Large Venous Sac Thrombus Formation after Endovascular Embolization of Ruptured Pulmonary Arteriovenous Malformation: Usefulness of Time-Resolved MR Angiography in Decision Making

Publication date: Available online 19 September 2020Source: Journal of Vascular and Interventional RadiologyAuthor(s): Jihoon Hong, Sang Yub Lee, Jung Guen Cha, Jae-Kwang Lim, Seung-Ick Cha, Young Woo Do
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research

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Recently, computed tomography pulmonary angiography (CTPA) has emerged as the first line modality for the diagnosis of pulmonary embolism (PE) as it is fast, reliable and widely available [1]. However, with increasing use of CTPA, there has been an associated increase in the incidence of PE with no significant change in mortality [2]. Overuse of CTPA leads to unnecessary radiation and contrast exposure, increased costs, as well as incidental findings, raising the question of over-diagnosis of clinically insignificant PEs conferring a major burden on both patients and healthcare system (2,3).
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
This study evaluates the yield of CTPA for pulmonary embolism across a variety of patient care settings in a community-based healthcare system, providing relevant benchmarks for potential quality improvement efforts.MethodsThis retrospective study included data collected from three sites within a single community-based healthcare system, including a tertiary care level 1 trauma center, an urban community hospital, and a suburban free-standing emergency department. CTPAs were identified by Current Procedural Terminology codes, and diagnoses of pulmonary embolism were identified via International Classification of Diseases c...
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research
CONCLUSIONS: Mechanically ventilated COVID-19 patients present with an imbalance between markedly increased factor V/VIII activity and overwhelmed protein C/S pathway. Plasma D-dimer may be a useful biomarker at the bedside for suspicion of VTE. PMID: 32965009 [PubMed - as supplied by publisher]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
I came across this post from 2015 while answering a question on Twitter, and decided to repost it:http://hqmeded-ecg.blogspot.com/2015/12/syncope-shock-av-block-large-rv.htmlSyncope, Shock, AV block, RBBB, Large RV, " Anterior " ST Elevation in V1-V3An elderly male had a syncopal episode. 911 was called. When medics arrived, the patient was alert and following commands. In the presence of the medics, he lost consciousness and became apneic and underwent 30 seconds of chest compressions, after which he started moaning and was again able to communicate and follow commands.  No shock was ever del...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Abstract BACKGROUND: Acute pulmonary embolism (PE) has been described as a frequent and prognostically relevant complication of COVID-19 infection. AIM: We performed a systematic review and meta-analysis of the in-hospital incidence of acute PE among COVID-19 patients based on studies published within four months of COVID-19 outbreak. MATERIAL AND METHODS: Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in abstracting data and assessing validity. We searched Medline, Scopus and Web of Science to locate all articles published up to August 1, 2020 reporting the incidence of acute PE ...
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Objective: The clinical presentation of pulmonary embolism (PE) can be various and misleading. We analysed patients with suspicion of PE and subsequently performed computed tomography pulmonary angiography (CTPA) in an emergency department of Internal Medicine, focusing on patient groups in which PE might be underestimated in the emergency setting, such as young patients and patients with low clinical probability. Material and Methods: In 2016 and 2017, all patients receiving a CTPA for the question of PE were retrospectively evaluated for clinical (age, symptoms, vital parameters) and D-Dimers. The Wells score was calcul...
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
COVID-19 patients have a strong propensity to develop thrombosis and their respiratory symptoms often prompt clinicians to assess for the presence of a pulmonary thromboembolism (PTE) [1,2]. Prior research estimates that approximately 20% to 30% of patients with COVID-19 have a PTE demonstrated by computed tomography pulmonary angiography (CTPA) [3,4]. Some clinical decision rules such as the Pulmonary Embolism Rule-Out Criteria (PERC) and Wells' Criteria are used to assess a patient's risk of PTE.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
CONCLUSIONS: Pulmonary ART plus local thrombolysis of the pulmonary artery for HR-PE or IHR-PE is feasible and appears to be safe. Further studies are warranted to investigate comparative efficacy compared to existing treatments. PMID: 32863245 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Abstract BACKGROUND: Validated diagnostic algorithms are used to manage patients with suspected pulmonary embolism (PE). The recently published YEARS study proposed a simplified diagnostic strategy to reduce the use of computed tomography pulmonary angiography. OBJECTIVES: To externally validate this strategy in an independent cohort. METHODS: We analyzed data from three previous prospective cohort studies of outpatients with suspected PE. We retrospectively applied the YEARS algorithm. The three YEARS clinical criteria are: clinical signs of deep vein thrombosis, hemoptysis, and PE as the most likely di...
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
Current guidelines recommend the use of unenhanced chest computed tomography (CT) as first-line imaging in patients suspected of having COVID-19 pneumonia, in order to assess the extent of lung damage [1,2]. Although most patients have a favorable disease course, some of them develop secondary disease worsening due to an excessive systemic inflammatory response, evidenced by high serum levels of biomarkers such as IL-6, which promotes an hypercoagulability state leading to thrombotic complications [3,4].
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
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