Search results for "embolism"
showing 10 items of 457 documents
Management of Pulmonary Embolism: Results from the German Chest Pain Unit Registry.
2020
<b><i>Introduction:</i></b> Since 2008, specialized chest pain units (CPUs) were implemented across Germany ensuring structured diagnostics in acute chest pain. This study aims to analyze the management of pulmonary embolism (PE) patients in such certified CPUs. <b><i>Methods:</i></b> Data were retrieved from 13,902 patients enrolled in the German CPU registry and analyzed for the diagnosis of PE including patient characteristics, critical time intervals, diagnostic workup, treatment, and prognosis. PE patients were compared to the overall CPU patient cohort. Only patients with a complete 3-month follow-up were included. <b><i>Resu…
Speckle tracking analysis in intensive care unit: A toy or a tool?
2018
The use of conventional echocardiography in the intensive care unit (ICU) is today established to assess left and right ventricular systolic function, for preload determination and procedural guidance. Next step in ICU echocardiography could be the use of novel ultrasound techniques such as strain echocardiography to assist in the management of patients with acute coronary syndrome, heart failure, or pulmonary embolism. This review has gathered the available evidence supporting the incremental value of strain in the diagnostic workup of cardiac diseases treated in ICU.
Home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: Rationale and design of the HoT-PE Trial
2016
SummaryPulmonary embolism (PE) is a potentially life-threatening acute cardiovascular syndrome. However, more than 95 % of patients are haemodynamically stable at presentation, and among them are patients at truly low risk who may qualify for immediate or early discharge. The Home Treatment of Pulmonary Embolism (HoT-PE) study is a prospective international multicentre single-arm phase 4 management (cohort) trial aiming to determine whether home treatment of acute lowrisk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. Patients with confirmed PE, who have no right ventricular dysfunction or free floating thrombi in the right atrium or ventricle, are eligib…
Anti-Factor Xa levels correlate with recurrent venous thromboembolism and clinically relevant bleeding in patients receiving low-molecular-weight hep…
2019
Background: The aim of our study was to investigate whether anti-Xa levels assessed in selected groups of LMWH-treated patients with VTE correlate with the risk of developing thromboembolic or bleeding complications. Methods: Retrospective study, in adult patients treated with anti-Xa-adjusted LMWH analysing the association between anti-Xa activity and recurrent VTE or bleeding. Primary outcomes were symptomatic fatal or nonfatal objectively diagnosed VTE and clinically relevant bleeding (ISTH criteria). Results: From 2007-2017, 192 patients were recruited. Mean age was 62 (SD 18) years and 48% were men. Indications for anti-Xa monitoring were: VTE recurrence under anticoagulation (20.8%), …
Derivation and validation of a novel bleeding risk score for elderly patients with venous thromboembolism on extended anticoagulation
2017
SummaryExisting clinical scores do not perform well in predicting bleeding in elderly patients with acute venous thromboembolism (VTE). We sought to derive an easy-to-use clinical score to help physicians identify elderly patients with VTE who are at high-risk of bleeding during extended anticoagulation (>3 months). Our derivation sample included 743 patients aged ≥65 years with VTE who were enrolled in a prospective multicenter cohort study. All patients received extended anticoagulation with vitamin K antagonists. We derived our score using competing risk regression, with the time to a first major bleeding up to 36 months of extended anticoagulation as the outcome, and 17 candidate var…
Combined use of antifibrinolytics and activated prothrombin complex concentrate (aPCC) is not related to thromboembolic events in patients with acqui…
2019
Antifibrinolytics combined with aPCC are not routinely administered to patients with acquired hemophilia A due to increased thrombotic risk. This association normalizes clot stability, and improves the efficacy of therapy, but can increase the risk of severe side effects. Due to these premises it has always raised doubts and perplexities in the clinics. We now report the data of the "FEIBA® on acquired haemophilia A Italian Registry (FAIR Registry)", a retrospective-prospective study that included 56 patients. This is the first study that assessed the clinical response of the combination of aPCC and antifibrinolytic agents in patients with acquired haemophilia A. A total of 101 acute bleeds…
COVID ‐19, thromboembolic risk, and Virchow's triad: Lesson from the past
2020
Abstract COronavirus Infectious Disease which started in 2019 (COVID‐19) usually presents with the signs and symptoms of pneumonia. However, a growing number of recent reports highlight the fact that the infection may be by far more than only a respiratory disease. There is evidence of an increased thromboembolic risk in COVID‐19 patients, with a variety of manifestations in terms of ischemic stroke, deep vein thrombosis, acute pulmonary embolism, acute myocardial infarction, systemic arterial embolism, and placental thrombosis. The German physician Rudolph Virchow, about two centuries ago, described three pivotal factors contributing together to thromboembolic risk: endothelial injury, hyp…
Aspirin After Oral Anticoagulants for Prevention of Recurrence in Patients with Unprovoked Venous Thromboembolism. the Warfasa STUDY
2011
Abstract Abstract 543 Background A recurrence occurs in 15–20% of patients with unprovoked venous thromboembolism (VTE) in the two years after the withdrawal of oral anticoagulant treatment. Extending anticoagulant treatment is effective but associated with increased bleeding risk. We assessed the efficacy and safety of aspirin for the prevention of VTE recurrence after a conventional course of oral anticoagulation. Methods Warfasa was an investigator-initiated double-blind randomized placebo-controlled event-driven study. Patients with a first-ever unprovoked VTE who had completed 6–12 months of oral anticoagulant treatment were randomized to receive aspirin, 100 mg daily, or placebo for a…
Risk Factors for Pulmonary Embolism in Patients with Paralysis and Deep Venous Thrombosis
2021
Background. Venous thromboembolism is a frequent complication and an important cause of death in patients with paralysis. We aimed to investigate predictors of pulmonary embolism (PE) and the impact of PE on the survival of patients with paralysis in comparison to those with deep venous thrombosis or thrombophlebitis (DVT). Methods: Patients were selected by screening the German nationwide inpatient sample (2005–2017) for paralysis, and were stratified for venous thromboembolism (VTE) and the VTE-sub-entity PE (ICD-code I26). Impact of PE on mortality and predictors for PE were analyzed. Results: Overall, 7,873,769 hospitalizations of patients with paralysis were recorded in Germany 2005–20…
Elevated systolic pulmonary artery pressure for prediction of myocardial necrosis and right ventricular dysfunction in acute pulmonary embolism
2016
Kontext: Echokardiografie je v soucasnosti hlavni metodou pro vysetřeni dysfunkce prave komory (right ventricular dysfunction, RVD) u akutni plicni embolie (PE). Dysfunkce prave komory je sice spojena s nepřiznivou prognozou, dosud vsak nebyla přijata žadna obecně uznavana definice. Systolický tlak v plicnici (systolic pulmonary artery pressure, sPAP) větsinou neni soucasti kriterii RVD. Cilem nasi studie bylo zhodnotit možnost použiti sPAP v predikci nekrozy myokardu a RVD u akutni PE.Metody: Retrospektivně byly analyzovany udaje 182 pacientů s akutni PE. Pacienti s PE a hodnotami sPAP ≤ 30 mm Hg byli srovnavani s pacienty s PE a hodnotami sPAP > 30 mm Hg. Vztahy mezi sPAP na jedne straně …