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https://www.readbyqxmd.com/read/29758206/peripheral-distribution-of-thrombus-does-not-affect-outcomes-after-surgical-pulmonary-embolectomy-commentary
#1
Eric J Lehr, Juan Nicolas Pulido
No abstract text is available yet for this article.
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29739630/extracorporeal-life-support-as-salvage-therapy-for-massive-pulmonary-embolus-and-cardiac-arrest-in-pregnancy
#2
Michael E Takacs, Kristina E Damisch
BACKGROUND: Massive pulmonary embolus (PE) with prolonged cardiac arrest in the setting of pregnancy has few treatment options. Selections are further restricted if there are contraindications to the standard therapies of embolectomy and thrombolysis. We report a case of extracorporeal life support (ECLS) used as salvage therapy for a critically ill pregnant patient. CASE REPORT: A 21-year-old woman presented to a small rural hospital with chest pain, dyspnea, hypoxia, and syncope...
May 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29730125/triage-and-optimization-a-new-paradigm-in-the-treatment-of-massive-pulmonary-embolism
#3
Chetan Pasrija, Aakash Shah, Praveen George, Anthony Kronfli, Maxwell Raithel, Francesca Boulos, Mehrdad Ghoreishi, Gregory J Bittle, Michael A Mazzeffi, Lewis Rubinson, James S Gammie, Bartley P Griffith, Zachary N Kon
BACKGROUND: Massive pulmonary embolism (PE) remains a highly fatal condition. Although venoarterial extracorporeal membrane oxygenation (VA-ECMO) and surgical pulmonary embolectomy in the management of massive PE have been reported previously, the outcomes remain less than ideal. We hypothesized that the institution of a protocolized approach of triage and optimization using VA-ECMO would result in improved outcomes compared with historical surgical management. METHODS: All patients with a massive PE referred to the cardiac surgery service between 2010 and 2017 were retrospectively reviewed...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29708218/stroke-code-simulation-benefits-advanced-practice-providers-similar-to-neurology-residents
#4
Muhib Khan, Grayson L Baird, Theresa Price, Tricia Tubergen, Omran Kaskar, Michelle De Jesus, Joseph Zachariah, Adam Oostema, Raymond Scurek, Robert R Coleman, Wendy Sherman, Cynthia Hingtgen, Tamer Abdelhak, Brien Smith, Brian Silver
Background: Advanced practice providers (APPs) are important members of stroke teams. Stroke code simulations offer valuable experience in the evaluation and treatment of stroke patients without compromising patient care. We hypothesized that simulation training would increase APP confidence, comfort level, and preparedness in leading a stroke code similar to neurology residents. Methods: This is a prospective quasi-experimental, pretest/posttest study. Nine APPs and 9 neurology residents participated in 3 standardized simulated cases to determine need for IV thrombolysis, thrombectomy, and blood pressure management for intracerebral hemorrhage...
April 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29703832/complete-resolution-of-extensive-thrombosis-of-atheromatous-non-aneurysmal-descending-aorta-and-pulmonary-embolism-with-warfarin-therapy
#5
Shrikant D Pande, Steven Kum, Farah Safdar Husain, Vishaka Kerner
A 54-year-old man underwent decompressive craniectomy following a stroke. He further developed right lower limb ischaemia, and CT aortography revealed extensive aortic atherosclerotic disease. Urgent embolectomy prevented him from having a major amputation. He subsequently developed pulmonary embolism. This was initially treated with heparin followed by warfarin apart from antiplatelets and statin. A follow-up aortography at 3 months interval showed near complete resolution of atheromatous disease of the aorta...
April 27, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29659045/surgical-pulmonary-embolectomy-and-catheter-directed-thrombolysis-for-treatment-of-submassive-pulmonary-embolism
#6
Ahmed A Kolkailah, Sameer Hirji, Gregory Piazza, Julius I Ejiofor, Fernando Ramirez Del Val, Jiyae Lee, Siobhan McGurk, Sary F Aranki, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Acute pulmonary embolism (PE) with preserved hemodynamics but right ventricular dysfunction, classified as submassive PE, carries a high risk of mortality. We report the results for patients who did not qualify for medical therapy and required treatment of submassive PE with surgical pulmonary embolectomy and catheter-directed thrombolysis (CDT). METHODS: Between October 1999 and May 2015, 133 submassive PE patients underwent treatment with pulmonary embolectomy (71) and CDT (62)...
April 16, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29626452/peripheral-distribution-of-thrombus-does-not-affect-outcomes-after-surgical-pulmonary-embolectomy
#7
Chetan Pasrija, Aakash Shah, Praveen George, Isa Mohammed, Francis A Brigante, Mehrdad Ghoreishi, Jean Jeudy, Bradley S Taylor, James S Gammie, Bartley P Griffith, Zachary N Kon
BACKGROUND: Thrombus located distal to the main or primary pulmonary arteries has been previously viewed as a relative contraindication to surgical pulmonary embolectomy. We compared outcomes for surgical pulmonary embolectomy for submassive and massive pulmonary embolism (PE) in patients with central versus peripheral thrombus burden. METHODS: All consecutive patients (2011-2016) undergoing surgical pulmonary embolectomy at a single center were retrospectively reviewed...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29623727/myxoid-emboli
#8
Badr AbdullGaffar, Krysztof Waslewski
Emboli are common clinicopathologic findings. Recognition of the type of arterial emboli could be the first clue to the original source. Emboli with myxomatous changes are rare. Myxoma-like features in mural organizing thrombi have been reported. The most challenging differential diagnosis is between embolic cardiac myxomas and myxomatous thromboemboli. Emboli from sarcomas and arteriosclerotic plaques with myxoid features are also potential pitfalls. There is scarcity of studies focusing on myxoid emboli and their clinical and pathologic importance...
April 1, 2018: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29616915/refractory-hypoxemia-in-a-patient-with-submassive-pulmonary-embolism-and-an-intracardiac-shunt-a-case-report-and-review-of-the-literature
#9
REVIEW
Jean Liew, Janelle Stevens, Christopher Slatore
INTRODUCTION: Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt...
March 2, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#10
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29570428/intravascular-cooling-catheter-related-venous-thromboembolism-after-hypothermia-a-case-report-and-review-of-the-literature
#11
Xuan Wang, Brian T Moy, Brett J Hiendlmayr, Felix Krainski, W Lane Duvall, Antonio B Fernandez
Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase...
March 23, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29554859/unilateral-acute-renal-artery-embolism-an-index-case-of-successful-mechanical-aspiration-thrombectomy-with-use-of-penumbra-indigo-aspiration-system-and-a-review-of-the-literature
#12
Ali Yousif, Rajesh Samannan, Mazen Abu-Fadel
Acute renal artery embolism (RAE) is a rare condition associated with significant morbidity and mortality. The treatment strategy for RAE includes anticoagulation with or without thrombolysis or surgical or endovascular embolectomy. We describe here a case presentation of acute RAE secondary to atrial fibrillation treated successfully with Penumbra Indigo Aspiration System, a novel device in peripheral endovascular interventions. Our patient had ongoing symptoms and acute renal failure on presentation with contraindication to thrombolysis given hypertensive emergency...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29550600/embolectomy-through-the-aneurysm-wall-for-the-iatrogenic-occlusion-of-m1-portion-during-coil-embolization-technical-note-for-trans-aneurysmal-embolectomy
#13
Masanori Suzuki, Takayuki Mizunari, Naotaka Iwamoto, Akio Morita
No abstract text is available yet for this article.
March 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29541695/cardiac-tamponade-and-coronary-artery-pseudoaneurysm-after-brachial-arterial-embolectomy-possible-role-for-an-aberrant-origin-of-the-right-coronary-artery
#14
Irit Stessman-Lande, Ronza Salem, Chen Rubinstein, Nurith Hiller, Samuel N Heyman, Ronny Alcalai
A patient developed hemopericardium shortly after left brachial arterial embolectomy using an embolectomy catheter. Evaluation disclosed evolving pseudoaneurysm of the right coronary artery that was successfully managed by stenting. Misplacement of the embolectomy catheter within the coronary vessel was facilitated by an anomalous origin of the right coronary artery. This complication highlights the importance of correct insertion of the embolectomy catheter using the markers to avoid maladvancement and damage to central vessels...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29533946/apparent-diffusion-coefficient-signal-intensity-ratio-predicts-the-effect-of-revascularization-on-ischemic-cerebral-edema
#15
Matthew B Bevers, Thomas W K Battey, Ann-Christin Ostwaldt, Reza Jahan, Jeffrey L Saver, W Taylor Kimberly, Chelsea S Kidwell
BACKGROUND: Apparent diffusion coefficient (ADC) imaging is a biomarker of cytotoxic injury that predicts edema formation and outcome after ischemic stroke. It therefore has the potential to serve as a "tissue clock" to describe the extent of ischemic injury and potentially predict response to therapy. The goal of this study was to determine the relationship between baseline ADC signal intensity, revascularization, and edema formation. METHODS: We examined the ADC signal intensity ratio (ADCr) of the stroke lesion (defined as the baseline DWI hyperintense region) compared to the contralateral normal hemisphere in 65 subjects from the Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy trial...
March 13, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29529323/rapid-m1-hemoclips-arteriotomy-repair-after-emergency-coil-embolectomy
#16
Hassan Saad, Khaled M Krisht, Wei-Hsun Yang, Emad Aboud, Ali F Krisht
BACKGROUND: The vascular closure staple clips have been studied in animal models and shown to have comparable results with sutured repair when it comes to the healing process, degree of vessel narrowing, and risk of thrombosis. However, they are clearly superior when the speed of application is taken into account, and they were clinically used in many vascular repair processes. Nevertheless, their usefulness in intracranial vascular surgery has not been described. OBJECTIVE: To describe the usefulness of hemoclips in fast and efficient repair of medium-sized and large intracranial vessels...
February 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29524461/endolymphatic-interventions-for-the-treatment-of-chylothorax-and-chylous-ascites-in-neonates-technical-and-clinical-success-and-complications
#17
Rajiv N Srinivasa, Jeffrey Forris Beecham Chick, Joseph J Gemmete, Anthony N Hage, Ravi N Srinivasa
BACKGROUND: The aim of this study was to report the technical and clinical success of performing minimally invasive endolymphatic embolization in neonates presenting with a chylothorax or chylous ascites. METHODS: Three neonates, 2 males and 1 female, with a mean age of 28 days (range: 19-39 days) presented with a chylothorax or chylous ascites that was refractory to conservative management. All 3 patients (1 previously reported) underwent intranodal lymphangiography, followed by thoracic duct embolization, with 1 patient undergoing additional sclerosis of the retroperitoneal abdominal lymphatics...
March 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29515698/management-of-pulmonary-thromboembolism-based-on-severity-and-vulnerability-to-thrombolysis
#18
Wakako Fukuda, Satoshi Taniguchi, Ikuo Fukuda, Mari Chiyoya, Chikashi Aoki, Norihiro Kondo, Kaoru Hattori, Kazuyuki Daitoku, Ryosuke Kowatari, Masahito Minakawa, Yasuyuki Suzuki
Background : The incidence of pulmonary thromboembolism has been considered rare in Japan. However, its occurrence has been increasing because of westernized lifestyle and diet, increased diagnostic technique, and recognition of this disease. Method : Between January 2003 and September 2014, 179 patients were treated for pulmonary thromboembolism. We classified these patients into 3 groups; Massive (n=35), Sub-massive (n=29) and Nonmassive (n=115) and retrospectively reviewed the treatment options and the outcome...
December 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29511564/management-of-patients-with-high-risk-pulmonary-embolism-a-narrative-review
#19
REVIEW
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29503401/variation-in-patient-backgrounds-practice-patterns-and-outcomes-of-high-risk-pulmonary-embolism-in-japan
#20
Hiraku Funakoshi, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
High-risk pulmonary embolism (PE) with hypotension, circulatory failure, or cardiac arrest is a rare, but life-threating condition. Many guidelines recommend that thrombolytic therapy is the first-line therapy for this condition and surgical embolectomy is an alternative treatment. However, nationwide data have been lacking on patient characteristics and practice patterns for high-risk PE in a real-world clinical setting.We defined high-risk PE patients as those who received noradrenaline and underwent surgical embolectomy or thrombolysis within one day after admission...
March 30, 2018: International Heart Journal
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