High-sensitive cardiac troponin T as a marker of hemorrhagic complications in elderly patients anticoagulated for non-massive pulmonary embolism
Recent data have raised concerns about the risk/benefit ratio of thrombolysis in non-high risk pulmonary embolism patients due to increased serious bleeding events. Whether cardiac biomarkers could be of help for bleeding risk stratification in this setting remains elusive.
Conclusion: In Behçet's disease, coronary artery bypass grafting is a procedure with high mortality, especially in the acute period. The on-pump surgery technique in these cases can be safely performed for multiple bypa sses and in patients above 40 years old.
AbstractThe optimal dose and duration of tissue plasminogen activator (tPA) administered with ultrasound-facilitated catheter-directed thrombolysis (USCDT) to patients with acute PE remains to be determined. Our institution recently adopted a shorter duration (4 h) of USCDT and lower dosing strategy (tPA 1 mg/h) based on data from the OPTALYSE PE Trial. The purpose was to evaluate the implementation at our institution of shorter duration (4 h) of USCDT and lower dosing strategy (tPA 1 mg/h) as outlined by OPTALYSE PE Trial. This was a retrospective, si ngle-center, observational study included patients...
CONCLUSIONS: Endovascular techniques seem to have satisfactory long-term outcomes in IFDVT, regarding to PTS risk and IF patency. However, further investigation with prospective randomized clinical trials with large populations and long follow-ups is necessary. PMID: 31782288 [PubMed - as supplied by publisher]
AbstractVenous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is the most common cause of 30-day morbidity in oncology patients following surgery due to their hypercoagulable state. To combat this, VTE prophylaxis with anticoagulation extending beyond hospital discharge, termed extended duration chemoprophylaxis (EDCP), has been proposed, with the most recent guidelines recommending 28 post-operative days of EDCP. However, the literature has demonstrated poor compliance to these recommendations. We extended the duration of EDCP to 28 days post hospital discharge, effectively creating a stan...
ConclusionsEndobronchial administration of ε-aminocaproic acid during bronchoscopy may be a safe and efficacious option in the treatment and prevention of pulmonary bleeding. Further studies are necessary to better define ε-aminocaproic acid's safety profile, optimal routes of administration, and comparative effectiveness to tranexamic acid.
CONCLUSIONS: Systemic thrombolysis is utilized more often than CDT in patients with acute PE, in particular among those with a greater prevalence of high-risk features. Among patients treated with CDT, there were no differences in events between CDT-US and CDT alone. PMID: 31783016 [PubMed - as supplied by publisher]
CONCLUSIONS: Nebulized AT and heparin attenuate lung injury through decreasing coagulation and inflammation without altering systemic coagulation and no bleeding. However, combined AT and heparin did not produce a synergistic effect. PMID: 31755229 [PubMed - as supplied by publisher]
2 trials report effective secondary prevention with low dose apixaban or rivaroxaban after the initial treatment period for VTE (Agnelli 2013 &Weitz 2017). This is a retrospective service evaluation of low dose DOAC over 1 year in patients with unprovoked VTE.Methods: At 3 months post PE or proximal DVT, patients are assessed for VTE and bleeding risk factors. Patients with unprovoked VTE (without chronic thromboembolic pulmonary hypertension, high risk inherited thrombophilia or antiphospholipid syndrome &
Conclusions: In selected subgroups of patients with VTE, anti-Xa levels may represent a marker for the risk of developing recurrent VTE or bleeding events. Whether adjustment of the LMWH dosage would minimize this risk remains to be investigated in management studies.
Introduction: In randomized controlled trials, direct oral anticoagulants are at least as effective and probably safer than standard anticoagulation in patients with venous thromboembolism (VTE). Real-life studies are of particular interest for the assessment of their efficacy and safety in unselected patients.Methods: We conducted a retrospective analysis of a prospective monocentric cohort including patients with symptomatic pulmonary embolism (PE) treated with VKA or rivaroxaban (riva) with a 6-month follow-up. We distinguished 2 periods: P1 (2010-2013) when only VKA was available; P2 (2014-2017) when VKA and riva were ...