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thrombolysis in children

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https://www.readbyqxmd.com/read/29875993/thrombogenic-superior-vena-cava-syndrome-from-long-standing-central-venous-access-in-a-5-year-old-patient-treated-with-balloon-expandable-stents
#1
Dabin Ji, Anne Elizabeth Gill, Robert Mitchell Ermentrout, Clifford Matthew Hawkins
Thrombogenic superior vena cava syndrome is an uncommon, dangerous complication of long-standing central venous catheter use. The increased use of central venous catheters has resulted in more non-malignant cases of superior vena cava syndrome across all age groups. We present a 5-year-old male with superior vena cava syndrome associated with acute onset of severe upper extremity and facial swelling, dyspnea, and a right subclavian central venous catheter malfunction. The patient was ultimately treated with percutaneous stenting of the superior vena cava with balloon-expandable Palmaz stents following unsuccessful angioplasty, catheter-directed thrombolysis, and percutaneous thrombectomy...
April 2018: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/29860923/a-systematic-review-of-paediatric-deep-venous-thrombolysis
#2
Mohamed Ah Taha, Andrew Busuttil, Roshan Bootun, Alun H Davies
Objectives The aim was to assess the effectiveness and safety of catheter-directed thrombolysis in children with deep venous thrombosis and to evaluate its long-term effect. Method and results EMBASE, Medline and Cochrane databases were searched to identify studies in which paediatric acute deep venous thrombosis patients received thrombolysis. Following title and abstract screening, seven cohort studies with a total of 183 patients were identified. Technical success was 82% and superior in regional rather than systemic thrombolysis (p < 0...
January 1, 2018: Phlebology
https://www.readbyqxmd.com/read/29803279/pulmonary-embolism-in-children
#3
REVIEW
Sarah Ramiz, Madhvi Rajpurkar
Pulmonary embolism (PE) in children is a rare condition with potential for high mortality. PE incidence is increasing owing to increased survival of children with predisposing conditions, increased use of central venous catheters, and improved awareness and recognition. Although pediatric PE is distinct from adult PE, management guidelines in children are extrapolated from the adult data. Treatment includes thrombolysis or thrombectomy, and pharmacologic anticoagulation. Ongoing clinical trials are evaluating the use of direct oral anticoagulants in children...
June 2018: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/29731013/hypertension-canada-s-2018-guidelines-for-diagnosis-risk-assessment-prevention-and-treatment-of-hypertension-in-adults-and-children
#4
Kara A Nerenberg, Kelly B Zarnke, Alexander A Leung, Kaberi Dasgupta, Sonia Butalia, Kerry McBrien, Kevin C Harris, Meranda Nakhla, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Raj S Padwal, Karen C Tran, Steven Grover, Simon W Rabkin, Gordon W Moe, Jonathan G Howlett, Patrice Lindsay, Michael D Hill, Mike Sharma, Thalia Field, Theodore H Wein, Ashkan Shoamanesh, George K Dresser, Pavel Hamet, Robert J Herman, Ellen Burgess, Steven E Gryn, Jean C Grégoire, Richard Lewanczuk, Luc Poirier, Tavis S Campbell, Ross D Feldman, Kim L Lavoie, Ross T Tsuyuki, George Honos, Ally P H Prebtani, Gregory Kline, Ernesto L Schiffrin, Andrew Don-Wauchope, Sheldon W Tobe, Richard E Gilbert, Lawrence A Leiter, Charlotte Jones, Vincent Woo, Robert A Hegele, Peter Selby, Andrew Pipe, Philip A McFarlane, Paul Oh, Milan Gupta, Simon L Bacon, Janusz Kaczorowski, Luc Trudeau, Norman R C Campbell, Swapnil Hiremath, Michael Roerecke, Joanne Arcand, Marcel Ruzicka, G V Ramesh Prasad, Michel Vallée, Cedric Edwards, Praveena Sivapalan, S Brian Penner, Anne Fournier, Geneviève Benoit, Janusz Feber, Janis Dionne, Laura A Magee, Alexander G Logan, Anne-Marie Côté, Evelyne Rey, Tabassum Firoz, Laura M Kuyper, Jonathan Y Gabor, Raymond R Townsend, Doreen M Rabi, Stella S Daskalopoulou
Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29695022/catheter-related-arterial-thrombosis-in-neonates-and-children-a-systematic-review
#5
Mattia Rizzi, Neil Goldenberg, Mariana Bonduel, Shoshana Revel-Vilk, Ernest Amankwah, Manuela Albisetti
Catheter-related arterial thrombosis (CAT) is increasingly recognized in children. Available data are scarce and based on expert opinions. This systematic review aimed to identify knowledge on paediatric CAT. Among 3,484 publications, 22 met inclusion criteria. Fourteen reported on CAT due to umbilical arterial catheter (UAC), two to extremity indwelling catheter (EIC), one to both and five to cardiac catheter (CC). The overall cumulative incidence of CAT was 21% (95% confidence interval [CI], 13-31) with a relative incidence of 20% (95% CI, 10-33) for UAC and 11% (95% CI, 3-21) for CC-related CAT...
June 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29679441/feasibility-safety-and-outcome-of-recanalisation-treatment-in-childhood-stroke
#6
Sandra Bigi, Andrea Dulcey, Jan Gralla, Corrado Bernasconi, Amber Melliger, Alexandre N Datta, Marcel Arnold, Johannes Kaesmacher, Joel Fluss, Annette Hackenberg, Oliver Maier, Johannes Weber, Claudia Poloni, Urs Fischer, Maja Steinlin
Objective Intravenous thrombolysis and endovascular therapy (IVT/EVT) are evidence-based treatments for adults with arterial ischemic stroke (AIS). However, randomized controlled trials in pediatric patients are lacking. This study aimed to describe feasibility, safety, and outcome of IVT/EVT in children with AIS. Methods Retrospective study (01/2000-12/2015) of a multicenter, population-based consecutive cohort of patients aged 1 month - 16 years diagnosed with AIS presenting with a pedNIHSS ≥4. Clinical and radiological data of patients receiving IVT/EVT were compared to those receiving standard care (SC) using linear regression to adjust for potential confounders...
April 20, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29567762/improving-community-stroke-preparedness-in-the-hhs-hip-hop-stroke-randomized-clinical-trial
#7
Olajide Williams, Ellyn Leighton-Herrmann Quinn, Jeanne Teresi, Joseph P Eimicke, Jian Kong, Gbenga Ogedegbe, James Noble
BACKGROUND AND PURPOSE: Deficiencies in stroke preparedness cause major delays to stroke thrombolysis, particularly among economically disadvantaged minorities. We evaluated the effectiveness of a stroke preparedness intervention delivered to preadolescent urban public school children on the stroke knowledge/preparedness of their parents. METHODS: We recruited 3070 fourth through sixth graders and 1144 parents from 22 schools into a cluster randomized trial with schools randomized to the HHS (Hip-Hop Stroke) intervention or attentional control (nutrition classes)...
April 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29417035/a-misplaced-intramuscular-injection-and-limb-threatening-ischemia
#8
Sumantra Sarkar, Sarbani Misra, Madhumita Nandi, Rakesh Mondal
Femoral artery thrombosis is a rare complication of intramuscular (IM) injection in children. A 12-month-old boy presented with right lower limb ischemia and digital gangrene 3 days after an injection of ceftriaxone administered to his medial aspect of the right thigh. Successful thrombolysis and partial limb salvage was possible with enoxaparin despite a late presentation. Unnecessary and unsafe IM injection in community practice might lead to such devastating outcome which should be avoided.
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29378443/thrombolysis-in-pregnancy-a-literature-review
#9
Marina Sousa Gomes, Mariana Guimarães, Nuno Montenegro
BACKGROUND: Changes in the coagulation system during pregnancy and puerperium produce a physiological hypercoagulable state. These changes are thought to be the cause of the higher rates of deep vein thrombosis (DVT), pulmonary embolism (PE), stroke, and mechanical prosthetic valve thrombosis (PVT) during pregnancy. Thrombolysis can be a treatment option in this case. However, there are no available data from randomized controlled trials in pregnant patients and information about the security of thrombolytics in pregnancy is missing...
February 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29238322/acute-ischemic-pediatric-stroke-management-an-extended-window-for-mechanical-thrombectomy
#10
Ashish Kulhari, Elizabeth Dorn, Jonathan Pace, Vilakshan Alambyan, Stephanie Chen, Osmond C Wu, Macym Rizvi, Anthony Hammond, Ciro Ramos-Estebanez
Ischemic stroke is a rare condition to afflict the pediatric population. Congenital cardiomyopathy represents one of several possible etiologies in children. We report a 9-year-old boy who developed right middle cerebral artery stroke secondary to primary restrictive cardiomyopathy. In the absence of pediatric guidelines, the child met adult criteria for mechanical thrombectomy given the small core infarct and large penumbra. The literature suggests children may benefit from mechanical thrombectomy in carefully selected cases...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#11
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
May 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29063260/-childhood-stroke-what-are-the-special-features-of-childhood-stroke
#12
REVIEW
L Gerstl, M V Bonfert, T Nicolai, M Dieterich, C Adamczyk, F Heinen, M Olivieri, M Steinlin
Childhood arterial ischemic stroke differs in essential aspects from adult stroke. It is rare, often relatively unknown among laypersons and physicians and the wide variety of age-specific differential diagnoses (stroke mimics) as well as less established care structures often lead to a considerable delay in the diagnosis of stroke. The possible treatment options in childhood are mostly off-label. Experiences in well-established acute treatment modalities in adult stroke, such as thrombolysis and mechanical thrombectomy are therefore limited in children and only based on case reports and case series...
December 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29058996/successful-use-of-extracorporeal-membrane-oxygenation-in-a-child-with-obstructive-shock-due-to-massive-bilateral-pulmonary-embolism
#13
Aditya Badheka, Pradeep Bangalore Prakash, Veerajalandhar Allareddy
BACKGROUND: Acute massive pulmonary embolism (PE) is a very rare condition in children. We report the successful use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a lifesaving modality in a child with acute massive PE. CASE PRESENTATION: A nine-year-old female with spinal muscular atrophy type 1, chronic respiratory failure with tracheostomy and ventilator dependence presented with tachypnea and hypoxia. She had recent coiling of her pulmonary arterio-venous malformation...
May 2018: Perfusion
https://www.readbyqxmd.com/read/28959488/review-of-acute-ischaemic-stroke-in-pakistan-progress-in-management-and-future-perspectives
#14
REVIEW
Ali Zohair Nomani, Sumaira Nabi, Mazhar Badshah, Shahzad Ahmed
Ischaemic stroke is a major cause of neurological morbidity and mortality. The objective of this review article is to summarise facts pertaining to acute ischaemic stroke and its various aspects in a developing country like Pakistan, where resources are limited and the healthcare system is underdeveloped. No large-scale epidemiological studies are available to determine the true incidence of stroke in Pakistan. We reviewed the available literature on stroke from Pakistan and through this article we primarily aim to present the current acute ischaemic stroke management in Pakistan in juxtaposition to that of the developed world...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28853209/inferior-vena-cava-atresia-predisposing-to-acute-lower-extremity-deep-vein-thrombosis-in-children-a-descriptive-dual-center-study
#15
MULTICENTER STUDY
Cristina Tarango, Riten Kumar, Manish Patel, Anne Blackmore, Patrick Warren, Joseph S Palumbo
PURPOSE: Thrombosis in the healthy pediatric population is a rare occurrence. Little is known about the optimal treatment or outcomes of children with unprovoked acute lower extremity (LE) deep vein thrombosis (DVT) associated with atresia of the inferior vena cava (IVC). METHODS: We retrospectively analyzed the records of patients with acute LE DVT subsequently found to have IVC atresia who presented to two tertiary pediatric institutions between 2008 and 2016...
February 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28844524/mechanical-thrombectomy-for-pediatric-acute-stroke-and-ventricular-assist-device
#16
Robert Clinton Stowe, Peter Kan, Day Burruss Breen, Sonika Agarwal
BACKGROUND: Certain pediatric populations have increased risk of ischemic strokes, including those with cardiac disease and those dependent on mechanical circulatory devices such as ventricular assist devices. Due to their need for chronic anticoagulation, patients with mechanical circulatory devices are not candidates for systemic thrombolysis and thus treatment of acute ischemic stroke is limited. CASE: A 9-year-old boy with a ventricular assist device presented with acute onset of dense right hemiparesis, global aphasia, and a pediatric NIHSS score of 23...
January 2018: Brain & Development
https://www.readbyqxmd.com/read/28610742/interventional-treatment-for-hepatic-artery-thrombosis-after-liver-transplantation
#17
Hua Zhang, Sheng Qian, Rong Liu, Wei Yuan, Jian-Hua Wang
PURPOSE: To evaluate short-term and long-term effectiveness of interventional treatment for hepatic artery thrombosis (HAT). MATERIALS AND METHODS: From March 2003 to October 2015, 34 patients (32 male and 2 female; mean age, 45 y; range 7-64 y) with HAT were identified 0-21d (mean 6.5 d ± 6.0) after liver transplantation and underwent interventional treatments. Technical success, clinical success, complications, hepatic artery patency, and survival time were assessed...
August 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28589229/-stroke-in-children-and-adolescents
#18
REVIEW
S Meyer, M Poryo, M Flotats-Bastardas, D Ebrahimi-Fakhari, U Yilmaz
The occurrence of a stroke in children and adolescents constitutes a rare, critical event that is associated with substantial morbidity and mortality. In addition to the individual suffering for the young patient and the medical burden for the affected family, a stroke is also associated with high follow-up costs for the health system because of the necessary long-term rehabilitative treatment. Establishing an early and prompt diagnosis is of great therapeutic importance. Because of the rarity of the illness and the plethora of clinical manifestations, diagnosis is often delayed...
July 2017: Der Radiologe
https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#19
Madhvi Rajpurkar, Tina Biss, Ernest K Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
June 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28265128/how-we-manage-pediatric-deep-venous-thrombosis
#20
REVIEW
Marisol Betensky, Mark A Bittles, Paul Colombani, Neil A Goldenberg
Over the past two decades, the incidence and recognition of venous thromboembolism (VTE) in children has significantly increased, likely as a result of improvements in the medical care of critically ill patients and increased awareness of thrombotic complications among medical providers. Current recommendations for the management of VTE in children are largely based on data from pediatric registries and observational studies, or extrapolated from adult data. The scarcity of high-quality evidence-based recommendations has resulted in marked variations in the management of pediatric VTE among providers...
March 2017: Seminars in Interventional Radiology
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