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Front Cardiovasc Med 2022 8;9:856594. Epub 2022 Mar 8.

Department of Cardiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

Diagnosis of acute PE in pregnant women with haemodynamic instability is following the general integrated risk-adapted diagnostic algorithm and starts with bedside echocardiography to assess RV function. If RV dysfunction is identified, a prompt and immediate reperfusion without further imaging should be initiated. Although pregnancy is listed as a relative contraindication of systemic thrombolysis, in pregnant women with acute PE and haemodynamic instability thrombolysis must be considered. Read More

Ultrasound J 2022 Jan 10;14(1). Epub 2022 Jan 10.

Barbacena Medical School, Minas Gerais, Brazil.

Background: Point of care ultrasound (PoCUS) is a useful tool for the early diagnosis of thrombosis related to the central venous catheter for dialysis (TR-CVCd). However, the application of PoCUS is still not common as a bedside imaging examination and TR-CVCd remains often underdiagnosed in the routine practice. The aim of this study was to investigate if a compression technique for the diagnosis of TR-CVCd blindly performed by PoCUS experts and medical students is accurate when compared to a Doppler study. Read More

J Med Ultrason (2001) 2021 Nov 26. Epub 2021 Nov 26.

Department of Urology, Sakaiheisei Hospital, Osaka, Japan.

When vascular access (VA) for hemodialysis is established using an autologous fistula or synthetic graft, repeated damage from needle insertion at each dialysis session can lead to thrombosis, resulting in vascular stenosis or occlusion that can cause poor blood removal, elevated venous pressure, and other impairments of blood flow. Compact, high-performance ultrasound devices have been developed in recent years. Such devices are used for point-of-care ultrasound (POCUS), which has been used on many occasions for emergency evaluation in the dialysis room and is becoming an important tool in VA management. Read More

A A Pract 2021 Nov 17;15(11):e01529. Epub 2021 Nov 17.

From the Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, Oregon.

Perioperative deep vein thrombosis (DVT) is a serious and increasingly common complication. While point-of-care ultrasound is commonly used in regional nerve blocks, central vascular access, and difficult peripheral vascular, access there are very few reports of DVT incidentally discovered by anesthesiologists. We report 2 cases of diagnosis of DVT that resulted from ultrasound for difficult peripheral venous access. Read More

Eur J Neurol 2021 12;28(12):4258-4260

Neurology Department, Coimbra University and Hospital Centre, Coimbra, Portugal.

Cerebral venous thrombosis (CVT) can rarely present with acute ipsilateral cochlear and/or vestibular loss, to date always in the absence of a clear local otogenic process evidenced by magnetic resonance imaging (MRI). This association has been putatively attributed to inner ear anoxia due to blockage of inner ear venous drainage. We present a nonreported case of thrombosis of the left transverse and sigmoid sinuses presenting with acute unilateral vestibulopathy in which MRI disclosed concurrent ipsilateral labyrinthine haemorrhage. Read More

Front Neurol 2021 21;12:696665. Epub 2021 Jul 21.

Department of Neurology, The First Hospital of Jilin University, Changchun, China.

The clinical presentation of cerebral venous sinus thrombosis (CVST) overlaps with that of idiopathic intracranial hypertension (IIH), but no screening tool exists. We investigated the role of eye-neck integrated ultrasound in the diagnosis and differentiation of IIH and CVST. Twenty IIH patients, 30 CVST patients, and 40 healthy controls were retrospectively analyzed. Read More

Chest 2021 11 13;160(5):1853-1863. Epub 2021 Jul 13.

Department of Medicine, Division of Pulmonary and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA.

The point-of-care ultrasound DVT (POCUS DVT) examination can facilitate rapid bedside diagnosis and treatment of lower extremity DVT. Awaiting radiology-performed Doppler ultrasonography and interpretation by radiologists can lead to delays in lifesaving anticoagulation, and the POCUS DVT examination can provide timely diagnostic information in the patient with lower extremity symptoms. This article outlines accepted techniques for the POCUS DVT examination, discusses the historical context from which the current recommendations have evolved, and provides illustrations alongside ultrasound images of relevant venous anatomy to orient the clinician. Read More

Cureus 2021 May 4;13(5):e14833. Epub 2021 May 4.

Diagnostic Radiology, St. Joseph Mercy Oakland Hospital, Pontiac, USA.

Coronavirus disease 2019 (COVID-19) is known to cause a severe acute respiratory syndrome with increased morbidity and mortality due to multiorgan involvement. COVID-19 is associated with an increased risk of venous thromboembolism (VTE), ranging from asymptomatic to potentially fatal presentations. Predictors of VTE in COVID-19 are not fully defined, and the role of anticoagulation in these patients is debatable. Read More

Transl Pediatr 2021 Apr;10(4):1117-1137

Unidad de Radiología Pediátrica, Servicio de Radiodiagnóstico, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Cranial ultrasound (CUS) is an extremely valuable tool to evaluate the brain during the first year of life, in experienced hands. It is the initial screening imaging tool to evaluate the infants' brain and complementary to the use of computed tomography (CT) and magnetic resonance imaging (MRI). It is an accessible, inexpensive and harmless technique that can be used bedside as frequently as needed. Read More

Port J Card Thorac Vasc Surg 2021 Apr 8;28(1):65-67. Epub 2021 Apr 8.

Vascular Surgery Department- Hospital da Senhora da Oliveira, Guimarães; Portugal.

Catheter directed thrombolysis is a minimally invasive procedure that results in a significant reduction in venous obstruction after deep vein thrombosis. The technique implies the performance of phlebographies to monitor the thrombolysis progression. The objective of this paper is to describe the use of vascular ultrasound to follow the thrombus lysis and to adjust the catheter position according to the progression of the thrombolysis. Read More

J Med Case Rep 2021 Mar 2;15(1):112. Epub 2021 Mar 2.

Department of Medicine, Abington Hospital-Jefferson Health, Abington, PA, USA.

Background: Severe acute respiratory syndrome coronavirus 2 infection can lead to a constellation of viral and immune symptoms called coronavirus disease 2019. Emerging literature increasingly supports the premise that severe acute respiratory syndrome coronavirus 2 promotes a prothrombotic milieu. However, to date there have been no reports of acute aortic occlusion, itself a rare phenomenon. Read More

QJM 2021 04;114(2):147

From the Department of Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba, Ibaraki 305-0854, Japan.

QJM 2021 04;114(2):148-149

From the Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

J Orthop Surg Res 2021 Jan 25;16(1):82. Epub 2021 Jan 25.

State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, P.R. China.

Purpose: To compare the specificity and sensitivity of preoperative D-dimer and age-adjusted D-dimer value for predicting the incidence of the DVT preoperatively in total joint arthroplasty (TJA) patients.

Methods: We enrolled 406 patients finally above 50 years old. Everyone had done ultrasonography bedside, and D-dimer concentrations were collected before surgery. Read More

Medicina (Kaunas) 2020 Dec 14;56(12). Epub 2020 Dec 14.

Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu 41404, Korea.

Budd-Chiari syndrome (BCS) is a rare intrahepatic vascular disease that is characterized by a hepatic venous outflow obstruction. Intravenous leiomyomatosis (ILs) is a rare complication of a myoma. Here, we report a case of BCS that was caused by intracaval ILs. Read More

Res Pract Thromb Haemost 2020 Jul 9. Epub 2020 Jul 9.

Blood Research Institute, Versiti, Department of Medicine Medical College of Wisconsin Milwaukee WI USA.

Background: Best practice for prevention, diagnosis, and management of venous thromboembolism (VTE) in patients with SARS-CoV-2 disease 2019 (COVID-19) is unknown due to limited published data in this population.

Objectives: We aimed to assess current global practice and experience in management of COVID-19 associated coagulopathy to identify information to guide prospective and randomized studies.

Methods: Physicians were queried about their current approach to prophylaxis, diagnosis, and treatment of VTE in patients with COVID-19 using an online survey tool distributed through multiple international organizations between April 10 and 14, 2020. Read More

J Ultrasound Med 2021 Mar 14;40(3):443-456. Epub 2020 Aug 14.

Department of Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA.

Objectives: To perform a prospective longitudinal analysis of lung ultrasound findings in critically ill patients with coronavirus disease 2019 (COVID-19).

Methods: Eighty-nine intensive care unit (ICU) patients with confirmed COVID-19 were prospectively enrolled and tracked. Point-of-care ultrasound (POCUS) examinations were performed with phased array, convex, and linear transducers using portable machines. Read More

J Clin Ultrasound 2020 Nov 5;48(9):522-526. Epub 2020 Aug 5.

Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Purpose: The aim of this study was to evaluate the applicability of bedside ultrasonography for the diagnosis of deep venous thrombosis (DVT) in patients infected with corona virus disease 2019 (COVID-19) with and without treatment with low molecular weight heparin (LMWH).

Methods: We retrospectively analyzed the records of deceased and surviving patients in whom ultrasonography detected or not a DVT, and in whom LMWH was or not prescribed.

Results: The incidence of DVT is higher in the deceased (33/35) than in the surviving (22/46) patients. Read More

QJM 2020 11;113(11):817-819

From the Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan 430022, China.

Fukushima J Med Sci 2020 Aug 22;66(2):113-117. Epub 2020 Jul 22.

Department of Disaster and Comprehensive Medicine, Fukushima Medical University.

We encountered a case of pulmonary thromboembolism, in which an 84-year-old woman (body weight 62 kg, height 150 cm) fell in the ward eight days after upper arm surgery. In this event, she had fractured her ankle and hit her head, with transient loss of consciousness. She needed surgery for the ankle fracture under general anesthesia. Read More

Eur J Emerg Med 2021 Jan;28(1):25-28

Department of Emergency Medicine, Franciscus Hospital, Rotterdam, The Netherlands.

Introduction: The time factor in diagnosis and management of a deep vein thrombosis of the lower extremities (LE DVT) is of increasing importance in the era of crowding of emergency departments (ED). Current techniques used to detect LE DVT include a two-point regional compression ultrasound (rCUS), yet assessments are usually performed only during office hours. Outside office hours ultrasonography is postponed and low molecular weight heparin (LMWH) prescribed. Read More

Medicine (Baltimore) 2020 Jun;99(26):e20873

Department of Critical Care Medicine, Harrison International Peace Hospital, Hebei, China.

Introduction: Central venous catheters related thrombosis (CRT) insertion has been shown to increase the risk of venous thromboembolism, particularly pulmonary embolism (PE). Nevertheless, deaths cased due to PE have been rarely reported.

Patient Concerns: A central venous catheter was introduced through the right jugular vein during the operation due to severe septic shock from a 57-year-old male patient. Read More

Heart Fail Clin 2020 Jul;16(3):317-330

Department of Translational Medical Sciences, "Federico II" School of Medicine, "Federico II" University of Naples, Via Pansini 5, Naples 80131, Italy; Centre for Pulmonary Hypertension, Thoraxklinik at Heidelberg University Hospital. Electronic address:

Acute pulmonary embolism (PE) is the third most common acute cardiovascular condition, and its prevalence increases over time. D-dimer has a very high negative predictive value, and if normal levels of D-dimer are detected, the diagnosis of PE is very unlikely. The final diagnosis should be confirmed by computed tomographic scan. Read More

J Am Coll Radiol 2020 May;17(5S):S315-S322

Specialty Chair, UMass Memorial Medical Center, Worcester, Massachusetts.

This publication includes the appropriate imaging modalities to assess suspected deep vein thrombosis in the upper extremities. Ultrasound duplex Doppler is the most appropriate imaging modality to assess upper-extremity deep vein thrombosis. It is a noninvasive test, which can be performed at the bedside and used for serial evaluations. Read More

Indian J Crit Care Med 2020 Jan;24(Suppl 1):S6-S30

Department of Critical Care Medicine, Nayati Medicity, Mathura, Uttar Pradesh, India, , e-mail:

Background And Purpose: Short-term central venous catheterization (CVC) is one of the commonly used invasive interventions in ICU and other patient-care areas. Practice and management of CVC is not standardized, varies widely, and need appropriate guidance. Purpose of this document is to provide a comprehensive, evidence-based and up-to-date, one document source for practice and management of central venous catheterization. Read More

Cureus 2020 Mar 7;12(3):e7199. Epub 2020 Mar 7.

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

A 73-year-old man with a history of follicular lymphoma ten years ago with complete remission presented to the emergency room with a large unilateral left-leg swelling as the only symptom. Doppler ultrasonography ruled out deep vein thrombosis. Bedside point-of-care ultrasound (PoCUS) revealed left moderate hydronephrosis. Read More

Am Fam Physician 2020 03;101(5):275-285

Naval Hospital Jacksonville, Jacksonville, FL, USA.

Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. Read More

Chest 2020 09 20;158(3):1122-1127. Epub 2020 Feb 20.

University of Ottawa/The Ottawa Hospital, Ottawa, ON, Canada. Electronic address:

Ultrasound studies to detect DVT are traditionally performed and interpreted by sonographers and radiologists, respectively, but the growth of point-of-care ultrasound is putting this powerful tool in the hands of front-line physicians. Literature from ambulatory patients in the ED suggests this tool performs well in the hands of nonconventional users, and it is now being commonly deployed to aid in the management of critically ill patients. This article presents an approach for incorporating these tools into bedside practice, including illustrative figures and narrated video presentations to demonstrate the techniques described. Read More

BMC Med Educ 2020 Jan 31;20(1):30. Epub 2020 Jan 31.

Department of Internal Medicine, Univ Groningen, University Medical Center Groningen, Huispostcode AA41, Postbus 30.0016, 9700, RB, Groningen, the Netherlands.

Background: Point-of-care Ultrasound is a relative new diagnostic tool for internists. Since 2019, it is a mandatory skill for internal medicine residents in the Netherlands but an ultrasound curriculum still has to be developed. In this study we explored the current ultrasound training program and educational wishes from internal medicine residents. Read More

J Ultrasound 2021 Sep 27;24(3):323-329. Epub 2019 Nov 27.

Intensive Care Physicians, Intensive Care Unit, Clínica Cruz Azul, 2651, 60 St, Necochea, 7630, Argentina.

Patients with high-risk pulmonary embolism (PE) have a significant mortality rate, and thus a timely diagnosis and early treatment are essential to improve outcomes. Since these groups of patients are often too ill to be transferred to the radiology department to perform a chest computed tomography angiography, offering a feasible, reliable and bedside diagnostic tool may be desirable in this setting. We report the case of a middle-aged woman presenting to the emergency department with shock who was diagnosed with massive pulmonary embolism based on point-of-care ultrasound (POCUS). Read More