Therapy for recurrent bleeding from rectal varices by EUS-guided sclerosis

2015 ◽  
Vol 81 (5) ◽  
pp. 1280-1281 ◽  
Author(s):  
Esther K. Connor ◽  
Olga L. Duran-Castro ◽  
Rajeev Attam
Keyword(s):  
Recurrent Bleeding ◽  
Rectal Varices

Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 497-504 ◽  
Author(s):  
Tom De Beule ◽  
Jan Vranckx ◽  
Peter Verhamme ◽  
Veerle Labarque ◽  
Marie-Anne Morren ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Arteriovenous Malformations ◽  
Clinical Success ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Complete Disappearance ◽  
Ethylene Vinyl Alcohol ◽  
Initial Symptoms

Abstract. Background: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs. Patients and methods: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients’ general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms. Results: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients. Conclusions: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.

Mo1164 - Risk Factors for Recurrent Bleeding from Acute Hemorrhagic Rectal Ulcer

2018 ◽  
Vol 154 (6) ◽  
pp. S-693
Author(s):  
Naoyuki Nishimura ◽  
Motowo Mizuno ◽  
Yuichi Shimodate ◽  
Akira Doi ◽  
Hirokazu Mouri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Recurrent Bleeding ◽  
Rectal Ulcer

scholarly journals The long and short of it: using the new factor products

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Amy Dunn
Keyword(s):  
Half Life ◽  
Fresh Frozen Plasma ◽  
Recurrent Bleeding ◽  
Prophylactic Therapy ◽  
Improved Outcomes ◽  
Increased Risk ◽  
Plasma Factor ◽  
Fresh Frozen ◽  
Bleeding Episodes ◽  
Viral Attenuation

Abstract Hemophilia A (HA) and B (HB) are classified as mild (>5%-40%) moderate (1%-5%) and severe (<1%) disease based on plasma factor activity. Severity of bleeding is commensurate with baseline factor levels in general; however, heterogeneity of bleeding in patients is well described. Recurrent bleeding with painful and disabling musculoskeletal complications is the largest source of morbidity for persons with hemophilia (PWH) but treatment advances through the years has led to improved outcomes. In the early 20th century, only whole blood and fresh frozen plasma (FFP) was available to treat bleeding episodes. In 1959, cryoprecipitate was discovered and became an option for treatment of HA in 1965. In the 1970s plasma fractionation led to the first standard half-life (SHL) concentrates. These products ushered in the use prophylactic therapy to prevent bleeding episodes. However, viral contamination slowed the use of prophylaxis until the 1980s when viral attenuation steps increased the safety of plasma concentrates. In the 1990s recombinant concentrates were developed and prophylactic therapy is increasing widely yet not yet universally used. However even with frequent SHL concentrate infusions outcomes are not optimal as PWH spend the majority of time with factor levels below the normal range and are at increased risk for bleeding. In 2014, the first extended half-life (EHL) products were approved for use and have begun to change the landscape of hemophilia care. Challenges of EHL implementation include patient selection, product selection, dose and schedule of infusions, monitoring for safety, efficacy and outcomes, and managing economic aspects of care.

Embolization of Rectal Varices via a Paraumbilical Vein with an Abdominal Wall Approach in a Patient with Massive Ascites

2009 ◽  
Vol 20 (9) ◽  
pp. 1259-1261 ◽  
Author(s):  
Kenji Ibukuro ◽  
Kentaro Kojima ◽  
Ikutaro Kigawa ◽  
Rei Tanaka ◽  
Hozumi Fukuda ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Massive Ascites ◽  
Rectal Varices ◽  
Paraumbilical Vein

Thromboembolic events, recurrent bleeding and mortality after resuming anticoagulant following gastrointestinal bleeding

2015 ◽  
Vol 114 (10) ◽  
pp. 819-825 ◽  
Author(s):  
Chatree Chai-Adisaksopha ◽  
Christopher Hillis ◽  
Manuel Monreal ◽  
Daniel Witt ◽  
Mark Crowther
Keyword(s):  
Data Extraction ◽  
Meta Analysis ◽  
Anticoagulation Therapy ◽  
Phase Iii ◽  
Recurrent Bleeding ◽  
Thromboembolic Events ◽  
Gi Bleeding ◽  
Study Selection ◽  
Language Restriction ◽  
Randomised Controlled

SummaryGastrointestinal (GI) bleeding commonly complicates anticoagulant therapy. We aimed to systematically review the published literature to determine the risk of thromboembolism, recurrent GI bleeding and mortality for patients on long-term anticoagulation who experience GI bleeding based on whether anticoagulation therapy was resumed. We performed a systematic review of phase III randomised controlled trials and cohort studies in patients with atrial fibrillation or venous thromboembolism who received oral anticoagulant. We searched MEDLINE, EMBASE and CENTRAL (from 1996-July 2014), conferences abstracts (from January 2006-July 2014) and www.clinicaltrials.gov (up to the last week of July 2014) with no language restriction. Two reviewers independently performed study selection, data extraction and study quality assessment. A total of three studies were included in the meta-analysis. The resumption of warfarin was associated with a significant reduction in thromboembolic events (hazard ratio [HR] 0.68, 95 % confidence interval [CI] 0.52 to 0.88, p < 0.004, I2=82 %). There was an increase in recurrent GI bleeding but not statistically significant for patients who restarted warfarin compared to those who did not (HR 1.20, 95 % CI 0.97 to 1.48, p = 0.10, I2 = 0 %). Resumption of warfarin was associated with significant reduction in mortality (HR 0.76, 95 % CI 0.66 to 0.88, p < 0.001, I2 = 87 %). This meta-analysis demonstrates that resumption of warfarin following interruption due to GI bleeding is associated with a reduction in thromboembolic events and mortality without a statistically significant increase in recurrent GI bleeding.Institution where the work was performed: McMaster University, Hamilton, Ontario, Canada.

Microsurgery or Radiosurgery for Cerebral Arteriovenous Malformations? A Study of Two Paired Series

Neurosurgery ◽  
2007 ◽  
Vol 61 (1) ◽  
pp. 39-50 ◽  
Author(s):  
François Nataf ◽  
Michel Schlienger ◽  
Mohammed Bayram ◽  
May Ghossoub ◽  
Bernard George ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neurological Status ◽  
Recurrent Bleeding ◽  
Obliteration Rate ◽  
Initial Symptoms ◽  
Neurological Morbidity ◽  
Similar Patient ◽  
Martin Grade ◽  
Student’S T ◽  
Student’S T Test

Abstract OBJECTIVE To detect parameters that may augment the therapeutic strategy in patients with a cerebral arteriovenous malformation (AVM) that is considered equally suitable for treatment by neurosurgery or radiosurgery, we compared the efficacy and risks of these two methods in a paired series with similar patient and AVM characteristics. PATIENTS AND METHODS Two series of patients with AVM were studied, including a series of 39 patients treated using microsurgery (MS) and another series of 39 patients treated via radiosurgery (RS). These series were paired for age and sex, initial symptoms, size, location and Spetzler-Martin grade, and presence of embolization preceding treatment. We compared the posttreatment outcome in the two groups with respect to obliteration rate, neurological status, mortality rate, and recurrent bleeding. Statistical analysis was performed using paired Student's t test. RESULTS The Glasgow Outcome Scale values and Modified Rankin Scores measured at discharge and 12 to 24 months were significantly better in the RS series than in the MS series. The obliteration rate tended to be higher in the MS series (91% versus 81%; P = 0.10, not significant), whereas the rate of neurological deficit was higher in the MS series than in the RS series(P &lt; 0.001). The mortality rate was not significantly different in the two series, but the rate of recurrent bleeding was higher in the RS group (10% versus 0%; P = 0.04). CONCLUSIONS Although the rate of cure was similar for patients treated with MS and RS, neurological morbidity was higher after MS and recurrent bleeding was more frequent after RS.

scholarly journals Balloon-occluded antegrade transvenous obliteration of rectal varices: A case report

2021 ◽  
Vol 16 (11) ◽  
pp. 3363-3368
Author(s):  
Alireza Abrishami ◽  
Arezou Hashem Zadeh ◽  
Nastaran Khalili ◽  
Hadi Rokni Yazdi
Keyword(s):  
Case Report ◽  
Rectal Varices
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