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https://www.readbyqxmd.com/read/28101942/the-use-of-hemodynamic-support-in-massive-pulmonary-embolism
#1
Neal Kumar Bhatia, Neal W Dickert, Habib Samady, Vasilis Babaliaros
Massive pulmonary embolism is life threatening and can present as cardiogenic shock and cardiac arrest. We report a case of a 47-year-old male who arrested during his postoperative hospitalization and was found to have a massive pulmonary embolism with bilateral involvement of the pulmonary arteries. Given his profound shock and right ventricular failure, an Impella RP was used to stabilize his acute right ventricular failure while percutaneous embolectomy and thrombolysis was used to treat the pulmonary embolism...
January 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28100974/percutaneous-embolectomy-of-serpentine-thrombus-from-the-right-atrium-in-a-51-year-old-man
#2
Soumya Patnaik, Harish Seetha Rammohan, Mahek Shah, Shivani Garg, Vincent Figueredo, Sean Janzer, Salil Shah
Treatment of large, fresh thrombi in the vascular system can be challenging. AngioVac, a cardiopulmonary pump system, has been used to remove large thrombi and even some tumors by a percutaneous route. We report here a case of a 51-year-old man who presented with a large thrombus (7.5 × 1.5 cm) in his inferior vena cava, extending into his right atrium and right ventricle. Because the surgical risk was high, we attempted percutaneous embolectomy via the AngioVac aspiration system. We also review the literature concerning this emerging technique...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28063605/extracorporeal-membrane-oxygenation-in-massive-pulmonary-embolism
#3
Elena V Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
BACKGROUND: Extracorporeal Membrane Oxygenation (ECMO) has been suggested for cardiopulmonary support in patients with massive pulmonary embolism (PE) refractory to other treatment or as bridging to embolectomy. The survival benefit from ECMO in patients with massive PE remains unclear. METHODS: Here, we describe 5 cases in which ECMO was used as cardiopulmonary support following massive near-fatal pulmonary embolism. RESULTS: The overall mortality in patients with massive PE that received ECMO support was 40%...
January 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28024973/is-iv-tpa-still-relevant-for-mechanical-embolectomy-stroke-candidates
#4
Rudy J Rahme, Bernard R Bendok
No abstract text is available yet for this article.
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009768/thrombus-in-transit-a-potentially-life-threatening-complication-of-cerebral-sinus-thrombosis
#5
Martina Petracca, Rosalinda Calandrelli, Aldobrando Broccolini, Pietro Caliandro, Giacomo Della Marca, Giovanni Frisullo, Roberta Morosetti, Paolo Profice, Priscilla Lamendola, Faustino Pennestrì, Fabio Pilato
We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.
January 2017: Neurologist
https://www.readbyqxmd.com/read/27986848/continuous-aspiration-prior-to-intracranial-vascular-embolectomy-captive-a-technique-which-improves-outcomes
#6
Ryan A McTaggart, Eric L Tung, Shadi Yaghi, Shawna M Cutting, Morgan Hemendinger, Heather I Gale, Grayson L Baird, Richard A Haas, Mahesh V Jayaraman
BACKGROUND: Modern stent retriever-based embolectomy for patients with emergent large vessel occlusion improves outcomes. Techniques aimed at achieving higher rates of complete recanalization would benefit patients. OBJECTIVE: To evaluate the clinical impact of an embolectomy technique focused on continuous aspiration prior to intracranial vascular embolectomy (CAPTIVE). METHODS: A retrospective review was performed of 95 consecutive patients with intracranial internal carotid artery or M1 segment middle cerebral artery occlusion treated with stent retriever-based thrombectomy over an 11-month period...
December 16, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27924204/combined-use-of-a-double-lumen-tube-and-fogarty-catheter-to-prevent-the-endobronchial-spread-of-infection-a-case-report
#7
Jaewon Kim, Hyelim Lee, Han Park, Chang-Young Jeong
Huntington's disease is a neurodegenerative disorder with an autosomal dominant inheritance pattern. Patients with Huntington's disease show an increased risk of aspiration pneumonia when the pharyngeal muscle is invaded. We report a case of advanced-stage Huntington's disease in which the patient received right middle lobectomy for a lung abscess caused by repeated aspiration. The best lung isolation technique has not yet been established in these patients. We successfully performed selective lobar isolation of the right lower and middle lobes using a double lumen tube and a Fogarty embolectomy catheter...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27920844/popliteal-artery-embolism-of-bullet-after-abdominal-gunshot-wound
#8
Junjian Huang, Vivek Pandey, Rohan Shah, Vivek Yedavalli, Anand Joshi, Roger Stimpson, Mark Keldahl, Loren Zuiderveld
Bullet embolism to the peripheral arterial system is a rare phenomenon which frequently results in misdiagnosis due to lack of early symptoms. Embolisms can go to either arterial or venous systems with common sites of injury including the left ventricle, pulmonary vein, thoracic and abdominal aorta and peripheral arteries. Herein we present a case of a 19 year old patient with multiple gunshot wounds to the torso with a bullet embolism to the left popliteal artery necessitating embolectomy. This subsequently led to diagnosis and repair of an abdominal aortic psuedoaneurysm not clearly evident on initial imaging...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27916723/surgical-treatment-of-metallic-foreign-body-embolization-in-the-middle-cerebral-artery-case-report-and-literature-review
#9
Chuan Chen, Bo Hou, Lun Luo, Guo Ying
BACKGROUND: Intracranial artery embolization cases caused by foreign bodies are extremely rare clinically. Twenty-four cases in total have been reported in the literature; among them, 20 cases were caused by firearms, and only 4 cases originated from nonfirearm injuries in daily life. CASE DESCRIPTION: We report a fifth case of foreign body embolization in the cerebral artery caused by nonfirearm injuries. We used microsurgery and successfully removed the metal piece that embolized the middle cerebral artery of a 30-year-old male patient in our center...
December 1, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#10
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27807319/combined-brachial-embolectomy-and-stent-graft-endovascular-exclusion-in-the-treatment-of-acute-arm-ischemia-due-to-subclavian-artery-aneurysms-thrombosis-or-distal-embolization
#11
Andrea Siani, Federico Accrocca, Gennaro de Vivo, Luca Maria Siani, Federica Mounayergi
AIM: Purpose of this study is to report our results after simultaneous transbrachial embolectomy and endovascular aneurysm exclusion with stentgraft in the treatment of upper limb acute ischemia due to subclavian artery aneurysm thrombosis and embolization . METHODS: From January 2010 to December 2015, seven consecutive patients (6 men; mean age 71.5, range 44-85) underwent to emergent revascularization for upper limb ischemia due to thrombosis/embolization of SAA by means of brachial embolectomy and endovascular exclusion...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27790495/acute-right-heart-failure-in-a-patient-with-right-heart-thrombus-and-pulmonary-thromboembolism
#12
Mohammad Mostafa Ansari-Ramandi, Samaneh Ansari-Ramandi, Nasim Naderi
Right Heart Thrombus (RiHT) management is really controversial, and appropriate guidelines are not present for the management. In patients referring with RiHT and Pulmonary Embolism (PE), there are three ways of managing these patients. Out of the three, one is thrombectomy, which is with high risk taking in mind the comorbidities these patients have. The other is using thrombolytic which, in many cases is contraindicated or with high risk. The other less effective way is full anticoagulation. It is really controversial to choose between these ways of management and no clear approach is present...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27784819/resternotomy-a-single-center-experience
#13
Mehrdad Salehi, Ali Reza Bakhshandeh, Kianoush Saberi, Mahmood Alemohammad, Keivan Sobhanian, Maziar Karamnezhad, Farangis Sarouneh Rigi
Background Reoperations are technically more difficult because of the risks associated with reentry in a heart with more advanced pathology, little reserve, and more frequent comorbidities. Routine peripheral cannulation before resternotomy is inadvisable, time-consuming, and has no noticeable role in decreasing the risks of reentry. We present our experience of resternotomy without routine peripheral cannulation. Methods This was a retrospective study on 237 consecutive patients who underwent resternotomy between June 2011 and July 2013...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27760781/biomarkers-for-clinical-decision-making-in-the-management-of-pulmonary-embolism
#14
REVIEW
Evangelos Giannitsis, Hugo A Katus
BACKGROUND: Pulmonary embolism (PE) is associated with high all-cause and PE-related mortality and requires individualized management. After confirmation of PE, a refined risk stratification is particularly warranted among normotensive patients. Previous prognostic models favored combinations of echocardiography or computed tomography suggestive of right ventricular (RV) dysfunction together with biomarkers of RV dysfunction (natriuretic peptides) or myocardial injury (cardiac troponins) to identify candidates for thrombolysis or embolectomy...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/27733961/simulator-based-angiography-and-endovascular-neurosurgery-curriculum-a-longitudinal-evaluation-of-performance-following-simulator-based-angiography-training
#15
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
https://www.readbyqxmd.com/read/27725522/treatment-result-in-the-initial-stage-of-kanazawa-mobile-embolectomy-team-for-acute-ischemic-stroke
#16
Naoyuki Uchiyama, Kouichi Misaki, Masanao Mohri, Tomoya Kamide, Yuichi Hirota, Ryo Higashi, Hisato Minamide, Yukihiko Kohda, Takashi Asahi, Katsuo Shoin, Masayuki Iwato, Daisuke Kita, Yoshitaka Hamada, Yuya Yoshida, Mitsutoshi Nakada
Five recent multicenter randomized controlled trials (RCTs) have clearly shown the superiority of mechanical thrombectomy in large vessel occlusion acute ischemic stroke compared to systemic thrombolysis. Although 14 hospitals in Ishikawa prefecture have uninterrupted availability of systemic thrombolysis, mechanical thrombectomy is not available at all of these hospitals. Therefore, we established a Kanazawa mobile embolectomy team (KMET), which could travel to these hospitals and perform the acute reperfusion therapy...
December 15, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/27702929/aortic-valve-replacement-for-libman-sacks-endocarditis
#17
Jack B Keenan, Rajesh Janardhanan, Brandon T Larsen, Zain Khalpey
A 24-year-old man with systemic lupus erythematosus and antiphospholipid syndrome complicated by lupus nephritis presented with acute limb ischaemia secondary to an embolus. Following embolectomy, the patient underwent a transthoracic echocardiogram which revealed a large vegetation on all three cusps of the aortic valve. The patient was taken for an urgent aortic valve replacement with a mechanical valve. Cultures of one cusp remained sterile. Histopathological examination of the remaining two cusps revealed sterile fibrin-rich thrombotic vegetations characteristic of non-bacterial thrombotic endocarditis...
October 4, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27679725/takotsubo-cardiomyopathy-with-left-ventricular-thrombus-presenting-as-critical-limb-ischaemia
#18
Gaurav Gulsin, Solange Serna, Clare Morris, Abutariq Taher, Ian Loke
Takotsubo cardiomyopathy (TC) is a rare condition, characterized by acute left ventricular (LV) dysfunction in the absence of flow-limiting coronary artery disease, usually provoked by a physical or emotional stressor. The condition is far more common in women. The commonest presenting symptoms in patients with TC are chest pain and shortness of breath, often mimicking an acute coronary syndrome. A number of complications of TC are recognized, and very rarely patients experience cardioembolic phenomena secondary to LV thrombus formation in TC...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27666802/initial-experiences-with-endovascular-management-of-submassive-pulmonary-embolism-is-it-safe
#19
Timothy J Fuller, Christopher M Paprzycki, Muhammad H Zubair, Lala R Hussain, Brian A Kuhn, Matthew H Recht, Patrick E Muck
BACKGROUND: Interventional strategies for massive and submassive pulmonary embolism (smPE) have historically included either systematic intravenous thrombolytic alteplase or surgical embolectomy, both of which are associated with significant morbidity and mortality. However, with the advent of endovascular techniques, recent studies have suggested that an endovascular approach to the treatment of acute smPE may be both safe and effective with excellent outcomes. The purpose of this study was to evaluate the outcomes of patients who have undergone catheter-directed thrombolysis (CDT) for smPE at our institution in an effort to determine the safety of the procedure...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27660585/thromboembolism-in-transit-and-patent-foramen-ovale-should-screening-echocardiogram-be-routine-for-thromboembolic-disease
#20
Dawn S Hui, Fernando Fleischman, P Michael McFadden
BACKGROUND: Thromboembolism-in-transit straddling a patent foramen ovale (PFO) is a rare condition that requires urgent surgical intervention to prevent arterial emboli. CASE REPORT: We present the case of a 42-year-old female who presented with a symptomatic pulmonary embolism. Echocardiography identified a PFO, with a bridging thrombus-in-transit and evidence of right ventricular strain. Urgent surgery was performed because of the risk of systemic embolism. A large thrombus was identified during biatrial exploration...
2016: Ochsner Journal
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