Perfusion defects after pulmonary embolism: risk factors and clinical significance

2010 ◽  
Vol 8 (6) ◽  
pp. 1248-1255 ◽  
Author(s):  
O. SANCHEZ ◽  
D. HELLEY ◽  
S. COUCHON ◽  
A. ROUX ◽  
A. DELAVAL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Clinical Significance ◽  
Perfusion Defects

Incidental Pulmonary Embolism Identified on Chest CT during Initial Trauma Evaluation

2008 ◽  
Vol 74 (12) ◽  
pp. 1146-1148
Author(s):  
Jean Marie Ruddy ◽  
Nancy S. Curry ◽  
E. Douglas Norcross ◽  
Stuart M. Leon
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Significance ◽  
Chest Ct ◽  
Pulmonary Emboli ◽  
Significant Morbidity ◽  
Incidental Pulmonary Embolism

Deep venous thrombosis and pulmonary embolism frequently occur after trauma and continue to account for significant morbidity and mortality in this population. Asymptomatic pulmonary emboli are also believed to be quite common, but the incidence as well as the implications of these events is unknown. This case report describes two patients whose pulmonary emboli were found incidentally on the initial trauma workup. Very little has been written concerning this issue and in this case report we review the risk factors and clinical significance of these “incidentally discovered” pulmonary emboli.

Characterization and clinical implications of peripheral arterial involvement in transthyretin cardiac amyloidosis cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Stamatelopoulos ◽  
D Delialis ◽  
D Bampatsias ◽  
M.E Tselegkidi ◽  
I Petropoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Significance ◽  
Vascular Involvement ◽  
Control Group ◽  
Peripheral Vascular ◽  
Cvd Risk Factors ◽  
Wave Reflections ◽  
Cvd Risk ◽  
Arterial Involvement ◽  
Peripheral Arterial

Abstract Background The sporadic form of transthyretin amyloidosis cardiomyopathy (ATTR-CM) is underdiagnosed but its prevalence is increasing due to the aging population. Given the poor prognosis of ATTR-CM understanding the underlying pathophysiologic mechanisms of the disease is imperative in order to improve strategies for early diagnosis and risk stratification and to develop new effective therapeutic options. ATTR-CM is associated with hypotension and there is preliminary experimental evidence of vascular involvement but its presence and clinical significance remains unknown. Purpose To characterize peripheral arterial involvement and explore its clinical role in ATTR-CM. Methods We consecutively recruited 28 previously untreated patients with newly diagnosed ATTR-CM and 34 elderly controls >70 years old, without ATTR-CM or heart failure. In both groups, flow-mediated dilatation (FMD) and intima-media thickness (IMT) in the carotid arteries were measured by high-resolution ultrasonography as markers of peripheral vascular reactivity and of subclinical atherosclerosis, respectively. Carotid-femoral pulse wave velocity (PWV) was measured as a marker of arterial stiffness. Aortic blood pressure (BP) and augmentation index (AI) using applanation tonometry were measured as markers of arterial wave reflections, peripheral arterial resistance and central hemodynamics. Echocardiography was performed in all ATTR patients. All cardiovascular (CV) measurements were performed before administration of any ATTR-specific therapy. Results ATTR patients were older and had lower prevalence of hypertension and male gender (p<0.05 for all) than the control group. Aortic and peripheral BP (p=0.016–0.088) and AI (p=0.003) were lower in ATTR patients. IMT in the common (cc) and internal carotid (ic) as well as in the carotid bulb (cb) were significantly higher in ATTR patients (p=0.001–0.042). After multivariable adjustment for traditional CV disease (CVD) risk factors, the ATTR group was independently associated with AI and IMT in cc, cb and ic (p<0.05 for all). In a subgroup of subjects with similar age between groups (n=13 and n=33 and 74.5±2.9 vs. 75.6±3.6 years, for ATTR vs. controls, respectively) differences in AI and cbIMT remained significant. Interestingly, AI was strongly and inversely associated with interventricular wall thickness (IVwt) in ATTR patients (spearman rho=−0.651, p=0.001). After adjustment for traditional CVD risk factors this association remained significant. Conclusion ATTR-CM is associated with lower aortic wave reflections, which correlate with more advanced structural cardiac disease, as assessed by IVwt. Further, ATTR-CM patients present accelerated subclinical carotid atherosclerosis as compared to elderly control subjects. These findings suggest that in ATTR-CM there is disease-specific peripheral vascular involvement in parallel to cardiac involvement. The clinical significance of these findings merits further investigation. Funding Acknowledgement Type of funding source: None

scholarly journals Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

2021 ◽  
Vol 10 (11) ◽  
pp. 2462
Author(s):  
Barbara Ruaro ◽  
Paola Confalonieri ◽  
Mario Santagiuliana ◽  
Barbara Wade ◽  
Elisa Baratella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Potential Risk ◽  
Smoking Habit ◽  
Age At Diagnosis ◽  
Antiphospholipid Antibody ◽  
Increased Risk ◽  
Significant Difference ◽  
Antibody Positivity ◽  
Potential Risk Factors

Background. Some studies with inconclusive results have reported a link between sarcoidosis and an increased risk of pulmonary embolism (PE). This study aimed at assessing a possible correlation between potential risk factors and PE in sarcoidosis patients. Methods. A total of 256 sarcoidosis patients (84 males and 172 females; mean age at diagnosis 49 ± 13) were enrolled after giving written informed consent. Clinical evaluations, laboratory and radiology tests were performed to evaluate the presence of pulmonary embolism. Results. Fifteen sarcoidosis patients with PE (4 males and 11 females; mean age at diagnosis 50 ± 11), diagnosed by lung scintigraphy and 241 sarcoidosis patients without PE (80 males and 161 females; mean age at diagnosis 47 ± 13), were observed. There was a statistically significant increase of the presence of antiphospholipid antibodies in the sarcoidosis group with pulmonary embolism. There was no statistically significant difference between the two groups as to smoking habit, obesity or hereditary thrombophilia frequency (p > 0.05, respectively). Conclusions. This study demonstrates a significant correlation between the presence of antiphospholipid antibody positivity and the pulmonary embolism events in our sarcoidosis patients. Furthermore, we propose screening for these antibodies and monitoring, aimed at timely treatment.

Silent Venous Thrombosis Revealed by Impedance and 125I-Fibrinogen

1975 ◽  
Author(s):  
M. Hume
Keyword(s):  
At Risk ◽  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Clinical Significance ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Clinical Evidence ◽  
Impedance Plethysmography ◽  
Patients At Risk ◽  
Lung Scan

100 post-operative subjects were observed following total hip replacement using 125I-fibrinogen (125I-Fg) and impedance plethysmography (IPG) with thigh cuff. Phlebo-grams were obtained if these tests indicated venous thrombosis. Also, lung scan was obtained if clinical evidence of pulmonary embolism developed. Sustained significant isotope localization occurred in 40. 32 of these had abnormal IPG. Four patients had minor pulmonary embolism, which was associated with abnormality of either 125I-Fg or IPG. All major obstructive venous thrombosis and all moderately extensive thrombosis was associated with abnormal IPG. Only minute thrombi were not correctly classified by IPG. The following conclusions are supported by this experience. 1) If prospectively applied in patients at risk, the combination of both techniques (125I-Fg, IPG) is capable of detecting all silent venous thrombosis even minute thrombi of negligible significance. 2) IPG is capable of detecting all major obstructive and all moderately extensive thrombi, that is, all thrombosis of clinical significance arising in the leg. 3) Minute thrombi will not be detected by IPG alone and small emboli resulting from detachment of such minute thrombi would be unheralded unless monitoring includes 125I-Fg.

scholarly journals Delayed pulmonary embolism after COVID-19 pneumonia: a case report

2020 ◽  
Author(s):  
Mohamad Kanso ◽  
Thomas Cardi ◽  
Halim Marzak ◽  
Alexandre Schatz ◽  
Loïc Faucher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Index Hospitalization ◽  
Rt Pcr ◽  
Moderate Severity ◽  
Respiratory Status ◽  
Case Summary ◽  
Pcr Test

Abstract Background  Since the onset of the COVID-19 pandemic, several cardiovascular manifestations have been described. Among them, venous thromboembolism (VTE) seems to be one of the most frequent, particularly in intensive care unit patients. We report two cases of COVID-19 patients developing acute pulmonary embolism (PE) after discharge from a first hospitalization for pneumonia of moderate severity. Case summary  Two patients with positive RT-PCR test were initially hospitalized for non-severe COVID-19. Both received standard thromboprophylaxis during the index hospitalization and had no strong predisposing risk factors for VTE. Few days after discharge, they were both readmitted for worsening dyspnoea due to PE. One patient was positive for lupus anticoagulant. Discussion  Worsening respiratory status in COVID-19 patients must encourage physicians to search for PE since SARS-CoV-2 infection may act as a precipitant risk factor for VTE. Patients may thus require more aggressive and longer thromboprophylaxis after COVID-19 related hospitalization.

scholarly journals Clinical significance and risk factors of urethrovesical anastomotic urinary leakage following robot-assisted radical prostatectomy: a multi-institutional study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shigenori Kakutani ◽  
Yuta Takeshima ◽  
Yuta Yamada ◽  
Tetsuya Fujimura ◽  
Shoichi Nagamoto ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Radical Prostatectomy ◽  
Clinical Significance ◽  
Final Analysis ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Urinary Leakage ◽  
Postoperative Continence ◽  
The University

Abstract Background There has been a limited number of reports on the significance and risk factors of urethrovesical anastomotic urinary leakage (AUL) following robot-assisted radical prostatectomy (RARP). We aimed to analyze the clinical significance of AUL and evaluated its risk factors. Methods We conducted a multi-institutional study to review patients with prostate cancer undergoing RARP in three centers (The University of Tokyo Hospital, Mitsui Memorial Hospital, and Chiba Tokushukai Hospital). “Positive AUL” was defined as urinary extravasation at the anastomosis detected by post-operative cystogram and was further categorized into minor or major AUL. Univariate and multivariate analyses were performed to identify predictors of AUL. Postoperative continence rates and time to achieve continence were also analyzed. Results A total of 942 patients underwent RARP for prostate cancer in 3 centers. Of these patients, a cystogram after the RARP procedure was not performed in 26 patients leaving 916 patients for the final analysis. AUL was observed in 56 patients (6.1%); 34 patients (3.7%) with minor AUL and 22 patients (2.4%) with major AUL. Patients with major AUL exhibited a significantly longer time to achieve continence than those without major AUL. Multivariate analysis demonstrated that longer console time (≥ 184 min) was significantly associated with overall AUL, and higher body mass index (≥ 25 g/kg2) was a significant predictor of both major and overall AUL. Conclusions The presence of major AUL was associated with the achievement of urinary continence, suggesting clinical relevance of its diagnosis by postoperative cystogram. A selective cystogram has been proposed for high-risk cases. Furthermore, identification of the risk factors of AUL will lead to optimal application.

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