Red blood cell transfusion in acute pulmonary embolism
Publication date: Available online 17 January 2020Source: Journal of Vascular and Interventional RadiologyAuthor(s): Assaf Graif, George Kimbiris, Christopher J. Grilli, Demetrios J. Agriantonis, Samuel G. Putnam, Daniel A. LeungAbstractPurposeTo examine the safety of therapeutic-dose anticoagulation during catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE).Materials and MethodsA retrospective review of 156 consecutive cases (age, 56.6 ± 15.4 years; 85 males) of CDT with alteplase for acute PE (symptoms,
Authors: Sucker C Abstract Venous thromboembolisms and pulmonary embolisms are one of the main causes of morbidity and mortality in pregnancy. The increased risk of thrombotic events caused by the physiological changes during pregnancy alone does not justify any medical antithrombotic prophylaxis. However, if there are also other risk factors such as a history of thromboses, hormonal stimulation as part of fertility treatment, thrombophilia, increased age of the pregnant woman, severe obesity or predisposing concomitant illnesses, the risk of thrombosis should be re-evaluated - if possible by a coagulation speciali...
Clinical scores have been proposed to stratify the risk of pulmonary thromboembolism (PTE), although this approach suffers a low specificity and the unavoidable need for computed tomography pulmonary angiography (CTPA) scans.
Both acute myocardial infarction and acute pulmonary embolism are distinct medical urgencies while they may conincide. Leriche ’s syndrome is a relatively rare aortoiliac occlusive disease characterized by clau...
To examine the safety of therapeutic-dose anticoagulation during catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE).
The objective of this study was to evaluate the efficacy of protocolized use of catheter-directed thrombolysis and echocardiography in submassive pulmonary embolism patients. METHODS: A retrospective study at a single institution of 28 patients that presented with submassive pulmonary embolism from July 2016 to September 2019 was performed. All patients were diagnosed using chest computed tomography demonstrating a pulmonary embolism and abnormal right ventricular to left ventricular ratio. Patients with severe right heart dysfunction (right ventricular to left ventricular ratio ⩾1.4) were protocolized to receive ca...
CONCLUSION: Left ventricular unloading was associated with a significant reduction in left ventricular preload parameters in the setting of veno-arterial extracorporeal life support. This effect may be most pronounced for micro-axial blood pump and atrial septostomy. PMID: 31948360 [PubMed - as supplied by publisher]
We present a contemporary review summarizing the different catheter directed interventions currently available for acute PE, their indications, technical considerations, clinical effectiveness, complication rates and long-term outcomes.Expert opinion: For intermediate high-risk PE patients without a contraindication for thrombolysis, CDIs should be considered in patients at risk for clinical decompensation. For high risk PE patients with a major contraindication to thrombolytic therapy, suction thrombectomy can be considered in places with appropriate clinical and technical expertise. PMID: 31937150 [PubMed - as supplied by publisher]
The limitations of clinical decision rules1 are exemplified by the performance of the Wells criteria in primary care.2 The latter study enrolled 598 patients in whom the general practitioner considered that pulmonary embolism might be present. Suspicion of pulmonary embolism was based on the presence of 1 or more of the following symptoms: unexplained (sudden) dyspnea, deterioration in existing dyspnea, pleuritic pain, and unexplained cough. After recording the Wells score, the primary care doctor was required to refer the patient to secondary care for further evaluation.
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