Clinical Case of Successful Endovascular Treatment of Obstructive Post-thrombotic Syndrome in the Lower Extremity With Plain Balloon Angioplasty as a Standalone Method

We present the case of 71-years old female with post-thrombotic syndrome who had long-term non-healing trophic ulcers, swelling and pain in her right leg. Deep vein thrombosis (DVT) of the right lower limb first occurred in 1971. In 1972 she noticed appearance of trophic nonhealing ulcers in the medial aspect of right shin. Thereafter two episodes of sudden edema and pain in right leg occurred with large time period in between. Although prescribed as early as in 1971, patient didn't take anticoagulant medication on the regular basis and used only compression bandage and local treatment for trophic ulcers.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research

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We report a case of MTS to describe its clinical utility and advantages. Patient concerns: A 49-year-old male experienced isolated left leg swelling and pain for half a month. He had a history of chronic renal insufficiency that made contrast-enhanced imaging studies inadequate. Diagnoses: A lower extremity venous Duplex scan showed a thrombus extending from the left distal femoral vein to the popliteal vein with valvular reflux, consistent with infrainguinal deep vein thrombosis (DVT). The suprainguinal DVT was evaluated by non-contrast-enhanced MRV. The results showed sandwich external compression of the left commo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
A 40-something male presents to the stabilization room for evaluation following head on motor vehicle collision (MVC).  Pt was reported restrained driver, hit at city speeds,  with + airbag deployment.The MVC was unquestionably caused by the other car, not by this driver.The patient complained to EMS of chest pain and a prehospital EKG en route was concerning for STEMI.The patient was at all times hemodynamically stable, without evidence of any profuse bleeding.He had an ECG recorded on arrival to the ED:Anterior and Inferior STEMI with diffuse hyperacute T-waves. This ECG really can't be anything else. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
We report a 32-year-old female worker presenting pain in her left upper-extremity for 7 months. Her left hand became paler and cold when the temperature decreased, and the symptoms could not be eased through rest, physiotherapy and drugs medication. Diagnoses: Compression of left subclavian artery with axillary and brachial arteries thrombosis was confirmed by duplex ultrasound and computed tomography angiography. ATOS caused by cervical ribs was confirmed by medical history, physical examination, and imaging. Interventions: The patients underwent acute thrombolysis and balloon angioplasty. Outcomes: Symptoms of p...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Cardiologists are grappling with at least  half a dozen time windows  in the management of STEMI. (It can be combinations of any of the following :Symptom – DAPT Loading – Door – Needle /Balloon-Sheath, wire crossing etc ) Time windows are Important in choosing the right (or no)modality of re-perfusion . Though superiority of  primary PCI  is thought to be established in academic community , it  may not be in real world. Published studies that suggest pPCI is superior to lysis at any time window  still lack good evidence. Why is this long drawn confusion&n...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cath lab tips and tricks PCI PTCA Hardware Primary -PCI STEMI STEMI -Managment STEMI-Primary PCI Thrombolysis how to estimate the age of thrombus in stemi acs soft vs hard thrombus in stemi thrombus hardening time thrombus organising t Source Type: blogs
This study from Herzog et al (from our own Hennepin County Medical Center) included patients from a national registry and compared 3049 patients on dialysis admitted and eventually found to have acute MI compared with 534,395 patients not on dialysis admitted with an eventual diagnosis of acute MI. Of these groups, only 22% of dialysis patients had an admission diagnosis consistent with acute MI while 43.8% of nondialysis patients had the correct admission diagnosis of acute MI.  Dialysis patients had double the rate of cardiac arrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Authors: Tomoi Y, Kuramitsu S, Soga Y, Hiramori S, Ando K Abstract Unlike coronary arteries, little is known about peri-stent contrast staining (PSS) formation after drug-eluting stent (DES) implantation for infrapopliteal arteries. Herein, we report exacerbated PSS assessed by serial angiography and optical coherence tomography (OCT) after platinum-chromium everolimus-eluting stent (PtCr-EES) implantation for infrapopliteal artery lesions. A 68-year-old women with recurrent left critical limb ischemia was admitted to our hospital. Standard endovascular techniques were performed for the popliteal artery (POP) and t...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
One of our graduates, Rochelle Zarzar, who is now an education fellow, sent me this from one of the hospitals she works at now:An elderly woman presented with chest pain.  She had been nauseous the night before and did not feel well, then awoke 2 hours prior with chest pain.She had had a completely normal angiogram 3 months prior.Here is that angiogram report:The left main coronary artery is normal.Left anterior descending is a type 3 vessel and is normal.Left circumflex is nondominant and normal.The right coronary artery is dominant and normal.The nurses immediately recorded an ECG.  This was 2 hours after the o...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
A 47-year-old woman with bilateral lower-extremity swelling and pain presented for evaluation 2 months after placement of a G ünther Tulip inferior vena cava (IVC) filter (Cook, Bloomington, Indiana) for the treatment of right lower-extremity deep vein thrombosis. Anticoagulation was contraindicated as a result of concurrent gastrointestinal bleeding. Venography revealed extensive subocclusive thrombus within the IVC and bilateral common iliac veins (Fig 1). Balloon maceration of the thrombus in the IVC and iliac veins with 10-mm semicompliant balloon angioplasty (Evercross; Medtronic, Minneapolis, Minnesota) was unsu...
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Extreme IR Source Type: research
Conclusions A combination of early thrombus removal, thoracoscopic first rib resection, and postoperative venous balloon angioplasty seems to yield acceptable intermediate-term results after Paget-Schroetter thrombosis.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
Conclusions PVR-TIPS is safe and effective in selected patients with chronic non-cirrhotic PVT. Due to technical complexity and possible complications, it should be performed only in specialized centers with high experience in TIPS procedures. PMID: 29113006 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Gastroenterologie - Category: Gastroenterology Authors: Tags: Z Gastroenterol Source Type: research
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