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Latest & greatest articles for pulmonary embolism
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Vena caval filters for the prevention of pulmonaryembolism. Pulmonary emboli (PE), or blood clots in the lungs,can be potentially fatal. Anticoagulation is the first line therapy to prevent PE. In some instances anticoagulation fails to prevent more emboli, or cannot be given because the person has a high risk of bleeding. Inferior vena caval filters (VCFs) are metal alloy devices that mechanically trap fragmented emboli from the deep leg veins en route to the pulmonary circulation (...) . Retrievable filters are designed to be introduced and removed percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile is unclear. This is the third update of a Cochrane Review first published in 2007.To assess the evidence for the effectiveness and safety of vena caval filters (VCFs) in preventing pulmonaryembolism (PE).For this review update, the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (last
Thorac Surg Actions . 2020 Mar 6;S0003-4975(20)30345-3. doi: 10.1016/j.athoracsur.2020.01.075. Online ahead of print. Surgical Pulmonary Embolectomy Outcomes for Acute PulmonaryEmbolism , , , , , , , , , , , , Affiliations Expand Affiliations 1 Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania. 2 Faculty of Medicine, University of Chile, Santiago, Chile. 3 Division of Critical Care, Pulmonary/Allergy, and Immunology, Thomas Jefferson University, Philadelphia (...) Review Surgical Pulmonary Embolectomy Outcomes for Acute PulmonaryEmbolism Jae Hwan Choi et al. Ann Thorac Surg . 2020 . Show details Ann Thorac Surg Actions . 2020 Mar 6;S0003-4975(20)30345-3. doi: 10.1016/j.athoracsur.2020.01.075. Online ahead of print. Authors , , , , , , , , , , , , Affiliations 1 Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania. 2 Faculty of Medicine, University of Chile, Santiago, Chile. 3 Division of Critical Care, Pulmonary/Allergy
-sided heart strain. x 3 Goldhaber, S.Z., Visani, L., and De Rosa, M. Acute pulmonaryembolism: clinical outcomes in the International Cooperative PulmonaryEmbolism Registry (ICOPER). Lancet . 1999 ; 353 : 1386–1389 | | | | | , x 4 Kearon, C., Akl, E.A., Ornelas, J. et al. Antithrombotic therapy for VTE disease: CHEST guideline expert panel report. Chest . 2016 ; 149 : 315–352 | | | | | Full-dose thrombolysis may be beneficial in hemodynamically unstable patients with pulmonaryembolism (...) , but this therapy increases the risk of major bleeding. x 4 Kearon, C., Akl, E.A., Ornelas, J. et al. Antithrombotic therapy for VTE disease: CHEST guideline expert panel report. Chest . 2016 ; 149 : 315–352 | | | | | , x 5 Meyer, G., Vicaut, E., Danays, T. et al. Fibrinolysis for patients with intermediate-risk pulmonaryembolism. N Engl J Med . 2014 ; 370 : 1402–1411 | | | , x 6 Konstantinides, S.V., Torbicki, A., Agnelli, G. et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary
A systematic review on internal jugular vein thrombosis and pulmonaryembolism. Whereas the internal jugular vein is the most common site of thrombosis in patients with deep venous thrombosis (DVT) of the upper extremity, the association between internal jugular vein thrombus and pulmonaryembolism (PE) has not been clearly characterized. The objective of this paper was to determine the risk of embolization of an isolated internal jugular vein thrombus causing a clinically overt PE (...) resolution while carrying the risk of bleeding complications in these patients, who often have severe comorbidities.Despite the proximity of the jugular vein to the right side of the heart and the pulmonary vasculature, there is little proof of propagation of the thrombus to cause a clinically overt PE. Whereas current practice is to treat the patients with IJVT in the same way as patients with lower extremity DVTs are treated, the lack of any survival benefit in those with isolated IJVT and the risk
Use of fragmented QRS in prognosticating clinical deterioration and mortality in pulmonaryembolism: A meta-analysis. Fragmented QRS (fQRS) on electrocardiography is potentially valuable in prognosticating acute pulmonaryembolism (PE). ECG is one of the first tests performed in the emergency department, quickly interpretable, noninvasive, inexpensive, and available in remote areas. We aimed to review fQRS's role in PE prognostication.We searched MEDLINE, EMBASE, Google Scholar, Web of Science
1. Chest radiograph and chest computed tomography showed pleural effusion and pulmonaryembolism. Pleural pigtail insertion was performed and anticoagulant medication, albumin, and lasix were given. The patient's recovery was uneventful. Several factors have been advanced to explain including the prolonged duration of the operation. Management options include supplemental oxygen therapy, and pigtail catheter insertion. Mechanical prophylaxis (sequential compression devices and graduated (...) Right postoperative pleural effusion and pulmonaryembolism following laparoscopic gynecological surgery: A rare case report and PRISMA-driven systematic review. The incidence of postlaparoscopic pleural effusion and pulmonaryembolism were rare. However, it might be life-threatening. Therefore, confirming the risk factor and management is important. We present a 53-year-old woman with ovarian endometriosis arranged for laparoscopic surgery. However, desaturation was noted on postoperation day
A systematic literature review and meta-analysis of spectral CT compared to scintigraphy in the diagnosis of acute and chronic pulmonaryembolisms. To examine the diagnostic accuracy of spectral CT pulmonary angiography (S-CTPA) using ventilation-perfusions lung scintigraphy (V/Q-scan) as a reference standard in the diagnosis of acute or chronic pulmonaryembolism (APE/CPE) and chronic thromboembolic pulmonary hypertension (CTEPH).PubMed, Embase, Scopus, and Web of Science were searched
Pulmonary vasodilation in acute pulmonaryembolism - a systematic review. Acute pulmonaryembolism is the third most common cause of cardiovascular death. Pulmonaryembolism increases right ventricular afterload, which causes right ventricular failure, circulatory collapse and death. Most treatments focus on removal of the mechanical obstruction caused by the embolism, but pulmonary vasoconstriction is a significant contributor to the increased right ventricular afterload and is often left (...) in acute pulmonaryembolism seems attractive but all come with a risk of systemic vasodilation or worsening of pulmonary ventilation-perfusion mismatch. In animal models of acute pulmonaryembolism, modulators of the nitric oxide-cyclic guanosine monophosphate-protein kinase G pathway, endothelin pathway and prostaglandin pathway have been investigated. But only a small number of clinical case reports and prospective clinical trials exist. The aim of this review is to give an overview of the causes
Clinical features of pulmonaryembolism in patients with lung cancer: A meta-analysis. Pulmonaryembolism (PE) is correlated with increased mortality among patients with lung cancer (LC). The characteristics of patients with LC presenting with PE have not been fully established, and our meta-analysis aims to comprehensively investigate the clinical characteristics associated with PE in patients with LC to help physicians identify PE earlier in these patients.Multiple databases were searched (...) that history of chronic obstructive pulmonary disease (OR = 2.59, 95% CI: 1.09, 6.15; P = 0.03), adenocarcinoma (OR = 2.28, 95% CI: 1.88, 2.77; P < 0.01), advanced tumour stage (TNM III-IV vs. I-II, OR = 2.38, 95% CI: 1.99, 2.86; P < 0.01), history of central venous catheter (OR = 1.95, 95% CI: 1.36, 2.78; P < 0.01), history of chemotherapy (OR = 2.32, 95% CI: 1.80, 2.99, P < 0.01), high levels of D-dimer (WMD = 4.31, 95% CI: 2.53, 6.10; P < 0.01) and carcinoembryonic antigen (WMD = 10.30, 95% CI: 9.95
Diagnostic Accuracy of Dual-Energy CT in Detection of Acute PulmonaryEmbolism: A Systematic Review and Meta-Analysis. In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonaryembolism (PE).We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality
Ruling out pulmonaryembolism across different subgroups of patients and healthcare settings: protocol for a systematic review and individual patient data meta-analysis (IPDMA). Diagnosing pulmonaryembolism in suspected patients is notoriously difficult as signs and symptoms are non-specific. Different diagnostic strategies have been developed, usually combining clinical probability assessment with D-dimer testing. However, their predictive performance differs across different healthcare (...) settings, patient subgroups, and clinical presentation, which are currently not accounted for in the available diagnostic approaches.This is a protocol for a large diagnostic individual patient data meta-analysis (IPDMA) of currently available diagnostic studies in the field of pulmonaryembolism. We searched MEDLINE (search date January 1, 1995, till August 25, 2016) to retrieve all primary diagnostic studies that had evaluated diagnostic strategies for pulmonaryembolism. Two authors independently
Clozapine associated pulmonaryembolism: systematic review. Background: Clozapine is a second-generation antipsychotic used in refractory schizophrenia. Clozapine can lead to pulmonaryembolism (PE) by various mechanisms including immobility, weight gain and increased platelet aggregation. Objectives: We performed a systematic review on published cases of PE associated with clozapine. Methods: Comprehensive search of Medline, Embase and Cochrane library was done for relevant articles from
Systematic Review: The Role of Thrombolysis in Intermediate-Risk PulmonaryEmbolism. This systemic review provides practicing emergency physicians updated information about the role of thrombolysis in the treatment of intermediate-risk pulmonary embolism.A PubMed literature search from January 1, 2005 to December 31, 2018 was conducted and limited to human clinical trials written in English with relevant keywords. High-quality studies were identified and then underwent a structured review (...) . Recommendations are made based on the literature review.Sixty-three articles met criteria for rigorous review, of which 13 were appropriate for citation in this review. Of these 13, there were 6 prospective studies and 7 retrospective studies.Thrombolysis, either catheter-directed or systemic, is a treatment option in the management of patients with intermediate-risk pulmonaryembolism and a high likelihood of clinical deterioration. Each method of thrombolysis carries risks and benefits. Based
Antipsychotic drugs and risk of developing venous thromboembolism and pulmonaryembolism: A systematic review and meta-analysis. Antipsychotic (AP) medications is the cornerstone treatment for schizophrenia and some other psychiatric diseases. However, some observational studies suggest that these medications might increase the risk of venous thromboembolism (VTE) and pulmonaryembolism (PE).The aim of this study was to assess whether AP medications are associated with the development of VTE
A Systematic Review of Double Low-dose CT Pulmonary Angiography in PulmonaryEmbolism. The aim of this study is to perform a systematic review of the feasibility and clinical application of double low-dose CT pulmonary angiography (CTPA) in the diagnosis of patients with suspected pulmonary embolism.A total of 13 studies were found to meet selection criteria reporting both low radiation dose (70 or 80 kVp versus 100 or 120 kVp) and low contrast medium dose CTPA protocols. Lowdose CTPA resulted (...) quality (in terms of signal-to-noise ratio and contrast-to-noise ratio) showed that low-dose CTPA was associated with higher, lower and no change in image quality in 3, 3 and 6 studies, respectively when compared to the standard CTPA protocol. The subjective assessment indicated similar image quality in 11 studies between low-dose and standard CTPA groups, and improved image quality in 1 study with low-dose CTPA.This review shows that double low-dose CTPA is feasible in the diagnosis of pulmonary
Anticoagulant treatment for subsegmental pulmonaryembolism. Acute pulmonaryembolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke. The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate (...) . However, the clinical significance in patients, and their prognosis, needs to be studied to evaluate whether anticoagulation therapy is required. This is the second update of the Cochrane systematic review published in 2014.To assess the effectiveness and safety of anticoagulation therapy versus control in patients with isolated subsegmental pulmonaryembolism (SSPE) or incidental SSPE.The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE