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    1 OF 964

    Personalized thromboprophylaxis using a risk score for the management of pregnancies with high risk of thrombosis: a prospective clinical study.
    J Thromb Haemost 2017 Feb 23. Epub 2017 Feb 23.
    Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon.
    Background: Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with increased risk of VTE was previously described by our group (Lyon-VTE-score).

    Objectives: The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. Read More

    Overall Survival and Metastasis Resections in Patients with Metastatic Colorectal Cancer Using Electronic Medical Records.
    J Gastrointest Cancer 2017 Feb 23. Epub 2017 Feb 23.
    Department of Oncology, University of Turku and Turku University Hospital, Hameentie 11, 20521, Turku, Finland.
    Purpose: Treatment for patients with metastatic colorectal cancer is chemotherapy commonly combined with monoclonal antibodies against vascular endothelial growth factor (bevacizumab) or epidermal growth factor receptor (cetuximab or panitumumab), the efficacy of which has been proven in randomized controlled trials. The objective of the current retrospective study was to analyze the impact of targeted therapy, adverse events, and dose reduction on overall survival (OS) and metastasis resection rates.

    Methods: A hospital-based electronic informatics center was used to gather clinical data and outcome information in a "real-life" setting in a single academic hospital. Read More

    Safety and efficacy of postoperative pharmacologic thromboprophylaxis with enoxaparin after pancreatic surgery.
    Surg Today 2017 Feb 22. Epub 2017 Feb 22.
    Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
    Purpose: Pharmacologic thromboprophylaxis is recommended for preventing pulmonary embolism according to some abdominal surgery guidelines. However, few reports have so far described pharmacologic thromboprophylaxis after pancreatic surgery. In addition, concern remains regarding postoperative bleeding due to pharmacologic thromboprophylaxis. Read More

    Omental flap transposition for inferior vena cava filter penetration.
    Radiol Case Rep 2017 Mar 29;12(1):81-83. Epub 2016 Nov 29.
    Department of Cardiology, Musashino Red Cross Hospital, 1-26-1 Kyonan-cho, Musashino City, Tokyo 180-8610, Japan.
    A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. Read More

    Ten-Year Temporal Trends in Medical Complications After Acute Intracerebral Hemorrhage in the United States.
    Stroke 2017 Feb 22. Epub 2017 Feb 22.
    From the Department of Neurology, University of Miami Miller School of Medicine, FL.
    Background And Purpose: Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States.

    Methods: A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Read More

    Risk of Pulmonary Embolism After Cerebral Venous Thrombosis.
    Stroke 2017 Feb 22. Epub 2017 Feb 22.
    From the Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (A.L.L.); Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute (A.E.M., G.G., S.B.M., H.K., B.B.N.), and Department of Neurology, Weill Cornell Medicine (A.E.M., G.G., S.B.M., H.K., B.B.N.), New York, NY; Department of Neurology, University of Pennsylvania, Philadelphia (S.R.M.); and Department of Neurology, Weill Cornell Medicine, New York-Presbyterian Queens, Flushing, NY (M.P.L.).
    Background And Purpose: Cerebral vein thrombosis (CVT) is a type of venous thromboembolism. Whether the risk of pulmonary embolism (PE) after CVT is similar to the risk after deep venous thrombosis (DVT) is unknown.

    Methods: We performed a retrospective cohort study using administrative data from all emergency department visits and hospitalizations in California, New York, and Florida from 2005 to 2013. Read More

    Comparison of PESI, echocardiogram, CTPA, and NT-proBNP as risk stratification tools in patients with acute pulmonary embolism.
    Indian Heart J 2017 Jan - Feb;69(1):68-74. Epub 2016 Aug 1.
    Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
    Objective: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients.

    Methods: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay. Read More

    Perspective imaging of flow in arterial model obtained with continuous wave Doppler focusing technique.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2315-2318
    Flowing emboli in the circulatory system cause fatal diseases such as stroke or pulmonary embolism. Conventional transcranial Doppler ultrasound for detection of emboli requires precise positioning by experienced examiner. In the present study, an easier emboli detection device by visualizing perspective view of blood vessel is proposed. Read More

    Primary total hip replacement for acute displaced subcapital femoral fractures with a minimal three-year follow-up.
    Hip Int 2005 Jan - Mar;15(1):33-37
    Department of Orthopaedic Surgery, Rotherham General Hospitals (NHS) Trust, Rotherham - UK.
    The aim of the study was to review the results of total hip replacement (THR) in relatively fit and mobile patients with Garden 3 and 4 fractures of the neck of femur. Forty-one patients who underwent THR for displaced intracapsular hip fractures from 1993 to 2001 were reviewed. Only those patients with three years or more follow-up were reviewed. Read More

    Performance of the age-adjusted cut-off for D-dimer in patients with cancer and suspected pulmonary embolism.
    Thromb Res 2017 Feb 13;152:49-51. Epub 2017 Feb 13.
    Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Tergooi Hospital, Hilversum, The Netherlands. Electronic address:
    Background: Cancer patients frequently present with suspected pulmonary embolism (PE). The D-dimer (DD) test is less useful in excluding PE in cancer patients due to the lower specificity. In the general population, the age-adjusted cutoff for DD combined with a clinical decision rule (CDR) improved specificity in the diagnosis of PE. Read More

    Interventional Management of Venous Thromboembolism: State of the Art.
    AJR Am J Roentgenol 2017 Feb 22:1-16. Epub 2017 Feb 22.
    2 Department of Internal Medicine, Division of Cardiovascular Diseases, Temple University Hospital, 3401 N Broad St, 9 PP, Philadelphia, PA 19140.
    Objective: The purpose of this article is to describe the indications for and approach to catheter-based treatment of acute venous thromboembolism (VTE).

    Conclusion: Catheter-based treatment of VTE is a viable adjunct to anticoagulant therapy and is being rapidly adopted around the United States. Early data suggest that these therapies reduce postthrombotic sequelae and improve quality of life, but bleeding events are still frequent, particularly at low-volume centers. Read More

    Combined application versus topical and intravenous application of tranexamic acid following primary total hip arthroplasty: a meta-analysis.
    BMC Musculoskelet Disord 2017 Feb 21;18(1):90. Epub 2017 Feb 21.
    Dalian Medical University, Dalian, Liaoning, 116044, China.
    Background: The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. Read More

    Thrombolysis with intravenous recombinant tissue plasminogen activator during early postpartum period: A review of the literature.
    Acta Obstet Gynecol Scand 2017 Feb 21. Epub 2017 Feb 21.
    Department of Obstetrics and Gynecology, Fukuoka Red Cross Hospital, Fukuoka, Japan.
    Thromboembolic events are one of the leading causes of maternal death during the postpartum period. Postpartum thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) is controversial because the treatment may lead to massive bleeding. Data centralization may be beneficial for analyzing the safety and effectiveness of systemic thrombolysis during the early postpartum period. Read More

    Disproportional increase of pulmonary embolism in young females in Germany: trends from 2005 to 2014.
    J Thromb Thrombolysis 2017 Feb 20. Epub 2017 Feb 20.
    Department of Angiology, Gefäßklinik, Helios Klinikum Krefeld, Lutherplatz 40, 47805, Krefeld, Germany.
    We analysed the number of pulmonary embolism (PE) in young females aged 10-39 years in the period from 2005 to 2014 in Germany to see any trends that possibly may reflect some influences of newer oral contraceptives. Detailed lists of all hospitalized cases with the principal diagnosis PE coded as I26 in the years 2005-2014 were provided by the Federal Statistical Office. In males, the absolute number of all hospitalized cases with the principal diagnosis PE increased from 16,066 in 2005 to 25,364 in 2014 (rate +57. Read More

    Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial.
    Lancet Haematol 2017 Feb 16. Epub 2017 Feb 16.
    Department of Vascular Medicine, Darmstadt Municipal Hospital, Darmstadt, Germany; Centre of Thrombosis and Haemostasis, University of Mainz, Mainz, Germany.
    Background: Superficial-vein thrombosis can lead to deep-vein thrombosis and pulmonary embolism. Rivaroxaban, an oral factor Xa inhibitor, might simplify treatment compared with fondaparinux because it does not require daily subcutaneous injection and is cheaper. We compared efficacy outcomes in patients with superficial-vein thrombosis and additional risk factors given either rivaroxaban or fondaparinux to assess whether rivaroxaban is non-inferior to fondaparinux in the prevention of thromboembolic complications. Read More

    Contraceptive Implant Embolism Into the Pulmonary Artery: Thoracoscopic Retrieval.
    Ann Thorac Surg 2017 Mar;103(3):e271-e272
    Department of Thoracic Surgery, Hôpital Nord-APHM, Aix-Marseille University, Marseille, France.
    An 18-year old woman had migration of a subdermal contraceptive implant in a subsegmental branch of her left lower lobe pulmonary artery. She was managed successfully through a conservative surgical approach, as the implant was removed from the pulmonary artery thoracoscopically, thereby avoiding the need of thoracotomy or lung resection. Read More

    The prevalence and radiological findings of pulmonary embolism in HIV-positive patients referred for computed tomography pulmonary angiography in the Western Cape of South Africa.
    Cardiovasc J Afr 2017 Feb 15;28:1-8. Epub 2017 Feb 15.
    Department of Radiology, Mitchell's Plain Hospital, Mitchells Plain, Cape Town, South Africa.
    Aim: To provide imaging data and report associations between human immunodeficiency virus (HIV), tuberculosis (TB) and pulmonary embolism (PE) in a South African population that underwent computed tomography pulmonary angiography (CTPA) for suspected PE.

    Methods: A validated Qanadli severity scoring system for PE was used for 164 CTPA scans, and parenchymal, pleural and cardiovascular complications were reported. Serological confirmation of HIV testing and microbiological confirmation of TB were recorded. Read More

    First in vivo magnetic particle imaging of lung perfusion in rats.
    Phys Med Biol 2017 Feb 20. Epub 2017 Feb 20.
    Bioengineering,University of California Berkeley, Berkeley, California,UNITED STATES.
    Pulmonary embolism (PE), along with the closely related condition of deep vein thrombosis, affect an estimated 600,000 patients in the US per year. Untreated, PE carries a mortality rate of 30%. Because many patients experience mild or non-specific symptoms, imaging studies are necessary for definitive diagnosis of PE. Read More

    Right ventricular metastatic tumor from a primary carcinoma of uterine cervix: A cause of pulmonary embolism.
    Obstet Gynecol Sci 2017 Jan 15;60(1):129-132. Epub 2017 Jan 15.
    Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
    The presence of intracavitary cardiac metastasis from squamous cell carcinoma of the uterine cervix is extremely rare. The diagnosis is made almost exclusively postmortem. Apart from causing intracardiac obstruction, it can present as pulmonary emboli and the prognosis is extremely poor. Read More

    Subacute right heart failure revealing three simultaneous causes of post-embolic pulmonary hypertension in metastatic dissemination of breast cancer.
    ESC Heart Fail 2017 Feb 6;4(1):75-77. Epub 2016 Dec 6.
    Centre Hospitalier Universitaire de Lille Institut coeur-poumon, Clinique de cardiologie Lille France.
    A 72-year-old woman with history of breast cancer only treated surgically was referred to our department for pulmonary hypertension (PH) suspicion. Echocardiogram revealed elevated right ventricular systolic pressure. Computed tomography (CT) angiogram showed no pulmonary embolism (PE), but lung scan revealed two ventilation-perfusion mismatch areas. Read More

    Examination of Some Factors Affected Right-to-left Shunt Rate and the Normal Value of Right-to-left Shunt Rate in Lung Perfusion Scintigraphy.
    Nihon Hoshasen Gijutsu Gakkai Zasshi 2017 ;73(2):120-127
    Department of Radiological Technology, Hamamatsu Medical Center.
    Purpose: Diagnosis for right-to-left shunt was determined by the assessment of shunt-rate, which was obtained by using (99 m)Tc-macroaggregated albumin. However, it is difficult to diagnose right-to-left shunt, using the normal level of shunt-rate measured by using conventional methods. To solve this problem, we investigated ourselves the normal level of shunt-rate. Read More

    Antiphospholipid antibodies disappearance in primary antiphospholipid syndrome: Thrombosis recurrence.
    Autoimmun Rev 2017 Feb 13. Epub 2017 Feb 13.
    Direction of Education and Research, Hospital de Especialidades Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico; Universidad Nacional Autónoma de México, Mexico City, Mexico. Electronic address:
    Objective: To evaluate the clinical outcome after aPL (antiphospholipid antibodies) disappearance in primary APS patients.

    Methods: From a cohort of 70 patients with primary APS, we selected patients with positive aPL determinations at onset and ≥2 subsequent negative aPL determinations during the last 5years. To corroborate the immunologic profile, we determined IgG/IgM aCL antibodies, IgG/IgM antiβ2GPl, anti-annexin A5 antibodies and lupus anticoagulant (LA). Read More

    [Antithrombotic therapy in patients with atrial flutter before planned cardioversion].
    Wiad Lek 2016 ;69(6):742-746
    Introduction: atrium flutter and fibrillation are the heart rhythm disorders that increase the risk of life-dangerous complications, e.g. cardioembolic stroke, pulmonary embolism. Read More

    Incidence of pulmonary embolism in patients with isolated calf deep vein thrombosis.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 14;5(2):274-279. Epub 2016 Dec 14.
    Division of Vascular Surgery, Stony Brook School of Medicine, Stony Brook, NY. Electronic address:
    Background: The severity of pulmonary embolism (PE) after isolated calf deep vein thrombosis (C-DVT) is controversial, which leads to inconsistent clinical decision making when treating C-DVT. This systematic review assessed PE frequency and severity in patients with C-DVT.

    Methods: Database searches were completed using MEDLINE and Scopus along with cross-referencing. Read More

    Systemic thrombolysis increases hemorrhagic stroke risk without survival benefit compared with catheter-directed intervention for the treatment of acute pulmonary embolism.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 16;5(2):171-176.e1. Epub 2017 Jan 16.
    Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
    Background: Systemic thrombolysis (ST) and catheter-directed intervention (CDI) are both used in the treatment of acute pulmonary embolism (PE), but the comparative outcomes of these two therapies remain unclear. The objective of this study was to compare short-term mortality and safety outcomes between the two treatments using a large national database.

    Methods: Patients presenting with acute PE were identified in the National Inpatient Sample (NIS) from 2009 to 2012. Read More

    Catheter-directed, ultrasound-assisted thrombolysis is a safe and effective treatment for pulmonary embolism, even in high-risk patients.
    J Vasc Surg Venous Lymphat Disord 2017 Mar 12;5(2):165-170. Epub 2017 Jan 12.
    The Cardiovascular Care Group, Westfield, NJ. Electronic address:
    Objective: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy.

    Methods: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography. Read More

    Current guidelines do not sufficiently discriminate venous thromboembolism risk in urology.
    Urol Oncol 2017 Feb 14. Epub 2017 Feb 14.
    Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada. Electronic address:
    Purpose: Venous thromboembolism (VTE) is the leading cause of noncancer death following major cancer surgery. Current thromboprophylaxis guidelines do not address procedure-specific risk of venous thromboembolism for urological patients. This project was created to determine the risk and timing of VTE after major urological surgery and to evaluate if surgical procedure was an independent risk factor for VTE after adjusting for previously established risk factors. Read More

    A Comparison of Two Dosing Regimens of ASA Following Total Hip and Knee Arthroplasties.
    J Arthroplasty 2017 Jan 24. Epub 2017 Jan 24.
    Department of Orthopaedic Surgery, Sidney Kimmel Medical School at Thomas Jefferson University, Rothman Institute, Philadelphia, Pennsylvania.
    Background: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty.

    Methods: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month. Read More

    Arrhythmogenic right ventricular dysplasia: Atypical clinical presentation.
    Rev Port Cardiol 2017 Feb 14. Epub 2017 Feb 14.
    Serviço de Endocrinologia, Hospital de Santa Maria/CHLN, Lisboa, Portugal; Departamento de Medicina, Hospital de Santa Maria/CHLN, Faculdade de Medicina de Lisboa, Lisboa, Portugal. Electronic address:
    A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. Read More

    The relation between international normalized ratio and mortality in acute pulmonary embolism: A retrospective study.
    J Clin Lab Anal 2017 Feb 18. Epub 2017 Feb 18.
    Department of Cardiology, Medical School, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
    Background: Acute pulmonary embolism (PE) is a serious clinical disease characterized by a high mortality rate. The aim of this study was to assess the prognostic value of international normalized ratio (INR) in acute PE patients not on anticoagulant therapy.

    Methods: The study included 244 hospitalized acute PE patients who were not receiving previous anticoagulant therapy. Read More

    Evaluation of vegetation size and its relationship with septic pulmonary embolism in tricuspid valve infective endocarditis: A real time 3DTEE study.
    Echocardiography 2017 Feb 18. Epub 2017 Feb 18.
    Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
    Background: Tricuspid valve infective endocarditis (TVIE) causes septic pulmonary embolism (PE). However, the impact of vegetation size on PE is not fully elucidated.

    Methods: In 26 consecutive patients with definite TVIE according to Duke criteria, we tested clinical, microbiological, and echocardiographic data including real time three-dimensional transesophageal echocardiography (3DTEE) as potential predictors of PE. Read More

    Correlations between electrocardiogram and biomarkers in acute pulmonary embolism: Analysis of ZATPOL-2 Registry.
    Ann Noninvasive Electrocardiol 2017 Feb 18. Epub 2017 Feb 18.
    Department of Pulmonary Circulation and Thromboembolic Diseases, The Medical Centre of Postgraduate Medication, European Health Centre Otwock, Otwock, Poland.
    Background: Electrocardiography (ECG) is still one of the first tests performed at admission, mostly in patients (pts) with chest pain or dyspnea. The aim of this study was to assess the correlation between electrocardiographic abnormalities and cardiac biomarkers as well as echocardiographic parameter in patients with acute pulmonary embolism.

    Methods: We performed a retrospective analysis of 614 pts. Read More

    Interventional Treatment of Pulmonary Embolism.
    Circ Cardiovasc Interv 2017 Feb;10(2)
    From the Cardiology Division (D.M.D., K.R.) and Vascular Medicine (K.R.), Massachusetts General Hospital, Boston; and Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia (J.G.).
    Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. Read More

    Pulmonary Embolism in the Postanesthesia Care Unit: A Case Study.
    J Perianesth Nurs 2017 Feb;32(1):6-14
    Pulmonary embolism (PE) is a complication that can occur at any time during the perioperative period. The patient undergoing surgery to repair a hip fracture is at a high risk of developing a PE due to venous thrombosis, tissue, or fat emboli. The signs and symptoms of a PE are often nonspecific and can be obscured in the patient receiving or recovering from general anesthesia. Read More

    Point-of-care ultrasonography for evaluation of acute dyspnea in the emergency department.
    Chest 2017 Feb 14. Epub 2017 Feb 14.
    Emergency Department, Careggi University Hospital, Florence, Italy.
    Background: Acute dyspnea is a common symptom in the emergency department (ED). Standard approach to dyspnea often relies on radiologic and laboratoristic results, causing excessive delay before adequate therapy is started; an integrated point-of-care ultrasonography (PoCUS) approach can shorten the time needed to formulate a diagnosis maintaining an acceptable safety profile.

    Methods: Consecutive adult patients presenting with dyspnea and admitted after ED evaluation were prospectively enrolled. Read More

    Net clinical benefit of dabigatran vs. warfarin in venous thromboembolism: analyses from RE-COVER(®), RE-COVER™ II, and RE-MEDY™.
    J Thromb Thrombolysis 2017 Feb 16. Epub 2017 Feb 16.
    Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
    The direct oral anticoagulants, e.g., dabigatran etexilate (DE), are effective and well tolerated treatments for venous thromboembolism (VTE). Read More

    Successful provision of inter-hospital extracorporeal cardiopulmonary resuscitation for acute post-partum pulmonary embolism.
    Int J Obstet Anesth 2017 Jan 9. Epub 2017 Jan 9.
    School of Medicine, University of Queensland, Brisbane, Australia; Adult Intensive Care Service, The Prince Charles Hospital, Chermside, Queensland 4032, Australia.
    Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Read More

    Thrombophilic Evaluation in Patients with Acute Pulmonary Embolism.
    Semin Respir Crit Care Med 2017 Feb 16;38(1):107-120. Epub 2017 Feb 16.
    Department of Medicine, Hofstra Northwell, School of Medicine, Hempstead, New York.
    Patients with acute pulmonary embolism (PE) are often tested for thrombophilias, which are hereditary and acquired conditions that predispose to thrombosis. If a hereditary condition is identified, then testing is often performed on members of the patient's family. Testing for these conditions can be complex, as the presence of acute thrombosis and antithrombotic therapies can make the results of many tests unreliable. Read More

    Acute Pulmonary Embolism after Discharge: Duration of Therapy and Follow-up Testing.
    Semin Respir Crit Care Med 2017 Feb 16;38(1):94-106. Epub 2017 Feb 16.
    Stroke Unit, Department of Vascular Emergency Medicine, University of Perugia, Perugia, Italy.
    Pulmonary embolism (PE) is a frequent cause of death and serious disability with a risk extending far beyond the acute phase of the disease. Anticoagulant treatment reduces the risk for death and recurrent VTE after a first PE. The optimal duration of anticoagulation after a first episode of PE remains controversial and should be made on an individual basis, balancing the estimated risk for recurrence without anticoagulant treatment against bleeding risk under anticoagulation. Read More

    Inferior Vena Cava Filters: When to Place and When to Remove.
    Semin Respir Crit Care Med 2017 Feb 16;38(1):84-93. Epub 2017 Feb 16.
    Division of Interventional Radiology, Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, California.
    Pulmonary embolism (PE) is a common and feared result of deep vein thrombosis. While anticoagulation is the mainstay of management, interruption of flow of thrombus from leg veins to the pulmonary circulation is frequently desired either in lieu of or in addition to anticoagulation. Inferior vena cava filters have become frequently used to prevent PE despite a paucity of evidence for efficacy and increasing concerns about the long-term complications of indwelling filters. Read More

    Catheter-Based Approaches for the Treatment of Acute Pulmonary Embolism.
    Semin Respir Crit Care Med 2017 Feb 16;38(1):73-83. Epub 2017 Feb 16.
    Respiratory Department, Ramon y Cajal Hospital, IRYCIS, Alcala de Henares University, Madrid, Spain.
    Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. Read More

    Massive Pulmonary Embolism: Extracorporeal Membrane Oxygenation and Surgical Pulmonary Embolectomy.
    Semin Respir Crit Care Med 2017 Feb 16;38(1):66-72. Epub 2017 Feb 16.
    Division of Lung Transplantation, Extracorporeal Life Support Program, Department of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
    Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE. Read More

    Systemic Thrombolytic Therapy for Acute Pulmonary Embolism: Who Is a Candidate?
    Semin Respir Crit Care Med 2017 Feb 16;38(1):56-65. Epub 2017 Feb 16.
    Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
    Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques. Read More

    The Pulmonary Embolism Response Team: What Is the Ideal Model?
    Semin Respir Crit Care Med 2017 Feb 16;38(1):51-55. Epub 2017 Feb 16.
    Pulmonary Hypertension and Thromboendarterectomy Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
    Treatment of patients with intermediate- and high-risk pulmonary embolism (PE) is a controversial area. Many therapeutic options exist, and deciding on appropriate treatment can be difficult. In addition, multiple specialties are often involved in the care of PE patients. Read More

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