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management of pulmonary embolism

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https://www.readbyqxmd.com/read/29458084/severe-pulmonary-embolism-secondary-to-cement-embolism-in-the-inferior-vena-cava-after-percutaneous-vertebroplasty
#1
Zhaoshun Yuan, Yangzhao Zhou, Xinmin Zhou, Xiaobo Liao
Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occur simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. The patient's symptom and image tests manifested that the cPE was secondary to cIE. Even though the cIE was found on the first day after PVP, local surgeons treated the patient with a regular anticoagulant instead of more effective therapeutic measures...
February 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29455405/bariatric-surgery-in-patients-on-chronic-anticoagulation-therapy
#2
Gautam Sharma, Zubaidah Nor Hanipah, Ali Aminian, Suriya Punchai, Emre Bucak, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Perioperative management of chronically anti-coagulated patients undergoing bariatric surgery requires a balance of managing hemorrhagic and thromboembolic risks. The aim of this study is to evaluate the incidence of hemorrhagic complications and their management in chronically anticoagulated (CAT) patients undergoing bariatric surgery. METHODS: A retrospective review of CAT patients undergoing bariatric surgery at an academic center from 2008 to 2015 was studied...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29451506/-ten-questions-on-the-management-of-patients-with-acute-pulmonary-embolism
#3
Cecilia Becattini, Cristian Mattei, Giancarlo Agnelli
Clinical management of acute pulmonary embolism has changed over the years based on new evidence on diagnosis, prognostic stratification and treatment. The increasing availability of computed tomography angiography has made the diagnosis faster and accurate, although with some concern on radiation exposure and potential for overdiagnosis. The efficacy and safety of simple-to-use oral anticoagulant agents acting as selective direct inhibitors of coagulation certainly offer considerable benefits to the patients...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29445486/aneurysm-of-the-inferior-vena-cava-with-thrombosis
#4
Masashi Inoue, Takeshi Sudo, Megumi Yamaguchi, Shingo Seo, Tatsuya Miyamoto, Toshihiro Misumi, Wataru Shimizu, Toshimitsu Irei, Takahisa Suzuki, Takashi Onoe, Yosuke Shimizu, Takao Hinoi, Hirotaka Tashiro
Inferior vena cava (IVC) aneurysms are extremely rare. Patients can be asymptomatic, have thrombosis, rupture, or pulmonary embolism. Thrombosis of the IVC aneurysm may mimic a retroperitoneal tumor. Surgical treatment of abdominal venous aneurysms with thrombosis is warranted and is necessary for the management of intraoperative bleeding and thrombosis.
February 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29445314/prognostic-assessment-for-patients-with-cancer-and-incidental-pulmonary-embolism
#5
George Bozas, Natalie Jeffery, Deiva Ramanujam-Venkatachala, Ged Avery, Andrew Stephens, Hilary Moss, June Palmer, Mandi Elliott, Anthony Maraveyas
Background: An incidental/unsuspected diagnosis of pulmonary embolism (IPE) in cancer patients is a frequent occurrence. This single-institution analysis of uniformly managed patients investigates short and long-term outcomes and proposes a prognostic risk score, aiming to assist clinical decision-making. Methods: Data from a prospectively recorded cohort of 234 consecutive cancer patients with IPE were analysed. Multivariate logistic regression and the Cox regression survival methods were used to identify factors with independent association with early (30-day, 3-month, 6-month) mortality and survival...
2018: Thrombosis Journal
https://www.readbyqxmd.com/read/29443835/venous-thromboembolism-incidence-after-craniofacial-surgery
#6
Wilson I Omesiete, James A Walker, Jack C Yu
INTRODUCTION: Current protocols for venous thromboembolism (VTE) prophylaxis after craniofacial surgery (CFS) vary widely with substantial disagreements in both indications and managements. An evidence-based approach to this issue requires the following: the incidence of postoperative VTE, comorbidities associated with coagulopathy, risk reduction after VTE prophylaxis, and complications attributable to prophylaxis. This study addresses the first two. DESIGN: Retrospective cross-sectional study...
February 13, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29437738/an-unusual-presentation-of-pulmonary-embolism-leading-to-infarction-cavitation-abscess-formation-and-bronchopleural-fistulation
#7
Eva Teng, Luke Bennett, Tommaso Morelli, Anindo Banerjee
We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Serial chest x-rays showed progression from lobar consolidation to a large loculated left-sided pleural collection. CT chest showed left-sided lung abscess, empyema and bronchopleural fistulation...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29431911/the-years-algorithm-for-suspected-pulmonary-embolism-shorter-visit-time-and-reduced-costs-at-the-emergency-department
#8
L M van der Pol, C E A Dronkers, T van der Hulle, P L den Exter, C Tromeur, C Heringhaus, A T A Mairuhu, M V Huisman, W B van den Hout, F A Klok
BACKGROUND: Recently, the safety of the YEARS algorithm, designed to simplify the diagnostic work-up of pulmonary embolism (PE), was demonstrated. We hypothesize that by design, YEARS would be associated with a shorter diagnostic emergency department (ED) visit time due to simultaneous assessment of pre-test probability and D-dimer level and reduction in CT-scans. AIM: To investigate whether implementation of the YEARS diagnostic algorithm is associated with a shorter ED visit time compared to the conventional algorithm and to evaluate the associated cost savings...
February 12, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29428532/severe-pulmonary-embolism-was-secondary-to-cement-inferior-vena-cava-embolism-after-percutaneous-vertebroplasty
#9
Zhaoshun Yuan, Yangzhao Zhou, Xinmin Zhou, Xiaobo Liao
Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occured simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. Patient's symptom and image tests manifest that the cPE was secondary to cIE. Even though cIE was found at the first day after PVP, the local surgeons treat the patient with a regular anticoagulant without another more effective therapeutic measure...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29427478/from-ruling-out-to-ruling-in-putting-pocus-in-focus
#10
Arjun K Venkatesh, Charles D Scales, Marta E Heilbrun
Over the past twenty years, the Emergency Department (ED) has transformed from a location that managed patients with acute life-threatening illness or injury to an acute diagnostic center. The advent of rapid and accurate imaging, novel biomarkers, and other innovations concurrent with effects from financial and social forces has supported the development of an acute care system focused on "ruling out" low-frequency, high-mortality events such as acute myocardial infarction, stroke, pulmonary embolism, and aortic dissection...
February 10, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29415816/-impact-of-the-2009-afssaps-guidelines-on-the-management-of-venous-thromboembolic-disease-in-emergency-department-before-after-study
#11
L De Massari, Y Jamilloux, J-C Lega, A Sigal, X Jacob, K Tazarourte, K Mensah, P Sève
INTRODUCTION: The French Agency for Health Safety of Products published recommendations of good practices (RGP) for the treatment of venous thromboembolic disease in 2009. Four of these recommendations apply to the initial management of the disease, with the objective of this study is to determine whether the development and diffusion of the four RGP has had an impact on the practice. METHODS: A retrospective before/after study comparing 132 patients treated in emergency department of the Civil Hospices of Lyon for pulmonary embolism (PE) and/or deep venous thrombosis (DVT) in 2008-2009 ("before") and 153 patients in 2010-2011 ("after")...
February 4, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29410163/management-of-low-risk-pulmonary-embolism-lope-patients-without-hospitalization-the-lope-prospective-management-study
#12
Joseph Bledsoe, Scott Woller, Scott Stevens, Valerie Aston, Rich Patten, Todd Allen, Benjamin Horne, Lydia Dong, James Lloyd, Greg Snow, Troy Madsen, Gregory Elliott
BACKGROUND: The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic venous thromboembolism (VTE), major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient hospitalization; and to measure patient satisfaction. METHODS: We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five emergency departments...
February 1, 2018: Chest
https://www.readbyqxmd.com/read/29407080/arterial-hypertension-in-patients-with-atrial-fibrillation-in-europe-a-report-from-the-eurobservational-research-programme-pilot-survey-on-atrial-fibrillation
#13
G A Dan, E Badila, E Weiss, C Laroche, G Boriani, A Dan, L Tavazzi, A P Maggioni, H J Crijns, R Popescu, D Blommaert, W Streb, G Y H Lip
BACKGROUND: Hypertension (HTN) is the most prevalent co-morbidity among atrial fibrillation (AF) patients; the relationship between the two is bidirectional, with an incremental effect on adverse outcomes. PURPOSE: To study clinical features, treatment patterns and 1year outcomes amongst AF patients with HTN in the EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry, a prospective multi-national survey conducted by the European Society of Cardiology in 9 European countries...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29406559/lemierres-syndrom-%C3%A2-en-p%C3%A3-minnelse-om-%C3%A2-den-gl%C3%A3-mda-sjukdomen%C3%A2-god-kunskap-under-hela-v%C3%A3-rdkedjan-viktigt-f%C3%A3-r-att-i-tid-v%C3%A3-cka-misstanke
#14
Jan Hedenmark, Karin Holm, Fredrik Moberger, Erik Torell
The purpose of this case report and discussion is to heighten the awareness of Lemierres syndrome (postanginal sepsis).  Affected patients present in various fields of medicine and an increased incidence of "the forgotten disease" may be expected. Fusobacterium necrophorum is the most common pathogen. The clinical course includes a primary head or neck infection with thrombosis of the internal jugular vein with subsequent septic pulmonary embolization. The syndrome bears considerable morbidity and even mortality...
February 2, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29399535/deep-venous-thrombosis-in-pregnancy-incidence-pathogenesis-and-endovascular-management
#15
REVIEW
Paola Devis, M Grace Knuttinen
Deep venous thrombosis (DVT) during pregnancy is associated with high mortality, morbidity, and costs. Pulmonary embolism (PE), its most feared complication, is the leading cause of maternal death in the developed world. DVT can also result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. Women are up to 5 times more likely to develop DVT when pregnant. The current standard of care for this condition is anticoagulation. This review discusses the epidemiology, pathogenesis, prophylaxis and diagnosis of DVT during pregnancy, and then focuses on endovascular treatment modalities...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399531/deep-vein-thrombosis-pathogenesis-diagnosis-and-medical-management
#16
REVIEW
Jonathan Stone, Patrick Hangge, Hassan Albadawi, Alex Wallace, Fadi Shamoun, M Grace Knuttien, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide. Venous thromboembolism (VTE), which includes DVT and pulmonary embolism (PE), affects an estimated 1 per 1,000 people and contributes to 60,000-100,000 deaths annually. Normal blood physiology hinges on a delicate balance between pro- and anti-coagulant factors. Virchow's Triad distills the multitude of risk factors for DVT into three basic elements favoring thrombus formation: venous stasis, vascular injury, and hypercoagulability...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399526/catheter-directed-thrombolysis-of-deep-vein-thrombosis-literature-review-and-practice-considerations
#17
REVIEW
Drew Fleck, Hassan Albadawi, Fadi Shamoun, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Deep vein thrombosis (DVT) is a major health problem worldwide. The risk of pulmonary embolism following DVT is well established, but the long-term vascular sequelae of DVT are often underappreciated, costly to manage, and can have extremely detrimental effects on quality of life. Treatment of DVT classically involves oral anticoagulation, which reduces the risk of pulmonary embolism but does not remove the clot. Anticoagulation therefore does little to prevent the venous damage and scarring that occurs following DVT, leaving the patient at risk for permanent venous insufficiency and development of post-thrombotic syndrome (PTS)...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399522/can-thrombus-age-guide-thrombolytic-therapy
#18
REVIEW
Christopher Czaplicki, Hassan Albadawi, Sasan Partovi, Ripal T Gandhi, Keith Quencer, Amy R Deipolyi, Rahmi Oklu
Venous thrombosis (VT) is a common yet complex clinical condition that has shown minimal alteration in clinical management for decades. It is well known that thrombus evolves structurally over time, with complex changes resulting from the interplay between coagulation factors, cytokines, leukocytes and a myriad of other factors. Our current treatment options are most effective in the acute thrombus, which is composed predominantly of a loose mesh of fibrin and red blood cells (RBCs), making current anticoagulation therapies and thrombolytics quite effective in treatment...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29399516/below-knee-deep-vein-thrombosis-dvt-diagnostic-and-treatment-patterns
#19
Drew Fleck, Hassan Albadawi, Alex Wallace, Grace Knuttinen, Sailendra Naidu, Rahmi Oklu
Background: Guidelines are lacking for isolated below-knee deep vein thrombosis (BKDVT). The American College of Chest Physicians (ACCP) suggests anticoagulation only if symptoms are severe, otherwise surveillance with follow-up ultrasound in 2 weeks is recommended. Yet clinical practice remains highly variable. Little is known about the natural history of BKDVT and how to best manage these patients. Methods: A retrospective analysis was conducted of medical records from 2014-2016...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29396158/an-institution-wide-algorithm-for-direct-stick-embolization-of-peripheral-venous-malformations
#20
Naiem Nassiri, Lauren A Huntress, Mitchell Simon, Susan Murphy
OBJECTIVE: No standardized therapeutic algorithm or embolic agent of choice has yet been identified for management of congenital peripheral venous malformations (VMs). Treatment options and reported outcomes therefore vary widely. Herein, we present an institution-wide algorithm for management of symptomatic congenital peripheral VMs using a single embolotherapeutic modality. METHODS: During 36 months, patients with symptomatic congenital peripheral VMs underwent contrast-enhanced magnetic resonance imaging...
January 29, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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