Early Covered Self-Expandable Metal Stent Placement Is Effective for Massive Post-endoscopic Sphincterotomy Bleeding

AbstractBackgroundPlacement of covered self-expandable metallic stent (CSEMS) for post-endoscopic sphincterotomy (ES) bleeding achieves excellent hemostasis results. Although CSEMS placement is typically performed after failure of conventional endoscopic combination therapy, its excellent outcomes may justify earlier placement.AimsWe aimed to examine the efficacy of “early” CSEMS placement for massive post-ES bleeding.MethodsThe medical records of 2750 patients who underwent ES between 2005 and 2019 were reviewed retrospectively, and 61 patients who developed massive post-ES bleeding were enrolled. These patients were divided into those who underwent early CSEMS placement (E-CSEMS group) and those who underwent conventional endoscopic combination therapy (Conventional group). The outcomes of hemostasis procedures were compared between the groups.ResultsThe primary success rates of endoscopic hemostasis were 100% (21/21) and 98% (39/40) in the E-CSEMS group and Conventional group, respectively, without significant differences (P = 1.000). However, in the E-CSEMS group, re-bleeding was significantly less frequent (5% vs. 31%;P = 0.023), the median hemostasis procedure time was significantly shorter (14 min vs. 26 min;P 
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research

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Conclusion: Most cases of RPH had an excellent outcome with conservative management alone. PMID: 32089021 [PubMed - as supplied by publisher]
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
This study (NCT03381742) retrospectively analyzed the data from 11 hospitals on 3,043 patients with coronary artery disease, who received C75QD, T90BID, ticagrelor 45 mg BID (T45BID), or ticagrelor 90 mg QD (T90QD). Compared with C75QD, both T45BID and T90QD showed significantly higher inhibition of platelet aggregation (P
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Authors: Le Marec J, Henique H, Rubenstein E, Bigot A, Puyade M, Urbanski G, Lozac'h P, Allain JS, Bayer G, Fain O, Lioger B PMID: 32089036 [PubMed - as supplied by publisher]
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Authors: Karaman K, Yürektürk E, Geylan H, Yaşar AŞ, Karaman S, Aymelek HS, Çetin M, Oner AF Abstract Glanzmann's thrombasthenia (GT) is an autosomal recessive disorder in which the underlying problem is the lack or dysfunction of the GpIIb/IIIa receptor on the platelet surface. The present study determines the genetic mutation typology and analyzes the association between mutation types and clinical findings in patients diagnosed with GT who were followed up in Department of Pediatric Hematology of the Yüzüncü Yıl University School of Medicine. The medical charts of 17 patients w...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
Conditions:   Dialysis; Complications;   Wound Complication;   Catheter Complications;   Hemorrhage;   Bleeding Wound Intervention:   Device: Application of device which monitors for bleeding - Blood Warning Technology with Continuous Hemoglobin sensor (BWATCH) Sponsor:   Changi General Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractAim : Type 3 von Willebrand disease (VWD) is the most severe form of VWD, characterized by a near-total absence of von Willebrand factor (vWF) leading to a huge deficiency in plasmatic factor VIII (FVIII). VWD may be confused with hemophilia A, sometimes leading to misdiagnosis. The purpose of this work was to finalize the biological diagnosis of patients with FVIII activity deficiency in Abidjan, in order to guide the best type of management.Methods: We conducted a cross-sectional descriptive study from June 2018 to April 2019. Forty-nine patients, all of whom had lower FVIII levels or had been referred for b...
Source: Mediterranean Journal of Hematology and Infectious Diseases - Category: Hematology Authors: Source Type: research
Authors: Baldino G, Rossi UG, Di Gregorio S, Gori A Abstract Percutaneous endovascular abdominal aortic aneurysm repair is nowadays considered a safe and effective procedure and has gained widespread globally acceptance. However, intraoperative persistent bleeding due to percutaneous access closure device failure can occur. Open conversion is first-line treatment to manage this complication. The fascia suture technique was introduced as an alternative to access closure device or as a solution to manage unsatisfactory hemostasis during percutaneous endovascular abdominal aortic aneurysm repair. In this article, we r...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
AbstractPurposeThe aim of this study was to explore the safety and efficacy of bivalirudin in elderly patients undergoing percutaneous coronary intervention (PCI).MethodsAn electronic search was conducted for randomized controlled trials with outcomes of interest in the elderly ( ≥ 65 years of age). Pooled risk ratios (RR) and 95% confidence interval (CI) using random effects Der Simonian–Laird models were calculated. Primary outcomes were net adverse clinical events (NACE) and major bleeding events at 30 days. Secondary outcomes were major adverse cardiac events (MA CE) at 30 days. MACE, all...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
The prevalence of heart failure is rising1, 2 thus constantly widening the gap between donor hearts and patients listed for transplantation3. For an increasing number of patients with advanced heart failure, durable ventricular assist devices (VAD) prolong survival and improve quality of life4 by serving as bridge to transplant, or, for those not eligible for heart transplantation, as destination therapy, i.e. as a life-long support4, 5. Their long-term use, however, is hampered by stroke, bleeding, and infection.
Source: Journal of Infection - Category: Infectious Diseases Authors: Source Type: research
Scalp  surgeries can be complicated by intra- or postoperative hemorrhage, given that the scalp is an area with high blood supply. We daily perform surgical procedures in patients who require anticoagulation. In general, the risk-benefit balance indicates that anticoagulation should not be withdrawn befo re skin surgeries. Although severe hemorrhages rarely occur, intraoperative bleeding can be annoying for the surgeon, and postoperative hemorrhage is usually an unpleasant inconvenience for the patient.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Authors: Tags: JAAD Online Source Type: research
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