Diagnostic yield of intravascular ultrasound in patients with clinical signs and symptoms of lower extremity venous disease

ConclusionsIVUS is an effective diagnostic tool that displays high quality, real-time cross-sectional anatomy during venous interventions. When used as the sole intraoperative diagnostic modality, it seems to have a high clinical yield in patients in whom signs and symptoms of venous disease are severe enough to merit intervention.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research

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Publication date: Available online 26 December 2019Source: Journal of Vascular and Interventional RadiologyAuthor(s): Subin Heo, Je Hwan Won, Jinoo Kim, Jong Yeop Kim, Han Bum JoeAbstractPurposeTo evaluate the efficacy and safety of the ultrasound-guided supraclavicular brachial plexus block (BPB) during angioplasty of dysfunctional arteriovenous access.Materials and MethodsEighty study participants with dysfunctional arteriovenous access were enrolled in this prospective, randomized clinical trial between November 2016 and February 2018. Eighty patients were randomized to either the ultrasound-guided supraclavicular BPB g...
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
Publication date: Available online 3 December 2019Source: Journal of Cardiology CasesAuthor(s): Kazunori Takemura, Masaharu Maegaki, Ryuta Nakamura, Tetsuro Takase, Kaneto Mitsumata, Tomoaki Tanabe, Imun TeiAbstractSpontaneous coronary artery dissection (SCAD) usually occurs in women, which can result in significant morbidities. A 38 year-old obese man who is currently smoking was referred to our hospital with chest pain. His electrocardiography and echocardiography suggested myocardial infarction in proximal region of left coronary artery. Emergent coronary angiography revealed 99% stenosis at mid portion of LAD and diffu...
Source: Journal of Cardiology Cases - Category: Cardiology 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
Pocket-size ultrasound devices that cost 50 times less than the machines in hospitals (and connect to your phone). Virtual reality that speeds healing in rehab. Artificial intelligence that’s better than medical experts at spotting lung tumors. These are just some of the innovations now transforming medicine at a remarkable pace. No one can predict the future, but it can at least be glimpsed in the dozen inventions and concepts below. Like the people behind them, they stand at the vanguard of health care. Neither exhaustive nor exclusive, the list is, rather, representative of the recasting of public health and medic...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized HealthSummit19 technology Source Type: news
This is written by Brooks Walsh.https://twitter.com/BrooksWalshA 30 year-old woman was brought to the ED with chest pain.It had started just after nursing her newborn, about an hour prior, and she described it as a severe non-pleuritic “pressure” radiating to the back.She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying " I'm just an anxious person. "A CXR and a CTA for PE were normal.The ECGsAn initial ECG was obtained as the pain was rapidly resolving:Minimal upsloping ST Elevation in III, with a steeply biphasic...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Abstract BACKGROUND: Endovascular treatment of occlusive disease of the superficial femoral artery (SFA) has evolved from plain old balloon angioplasty (POBA) through primary stenting strategy to drug eluting technology-based approach. The RAPID trial investigates the added value of drug coated balloons (DCB, Legflow) in a primary stenting strategy (Supera stent) for intermediate (5-15 cm) and long segment (>15 cm) SFA lesions. METHODS: In this multicenter, patient-blinded trial, 160 patients with intermittent claudication, ischemic rest pain, or tissue loss due to intermediate or long SFA lesions were ran...
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Rationale: Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, and nowadays poorly understood. The overall incidence of SCAD ranges from 0.28% to 1.1% in angiographic studies. Therefore, the true incidence of SCAD is most likely underestimated due to asymptomatic or sudden cardiac death before diagnosis. Stent fracture (SF) is a multifactorial issue. Longer vessel remodeled by 2 stents can be more prone to have SF due to higher radial force. Patient concerns: In this paper we report a 48-year-old man with chest pain for 2 years. Diagnoses: Elective coronary angiography revealed a linear dissec...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Discussion Budd-Chiari syndrome (BCS) is a rare liver disease caused by hepatic venous outflow obstruction (HVOTO). The obstruction can be anywhere from the small intrahepatic veins up to the inferior vena cava junction with the right atrium. The liver parenchyma itself is not directly affected but becomes compromised because of the increased hepatic sinusoidal pressure over time. The causes include: prothrombic events (35% of cases such as Protein C or Protein S deficiency, Factor V Leiden or antithrombin deficiency), myeloproliferative conditions, oral contraceptive use, and local factors. BCS can occur in any age but i...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
A 77 y.o. woman with a history of hypertension and congestive heart failure presented for acute onset chest pain and shortness of breath. She stated that she woke up in the morning with a central chest pressure with associated shortness of breath. She had been feeling well the day before.She had no h/o CAD but had a history of " unspecified cardiomyopathy "No old EKGs or angiogram were available.This ECG was texted to me with no information:What do you think?There is ST elevation in inferior leads, with reciprocal ST depression in aVL, so one must strongly suspect acute inferior MI.However, 3 features made me thi...
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
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