of gestation was scheduled for repeat cesarean section...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29451506/-ten-questions-on-the-management-of-patients-with-acute-pulmonary-embolism
#2
Cecilia Becattini, Cristian Mattei, Giancarlo Agnelli
Clinical management of acute pulmonary embolism has changed over the years based on new evidence on diagnosis, prognostic stratification and treatment. The increasing availability of computed tomography angiography has made the diagnosis faster and accurate, although with some concern on radiation exposure and potential for overdiagnosis. The efficacy and safety of simple-to-use oral anticoagulant agents acting as selective direct inhibitors of coagulation certainly offer considerable benefits to the patients...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29446668/improved-opacification-of-a-suboptimally-enhanced-pulmonary-artery-in-chest-ct-experience-using-a-dual-layer-detector-spectral-ct
#3
Kyungsoo Bae, Kyung Nyeo Jeon, Soo Buem Cho, Sung Eun Park, Jin Il Moon, Hye Jin Baek, Bo Hwa Choi
OBJECTIVE: The objective of our study was to evaluate the quality of virtual monoenergetic imaging (VMI) from dual-layer detector spectral CT and the effect of virtual monoenergetic images obtained at low energies on the detection of pulmonary embolism (PE) in patients with a suboptimally enhanced pulmonary artery on chest CT. MATERIALS AND METHODS: Of 1552 consecutive chest CT examinations performed with dual-layer detector spectral CT using a routine protocol with a tube voltage of 120 kVp, 79 examinations with suboptimal enhancement of the pulmonary artery (i...
February 15, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29442347/f-18-fdg-pet-ct-in-pulmonary-artery-sarcoma-clinical-vignette
#4
Stjepan Hmelik, Margareta Dobrenić, Dražen Huić
Pulmonary artery sarcomas (PAS's) are extremely rare malignant tumors that arise from the endothelial lining of the pulmonary arteries. On CT scans PAS's appear as intraluminal filling defects in the pulmonary arteries, mimicking pulmonary embolism (PE). Due to the similarities in radiographic features as well as in clinical presentation, PAS's are usually misdiagnosed as pulmonary embolism. Since PASs are F-18 FDG avid, F-18 FDG PET/CT scan is a useful imaging tool for differentiating between these two conditions, as shown in this case report...
2018: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/29441158/computed-tomography-pulmonary-angiography-is-overused-to-diagnose-pulmonary-embolism-in-the-emergency-department-of-academic-community-hospital
#5
Mohammed Osman, Suresh Kumar Subedi, Azza Ahmed, Jahangir Khan, Thair Dawood, Carlos F Ríos-Bedoya, Ghassan Bachuwa
Background : Pulmonary embolism (PE) is a common disease in the USA responsible for up to 10% of hospital mortality. Modified wells score (MWS) and D-dimer assay are used to categorize patients into high or low probability of PE. Patient with high probability need Computed tomography pulmonary angiography (CTPA), while patients with low probability and low D-dimer can safely forgo the CTPA. Objectives: The aim of this study was to investigate the rate of inappropriate CTPA use in the emergency department of a community teaching hospital...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29438139/optimizing-pulmonary-embolism-computed-tomography-in-the-age-of-individualized-medicine-a-prospective-clinical-study
#6
Babs M F Hendriks, Nienke G Eijsvoogel, Madeleine Kok, Bibi Martens, Joachim E Wildberger, Marco Das
PURPOSE: The aim of the study was to simultaneously optimize contrast media (CM) injection and scan parameters for the individual patient during computed tomography pulmonary angiography (CTPA). METHODS: In this study (NCT02611115), 235 consecutive patients suspected of having pulmonary embolism were prospectively enrolled. Automated kV selection software on a third-generation multidetector computed tomography adapted tube voltage to the individual patient, based on scout scans...
February 12, 2018: Investigative Radiology
https://www.readbyqxmd.com/read/29437738/an-unusual-presentation-of-pulmonary-embolism-leading-to-infarction-cavitation-abscess-formation-and-bronchopleural-fistulation
#7
Eva Teng, Luke Bennett, Tommaso Morelli, Anindo Banerjee
We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Serial chest x-rays showed progression from lobar consolidation to a large loculated left-sided pleural collection. CT chest showed left-sided lung abscess, empyema and bronchopleural fistulation...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436310/ultrasound-assisted-catheter-directed-thrombolysis-for-submassive-pulmonary-embolism
#8
Prasoon P Mohan, John J Manov, Francisco Contreras, Michael E Langston, Mehul H Doshi, Govindarajan Narayanan
PURPOSE: Catheter-directed thrombolysis (CDT) is a relatively new therapy for pulmonary embolism that achieves the superior clot resolution compared to systemic thrombolysis while avoiding the high bleeding risk intrinsically associated with that therapy. In order to examine the efficacy and safety of CDT, we conducted a retrospective cohort study of patients undergoing ultrasound-assisted CDT at our institution. METHODS: The charts of 30 consecutive patients who underwent CDT as a treatment of pulmonary embolism at our institution were reviewed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29435465/missed-massive-pulmonary-embolism-and-the-hidden-threat-of-a-distal-deep-vein-thrombosis
#9
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29431911/the-years-algorithm-for-suspected-pulmonary-embolism-shorter-visit-time-and-reduced-costs-at-the-emergency-department
#10
L M van der Pol, C E A Dronkers, T van der Hulle, P L den Exter, C Tromeur, C Heringhaus, A T A Mairuhu, M V Huisman, W B van den Hout, F A Klok
BACKGROUND: Recently, the safety of the YEARS algorithm, designed to simplify the diagnostic work-up of pulmonary embolism (PE), was demonstrated. We hypothesize that by design, YEARS would be associated with a shorter diagnostic emergency department (ED) visit time due to simultaneous assessment of pre-test probability and D-dimer level and reduction in CT-scans. AIM: To investigate whether implementation of the YEARS diagnostic algorithm is associated with a shorter ED visit time compared to the conventional algorithm and to evaluate the associated cost savings...
February 12, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29429141/utility-of-second-generation-single-energy-metal-artifact-reduction-in-helical-lung-computed-tomography-for-patients-with-pulmonary-arteriovenous-malformation-after-coil-embolization
#11
Yudai Asano, Akihiro Tada, Takayoshi Shinya, Yoshihisa Masaoka, Toshihiro Iguchi, Shuhei Sato, Susumu Kanazawa
PURPOSE: The quality of images acquired using single-energy metal artifact reduction (SEMAR) on helical lung computed tomography (CT) in patients with pulmonary arteriovenous malformation (PAVM) after coil embolization was retrospectively evaluated. MATERIALS AND METHODS: CT images were reconstructed with and without SEMAR. Twenty-seven lesions [20 patients (2 males, 18 females), mean age 61.2 ± 11.0 years; number of embolization coils, 9.8 ± 5.0] on contrast-enhanced CT and 18 lesions of non-enhanced lung CT concurrently performed were evaluated...
February 10, 2018: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29427478/from-ruling-out-to-ruling-in-putting-pocus-in-focus
#12
Arjun K Venkatesh, Charles D Scales, Marta E Heilbrun
Over the past twenty years, the Emergency Department (ED) has transformed from a location that managed patients with acute life-threatening illness or injury to an acute diagnostic center. The advent of rapid and accurate imaging, novel biomarkers, and other innovations concurrent with effects from financial and social forces has supported the development of an acute care system focused on "ruling out" low-frequency, high-mortality events such as acute myocardial infarction, stroke, pulmonary embolism, and aortic dissection...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29426964/incidental-pulmonary-embolism-in-suspected-stroke-patients-undergoing-carotid-ct-angiography
#13
Guang-Liang Chen, Dong-Hui Shen, Jin Wei, Hua Wang, Yuan-Fen Liu, Qing Duan
PURPOSE: The purpose of this study was to investigate the prevalence of incidental pulmonary embolism (IPE) in suspected stroke patients receiving carotid computed tomography angiography (CTA) and its characteristics. MATERIALS AND METHODS: A total of 4873 cases receiving carotid CTA between January 2013 and December 2016 were retrospectively reassessed by one radiologist. Patients with previous or suspected PE were excluded. The remaining prior contrast-enhanced carotid CTA studies were regarded as a "potentially incidental" IPE when a filling defect was found in one or more pulmonary arteries and subjected to the other two thoracic radiologists independently for reviewing and assessing for characteristics of the IPE and the image quality of the PE...
February 9, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29419477/imaging-for-pulmonary-embolism-in-sickle-cell-disease-a-17-year-experience
#14
Patrick Tivnan, Henny H Billett, Leonard M Freeman, Linda B Haramati
Sickle cell disease, a complex disorder with known pulmonary complications, has the potential to confound the diagnosis of pulmonary embolism. We hypothesized that when the choice of imaging is guided by chest radiographic results, CT pulmonary angiography (CTPA) and Ventilation-Perfusion (V/Q) scintigraphy have comparable diagnostic performance in sickle cell disease. Methods: A retrospective cohort of adults with sickle cell disease who were imaged for suspected pulmonary embolism with either CTPA or V/Q, from 2000-2016, at our institution, was established...
February 1, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29417409/a-new-method-of-ct-for-the-cardiac-measurement-correlation-of-computed-tomography-measured-cardiac-parameters-and-pulmonary-obstruction-index-to-assess-cardiac-morphological-changes-in-acute-pulmonary-embolism-patients
#15
Zhi-Jun Guo, Hai-Tao Liu, Ze-Mei Bai, Qiang Lin, Bao-Hong Zhao, Qian Xu, Yan-Hong Zeng, Wen-Qiu Feng, Hai-Tao Zhou, Fei Liang, Ji-Yan Cui
Acute pulmonary embolism (APE) is a serious disease which is life-threatening. Since it is crucial for APE patients to assess the changes of cardiac function safely and timely, the imaging research of cardiac morphology and function is becoming more and more important. The correlation of computed tomography (CT) measured cardiac parameters and pulmonary obstruction index (POI) was analyzed to discuss the morphological changes of the heart of APE patients in order to provide a new method to evaluate cardiac functions accurately and effectively...
February 7, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29415937/-portal-vein-thrombosis-associated-with-idiopathic-hypereosinophilic-syndrome
#16
Satoshi Kaito, Sakiko Harada, Masao Tsukada, Akira Kojima, Kanichi Iwama, Kazunari Yamada, Kouichi Kajiwara, Kentaro Morikawa, Keiki Shimizu, Yasuji Kozai, Hideki Koudo
A 35-year-old man who previously underwent splenectomy for hereditary spherocytosis at age 29 visited our hospital complaining of fatigue that had started 7 days ago and right upper abdominal pain. Laboratory data showed increased white blood cell and eosinophil count accompanied by severe transaminitis and clotting abnormalities. Computed tomography scan showed multiple embolisms in the portal vein, superior mesenteric vein, right pulmonary artery, and inferior vena cava. Severe liver damage presumably caused by portal vein thrombosis was also observed...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29411239/venous-phase-contrast-enhanced-computed-tomography-facilitates-the-detection-of-pulmonary-venous-tumor-thrombus
#17
Kenta Nakahashi, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Akira Hamada, Takayuki Sasage, Mitsuaki Sadahiro
A 64-year-old woman, with a history of hepatocellular carcinoma, developed recurrent metastatic lung nodules after lung metastasectomy 10 years ago. Computed tomography (CT) revealed tumors in the right middle, and left lower lobes. We planned a right middle lobectomy. Before operating, a contrast-enhanced CT in the pulmonary venous phase revealed a tumor in the pulmonary vein resembling a thrombus, indicating that the CT failed to facilitate accurate diagnosis. Following venous clamping and incision, the intravenous polypoid mass was surgically removed...
February 6, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29404367/paradoxical-emboli-following-a-pulmonary-embolus-in-the-presence-of-a-patent-foramen-ovale
#18
Khalid Najib, Mark Heckle, Sameh Goubran, Rhadika Mehta, Rohan Goswami, Rami N Khouzam
A paradoxical embolism is defined as a systemic arterial embolus due to passage of a venous thrombus through a right to left shunt. We describe a case of acute cerebral vascular accident (CVA), right subclavian arterial embolus, and pulmonary emboli in the setting of a large patent foramen ovale (PFO). A 74-year-old woman with multiple comorbidities presented to the emergency department with acute onset of shortness of breath, weakness, and right arm pain. She was found to have bilateral pulmonary emboli, left CVA, and a right subclavian arterial embolus on computed tomography (CT)...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29404166/does-the-incidence-and-mortality-of-pulmonary-thromboembolism-change-over-the-years
#19
Savaş Sedat Özsu, Zerrin Gürel Durmuş, Mustafa Buğra Coşkuner, Yılmaz Bülbül, Funda Öztuna, Tevfik Özlü
OBJECTIVES: In the last 20 years, with the use of computed tomography (CT) angiography, the number of patients diagnosed with pulmonary thromboembolism (PTE) has increased. At the same time, data show that pulmonary embolism mortality has also reduced in this duration. MATERIAL AND METHODS: In this study, we analyzed records of patients with PTE (using ICD's) in the hospital automation system from 2001 to 2013. Data regarding age, sex, date of diagnosis, diagnosis of cancer, hemodynamic status, initial and maintenance treatment, hospital length of stay, and hospital mortality were recorded...
July 2017: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29399516/below-knee-deep-vein-thrombosis-dvt-diagnostic-and-treatment-patterns
#20
Drew Fleck, Hassan Albadawi, Alex Wallace, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Background: Guidelines are lacking for isolated below-knee deep vein thrombosis (BKDVT). The American College of Chest Physicians (ACCP) suggests anticoagulation only if symptoms are severe, otherwise surveillance with follow-up ultrasound in 2 weeks is recommended. Yet clinical practice remains highly variable. Little is known about the natural history of BKDVT and how to best manage these patients. Methods: A retrospective analysis was conducted of medical records from 2014-2016...
December 2017: Cardiovascular Diagnosis and Therapy
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