Pulmonary Embolization of Radiolucent Intravenous Cannula: Endovascular Retrieval

AbstractFracture and embolization of peripheral intravenous cannula is very rare. Although endovascular retrieval is the standard of care for most of the embolized intravascular devices, endovascular management of embolized peripheral intravenous cannula is technically difficult due to its radiolucent nature and it is not described previously in the literature. We describe the clinical presentation, imaging findings, and endovascular management in a middle aged male who had fractured peripheral intravenous cannula which was embolized into the pulmonary artery branch. Technical nuances associated with retrieval of this radiolucent little plastic tube have been discussed.

Download Full-text

Caroticocavernous Fistulae: Clinical Presentation, Imaging, and Endovascular Treatment

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0039-3400432 ◽

2019 ◽

Vol 03 (03) ◽

pp. 171-179

Author(s):

Pushpinder S. Khera ◽

Pawan K. Garg ◽

Sarbesh Tiwari ◽

Binit Sureka ◽

Taruna Yadav ◽

...

Keyword(s):

High Pressure ◽

Clinical Presentation ◽

Imaging Findings ◽

Endovascular Management ◽

Common Cause ◽

Interventional Radiologist ◽

Clinical Presentations ◽

Pictorial Essay ◽

Two Wheeler

AbstractCaroticocavernous fistulas (CCFs) occur due to an abnormal communication between the high-pressure carotid artery system and the relatively lower pressure cavernous sinus system. They present with dramatic clinical presentations comprising among other things a swollen red eye with associated loss of vision to a varying degree. Blunt trauma sustained to the head, especially by two-wheeler riders, is the most common cause of the direct CCF and hence a practicing interventional radiologist in a developing country is very likely to encounter this entity in clinical practice. The authors intend to present a pictorial essay of the clinical presentations, imaging findings, endovascular management, and clinical follow-up for CCFs.

Download Full-text

Pulmonary Embolization in the Dog: Its Effects on Blood Coagulation and on Pulmonary Artery Pressures

Thrombosis and Haemostasis ◽

10.1055/s-0038-1654536 ◽

1961 ◽

Vol 06 (01) ◽

pp. 025-036 ◽

Cited By ~ 1

Author(s):

James W. Hampton ◽

William E. Jaques ◽

Robert M. Bird ◽

David M. Selby

Keyword(s):

Pulmonary Hypertension ◽

Particulate Matter ◽

Pulmonary Artery ◽

Amniotic Fluid ◽

Blood Coagulation ◽

Glass Beads ◽

Pulmonary Vessels ◽

Pulmonary Embolization ◽

Biological Nature

Summary1. Infusions containing particulate matter, viz. whole amniotic fluid, amniotic fluid sediment, and glass beads, produce in dogs changes in both early and late phases of the clotting reaction. These changes are associated with the development of pulmonary hypertension.2. When dogs were given an active fibrinolysin followed by an infusion of whole amniotic fluid, the alterations in the clotting mechanism were either delayed or did not appear. No pulmonary hypertension developed in these animals.3. We infer that infusions containing particulate matter will produce in dogs both pulmonary hypertension and changes in the clotting mechanism. Although these are independent changes, both are as closely related to the damage to the pulmonary vessels as they are to the biological nature of the infusions.

Download Full-text

Myocardial Infarction with and without ST-segment Elevation: a Contemporary Reappraisal of Similarities and Differences

Current Cardiology Reviews ◽

10.2174/1573403x16999201210195702 ◽

2020 ◽

Vol 16 ◽

Author(s):

Andreas Mitsis ◽

Felice Gragnano

Keyword(s):

Myocardial Infarction ◽

Clinical Presentation ◽

Standard Of Care ◽

Epidemiologic Studies ◽

Total Occlusion ◽

St Segment Elevation ◽

P2y12 Inhibitors ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Similarities And Differences

Abstract:: Understanding the similarities and differences between myocardial infarction with or without ST-segment elevation is an essential step for a proper patients’ management in current practice. Both syndromes are caused by a critical stenosis or a total occlusion of coronary arteries (mostly due to thrombosis on atherosclerotic plaque), and manifest with a similar clinical presentation. Recent epidemiologic studies show that the relative incidence of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) moves in an opposite fashion (decreasing and increasing respectively), with a prognosis that is worse at short-term follow-up for STEMI but comparable at long-term. Current management differs, as for STEMIs an immediate reperfusion is recommended, while for NSTEMIs risk stratification is mandatory in order to stratify patients’ risk, and then decide the timing for coronary angiography. Periprocedural and technical aspects of the interventional management as well antithrombotic medications are for the most similarly implemented in the two types of MI, with routine radial access, DES implant, and novel P2Y12 inhibitors representing the standard of care in both cases. The following review article aims to compare the two types of MI, with and without persistent ST-segment elevation. The main purpose is to explore their similarities and differences and address areas of uncertainty with regards to clinical presentation, therapeutic management, and prognosis. The identification of high-risk NSTEMI patients is important as they may require an individualised approach that can substantially overlap with current STEMI recommendations and their mortality remains high if their management is delayed.

Download Full-text

Hemodynamic Support Using Percutaneous Transfemoral Impella 5.0 and Impella RP for Refractory Cardiogenic Shock

Case Reports in Cardiology ◽

10.1155/2019/4591250 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Pratik K. Dalal ◽

Amy Mertens ◽

Dinesh Shah ◽

Ivan Hanson

Keyword(s):

Left Ventricle ◽

Pulmonary Artery ◽

Cardiogenic Shock ◽

Ventricular Function ◽

Standard Of Care ◽

Left Ventricular ◽

Biventricular Failure ◽

Ventricular Support ◽

The Right ◽

Flow Pump

Acute myocardial infarction (AMI) resulting in cardiogenic shock continues to be a substantial source of morbidity and mortality despite advances in recognition and treatment. Prior to the advent of percutaneous and more durable left ventricular support devices, prompt revascularization with the addition of vasopressors and inotropes were the standard of care in the management of this critical population. Recent published studies have shown that in addition to prompt revascularization, unloading of the left ventricle with the placement of the Impella percutaneous axillary flow pump can lead to improvement in mortality. Parameters such as the cardiac power output (CPO) and pulmonary artery pulsatility index (PAPi), obtained through pulmonary artery catheterization, can help ascertain the productivity of right and left ventricular function. Utilization of these parameters can provide the information necessary to escalate support to the right ventricle with the insertion of an Impella RP or the left ventricle with the insertion of larger devices, which provide more forward flow. Herein, we present a case of AMI complicated by cardiogenic shock resulting in biventricular failure treated with the percutaneous insertion of an Impella RP and Impella 5.0 utilizing invasive markers of left and right ventricular function to guide the management and escalation of care.

Download Full-text

Pulmonary artery fungal infection with imaging findings resembling pulmonary artery sarcoma

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02208-0 ◽

2021 ◽

Author(s):

WeiXia Nie ◽

Li Gao ◽

Yan Du ◽

XuChun Yuan

Keyword(s):

Pulmonary Artery ◽

Fungal Infection ◽

Imaging Findings ◽

Pulmonary Artery Sarcoma

Download Full-text

Transthyretin Amyloid Cardiomyopathy—Current and Future Therapies

Annals of Pharmacotherapy ◽

10.1177/10600280211000351 ◽

2021 ◽

pp. 106002802110003

Author(s):

Jankhna D. Yadav ◽

Harjot Othee ◽

Kelly A. Chan ◽

Damen C. Man ◽

Paul P. Belliveau ◽

...

Keyword(s):

Cardiac Amyloidosis ◽

Complex Disease ◽

Clinical Presentation ◽

Target Therapy ◽

Data Extraction ◽

Organ Transplant ◽

Standard Of Care ◽

Transthyretin Amyloidosis ◽

Treatment Benefits ◽

Amyloid Cardiomyopathy

Objective: To describe the clinical presentation of transthyretin amyloid cardiomyopathy (ATTR-CM) and discuss current treatments and investigational products and their effect on patient outcomes. Data Sources: A literature search was performed in PubMed (September 2018 to December 2020) using the following keywords: transthyretin amyloidosis, cardiomyopathy, polyneuropathy and transthyretin amyloid cardiomyopathy, monoclonal light-chain, tafamidis, cardiac amyloidosis, ATTR cardiomyopathy, green tea and inhibition of cardiac amyloidosis, AG10, tolcapone, tolcapone and leptomeningeal ATTR, PRX004, NI006, patisiran, inotersen, vutrisiran, AKCEA-TTR-LRx, and NTLA-2001. Study Selection and Data Extraction: Clinical trials were evaluated for evidence supporting pharmacology, safety, efficacy, and measured outcomes. Data Synthesis: Until 2019, there were no approved treatments for ATTR-CM. Treatment consisted of symptom management and organ transplant. Nonpharmacological and pharmacological treatments focused on the symptoms of heart failure (HF) associated with ATTR-CM. However, there are several emerging therapies recently approved or in development to address the underlying pathophysiology. Treatment classes for ATTR-CM include transthyretin stabilizers, human monoclonal antibodies, gene silencers, and CRISPR/Cas9 gene editing. Relevance to Patient Care and Clinical Practice: ATTR-CM is a complex disease in which amyloidosis causes cardiomyopathy. Underdiagnosis is attributed to the clinical presentation being heterogeneous, indistinguishable from HF caused by other etiologies, and the need for invasive testing modalities, including endomyocardial biopsy. Improved diagnostic approaches along with targeted therapies can slow disease progression and enhance patient quality of life. Conclusion: Diagnostic modalities along with biomarker and genetic testing could detect disease earlier and target therapy more accurately. Novel therapies demonstrate potential treatment benefits and can help shape the standard of care for these patients.

Download Full-text