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https://www.readbyqxmd.com/read/28417266/guided-longer-pulses-from-a-diagnostic-ultrasound-and-intraclot-microbubble-enhanced-catheter-directed-thrombolysis-in-vivo
#1
Shunji Gao, Qiong Zhu, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#2
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28372484/single-center-retrospective-review-of-ultrasound-accelerated-versus-traditional-catheter-directed-thrombolysis-for-acute-lower-extremity-deep-venous-thrombosis
#3
Tony Lu, Thomas M Loh, Hosam F El-Sayed, Mark G Davies
Objective Systemic anticoagulation remains the standard for acute lower extremity (LE) deep venous thrombosis (DVT), but growing interest in catheter-directed thrombolysis (CDT) and its potential to reduce the incidence of post-thrombotic syndrome (PTS) has led to advent of ultrasound-accelerated CDT (US-CDT). Few studies to date have examined the outcomes of US-CDT against traditional CDT (T-CDT). Methods This is a retrospective, single-center review of all patients treated for acute LE DVT over a five-year period with either US- and T-CDT...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28372458/hepatocellular-carcinoma-presenting-with-budd-chiari-syndrome-right-atrial-thrombus-and-pulmonary-emboli
#4
Luís C Lourenço, David V Horta, Sara F Alberto, Jorge Reis
A 47-year-old patient presented with a two-week history of right upper quadrant pain, abdominal distention and new onset of shortness of breath. He had a history of intravenous drug abuse, no alcohol consumption and denied any known liver disease. On physical examination, he was tachypneic and had dullness in the flanks. His blood analysis at admission was as follows: hemoglobin, 12.9 g/dL; leukocyte count, 6,800/uL; platelet count, 63,000/uL; INR, 2.1; serum creatinine, 1.27 mg/dL; liver biochemistry tests were notable for marginal derangement, HBsAg was negative, anti-HCV was positive, HCV RNA was 367,498 IU/ml and alpha-fetoprotein was 992 mg/dL...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28362573/ultrasound-assessed-gastric-antral-area-correlates-with-aspirated-tube-feed-volume-in-enterally-fed-critically-ill-patients
#5
Vibhu Sharma, Deepthi Gudivada, Renaud Gueret, John Bailitz
BACKGROUND: Enteral tube feed (ETF) intolerance occurs frequently in hospitalized patients and more so in critically ill patients. Most critical care nurses continue to assess gastric residual volume (GRV), especially among those with a history of ETF intolerance. We hypothesized that ultrasound assessment of GRV correlates directly with aspirated tube feed volume. METHODS: This was a prospective cohort study of a convenience sample of critically ill mechanically ventilated patients admitted to an intensive care unit receiving ETF...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28348943/correlation-of-ivc-diameter-and-collapsibility-index-with-central-venous-pressure-in-the-assessment-of-intravascular-volume-in-critically-ill-patients
#6
Abid Ilyas, Wasib Ishtiaq, Salman Assad, Haider Ghazanfar, Salman Mansoor, Muhammad Haris, Aayesha Qadeer, Aftab Akhtar
OBJECTIVE: The objective of our study is to assess the correlation between inferior vena cava (IVC) diameters, central venous pressure (CVP) and the IVC collapsibility index for estimating the volume status in critically ill patients. METHODS: This cross-sectional study used the convenient sampling of 100 adult medical intensive care unit (ICU) patients for a period of three months. Patients ≥ 18 years of age with an intrathoracic central venous catheter terminating in the distal superior vena cava connected to the transducer to produce a CVP waveform were included in the study...
February 12, 2017: Curēus
https://www.readbyqxmd.com/read/28342574/ultrasound-findings-in-tension-pneumothorax-a-case-report
#7
Maxine Inocencio, Jeannine Childs, Mikaela L Chilstrom, Kristin Berona
BACKGROUND: Delayed recognition of tension pneumothorax can lead to a mortality of 31% to 91%. However, the classic physical examination findings of tracheal deviation and distended neck veins are poorly sensitive in the diagnosis of tension pneumothorax. Point-of-care ultrasound is accurate in identifying the presence of pneumothorax, but sonographic findings of tension pneumothorax are less well described. CASE REPORT: We report the case of a 21-year-old man with sudden-onset left-sided chest pain...
March 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#8
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28271386/serial-lung-and-ivc-ultrasound-in-the-assessment-of-congestive-heart-failure
#9
Rachel Spevack, Mohamed Al Shukairi, Dev Jayaraman, Jerrald Dankoff, Lawrence Rudski, Jed Lipes
BACKGROUND: Management of congestive heart failure (CHF) is dependent on clinical assessments of volume status, which are subjective and imprecise. Point-of-care ultrasound (POCUS) is useful in the diagnosis of CHF, but how POCUS findings correlate with therapy remains unknown. This study aimed to determine whether the changes in clinical evaluation of CHF with treatment are mirrored with changes in the number of B lines on lung ultrasound (LUS) and inferior vena cava (IVC) size. In this prospective observational study, investigators performed serial clinical and ultrasound assessments within 24 h of admission (T1), day 1 in hospital (T2) and within 24 h of discharge (T3)...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28193644/tumour-thrombus-of-the-inferior-vena-cava-extending-into-the-right-atrium-in-the-setting-of-colon-cancer
#10
Daniel Meyers, Nancy A Nixon, Angela Franko, Danny Ng, Vincent C Tam
Tumour thrombus is seen in renal cell and hepatocellular carcinoma, but is rarely reported in colorectal cancer. A woman aged 46 years, with metastatic colonic adenocarcinoma, was found to have a large mass in the inferior vena cava (IVC) extending into the right atrium. Although this lesion was initially thought to be bland thrombus, imaging with contrast-enhanced CT scan and contrast-enhanced ultrasound supported the diagnosis of tumour thrombus. Despite the large size of the lesion, the patient was asymptomatic...
February 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28163172/endovascular-management-of-para-prosthetic-aortocaval-fistula-case-report-and-systematic-review-of-the-literature
#11
Claudio Bianchini Massoni, Giulia Rossi, Tiziano Tecchio, Paolo Perini, Antonio Freyrie
The aim of this article is to report a case of asymptomatic para-anastomotic aortocaval fistula (ACF) treated by endovascular aortic repair, and to review data of the literature on arteriovenous fistulae secondary to abdominal aortic surgery. A 78-year-old male complained of worsening pain in the right lower limb since 2 months. He presented a history of right femoropopliteal bypass for peripheral arterial occlusive disease and elective surgical treatment for a non-ruptured infrarenal aortic aneurysm (Dacron tube graft)...
February 3, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#12
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28132743/editor-s-choice-factors-associated-with-long-term-outcome-in-191-patients-with-ilio-femoral-dvt-treated-with-catheter-directed-thrombolysis
#13
P Foegh, L P Jensen, L Klitfod, R Broholm, N Bækgaard
OBJECTIVE: To identify factors associated with long-term treatment success after catheter-directed thrombolysis (CDT) for acute deep venous thrombosis (DVT) involving the ilio-femoral vein. MATERIAL AND METHODS: This was a non-randomised observational cohort study. From 1999 to 2013, 191 consecutive patients (203 limbs) attending a tertiary vascular centre at Gentofte University Hospital, Denmark underwent CDT. All patients had ultrasonically verified acute ilio-femoral DVT with open distal popliteal vein and calf veins...
March 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28123971/advanced-imaging-in-acute-and-chronic-deep-vein-thrombosis
#14
REVIEW
Gita Yashwantrao Karande, Sandeep S Hedgire, Yadiel Sanchez, Vinit Baliyan, Vishala Mishra, Suvranu Ganguli, Anand M Prabhakar
Deep venous thrombosis (DVT) affecting the extremities is a common clinical problem. Prompt imaging aids in rapid diagnosis and adequate treatment. While ultrasound (US) remains the workhorse of detection of extremity venous thrombosis, CT and MRI are commonly used as the problem-solving tools either to visualize the thrombosis in central veins like superior or inferior vena cava (IVC) or to test for the presence of complications like pulmonary embolism (PE). The cross-sectional modalities also offer improved visualization of venous collaterals...
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28090072/reconsideration-of-inferior-vena-cava-parameters-for-estimating-right-atrial-pressure-in-an-east-asian-population%C3%A3-comparative-simultaneous-ultrasound-catheterization-study
#15
MULTICENTER STUDY
Takayuki Kawata, Masao Daimon, Seitetsu L Lee, Koichi Kimura, Naoko Sawada, Shuo-Ju Chiang, Keitaro Mahara, Takeshi Okubo, Tomoko Nakao, Megumi Hirokawa, Boqing Xu, Tomoko S Kato, Masafumi Watanabe, Yutaka Yatomi, Issei Komuro
BACKGROUND: Ultrasound measurements of the inferior vena cava (IVC) diameter (IVCD), together with its respiratory variation, provide a noninvasive estimate of right atrial pressure (RAP). However, there is a paucity of studies that have compared this technique with simultaneous catheterization. We explored the best cut-off values of IVC parameters for elevated RAP in comparison with RAP measured by catheterization.Methods and Results:We prospectively enrolled 120 East Asian patients who were scheduled for catheterization...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28050077/retrocaval-ureter-or-preureteral-vena-cava-lest-we-forget-this-rare-cause-of-hydronephrosis
#16
Saikat Bhattacharjee, Sunil Sanga, Pooja Gupta, R A George
Retrocaval ureter or circumcaval ureter is a rare congenital abnormality arising from dysgenesis of the inferior vena cava (IVC) that results in the right ureter coursing behind and medial to the IVC. The ideal nomenclature for the anomaly is preureteral vena cava, keeping in mind the aberrant embryology. It can result in hydronephrosis and is a rare cause of long-standing cyclical pain abdomen. Ultrasound, intravenous urography, nuclear scintigraphy, computed tomography urography (CTU) and magnetic resonance urography (MRU) have been used in the diagnosis of this abnormality but CTU, with its ability to depict the abnormality in three dimensions gives the most "wholesome" solution to its diagnosis...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28046769/su-g-iep4-15-ultrasound-imaging-of-absorbable-inferior-vena-cava-filters-for-proper-placement
#17
T Mitcham, R Bouchard, A Melancon, M Eggers, M Melancon
PURPOSE: Inferior vena cava filters (IVCFs) are used in patients with a high risk of pulmonary embolism in situations when the use of blood thinning drugs would be inappropriate. These filters are implanted under x-ray guidance; however, this provides a dose of ionizing radiation to both patient and physician. B-mode ultrasound (US) imaging allows for localization of certain implanted devices without radiation dose concerns. The goal of this study was to investigate the feasibility of imaging the placement of absorbable IVCFs using US imaging to alleviate the dosage concern inherent to fluoroscopy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28030505/ultrasound-assessment-of-volume-responsiveness-in-critically-ill-surgical-patients-two-measurements-are-better-than-one
#18
Sarah B Murthi, Syeda Fatima, Ashely R Menne, Jacob J Glaser, Samuel M Galvagno, Stephen Biederman, Raymond Fang, Hegang Chen, Thomas M Scalea
BACKGROUND: The intended physiologic response to a fluid bolus is an increase in stroke volume (SV). Several ultrasound (US) measures have been shown to be predictive. The best measure(s) in critically ill surgical patients remains unclear. METHODS: This is a prospective observational study in critically ill surgical patients receiving a bolus of crystalloid, colloid or blood. A transthoracic echocardiogram was performed before (pre-transthoracic echocardiogram) and after...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28008296/point-of-care-ultraportable-echocardiography-predicts-diuretic-response-in-patients-admitted-with-acute-decompensated-heart-failure
#19
Dena K Krishnan, Barbara Pawlaczyk, Peter A McCullough, Susan Enright, Arvind Kunadi, Thomas E Vanhecke
BACKGROUND: Routine management of patients with acute decompensated heart failure (ADHF) requires careful attentiveness to fluid status and diuretic treatment efficacy. New advances in ultrasound have made ultraportable echocardiography (UE) available to physicians for point-of-care use. The purpose of this study is to explore physiologic measures of intravascular fluid volume derived from UE and explore predictors of diuretic response in ADHF. METHODS: Various echocardiography imaging measurements, particularly diameter and collapse of inferior vena cava (IVC), were collected from 77 patients admitted with a primary diagnosis of ADHF...
2016: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/27998322/international-federation-for-emergency-medicine-consensus-statement-sonography-in-hypotension-and-cardiac-arrest-shoc-an-international-consensus-on-the-use-of-point-of-care-ultrasound-for-undifferentiated-hypotension-and-during-cardiac-arrest
#20
Paul Atkinson, Justin Bowra, James Milne, David Lewis, Mike Lambert, Bob Jarman, Vicki E Noble, Hein Lamprecht, Tim Harris, Jim Connolly
Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest. METHODS: The IFEM USIG invited 24 recognized international leaders in PoCUS from emergency medicine and critical care to form an expert panel to develop the sonography in hypotension and cardiac arrest (SHoC) protocol...
December 21, 2016: CJEM
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