High Wall Shear Stress Is Related to Atherosclerotic Plaque Rupture in the Aortic Arch of Patients with Cardiovascular Disease: A Study with Computational Fluid Dynamics Model and Non-Obstructive General Angioscopy.
CONCLUSIONS: Aortic RP detected by NOGA was strongly associated with a higher maximum WSS in the aortic arch derived by CFD using 3D-CT. The maximum WSS value may have an important role in the underlying mechanism of not only aortic atherosclerosis, but also aortic RP. PMID: 33012739 [PubMed - as supplied by publisher]
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 . However, with increasing use of CTPA, there has been an associated increase in the incidence of PE with no significant change in mortality . 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).
Authors: Jung SH, Son RC, Kim HK Abstract BACKGROUND: To introduce a transjugular retrograde approach for AngioJet rheolytic thrombectomy (RT) just after transjugular placement of inferior vena cava filter (IVCF) to treat acute deep vein thrombosis (DVT). METHODS: From September 2018 to April 2019, transjugular Angiojet RT using pulse spray method was performed just after transjugular placement of IVCF in five patients (M:F = 3:2, mean age 70 years). Patients less than 165 cm in height with acute (
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]
CONCLUSIONS Subsequent CTA gives valid information on occluded arteries and associated findings, which impact decision-making and are correlated with patient outcome. Our protocol of DUS has high sensitivity and diagnostic accuracy for use in in eHAT patients with partial occlusion, and it can be applied for IVT treatment, avoiding the need for reoperation and preventing long-term biliary complications. PMID: 32958738 [PubMed - in process]
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...
Bioprosthetic valve thrombosis (BPVT) is a recognised complication of prosthetic aortic valves and can be found in up to 13% of patients after transcatheter implantation. The mechanism of BPVT is not well known, abnormal flow conditions in the new and native sinuses and lack of functional endothelialisation are suspected causes. BPVT may result in valve dysfunction, possibly related to degeneration, and recurrence of patient symptoms, or remain subclinical. BPVT is best diagnosed at multiphase gated computed tomography (CT) angiography as the presence of reduced leaflet motion (RELM) and hypoattenuating aortic leaflet thickening (HALT).
ConclusionA CCT protocol adding a 6-min delayed phase to the angiographic phase can be considered optimized for the diagnosis of LAA thrombi, with a low radiation dose.Key Points• In patients with persistent atrial fibrillation referred for ablation procedures, a cardiac CT examination comprising an angiographic-phase acquisition and, in case of filling defects, a 6-min delayed phase may help reduce the need for transesophageal echocardiography.• Cardiac CT would provide morphological and volumetric data, along with the potential to exclude the presence of thrombi in the left atrial appendage.
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.
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...
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].