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https://www.readbyqxmd.com/read/29304488/factors-associated-with-elevated-cardiac-troponin-levels-in-patients-with-acute-pulmonary-thromboembolism
#1
Samad Ghaffari, Nariman Sepehrvand, Leili Pourafkari, Reza Hajizadeh, Elnaz Javanshir, Mehdi Nadiri, Nader D Nader
PURPOSE: We aimed to investigate the factors that are associated with increased cardiac troponin I (cTnI) leakage in the acute pulmonary embolism (PTE) setting and their alignment with patient outcome. METHODS: Adult patients with a diagnosis of PTE were enrolled in this prospective cohort study. The primary endpoint of interest was major adverse cardio-pulmonary events (MACPE), defined as the composite of in-hospital all-cause mortality, need for thrombolysis and mechanical ventilation and surgical embolectomy during index hospitalization...
December 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29302122/rvad-support-in-the-setting-of-submassive-pulmonary-embolism
#2
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/29302121/use-of-a-modified-cardiopulmonary-bypass-circuit-for-suction-embolectomy-with-the-angiovac-device
#3
Cara M Michelson, Cornelius M Dyke, Douglas J Wick, Rory Guenther, Dylan Dangerfield, Matthew E Wiisanen
The AngioVac suction cannula and circuit were designed for the percutaneous removal of soft thrombus and emboli in procedures requiring extracorporeal circulatory support. We describe a modification of the AngioVac suction catheter and cardiopulmonary bypass (CPB) circuit to effectively remove thrombus while maintaining the ability to rapidly initiate full CPBs during a medical crisis. This article will discuss the design concepts of the modified circuit as well as procedural protocols and considerations. The design modifications of incorporating an oxygenator, reservoir, and bridge allow for an increased flexibility that allows adaption to veno-venous extracorporeal membrane oxygenation or full CPB support when required for oxygenation or hemodynamic support...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29273536/variability-of-stroke-patients-meeting-endovascular-stroke-trial-criteria-in-a-non-clinical-trial-setting
#4
Jennifer E Fugate, Waleed Brinjikji, Harry Cloft, David F Kallmes, Alejandro A Rabinstein
BACKGROUND: Five randomized trials proving the efficacy and safety of mechanical embolectomy for ischemic stroke within 8hours used differing radiological methods to select patients. We aimed to evaluate the proportion of patients in clinical practice that would meet radiological criteria for inclusion in these trials. METHODS: Retrospective study of ischemic stroke patients at a large academic medical center who were considered for endovascular stroke therapy based on confirmed intracranial large vessel occlusion from April 2010-November 2014...
December 19, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29249784/-surgical-embolectomy-for-acute-massive-pulmonary-thromboembolism-requiring-percutaneous-cardiopulmonary-support-after-thoracoabdominal-aorta-replacement
#5
Takahiko Masuda, Masaki Hata, Kazuhiro Yamaya, Tomoyuki Suzuki, Yukihiro Hayatsu, Kyohei Ueno, Masaaki Naganuma, Naoya Terao
A 48-year-old man was admitted to our hospital and underwent thoracoabdominal aorta replacement. Eight days postoperatively, he developed severe dyspnea and transient drop in blood pressure suddenly following walk rehabilitation. Contrast-enhanced computed tomography showed thrombi in the bilateral main pulmonary artery. Respiratory failure and unstable hemodynamics developed, which required percutaneous cardiopulmonary support (PCPS). Because catheter embolectomy and thrombolytic therapy via pulmonary artery catheter were not effective, surgical thrombectomy was performed...
December 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29219944/minimally-invasive-surgical-pulmonary-embolectomy-a-potential-alternative-to-conventional-sternotomy
#6
Chetan Pasrija, Aakash Shah, Elliot Sultanik, Michael Rouse, Mehrdad Ghoreishi, Gregory J Bittle, Francesca Boulos, Bartley P Griffith, Zachary N Kon
OBJECTIVE: Surgical pulmonary embolectomy has gained increasing popularity over the past decade with multiple series reporting excellent outcomes in the treatment of submassive pulmonary embolism. However, a significant barrier to the broader adoption of surgical pulmonary embolectomy remains the large incision and long recovery after a full sternotomy. We report the safety and efficacy of using a minimally invasive approach to surgical pulmonary embolectomy. METHODS: All consecutive patients undergoing surgical pulmonary embolectomy for a submassive pulmonary embolism (2015-2017) were reviewed...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29208189/enlightenment-and-lesson-from-the-successful-treatment-of-acute-superior-mesenteric-artery-embolism
#7
Bei Wang, Rongju Sun, Wei Chen, Tanshi Li
 Despite recent advances, treatment of acute superior mesenteric artery embolism (SMAE) in emergency is still very difficult. The comparative rarity, the difficulty of early diagnosis, and the extremely high mortality of SMAE give us the sufficient reasons to report our successful experience in curing a patient with acute SMAE. In the present case, the patient was diagnosed early without evidence of intestinal necrosis. The diagnosis of SMAE was verified by computed tomography angiography (CTA). A comprehensive treatment was immediately employed including a combination of intra-arterial thrombolysis and embolectomy operation with emergent laparotomy...
November 30, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29189832/-peripheral-embolization-and-rapid-growth-of-papillary-fibroelastoma-in-a-young-woman
#8
Alessandro Minati, Danilo Ruggiero, Florida Gripshi, Antonella Cherubini, Lorenzo Zandonà, Andrea Di Lenarda, Aniello Pappalardo
Papillary fibroelastoma, a benign cardiac tumor, is a rare clinical condition. Before the echocardiography era, the diagnosis was often occasional, especially during other cardiac procedures; but nowadays it has improved with the advent of higher-resolution imaging technology. The clinical presentation can vary from asymptomatic to severe complications such as cerebrovascular or ischemic events due to tumor embolization.We present the case of a 33-year-old female with a papillary fibroelastoma on the anterior leaflet of the mitral valve undergoing clinical examination for claudicatio intermittens...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29181220/angio-seal%C3%A2-embolization-a-rare-etiology-of-an-acute-distal-limb-ischemia
#9
Glenmore Lasam, Joshua Brad Oaks, Jeffrey Brensilver
We herein report a serious vascular complication of diagnostic cardiac catheterization due to an embolization of an Angio-Seal closure device causing acute lower limb ischemia. The Angio-Seal was deployed via the right femoral artery following the catheterization which embolized several hours later to the right popliteal artery. Fogarty embolectomy restored perfusion to the right lower limb; however, compartment syndrome subsequently developed which required evacuation of a hematoma and repair of right popliteal artery...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/29174781/utilization-of-veno-arterial-extracorporeal-membrane-oxygenation-for-massive-pulmonary-embolism
#10
Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon
BACKGROUND: The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat these patients. METHODS: All patients with a massive pulmonary embolism who were placed on VA-ECMO, as an initial intervention determined by protocol, were retrospectively reviewed...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#11
Joyce S Balami, Philip M White, Peter J McMeekin, Gary A Ford, Alastair M Buchan
Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29162028/endovascular-renal-artery-stent-retriever-embolectomy-in-a-young-patient-with-cardiac-myxoma-case-report-and-review-of-the-literature
#12
Michael A Silva, Alfred P See, Samir K Shah, Priyank Khandelwal, Nirav J Patel, Heather Lyu, Matthew T Menard, Mohammad Ali Aziz-Sultan
PURPOSE: Cardiac myxomas are common tumors of the heart with disproportionate impact on young patients, occasionally with dramatic systemic dissemination of tumor emboli with catastrophic multiorgan system ischemia. The coincident comorbidities can increase the risk of traditional treatments for tumor embolus in each region. CASE REPORT: A young patient with previously unknown cardiac myxoma presented with seizure and was found to have stress cardiomyopathy, multiple cerebral large vessel occlusions with acute ischemic stroke, bilateral lower extremity tumor emboli and rhabdomyolysis, and renal tumor embolus with acute tubular necrosis...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29157528/catheter-based-embolectomy-for-acute-pulmonary-embolism-devices-technical-considerations-risks-and-benefits
#13
REVIEW
Wissam A Jaber, Michael C McDaniel
A significant number of patients with high-risk pulmonary embolism have contraindications to thrombolytic therapy. Catheter-based therapy may be helpful and consists of a multitude of catheters and techniques, some old and some new. Although there are few data supporting the use of any of these techniques, there has been a recent rise in interest and use of catheter-based pulmonary embolectomy. This text describes the contemporary devices used in pulmonary embolism treatment, discusses their challenges, and proposes some future directions...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157526/systemic-thrombolysis-for-pulmonary-embolism-evidence-patient-selection-and-protocols-for-management
#14
REVIEW
Hafeez Ul Hassan Virk, Sanjay Chatterjee, Partha Sardar, Chirag Bavishi, Jay Giri, Saurav Chatterjee
Acute pulmonary embolism presents a clinical challenge for optimal risk stratification. Although associated with significant morbidity and mortality at the population level, the spectrum of presentation in an individual patient varies from mild symptoms to cardiac arrest. Treatment options include anticoagulation, systemic thrombolysis, catheter-based interventions, and surgical embolectomy. In this article, an attempt is made to optimally identify patients who, based on available evidence, may benefit from systemic thrombolytic therapy...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29153872/malignant-lymphoma-arising-in-cardiac-myxoma-presenting-with-peripheral-arterial-emboli
#15
Cheol Keun Park, Yoon Ah Cho, Moonsik Kim, Hyo Sup Shim
Composite tumors of cardiac myxoma and malignant lymphoma are extremely rare, with 11 of such cases reported in the literature. A 44-year-old man presented to us with abrupt right lower leg pain. A computed tomography angiogram revealed segmental obstruction of the right common femoral artery, and embolectomy was performed. The embolectomy specimen contained several clusters of degenerated round/oval atypical cells in the fibrinous or myxoid background. Immunohistochemical examination revealed that these atypical cells were negative for cytokeratin and non-specifically expressed CD45...
October 14, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29153434/surgical-embolectomy-for-pulmonary-embolism-about-time-for-a-randomized-clinical-trial
#16
EDITORIAL
Sameer A Hirji, Tsuyoshi Kaneko, Sary Aranki
No abstract text is available yet for this article.
October 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29129419/is-it-time-to-expand-the-indications-for-pulmonary-embolectomy
#17
EDITORIAL
Juan A Crestanello
No abstract text is available yet for this article.
October 27, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29128034/use-of-extracorporeal-membrane-oxygenation-and-surgical-embolectomy-for-massive-pulmonary-embolism-in-the-emergency-department
#18
De Ante Russ, Nicole Payne, Mark Bonnell, Viviane Kazan
BACKGROUND: Massive pulmonary embolism (PE) carries significant morbidity and mortality with current standard of care modalities. CASE REPORT: We present the case of a 63-year-old male status post abdominal surgery 2 weeks before presenting to the emergency department with a massive pulmonary embolism and subsequent acute cardiopulmonary failure. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Here we describe a case of extracorporeal membrane oxygenation (ECMO) deployed in the emergency department as a bridge to embolectomy to successfully treat massive pulmonary embolism...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29111332/floating-right-heart-thrombi-a-pooled-analysis-of-cases-reported-over-the-past-10years
#19
Lucrecia María Burgos, Juan Pablo Costabel, Victoria Galizia Brito, Alan Sigal, Daniela Maymo, Ana Iribarren, Marcelo Trivi
INTRODUCTION: Floating right heart thrombi (FRHTS) are a rare phenomenon associated with high mortality. Immediate treatment is mandatory, but optimal therapy is controversial. OBJECTIVE: To compare the clinical characteristics according to different treatment strategies and to identify predictors of mortality on patients with FRHTS. METHODS: We conducted a systematic search of reported clinical cases of TTRH from 2006 to 2016. RESULTS: 207 patients were analyzed, median age was 60years, 51...
October 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29063065/paradoxical-embolism-experiences-from-a-single-center
#20
Hong-Liang Zhang, Zhi-Hong Liu, Qin Luo, Yong Wang, Zhi-Hui Zhao, Chang-Ming Xiong
OBJECTIVE: To present our treatment experiences and the follow-up data of patients with paradoxical embolism (PDE). METHODS: The clinical characteristics, management, and follow-up data of all included patients who were diagnosed with PDE at Fuwai Hospital from January 1994 to October 2015 were recorded. RESULTS: Twelve patients were included; all had a pulmonary embolism, and 8 had deep venous thrombosis. The artery embolisms involved the cerebral artery (7 patients), renal artery (2 patients), mesentery artery (2 patients), popliteal artery (1 patient), descending aorta thrombus (1 patient), and thrombus-straddled patent foramen ovale (PFO) (1 patient)...
June 25, 2017: Chronic Diseases and Translational Medicine
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