0000000000442263
AUTHOR
Aleksejs Kaminskis
Preventīvas embolizācijas nozīme pacientiem ar gastroduodenālās čūlas asiņošanu pēc endoskopiskas hemostāzes
Augšējā kuņģa – zarnu trakta asiņošana sakarā ar gastroduodenālas čūlas slimību ir viens no galvenajiem augstas mirstības cēloņiem nevarikozas asiņošanas gadījumos. Neskatoties uz farmakoterapijas attīstību, mirstība asiņojošas čūlas gadījumā joprojām variē no 5% līdz 10% (Sung JJ et al., 2010; Iwasaki H et al., 2021). Galvenie asiņošanas riska faktori ir smēķēšana, NSPL un antikoagulantu lietošana. Augstākam riskam ir pakļauti vīrieši, veci cilvēki ar smagām blakusslimībām un cilvēki ar gastroduodenālu patoloģiju anamnēzē (Sung JJ et al.,2010; Mille M et al., 2021). Augšējās kuņģa – zarnu trakta asiņošanas hemostāzes veidi ir medikamentoza terapija (protonu sūkņa inhibitori), endoskopiska …
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…
Rockall Score Larger Than 7 as a Reliable Criterion for the Selection of Indications for Preventive Transarterial Embolization in a Subgroup of High-Risk Elderly Patients After Primary Endoscopic Hemostasis for Non-Variceal Upper Gastrointestinal Bleeding
Background Transarterial embolization (TAE) is an alternative procedure to repeat endoscopy or surgical intervention in the case of re-bleeding after primary endoscopic treatment. The aim of the study was to assess the Rockall score as a criterion for TAE in the case of re-bleeding after endoscopic treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). Methods Out of the 673 patients who underwent emergent endoscopic hemostasis due to NVUGIB, 111 had a high risk of re-bleeding having a Forrest I-IIb ulcer and the Rockall score ≥ 5. From 111 patients, 37 accepted preventive TAE (PE+ group). The control group consisted of 74 patients who underwent standard treatment (PE- group). …
Endoscopic hemostasis followed by preventive transarterial embolization in high-risk patients with bleeding peptic ulcer: 5-year experience
Abstract Background Upper gastrointestinal bleeding (UGIB) due to peptic ulcer disease is one of the leading causes of death in patients with non-variceal bleeding, resulting in up to 10% mortality rate, and the patient group at high risk of rebleeding (Forrest IA, IB, and IIA) often requires additional therapy after endoscopic hemostasis. Preventive transarterial embolization (P-TAE) after endoscopic hemostasis was introduced in our institution in 2014. The aim of the study is an assessment of the intermediate results of P-TAE following primary endoscopic hemostasis in patients with serious comorbid conditions and high risk of rebleeding. Methods During the period from 2014 to 2018, a tota…