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https://www.readbyqxmd.com/read/28212135/the-role-of-residual-intrastent-thrombus-during-primary-angioplasty-insights-from-the-coctail-ii-study
#1
Laura Gatto, Enrico Romagnoli, Francesco Versaci, Ugo Limbruno, Tomasz Pawlowski, Italo Porto, Valeria Marco, Luca Di Vito, Fabrizio Imola, Alberto Cremonesi, Francesco Prati
AIMS: Recent frequency-domain optical coherence tomography studies showed that a complete removal of thrombotic materials is rarely achieved after percutaneous coronary interventions for ST segment elevation myocardial infarction. Residual intrastent thrombus can embolize distally leading to microcirculatory injury. The aim was to find a possible correlation between residual intrastent thrombus and angiographic indexes of myocardial reperfusion. METHODS: The population consisted of 128 ST segment elevation myocardial infarction patients enrolled in the COCTAIL II trial...
February 15, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28211168/the-medtronic-micro-vascular-plug%C3%A2-for-vascular-embolization-in-children-with-congenital-heart-diseases
#2
Shyam Sathanandam, Henri Justino, B Rush Waller, Srinath T Gowda, Wolfgang Radtke, Athar M Qureshi
OBJECTIVES: To describe the early multi-center, clinical experience with the Medtronic Micro Vascular Plug™ (MVP) in children with congenital heart disease (CHD) undergoing vascular embolization. BACKGROUND: The MVP is a large diameter vascular occlusion device that can be delivered through a microcatheter for embolization of abnormal blood vessels. METHODS: A retrospective review of embolization procedures using the MVP in children with CHD was performed in 3-centers...
February 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28210989/net-clinical-benefit-of-dabigatran-vs-warfarin-in-venous-thromboembolism-analyses-from-re-cover-%C3%A2-re-cover%C3%A2-ii-and-re-medy%C3%A2
#3
Martin Feuring, Sam Schulman, Henry Eriksson, Ajay J Kakkar, Sebastian Schellong, Stefan Hantel, Elke Schueler, Jörg Kreuzer, Samuel Z Goldhaber
The direct oral anticoagulants, e.g., dabigatran etexilate (DE), are effective and well tolerated treatments for venous thromboembolism (VTE). Net clinical benefit (NCB) is a useful concept in weighing potential benefits against potential harm of comparator drugs. The NCB of DE vs. warfarin in VTE treatment was compared. Post-hoc analyses were performed on pooled data from the 6-month RE-COVER® and RE-COVER™ II trials, and data from the RE-MEDY™ trial (up to 36 months), to compare the NCB of DE (150 mg twice daily) and warfarin [target international normalized ratio (INR) 2...
February 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28210931/serotonin-syndrome-from-5-hydroxytryptophan-supplement-ingestion-in-a-9-month-old-labrador-retriever
#4
Hopkins Jennifer, Pardo Mariana, Bischoff Karyn
INTRODUCTION: 5-Hydroxytryptophan (5-HTP) supplements are available over the counter and labeled as sleeping aids and anxiolytics for human use. 5-HTP is a serotonin precursor and overdose can lead to serotonin syndrome. CASE REPORT: A 9-month-old female Labrador retriever was evaluated after ingestion of a 5-HTP supplement. Signs of agitation developed within 1 h of ingestion, and emesis was attempted by the owner with  3% hydrogen peroxide (H2O2) orally. On presentation, the dog was obtunded, bilaterally mydriatic and salivating...
February 16, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28210801/patient-radiation-doses-and-reference-levels-in-pediatric-interventional-radiology
#5
Bouchra Habib Geryes, Adeline Bak, Julie Lachaux, Augustin Ozanne, Nathalie Boddaert, Francis Brunelle, Olivier Naggara, Guillaume Saliou
OBJECTIVES: To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures. METHODS: From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2-7 years (A5), 8-12 years (A10) and 13-18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy...
February 16, 2017: European Radiology
https://www.readbyqxmd.com/read/28210507/super-selective-mesenteric-embolization-provides-effective-control-of-lower-gi-bleeding
#6
Toan Pham, Bob Anh Tran, Kevin Ooi, Marcus Mykytowycz, Stephen McLaughlin, Matthew Croxford, Iain Skinner, Ian Faragher
Introduction. We aimed to assess the efficacy and safety of digital subtraction angiography (DSA) and super-selective mesenteric artery embolization (SMAE) in managing lower GI bleeding (LGIB). Method. A retrospective case series of patients with LGIB treated with SMAE in our health service. Patients with confirmed active LGIB, on either radionuclide scintigraphy (RS) or contrast-enhanced multidetector CT angiography (CE-MDCT), were referred for DSA +/- SMAE. Data collected included patient characteristics, screening modality, bleeding territory, embolization technique, technical and clinical success, short-term to medium-term complications, 30-day mortality, and progression to surgery related to procedural failure or complications...
2017: Radiology Research and Practice
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#7
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28209398/pulmonary-embolism-associated-with-upper-extremity-deep-venous-thrombosis-after-shoulder-arthroscopy-a-case-report
#8
Hisato Watanabe, Yuichi Nagase, Kazuya Tamai, Sakae Tanaka
No abstract text is available yet for this article.
February 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28209306/successful-coil-embolization-of-a-ruptured-mycotic-aneurysm-that-developed-three-days-after-septic-embolic-infarction-case-report-and-review-of-the-literature
#9
Joshua L Wang, Archana P Hinduja, Ciarán J Powers
BACKGROUND: Infectious intracranial aneurysms (IIAs) are rare entities and are often associated with septic embolus from infectious endocarditis. They may develop rapidly and carry a higher risk of rupture and mortality compared to noninfectious aneurysms. However, the development and rupture of an IIA within 48h in a patient with septic infarction patient is exceedingly rare. CASE DESCRIPTION: In this report, we describe a 25-year-old male who presented with left-sided hemiparesis and dysarthria from septic embolus to the right middle cerebral artery...
February 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28209216/hypertrophic-cardiomyopathy-with-left%C3%A2-ventricular-apical-aneurysm-implications-for-risk-stratification-and-management
#10
Ethan J Rowin, Barry J Maron, Tammy S Haas, Ross F Garberich, Weijia Wang, Mark S Link, Martin S Maron
BACKGROUND: A previously under-recognized subset of hypertrophic cardiomyopathy (HCM) patients with left ventricular (LV) apical aneurysms is being identified with increasing frequency. However, risks associated with this subgroup are unknown. OBJECTIVES: The authors aimed to clarify clinical course and prognosis of a large cohort of HCM patients with LV apical aneurysms over long-term follow-up. METHODS: The authors retrospectively analyzed 1,940 consecutive HCM patients at 2 centers, 93 of which (4...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28208947/delayed-uterine-necrosis-rare-cause-of-nonhealing-wound
#11
Aruna Nigam, Neha Gupta, Arifa A Elahi, Zeeba S Jairajpuri, Swaraj Batra
Uterine necrosis is a very rare condition and most of the reported cases occurred after pelvic arterial embolization for post-partum haemorrhage, embolization of fibroid uterus or application of B-Lynch sutures. A case of delayed myometrial necrosis is reported in post-cesarean patient where no embolization or uterine compression sutures have been applied. Patient presented with foul smelling discharge from the gaped abdominal wound following caesarean section. Abdomen was closed after exploration and lavage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208204/thrombophilic-evaluation-in-patients-with-acute-pulmonary-embolism
#12
Scott M Stevens, Jack E Ansell
Patients with acute pulmonary embolism (PE) are often tested for thrombophilias, which are hereditary and acquired conditions that predispose to thrombosis. If a hereditary condition is identified, then testing is often performed on members of the patient's family. Testing for these conditions can be complex, as the presence of acute thrombosis and antithrombotic therapies can make the results of many tests unreliable. Many risk factors for thrombosis exist that are not routinely assessed by laboratory testing, and it is likely that many hereditary thrombophilia conditions remain to be discovered...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208203/acute-pulmonary-embolism-after-discharge-duration-of-therapy-and-follow-up-testing
#13
Cecilia Becattini, Laura Franco, Giancarlo Agnelli
Pulmonary embolism (PE) is a frequent cause of death and serious disability with a risk extending far beyond the acute phase of the disease. Anticoagulant treatment reduces the risk for death and recurrent VTE after a first PE. The optimal duration of anticoagulation after a first episode of PE remains controversial and should be made on an individual basis, balancing the estimated risk for recurrence without anticoagulant treatment against bleeding risk under anticoagulation. Current recommendations on duration of anticoagulation are based on a 3% per year risk of major bleeding expected during long-term warfarin treatment...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208202/inferior-vena-cava-filters-when-to-place-and-when-to-remove
#14
John M Moriarty, Jonathan D Steinberger, Anshuman K Bansal
Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters.
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208201/catheter-based-approaches-for-the-treatment-of-acute-pulmonary-embolism
#15
Victor F Tapson, David Jimenez
Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher with thrombolytic therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#16
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#17
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208198/the-pulmonary-embolism-response-team-what-is-the-ideal-model
#18
Josanna Rodriguez-Lopez, Richard Channick
Treatment of patients with intermediate- and high-risk pulmonary embolism (PE) is a controversial area. Many therapeutic options exist, and deciding on appropriate treatment can be difficult. In addition, multiple specialties are often involved in the care of PE patients. To better organize the response to serious PE patients, several hospitals and academic centers across the United States, spearheaded by Massachusetts General Hospital, have created pulmonary embolism response teams (PERTs). The goal of a PERT is to have a single multidisciplinary team of experts in thromboembolic disease, who can respond rapidly to patients with acute PE, and offer consultation with the full spectrum of therapeutic options...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208195/echocardiography-in-the-risk-assessment-of-acute-pulmonary-embolism
#19
Talal Dahhan, Fawaz Alenezi, Zainab Samad, Sudarshan Rajagopal
Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At this time, the management of patients with submassive PE remains controversial and approaches for improving risk assessment are critical. In this review, we discuss several echocardiographic methods to assess right heart function that may aid in the risk assessment of patients with acute PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208194/risk-stratification-for-proven-acute-pulmonary-embolism-what-information-is-needed
#20
Deisy Barrios, Roger D Yusen, David Jiménez
Classification of risk drives treatment decisions for patients with acute symptomatic pulmonary embolism (PE). High-risk patients with acute symptomatic PE have hemodynamic instability (i.e., shock or hypotension present), and treatment guidelines suggest systemically administered thrombolytic therapy in this setting. Normotensive PE patients at low risk for early complications (low-risk PE) might benefit from treatment at home or early discharge, while normotensive patients with preserved systemic arterial pressure deemed as having a high risk for PE-related adverse clinical events (intermediate-high-risk PE) might benefit from close observation and consideration of escalation of therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
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