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Sample records for cava tumor thrombus

  1. CT Findings of Intrarenal Yolk Sac Tumor with Tumor Thrombus Extending into the Inferior Vena Cava: A Case Report

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    Lin, Shao Chun; Li, Xue Hua; Sun, Can Hui; Feng, Shi Ting; Peng, Zhen Peng; Huang, Si Yun; Li, Zi Ping [Dept. of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou (China)

    2014-10-15

    Yolk sac tumor (YST) is a rare germ cell neoplasm of childhood that usually arises from the testis or ovary. The rare cases of YST in various extragonadal locations have been reported, but the primary intrarenal YST is even more uncommon. Here, we report a case of a primary intrarenal YST with tumor thrombus of the inferior vena cava and left renal vein in a 2-year-old boy, with an emphasis on the CT features. To our knowledge, this is the first reported case of an intrarenal YST with intravascular involvement.

  2. Adrenocortical carcinoma with inferior vena cava, left renal vein and right atrium tumor thrombus extension

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    Pronio Annamaria

    2015-01-01

    Conclusion: We present a rare case of Adrenocortical carcinoma with tumor thrombus extending into the IVC and right atrium. Complete resection with negative margins represents the best therapeutic chance for these patients.

  3. Tumor thrombus

    DEFF Research Database (Denmark)

    Ravina, Mudalsha; Hess, Søren; Chauhan, Mahesh Singh; Jacob, Mattakorottu Joseph; Alavi, Abass

    2014-01-01

    PURPOSE: Thrombosis in cancer may manifest itself as venous thromboembolic disease or tumor thrombosis (TT). We present our experience with incidentally detected TT on FDG PET/CT in 21 oncologic patients. PATIENTS AND METHODS: We retrospectively reviewed all FDG PET/CT examinations during a 5-year......-one patients were included; the most common malignancies were renal cell carcinoma (n=6), hepatocellular carcinoma (n=3), and lung cancer (n=3). Indication for the scan was initial staging (n=15) and suspected recurrence (n=6). Several vessels were affected, the most common was the inferior vena cava (n=14...

  4. Radiodiagnostic methods in determining the structure of tumor thrombus in the inferior vena cava in kidney cancer

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    N. B. Vikhrova

    2015-01-01

    Full Text Available Renal cell carcinoma (RCC is the most common primary tumor of the renal parenchyma. Venous involvement is one of the most important anatomic characteristics of tumor. It is known that venous spread influences the survival of patients with RCC. Tumor thrombosis of IVC in patients with renal cell carcinoma has been reported in 4–10 %. The reference standard for RCC with tumor thrombus remains surgical resection. The structure of thrombus determines some technical difficulties in the management of tumor. Spongeous thrombus correlate with higher risk of thrombus detachment during surgery resulting in PE. Therefore determination of IVC thrombus consistency is very important part of preoperative radiologic assessment of tumor in patients with RCC.

  5. Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

    International Nuclear Information System (INIS)

    Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX2 was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy, and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan–Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 ± 0.12 kg, 57.83 ± 8.68 days, (16.73 ± 5.18 %), (29.47 ± 7.18 %), and 2.03 ± 0.13 kg, 43.67 ± 5.28 days, (63.01 ± 2.01 %), (6.02 ± 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT in rabbit model

  6. Iodine-125 Seeds Strand for Treatment of Tumor Thrombus in Inferior Vena Cava: An Experimental Study in a Rabbit Model

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    Zhang, Wen, E-mail: wenzhangxiao@126.com; Yan, Zhiping, E-mail: Yan.zhiping@zs-hospital.sh.cn; Luo, Jianjun, E-mail: luo.jianjun@zs-hospital.sh.cn; Fang, Zhuting, E-mail: 470389481@qq.com; Wu, Linlin, E-mail: linlinzhifubao@126.com; Liu, QingXin, E-mail: liu.qingxin@zs-hospital.sh.cn; Qu, Xudong, E-mail: qu.xudong@zs-hospital.sh.cn; Liu, Lingxiao, E-mail: liu.lingxiao@zs-hospital.sh.cn; Wang, Jianhua, E-mail: wang.jianhua@zs-hospital.sh.cn [Fudan University, Department of Interventional Radiology, Zhongshan Hospital (China)

    2013-10-15

    Objective: The purpose of this study was to establish an animal model of implanted inferior vena cava tumor thrombus (IVCTT) and to evaluate the effect of linear iodine-125 seeds strand in treating implanted IVCTT. Methods: Tumor cell line VX{sub 2} was inoculated subcutaneously into New Zealand rabbit to develop the parent tumor. The tumor strip was inoculated into inferior vena cava (IVC) to establish the IVCTT model. The IVCTT was confirmed by multidetector computed tomography (MDCT) after 2 weeks. Twelve rabbits with IVCTT were randomly divided into two groups. Treatment group (group T; n = 6) underwent Iodine-125 seeds brachytherapy, and the control group (group C; n = 6) underwent blank seeds strand. The blood laboratory examination (including blood routine examination, hepatic and renal function), body weight, survival time, and IVCTT volume by MDCT were monitored. All rabbits were dissected postmortem, and the therapeutic effects were evaluated on the basis of histopathology. The proliferating cell nuclear antigen index (PI) and apoptosis index (AI) of IVCTT were compared between two groups. T test, Wilcoxon rank test, and Kaplan-Meier survival curve analysis were used. Results: The success rate of establishing IVCTT was 100 %. The body weight loss and cachexia of rabbits in group C appeared earlier than in group T. Body weight in the third week, the mean survival time, PI, AI in groups T and C were 2.23 {+-} 0.12 kg, 57.83 {+-} 8.68 days, (16.73 {+-} 5.18 %), (29.47 {+-} 7.18 %), and 2.03 {+-} 0.13 kg, 43.67 {+-} 5.28 days, (63.01 {+-} 2.01 %), (6.02 {+-} 2.93 %), respectively. There were statistically significant differences between group T and group C (P < 0.05). The IVCTT volume of group T was remarkably smaller than that of group C. Conclusions: Injecting and suspensory fixing VX2 tumor strip into IVC is a reliable method to establish IVCTT animal model. The linear Iodine-125 seeds strand brachytherapy was a safe and effective method for treating IVCTT

  7. Tumor thrombus of inferior vena cava in patients with renal cell carcinoma – clinical and oncological outcome of 50 patients after surgery

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    Kocot Arkadius

    2012-06-01

    Full Text Available Abstract Background To evaluate oncological and clinical outcome in patients with renal cell carcinoma (RCC and tumor thrombus involving inferior vena cava (IVC treated with nephrectomy and thrombectomy. Methods We identified 50 patients with a median age of 65 years, who underwent radical surgical treatment for RCC and tumor thrombus of the IVC between 1997 and 2010. The charts were reviewed for pathological and surgical parameters, as well as complications and oncological outcome. Results The median follow-up was 26 months. In 21 patients (42% distant metastases were already present at the time of surgery. All patients underwent radical nephrectomy, thrombectomy and lymph node dissection through a flank (15 patients/30%, thoracoabdominal (14 patients/28% or midline abdominal approach (21 patients/42%, depending upon surgeon preference and upon the characteristics of tumor and associated thrombus. Extracorporal circulation with cardiopulmonary bypass (CPB was performed in 10 patients (20% with supradiaphragmal thrombus of IVC. Cancer-specific survival for the whole cohort at 5 years was 33.1%. Survival for the patients without distant metastasis at 5 years was 50.7%, whereas survival rate in the metastatic group at 5 years was 7.4%. Median survival of patients with metastatic disease was 16.4 months. On multivariate analysis lymph node invasion, distant metastasis and grading were independent prognostic factors. There was no statistically significant influence of level of the tumor thrombus on survival rate. Indeed, patients with supradiaphragmal tumor thrombus (n = 10 even had a better outcome (overall survival at 5 years of 58.33% than the entire cohort. Conclusions An aggressive surgical approach is the most effective therapeutic option in patients with RCC and any level of tumor thrombus and offers a reasonable longterm survival. Due to good clinical and oncological outcome we prefer the use of CPB with extracorporal

  8. Inferior vena cava tumor thrombus after partial nephrectomy for renal cell carcinoma

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    Akatsuka, Jun; Suzuki, Yasutomo; Hamasaki, Tsutomu; Shindo, Takao; Yanagi, Masato; Kimura, Go; Yamamoto, Yoichiro; Kondo, Yukihiro

    2014-01-01

    Background Partial nephrectomy is now the gold standard treatment for small renal tumors. Local recurrence is a major problem after partial nephrectomy, and local recurrence in the remnant kidney after partial nephrectomy is common. Case presentation A 77-year-old man underwent right partial nephrectomy for a T1 right renal cell carcinoma. Microscopic examination revealed a clear cell renal carcinoma, grade 2, stage pT3a. Although the surgical margin was negative, the carcinoma invaded the pe...

  9. 下腔静脉癌栓的诊治进展%Advancements in Diagnosis and Treatment of Inferior Vena Cava Tumor Thrombus

    Institute of Scientific and Technical Information of China (English)

    郝嘉; 游凯

    2011-01-01

    下腔静脉癌栓常在恶性肿瘤中伴发,治疗上仍较棘手.目前如何选择适宜的诊治方法和它对肿瘤预后的影响尚未达成共识.现系统回顾下腔静脉癌栓的分型、诊断、围术期的综合治疗方法和预后方面的进展,重点综述外科治疗下腔静脉癌栓的各种辅助方法、手术切口和术后联合治疗方式.%Inferior vena cava tumor thrombus ( IVCTT) is one of the factors resulting in a poor prognosis for patients with carcmoma.The classification, improvement of diagnosis, comprehensive treatments, and overall suwival of IVCTT were analyzed. The review focuses on multiple surpcal methods, incision access, and combined postoperative therapies.

  10. Study of 99Tcm-annexin V distribution in inferior vena cava thrombus models of rabbits

    International Nuclear Information System (INIS)

    To study 99Tcm-Annexin V distribution in inferior vena cava thrombus models of rabbits and uptake of 99Tcm-Annexin V in fresh and old venous thrombus. Rabbits (n=15) were randomly grouped into 3 groups (the fresh thrombus group, old thrombus group, and control group). The rabbits of two thrombus groups developed inferior vena cava thrombus models by operations. The control group received sham operation. The fresh thrombus group and control group rabbits were injected 99Tcm-Annexin V after operating 1 d; the old thrombus group 14 d. After 1 h all rabbits were killed by injecting overdose pentobarbital sodium. The thrombus (or the inferior vena cava about 3 cm below inferior pole of right kidney level in the control group rabbits), blood, thrombus area inferior vena cava, head lateral inferior vena cava (except the control group), thigh muscle, stomach, myocardium, pulmonary, liver, kidney, spleen, bone and small intestine were obtained from all group rabbits. The ex tissue and blood were weighed and measured by a Well-type detector. The percentage of the injected dose per gram of ex tissue (or blood) was calculated by the above data. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and thigh muscle ratios were calculated by percentage of the injected dose per gram of ex tissue (or blood). The test was used to compare the fresh thrombus group and old thrombus group by SPSS 17.0. The percentage of' the injected dose per gram of thrombi (0.01894± 0.002 16% ID/g) in the fresh thrombus group was higher than the old thrombus group (0.00473±0.001 28% ID/g), P<0.05. The thrombus to blood, thrombus area inferior vena cava, head lateral inferior vena cava and muscle ratios (3.42±1.06, 26.32±13.60, 31.23 ±16.00, 111.62±52.23) in the fresh thrombus group were higher than the old thrombus group (0.98±0.09, 5.12±2.01, 6.25±2.38, 21.82±5.93), P<0.05 for all. All the thrombi of the fresh thrombus group were confirmed fresh

  11. Residual Inferior Vena Cava Thrombus Detected by Transesophageal Echocardiography After Resection of a Malignant Adrenal Mass.

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    Burbano, Nelson H; Vlah, Claudene; Argalious, Maged

    2015-10-15

    A 43-year-old woman with a history of the Cushing syndrome secondary to adrenocortical carcinoma presented to the operating room for right adrenalectomy, hepatectomy, nephrectomy, and inferior vena cava (IVC) thrombectomy. Initial intraoperative transesophageal echocardiogram (TEE) confirmed the presence of an IVC tumor below the hepatic veins. Total vascular exclusion of the liver was necessary to perform the operation. A repeat TEE showed a residual thrombus within the IVC prompting an additional cavotomy to successfully remove the entire mass. The remainder of the procedure finalized uneventfully. The case highlights the importance of TEE monitoring for noncardiac surgery with thrombotic involvement of the IVC. PMID:26466307

  12. Nephron Sparing Surgery for Renal Angiomyolipoma with Inferior Vena Cava Thrombus in Tuberous Sclerosis

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    Adrien Riviere

    2014-01-01

    Full Text Available Introduction. Angiomyolipoma is a common benign renal tumor. It is associated with Tuberous Sclerosis Complex (TSC in 20% of patients. Angiomyolipomas are classically multiple, bilateral, and growing; they may lead to complications such as Wunderlich syndrome or, in rare cases, to venous extension. Observation. a 74-year-old woman with TSC presented with an angiomyolipoma of the right kidney with inferior vena cava (IVC fatty thrombus. She underwent partial nephrectomy and thrombectomy. After a 7-year follow-up there was no evidence of recurrence or metastasis and her renal function was preserved. Review of Literature. It is the 44th reported angiomyolipoma associated with IVC thrombus. The mean size of angiomyolipomas was 86.1 mm and 67.4% of patients were symptomatic. Pulmonary embolism was found in 6 patients. There were 2 cases of recurrence/metastatic outcome after radical nephrectomy and thrombectomy. They were associated with epithelioid form. The mean size of epithelioid tumors was significantly bigger than in classical angiomyolipomas (127.1 mm versus 82.6 mm, P=0.037. With a median follow-up of 12 months, 91.3% of patients were recurrence and metastasis free, with 3 cases of nephron sparing surgery. Conclusion. Nephron sparing surgery for angiomyolipoma with IVC fatty thrombus can be safely performed in TSC, even in sporadic angiomyolipoma.

  13. Extensive tumor thrombus in a case of carcinoma lung detected by F18-FDG-PET/CT.

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    Mudalsha, Ravina; Jacob, Mj; Pandit, Ag; Jora, Charu

    2011-04-01

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma.[1] Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where F18-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. PMID:22174524

  14. Extensive tumor thrombus in a case of carcinoma lung detected by 18F-FDG-PET/CT

    International Nuclear Information System (INIS)

    Tumor thrombus is a rare complication of solid cancers, mainly seen in cases of renal cell carcinoma, Wilm's tumor, testicular carcinoma, adrenal cortical carcinoma and hepatocellular carcinoma. Tumor thrombus in inferior vena cava is a rare complication of primary carcinoma lung. It should be identified so as to rule out venous thromboembolism and avoiding unnecessary anticoagulant therapy. We describe a case where 18F-Fluorodeoxyglucose (FDG) positron emission tomography - computed tomography (PET/CT) helped to identify extensive tumor thrombus. (author)

  15. Metastatic Adenocarcinoma Presenting as Extensive Cavoatrial Tumor Thrombus

    International Nuclear Information System (INIS)

    The presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (IVC) or supradiaphragmatic carcinoma into the superior vena cava (SVC). Right atrial tumor thrombus with extension into both SVC and IVC has not been reported in the literature. We present a patient who presented with symptoms of right atrial and SVC obstruction. Imaging revealed presence of a thrombus in the right atrium, extending to the SVC and IVC, with the additional findings of a left adrenal mass and multiple liver lesions. The histopathological examination of the right atrial mass revealed metastatic adenocarcinoma cells. The patient was given a presumptive diagnosis of metastatic adenocarcinoma, most likely adrenal in origin, with multiple hepatic lesions suspicious for metastasis. The clinical outcome of the patient was not favorable; the patient succumbed before the adrenal mass could be confirmed to be the primary tumor. This case highlights that in patients manifesting with extensive cavoatrial thrombus as, the existence of primary carcinoma should be considered especially in the adrenal cortex or in the lung

  16. Role of fluorine-18 fluorodeoxyglucose positron emission tomography in a case of renal cell carcinoma to differentiate tumor thrombus from bland thrombus

    International Nuclear Information System (INIS)

    Tumor thrombus is a rare complication of many solid tumors. We present a case of renal cell carcinoma whose baseline contrast-enhanced computerized tomography (CT) revealed an heterogeneously enhancing mass in the upper half of right kidney with tumor thrombus in the right renal vein extending to suprarenal inferior vena cava (IVC), crossing the cavoatrial junction and reaching up to the right atrium (Grade IV). Fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT imaging revealed large irregular right renal mass, hypermetabolic tumor thrombus extending from the right renal vein to suprarenal IVC reaching up to the right atrium. There was no FDG uptake noted in the infrarenal IVC and bilateral iliofemoral venous thrombi. Thus, 18F-FDG PET/CT was not only helpful in the staging, but was also helpful in differentiating tumor thrombus from bland thrombus in our patient

  17. Extension of adrenal tumors into the vena cava: results of magnetic resonance angiography

    International Nuclear Information System (INIS)

    In rare cases, large adrenal masses with a suspicion of malignancy exhibit tumor extension into the adrenal vein and inferior vena cava. When planning surgery, the relationship of the extension to the inferior vena cava is of decisive improtance. We describe in two cases on the detection of a tumor thrombus in the inferior vena cava arising from a malignant adrenal mass by means of MR angiography (TOF, coronary 2D GRE images [FLASH], 3 slices acquired during 15 second apnea). The angiograms correlated well with the results of DSA venacavography and with the intraoperative findings. Thus, MRA has been demonstrated to be suitable for the certain proof of a venous tumor thrombus not only in cases of renal cell carcinomas but also in cases of malignant adrenal masses. The method should be applied whenever there is evidence of a venous involvement in the adrenal MR images. (orig.)

  18. Rectal cancer presenting tumor thrombosis in the inferior vena cava and common iliac vein: case report

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    Rhee, Sun Jung; Park, Seong Jin; Lee, Hae Kyung; Yi, Boem Ha; Park, Sung Il; Hong, Soo Jin; Kim, Hee Kyung; Park, Jeong Mi [Soonchunhyang University Hospital, Bucheon (Korea, Republic of)

    2008-10-15

    We report the radiologic findings of a rectal carcinoma case with tumor thrombus in the inferior vana cava and left common iliac vein of a 48-year-old woman. The patient complained of swelling in the left leg and consequently underwent a lymphoscintigraphy, CT venography, abdominal CT, PET-CT, pelvis MRI, and ultrasound doppler. The rectal cancer was determined via a colonoscopy. The tissue biopsy of tumor thrombus in the IVC was done during insertion of IVC filter and poorly differentiated adenocarcinoma was revealed by pathology.

  19. Percutaneous transfemoral placement of inferior vena cava filter to prevent pulmonary embolism in patients with malignant tumor

    International Nuclear Information System (INIS)

    Objective: To evaluate the effectiveness and safety of inserting an inferior vena cava filter to prevent the pulmonary embolism (PE) due to detachment of the thrombus in the lower extremities. Methods: Inferior vena cava filter were placed in 37 patients with malignant tumor and deep venous thrombosis from 1998 to 2004. Malignancy was confirmed by pathological or cellular biological examination in all cases. The episode of pulmonary embolism was monitored during a post-intervention follow-up. Results: All the filters were placed in the inferior vena cava safely via a percutaneous femoral venous access. No serious complications such as pulmonary embolism occurred during the follow-up periods. Conclusion: The inferior vena cava filter placement is an effective and safe procedure in preventing the pulmonary embolism in patients with malignant tumor and deep venous thrombosis. (authors)

  20. Xanthogranulomatous Pyelonephritis in a male child with renal vein thrombus extending into the inferior vena cava: a Case Report

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    Kotasthane Vaishali D

    2010-07-01

    Full Text Available Abstract Background We present a case of Xanthogranulomatous pyelonephritis (XGPN in a male child with renal vein thrombus extending into the inferior vena cava. This is a rare presentation. XGPN is a rare type of renal infection characterised by granulomatous inflammation with giant cells and foamy histiocytes. The peak incidence is in the sixth to seventh decade with a female predominance. XGPN is rare in children. Case presentation An 11 year old male child presented with a history of high grade fever and chills, right flank pain and progressive pyuria for two months. He had a history of vesical calculus for which he was operated four years back. In our case, a subcapsular right nephrectomy was performed. The surgical specimens were formalin fixed and paraffin embedded. The sections were stained with routine Hematoxylin & Eosin stain. Grossly; the kidney was enlarged with adherent capsule and thickening of the perinephric tissue. The pelvicalyceal system was dilated and was filled with a cast of pus. Histological evaluation revealed diffuse necrosis of the renal parenchyma and perinephric fat. Neutrophils, plasma cells, sheets of foamy macrophages and occasional multinucleate giant cells were seen. The renal vein was partially occluded by an inflammatory thrombus with fibrin, platelets and mixed inflammatory cells. The thrombus was focally adherent to the vein wall with organization. Conclusions The clinical presentation and the macroscopic aspect, together with the histological pattern, the cytological characteristics addressed the diagnosis towards XGPN with a vena caval thrombus. Our case illustrates that the diagnosis of XGPN should be considered even in paediatric age group when renal vein and vena caval thrombi are present.

  1. Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus

    OpenAIRE

    Jia, Weidong

    2015-01-01

    Portal vein tumor thrombus (PVTT) is one of the important biological characteristics of hepatocellular carcinoma (HCC), and also a serious complication and a metastatic mode. Surgical treatment is still the most effective therapy for HCC with PVTT. This article describes the history and present situation of surgical treatment of HCC with PVTT, the anatomical basis for PVTT formation, classification of PVTT, indications for surgery, selection of surgical approaches, and evaluation of the surgi...

  2. A Novel Technique for Endovascular Removal of Large Volume Right Atrial Tumor Thrombus

    Energy Technology Data Exchange (ETDEWEB)

    Nickel, Barbara, E-mail: nickel.ba@gmail.com [US Teleradiology and Quantum Medical Radiology Group (United States); McClure, Timothy, E-mail: tmcclure@gmail.com; Moriarty, John, E-mail: jmoriarty@mednet.ucla.edu [UCLA Medical Center, Department of Interventional Radiology (United States)

    2015-08-15

    Venous thromboembolic disease is a significant cause of morbidity and mortality, particularly in the setting of large volume pulmonary embolism. Thrombolytic therapy has been shown to be a successful treatment modality; however, its use somewhat limited due to the risk of hemorrhage and potential for distal embolization in the setting of large mobile thrombi. In patients where either thrombolysis is contraindicated or unsuccessful, and conventional therapies prove inadequate, surgical thrombectomy may be considered. We present a case of percutaneous endovascular extraction of a large mobile mass extending from the inferior vena cava into the right atrium using the Angiovac device, a venovenous bypass system designed for high-volume aspiration of undesired endovascular material. Standard endovascular methods for removal of cancer-associated thrombus, such as catheter-directed lysis, maceration, and exclusion, may prove inadequate in the setting of underlying tumor thrombus. Where conventional endovascular methods either fail or are unsuitable, endovascular thrombectomy with the Angiovac device may be a useful and safe minimally invasive alternative to open resection.

  3. A Novel Technique for Endovascular Removal of Large Volume Right Atrial Tumor Thrombus

    International Nuclear Information System (INIS)

    Venous thromboembolic disease is a significant cause of morbidity and mortality, particularly in the setting of large volume pulmonary embolism. Thrombolytic therapy has been shown to be a successful treatment modality; however, its use somewhat limited due to the risk of hemorrhage and potential for distal embolization in the setting of large mobile thrombi. In patients where either thrombolysis is contraindicated or unsuccessful, and conventional therapies prove inadequate, surgical thrombectomy may be considered. We present a case of percutaneous endovascular extraction of a large mobile mass extending from the inferior vena cava into the right atrium using the Angiovac device, a venovenous bypass system designed for high-volume aspiration of undesired endovascular material. Standard endovascular methods for removal of cancer-associated thrombus, such as catheter-directed lysis, maceration, and exclusion, may prove inadequate in the setting of underlying tumor thrombus. Where conventional endovascular methods either fail or are unsuitable, endovascular thrombectomy with the Angiovac device may be a useful and safe minimally invasive alternative to open resection

  4. Myofibroblastic tumor associated to superior vena cava syndrome

    International Nuclear Information System (INIS)

    Inflammatory myofibroblastic tumor (IMT) is an uncommon pathological entity of unknown cause, composed of differentiated myofibroblastic cells accompanied by plasma cells, lymphocytes and eosinophils, which involve extrapulmonary and pulmonary tissues. IMT has an unpredictable clinical course, rarely undergoes malignant transformation. Local invasion and involvement of the mediastinum and hiliar structures are unusual manifestations; however; we reports a case of superior vena cava syndrome and IMT

  5. Rare case of primary inferior vena cava leiomyosarcoma on F-18 fluorodeoxyglucose positron emission tomography-computed tomography scan: Differentiation from nontumor thrombus in a background of procoagulant state

    International Nuclear Information System (INIS)

    We report a rare case of leiomyosarcoma of the inferior vena cava (IVC) in which F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography-computed tomography (PET-CT) scan provided vital evidence, which led to its diagnosis, in a background of procoagulant state of the patient, where previous ultrasound-Doppler and echocardiography studies were nonspecific and revealed bilateral lower limb deep vein thrombosis with thrombus in IVC. The whole body F-18 FDG PET-CT scan was done in view of no significant improvement in clinical status of the patient over few months in spite of appropriate medical management. FDG PET-CT scan revealed high grade uptake in a large mass lesion occupying the right atrium, extending superiorly into terminal superior vena cava, inferiorly into dilated IVC and probably into hepatic veins. CT guided biopsy of this F-18 FDG avid mass was consistent with the diagnosis of leiomyosarcoma, which however was not amenable to surgery at this stage. F-18 FDG PET-CT accurately differentiated tumor mass from bland thrombus and further had a significant impact on the management, since aggressive surgery combined with adjuvant therapy offers the best outcome for patients with leiomyosarcoma of the IVC

  6. Combination radiotherapy for hepatocellular carcinoma with intraductal tumor thrombus: A case report

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    Tanizaki, Hiroshi E-mail: info@shin-tokyohospital.or.jp; Furuse, Junji; Yoshino, Masahiro; Ogino, Takashi; Ishikura, Satoshi; Satake, Mitsuo; Hasebe, Takahiro

    2001-06-01

    We report the successful treatment of hepatocellular carcinoma (HCC) associated with an intraductal tumor thrombus in a 67-year-old male. Abdominal ultrasonography (US) and computed tomography (CT) revealed intrahepatic biliary dilatation in the left hepatic lobe and an intraductal tumor thrombus. The main tumor lesion was not clearly visualized on abdominal US, dynamic CT, and hepatic angiography. We biopsied the intraductal tumor thrombus under US guidance. Histologically the biopsy specimen was a poorly differentiated HCC We thus diagnosed HCC with intraductal tumor thrombus. The total serum bilirubin level gradually rose to 3.1 mg/dl. This tumor was inoperable because of severe hepatic dysfunction. We chose to treat the patient with radiotherapy aimed only at the intraductal tumor thrombus because the main tumor was unclear. A percutaneous transhepatic biliary drainage (PTBD) tube was inserted into the common bile duct beyond the tumor thrombus and the tube was dilated. Once total serum bilirubin had reached the normal range, a combination of external beam radiation therapy (EBRT) plus an intraluminal brachytherapy, {sup 192}Ir boost was administered. The intraductal tumor thrombus was found to have vanished and the PTBD tube was removed. After this treatment, transcatheter hepatic arterial embolization was performed at the point of tumor appearance. This patient had a relatively long survival, {approx}30 months, with no clinical evidence of recurrent disease and biliary drainage was not necessary.

  7. Treatment of hepatocellular carcinoma accompanied by portal vein tumor thrombus

    Institute of Scientific and Technical Information of China (English)

    Masami Minagawa; Masatoshi Makuuchi

    2006-01-01

    The prognosis of patients with hepatocellular carcinoma (HCC)accompanied by portal vein tumor thrombus (PVTT) is generally poor if left untreated: a median survival time of 2.7-4.0 mo has been reported. Furthermore, while transcatheter arterial chemoembolization (TACE) has been shown to be safe in selected patients, the median survival time with this treatment is still only 3.8-9.5 mo. Systemic single-agent chemotherapy for HCC with PVTT has failed to improve the prognosis, and the response rates have been less than 20%. While regional chemotherapy with low-dose cisplatin and 5-fluorouracil or interferon and 5-fluorouracil via hepatic arterial infusion has increased the response rate, the median survival time has not exceeded 12 (range 4.5-11.8) mo.Combined treatment consisting of radiation for PVTT and TACE for liver tumor has achieved a high response rate, but the median survival rates have still been only 3.8-10.7 mo. With hepatic resection as monotherapy,the 5-year survival rate and median survival time were reportedly 4%-28.5% and 6-14 mo. The most promising results were reported for combined treatments consisting of hepatectomy and TACE, chemotherapy, or internal radiation. The reported 5-year survival rates and median survival times were 42% and 31 mo for TACE followed by hepatectomy; 36.3% and 22.1 mo for hepatectomy followed by hepatic arterial infusion chemotherapy; and 56% for chemotherapy or internal radiation followed by hepatectomy.

  8. Diagnosis of an infected central venous catheter with ultrasound and computed tomography; Diagnose eines infizierten Thrombus der Vena cava inferior mit Sonographie und Computertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Tacke, J. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Adam, G. [RWTH Aachen (Germany). Klinik fuer Radiologische Diagnostik; Sliwka, U. [RWTH Aachen (Germany). Neurologische Klinik; Klosterhalfen, B. [RWTH Aachen (Germany). Inst. fuer Pathologie; Schoendube, F. [RWTH Aachen (Germany). Klinik fuer Thorax- Herz- und Gefaesschirurgie

    1995-08-01

    The authors report the case of a 16-year-old male patient, who suffered from meningitis and Waterhouse-Friderichsen syndrome. After initial improvement in the intensive care unit, he developed septic temperatures, caused by an infected thrombus of a central venous catheter in the inferior vena cava, Color-coded ultrasound showed hyperechogenic signals and missing flow detection at the catheter tip. Computed tomography showed air bubbles in the thrombosed catheter tip and confirmed the diagnosis. Vasuclar surgery was done and an infected, 17-cm-long infected thrombus was removed. (orig./VHE) [Deutsch] Die Autoren berichten ueber den Fall eines 16jaehrigen Patienten, dem wegen einer Meningitis und der Zeichen eines Waterhouse-Friderichsen-Syndroms ein femoralvenoeser Zentralkatheter gelegt wurde. Nach initialer Entfieberung entwickelte sich eine Sepsis, deren Ursache in einem infizierten Thrombus des Zentralvenenkatheters lag. Die Diagnose wurde sonographisch gestellt und nachfolgend computertomographisch bestaetigt. In beiden Verfahren wiesen Lufteinschluesse im Katheterthrombus auf die Injektion hin. Der Befund wurde durch eine gefaesschirurgische Thrombektomie bestaetigt und therapiert. (orig./VHE)

  9. Clinical application of percutaneous drainage in treating hepatocellular carcinoma with bile duct tumor thrombus

    OpenAIRE

    Lu, Zaiming; Sun, Wei; Wen, Feng; Liang, Hongyuan; Shan, Ming; Guo, Qiyong

    2013-01-01

    Aim of the study This study aimed to evaluate the effect of percutaneous interventional treatment on obstructive jaundice caused by hepatocellular carcinoma with bile duct tumor thrombus. Material and methods A total of 16 patients with bile duct tumor thrombus were included in the current retrospective study. All the patients were subjected to percutaneous transhepatic biliary drainage (PTBD). Treatment included permanent external drainage, internal drainage and routine tube adjustment, and ...

  10. Placement and retrieval of a Guenther tulip filter in patients with a free floating thrombus in inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Min Hyun; Kim, Young Hwan; Lee, Sang Kwon; Choi, Jin Soo; Kim, Mi Jeong; Koo, Ja Hyun; Kim, Hyoung Tae; Cho, Won Hyun [Keimyung University College of Medicine, Daegu (Korea, Republic of); Seong, Nak Kwan [Daegu Catholic School of Medicine, Daegu (Korea, Republic of)

    2005-07-15

    We wanted to assess the technical feasibility and clinical efficacy of the placement and retrieval of a Guenther Tulip filter for the prevention of fatal pulmonary embolism during the management of patients with a free floating thrombus in their inferior vena ca va (IVC). Six patients having a free floating thrombus in their IVC (three patients with an isolated free floating thrombus in the IVC that resulted from immobilization due to traumatic liver injury or cerebral infarction, two patients with coexisting deep vein thrombosis in the left lower extremity that was caused by May-Thurner syndrome, and one patient with coexisting deep vein thrombosis in the right lower extremity that was due to nephrotic syndrome and immobilization after hip joint replacement) underwent placement and retrieval of a Guenther Tulip filter. The placement of the filter was performed through the right internal jugular vein to prevent the risk of detachment of the thrombus during the procedure. Retrieval of filter was performed after the free floating thrombus of the IVC had disappeared on follow-up CT because of anticoagulation therapy, aspiration thrombectomy or catheter directed Urokinase thrombolysis. The Guenther Tulip filter was successfully placed in the IVC in all six patients and it was retrieved after the management of the free floating thrombus. The mean duration of the placement of the filter was 11 days (range:7-25 days). Two patients underwent placement of an iliac vein stent for the management of May-Thurner syndrome. Detachment of the free floating thrombus in the IVC and the subsequent thrombus entrapment in the filter were documented during aspiration thrombectomy or Urokinase thrombolysis in four patients. Recurrent thrombus didn't occur during the follow-up period (range:3-20 months) in five of the six patients. In one patient, a recurrent thrombus due to the discontinuance of anticoagulation therapy was identified at the filter detachment site of the IVC on the

  11. Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report

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    Kosuke Endo

    2016-04-01

    Full Text Available Hepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus.

  12. Influence of Tumor Thrombus Location on the Outcome of External-beam Radiation Therapy in Advanced Hepatocellular Carcinoma With Macrovascular Invasion

    International Nuclear Information System (INIS)

    Purpose: The present study evaluates the influence of portal vein (PV) vs. inferior vena cava (IVC) tumor thrombosis sites on the effectiveness of external-beam radiation therapy (EBRT) in advanced hepatocellular carcinoma (HCC) with macrovascular invasion. Methods and Materials: We retrospectively reviewed 181 HCC patients with PV and/or IVC tumor thrombi who were referred for EBRT at our institution between 2000 and 2009. EBRT was designed to focus on the tumor thrombi with or without primary intrahepatic tumors to deliver a median total conventional dose of 50 Gy (range, 30–60 Gy). Predictors of survival were identified using univariate and multivariate analyses. Results: The median survival was 10.2, 7.4, 17.4, and 8.5 months for patients with PV branch, PV trunk, IVC, and PV plus IVC tumor thrombosis, respectively. Unfavorable pretreatment predictors were associated by multivariate analysis with lower albumin and higher α-fetoprotein levels, poorer Child-Pugh liver function classification, multiple intrahepatic foci, lymph node metastases, thrombus location, less chance to receive post-EBRT transarterial chemoembolization (TACE) and the two-dimensional EBRT technique. In comparison to patients with PV tumor thrombosis, patients with IVC thrombi had a higher occurrence of solitary intrahepatic lesions (p = 0.027), well-controlled intrahepatic tumors (p < 0.001), and a better response to EBRT (p < 0.001), and they were more likely to receive post-EBRT TACE (p = 0.033). Conclusions: In HCC, patients with IVC thrombus treated with EBRT had a better response rate and longer survival than those with PV thrombus.

  13. Massive portal vein tumor thrombus from colorectal cancer without any metastatic nodules in the liver parenchyma: report of a case

    Directory of Open Access Journals (Sweden)

    Yasushi Rino

    2011-10-01

    Full Text Available Metastatic lesions in the liver derived from colorectal cancer rarely invade the portal vein macroscopically. Portal vein tumor thrombus is commonly associated with hepatocellular carcinoma. Colorectal liver metastases are usually accompanied by microscopic tumor invasion into the intrahepatic portal vein, and the incidence of macroscopic tumor thrombus in the trunk of the portal vein is rare. Here, we provide unique appearance of metastatic colorectal cancer. To the best of our knowledge, macroscopically, the right portal vein filled with the tumor thrombus without any tumor in liver parenchyma has been quite rare.

  14. 18F-FDG PET-CT in diagnosis of tumor thrombus

    International Nuclear Information System (INIS)

    Full text: Venous thromboembolism is a relatively common phenomenon in cancer patients while tumor thrombosis is a rare complication of solid cancers. The correct diagnosis of tumor thrombosis and its differentiation from benign thrombus can change patient management and prevent unnecessary anticoagulation treatment. Materials and Methods: We conducted a retrospective review of FDG PET-CT scans of patients who underwent the study between July 2007 and July 2010. Any focal and/or linear area of increased FDG uptake (more than mediastinal blood pool) conforming to a blood vessel was taken as positive. SUVmax of the thrombus, SUVmax of tumor (if any) and SUVmax of mediastinal blood pool were calculated. PET-CT results were confirmed with clinical follow up, structural imaging and histopathology when available. Results: Total 24 patients (15 male and 9 female) with mean age of 43.8 years (range: 3-72; median-47.5) were evaluated. All patients underwent PET/CT for staging or restaging of a known malignancy and had a FDG avid thrombus. Based on structural imaging and clinical follow up, 9 patients had benign thromboembolism and 13 patients had tumor thrombosis. On FDG PET-CT, uptake in the thrombus was linear in 18 patients and focal in 6 patients. The most common site of thrombosis was IVC (n=14) followed by PV (n=7). One patient had catheter associated thrombosis. Four patients had only the thrombus as the FDG avid foci while remaining 18 patients had other FDG avid focus of disease. The mean SUVmax in the benign thrombosis group was 3.2 (range: 2.3-4.6; median-3.3). The mean SUVmax in the tumor thrombosis group was 6.0 (range: 2.3-13.8; median-3.3).There was significant difference in SUVmax between the two groups P = 0.013. On ROC analysis a cut off SUVmax of 3.63 was obtained to differentiate tumor thrombus from benign thromboembolism. In 6 patients FDG PET-CT detected occult vascular thrombosis, which was later confirmed with other imaging modality. Conclusion: FDG

  15. Superior Vena Cava Syndrome: A Presenting Feature of Mediastinal Germ Cell Tumor

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    Mahua Roy

    2010-04-01

    Full Text Available Superior vena cava syndrome (SVCS is rare in children. Non-Hodgkin’s Lymphoma (NHL is the most common cause of SVCS in children. This report an adolescent male who presented with SVCS due to mixed germ cell tumor (GCT of the anterior mediastinum with predominant yolk cell component. Such etiology of SVCS is rarely reported.

  16. Superior Vena Cava Syndrome: A Presenting Feature of Mediastinal Germ Cell Tumor

    OpenAIRE

    Mahua Roy; Rajat Bandyopadhyay; Narayan Pandit; Soumita Sengupta

    2010-01-01

    Superior vena cava syndrome (SVCS) is rare in children. Non-Hodgkin’s Lymphoma (NHL) is the most common cause of SVCS in children. This report an adolescent male who presented with SVCS due to mixed germ cell tumor (GCT) of the anterior mediastinum with predominant yolk cell component. Such etiology of SVCS is rarely reported.

  17. Large hemangioma in a persistent left superior vena cava.

    Science.gov (United States)

    Hu, Wen; Wang, Xiang; Tan, Sichuang; Fan, Songqing; Liu, Jun; Yu, Fenglei; Tang, Jingqun

    2012-12-01

    Cardiac hemangiomas represent 1 to 2% of all detected benign heart tumors. Tumors in the coronary sinus have been reported; however, to our knowledge, there have been no reports of masses in a persistent left superior vena cava. We report here the first case of a 58-year-old man with a rare huge unicamerate cardiac hemangiomas in a persistent left superior vena cava. A communication vein between the coronary sinus and hemangiomas could be identified, and thrombus formation was found in the hemangiomas as well. PMID:23180384

  18. Treatment of Superior Vena Cava (SVC) Syndrome and Inferior Vena Cava (IVC) Thrombosis in a Patient with Colorectal Cancer: Combination of SVC Stenting and IVC Filter Placement to Palliate Symptoms and Pave the Way for Port Implantation

    International Nuclear Information System (INIS)

    Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved.

  19. Unusual Finding of a Tumor Thrombus Arising From Osteosarcoma Detected on 18F-NaF PET/CT.

    Science.gov (United States)

    Verma, Priyanka; Purandare, Nilendu; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2016-06-01

    Osteosarcoma is the most common bone sarcoma in adolescents and children. Tumor thrombus arising from osteosarcoma is rare. We describe the case of a 13-year-old girl with osteosarcoma of the right femur, in whom the F-NaF PET/CT was done for initial staging to look for skeletal metastases. The scan showed abnormal increased tracer uptake in the primary tumor and the right common femoral and external iliac vein representing a tumor thrombus. Our case emphasizes the importance of extraosseous findings on F-NaF PET/CT, which may result in important management changes. PMID:26909709

  20. Transarterial chemoembolization combined with sorafenib for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

    Directory of Open Access Journals (Sweden)

    Zhang YF

    2016-07-01

    Full Text Available Yong-Fa Zhang,1–3,* Wei Wei,1–3,* Jia-Hong Wang,1–3,* Li Xu,1–3 Pei-En Jian,1–3 Cheng-Zuo Xiao,4 Xiao-Ping Zhong,1–3 Ming Shi,1–3 Rong-Ping Guo1–3 1Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, 2State Key Laboratory of Oncology in South China, 3Collaborative Innovation Center for Cancer Medicine, Guangzhou, 4Department of General Surgery, Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University, Shenzhen, People’s Republic of China *These authors contributed equally to this work Objective: To compare the treatment outcomes of sorafenib plus transarterial chemoembolization (TACE vs TACE alone in patients with hepatocellular carcinoma (HCC and hepatic vein tumor thrombus (HVTT.Methods: Twenty patients who were initially diagnosed with HCC and HVTT and received TACE combined with sorafenib during February 2009 to October 2013 were included in the study. To minimize selection bias, these patients were compared with 60 case-matched controls selected from a pool of 81 patients (in a 1:3 ratio who received TACE alone during the same period. The primary end point was overall survival (OS. The secondary end points were time to progression, disease control rate, and adverse events.Results: After a median follow-up period of 12.5 months (range, 1.03–44.23 months, the OS of the combined group was found to be significantly higher compared with the monotherapy group (14.9 vs 6.1 months, P=0.010. The time to progression was found to be significantly longer in the combined group (4.9 vs 2.4 months, P=0.016. Univariate and multivariate analyses revealed that the treatment allocation was an independent predictor of OS.Conclusion: Sorafenib plus TACE was well tolerated and was more effective in treating patients with advanced HCC and HVTT. Future trials with prospective larger samples are required to validate these results. Keywords: hepatocellular carcinoma, hepatic vein tumor thrombus, prognosis

  1. Percutaneous transcatheter implantation of 125I iodine seeds for the treatment of liver cancer associated with portal vein tumor thrombus: initial experience in 19 cases

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility and therapeutic efficacy of percutaneous transcatheter implantation of 125I iodine seeds in treating liver cancer associated with portal vein tumor thrombus. Methods: Nineteen patients with primary hepatocellular carcinoma complicated by portal vein tumor thrombus received implantation of 125I iodine seeds via portal vein. The puncturing of portal vein was guided by ultrasound. Under fluoroscopic guidance the 125I iodine seeds were implanted within the portal vein tumor thrombus at 8 mm distance. The number of 125I iodine seeds used in one procedure was 8 to 30 in total. The technical success rate, the postoperative complications, the hepatic and renal functions as well as routine blood test, and the suppression of portal vein tumor thrombus were determined, and the results were analyzed. Results: The implantation of 125I seeds was successfully accomplished in all the patients. No serious procedure-related complications occurred. During the follow-up period lasting for 3-22 months, the portal vein tumor thrombus showed a significant shrinkage in all patients. Conclusion: For the treatment of portal vein tumor thrombus, percutaneous transcatheter implantation of 125I iodine seeds is clinically feasible and effective. (authors)

  2. A long-surviving case of gastric cancer with main portal vein tumor thrombus after surgical resection and postoperative S-1 therapy.

    Science.gov (United States)

    Sato, Shinsuke; Nagai, Erina; Taki, Yusuke; Watanabe, Masaya; Takahashi, Michiro; Kyoden, Yusuke; Ohata, Ko; Kanemoto, Hideyuki; Oba, Noriyuki; Taku, Keisei; Suzuki, Makoto; Takagi, Masakazu

    2016-08-01

    Gastric cancer patients with main portal vein tumor thrombus usually have a short survival time, owing to its aggressive behavior. Herein, we report a long-surviving case of gastric cancer with main portal vein tumor thrombus. A 78-year-old man presenting with anorexia and body weight loss was diagnosed with gastric cancer. The patient was referred to our hospital for further examination and treatment. Endoscopy revealed a type 3 tumor (8.0 cm in length) in the body of the stomach. Biopsy led to the diagnosis of moderately differentiated adenocarcinoma. Enhanced computed tomography revealed a large tumor thrombus extending from the gastric coronary vein to the portal trunk. A total gastrectomy with lymphadenectomy, splenectomy, and thrombectomy was performed. Postoperative chemotherapy with S-1 was administered for 18 months. The patient died a natural death without recurrence at 49 postoperative months. To the best of our knowledge, the patient was the oldest to be diagnosed with gastric cancer with main portal vein tumor thrombus at diagnosis, who survived >36 months. Although gastric cancer with main portal vein tumor thrombus is a rare occurrence, its prognosis is extremely poor. Intensive surgery and long-term chemotherapy may be effective at improving survival time in these patients. PMID:27318995

  3. Transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus thrombosis

    International Nuclear Information System (INIS)

    Objective: To assess the therapeutic value of transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus. Methods: The data of 23 patients ranging from 34 to 70 years old [average age ( 56 ± 8) years] with primary hepatic carcinoma with portal vein tumor thrombosis of type Ⅱ and type Ⅲ were retrospectively collected. The tumor number of liver parenchyma ranged from 1 to 15 (median number 4). The average diameter of tumor thrombus was (20.5 ± 1.5) mm and average length was (37.4 ± 2.6) mm. All of the tumors of liver parenchyma in 23 patients were treated by transcatheter arterial chemoembolization (TACE) and tumor thrombus were treated with 125iodine seed implantation. Before the 125iodine seed implantation, the formula dosage, the number, the spatial distribution, the intensity of radioactivity and the matched peripheral dosage of seed were calculated by treatment planning system (TPS). Then the 125iodine seeds were implanted in different levels and locations of port vein thrombosis under CT guided. Results: The follow-up period ranged from 1 to 26 months. The times of transcatheter arterial chemoembolization were 1 to six times (median time 3.1±0.4) and the 125iodine seed implantation in the port vein thrombosis were 1 to 2 times (median time 1.4 ± 0.5). The numbers of implanted 125iodine seeds were 4 to 17 (median number 7.0 ± 1.0). The median survival time was 18.0 months (3-24 months). The 3,6 and 12 months survival rates were 91.3% (21/23), 69.6% (16/23), and 60.9% (14/23). There was no severe side-effect related to therapy. Conclusions: Transcatheter arterial chemoembolization combined 125iodine seed implantation for portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma with portal vein tumor thrombosis. (authors)

  4. Radiofrequency Ablation of the Main Lesion of Hepatocellular Carcinoma and Bile Duct Tumor Thrombus as a Radical Therapeutic Alternative

    Science.gov (United States)

    Gao, Jun; Zhang, Qingshuai; Zhang, Jun; Kong, Jian; Wang, Shaohong; Ding, Xuemei; Ke, Shan; Sun, Wenbing

    2015-01-01

    Abstract Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) formation is a rare entity found microscopically in 1% to 9.2% of resected specimens. The ideal treatment for HCC is surgical resection. However, because of poor hepatic functional reserve in patients with HCC, most tumors are unresectable. Here, we report 2 cases of HCC with BDTT type III accompanied by hepatic dysfunction that were successfully treated with radiofrequency (RF) ablation. We used RF ablation as both a radical therapeutic method and an efficient way to control bleeding from the origin of BDTT after BDTT removal. At the time of writing, the 2 patients have been disease-free for 16 and 12 months, respectively. Our results show that RF ablation may be used as a radical therapeutic alternative for HCC with BDTT in patients with liver cirrhosis and obstructive jaundice. PMID:26166111

  5. Proton beam therapy for a patient with a giant thymic carcinoid tumor and severe superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    Kaori Sugawara

    2014-05-01

    Full Text Available Surgical resection is the first choice for treatment of a thymic carcinoid tumor and radiotherapy is often performed as adjuvant therapy. Here, we report a case of an unresectable and chemoresistant thymic carcinoid tumor that was treated successfully using standalone proton beam therapy (PBT. The patient was a 66-year-old woman in whom surgical resection of the tumor was impossible because of cardiac invasion. Therefore, chemotherapy was administered. However, the tumor grew to 15 cm in diameter and she developed severe superior vena cava (SVC syndrome. She was referred to our hospital and received PBT at a dose of 74 GyE in 37 fractions. PBT was conducted without severe early toxicities. After PBT, the tumor mildly shrunk to 13 cm in diameter and SVC syndrome almost disappeared. Subsequently, the tumor has continued to decrease in size slowly over the last 2 years and late toxicities have not been observed. Our experience with this case suggests that PBT may be effective for an unresectable thymic carcinoid tumor.

  6. Prognosis of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:Assessment Based on Clinical and Computer Tomography Characteristics

    Directory of Open Access Journals (Sweden)

    Jia,Lizhong

    2012-04-01

    Full Text Available Patients with hepatocellular carcinoma (HCC complicated by portal vein tumor thrombus (PVTT have an extremely poor prognosis. It is important to select adequate therapeutic options based on reliable prognostic factors using imaging studies and clinical data. Prognostic factors were analyzed in patients with HCC with PVTT in the first branch or main trunk of the portal vein. From 2000 to 2007, 107 consecutive patients with HCC with PVTT in the major portal vein were reviewed, and diagnostic images and clinical characteristics were retrospectively observed. Thirty-eight possible prognostic factors for survival were analyzed by the log-rank test and multivariate analysis using Coxʼs proportional hazards model. Median overall survival was 14 months following PVTT diagnosis. Survival rates at 6 months, 1, 2, and 3 years were 72.1%, 52.6%, 32.6%, and 29.6%, respectively. Independent prognostic factors for longer survival included:patient age <65 years, Child-Pugh classification A/B, PVTT treatment, accumulation of Lipiodol in the PVTT after TACE, initial radical treatment for HCC, HCC located in a single lobe of the liver, and no invasion of HCC to the hepatic vein or bile duct. Survival was associated with liver function, tumor extension, and treatment for HCC and PVTT.

  7. Fat collections related to the intrahepatic inferior vena cava: CT features

    International Nuclear Information System (INIS)

    Purpose: To evaluate fat collections related to inferior vena cava, their causes, and to make a review of the literature about these benign incidental findings. Materials and Methods: Two thousands and one hundred thoracoabdominal CT scans were performed between May 2000 and March 2001. We used a PQ 5000 spiral CT scanner. The studies were performed with and without contrast media. Results: We found three cases of fat collections related to inferior vena cava (IVC). They were located posteromedial and anteromedial to IVC. Conclusion: Fat collections related to the IVC are benign incidental findings. The knowledge with regards to these findings should preclude erroneous diagnosis of intracaval thrombus, intracaval lipomas or secondary extensions of tumors. (author)

  8. Management of the Thrombosed Filter-Bearing Inferior Vena Cava

    OpenAIRE

    Sildiroglu, Onur; Ozer, Harun; Turba, Ulku Cenk

    2012-01-01

    Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombos...

  9. Differentiation of cardiac thrombus from cardiac tumor combining cardiac MRI and 18F-FDG-PET/CT Imaging.

    Science.gov (United States)

    Rinuncini, Massimo; Zuin, Marco; Scaranello, Fiorenzo; Fejzo, Majlinda; Rampin, Lucia; Rubello, Domenico; Faggian, Giuseppe; Roncon, Loris

    2016-06-01

    Radiological differentiation of an unknown cardiac masse is often a challenging issue. 18F-FDG-PET/CT imaging was performed to evaluate a left ventricle mass visualized on transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) in a patient with an history of ischemic heart disease. The metabolically inert area on the PET/CT, corresponding to the relatively homogenous hypodensity in the LV, was thought to represent an old organized LV thrombus. Histopathological examination confirmed the imaging diagnosis. PMID:27038712

  10. Design Optimization of Vena Cava Filters: An application to dual filtration devices

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Wang, S L; Diachin, D P

    2009-12-03

    Pulmonary embolism (PE) is a significant medical problem that results in over 300,000 fatalities per year. A common preventative treatment for PE is the insertion of a metallic filter into the inferior vena cava that traps thrombi before they reach the lungs. The goal of this work is to use methods of mathematical modeling and design optimization to determine the configuration of trapped thrombi that minimizes the hemodynamic disruption. The resulting configuration has implications for constructing an optimally designed vena cava filter. Computational fluid dynamics is coupled with a nonlinear optimization algorithm to determine the optimal configuration of trapped model thrombus in the inferior vena cava. The location and shape of the thrombus are parameterized, and an objective function, based on wall shear stresses, determines the worthiness of a given configuration. The methods are fully automated and demonstrate the capabilities of a design optimization framework that is broadly applicable. Changes to thrombus location and shape alter the velocity contours and wall shear stress profiles significantly. For vena cava filters that trap two thrombi simultaneously, the undesirable flow dynamics past one thrombus can be mitigated by leveraging the flow past the other thrombus. Streamlining the shape of thrombus trapped along the cava wall reduces the disruption to the flow, but increases the area exposed to abnormal wall shear stress. Computer-based design optimization is a useful tool for developing vena cava filters. Characterizing and parameterizing the design requirements and constraints is essential for constructing devices that address clinical complications. In addition, formulating a well-defined objective function that quantifies clinical risks and benefits is needed for designing devices that are clinically viable.

  11. Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy

    Directory of Open Access Journals (Sweden)

    Ross M. Simon

    2015-10-01

    Full Text Available ABSTRACT Purpose: To determine if patients with renal cell carcinoma (RCC with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB over cardiopulmonary bypass (CPB for high level (III/IV inferior vena cava (IVC tumor thrombectomy and concomitant radical nephrectomy. Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16 or VVB (n=5. We retrospectively reviewed our study population for complication rates and perioperative characteristics. Results: Our results are reported using the validated Dindo-Clavien Classification system comparing the VVB and CPB cohorts. No significant difference was noted in minor complication rate (60.0% versus 68.7%, P=1.0, major complication rate (40.0% versus 31.3%, P=1.0, or overall complication rate (60.0% versus 62.5%, P=1.0 comparing VVB versus CPB. We also demonstrated a trend towards decreased time on bypass (P=0.09 in the VVB cohort. Conclusion: The use of VVB over CPB provides no decrease in minor, major, or overall complication rate. The use of VVB however, can be employed on an individualized basis with final decision on vascular bypass selection left to the discretion of the surgeon based on specifics of the individual case.

  12. Clinically asymptomatic thrombosis of the inferior vena cava as an incidental finding by sonography after surgical treatment of a tumor in the mediastinum

    International Nuclear Information System (INIS)

    In the case of suspected thrombosis of the venia cava caudalis, ultrasonography, CT and NMR imaging are excellent diagnostic tools. For a diagnostic scanning of the collateral vene, phlebography of the inferior vena cava is the method yielding the most significant results. (orig.)

  13. Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus

    Science.gov (United States)

    Stamatiou, Konstantinos N.; Moschouris, Hippocrates; Marmaridou, Kiriaki; Kiltenis, Michail; Kladis-Kalentzis, Konstantinos; Malagari, Katerina

    2016-01-01

    This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas. PMID:27293932

  14. Impacts of clinicopathologic and operative factors on short-term and long-term survival in renal cell carcinoma with venous tumor thrombus extension: a multi-institutional retrospective study in Japan

    International Nuclear Information System (INIS)

    Although the percentage of patients with renal cell carcinoma (RCC) extending into venous systems is unexpectedly high, the prognostic impact and independency of venous tumor thrombus-related factors on overall survival (OS) remain controversial. Furthermore, the prognostic impact of various clinicopathologic factors including tumor thrombus-related factors on OS may change with elapsed years after the intervention and also with follow-up duration of participants. The aim of the study is to explore independent and universal predictive preoperative and intraoperative clinicopathologic factors on OS in patients with RCC extending into venous systems using subgroup analysis in terms of restricted follow-up duration and yearly-based survivors. Between 1980 and 2009, 292 patients diagnosed with RCC with venous tumor thrombus were retrospectively registered for this study. The prognostic impacts of various clinicopathologic and surgical treatment factors including levels of venous thrombus, venous wall invasion status and likelihood of aggressive cytoreductive operation, were investigated using Kaplan-Meier method and following multivariate Cox proportional hazards model for all patients and those still alive at 1, 2, and 3 years of follow-up. To investigate the impact of follow-up duration on the statistical analyses, multivariate logistic regression analyses were used to explore prognostic factors using restricted data until 1, 2, and 3 years of follow-up. The median follow-up duration was 40.4 months. The 5-year OS was 47.6%. Several independent predictive factors were identified in each subgroup analysis in terms of yearly-based survival and restricted follow-up duration. The presence of tumor thrombus invading to venous wall was independently related to OS in the full-range follow-up data and in survivors at 2 and 3 years of follow-up. Using restricted follow-up data until 1, 2, and 3 years of follow-up, many independent predictive factors changed with follow

  15. A dose-volume intercomparison of volumetric-modulated arc therapy, 3D static conformal, and rotational conformal techniques for portal vein tumor thrombus in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    We created volumetric-modulated arc therapy (VMAT) plans for portal vein tumor thrombus (PVTT) in hepatocellular carcinoma, and compared the results with those from three-dimensional conformal radiotherapy (3D-CRT) and rotational conformal radiotherapy (R-CRT) plans. CT scan data from 10 consecutive patients with PVTT treated with 3D-CRT between January 2008 and January 2010 were utilized in the analysis. We analyzed the dosimetric properties of the plans for the 10 patients using the three different techniques with three different isocenter doses of 50, 56 and 60 Gy in 2-Gy fractions. The D95, Dmean, homogeneity index and conformity index were compared for the planning target volume (PTV). The Dmean, V20 and V30 were also compared for normal livers. The monitor units (MUs) and the treatment time were also evaluated. The normal liver V30 for VMAT was significantly less than that for 3D-CRT for the prescribed doses of 56 and 60 Gy (P<0.05). It was also found that the normal liver V30 resulting from 3D-CRT was prohibitively increased when the prescribed dose was increased in two steps. For PTV D95, we found no significant differences between the three techniques for the 50- and 56-Gy prescriptions, or between VMAT and the other techniques for the 60-Gy prescription. The differences in the MUs and treatment times were not statistically significant between VMAT and 3D-CRT. We have demonstrated that VMAT may be a more advantageous technique for dose escalation reaching 60 Gy in the treatment of PVTT due to the reduced normal liver V30. (author)

  16. Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.

    Directory of Open Access Journals (Sweden)

    Yuri Jeong

    Full Text Available To investigate the value of changes in alpha-fetoprotein (AFP levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC patients with portal vein tumor thrombus (PVTT who received combined treatment of 3-dimensional conformal radiotherapy (3D-CRT and transarterial chemoembolization (TACE.A database of 154 HCC patients with PVTT and elevated AFP levels (>20 ng/mL treated with 3D-CRT and TACE as an initial treatment between August 2002 and August 2008 was retrospectively reviewed. AFP levels were determined 1 month after radiotherapy, and AFP response was defined as an AFP level reduction of >20% from the initial level. Radiologic response, overall survival (OS, and progression-free survival (PFS rates were compared between AFP responders and non-responders. Propensity-score based matching analysis was performed to minimize the effect of potential confounding bias.The median follow-up period was 11.1 months (range, 3.1-82.7 months. In the propensity-score matching cohort (92 pairs, a best radiologic response of CR or PR occurred in more AFP responders than AFP non-responders (41.3% vs. 10.9%, p < 0.001. OS and PFS were also longer in AFP responders than in non-responders (median OS 13.2 months vs. 5.6 months, p < 0.001; median PFS 8.7 months vs. 3.5 months, p < 0.001.AFP response is a significant predictive factor for radiologic response. Furthermore, AFP response is significant for OS and PFS outcomes. AFP evaluation after combined radiotherapy and TACE appears to be a useful predictor of clinical outcomes in HCC patients with PVTT.

  17. Occult left atrial ball-like thrombus in a patient referred for surgical removal of suspected cerebellum tumor

    International Nuclear Information System (INIS)

    Atrial fibrillation and related cardio-embolic cerebrovascular accidents are two well-defined major healthcare problems worldwide. It has been approximated that 2.2 million people in America and 4.5 million in European Union have paroxysmal or persistent atrial fibrillation. And atrial fibrillation itself is an independent long-term risk factor of stroke. We present a case of patient referred to our center for surgical removal of suspected cerebellum tumor, a case that had a rather unexpected ending. A 58-year-old male patient with a history of atrial fibrillation, congestive heart failure (NYHA II/III), stable coronary artery disease, diabetes type 2 and hyperlipidemia presented with vertigo, headaches, mainly during physical activity and increased tiredness. Performed computer tomography revealed two lesions in the cerebellum and in the left lateral chamber. The diagnosis of a proliferative disease of the cerebellum was established and patient was referred to the Neurosurgical Department. Fortunately, before the operation the echocardiography was performed, which revealed two lesions in left atrium. The decision of the Heart Team was to refer the patient for an open-heart surgery, in which two thrombi were removed. Neurosurgeons decided to withdraw from further surgery and proceed with head MRI and conservative treatment, deciding that the lesion in the cerebellum was most likely an ischemic area. Looking at the brain lesion should always be done from the whole patient’s perspective. And using mutlimodality imaging may lead to appropriate diagnosis, correct course of therapeutic action and unexpected ending of a rather non-extraordinary case

  18. [Bilateral deep venous thrombosis and vena cava aplasia treated with local thrombolysis

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jørgensen, Maja; Just, Sven Richardt Lundgren; Jensen, Leif Pandora

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thr...... thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis Udgivelsesdato: 2008/5/19......In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete...

  19. Thiol isomerases in thrombus formation

    OpenAIRE

    Furie, Bruce; Flaumenhaft, Robert

    2014-01-01

    Protein disulfide isomerase, ERp5 and ERp57, among perhaps other thiol isomerases, are important for the initiation of thrombus formation. Using the laser injury thrombosis model in mice to induce in vivo arterial thrombus formation, it was shown that thrombus formation is associated with PDI secretion by platelets, that inhibition of PDI blocked platelet thrombus formation and fibrin generation, and that endothelial cell activation leads to PDI secretion. Similar results using this and other...

  20. Computational Modeling of Blood Flow in the TrapEase Inferior Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Henshaw, W D; Wang, S L

    2008-02-04

    To evaluate the flow hemodynamics of the TrapEase vena cava filter using three dimensional computational fluid dynamics, including simulated thrombi of multiple shapes, sizes, and trapping positions. The study was performed to identify potential areas of recirculation and stagnation and areas in which trapped thrombi may influence intrafilter thrombosis. Computer models of the TrapEase filter, thrombi (volumes ranging from 0.25mL to 2mL, 3 different shapes), and a 23mm diameter cava were constructed. The hemodynamics of steady-state flow at Reynolds number 600 was examined for the unoccluded and partially occluded filter. Axial velocity contours and wall shear stresses were computed. Flow in the unoccluded TrapEase filter experienced minimal disruption, except near the superior and inferior tips where low velocity flow was observed. For spherical thrombi in the superior trapping position, stagnant and recirculating flow was observed downstream of the thrombus; the volume of stagnant flow and the peak wall shear stress increased monotonically with thrombus volume. For inferiorly trapped spherical thrombi, marked disruption to the flow was observed along the cava wall ipsilateral to the thrombus and in the interior of the filter. Spherically shaped thrombus produced a lower peak wall shear stress than conically shaped thrombus and a larger peak stress than ellipsoidal thrombus. We have designed and constructed a computer model of the flow hemodynamics of the TrapEase IVC filter with varying shapes, sizes, and positions of thrombi. The computer model offers several advantages over in vitro techniques including: improved resolution, ease of evaluating different thrombus sizes and shapes, and easy adaptation for new filter designs and flow parameters. Results from the model also support a previously reported finding from photochromic experiments that suggest the inferior trapping position of the TrapEase IVC filter leads to an intra-filter region of recirculating

  1. Evaluation of superior vena cava syndrome by axial CT and CT phlebography

    International Nuclear Information System (INIS)

    Transverse axial computed tomography (CT) has been combined with CT digital phlebography to study nine patients with superior vena cava syndrome. Six were due to malignancy, two were secondary to benign disease, and one was a paraneoplastic manifestation. This combined CT approach successfully identified the abnormal morphology of the superior vena cava, demonstrating external compression, encasement, or intraluminal thrombus in all patients and the collateral venous channels in eight. This technique is a rapid, informative, and cost-effective method for the workup of superior vena cava syndrome. The CT digital phlebogram, however, is not successful in regularly and optimally opacifying the normal superior vena cava because of the limited amount of contrast material, dilution effect of the nonopacified incoming flow from the jugular and azygos veins, and the lack of image enhancement from the CT digital scanograms

  2. Evaluation of superior vena cava syndrome by axial CT and CT phlebography

    Energy Technology Data Exchange (ETDEWEB)

    Moncada, R.; Cardella, R.; Demos, T.C.; Churchill, R.J.; Cardoso, M.; Love, L.; Reynes, C.J.

    1984-10-01

    Transverse axial computed tomography (CT) has been combined with CT digital phlebography to study nine patients with superior vena cava syndrome. Six were due to malignancy, two were secondary to benign disease, and one was a paraneoplastic manifestation. This combined CT approach successfully identified the abnormal morphology of the superior vena cava, demonstrating external compression, encasement, or intraluminal thrombus in all patients and the collateral venous channels in eight. This technique is a rapid, informative, and cost-effective method for the workup of superior vena cava syndrome. The CT digital phlebogram, however, is not successful in regularly and optimally opacifying the normal superior vena cava because of the limited amount of contrast material, dilution effect of the nonopacified incoming flow from the jugular and azygos veins, and the lack of image enhancement from the CT digital scanograms.

  3. 原发性肝癌伴门静脉癌栓的外科治疗%Surgical treatment of primary liver cancer with tumor thrombus in portal vein

    Institute of Scientific and Technical Information of China (English)

    严琦敏; 刘亚光; 高志清; 蒋江环; 宋波

    2012-01-01

    目的:探讨原发性肝癌伴门静脉癌栓(PVTT)外科治疗的方法及疗效.方法:27例均行肝癌连同PVTT切除或经门静脉断端取栓或切开主干取栓.术后18例同时行肝动脉及门静脉化疗,单纯行5例肝动脉插管化疗栓塞术(TACE),未做化疗4例.结果:术后1、3、5年生存率分别为66.7% (18/27)、29.63% (8/27) 、11.11% (3/27).结论:外科手术是治疗肝癌合并PVTT的有效方法,术后辅以门静脉化疗及TACE术能明显提高治疗效果.%Objective: To explore the methods and effects of surgical therapy for primary liver cancer (PLC) with tumor thrombus in portal vein (PVTT). Methods; Twenty - seven cases of PLC with PVTT underwent liver resection for PLC combined with tumor thrombectomy or the removal of tumor thrombus by broken ends of portal vein or by the section of portal vein. After operation, 18 cases were treated by transcatheter hepatic arterial chemo-embolization (TACE) and portal vein chemotherapy (PVC) while 5 cases only by TACE and 4 cases without chemotherapy. Results; Overall 1 - , 3 - , and 5 - year survivals were 18 cases (66.7% ) , 8 cases (29.63% ) , and 3 cases (11.11%), respectively. Conclusion; Surgical therapy is an effective way for PLC with PVTT and the surgical effects can be further improved with the assistance of PVC and TACE.

  4. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava.

    Science.gov (United States)

    Zhu, Daxing; Qiu, Xiaoming; Zhou, Qinghua

    2015-11-01

    A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC) utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava. PMID:26582230

  5. Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava

    Directory of Open Access Journals (Sweden)

    Daxing ZHU

    2015-11-01

    Full Text Available A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department. Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor. Chest contrast computed tomography revealed the tumor invaded right pulmonary artery, superior vena cava, and the persistant left superior vena cava flowed into the coronary sinus. The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava (SVC utilizing ringed polytetrafluoroethylene graft. To the best of our knowledge, this was the first report of complete resection of locally advanced lung cancer involving superior vena cava, right pulmonary artery trunk and main bronchus with persistant left superior vena cava.

  6. Modeling Flow Past a Tilted Vena Cava Filter

    International Nuclear Information System (INIS)

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  7. Modeling Flow Past a Tilted Vena Cava Filter

    Energy Technology Data Exchange (ETDEWEB)

    Singer, M A; Wang, S L

    2009-06-29

    Inferior vena cava filters are medical devices used to prevent pulmonary embolism (PE) from deep vein thrombosis. In particular, retrievable filters are well-suited for patients who are unresponsive to anticoagulation therapy and whose risk of PE decreased with time. The goal of this work is to use computational fluid dynamics to evaluate the flow past an unoccluded and partially occluded Celect inferior vena cava filter. In particular, the hemodynamic response to thrombus volume and filter tilt is examined, and the results are compared with flow conditions that are known to be thrombogenic. A computer model of the filter inside a model vena cava is constructed using high resolution digital photographs and methods of computer aided design. The models are parameterized using the Overture software framework, and a collection of overlapping grids is constructed to discretize the flow domain. The incompressible Navier-Stokes equations are solved, and the characteristics of the flow (i.e., velocity contours and wall shear stresses) are computed. The volume of stagnant and recirculating flow increases with thrombus volume. In addition, as the filter increases tilt, the cava wall adjacent to the tilted filter is subjected to low velocity flow that gives rise to regions of low wall shear stress. The results demonstrate the ease of IVC filter modeling with the Overture software framework. Flow conditions caused by the tilted Celect filter may elevate the risk of intrafilter thrombosis and facilitate vascular remodeling. This latter condition also increases the risk of penetration and potential incorporation of the hook of the filter into the vena caval wall, thereby complicating filter retrieval. Consequently, severe tilt at the time of filter deployment may warrant early clinical intervention.

  8. Development of Thrombus in a Systemic Vein after Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika; Yamagami, Takuji; Tanaka, Osamu; Miura, Hiroshi; Nishimura, Tsunehiko [Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto (Japan); Okuda, Kotaro; Hashiba, Mitsuoki [Fukuchiyama City Hospital, Kyoto (Japan)

    2012-06-15

    To retrospectively evaluate the frequency and risk factors for developing thrombus in a systemic vein such as the infrarenal inferior vena cava or the iliac vein, in which a balloon-occluded retrograde transvenous obliteration (B-RTO) catheter was indwelled. Forty-nine patients who underwent B-RTO for gastric varices were included in this study. The B-RTO procedure was performed from the right femoral vein, and the B-RTO catheter was retained overnight in all patients. Pre- and post-procedural CT scans were retrospectively compared in order to evaluate the development of thrombus in the systemic vein in which the catheter was indwelled. Additionally, several variables were analyzed to assess risk factors for thrombus in a systemic vein. In all 49 patients (100%), B-RTO was technically successful, and in 46 patients (94%), complete thrombosis of the gastric varices was achieved. In 6 patients (12%), thrombus developed in the infrarenal inferior vena cava or the right common-external iliac vein. All thrombi lay longitudinally on the right side of the inferior vena cava or the right iliac vein. One of the aforementioned 6 patients required anticoagulation therapy. No symptoms suggestive of pulmonary embolism were observed. Prothrombin time-international normalized ratio and the addition of 5% ethanolamine oleate iopamidol, on the second day, were related to the development of thrombus. Development of a thrombus in a systemic vein such as the inferior vena cava or iliac vein, caused by indwelling of the B-RTO catheter, is relatively frequent. Physicians should be aware of the possibility of pulmonary embolism due to iliocaval thrombosis.

  9. Bilateral dyb venos trombose og vena cava-aplasi behandlet med lokal trombolyse

    DEFF Research Database (Denmark)

    Pelta, A.M.; Jorgensen, M.; Jensen, L.P.; Just, Sven Richardt Lundgren

    2008-01-01

    In this case report the treatment of a young man with bilateral iliaco-femoral DVT and vena cava aplasia is presented. The patient was treated with catheter-directed thrombolysis; the catheters were introduced in the thrombus of both legs via v. popliteae. The treatment led to almost complete thr...... thrombus resolution and no valvular incompetence at three months follow-up. In our opinion this treatment should be offered even in complex cases of acute proximal deep venous thrombosis Udgivelsesdato: 2008/5/19...

  10. GIANT PROSTHETIC VALVE THROMBUS

    Directory of Open Access Journals (Sweden)

    Prashanth Kumar

    2015-04-01

    Full Text Available Mechanical prosthetic valves are predisposed to bleeding, thrombosis & thromboembolic complications. Overall incidence of thromboembolic complications is 1% per year who are on oral anticoagulants, whereas bleeding complications incidence is 0.5% to 6.6% per year. 1, 2 Minimization of Scylla of thromboembolic & Charybdis of bleeding complication needs a balancing act of optimal antithrombotic therapy. We are reporting a case of middle aged male patient with prosthetic mitral valve presenting in heart failure. Patient had discontinued anticoagulants, as he had subdural hematoma in the past. He presented to our institute with a giant prosthetic valve thrombus.

  11. Clinical study of esophageal cancer in patients with vasc ular tumor thrombus%食管癌合并脉管瘤栓患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    侯向生; 王玉香(通讯作者)

    2013-01-01

    Objective:To investigate the merger of esophageal cancer in patients with vascular invasion clinical and pathological fea -tures,and P53, Ki67, expression and 5 year survival .Methods:A retrospective analysis of 84 cases of esophageal cancer in patients with vascular invasion combined clinical and pathological data , P53, Ki67 expression and 5-year survival rate.Results:Esophageal cancer combined vascular invasion of lymph node metastasis in patients with the more higher the incidence of vascular invasion ( P <0.01 );poorly differentiated tumor cells /undifferentiated carcinoma , high /medium differentiation of vascular invasion was significant ( P <0. 01);esophageal combined vascular invasion and immunohistochemical P 53, Ki67-positive compared with negative differences (P <0. 05) .5-year survival rate of patients with esophageal cancer tumor thrombus in the vascular expression of positive and negative patients there was a significant difference between ( P <0.05 ) .CONCLUSION:Esophageal cancer incidence of vascular invasion combined with esophageal cancer patient's age, sex;lymph node metastasis and clinical pathology number and P 53, K6i7 positive expression was posi-tively correlated with the degree of cell differentiation expression was negatively correlated , the combined vascular tumor thrombus in pa-tients with poor prognosis .Pulse tube tumor thrombus into the existing TNM staging combined P 53, Ki67 combined detection may be more clinical significance .%目的:探讨食管癌合并脉管瘤栓患者的临床病理特点、与P53、Ki67、表达和5年生存率的关系。方法:回顾性分析84例食管癌合并脉管瘤栓患者的临床病理资料、P53、Ki67表达和5年生存率。结果:食管癌合并脉管瘤栓患者的淋巴结转移数目越多脉管瘤栓发生率越高(P<0.01);瘤细胞分化程度低/未分化癌较高/中分化的脉管瘤栓有显著意义(P<0.01);食管癌合并脉管瘤栓与免疫组化P53

  12. The Analysis of Postoperative Complications after Thrombectomy From Inferior Vena Cava in Renal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Atduev V.A.

    2012-06-01

    Full Text Available The aim of the investigation is to analyze the results of thrombectomy from inferior vena cava in renal cell carcinoma to reveal the main prognostic factors of postoperative complications. Materials and Methods. Nephrectomy with thrombectomy from inferior vena cava was performed in 34 patients. Thrombus level Т3b was revealed in 27 patients (79.4% (thrombus length — 5.10±1.75 cm, Т3с — in 7 patients (20.6% (thrombus length — 14.80±0.98 см. Postoperative complications were analyzed according to Clavien–Dindo classification of surgical complications. Results. Blood loss volume in operation was on average 866 ml (250–4000 ml. 18 patients (52.9% had no complications. Two patients (5.9% had I degree complication (anemia. The II degree of complication was revealed in 11 patients (32.3%, after the operation they underwent blood transfusion. One patients (2.9% had IIIa degree of complications (after the operation he required pleural punctures and pericardium drainage under local anesthesia, and one patients had IIIв degree of complications (descending colon perforation — he underwent relaparotomy and colostomy. There were no IV degree complications. One patient (2.9% died (V degree from pulmonary embolism. Correlation analysis determined high (r=0.7 complications dependence of thrombus size and blood loss volume (r=0.6 and low dependence — of tumour size (r=0.44. There were revealed no complication dependence of patients age (r=0.1, status on Karnofsky scale (r=0.0. All 33 patients discharged from hospital had lived over 6 months after the operation. Conclusion. After nephrectomy with thrombectomy from inferior vena cava there is high risk of postoperative complications, the frequency and type of which to a greater degree depend on thrombus size and blood loss volume.

  13. Microbubble mediated thrombus dissolution with diagnostic ultrasound for the treatment of chronic venous thrombi.

    Directory of Open Access Journals (Sweden)

    Shelby Kutty

    Full Text Available BACKGROUND: Central venous catheter (CVC thrombi result in significant morbidity in children, and currently available treatments are associated with significant risk. We sought to investigate the therapeutic efficacy of microbubble (MB enhanced sonothrombolysis for aged CVC associated thrombi in vivo. METHODS AND RESULTS: A model of chronic indwelling CVC in the low superior vena cava with thrombus in situ was established after feasibility and safety testing in 7 pigs; and subsequently applied for repeated, sonothrombolytic treatments in 9 pigs (total 24 treatments. Baseline intracardiac echocardiography (ICE, 10.5F, Siemens, fluoroscopy and saline flushing confirmed the absence of any pre-existing CVC thrombus. A thrombus was then allowed to form and age over 24 hours. The created thrombus was localized and measured by ICE, and transthoracic image guided high mechanical index (MI two-dimensional US treatments (1.1-1.7 MI; iE33, Philips applied intermittently whenever intravenously infused MBs (3% MRX-801; NuVox were visualized near the thrombus (n = 10; Group A. Control pigs (n = 10; Group B received US without MB. All treatments were randomized. Post-treatment thrombus area by ICE planimetry was compared with pre-treatment measurements. Thrombus area measurements before and after treatment were 0.22 and 0.10 cm(2 respectively in Group A; compared to 0.24 and 0.21 cm(2 in Group B (p  = 0.0003. Effectiveness of longer duration US and MB thrombolytic treatments were studied (n = 4, which suggested that near complete thrombus dissolution is possible. No pulmonary emboli, alterations in oxygen saturation, or hemodynamics occurred with either treatment. CONCLUSIONS: Guided high MI diagnostic US+systemic MB facilitates reduction of aged CVC associated thrombi in vivo. MB enhanced sonothrombolytic therapy may be a non-invasive safe alternative to thrombolytic agents in treating thrombotic CVC occlusions.

  14. Distribution of Functional Liver Volume in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus in the 1st Branch and Main Trunk Using Single Photon Emission Computed Tomography—Application to Radiation Therapy

    International Nuclear Information System (INIS)

    To analyze the distribution of functional liver volume (FLV) in the margin volume (MV) surrounding hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) before radiation therapy (RT) and to verify the safety of single photon emission computed tomography-based three-dimensional conformal radiotherapy (SPECT-B3DCRT) by exploring the relation of FLV in MV to radiation-induced liver disease (RILD). Clinical target volume (CTV) included main tumor and PVTT, and planning target volume (PTV) included CTV with a 10 mm margin. MV was defined as PTV–CTV. FLV ratio in MV was calculated as FLV in MV/MV × 100 (%). The two high-dose beams were planned to irradiate FLV as little as possible. Fifty-seven cases of HCC (26/57, 46%; Child–Pugh grade B) with PVTT underwent SPECT-B3DCRT which targeted the CTV to a total dose of 45 Gy/18 fractions. The destructive ratio was defined as radiation induced dysfunctional volume/FLV × 100 (%). We observed a significant negative correlation between FLV ratio in MV and CTV (p < 0.001). Three cases with CTVs of 287, 587 and 1184 cm3 experienced transient RILD. The FLV ratio in MV was highest in patients with RILD: nine patients with CTV of 200–300 cm3, three with CTV of 500–600 cm3, and two with CTV of 1100–1200 cm3. The destructive ratio yielded a mean value of 24.2 ± 1.5%. Radiation planning that takes into account the distribution of FLV appears to result in the least possible RILD

  15. Distribution of Functional Liver Volume in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus in the 1st Branch and Main Trunk Using Single Photon Emission Computed Tomography—Application to Radiation Therapy

    Directory of Open Access Journals (Sweden)

    Akira Ikoma

    2011-10-01

    Full Text Available Purpose: To analyze the distribution of functional liver volume (FLV in the margin volume (MV surrounding hepatocellular carcinoma (HCC with portal vein tumor thrombus (PVTT before radiation therapy (RT and to verify the safety of single photon emission computed tomography-based three-dimensional conformal radiotherapy (SPECT-B3DCRT by exploring the relation of FLV in MV to radiation-induced liver disease (RILD. Methods and Materials: Clinical target volume (CTV included main tumor and PVTT, and planning target volume (PTV included CTV with a 10 mm margin. MV was defined as PTV–CTV. FLV ratio in MV was calculated as FLV in MV/MV × 100 (%. The two high-dose beams were planned to irradiate FLV as little as possible. Fifty-seven cases of HCC (26/57, 46%; Child–Pugh grade B with PVTT underwent SPECT-B3DCRT which targeted the CTV to a total dose of 45 Gy/18 fractions. The destructive ratio was defined as radiation induced dysfunctional volume/FLV × 100 (%. Results: We observed a significant negative correlation between FLV ratio in MV and CTV (p < 0.001. Three cases with CTVs of 287, 587 and 1184 cm3 experienced transient RILD. The FLV ratio in MV was highest in patients with RILD: nine patients with CTV of 200–300 cm3, three with CTV of 500–600 cm3, and two with CTV of 1100–1200 cm3. The destructive ratio yielded a mean value of 24.2 ± 1.5%. Conclusions: Radiation planning that takes into account the distribution of FLV appears to result in the least possible RILD.

  16. Primary lung lymphoma involving the superior vena cava

    Directory of Open Access Journals (Sweden)

    Wei Sen

    2012-06-01

    Full Text Available Abstract Primary lung lymphoma (PLL presenting as a primary pulmonary lesion is rare and usually affects elderly people. Here we describe a 25-year-old Chinese man diagnosed with primary lung lymphoma, which presented as a huge lung tumor mimicking a primary lung cancer and involving the superior vena cava. He underwent double-sleeve reconstructions of bronchus and pulmonary arteries with right upper- and middle-lobe lobectomy along with replacement of the superior vena cava with a graft, and was then given standard chemotherapy of CHOP plus Rituximab. The patient has been well, showing no local recurrence or distal metastasis during a 27-month follow-up.

  17. Thrombus aspiration catheter is a Dottering balloon.

    Science.gov (United States)

    Sheshagiri Rao, D; Barik, Ramachandra; Prasad, Akula Siva

    2016-01-01

    Coronary angiogram in a young man with history of STEMI with delayed presentation revealed subtotal occlusion of left anterior descending artery (LAD) with large thrombotic filling defect distal to the critical lesion. PCI was preferred without delay because of ongoing chest pain. Several runs of thrombus aspiration failed to detect any visible thrombus. However, the immediate angiogram after thrombus aspiration showed complete distal embolization of the thrombus which could have been achieved by Dottering or balloon dilatation. In contrary to the general perception, does thrombus aspiration push more thrombus than it can aspirate? PMID:27543477

  18. [Mediastinal Mature Teratoma Necessitating Resection of Superior Vena Cava].

    Science.gov (United States)

    Aragaki, Masato; Iimura, Yasuaki; Hasegawa, Naoto; Kaga, Kichizo

    2015-09-01

    A 43-year-old woman was referred to our hospital for an abnormal shadow on chest X-ray. Computed tomography revealed a tumor with calcification of 9.8 cm in size at the anterior mediastinum. The infiltration into the left brachiocephalic vein and superior vena cava by tumor was suspected. Surgery was performed under a diagnosis of mature teratoma. The tumor was found to adhere firmly to superior vena cava (SVC), left brachiocephalic vein, right phrenic nerve, and the arch of the azygos vein. To ensure the blood flow, an artificial blood vessel was placed between left brachiocephalic vein and right atrium. Then SVC was clamped and the tumor was resected with the part of SVC. PMID:26329629

  19. The implantation of retrievable superior vena cava filter: report of 6 cases

    International Nuclear Information System (INIS)

    Objective: To discuss the techniques and clinical value of the placement of retrievable superior vena cava (SVC) filter. Methods: Under DSA guidance, the placement of retrievable SVC filter was performed in 6 patients with jugular vein thrombosis or upper extremity deep vein thrombosis. The diagnoses were proved by colour Doppler ultrasound and venography. All patients were affected with malignancy. The venous thrombosis was caused by the insertion of PICC (n=3) or by the compression or invasion of tumor (n=3). Catheterization was carried out via the right femoral vein. After venography of SVC, the delivery system of SVC filter was inserted into SVC, and the filter was placed at the site slightly below the confluence of brachiocephalic veins. The retrieval of the filter was performed through the femoral vein route. Results: The retrievable filter was successfully placed in SVC in all cases. No dislodgement or migration of the filters occurred during the procedure. The filter was successfully retrieved via the femoral vein in two cases at 15 days and 28 days after the placement respectively as color Dopper ultrasound showed that the venous thrombus disappeared. The remaining 4 patients were unwilling to take the procedure of filter retrieval. All the patients were followed up periodically. During the follow-up course, five patients died of some causes (deterioration of the tumor, etc.) unrelated to filter placement in 2-16 months after the procedure. No serious complications such as SVC thrombosis, pulmonary embolism, migration of filter, vascular perforation, etc. occurred. Conclusion: The placement of retrievable SVC filter is technically simple, clinically feasible and safe, and the filter can be retrieved easily. This technique is very useful for preventing both the pulmonary embolism caused by jugular vein or upper extremity deep vein thrombosis and the complications related to long-term retention of the filter within SVC. (authors)

  20. Reproduction of a new inferior vena cava thrombosis model and study of the evolutionary process of thrombolysis in rats

    Directory of Open Access Journals (Sweden)

    Jian FU

    2015-10-01

    Full Text Available Objective To investigate the reproduction of a new model of thrombosis of inferior vena cava (IVC, and explore the natural process of thrombolysis and its mechanism in rats. Methods Forty-eight SD rats were randomly classified into experimental group and control group. In the experimental group, the lumen of the vena cava was blocked by about 80%-90% with a ligature of IVC below the left renal vein, and then the animals were redivided into three subgroups (n=12, each. In group A, the IVC endothelium was damaged and its tributaries were ligated. In group B, the IVC endothelium was damaged and its tributaries were not ligated. In group C, no damage was done to the endothelium of the IVC but all its tributaries were ligated. A sham-operated group served as control. The length and weight of the vinous thrombus and the percentage of the IVC luminal area were compared after operation to determine the optimum animal model of venous thrombosis. According to the best mode to establish the model, the thrombus specimens were collected and detected by HE and Masson staining, and the ED-1 expressions were examined by immunohistochemical staining after thrombus formation in 30 rats. The natural evolution of intravenous thrombolysis was analyzed dynamically and the cell types involved in this process were observed. Results Gross observation showed that the experimental group was successfully induced thrombus formation. The thrombus length and weight in group A was significantly higher than that in group B and group C, and no difference between group B and C. The thrombus area in group A was significantly higher than that in groups B and group C, which identified the group A was the optimal model group of venous thrombosis. In the group reproduced by the best mode of the model, HE and Masson staining results showed that new capillaries and the components of collagen and extracellular matrix increased gradually with the passage of time in the process of

  1. Experimental evaluation of a new retrievable inferior vena cava filter for protection from acute pulmonary embolism in canine

    International Nuclear Information System (INIS)

    Objective: To evaluate the validity, safety and feasibility of a new retrieval inferior vena cava filter for the prevention of pulmonary embolism in an animal model. Methods: The model of deep iliofemoral venous thrombosis was established in 12 experimental dogs. In control group(6 experimental dogs), the deep venous thrombosis was made to fall off directly. In experimental group (6 experimental dogs), the deep venous thrombosis was made to fall off with an implanted filter in inferior vena cava. The filter's thrombus-trapping efficacy was evaluated by angiography of pulmonary artery, measurement of the mean pressure of pulmonary artery and arterial oxygen saturation before and after the deep venous thrombus falling off. Results: All filters implanted in the experimental dogs could successfully capture clot coming from deep venous thrombosis. There was no case of pulmonary embolism in experimental groups. On the other hand, pulmonary embolism occurred following the fall of deep venous thrombus in all dogs of control group. Conclusion: The retrievable inferior vena cava filter can effectively prevent from the pulmonary embolism due to falling off of the emboli from deep venous thrombosis. The process of implantation and retrieval is relatively simple and easy. (authors)

  2. Massive catheter-related thrombosis of vena cava superior protruding into the right atrium in a hemodialysis patient.

    Science.gov (United States)

    Mach, Lukas; Ondruskova, Olga; Nemec, Petr; Orban, Marek

    2015-10-01

    A 36-year-old man with chronic renal insufficiency secondary to type 1 diabetes mellitus was on hemodialysis via central venous catheter (CVC), newly placed into the right subclavian vein after his arteriovenous fistula became dysfunctional. Seven days after CVC insertion, the patient developed fever and on day 11 echocardiography showed a large nearly occluding thrombus in the superior vena cava (SVC) extending into the right atrium (RA). Emergency surgical thrombectomy was successfully performed and an 11 cm long thrombus extending from the RA cranially into the SVC occupying majority of the vein's lumen was removed. Cultures from the thrombus and CVC were negative, but polymerase chain reaction was positive for Staphylococcus aureus. This particular case was interesting for a marked discrepancy between large SVC occluding thrombosis and a relatively mild clinical presentation with fever, and it highlights the importance of correct timing of echocardiography exam which might prevent potentially fatal consequences such as pulmonary embolism. PMID:25645521

  3. Brachytherapy for the prevention of neointimal hyperplasia in the canine inferior vena cava after stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Isota, Masayuki; Kaminou, Toshio; Sakai, Yukimasa; Nakamura, Kenji; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

    2002-06-01

    The aim of this study was to evaluate the efficacy of brachytherapy for preventing neointimal hyperplasia in the inferior vena cava (IVC) after stent placement. Sixteen beagles underwent Z-stent placement in the IVC and the aorta. For 8 of 16 beagles, irradiation (15 Gy) was delivered endoluminally to the stented segments of each vessel immediately after stent placement using the {sup 192}Ir. All animals were sacrificed after 6 weeks for morphometric and histopathologic examination. Morphometrically, neointimal thickness in the IVC of the radiation group was significantly decreased compared with the control group as well as that in the aorta (p<0.05). Histopathologic findings showed the neointima in the IVC of the control group contained markedly organization of thrombus and neovascularization though that in the IVC of the radiation group consisted mainly of smooth muscle cells without organization of thrombus and neovascularization. From these data intravenous irradiation may prevent clinical restenosis after stent placement. (author)

  4. Thrombus aspiration in acute myocardial infarction.

    Science.gov (United States)

    Mahmoud, Karim D; Zijlstra, Felix

    2016-07-01

    The success of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is often hampered by incomplete microvascular myocardial reperfusion owing to distal embolization of thrombus resulting in microvascular obstruction. To address this problem, thrombus aspiration devices have been developed that can be used to evacuate coronary thrombus either manually or mechanically. Thrombus aspiration has the potential to reduce the local thrombus load, minimize the need for balloon predilatation, facilitate direct stenting, prevent distal embolization, and ultimately improve myocardial reperfusion. Furthermore, thrombus aspiration has enabled us to study coronary thrombus in vivo, and has facilitated recognition of distinct mechanisms of coronary thrombosis. Clinical trials focusing on manual thrombus aspiration in primary PCI have generally shown improved myocardial reperfusion. However, in two large trials powered for clinical end points, no reduction in 1-year mortality or other adverse clinical events was observed with the use of this strategy. Moreover, one of these trials showed a marginally increased risk of stroke. Consequently, current guidelines do not recommend routine use of thrombus aspiration. Future studies should focus on the identification of subgroups of patients with STEMI who might derive benefit from manual thrombus aspiration, and establish the effect of operator performance on the efficacy and safety of the procedure. PMID:26961064

  5. Hepatic and postrenal segment anomalies of inferior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Yeon Hyeon; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-06-15

    Postrenal segment anomalies of inferior vena cava such as bilateral inferior vena cava and left-sided inferior vena cava can simulate lymphadenopathy on CT scan and these anomalous veins need consideration in retroperitoneal operations such as procedures for prevention of venous embolism, splenorenal shunt operation and aortic prosthetic replacement. Retrocaval ureter is a rare cause of obstructive uropathy or medical deviation of ureter. We analyzed 16 cases of postrenal segment anomalies diagnosed by CT, vena cavography, retrograde pyelography and ultrasonography including six rare positional anomalies at hepatic segment of inferior vena cava diagnosed by cardiac angiography. The results were as follows. 1. Postrenal segment anomalies were 6 cases of bilateral IVC, 8 cases of left-sided IVC and 2 cases of retrocaval ureters. On CT scan, 3 cases of bilateral IVC and 4 cases of left-sided IVC were accompanied by malignant tumors, but caval veins could be discriminated from enlarged nodes because of continuous tubular nature of vein on consecutive sections with homogeneous strong enhancement. Two cases of retrocaval ureters showed hydroureteronephrosis due to ureteral compression by IVC. 2. Hepatic segment anomalies were 6 cases. Five cases of IVC on left side of vertebra crossed midline at live to enter right-sided right atrium and one case of IVC on right side crossed midline to enter left-sided right atrium. Four cases of complex cardiac anomalies, 4 cases of annapolis and 2 cases of situs ambiguous were associated with these anomalies.

  6. Acute lymphoid leukemia presenting with superior vena cava syndrome

    OpenAIRE

    Mohammad Emami Ardestani; Firouzeh Moeinzadeh

    2013-01-01

    When superior vena cava (SVC) compress or obstructed by internal or external pressure, we encounter to SVC syndrome. The cause of this compression is malignant or benign. Although the widespread use of permanent central venous access catheters coupled with the improved success of chemotherapy has increased the incidence of SVC syndrome not caused by direct tumor infiltration (non-malignant SVC syndrome) but SVC syndrome may be a sign of advanced malignancy. In this report, we present a 30-yea...

  7. Thrombus in Transit through Patent Foramen Ovale

    OpenAIRE

    Hassan Baydoun; Iskander Barakat; Elie Hatem; Michel Chalhoub; Ali Mroueh

    2013-01-01

    A thrombus in transit through a patent foramen ovale (PFO) with impending paradoxical embolism is an extremely rare event. Due to its transient nature, it is unable to identify the thrombus, and most of the cases have been reported at autopsy. We are reporting a case of thrombus straddling the foramen ovale which was diagnosed by echocardiography and treated surgically. Through this personal case, an exhaustive review of the literature was performed. There were 88 cases reported. We concluded...

  8. Measurement of Thrombus Flux Using Transesophageal Echocardiography

    Science.gov (United States)

    Yamaguchi, Tadashi; Hirai, Kazuki; Aoki, Masami; Miyagi, Jin; Suzuki, Masahiko; Moriya, Hideshige; Hachiya, Hiroyuki

    2006-05-01

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the FSET to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed.

  9. Measurement of thrombus flux using transesophageal Echocardiography

    International Nuclear Information System (INIS)

    Deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE) are serious problem of total knee replacement (TKR). These diseases may be caused by a thrombus formed during the TKR operation. Therefore, understanding the flow volume of thrombus is important for curing and preventing PTE. In this paper, we tried to understanding the situation of the flow of thrombus by using transesophageal echocardiography movies. We applied the signal processing technique the fiber structure extraction technique (FSET) to extract the anomalous information from ultrasonic echo image. As a result of processing, the time change of the flow volume of thrombus was confirmed. (author)

  10. Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings

    International Nuclear Information System (INIS)

    Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

  11. Nursing care of the complications caused by vena cava filter placement and thrombolytic therapy

    International Nuclear Information System (INIS)

    Objective: To discuss the nursing care and observation measures for the complications occurred after vena cava filter placement and thrombolytic therapy. Methods: During the period of July 2007-March 2010, vena cava filter placement and thrombolytic therapy were employed in 70 patients. The observation for the main procedure-related complications was made. The main complications included bleeding tendency, pulmonary embolism, filter migration or loss, thrombus formation within filter, IVC perforation due to filter, venous insufficiency and skin blisters of the affected lower extremity. Results: The total effective rate of thrombolytic treatment in 70 patients was 95.7%. As reasonable and effective nursing care measures were implemented, no major complications, such as pulmonary embolism, filter migration or loss,thrombus formation within filter, IVC perforation due to filter, infection, etc. occurred. The other complications developed in some patients,which included hematuria (n=4), bleeding at puncturing site (n=3), bleeding at abdominal incision (n=3), subcutaneous ecchymosis (n=3) and skin vesicles of diseased limb (n=3), all of which were cured after proper management. Conclusion: Postoperative nursing is a kind of prospective nursing care, the primary purpose of which is to prevent the occurrence of the potential complications after surgery. Therefore, solid fundamental knowledge, careful observation ability and strong consciousness of responsibility are most important.(authors)

  12. A new type of inferior vena cava filter and its animal experiment

    Institute of Scientific and Technical Information of China (English)

    YU; Xue-bao; LIU; Mei-rong; GUO; Jin-fang; HU; Yu-ling

    2005-01-01

    This article explains the definition of pulmonary embolism as well as its causes and elaborates on a new type of inferior vena cava filter(VCF)we have developed. Shaped like a waistdrum,the VCF is mainly made of TiNi shape memory alloy-wire. It has a subulate wire frame which can intercept the thrombus on each side. Its medial body is made up of straight shape memory alloywire . Every pillar is bound by several shape memory alloy springs. This type of inferior vena cava filter has a good resistance to fatigue and is hard to be broken. Through animal experiments its framework has been proved to be lasting. Neither deformation nor fragmentation happened when the VCF had been kept in the body for a long time. The thrombus interception efficiency of our VCF is higher than imported VCFs. The filter is unfavorable for thrombosis. After implantation,the IVC was completely unimpeded and no displacement occurred. Moreover the VCF did little damage to the Wall of vein. Neither IVC perforation nor haematoma occurred after the operation.

  13. Multi-Constituent Simulation of Thrombus Deposition

    CERN Document Server

    Wu, Wei-Tao; Massoudi, Mehrdad; Wagner, William R; Antaki, James F

    2016-01-01

    Based on the transport model of Sorensen et al. (1999), an improved mathematical model describing the process of thrombus deposition and growth was developed. Blood is treated as a multi-constituent mixture comprised of a linear fluid phase and a thrombus phase. The transport and reactions of 10 chemical and biological species are modeled using a system of coupled convection-reaction-diffusion (CRD) equations. These represent three main processes: initiation, propagation and stabilization. Computational fluid dynamic (CFD) simulations using the libraries of OpenFOAM were performed for two illustrative benchmark problems: mural thrombus growth in an injured blood vessel and thrombus deposition in a small (125 x 95 micros) crevice observed in vitro. For both problems, the simulated thrombus deposition agreed very well with experimental observations, both spatially and temporally. These promising results encourage further simulations to investigate clinical conditions and design factors that affect the risk of t...

  14. Superior vena caval syndrome caused by the tumor of the left hilum in a patient with unilateral persistent left superior vena cava diagnosed with multislice spiral computed tomography-a case report

    International Nuclear Information System (INIS)

    Unilateral persistent left superior vena cava (PLSVC) is an infrequent finding with incidence of 18-20% among the individuals with PLSVC. The persistence of the left-sided superior vena cava is an effect of disturbances in development of the connection between the precardinal veins (anterior cardinal veins) and formation of the sinus venosus in early stages of embryogenesis. The paper presents a case of a 62-year-old patient with a mass lesion of the left hilum, which caused left-sided superior vena caval syndrome in the presence of unilateral SVC. Developmental mechanisms of superior vena caval syndrome are discussed. The evolution of changes related to infiltration and occlusion of PLSVC is shown on the basis of three selected MSCT examinations. (author)

  15. Vena cava filters in cancer patients: experience with 50 patients Filtros de veia cava inferior em pacientes com câncer: experiência em 50 casos

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Zerati

    2005-10-01

    Full Text Available OBJECTIVE: To study the immediate and late results obtained from the implantation of vena cava filters in cancer patients with deep vein thrombosis concomitant with neoplasia. METHODS: This was a retrospective evaluation of 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and the insertion of permanent vena cava filters. The indications for the procedure, filter implantation technique, early and late complications related to the operation, and the clinical evolution were evaluated. RESULTS: The most frequent indication for filter implantation was the contraindication for full anticoagulant treatment (80%. The femoral vein was the preferred access route (86% of the patients. There were no complications related to the surgical procedure. During the follow-up, the following complications were observed: 1 episode of nonfatal pulmonary thromboembolism, 2 cases of occlusion of the inferior vena cava, and 1 case of thrombus retained in the device. Twenty patients (40% died due to progression of the neoplasm. CONCLUSIONS: Interruption of the inferior cava vein using an endoluminal filter is a procedure with a low rate of complications. It is a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs.OBJETIVO: Estudar os resultados imediatos e tardios obtidos com a implantação de filtros de veia cava inferior em pacientes com trombose venosa profunda concomitante a neoplasia. MÉTODOS: Avaliamos retrospectivamente 50 pacientes com câncer e trombose venosa profunda associada submetidos a interrupção de veia cava inferior com filtros intraluminais definitivos. Foram estudados aspectos referentes à indicação do procedimento, à técnica de implante dos dispositivos, complicações precoces e tardias relacionadas à operação e à evolução dos pacientes. RESULTADOS: A indicação mais freqüente para o

  16. Traumatismos de veia cava inferior Inferior vena cava injuries

    Directory of Open Access Journals (Sweden)

    Cleinaldo de Almeida Costa

    2005-10-01

    Full Text Available OBJETIVO: Avaliar a incidência, o perfil clínico e as estratégias operatórias dos ferimentos de Veia Cava Inferior (VCI. MÉTODOS: Foram analisados retrospectivamente os prontuários de 76 doentes com ferimento de VCI atendidos nos dois prontossocorros de Manaus, no período de janeiro de 1997 a julho de 2002. Mecanismo de lesão, mortalidade, estado hemodinâmico, índice de trauma abdominal penetrante (PATI, achados intra-operatórios e conduta cirúrgica foram estudados. RESULTADOS: Quarenta e nove (65% doentes sofreram lesão por arma branca, 26 (34% por arma de fogo e um por traumatismo abdominal fechado. Quarenta e um (54% doentes sobreviveram. Quase todos chegaram acordados, entretanto 40% estavam hipotensos (pressão arterial sistólica BACKGROUND: Injuries of inferior vena cava (IVC require immediate and definitive action. Our objective is to evaluate the incidence, the clinical findings and the operative approach to IVC injuries. METHODS: We retrospectively studied 76 patients with IVC injuries treated in two Emergency Hospitals of Manaus, AM, Brazil, from January 1997 to July 2002. Mechanisms of injuries, mortality, hemodynamic status, penetrating abdominal trauma index (PATI, intraoperative findings and surgical approach were among assessed data. RESULTS: Fourty-nine patients (65% had stab wounds, 26 (34% gunshot wounds, and one had blunt abdominal trauma. Fourty-one (54% patients survived. Almost all patients entered the emergency room awake, although 40% were hypotensive (systolic blood pressure < 70 mmHg, and the penetrating abdominal trauma index average was above 40. At laparotomy, active retroperitoneal bleeding or an expanding retroperitoneal hematoma were detected in all cases. Caval injury was retro-hepatic in 21 patients, and infrahepatic in the other 55. The prevailing surgical approach was lateral repair in 65 patients. Atrial-caval shunting was tried in six patients, with only three survivals. CONCLUSIONS: We

  17. Acute wiiitis representing as thrombosis of the inferior vena cava and left pelvic veins.

    Science.gov (United States)

    Brodmann, M; Gary, T; Hafner, F; Eller, P; Deutschmann, H; Pilger, E; Seinost, G

    2015-08-01

    Deep venous thrombosis as a result of venous wall injury provoked by trauma is a common finding. It often occurs in patients with sportive overstraining, caused by over fatigue of the body structures. In 2007, the entity of "acute wiiitis" was first described in a letter to the New England Journal of Medicine. Acute wiiitis sums up all affections, mainly skeletal and muscle affections, provoked by playing Nintendo Wii, a very common and loved video-game system. Deep venous thrombosis as a consequence of Nintendo Wii has not been described so far. We present a patient with a massive free floating thrombus of the left pelvic veins originating from the gluteal veins and reaching into the inferior vena cava after playing Nintendo Wii. PMID:24681523

  18. Soft thrombus formation in radiofrequency catheter ablation

    NARCIS (Netherlands)

    Demolin, JM; Eick, OJ; Munch, K; Koullick, E; Nakagawa, H; Wittkampf, FHM

    2002-01-01

    During RF catheter ablation, local temperature elevation can result in coagulum formation on the ablation electrode, resulting in impedance rise. A recent study has also demonstrated the formation of a so-called soft thrombus during experimental ablations. This deposit poorly adhered to the catheter

  19. Research progress in non-permanent vein cava filters

    International Nuclear Information System (INIS)

    Vein cava filter placement has already become one of the most effective measures for preventing pulmonary embolism which is usually secondary to deep vein thrombosis. With the development of research, non-permanent vein cava filter has been widely used. This paper aims to describe the recent progress in the research of non-permanent vein cava filters. (authors)

  20. Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Katsuro Harada Júnior

    2012-09-01

    Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

  1. Percutaneous placement of bird's nest inferior vena cava filter

    International Nuclear Information System (INIS)

    To describe clinical experiences of the use of Bird's Nest inferior vena cava(IVC) filter. Between August 1991 and August 1997, IVC filter was percutaneously inserted in 51 patients with pulmonary embolism(PE) and deep vein thrombosis of the lower extremities. Indications for the placement of this filter were contraindication to anticoagulation in 17 patients, prophylaxis of PE in 17, failed anticoagulation in 11, massive PE with residual floating thrombus in three and complications involving anticoagulation in 3. In order to delineate the location of renal vein and extension of deep vein thrombosis into the IVC, all patients under went inferior vena cavography before filter placement. Thirty filters were inserted through the right femoral vein, 19 through the right internal jugular vein and three through the left femoral vein. The patients involved were followed up for periods ranging from one week to six years (mean 10 months). A Bird's Nest IVC filter was placed in the infrarenal IVC in 44 patients and in the suprarenal IVC in 7. Certain complicatioins ensued. IVC penetration occurred in three patients(5.9%), and in seven(1.37%) the filter wire prolapsed. Except for transient pain, however, there were no serious IVC penetration-related complications and no evidence of recurrence of PE in the cases involving prolapse of the filter wire. During follow up, clinically suspected recurrent PE was noted in two patients(3.9%), but there was no evidence of newly developed occlusion of the IVC. In patients who under went follow up, Bird's Nest IVC filter effectively prevented the development and recurrence of PE, and there were no complications. To prevent of penetration of the IVC and prolapse of the filter, however, technical skill was needed

  2. Adrenocortical carcinoma with extension to the inferior vena cava and right atrium: 20-month-old girl with TP53 mutation

    Directory of Open Access Journals (Sweden)

    Terry L. Levin, MD

    2015-01-01

    Full Text Available A 20-month-old female presented with respiratory distress and a right adrenal mass extending into the inferior vena cava and right atrium. The mass was initially thought to be neuroblastoma. Pathology later revealed adrenocortical carcinoma. Inferior vena cava extension is far more common in adrenocortical carcinoma than neuroblastoma, and its presence should prompt clinical and laboratory evaluation for an adrenocortical tumor. The genetic findings in TP53 associated with this disease are discussed.

  3. Prenatal diagnosis of isolated interrupted inferior vena cava with azygos continuation to superior vena cava

    Directory of Open Access Journals (Sweden)

    Do Thi Cam Giang

    2014-01-01

    Full Text Available Absence of inferior vena cava is an uncommon congenital abnormality. It is usually associated with other structural anomalies, typically left isomerism. We report a case of interrupted inferior vena cava with azygos continuation diagnosed as an isolated finding during routine prenatal ultrasound scan, confirmed by post-natal echocardiography. Detailed ultrasound examination of the fetal anatomy failed to demonstrate other anomalies. The neonatal course of this fetus was uneventful.

  4. Endovascular treatment of superior vena cava syndrome

    DEFF Research Database (Denmark)

    Duvnjak, Stevo; Andersen, Poul Erik

    2011-01-01

    clinically with superior vena cava syndrome and according caval stenosis confirmed by computed tomography. The causes of stenoses were non-small cell carcinoma in 22 patients and small cell carcinoma in 8 patients. RESULTS: In all patients the stents were placed as intended in all patients there was an...

  5. Inferior vena cava aneurysm. A case report

    International Nuclear Information System (INIS)

    Aneurysmal dilatation of the inferior vena cava can occur in patients with heart disease or, very likely, with congenital weakness of the vascular wall. Chest x-ray discloses a mass in right cardiophrenic angle. The diagnosis can be confirmed by ultrasound, more invasive measures being unnecessary. (Author) 6 refs

  6. Thrombus in Transit through Patent Foramen Ovale.

    Science.gov (United States)

    Baydoun, Hassan; Barakat, Iskander; Hatem, Elie; Chalhoub, Michel; Mroueh, Ali

    2013-01-01

    A thrombus in transit through a patent foramen ovale (PFO) with impending paradoxical embolism is an extremely rare event. Due to its transient nature, it is unable to identify the thrombus, and most of the cases have been reported at autopsy. We are reporting a case of thrombus straddling the foramen ovale which was diagnosed by echocardiography and treated surgically. Through this personal case, an exhaustive review of the literature was performed. There were 88 cases reported. We concluded that there is no medical consensus about the best option for treatment. Nevertheless, surgery, which is associated with fewer complications of recurrent embolic events than those of thrombolysis and anticoagulation, appeared to be the best approach in patients who are not at a high surgical risk. Anticoagulant treatment appears to be an acceptable therapeutic alternative to surgery, particularly in patients with comorbidities who are at high surgical risk and for patients with small PFO. Thrombolysis is linked to the highest mortality, which could be explained by the severity of the patient's initial presentation. In conclusion, and after the cumulative effects of these case reports, we propose a diagram consisting of the use of the three therapeutic options in the different clinical scenarios. PMID:24826281

  7. Thrombus in Transit through Patent Foramen Ovale

    Directory of Open Access Journals (Sweden)

    Hassan Baydoun

    2013-01-01

    Full Text Available A thrombus in transit through a patent foramen ovale (PFO with impending paradoxical embolism is an extremely rare event. Due to its transient nature, it is unable to identify the thrombus, and most of the cases have been reported at autopsy. We are reporting a case of thrombus straddling the foramen ovale which was diagnosed by echocardiography and treated surgically. Through this personal case, an exhaustive review of the literature was performed. There were 88 cases reported. We concluded that there is no medical consensus about the best option for treatment. Nevertheless, surgery, which is associated with fewer complications of recurrent embolic events than those of thrombolysis and anticoagulation, appeared to be the best approach in patients who are not at a high surgical risk. Anticoagulant treatment appears to be an acceptable therapeutic alternative to surgery, particularly in patients with comorbidities who are at high surgical risk and for patients with small PFO. Thrombolysis is linked to the highest mortality, which could be explained by the severity of the patient’s initial presentation. In conclusion, and after the cumulative effects of these case reports, we propose a diagram consisting of the use of the three therapeutic options in the different clinical scenarios.

  8. Leiomyosarcoma of the Inferior Vena Cava Confirmed by Aspiration Biopsy With a Catheter During Digital Subtraction Angiography.

    Science.gov (United States)

    Yakupoglu, Abdullah; Ulus, Sila; Cantasdemir, Murat

    2016-04-01

    Leiomyosarcoma of the vascular origin is a rare malignant tumor. It originates from the smooth muscle cells of the media with intra- or extraluminal growth, and in most cases it arises in the inferior vena cava. The diagnosis is often delayed because the clinical symptoms of this disease are often nonspecific. Accurate diagnosis of inferior vena cava leiomyosarcoma (IVCLMS) needs histologic confirmation. We report a case of IVCLMS histologically confirmed by aspiration biopsy with a catheter during digital subtraction angiography presenting with pulmonary emboli in a 65-year-old man. PMID:27000390

  9. Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

    Directory of Open Access Journals (Sweden)

    Valary T. Raup

    2015-01-01

    Full Text Available Testicular cancer is the most common malignancy of men aged 15–40. Metastatic spread classically begins with involvement of the retroperitoneal lymph nodes, with metastases to the liver, lung, bone, and brain representing advancing disease. Treatment is based on pathologic analysis of the excised testicle and presence of elevated tumor markers. We report a case of a 34-year-old male presenting with back pain who was found to have a right renal mass with tumor extension into the inferior vena cava. Subsequent biopsy was consistent with seminoma. We review this rare case and discuss the literature regarding its diagnosis and management.

  10. Multimodality Evaluation of Intravenous Leiomyomatosis: A Rare, Benign but Potentially Life-Threatening Tumor

    Science.gov (United States)

    Fornaris, Reinaldo J.; Rivera, Melisa; Jiménez, Luis; Maldonado, José

    2015-01-01

    Patient: Female, 40 Final Diagnosis: Intravenous leiomyomatosis Symptoms: Chest pain • syncope Medication: — Clinical Procedure: Thoracotomy Specialty: Radiology • Cardiology Objective: Rare disease Background: Intravenous leiomyomatosis (IVL) is a rare tumor, which is usually of uterine origin, characterized by intravascular nodular masses of histologically benign smooth muscle that may extend variable distances, including into the inferior vena cava, right atrium and pulmonary arteries. Tumors may arise from uterine leiomyoma, walls of the uterine vessel, or myometrium. It usually occurs at between 20–70 years of age with a median age of 45 years. The most commonly affected women are pre-menopausal and multiparous. Intra-cardiac extension may represent a diagnostic challenge as it is usually misdiagnosed as a right atrial myxoma and may cause multiple symptoms, such as shortness of breath, tachycardia, chest pain, syncope, and even death. Case Report: We present the case of a 40-year-old female patient with past medical history of arterial hypertension, who was referred to a cardiovascular center due to an intra-cardiac mass found on 2D echocardiogram. The patient was given the rare diagnosis of intravenous leiomyomatosis of the uterus with extension into the gonadal veins, inferior vena cava, right atrium, right ventricle, and main pulmonary arteries. Imaging workup including trans-esophageal echocardiogram, cardiac catheterization, contrast-enhanced abdomen and pelvic CT scans, and cardiac MRI was performed for evaluation. Conclusions: Intravenous leiomyomatosis is a rare diagnosis that merits consideration in a young pre-menopausal female patient with cardiac symptoms associated with a right atrial mass. Radiologists play a vital role in the diagnosis and follow-up of patients with the diagnosis of intravenous leiomyomatosis. Differential diagnosis includes vascular thrombus as well as primary and metastatic tumors. Early detection is imperative for

  11. Angiosarcoma of the superior vena cava

    International Nuclear Information System (INIS)

    The first reported case of an angiosarcoma apparently arising from the superior vena cava is presented. The patient, a 20-year-old white man, was treated by surgical excision and reconstruction with dacron grafts from the left and right brachiocephalic veins to the right atrium. This was followed by a course of mediastinal irradiation. The patient remained clinically disease-free at 24 months post-treatment. The patient had occasional occupational exposure to polyvinyl chloride

  12. Angiosarcoma of the superior vena cava

    Energy Technology Data Exchange (ETDEWEB)

    Abratt, R.P.; Williams, M.; Raff, M.; Dodd, N.F.; Uys, C.J.

    1983-08-15

    The first reported case of an angiosarcoma apparently arising from the superior vena cava is presented. The patient, a 20-year-old white man, was treated by surgical excision and reconstruction with dacron grafts from the left and right brachiocephalic veins to the right atrium. This was followed by a course of mediastinal irradiation. The patient remained clinically disease-free at 24 months post-treatment. The patient had occasional occupational exposure to polyvinyl chloride.

  13. Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins

    Directory of Open Access Journals (Sweden)

    Wang Quan

    2012-06-01

    Full Text Available Abstract Leiomyosarcoma of the inferior vena cava (IVCL is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.

  14. Tratamento da síndrome da veia cava superior Treatment of superior vena cava syndrome

    OpenAIRE

    Luís Marcelo Inaco Cirino; Rafael Ferreira Coelho; Ivan Dias da Rocha; Bernardo Pinheiro de Senna Nogueira Batista

    2005-01-01

    A veia cava superior é formada pela união das duas veias inominadas, direita e esquerda, e localiza-se no mediastino médio, à direita da artéria aorta e anteriormente à traquéia. A síndrome da veia cava superior representa um conjunto de sinais (dilatação das veias do pescoço, pletora facial, edema de membros superiores, cianose) e sintomas (cefaléia, dispnéia, tosse, edema de membro superior, ortopnéia e disfagia) decorrentes da obstrução do fluxo sanguíneo através da veia cava superior em d...

  15. Percutaneous insertion of the inferior vena cava filter

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of inferior vena cava filter for prevention of pulmonary embolus (PE) formation. Methods: Twenty-eight cases of deep venous thrombosis (DVT) were treated with insertion of the inferior vena cava filter. Results: The filter was implanted into inferior vena cava below the rena vein. There were no severe complications occurred in the group. Twenty-seven cases were followed up to 2-34 months, and no migration of the filters were found. And no pulmonary embolism were revealed in fifteen cases without pulmonary thromboembolism. Conclusions: The inferior vena cava filter implantation is a safe and effective method to prevent pulmonary thromboembolism

  16. Detection of extracellular genomic DNA scaffold in human thrombus

    DEFF Research Database (Denmark)

    Oklu, Rahmi; Albadawi, Hassan; Watkins, Michael T;

    2012-01-01

    PURPOSE: Mechanisms underlying transition of a thrombus susceptible to tissue plasminogen activator (TPA) fibrinolysis to one that is resistant is unclear. Demonstration of a new possible thrombus scaffold may open new avenues of research in thrombolysis and may provide mechanistic insight into t...

  17. Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction.

    OpenAIRE

    Fröbert, Ole; Lagerqvist, Bo; Olivecrona, Göran; Omerovic, Elmir; Gudnason, Thorarinn; Maeng, Michael; Aasa, Mikael; Angerås, Oskar; Calais, Fredrik; Danielewicz, Mikael; Erlinge, David; Hellsten, Lars; Jensen, Ulf; Johansson, Agneta C; Kåregren, Amra

    2013-01-01

    Background The clinical effect of routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is uncertain. We aimed to evaluate whether thrombus aspiration reduces mortality. Methods We conducted a multicenter, prospective, randomized, controlled, open-label clinical trial, with enrollment of patients from the national comprehensive Swedish Coronary Angiography and Angioplasty Registry (...

  18. Categorization of aortic aneurysm thrombus morphology by magnetic resonance imaging

    DEFF Research Database (Denmark)

    de la Motte, Louise; Pedersen, Mads Møller; Thomsen, Carsten;

    2013-01-01

    Magnetic resonance imaging (MRI) has been proposed for qualitative categorization of intraluminal thrombus morphology. We aimed to correlate the qualitative MRI categorization previously described to quantitative measurements of signal intensity and to compare morphological characteristics of...... intraluminal thrombus specimens to the appearance on magnetic resonance imaging....

  19. Long-Term Safety and Effectiveness of the “OptEase” Vena Cava Filter

    International Nuclear Information System (INIS)

    Purpose: To assess the long-term safety and effectiveness of the OptEase inferior vena cava (IVC) filter. Materials and Methods: In this Institutional Review Board-approved, retrospective study, we reviewed data of 71 patients who received an OptEase filter at our institution from 2002 to 2007. Thirty-nine (55%) patients had symptoms of venous thromboembolism before filter placement. The indications for filter included contraindication to anticoagulation in 31 (44%) patients, prophylaxis against pulmonary embolism (PE) in 29 (41%) patients, and failure of anticoagulation in 11 (15%) patients. Procedure-related complications, such as symptomatic post-filter PE, deep venous thrombosis (DVT), IVC occlusion, and incidental imaging-evident filter-related complications, were recorded. Safety was assessed by the occurrence of filter-related complications during placement and follow-up. Effectiveness was assessed by the occurrence of post-filter PE. Results: Sixty-five (92%) filters were placed under fluoroscopy, and 6 (8%) were placed using intravascular ultrasound guidance. Seventy (99%) filters were placed successfully. Seven (10%) filters were placed in the suprarenal cava. Retrieval was attempted in 14 (20%) patients, and 12 filters were successfully retrieved. Clinical follow-up was available for 20 ± 21 months. Symptoms of postfilter PE and DVT occurred in 15% (n = 11) and 10% (n = 7) patients, respectively. None of these patients had computed tomography (CT)-proven PE, and only one had ultrasound-proven new DVT. One patient had symptomatic IVC occlusion. Follow-up abdominal CT in 20 patients showed thrombus in the filter in two of them. There were no instances of filter migration, filter tilt, or caval wall penetration. Conclusion: The OptEase filter appears to have an acceptable long-term safety profile. The filter was effective against PE.

  20. Clinical application and advancement of inferior vena cava filter

    International Nuclear Information System (INIS)

    Deep venous thrombosis is a common disorder, with a considerably high incidence and mortality. Inferior vena cava filter provides fruitful means in decrease and prevention of fatal pulmonary embolism. The authors reviewed the history, indications and applications of inferior vena cava filter for different types of deep venous thrombosis, with outlook of future trends. (authors)

  1. Gunther Tulip Inferior Vena Cava Filter Placement During Treatment for Deep Venous Thrombosis of the Lower Extremity

    International Nuclear Information System (INIS)

    Purpose. To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity. Methods. We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology. Results. Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients. All attempts at implantation of the GTF were safely accomplished. Perforation and migration experienced by one patient was the only complication. Mean period of treatment for DVT under protection from pulmonary embolism by the GTF was 12.7 ± 8.3 days (mean ± SD, range 4-37 days). We attempted retrieval of GTFs in 18 patients in whom the venous thrombus had disappeared after therapy, and retrieval in one of these 18 cases failed. GTFs were left in the vena cava in 24 patients for permanent use when the DVT was refractory to treatment. Conclusion. The ability of the GTF to protect against pulmonary embolism during treatment of DVT was demonstrated. Safety in both placement and retrieval was clarified. Because replacement with a permanent filter was not required, use of the GTF was convenient when further protection from complicated pulmonary embolism was necessary

  2. Superior vena cava syndrome in children.

    OpenAIRE

    Gupta, Vineeta; Ambati, Srikanth R.; Pant, P.; Bhatia, Baldev

    1981-01-01

    Superior vena cava syndrome (SVCS) is rare in childhood. 18 cases of SVCS were seen in children ranging from 3–14 years with a mean age of 8.8 years. There were 15 males and 3 female children. Diagnosis could be confirmed in 17 cases as one child succumbed to severe respiratory distress without a definitive diagnosis. The commonest cause of SVCS was lymphoma. Non-Hodgkin’s lymphoma (NHL) was more common than Hodgkin’s disease. In two cases the final diagnosis was tuberculosis of mediastinal l...

  3. Right superior vena cava draining into the left atrium

    International Nuclear Information System (INIS)

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  4. Thrombus age is ideally measured by history or MRV prior to thrombus removal

    DEFF Research Database (Denmark)

    Bækgaard, N; Foegh, P; Wittens, C H A;

    2015-01-01

    Many factors are known to be important in order to achieve optimal results after thrombus removal for iliofemoral DVT. Not much is published in the literature about timing the treatment, though many guidelines recommend treatment within 14 days. This time span lies within the phrase of acute DVT...... according to the definition given in many reporting standards. This article will highlight the value of information acquired from patients directly regarding onset of symptoms versus information acquired from imaging with the purpose of a more precise selection of patients for catheter-directed thrombolysis...

  5. Superior vena cava syndrome in hemodialysis patient

    Directory of Open Access Journals (Sweden)

    Azeb Molhem

    2011-01-01

    Full Text Available Obstruction of blood flow in the superior vena cava (SVC results in symptoms and signs of SVC syndrome. SVC obstruction can be caused either by invasion or external compression of the SVC by contagious pathologic processes involving the right lung, lymph nodes, and other mediastinal structures, or by thrombosis of blood within the SVC. Occasionally, both mechanisms co-exist. We hereby report a case of a 28-year-old male, Saudi patient who was diagnosed with end-stage renal disease and was maintained on regular hemodiaysis via right jugular vein dual lumen catheter for ten months. Three years later, the patient presented with signs and symptoms suggestive of SVC obstruction that was successfully managed with SVC stenting.

  6. Injuries of the inferior vena cava.

    Science.gov (United States)

    Burch, J M; Feliciano, D V; Mattox, K L; Edelman, M

    1988-12-01

    Beginning in 1946, 577 patients with inferior vena cava injuries were managed at a single institution. After decreasing from 37 to 30 percent, the mortality rate showed a distinct increase in the last 7 years studied. This increase was related to an increasing percentage of patients who arrived in the emergency center in severe shock and required resuscitative thoracotomy. In-hospital care advances have not kept pace with improvements in prehospital care. Although venous complications have not been infrequent, morbidity has not been a significant long-term problem. Fatal pulmonary embolism occurred and was a special problem for patients over the age of 50. More basic research is needed to expedite diagnosis and vascular control in addition to understanding and treating the severe metabolic problems of patients dying from shock and hemorrhage. PMID:3202271

  7. Neoplasms of the inferior vena cava - pictorial essay

    International Nuclear Information System (INIS)

    This pictorial essay reviews common and rare neoplasms affecting the inferior vena cava (IVC, Table 1), with a particular emphasis on the clinical implications and the role and efficacy of the various imaging techniques. (author)

  8. Troubleshooting OptEase inferior vena cava filter retrieval.

    Science.gov (United States)

    Nakashima, Masaya; Kobayashi, Hideaki; Kobayashi, Masayoshi

    2016-01-01

    For treatment of deep vein thrombosis and prevention of pulmonary thromboembolism, a retrievable inferior vena cava filter is commonly utilized as an effective bridge to anticoagulation. However, we have experienced difficulties in retrieving inferior vena cava filters. Endovascular retrieval assisted by disposable biopsy forceps is an appropriate approach because it provides a less-invasive low-cost way to remove a migrated filter. We suggest this troubleshooting technique to deal with filter hook migration into the caval wall. PMID:24828829

  9. Superior vena cava syndrome: A radiation oncologist's perspective.

    Science.gov (United States)

    Talapatra, Kaustav; Panda, Soumadip; Goyle, Sandeep; Bhadra, Kallol; Mistry, Rajesh

    2016-01-01

    Superior vena cava syndrome is referred to as a constellation of symptoms and signs caused by obstruction of superior vena cava. It can occur due to both benign and malignant causes with the latter being the predominant. There is a paradigm shift in the approach to manage this condition. It is no longer considered a medical emergency and histological diagnosis is necessary before treatment. This article reviews the causes, symptoms, pathophysiology, and overall management policy which have changed over decades. PMID:27461602

  10. Nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage: case report

    Directory of Open Access Journals (Sweden)

    Morinaga Yukiko

    2011-02-01

    Full Text Available Abstract A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7 days after admission. Transesophageal echocardiography showed that mobile, echo-dense masses were attached to the anterior and posterior mitral valve leaflet. Furthermore, there was a thrombus in the left auricular appendage despite sinus rhythm. These findings led to a diagnosis of suspected infectious endocarditis with subsequent multiple brain infarctions. The patient's general condition worsened and he died 13 days after admission. An autopsy was performed, and, while poorly differentiated cancer was observed in multiple organs, no primary tumor could be identified. Histological analysis showed that the masses of the mitral valve consisted mainly of fibrin without bacteria or oncocytes. This patient was therefore diagnosed with nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage.

  11. Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis

    OpenAIRE

    Diaz, Jose A.; Wrobleski, Shirley K.; Hawley, Angela E; Lucchesi, Benedict R.; Wakefield, Thomas W.; Myers

    2011-01-01

    Animal models serve a vital role in deep venous thrombosis (DVT) research in order to study thrombus formation, thrombus resolution and to test potential therapeutic compounds (1). New compounds to be utilized in the treatment and prevention of DVT are currently being developed. The delivery of potential therapeutic antagonist compounds to an affected thrombosed vein has been problematic. In the context of therapeutic applications, a model that uses partial stasis and consistently generates t...

  12. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    International Nuclear Information System (INIS)

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment

  13. Interobserver Variability in Target Definition for Hepatocellular Carcinoma With and Without Portal Vein Thrombus: Radiation Therapy Oncology Group Consensus Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Theodore S., E-mail: tshong1@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Bosch, Walter R. [Department of Radiation Oncology, Washington University in St. Louis School of Medicine, St. Louis, Missouri (United States); Krishnan, Sunil [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Kim, Tae K. [Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women' s College Hospital, University of Toronto, Toronto, Ontario (Canada); Mamon, Harvey J. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Shyn, Paul [Department of Radiology, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (United States); Seong, Jinsil [Department of Radiation Oncology, Yonsei University Medical College, Seoul (Korea, Republic of); Haddock, Michael G. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Cheng, Jason C. [Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Feng, Mary U. [Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan (United States); Stephans, Kevin L. [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Roberge, David [Department of Radiation Oncology, Montreal General Hospital/McGill University Health Centre, Montreal, Quebec (Canada); Crane, Christopher [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); and others

    2014-07-15

    Purpose: Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials: Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results: Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions: In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment

  14. Phlegmasia Caerulea Dolens in a Patient With an Inferior Vena Cava Filter: Treatment of Massive Iliocaval Thrombosis Using Local Intravenous Catheter-Directed Thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Cookson, Daniel, E-mail: danielthomascookson@yahoo.co.uk [Middlemore Hospital, Department of Radiology (New Zealand); Caldwell, Stuart, E-mail: stuart.caldwell@middlemore.co.nz [Middlemore Hospital, Department of Vascular Surgery (New Zealand)

    2012-10-15

    Phlegmasia caerulea dolens (PCD) is a potentially disastrous complication of inferior vena cava filter insertion, and its optimum management has not been clearly established. We present a case report of a patient with pulmonary embolism and acute adrenal haemorrhage who developed PCD secondary to massive iliocaval thrombosis after insertion of a Cook Celect removable filter. Local intravenous catheter-directed thrombolysis (CDT), followed by systemic anticoagulation, achieved limb salvage and virtual resolution of symptoms at 3 months without complications. CDT can be a successful primary treatment of filter-associated PCD and can be safe in selected patients with acute nontraumatic haemorrhage. Systemic anticoagulation may subsequently restore complete venous patency and may therefore be a useful approach to postthrombolysis management of residual iliocaval thrombus when filter removal is indicated.

  15. Phlegmasia Caerulea Dolens in a Patient With an Inferior Vena Cava Filter: Treatment of Massive Iliocaval Thrombosis Using Local Intravenous Catheter-Directed Thrombolysis

    International Nuclear Information System (INIS)

    Phlegmasia caerulea dolens (PCD) is a potentially disastrous complication of inferior vena cava filter insertion, and its optimum management has not been clearly established. We present a case report of a patient with pulmonary embolism and acute adrenal haemorrhage who developed PCD secondary to massive iliocaval thrombosis after insertion of a Cook Celect removable filter. Local intravenous catheter-directed thrombolysis (CDT), followed by systemic anticoagulation, achieved limb salvage and virtual resolution of symptoms at 3 months without complications. CDT can be a successful primary treatment of filter-associated PCD and can be safe in selected patients with acute nontraumatic haemorrhage. Systemic anticoagulation may subsequently restore complete venous patency and may therefore be a useful approach to postthrombolysis management of residual iliocaval thrombus when filter removal is indicated.

  16. Advances in our understanding of mechanisms of venous thrombus resolution.

    Science.gov (United States)

    Altmann, Johanna; Sharma, Smriti; Lang, Irene M

    2016-01-01

    Traditionally, venous thrombosis has been seen as the consequence of a regulated cascade of proteolytic steps leading to the polymerization of fibrinogen and fibrin crosslinking that is facilitated by platelets. A new view of thrombosis is providing a more integrated concept, with components of the vascular wall contributing to the vascular remodeling of thrombosis. Angiogenesis and inflammation are two key mechanisms that safeguard venous thrombus resolution and restitution of vascular patency after thrombosis. Disturbance of these processes leads to thrombus persistence and has potentially severe consequences for affected patients. Examples for clinical conditions associated with recurrent or persisting venous thrombosis are post-thrombotic syndrome or chronic thromboembolic pulmonary hypertension. Recently, studies using animal models of venous thrombosis have contributed to a better understanding of thrombus non-resolution that will eventually lead to modification of current treatment concepts. For example, recent data suggest that innate immunity is involved in the modification of thrombosis. PMID:26629617

  17. Synthetic thrombus model for in vitro studies of laser thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Hermes, R.E.; Trajkovska, K.

    1998-07-01

    Laser thrombolysis is the controlled ablation of a thrombus (blood clot) blockage in a living arterial system. Theoretical modeling of the interaction of laser light with thrombi relies on the ability to perform in vitro experiments with well characterized surrogate materials. A synthetic thrombus formulation may offer more accurate results when compared to in vivo clinical experiments. The authors describe the development of new surrogate materials based on formulations incorporating chick egg, guar gum, modified food starch, and a laser light absorbing dye. The sound speed and physical consistency of the materials were very close to porcine (arterial) and human (venous) thrombi. Photographic and videotape recordings of pulsed dye laser ablation experiments under various experimental conditions were used to evaluate the new material as compared to in vitro tests with human (venous) thrombus. The characteristics of ablation and mass removal were similar to that of real thrombi, and therefore provide a more realistic model for in vitro laser thrombolysis when compared to gelatin.

  18. Predictors of the immediate results of thrombectomy in kidney cancer patients with venous tumor thrombosis

    Directory of Open Access Journals (Sweden)

    M. I. Davydov

    2014-01-01

    Full Text Available Objective: to identify the predictors of perioperative complications and deaths in surgically treated patients with kidney cancer complicated by venous tumor thrombosis.Subjects and methods. The investigation included data on 463 kidney cancer patients with venous tumor thrombosis. The patients, median age was 57 years. The male / female ratio was 2.5:1. Perirenal, subhepatic, retrohepatic, and supradiaphragmatic tumor thrombi were diagnosed in 161 (34.8 %, 135 (29.2 %, 82 (17.7 %, and 85 (18.3 % patients, respectively. Regional and distant metastases occurred in 90 (19.4 % and 145 (31.3 % cases, respectively. All the patients underwent thrombectomy, retroperitoneal lymphadenectomy; a tumor-affected kidney was removed in 452 (97.6 % patients.Results. Median surgery duration was 259 (30–580 min; median blood loss was 3500 (100–27 000 ml. The incidence of intraoperative complications was 24.6 % (114 / 463; mortality was 0.9 % (4 / 463. The independent risk factors of intraoperative complications were cranial margin of a tumor thrombus (odds ratio (OR 1.9; 95 % CI 1.4–2.6; p < 0.0001 and circular resection of the inferior vena cava (OR 5.8; 95 % CI 1.2–27.8; p < 0.0001. The incidence of postoperative complications was 25.7 % (118 / 459;mortality was 6.0 % (28 / 459. Resurgery was required in 31 (6.8 % cases. Regression analysis identified the risk factors of postoperative complications (highly located cranial thrombus margin (OR 2.6; 95 % CI 1.1–6.4; p = 0.037 and lactate acidosis (OR27.1; 95 % CI 1.2–613.1; p = 0.038, postoperative death (hepatic vein thrombosis (OR 15.6; 95 % CI 4.5–54.3; p < 0.0001,lactate acidosis (OR 23.1; 95 % CI 3.4–158.4; p = 0.001 thrombus removal from the heart (OR 5.0; 95 % CI 2.1–12.2; p < 0.0001,perioperative death (cranial thrombus margin (OR 1.9; 95 % CI 1.2–3.2; р = 0.007, contralateral renal vein thrombosis (O R 4.4;95 % CI 1.2–15.8; p = 0.025, lactate acidosis (OR 28.4; 95 % CI 4

  19. Filtros de vena cava en pacientes con cáncer

    Directory of Open Access Journals (Sweden)

    Fernando A. Díaz Couselo

    2012-08-01

    Full Text Available Los pacientes con tromboembolismo venoso (TEV y cáncer tienen más complicaciones vinculadas al tratamiento anticoagulante que la población general. Los filtros de vena cava constituyen una herramienta útil para el tratamiento del TEV y su utilización es controvertida en estadios avanzados de la enfermedad. En este trabajo se revisaron las indicaciones, complicaciones y frecuencia de retiro de los filtros de vena cava en una población de pacientes oncológicos con TEV. Se analizaron 27 pacientes a quienes se les había colocado filtros de vena cava. Veinticinco tenían tumores sólidos y dos linfomas no Hodgkin. Veinticinco estaban bajo tratamiento activo (cirugía y/o quimioterapia. Diecinueve se hallaban en estadio IV de su enfermedad. El motivo de su indicación fue profilaxis en el período perioperatorio en 14 casos (51.9%, hemorragia (n = 5, trombocitopenia (n = 4, metástasis en sistema nervioso central (n = 2, accidente cerebrovascular (n = 1 y neurocirugía previa no reciente (n = 1. Se retiraron 8 (29.6% filtros. La mediana del tiempo de permanencia fue 21 días (6-75. No hubo diferencias estadísticamente significativas en la frecuencia de retiro entre los filtros colocados en el perioperatorio (6/14 y los colocados por otras contraindicaciones para la anticoagulación (2/13; p = 0.2087. No hubo fracasos ni complicaciones en los procedimientos de colocación y retiro.

  20. The application of GxA8xB9nther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity

    International Nuclear Information System (INIS)

    Objective: To discuss the therapeutic efficacy and manipulation skill of Gunther Tulip retrievable inferior vena cava filter in interventional treatment for acute deep venous thrombosis of lower extremity. Methods: From September 2007 to April 2008, a total of 36 patients with acute deep venous thrombosis of lower extremity were treated in our hospital. The time of the onset of disease ranged from 1 day to 12 days. The precipitation causes included prolonged lying in bed due to surgery or bone fracture (n = 18) and postpartum (n = 5), while no obvious precipitation causes could be found in 13 patients. Pulmonary embolism was coexisted in 12 cases. Clinically, the affected limb was swelling and painful, the skin was cyan-purple or pale in color with higher skin temperature. The circumferential length of the affected thigh was 3-10 cm longer than that of normal side. Patients with coexisted pulmonary embolism had the clinical presentation of dyspnea, chest pain, hemoptysis, etc. Gunther Tulip retrievable inferior vena cava filter was implanted via femoral venous access or via right internal jugular venous access, which was followed by intravenous transcatheter thrombolysis. Vascular ultrasonography and angiography were performed 45-75 days after the treatment to confirm that there was no fresh or free thrombus in the veins of lower limb or in the pulmonary arteries. When it was confirmed, Gunther Tulip retrievable inferior vena cava filter was taken out via right internal jugular venous access, which was followed by inferior venacavography. After the procedure anticoagulation and antibiotic medication were employed for 3-5 days. A follow-up for 4-10 months was made. Results: A total of 36 Gunther Tulip retrievable inferior vena cava filters were successfully implanted by one procedure, the average time cost for the filter delivery was 1.5 minutes (0.5-5 minutes). During the delivery procedure, the amplitude of elastic displacement of filter was less than 2 mm. One

  1. Analysing Temporally Annotated Corpora with CAVaT

    CERN Document Server

    Derczynski, Leon

    2012-01-01

    We present CAVaT, a tool that performs Corpus Analysis and Validation for TimeML. CAVaT is an open source, modular checking utility for statistical analysis of features specific to temporally-annotated natural language corpora. It provides reporting, highlights salient links between a variety of general and time-specific linguistic features, and also validates a temporal annotation to ensure that it is logically consistent and sufficiently annotated. Uniquely, CAVaT provides analysis specific to TimeML-annotated temporal information. TimeML is a standard for annotating temporal information in natural language text. In this paper, we present the reporting part of CAVaT, and then its error-checking ability, including the workings of several novel TimeML document verification methods. This is followed by the execution of some example tasks using the tool to show relations between times, events, signals and links. We also demonstrate inconsistencies in a TimeML corpus (TimeBank) that have been detected with CAVaT...

  2. A Predictive Model of High Shear Thrombus Growth.

    Science.gov (United States)

    Mehrabadi, Marmar; Casa, Lauren D C; Aidun, Cyrus K; Ku, David N

    2016-08-01

    The ability to predict the timescale of thrombotic occlusion in stenotic vessels may improve patient risk assessment for thrombotic events. In blood contacting devices, thrombosis predictions can lead to improved designs to minimize thrombotic risks. We have developed and validated a model of high shear thrombosis based on empirical correlations between thrombus growth and shear rate. A mathematical model was developed to predict the growth of thrombus based on the hemodynamic shear rate. The model predicts thrombus deposition based on initial geometric and fluid mechanic conditions, which are updated throughout the simulation to reflect the changing lumen dimensions. The model was validated by comparing predictions against actual thrombus growth in six separate in vitro experiments: stenotic glass capillary tubes (diameter = 345 µm) at three shear rates, the PFA-100(®) system, two microfluidic channel dimensions (heights = 300 and 82 µm), and a stenotic aortic graft (diameter = 5.5 mm). Comparison of the predicted occlusion times to experimental results shows excellent agreement. The model is also applied to a clinical angiography image to illustrate the time course of thrombosis in a stenotic carotid artery after plaque cap rupture. Our model can accurately predict thrombotic occlusion time over a wide range of hemodynamic conditions. PMID:26795978

  3. Leiomiossarcoma da veia cava inferior: relato de caso

    Directory of Open Access Journals (Sweden)

    Rafael Lemos Nascif

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clínico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame físico constatou-se massa abdominal palpável. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogêneo e íntima relação com a veia cava inferior. Realizou-se ressecção em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  4. Liver trauma and transection of the inferior vena cava

    International Nuclear Information System (INIS)

    CT of a child with severe liver trauma due to a seat belt injury demonstrated avulsion of a portion of the lateral segment of the left lobe of the liver. The location of nondependent extravasated contrast material aided in identification of the visceral fracture site (the sentinel contrast sign). Associated transection of the inferior vena cava was evidenced by hypoatenuating zones adjacent to all the major hepatic veins and vena cava (hepatic perivenous tracking). Recognition of these two signs is important so that the radiologist can help the surgeon select the optimal operative approach. (orig.)

  5. Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

    LENUS (Irish Health Repository)

    Leong, S

    2010-06-19

    BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

  6. Duodenal Perforation Caused by an Inferior Vena Cava Filter

    OpenAIRE

    Bae, Mi Ju; Chung, Sung Woon; Lee, Chung Won; Kim, Sangpil; Song, Seunghwan

    2012-01-01

    The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter.

  7. Duodenal perforation caused by an inferior vena cava filter.

    Science.gov (United States)

    Bae, Mi Ju; Chung, Sung Woon; Lee, Chung Won; Kim, Sangpil; Song, Seunghwan

    2012-02-01

    The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter. PMID:22363914

  8. Acetylcholinesterase and Butyrylcholinesterase Inhibitory Compounds from Corydalis cava (Fumariaceae)

    Czech Academy of Sciences Publication Activity Database

    Chlebek, J.; Macáková, K.; Cahlíková, L.; Kurfürst, Milan; Kuneš, J.; Opletal, J.

    2011-01-01

    Roč. 6, č. 5 (2011), s. 607-610. ISSN 1934-578X Institutional research plan: CEZ:AV0Z40720504 Keywords : corydalis cava * fumariaceae * alzheimer ´s disease Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 1.242, year: 2011

  9. Analysis of Doppler flow spectra of the superior vena cava in a canine model of acute thromboembolic pulmonary hypertension.

    Science.gov (United States)

    Sun, Dan Dan; Chen, Hong Mao; Duan, Yun You; Yuan, Li Jun; Shang, Fu Jun; Liang, Ning Nan; Cao, Wei

    2011-10-01

    We aimed to establish a canine model of acute thromboembolic pulmonary hypertension (ATEPH) and to explore the feasibility of diagnosing pulmonary hypertension (PH) through the Doppler flow spectra of the superior vena cava (SVC). A canine model of ATEPH was developed by infusing thrombus into the right femoral vein. The pulmonary arterial pressure was simultaneously measured via a right heart catheter with the guidance of ultrasound. The maximum systolic peak flow velocity (SPV), ventricular reverse peak flow velocity (VRPV), diastolic peak flow velocity (DPV), and atrial reverse peak flow velocity (ARPV) of the SVC were measured by transthoracic echocardiography. ATEPH was successfully established in 24 dogs (88.9%) with the pulmonary arterial systolic pressure (PASP) greater than 30 mmHg. ARPV increased significantly with the increase of PASP, and was positively correlated with PASP (PSPV larger than 0.8 could be better adopted to identify all the subjects with PH in this study. The Doppler flow spectra of the SVC could be employed to assess the severity of ATEPH.  PMID:21916968

  10. Impact of thrombus aspiration during ST-Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Olivecrona, Göran K; Lagerqvist, Bo; Fröbert, Ole;

    2016-01-01

    analysed the quadruple composite endpoint of cardiovascular death, cardiogenic shock, rehospitalisation for myocardial infarction, or new hospitalisation for heart failure. Furthermore, an extended net-benefit composite endpoint including stent thrombosis, target vessel revascularization or stroke within......-benefit composite endpoint in 12.0 % (436) vs. 13.2 % (479) (HR, 0.90; 95 % CI; 0.79 - 1.03, P = 0.12). Stroke within 30 days occurred in 0.7 % (27) vs. 0.7 % (24) (HR, 0.89; 95 % CI; 0.51-1.54, P = 0.68). CONCLUSIONS: A large and an extended composite endpoint analysis from the TASTE trial did not demonstrate any...... clinical benefit of routine thrombus aspiration during PCI in patients with STEMI. There was no evidence of an increased risk of stroke with thrombus aspiration....

  11. Cocaine-Induced Delayed Myocardial Infarction Complicated by Apical Thrombus.

    Science.gov (United States)

    Khan, Rafay; Arshed, Sabrina; Jehangir, Waqas; Sen, Shuvendu; Yousif, Abdalla

    2016-01-01

    It is well demonstrated in the literature that cocaine use has been well linked to the formation of various forms of acute and chronic cardiovascular problems including but not limited to acute coronary syndromes. However, cocaine has been commonly associated with coronary vasospasms and less commonly with myocardial infarction and the formation of atrial thrombus. Through this case presentation, we illustrate the findings of a 35-year-old gentleman with history of cocaine use presenting with acute coronary syndrome and complicated by thrombus formation. Furthermore, through this report, we illustrate in a patient with no other risk factors and at a young age, how chronic cocaine use or even a history of usage may result in complications even weeks after its consumption. PMID:26668686

  12. Imaging thrombus with radiolabelled monoclonal antibody to platelets

    International Nuclear Information System (INIS)

    Indium-111-hydroxyquinoline labelled platelets, though useful in the detection of thrombus, have not gained widespread use owing to the time and technical skill required for their preparation. A study was therefore conducted evaluating a new method of imaging thrombus with platelets radiolabelled with a 111In labelled monoclonal antibody, P256, directed to the platelet surface glycoprotein complex IIb/IIIa. When the number of receptors occupied by P256 was less than 3% of the total available on the platelet surface platelet function, as assessed by platelet aggregometry, was undisturbed. P256 was radiolabelled with 111In using diethylenetriaminepenta-acetic acid, which achieved a specific activity of 185 MBq (5 mCi)/mg. No impairment of immunoreactivity was detected at this specific activity. Platelets were labelled with radiolabelled monoclonal antibody in vitro in two patients at a receptor occupancy of 6% and in vivo - that is, by direct intravenous injection of P256 - in six patients at a receptor occupancy of 1%. In vivo recovery and biodistribution kinetics suggested that after in vitro labelling platelets were minimally activated. The 111In kinetics recorded after intravenous P256 suggested rapid and efficient radiolabelling of platelets and gave no indication of platelet activation. Of the six patients who received intravenous P256, three had documented thrombus, tow of whom gave positive results on P256 platelet scintigraphy. The third subject had chromic deep venous thrombosis and was scintigraphically negative. Imaging thrombus using a radiolabelled monoclonal antibody directed to platelets appears to offer great potential as a simple, non-invasive approach to the diagnosis of thrombosis. 3 refs. (Author)

  13. Promotion of experimental thrombus formation by the procoagulant activity of breast cancer cells

    International Nuclear Information System (INIS)

    The routine observation of tumor emboli in the peripheral blood of patients with carcinomas raises questions about the clinical relevance of these circulating tumor cells. Thrombosis is a common clinical manifestation of cancer, and circulating tumor cells may play a pathogenetic role in this process. The presence of coagulation-associated molecules on cancer cells has been described, but the mechanisms by which circulating tumor cells augment or alter coagulation remains unclear. In this study we utilized suspensions of a metastatic adenocarcinoma cell line, MDA-MB-231, and a non-metastatic breast epithelial cell line, MCF-10A, as models of circulating tumor cells to determine the thromobogenic activity of these blood-foreign cells. In human plasma, both metastatic MDA-MB-231 cells and non-metastatic MCF-10A cells significantly enhanced clotting kinetics. The effect of MDA-MB-231 and MCF-10A cells on clotting times was cell number-dependent and inhibited by a neutralizing antibody to tissue factor (TF) as well as inhibitors of activated factor X and thrombin. Using fluorescence microscopy, we found that both MDA-MB-231 and MCF-10A cells supported the binding of fluorescently labeled thrombin. Furthermore, in a model of thrombus formation under pressure-driven flow, MDA-MB-231 and MCF-10A cells significantly decreased the time to occlusion. Our findings indicate that the presence of breast epithelial cells in blood can stimulate coagulation in a TF-dependent manner, suggesting that tumor cells that enter the circulation may promote the formation of occlusive thrombi under shear flow conditions

  14. Promotion of experimental thrombus formation by the procoagulant activity of breast cancer cells

    Science.gov (United States)

    Berny-Lang, M. A.; Aslan, J. E.; Tormoen, G. W.; Patel, I. A.; Bock, P. E.; Gruber, A.; McCarty, O. J. T.

    2011-02-01

    The routine observation of tumor emboli in the peripheral blood of patients with carcinomas raises questions about the clinical relevance of these circulating tumor cells. Thrombosis is a common clinical manifestation of cancer, and circulating tumor cells may play a pathogenetic role in this process. The presence of coagulation-associated molecules on cancer cells has been described, but the mechanisms by which circulating tumor cells augment or alter coagulation remains unclear. In this study we utilized suspensions of a metastatic adenocarcinoma cell line, MDA-MB-231, and a non-metastatic breast epithelial cell line, MCF-10A, as models of circulating tumor cells to determine the thromobogenic activity of these blood-foreign cells. In human plasma, both metastatic MDA-MB-231 cells and non-metastatic MCF-10A cells significantly enhanced clotting kinetics. The effect of MDA-MB-231 and MCF-10A cells on clotting times was cell number-dependent and inhibited by a neutralizing antibody to tissue factor (TF) as well as inhibitors of activated factor X and thrombin. Using fluorescence microscopy, we found that both MDA-MB-231 and MCF-10A cells supported the binding of fluorescently labeled thrombin. Furthermore, in a model of thrombus formation under pressure-driven flow, MDA-MB-231 and MCF-10A cells significantly decreased the time to occlusion. Our findings indicate that the presence of breast epithelial cells in blood can stimulate coagulation in a TF-dependent manner, suggesting that tumor cells that enter the circulation may promote the formation of occlusive thrombi under shear flow conditions.

  15. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

    Directory of Open Access Journals (Sweden)

    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  16. Angioplasty of symptomatic high-grade internal carotid artery stenosis with intraluminal thrombus: therapeutic approach

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, A.; Mayol, A. [Seccion de Neurorradiologia Intervencionista, Servicio de Radiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Gil-Peralta, A.; Gonzalez-Marcos, J.R. [Servicio de Neurologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Boza, F. [Servicio de Neurofisiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Ruano, J. [Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain)

    2004-04-01

    Intraluminal thrombus in the internal carotid artery (ICA) is usually found in patients with severe atheromatous stenosis. Having reviewed 300 carotid angioplasties for symptomatic >70% ICA stenosis, we found three patients (1%) with intraluminal thrombus. Conservative treatment with anticoagulants and double antiplatelet coverage can result in lysis of the thrombus without severe risks. Percutaneous transluminal angioplasty and stenting, preferably with distal protection, can be an excellent alternative to carotid endarterectomy. (orig.)

  17. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Emilie M.M. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, P.O. Box 2040, Rotterdam (Netherlands); Department of Radiology, AMC, Amsterdam (Netherlands); Yoo, Albert J. [Texas Stroke Institute, Plano, TX (United States); Beenen, Ludo F.; Majoie, Charles B. [Department of Radiology, AMC, Amsterdam (Netherlands); Berkhemer, Olvert A. [Department of Radiology, AMC, Amsterdam (Netherlands); Department of Neurology, Erasmus MC, Rotterdam (Netherlands); Blanken, Mark D. den; Wismans, Carrie [AMC, Department of Biomedical Engineering and Physics, Amsterdam (Netherlands); Niessen, Wiro J. [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, P.O. Box 2040, Rotterdam (Netherlands); Delft University of Technology, Faculty of Applied Sciences, Delft (Netherlands); Marquering, Henk A. [Department of Radiology, AMC, Amsterdam (Netherlands); AMC, Department of Biomedical Engineering and Physics, Amsterdam (Netherlands); Collaboration: on behalf of the MR CLEAN investigators

    2016-02-15

    Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers. For 132 consecutive patients with acute ischemic stroke, three experts and two trained observers determined thrombus density by placing three standardized regions of interest (ROIs) in the thrombus and corresponding contralateral arterial segment. Subsequently, absolute and relative thrombus densities were determined using either one or three ROIs. Intraclass correlation coefficient (ICC) was determined, and Bland-Altman analysis was performed to evaluate interobserver and intermethod agreement. Accuracy of the trained observer was evaluated with a reference expert observer using the same statistical analysis. The highest interobserver agreement was obtained for absolute thrombus measurements using three ROIs (ICCs ranging from 0.54 to 0.91). In general, interobserver agreement was lower for relative measurements, and for using one instead of three ROIs. Interobserver agreement of trained non-experts and experts was similar. Accuracy of the trained observer measurements was comparable to the expert interobserver agreement and was better for absolute measurements and with three ROIs. The agreement between the one ROI and three ROI methods was good. Absolute thrombus density measurement has superior interobserver agreement compared to relative density measurement. Interobserver variation is smaller when multiple ROIs are used. Trained non-expert observers can accurately and reproducibly assess absolute thrombus densities using three ROIs. (orig.)

  18. Observer variability of absolute and relative thrombus density measurements in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    Thrombus density may be a predictor for acute ischemic stroke treatment success. However, only limited data on observer variability for thrombus density measurements exist. This study assesses the variability and bias of four common thrombus density measurement methods by expert and non-expert observers. For 132 consecutive patients with acute ischemic stroke, three experts and two trained observers determined thrombus density by placing three standardized regions of interest (ROIs) in the thrombus and corresponding contralateral arterial segment. Subsequently, absolute and relative thrombus densities were determined using either one or three ROIs. Intraclass correlation coefficient (ICC) was determined, and Bland-Altman analysis was performed to evaluate interobserver and intermethod agreement. Accuracy of the trained observer was evaluated with a reference expert observer using the same statistical analysis. The highest interobserver agreement was obtained for absolute thrombus measurements using three ROIs (ICCs ranging from 0.54 to 0.91). In general, interobserver agreement was lower for relative measurements, and for using one instead of three ROIs. Interobserver agreement of trained non-experts and experts was similar. Accuracy of the trained observer measurements was comparable to the expert interobserver agreement and was better for absolute measurements and with three ROIs. The agreement between the one ROI and three ROI methods was good. Absolute thrombus density measurement has superior interobserver agreement compared to relative density measurement. Interobserver variation is smaller when multiple ROIs are used. Trained non-expert observers can accurately and reproducibly assess absolute thrombus densities using three ROIs. (orig.)

  19. Counting the platelets: a robust and sensitive quantification method for thrombus formation.

    Science.gov (United States)

    Claesson, Kjersti; Lindahl, Tomas L; Faxälv, Lars

    2016-06-01

    Flow chambers are common tools used for studying thrombus formation in vitro. However, the use of such devices is not standardised and there is a large diversity among the flow chamber systems currently used, and also in the methods used for quantifying the thrombus development. It was the study objective to evaluate a new method for analysis and quantification of platelet thrombus formation that can facilitate comparison of results between research groups. Whole blood was drawn over a collagen patch in commercial Ibid or in-house constructed PDMS flow chambers. Five percent of the platelets were fluorescently labelled and z-stack time-lapse images were captured during thrombus formation. Images were processed in a Python script in which the number of platelets and their respective x-, y- and z-positions were obtained. For comparison with existing methods the platelets were also labelled and quantified using fluorescence intensity and thrombus volume estimations by confocal microscopy. The presented method was found less sensitive to microscope and image adjustments and provides more details on thrombus development dynamics than the methods for measuring fluorescence intensity and thrombus volume estimation. The platelet count method produced comparable results with commercial and PDMS flow chambers, and could also obtain information regarding the stability of each detected platelet in the thrombus. In conclusion, quantification of thrombus formation by platelet count is a sensitive and robust method that enables measurement of platelet accumulation and platelet stability in an absolute scale that could be used for comparisons between research groups. PMID:26842994

  20. Unusual variant of infrarenal duplication of inferior vena cava

    Directory of Open Access Journals (Sweden)

    Ranjan Kumar Sahoo

    2016-01-01

    Full Text Available Infrarenal inferior vena cava (IVC duplication is a rare anomaly. Most of the cases are asymptomatic and are detected incidentally. Prior knowledge of the anomaly is essential for safe procedure by intervention radiologist, retroperitoneal operation, and multi-visceral recovery operation from deceased donor by surgeon. We report a case of infrarenal IVC duplication detected incidentally during contrast-enhanced computed tomography examination of abdomen of a patient presenting with viral hepatitis and mild obstructive jaundice.

  1. Decompression of superior vena cava during bidirectional Glenn shunt

    OpenAIRE

    Kulkarni Venugopal; Mudunuri Ravikiran; Mulavisala Krishnaprasad; Byalal R

    2009-01-01

    Patients undergoing bi-directional Glenn shunt for various congenital anomalies of the heart will have their superior vena cava (SVC) clamped during the procedure. The duration of the procedure is variable, ranging from five to 30 minutes. This can affect the cerebral perfusion due to raised venous pressure [Cerebral blood flow = Mean arterial pressure − (Intracranial pressure + Central venous pressure)]. Shunting away the SVC blood is a well known technique to counter this probl...

  2. Asymptomatic Duodenal Perforation from an Inferior Vena Cava Filter

    OpenAIRE

    Park, Jean R.; Oza, Veeral M; Krishna, Somashekar G

    2014-01-01

    Recent exponential increase in inferior vena cava (IVC) filter placements has led to a higher rate of filter complications. A 46-year-old man with a past history of IVC filter placement for bilateral deep vein thrombosis presented with lower abdominal pain. Imaging studies demonstrated IVC filter strut penetrations into multiple structures. Upper endoscopy confirmed an uncomplicated single IVC filter strut penetration into the duodenal wall. The abdominal pain was determined to be unrelated t...

  3. Double vena cava inferior:A report of three cases

    Institute of Scientific and Technical Information of China (English)

    Isin Ureyen; Zeynep Kestel; Elif Gulsah Sahin; Alper Karalok; Taner Turan; Nurettin Boran; Gokhan Tulunay

    2013-01-01

    Congenital anomalies of the vena cava inferior (VCI) develop as a result of the persistence of the embryonic venous system. The majority of cases is clinically silent and is diagnosed in routine dissection studies, in retroperitoneal surgeries, or through imaging for other reasons. We report three cases with a double VCI. We outline our operative policy, summarize the embryological development of the VCI and present these cases as a reminder of this rare anatomical variation.

  4. Detection by means of CT of inferior vena cava filters

    International Nuclear Information System (INIS)

    Vena cava filters are an excellent tool for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT) of the lower limbs. However, these devices are not entirely free of complications as thrombi can develop inside them, threatening to occlude them completely. The objective of this report is to study the incidence of thrombosis in vena cava filters, as well as their impact on prognosis. We also mention the importance of CT as an imaging technique in the study of this complication. We present 30 patients in whom different filters were implanted and their prospective follow-up by means of CT over a mean follow-up period of 36 months. Chi-square analysis was used to determine whether there was a significant relationship among the complications encountered (p<0,05), and their course over time was studied by means of Kaplan-Meyer curves. Five cases (16%) of complete thrombosis of the filter were observed among patients in whom the Gunther model had been implanted, yielding an index of probability of complete permeability of the inferior vena cava at 13 months of 82%. Thrombi of different degrees (between 5% and 60%) were also observed inside the filter in ten patients (33%) with Gunther, Simon-Nitional and LGM models. Filter thrombosis was not significantly associated with the onset of recurrent PE or of venous disorders involving lower limbs, the relationship between PE and preimplantation presence of inferior vena cava thrombosis was significant (p<0.01). It was also observed that post implantation anti coagulation did not significantly prevent later onset of filter thrombosis. (Author)

  5. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography

    OpenAIRE

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; ZU, MAO-HENG

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS ...

  6. Failure of Femoral Access to Electrophysiological Evaluation Due to Aplasia of the Inferior Vena Cava

    Science.gov (United States)

    Parahuleva, Mariana S.; Burgazli, Mehmet; Soydan, Nedim; Franzen, Wolfgang; Güttler, Norbert; Erdogan, Ali

    2016-01-01

    We report an interesting case of a man with a persistent left superior vena cava (PLSVC) with left azygos vein who underwent electrophysiological evaluation. Further evaluation revealed congenital dilated azygos vein, while a segment connecting the inferior vena cava (IVC) to the hepatic vein and right atrium was missing. The azygos vein drained into the superior vena cava, and the hepatic veins drained directly into the right atrium. The patient did not have congenital anomalies of the remaining thoracoabdominal vasculature. PMID:27257399

  7. Inferior vena cava obstruction and collateral circulation as unusual manifestations of hepatobiliary cystadenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Nikolaos Arkadopoulos; Anneza I Yiallourou; Constantinos Palialexis; Emmanouil Stamatakis

    2013-01-01

    BACKGROUND: Hepatobiliary cystadenocarcinoma represents a rare epithelial malignant tumor derived from the intrahepatic bile duct. METHODS: A 71-year-old woman, who had undergone laparos-copic drainage of a cystic lesion of the right hepatic lobe, was misdiagnosed  as  having  hepatic  echinococcal  disease,  and received intracystic infusion of 95% ethanol four years ago. She was admitted to our hospital for further treatment. RESULTS: Physical  examination  revealed  dilated  superficial veins  across  the  right  abdominal  wall.  After  mapping  the direction of blood flow in these vessels, we assumed that this was a sign of inferior vena cava obstruction. Abdominal ultrasound, computed tomography, magnetic resonance imaging combined with  magnetic  resonance  angiography  showed  a  large  cystic mass in the right upper quadrant and epigastrium, displacing the  adjacent  structures,  adherent  to  the  inferior  vena  cava, which  was  not  patent,  resulting  in  dilation  of  superficial epigastric  veins.  The  patient  underwent  an  exploratory laparotomy.  Total  excision  of  the  huge  mass  measuring  16× 15  cm  was  possible  under  selective  vascular  exclusion  of  the liver. Removal of the tumor resulted in immediate restoration of flow in the inferior vena cava. On the basis of the pathology and findings of immunohistochemical analysis, a hepatobiliary cystadenocarcinoma was diagnosed. CONCLUSIONS: In the present case, hepatobiliary cystadenocar-cinoma was accompanied by dilated superficial venous collaterals due to inferior vena

  8. A new Nitinol stent for use in superior vena cava syndrome

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Midtgaard, Annette; Brenøe, Anne-Sofie;

    2015-01-01

    time of stent deployment. RESULTS: All patients had superior vena cava obstruction and clinical superior vena cava syndrome caused by malignant expansive mediastinal disease (eight patients non-small cell lung cancer and four small cell lung cancer). The technical success with deployment of the stents......AIM: The aim of the study was to assess the early clinical experience with the Zilver Vena stent in treating patients with malignant superior vena cava syndrome. METHODS: Demographic, procedural, and follow-up data of 12 patients (seven women; mean age 69 years) treated for superior vena cava...

  9. Matrix Metalloproteinase 9 (MMP-9 Regulates Vein Wall Biomechanics in Murine Thrombus Resolution.

    Directory of Open Access Journals (Sweden)

    Khanh P Nguyen

    Full Text Available Deep venous thrombosis is a common vascular problem with long-term complications including post-thrombotic syndrome. Post-thrombotic syndrome consists of leg pain, swelling and ulceration that is related to incomplete or maladaptive resolution of the venous thrombus as well as loss of compliance of the vein wall. We examine the role of metalloproteinase-9 (MMP-9, a gene important in extracellular remodeling in other vascular diseases, in mediating thrombus resolution and biomechanical changes of the vein wall.The effects of targeted deletion of MMP-9 were studied in an in vivo murine model of thrombus resolution using the FVB strain of mice. MMP-9 expression and activity significantly increased on day 3 after DVT. The lack of MMP-9 impaired thrombus resolution by 27% and this phenotype was rescued by the transplantation of wildtype bone marrow cells. Using novel biomechanical techniques, we demonstrated that the lack of MMP-9 significantly decreased thrombus-induced loss of vein wall compliance. Biomechanical analysis of the contribution of individual structural components showed that MMP-9 affected the elasticity of the extracellular matrix and collagen-elastin fibers. Biochemical and histological analyses correlated with these biomechanical effects as thrombi of mice lacking MMP-9 had significantly fewer macrophages and collagen as compared to those of wildtype mice.MMP-9 mediates thrombus-induced loss of vein wall compliance by increasing stiffness of the extracellular matrix and collagen-elastin fibers during thrombus resolution. MMP-9 also mediates macrophage and collagen content of the resolving thrombus and bone-marrow derived MMP-9 plays a role in resolution of thrombus mass. These disparate effects of MMP-9 on various aspects of thrombus illustrate the complexity of individual protease function on biomechanical and morphometric aspects of thrombus resolution.

  10. Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation

    Science.gov (United States)

    Makdisi, George; Hashmi, Zubair A.; Wozniak, Thomas C.

    2015-01-01

    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edema, or intracardiac clot formation. Therefore, it is of extreme importance to ensure an adequate left ventricular drainage. Here we present a case of LV thrombus developed while the patient is on central venoarterial (VA) ECMO. PMID:26716054

  11. Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation.

    Science.gov (United States)

    Makdisi, George; Hashmi, Zubair A; Wozniak, Thomas C; Wang, I-Wen

    2015-11-01

    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edema, or intracardiac clot formation. Therefore, it is of extreme importance to ensure an adequate left ventricular drainage. Here we present a case of LV thrombus developed while the patient is on central venoarterial (VA) ECMO. PMID:26716054

  12. Nursing for the catheter thrombolysis to the deep vein and inferior vena cava thrombosis%下肢深静脉合并下腔静脉血栓导管溶栓治疗的护理

    Institute of Scientific and Technical Information of China (English)

    杨云英; 叶思欣; 杨梅

    2015-01-01

    Objective To investigate the use of catheter thrombolysis therapy to the deep vein and inferior vena cava thrombosis and summarize the nursing points. Method Eight patients (13 limbs) deep vein thrombosis with inferior vena cava thrombosis adopted the catheter thrombolysis, under this procedure we did the care including the limbs and thrombolysis, and observed the complications. Result Five patients (9 limbs) had the thrombus completely dissolved, 3 cases (4 limbs) had the partial dissolution of thrombus. Conclusion Holding limb effective position, close observation of the disease and prevention of complications are very important to improve the efficacy for the catheter thrombolysis.%目的:探讨下肢深静脉合并下腔静脉血栓导管溶栓治疗的护理要点。方法对8例(13条患肢)下肢深静脉血栓合并下腔静脉血栓患者采用导管溶栓治疗,此过程做好患肢护理、溶栓护理、病情及并发症观察。结果5例(9条患肢)血栓完全溶解,3例(4条患肢)血栓部分溶解。结论保持患肢有效体位,严密病情观察及并发症的预防,对提高下肢深静脉合并下腔静脉血栓溶栓治疗效果具有重要意义。

  13. Performance of a thrombectomy device for aspiration of thrombus with various sizes based on a computational fluid dynamic modeling.

    Science.gov (United States)

    Soleimani, Sajjad; Dubini, Gabriele; Pennati, Giancarlo

    2016-06-01

    It is important to thoroughly remove the thrombus within the course of aspiration thrombectomy; otherwise, it may lead to further embolization. The performance of the aspiration thrombectomy device with a generic geometry is studied through the computational approach. In order to model the thrombus aspiration, a real left coronary artery is chosen while thrombi with various sizes are located at the bifurcation area of the coronary artery and, depending on the size of the thrombus, it is stretched toward the side branches. The thrombus occupies the artery resembling the blood current obstruction in the coronary vessel similar to the situation that leads to heart attack. It is concluded that the aspiration ability of the thrombectomy device is not linked to the thrombus size; it is rather linked to the aspiration pressure and thrombus age (organized versus fresh thrombus). However, the aspiration time period correlates to the thrombus size. The minimum applicable aspiration pressure is also investigated in this study. PMID:26351782

  14. Thrombus Aspiration during Percutaneous coronary intervention in Acute non-ST-elevation myocardial infarction Study (TAPAS II)-Study design

    NARCIS (Netherlands)

    Kampinga, M. A.; Vlaar, P. J.; Fokkema, M. L.; Gu, Y. L.; Zijlstra, F.

    2009-01-01

    Background and Objective. The Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS) has shown that thrombus aspiration improves myocardial perfusion and clinical outcome compared with conventional primary percutaneous coronary intervention (PCI) i

  15. Atherosclerotic geometries exacerbate pathological thrombus formation poststenosis in a von Willebrand factor-dependent manner

    NARCIS (Netherlands)

    Westein, Erik; Meer, van der Andries D.; Kuijpers, Marijke J.E.; Frimat, Jean-Philippe; Berg, van den Albert; Heemskerk, Johan W.M.

    2013-01-01

    Rupture of a vulnerable atherosclerotic plaque causes thrombus formation and precipitates cardiovascular diseases. In addition to the thrombogenic content of a plaque, also the hemodynamic microenvironment plays a major role in thrombus formation. How the altered hemodynamics around a plaque promote

  16. Tumour thrombus consistency has no impact on survival in patients with renal cell carcinoma.

    Science.gov (United States)

    Gołąbek, T; Przydacz, M; Okoń, K; Kopczyński, J; Bukowczan, J; Sobczyński, R; Curyło, Ł; Gołąbek, K; Curyło, Ł; Chłosta, P

    2016-06-01

    The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up. PMID:27543869

  17. Transcatheter Therapy for a Large Mobile Right Atrial Thrombus and Massive Pulmonary Embolism.

    Science.gov (United States)

    Narang, Akhil; Mediratta, Anuj; Estrada, Jeremy R; Rosenberg, Jonathan; DeCara, Jeanne M; Howell, Michael D; Lang, Roberto M; Paul, Jonathan D; Nathan, Sandeep; Shah, Atman P; Blair, John E

    2016-05-01

    A variety of interventional management approaches exist for the treatment of acute pulmonary embolism (PE). However, when PE is accompanied by residual right heart thrombus, the best therapeutic options are less clear. We describe a novel combined technique of percutaneous aspiration of unstable right atrial thrombus followed by ultrasound-directed thrombolysis of massive PE. PMID:27145056

  18. Successful catheter directed thrombolysis of IVC and renal vein occlusive thrombus.

    LENUS (Irish Health Repository)

    McCarthy, E

    2011-11-01

    Thrombus formation is a recognised complication of IVC filter placement, however IVC and bilateral renal vein occlusion secondary to thrombus is much less common. We present a case of infrahepatic caval and bilateral renal vein occlusion secondary to thrombosis of a suprarenal IVC filter. With progressive clinical deterioration and failure of conservative medical management the patient underwent successful mechanical disruption and catheter directed thrombolysis.

  19. Design and analysis of micro-stirrer for thrombus dissolution

    Science.gov (United States)

    Morita, Minoru; Jiang, Zhongwei; Chijimatsu, Naoki

    2007-12-01

    Thrombus or blood clot may cause cerebral infarction and myocardial infarction if the clot can not be dissolved within several hours after it was formed. The objective of this study is to design a new structure of stirrer for thrombus dissolution. In this paper, to stir the solution with a high viscosity like blood, large amplitude was confirmed to be necessary for the stirrer by the fundamental experiment. For this purpose, shape of the stirrer and type of the actuator were changed, and force and displacement of the stirrer were analyzed. Sine waves with the resonance frequencies of the stirrer (50 V; 571 Hz) were used as the input signals. The performance of the stirrer was simulated by Finite Element Analysis (FEA) to obtain large displacement. Results showed that the amplitude at the tip of stirrer was 100 times larger than the output displacement of the PZT actuator stimulated with the resonance frequency. Concluding this paper, a new type of the micro-stirrer was designed and analyzed by FEA and it was found that the proposed stirrer had a large amplitude with a good input voltage efficiency.

  20. Novel risk predictor for thrombus deposition in abdominal aortic aneurysms

    Science.gov (United States)

    Nestola, M. G. C.; Gizzi, A.; Cherubini, C.; Filippi, S.; Succi, S.

    2015-10-01

    The identification of the basic mechanisms responsible for cardiovascular diseases stands as one of the most challenging problems in modern medical research including various mechanisms which encompass a broad spectrum of space and time scales. Major implications for clinical practice and pre-emptive medicine rely on the onset and development of intraluminal thrombus in which effective clinical therapies require synthetic risk predictors/indicators capable of informing real-time decision-making protocols. In the present contribution, two novel hemodynamics synthetic indicators, based on a three-band decomposition (TBD) of the shear stress signal, are introduced. Extensive fluid-structure computer simulations of patient-specific scenarios confirm the enhanced risk-prediction capabilities of the TBD indicators. In particular, they permit a quantitative and accurate localization of the most likely thrombus deposition in realistic aortic geometries, where previous indicators would predict healthy operation. The proposed methodology is also shown to provide additional information and discrimination criteria on other factors of major clinical relevance, such as the size of the aneurysm.

  1. Mesothelioma with superior vena cava obstruction in young female following short latency of asbestos exposure

    Directory of Open Access Journals (Sweden)

    Anupam Patra

    2015-01-01

    Full Text Available An 18 years female was admitted with right-sided chest pain, dry cough, and low-grade fever and weight loss for last 1 month. On examination, patient had features of superior vena cava (SVC syndrome with right-sided pleural effusion. Chest X-ray showed mediastinal widening with nonhomogenous opacity mainly in the periphery of right upper and mid zone with right-sided pleural effusion. Ultrasonography thorax confirmed mild pleural effusion. Pleural fluid analysis showed lymphocytic, exudative, low adenosine deaminase with negative for Pap smear. Contrast-enhanced computed tomography (CT thorax revealed large extensive nodular soft tissue lesion along right mediastinum as well as costal pleura, with enlarged pretracheal lymphadenopathy and SVC obstruction. CT guided Tru-cut biopsy report came as malignant epithelial tumor with polygonal shape, abundant eosinophilic cytoplasm and nuclei with prominent nucleoli suggestive of mesothelioma of epithelioid type. The tumor cell expressed calretinin, WT-1, and immunonegative for thyroid transcription factor-1.

  2. Retrievable stent filter placement for the treatment of budd-chiari syndrome complicated with inferior vena cava thrombosis: its mid-term results

    International Nuclear Information System (INIS)

    Objective: To investigate the mid-term efficacy of retrievable stent filter placement for the treatment of Budd-Chiari syndrome (BCS) complicated with inferior vena cava (IVC) thrombosis. Methods: Eight patients of BCS complicated with IVC thrombosis were enrolled in this study. IVC thrombosis included segmental occlusion (n = 2) and membranous occlusion (n = 6). In all patients, the IVC was re-canalized by using blunt wire after anticoagulation and thrombolytic therapy, then, the re-canalized site was expanded with small balloon, which was followed by the placement of retrievable stent filter, and, finally, IVC size was dilated with larger balloon. Anticoagulation and thrombolytic therapy was given after the procedure. And all the retrievable stent filters were withdrawn from the IVC through internal jugular vein when the thrombus in IVC was dissolved. In patients with segmental occlusion of IVC, in addition to the placement of retrievable stent filter a 'Z' type vessel stent was also placed during the same interventional session. Follow-up examination with color Doppler sonography was conducted in all patients. Results: Technical success was achieved in all 8 patients without pulmonary infarction or other complications both during and after the operation. Immediately after the thrombus completely disappeared, the retrievable stent filter was successfully taken out in all patients. During a following-up period of 3-12 months, color Doppler sonographs showed that the IVC remained patent in 6 patients and had a recurrence of stenosis in 2 patients. Conclusion: Placement of retrievable stent filter is a safe and effective treatment for BCS complicated with IVC thrombosis. (authors)

  3. Ectopic Triggers of Superior Vena Cava in Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Jayasree Pillarisetti MD

    2009-04-01

    Full Text Available Superior vena cava (SVC triggers constitute 6- 8% of non-pulmonary vein (PV foci that initiate atrial fibrillation (AF.1 Since SVC cardiomyocytes originate from the right sinus horn they possess enhanced automacity and after-depolarization leading to arrhythmogenicity.2 In a recent study by Arruda et al. 12% of patients had SVC triggers and empiric adjunctive isolation of SVC-right atrium along with PVisolation resulted in higher long term success rate than the group that underwent PVI alone. They demonstrated that adjunctive isolation of SVC along with PV isolation (PVI is a safe and feasible strategy for ablation of AF.

  4. A Novel Technique for Inferior Vena Cava Filter Extraction

    Energy Technology Data Exchange (ETDEWEB)

    Johnston, Edward William, E-mail: ed.johnston@doctors.org.uk; Rowe, Luke Michael Morgan; Brookes, Jocelyn; Raja, Jowad; Hague, Julian, E-mail: julian.hague@uclh.nhs.uk [University College Hospital, Multidisciplinary Endovascular Team (United Kingdom)

    2013-05-02

    Inferior vena cava (IVC) filters are used to protect against pulmonary embolism in high-risk patients. Whilst the insertion of retrievable IVC filters is gaining popularity, a proportion of such devices cannot be removed using standard techniques. We describe a novel approach for IVC filter removal that involves snaring the filter superiorly along with the use of flexible forceps or laser devices to dissect the filter struts from the caval wall. This technique has used to successfully treat three patients without complications in whom standard techniques failed.

  5. Vena cava agenesi kan vise sig som inkarcereret lyskebrok

    DEFF Research Database (Denmark)

    Safir-Hansen, Kristina; Achiam, Michael Patrick

    The case describes a 45-year-old man with a rare finding of vena cava agenesia presented as incarcerated groin hernia. From childhood the patient had developed dilatation of subcutaneous veins with establishment of aneurismal dilatation in the lower right side of the abdomen and groin. The patient...... was submitted with severe abdominal pain in the lower right side. The case describes the difficulties of an initially incorrect radiological diagnosis of incarcerated groin hernia and the discrepancy of the clinical findings. The case stresses the importance of a thorough evaluation of each patient....

  6. Retrievable Inferior Vena Cava Filters for Venous Thromboembolism

    International Nuclear Information System (INIS)

    Inferior vena cava (IVC) filters are used as an alternative to anticoagulants for prevention of fatal pulmonary embolism (PE) in venous thromboembolic disorders. Retrievable IVC filters have become an increasingly attractive option due to the long-term risks of permanent filter placement. These devices are shown to be technically feasible in insertion and retrieval percutaneously while providing protection from PE. Nevertheless, there are complications and failed retrievals with these retrievable filters. The aim of the paper is to review the retrievable filters and their efficacy, safety, and retrievability

  7. Inferior Vena Cava Duplication: Incidental Case in a Young Woman.

    Science.gov (United States)

    Coco, Danilo; Cecchini, Sara; Leanza, Silvana; Viola, Massimo; Ricci, Stefano; Campagnacci, Roberto

    2016-01-01

    A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures. PMID:27217964

  8. Radiological evaluation of inferior vena cava obstruction: pictorial essay

    International Nuclear Information System (INIS)

    The clinical diagnosis of inferior vena cava (IVC) obstruction is often difficult, since patients may present with a multitude of signs and symptoms. The clinical manifestations depend on several factors: the underlying cause, the level of obstruction, the adequacy of collateral circulation, the presence of intercurrent disease, and the organ system involved. Although the most common clinical manifestations are deep venous thrombosis in the legs, abdominal pain, low back pain, loin pain and hematuria, patients may present with unusual and varied pathologic conditions. IVC obstruction may resemble or be associated with such conditions as congestive cardiac failure, cirrhosis of the liver or renal disease. (author)

  9. Estudi i millora d'una planta productora de cava

    OpenAIRE

    Boza Macías, Marta

    2008-01-01

    El present projecte té com a objectiu principal l’automatització d’una part del procés productiu del cava. Concretament, la millora que es desitja realitzar consisteix en la instal·lació d’un autòmat programable que controli l’emplenat i buidat dels dipòsits d’emmagatzematge. Aquest control es realitzarà utilitzant sensors capacitius, encarregats de controlar els nivells, tant alt com baix, dels citats dipòsits. A part de controlar en tot moment l’estat en que es troben les ...

  10. Síndrome de veia cava superior Superior vena cava syndrome

    Directory of Open Access Journals (Sweden)

    SAMUEL ZUÍNGLIO DE BIASI CORDEIRO

    2002-09-01

    Full Text Available A obstrução ao fluxo sanguíneo na VCS e suas manifestações clínicas têm hoje como causa principal o câncer de pulmão. A história relata que no século XVIII a sífilis e a tuberculose eram responsáveis por 40% dos casos conhecidos. O conhecimento das alterações hemodinâmicas compreendidas nesta síndrome assim como a apuração das técnicas de diagnóstico de imagem e de citopatologia permitem hoje que o médico possa tratar de seu paciente com mais segurança e conforto do que há 10 anos. A TC contrastada e a RM auxiliam no diagnóstico de localização da obstrução e técnicas mais antigas como a cavografia puderam ser abandonadas. O diagnóstico de obstrução da VCS e o estudo por Doppler realizado à beira do leito em muito contribuem para a realização de procedimentos de desobstrução como a angioplastia transluminal percutânea nos casos de trombose ou estenose do vaso. Também a utilização de próteses como PTFE é de importância fundamental na condução de casos de lesão traumática da VCS durante cirurgias para câncer pulmonar ou mediastinal. No campo da radioterapia, a técnica de fracionamento permite que altas doses de irradiação sejam administradas aos pacientes portadores de neoplasias malignas, com benefícios em 70% dos casos.Lung cancer is now the main cause of blood flow obstruction in the superior vena cava and of its clinical manifestations. History tells that in the 18th Century, syphilis and tuberculosis were responsible for 40% of the known cases. The knowledge of hemodynamic changes seen in this syndrome and the improvement of diagnostic and cytopathologic techniques allow for a safer and more comfortable treatment of the patient than 10 years ago. Contrast CT and MR added to the identification and location of the obstruction, and older techniques such as cavography could be abandoned. SVC obstruction diagnosis and Doppler studies carried out at the bed of the patient contribute to

  11. Ausência de veia cava inferior: relato de caso Absence of the inferior vena cava: case report

    Directory of Open Access Journals (Sweden)

    Elton Correia Alves

    2010-12-01

    Full Text Available A ausência congênita de veia cava inferior é achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razão de a maioria dos pacientes sem outras malformações serem assintomáticos, há dificuldade em estimar a prevalência dessas anomalias. O objetivo deste trabalho foi relatar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de tórax devido a quadro de febre alta (39ºC não-responsiva à medicação. Radiografia de tórax sugeriu dilatação de veia ázigos. Em inquérito dirigido para sintomas cardiovasculares, referiu dor torácica (durante atividade física e em repouso e dispneia ocasionais durante o sono associada ao período em que intensificou a prática de exercícios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas não esclareceram o caso, fazendo-se necessário angiotomografia, a qual evidenciou ausência de veia cava inferior torácica.The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-year-old patient, male, referred to thorax X-ray due to high fever state (39ºC, nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  12. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    International Nuclear Information System (INIS)

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  13. Left ventricular thrombus formation after acute myocardial infarction as assessed by cardiovascular magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Delewi, Ronak [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Interuniversity Cardiology Institute of the Netherlands (Netherlands); Nijveldt, Robin [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hirsch, Alexander [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Marcu, Constantin B.; Robbers, Lourens [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Hassell, Marriela E.C.J.; Bruin, Rianne H.A. de; Vleugels, Jim; Laan, Anja M. van der; Bouma, Berto J. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Tio, René A. [Thorax Center, University Medical Center Groningen, Groningen (Netherlands); Tijssen, Jan G.P. [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Rossum, Albert C. van [Department of Cardiology, VU University Medical Center, Amsterdam (Netherlands); Zijlstra, Felix [Thorax Center, Department of Cardiology, Erasmus University Medical Center, Rotterdam (Netherlands); Piek, Jan J., E-mail: j.j.piek@amc.uva.nl [Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands)

    2012-12-15

    Introduction: Left ventricular (LV) thrombus formation is a feared complication of myocardial infarction (MI). We assessed the prevalence of LV thrombus in ST-segment elevated MI patients treated with percutaneous coronary intervention (PCI) and compared the diagnostic accuracy of transthoracic echocardiography (TTE) to cardiovascular magnetic resonance imaging (CMR). Also, we evaluated the course of LV thrombi in the modern era of primary PCI. Methods: 200 patients with primary PCI underwent TTE and CMR, at baseline and at 4 months follow-up. Studies were analyzed by two blinded examiners. Patients were seen at 1, 4, 12, and 24 months for assessment of clinical status and adverse events. Results: On CMR at baseline, a thrombus was found in 17 of 194 (8.8%) patients. LV thrombus resolution occurred in 15 patients. Two patients had persistence of LV thrombus on follow-up CMR. On CMR at four months, a thrombus was found in an additional 12 patients. In multivariate analysis, thrombus formation on baseline CMR was independently associated with, baseline infarct size (g) (B = 0.02, SE = 0.02, p < 0.001). Routine TTE had a sensitivity of 21–24% and a specificity of 95–98% compared to CMR for the detection of LV thrombi. Intra- and interobserver variation for detection of LV thrombus were lower for CMR (κ = 0.91 and κ = 0.96) compared to TTE (κ = 0.74 and κ = 0.53). Conclusion: LV thrombus still occurs in a substantial amount of patients after PCI-treated MI, especially in larger infarct sizes. Routine TTE had a low sensitivity for the detection of LV thrombi and the interobserver variation of TTE was large.

  14. Medical image of the week: persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Hammode E

    2014-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 19 year old man with acute lymphocytic leukemia was admitted to the ICU with septic shock. Due to areas of cellulitis on the right side of the chest and neck and femoral venous thrombi, a left subclavian central access was attempted. The chest x-ray obtained after line placement is shown below (Figure 1. Blood gas done from the line was consistent with venous blood and venous tranduction was seen. A CT of the chest (Figure 2 confirmed the diagnosis of persistent left superior vena cava (PLSVC. A persistent left superior vena cava is the most common congenital thoracic venous anomaly, seen in 0.3-0.5% of the population (1. Incidence is increased in patients with congenital heart disease to 5%. In most patients a right sided SVC is also present; hence the term SVC duplication has also been used. Embryologically a PLSVC is formed when the left anterior cardinal vein is ...

  15. Advanced Techniques for Removal of Retrievable Inferior Vena Cava Filters

    Energy Technology Data Exchange (ETDEWEB)

    Iliescu, Bogdan; Haskal, Ziv J., E-mail: ziv2@mac.com [University of Maryland School of Medicine, Division of Vascular and Interventional Radiology (United States)

    2012-08-15

    Inferior vena cava (IVC) filters have proven valuable for the prevention of primary or recurrent pulmonary embolism in selected patients with or at high risk for venous thromboembolic disease. Their use has become commonplace, and the numbers implanted increase annually. During the last 3 years, in the United States, the percentage of annually placed optional filters, i.e., filters than can remain as permanent filters or potentially be retrieved, has consistently exceeded that of permanent filters. In parallel, the complications of long- or short-term filtration have become increasingly evident to physicians, regulatory agencies, and the public. Most filter removals are uneventful, with a high degree of success. When routine filter-retrieval techniques prove unsuccessful, progressively more advanced tools and skill sets must be used to enhance filter-retrieval success. These techniques should be used with caution to avoid damage to the filter or cava during IVC retrieval. This review describes the complex techniques for filter retrieval, including use of additional snares, guidewires, angioplasty balloons, and mechanical and thermal approaches as well as illustrates their specific application.

  16. Free floating left atrial ball thrombus: a rare cause of stroke.

    Science.gov (United States)

    Rider, Oliver J; Malhotra, Aneil; Newton, James D

    2013-10-01

    In the setting of mitral valve stenosis and atrial fibrillation, left atrial ball thrombus is a rare but recognized cause of stroke and can occur even in the presence of therapeutic anticoagulation. This case report highlights the need for echocardiography to rule out treatable cardioembolic substrates for stroke. We report a case of cardioembolic stroke as a result of free floating left atrial ball thrombus presenting as a complication of rheumatic mitral valve disease. This case highlights that, in all patients with a history of structural heart disease, atrial fibrillation, or rheumatic fever, prompt cardiac ultrasound to exclude free floating atrial thrombus is essential. PMID:22959106

  17. Distal migration of a floating carotid thrombus in a patient using oral contraceptives: a case report

    Directory of Open Access Journals (Sweden)

    Watanabe Masaki

    2009-07-01

    Full Text Available Abstract Introduction We report the case of a patient with distal migration of a floating carotid thrombus caused by oral contraceptives. Case presentation A 48-year-old woman using oral contraceptives suffered from dysarthria and gait disturbance. Examinations, including ultrasound and cerebral arteriogram, revealed a floating thrombus at the left carotid bifurcation with no stenosis. Despite antithrombotic therapy, the floating carotid thrombus migrated to the ipsilateral middle cerebral artery, resulting in a severe stroke. Conclusion Some floating thrombi are resistant to conservative therapy and have a risk of distal migration, which may cause a major stroke in the acute stage.

  18. Playing games with a thrombus: a dangerous match. Paradoxical embolism from a huge central venous cathether thrombus: a case report

    Directory of Open Access Journals (Sweden)

    Mariana Sylvie

    2010-03-01

    Full Text Available Abstract Thromboembolism is a major cause of death in cancer patients. The association between paraneoplastic hypercoagulability of oncological patients and long-term central venous catheters (CVC may result in CVC associated thrombosis. Patent Foramen Ovale (PFO, especially when associated with atrial septal aneurysm (ASA is a risk factor for paradoxical embolism. We report a case of paradoxical embolism with stroke in an oncological patient with a huge CVC thrombus playing "ping-pong" with an hypermobile ASA with a PFO. We review the management of hypercoagulability in oncologic patients and discuss the potential role of routine transthoracic echocardiography before the implantation of long term central venous catheters to identify predisposing conditions to paradoxical embolism and select patients for anticoagulant therapy.

  19. Simon nitinol vena cava filters: effectiveness and complications; Simon Nitinol-Vena-cava-Filter: Wirksamkeit und Komplikationen

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, F.; Thurnher, S.; Lammer, J. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria). Abt. fuer Angiographie und Interventionelle Radiologie

    2001-10-01

    Purpose: The aim of this retrospective analysis was to evaluate the clinical safety and effectiveness of the simon nitinol inferior vena cava filter (SNF) for prevention of pulmonary embolism. Patients and Methods: 117 patients (63 male, 54 female; aged 58.38 {+-} 14.59 years) underwent percutaneous implantation of an SNF from 1993 through 1999. Patient reports were retrospectively analysed for complications during and after implantation and deep venous thrombosis (DVT) and pulmonary embolism before and after implantation. Helical-CT with contrast media and plain abdominal radiography were performed on 35 patients, helical-CT alone on two patients. We checked the position and configuration of the SNF and looked for a perforation of the filter legs through the wall of the inferior vena cava (IVC). The IVC and deep pelvic veins were analysed for patency. Results: During implantation 10 of 117 (9%) patients had minor complications, major complications were reported in 0.9% (1/117). There was no significant increase in thrombosis of the deep pelvic veins and the IVC after implantation. Pulmonary re-embolism (PE) was documented in 9 out of 117 patients (7.7%). One out of the 35 examined patients (2.9%) showed a single strut fracture of the SNF. Tilting more than 15 was seen in 7 out of 37 patients (19%). Dislocation of the SNF more than 10 mm occurred in one out of 35 patients (2.9%), perforation through the wall of the IVC in all 37 patients. We found no occlusion of the IVC. (orig.) [German] Ziel: Das Ziel dieser Arbeit war, in einer retrospektiven Analyse die Sicherheit und Effektivitaet des simon nitinol vena cava filters (SNF) zu untersuchen. Patienten und Methoden: Zwischen 1993 und 1999 wurde bei 117 Patienten (63 Maenner, 54 Frauen; 58,38 Jahre {+-} 14,59 Jahre) ein SNF perkutan in die vena cava inferior (VCI) implantiert. Retrospektiv wurden die Krankengeschichten aller 117 Patienten studiert und auf Komplikationen in Bezug auf den SNF sowie auf neu

  20. Difference in left renal vein pressure: an indicator for free of reconstruction after ligation in retroperitoneal tumor patients

    OpenAIRE

    Chengli Miao; Mengmeng Xiao; Tengyan Li; Gang Liu; Xing Liu; Yue Kong; Chenghua Luo

    2015-01-01

    We hypothesized that the left renal vein pressure difference (ΔP) before and after the ligation can serve as an objective indicator for free of reconstruction after resection of a retroperitoneal tumor with renal segment of inferior vena cava and right kidney. After established a model of left renal vein compression, 45 miniature pigs were operated on experimental procedures including renal segment of inferior vena cava resection, right nephrectomy, and left renal vein ligation. The ΔPs of le...

  1. Inferior vena cava leiomyosarcoma confirmed by catheter suction biopsy during digital subtraction angiography.

    Science.gov (United States)

    Wei, Ning; Xu, Xiang-Dong; Xu, Hao; Zu, Mao-Heng

    2014-01-01

    Leiomyosarcoma of vascular origin is a rare disease and most cases arise in the inferior vena cava. Inferior vena cava leiomyosarcoma (IVCLMS) usually presents in females in their sixth decade of life. The clinical symptoms are often non-specific and the diagnosis is often delayed. Current imaging techniques can accurately differentiate inferior vena cava neoplasms from other non-neoplastic lesions. However, definitive diagnosis of IVCLMS needs histologic evidence. We report a case of IVCLMS in a 61-year old Chinese woman. This is the first IVCLMS case confirmed by catheter suction biopsy during digital subtraction angiography. PMID:25232438

  2. Intracardiac thrombus in Behçet's disease: Two case reports

    Directory of Open Access Journals (Sweden)

    Brahem Radhia

    2005-07-01

    Full Text Available Abstract Intracardiac thrombus in Behçet's disease is an extremely rare manifestation. We report two such cases. A 20-year-old man presented with dyspnoea, cough and haemoptysis. Right heart thrombus associated with pulmonary artery aneurysm and thromboembolism was identified by helical CT and transoesophageal echocardiography. The second case was a 29-year-old male admitted for fever and chest pain. A diagnosis of right atrial thrombosis associated with pulmonary embolism and hyperhomocysteinemia was made. Due to the absence of haemodynamic compromise, medical management consisting of immunosupressive and anticoagulation therapy was adopted which resulted in complete dissolution of the thrombus with dramatic clinical improvement in both cases of clinical status. Conclusion intracardiac thrombus is a rare complication of Behçet's disease. As shown in our patients, medical treatment should be considered as the first line.

  3. Usefulness of Thrombus Aspiration for the Treatment of Coronary Stent Thrombosis

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Vlaar, Pieter J.; van den Heuvel, Ad F. M.; Hillege, Hans L.; Zijlstra, Felix; de Smet, Bart J. G. L.

    2011-01-01

    Current treatment for coronary stent thrombosis (ST) often lacks satisfactory results and clinical outcome is poor. We investigated the impact of manual thrombus aspiration during percutaneous coronary intervention (PCI) on myocardial reperfusion and clinical outcome in patients with angiographicall

  4. No-Reflow Phoenomenon by Intracoronary Thrombus in Acute Myocardial Infarction

    OpenAIRE

    Lim, Sang Yup

    2016-01-01

    Recently, percutaneous coronary intervention has been the treatment of choice in most acute myocardial infarction cases. Although the results of percutaneous coronary interventions have ben good, the no-reflow phenomenon and distal embolization of intracoronary thrombus are still major problems even after successful interventions. In this article, we will briefly review the deleterious effects of no-reflow and distal embolization of intracoronary thrombus during percutaneous coronary interven...

  5. Methods to Determine the Lagrangian Shear Experienced by Platelets during Thrombus Growth

    Science.gov (United States)

    Pinar, Isaac P.; Arthur, Jane F.; Andrews, Robert K.; Gardiner, Elizabeth E.; Ryan, Kris; Carberry, Josie

    2015-01-01

    Platelets can become activated in response to changes in flow-induced shear; however, the underlying molecular mechanisms are not clearly understood. Here we present new techniques for experimentally measuring the flow-induced shear rate experienced by platelets prior to adhering to a thrombus. We examined the dynamics of blood flow around experimentally grown thrombus geometries using a novel combination of experimental (ex vivo) and numerical (in silico) methodologies. Using a microcapillary system, platelet aggregate formation was analysed at elevated shear rates in the presence of coagulation inhibitors, where thrombus formation is predominantly platelet-dependent. These approaches permit the resolution and quantification of thrombus parameters at the scale of individual platelets (2 μm) in order to quantify real time thrombus development. Using our new techniques we can correlate the shear rate experienced by platelets with the extent of platelet adhesion and aggregation. The techniques presented offer the unique capacity to determine the flow properties for a temporally evolving thrombus field in real time. PMID:26660525

  6. Optical coherence tomography assessment and quantification of intracoronary thrombus: Status and perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Porto, Italo, E-mail: italo.porto@gmail.com [Interventional Cardiology Unit, San Donato Hospital, Arezzo (Italy); Mattesini, Alessio; Valente, Serafina [Interventional Cardiology Unit, Careggi Hospital, Florence (Italy); Prati, Francesco [Interventional Cardiology San Giovanni Hospital, Rome (Italy); CLI foundation (Italy); Crea, Filippo [Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome (Italy); Bolognese, Leonardo [Interventional Cardiology Unit, San Donato Hospital, Arezzo (Italy)

    2015-04-15

    Coronary angiography is the “golden standard” imaging technique in interventional cardiology and it is still widely used to guide interventions. A major drawback of this technique, however, is that it is inaccurate in the evaluation and quantification of intracoronary thrombus burden, a critical prognosticator and predictor of intraprocedural complications in acute coronary syndromes. The introduction of optical coherence tomography (OCT) holds the promise of overcoming this important limitation, as near-infrared light is uniquely sensitive to hemoglobin, the pigment of red blood cells trapped in the thrombus. This narrative review will focus on the use of OCT for the assessment, evaluation and quantification of intracoronary thrombosis. - Highlights: • Thrombotic burden in acute coronary syndromes Is not adequately evaluated by standard coronary angiography, whereas Optical Coherence Tomography is exquisitely sensitive to the hemoglobin contained in red blood cells and can be used to precisely quantify thrombus. • Both research and clinical applications have been developed using the OCT-based evaluation of thrombus. In particular, whereas precise quantification scores are useful for comparing antithrombotic therapies in randomized trials, both pharmacological and mechanical, the most important practical applications for OCT-based assessment of thrombus are the individuation of culprit lesions in the context of diffuse atheromata in acute coronary syndromes, and the so-called “delayed stenting” strategies. • Improvements in 3D rendering techniques are on the verge of revolutionizing OCT-based thrombus assessment, allowing extremely precise quantification of the thrombotic burden.

  7. Bilirubin Levels and Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction.

    Science.gov (United States)

    Hamur, Hikmet; Duman, Hakan; Bakirci, Eftal Murat; Kucuksu, Zafer; Demirelli, Selami; Kalkan, Kamuran; Degirmenci, Husnu

    2016-07-01

    We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] µmol/L, P ≤ .001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤ .001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] µmol/L, P ≤ .001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤ .001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤ .001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI. PMID:26339042

  8. Methods to Determine the Lagrangian Shear Experienced by Platelets during Thrombus Growth.

    Directory of Open Access Journals (Sweden)

    Isaac P Pinar

    Full Text Available Platelets can become activated in response to changes in flow-induced shear; however, the underlying molecular mechanisms are not clearly understood. Here we present new techniques for experimentally measuring the flow-induced shear rate experienced by platelets prior to adhering to a thrombus. We examined the dynamics of blood flow around experimentally grown thrombus geometries using a novel combination of experimental (ex vivo and numerical (in silico methodologies. Using a microcapillary system, platelet aggregate formation was analysed at elevated shear rates in the presence of coagulation inhibitors, where thrombus formation is predominantly platelet-dependent. These approaches permit the resolution and quantification of thrombus parameters at the scale of individual platelets (2 μm in order to quantify real time thrombus development. Using our new techniques we can correlate the shear rate experienced by platelets with the extent of platelet adhesion and aggregation. The techniques presented offer the unique capacity to determine the flow properties for a temporally evolving thrombus field in real time.

  9. Abnormal draining of great cardiac vein into superior vena cava

    International Nuclear Information System (INIS)

    Full text: A 47-year-old man presented with atypical chest pain in last three months. Physical examination findings were normal. ECG showed normal sinus rhythm. Transthoracic echocardiography revealed normal left and right ventricular systolic functions. ECG gated coronary CT angiography was performed. The patient's coronary CT angiography showed normal coronary arteries, however the great cardiac vein course was abnormal. The course of the vein was not in atrioventicular groove, bypassing the coronary sinus and draining to superior vena cava. The coronary sinus of patient is formed by posterior marginal vein, middle cardiac vein and lateral marginal vein and drained into the right atrium. We also observed subtle myocardial bridges on coronary arteries. Myocardial bridges appeared to explain patient's chest pain. With optimal medical therapy, the patient's symptoms resolved

  10. Simon nitinol vena cava filters: effectiveness and complications

    International Nuclear Information System (INIS)

    Purpose: The aim of this retrospective analysis was to evaluate the clinical safety and effectiveness of the simon nitinol inferior vena cava filter (SNF) for prevention of pulmonary embolism. Patients and Methods: 117 patients (63 male, 54 female; aged 58.38 ± 14.59 years) underwent percutaneous implantation of an SNF from 1993 through 1999. Patient reports were retrospectively analysed for complications during and after implantation and deep venous thrombosis (DVT) and pulmonary embolism before and after implantation. Helical-CT with contrast media and plain abdominal radiography were performed on 35 patients, helical-CT alone on two patients. We checked the position and configuration of the SNF and looked for a perforation of the filter legs through the wall of the inferior vena cava (IVC). The IVC and deep pelvic veins were analysed for patency. Results: During implantation 10 of 117 (9%) patients had minor complications, major complications were reported in 0.9% (1/117). There was no significant increase in thrombosis of the deep pelvic veins and the IVC after implantation. Pulmonary re-embolism (PE) was documented in 9 out of 117 patients (7.7%). One out of the 35 examined patients (2.9%) showed a single strut fracture of the SNF. Tilting more than 15 was seen in 7 out of 37 patients (19%). Dislocation of the SNF more than 10 mm occurred in one out of 35 patients (2.9%), perforation through the wall of the IVC in all 37 patients. We found no occlusion of the IVC. (orig.)

  11. A rare case of left superior vena cava draining into left atrium demonstrated by MDCT.

    Science.gov (United States)

    Ardilouze, Paul; Bricot, Vincent; Maurel, Christophe; Christiaens, Luc

    2009-01-01

    We describe a rare case of persistent left superior vena cava draining directly into the left atrium with no associated anomaly of the coronary sinus or the atrial septum, discovered by multidetector computed tomography. PMID:17692952

  12. Temporary vena cava filter for the thrombolytic treatment of venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To study the value of the temporary vena cava filter in the prevention of ectopic embolism formation in cases with thrombolytic therapy of venous thrombosis. Methods: Of 11 patients, 10 suffered from venous thrombosis of lower limb and 1 from thrombosis of right internal jugular vein with persistent truncus arteriosus were treated by inserting permanent or temporary vena cava filter via median vein. Results: In all 11 case control of symptoms followed this treatment occurred 7 to 15 days, thrombi were completely or partly dissolute, the blood vessels re-canalized, and finally removed the temporary vena cava filter. There were no complication and ectopic emboli related to thrombolytic therapy. Conclusions: The observation indicated that temporary vena cava filter insertion is safe and effective to prevent ectopic embolism in thrombolytic therapy of venous thrombosis

  13. Potential application of labeled antibodies for thrombus detection

    International Nuclear Information System (INIS)

    Labeling platelets with monoclonal antibodies in whole blood for imaging thrombi is less cumbersome than the established 111In-oxine method. 7E3, a murine monoclonal antibody directed against glycoprotein IIb and/or IIIa on both human and dog platelets was used to label canine platelets. Thrombi were induced by transcatheter placement of a copper coil followed by electrocoagulation. 7E3 was iodinated with 131I and labelled with 111In using 7E3-DTPA conjugate. Whole blood was incubated with 0.5 - 1.0 μg labeled 7E3/mL blood. In 4/4 dogs, experimental deep vein thrombi were identified using both 131I-and 111In-labeled 7E3 within 5-30 min after injection. For both isotopes, 1 h blood clearance was 54 + - 9%. In 1/3 dogs, experimental coronary thrombus could be identified ex vivo at 4 h. Clot to blood ratios ranged between 7 to 13:1. Using the 111In-oxine method, 0/3 coronary thrombi were seen. Thus, 131I-and 111In-labeled 7E3 may be used to readily identify peripheral venous thrombi. For reliable and prompt identification of coronary thrombi, more rapid clearance of the labeled platelets is required. (author)

  14. A novel technique to remove inferior vena cava filters using a homemade snare device.

    Science.gov (United States)

    Singh, Kuldeep; Zia, Saqib; Khan, Muhammad Asad; Marco, Sean; Hill, David

    2014-01-01

    The need to retrieve inferior vena cava filters is quite evident due to the long-term complications. We present a novel technique to remove inferior vena cava filters using a homemade snare created using a looped a 0.014-inch semistiff wire. Employing this technique, 18 consecutive retrievable filters were removed. All filters were easily snared on the very first attempt, and no complications occurred. Our novel technique to retrieve filters is efficient, safe, and cost-effective. PMID:26992977

  15. Living donor liver transplantation in the absence of inferior vena cava: a case report.

    Science.gov (United States)

    Hatipoglu, S; Olmez, A; Ozgor, D; Kayaalp, C; Yilmaz, S

    2012-01-01

    Because of difficulties in the supply of cadaveric organs, of living donor liver transplantations are performed in increasing numbers. Congenital hepatic fibrosis associated with fibrosis and atrophy of the inferior vena cava were present in a potential recipient of living donor liver transplantation. This case report documented living donor liver transplantation as a treatment modality for a patient with absence of the inferior vena cava due to chronic liver failure. PMID:22841266

  16. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    OpenAIRE

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-01-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas.

  17. Anatomy of the ostia venae hepaticae and the retrohepatic segment of the inferior vena cava.

    Science.gov (United States)

    Camargo, A M; Teixeira, G G; Ortale, J R

    1996-02-01

    In 30 normal adult livers the retrohepatic segment of inferior vena cava had a length of 6.7 cm and was totally encircled by liver substance in 30% of cases. Altogether 442 ostia venae hepaticae were found, averaging 14.7 per liver and classified as large, medium, small and minimum. The localisation of the openings was studied according to the division of the wall of the retrohepatic segment of the inferior vena cava into 16 areas. PMID:8655416

  18. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    OpenAIRE

    Sakir Ongun; Sermin Coban; Abdullah Katgi; Funda Obuz; Aykut Kefi

    2014-01-01

    A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosi...

  19. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide

    OpenAIRE

    Korkmaz, Levent; Acar, Zeydin; Dursun, İhsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-01-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheter...

  20. Tratamento cirúrgico da síndrome da veia cava superior causado por timoma invasivo Surgical treatment of superior vena cava syndrome caused by invasive thymoma

    OpenAIRE

    George Ronald Soncini da Rosa; Ney Takizawa; Douglas Schimidt; Mitur Sugita

    2010-01-01

    Paciente do sexo masculino, branco, 57 anos, portador de síndrome da veia cava superior havia 3 meses, devido a timoma invasivo em mediastino médio e anterior, levando a comprometimento da veia cava superior intrínseca e extrinsecamente. Após avaliação por tomografia computadorizada e angiorressonância magnética de tórax, o paciente foi submetido à ressecção radical do timoma - derivação venosa da veia subclávia esquerda para átrio direito, com tubo de PTFE (politetrafluoroetileno). Relevante...

  1. Topology of the fibrinolytic system within the mural thrombus of human abdominal aortic aneurysms.

    Science.gov (United States)

    Houard, X; Rouzet, F; Touat, Z; Philippe, M; Dominguez, M; Fontaine, V; Sarda-Mantel, L; Meulemans, A; Le Guludec, D; Meilhac, O; Michel, J-B

    2007-05-01

    Development and progression of acquired abdominal aortic aneurysms (AAAs) involve proteolytic activity. In the present study, we investigate the distribution of fibrinolytic system components within mural thrombi of human AAAs. 20 mural thrombi and the remaining AAA walls were dissected. The luminal, intermediate and abluminal thrombus layers, and media and adventitia were separately incubated in cell culture medium. Conditioned media were then analysed for plasminogen activators (PAs), plasminogen activator inhibitor-1 (PAI-1), free-plasmin, plasmin alpha(2)-antiplasmin complexes (PAPs) and D-dimers release. In parallel, PA and PAI-1 mRNA expression analysis was performed by RT-PCR. The study was completed by immunohistochemical localization of these components in AAA, ex vivo functional imaging using (99m)Tc-aprotinin as a ligand and measurement of PAP and D-dimer plasma levels. All fibrinolytic system components were present in each aneurysmal layer. However, the mural thrombus was the main source of active serine-protease release. Interestingly, the luminal layer of the thrombus released greater amounts of PAPs and D-dimers. This paralleled the preferential immunolocalization of plasminogen and PAs, and the (99m)Tc-aprotinin scintigraphic signal observed in the luminal pole of the thrombus. In contrast, mRNA expression analysis showed an exclusive synthesis of tPA and PAI-1 within the wall, whereas uPA mRNA was also expressed within the thrombus. Taken together, these results suggest that the increased plasma concentrations of PAPs and D-dimers found in AAA patients are related to mural thrombus proteolytic activity, thus explaining their known link with AAA progression. Components of the fibrinolytic system could also represent a target for functional imaging of thrombus activities in AAA. PMID:17352452

  2. Safety of primary percutaneous coronary intervention with and without (selective) thrombus aspiration

    International Nuclear Information System (INIS)

    Objective: To determine the safety and efficacy of selective thrombus aspiration during Primary Percutaneous Coronary Intervention (PCI). Methods: This observational prospective study was conducted in the catheterization laboratory of a tertiary care cardiovascular centre. A total of 150 consecutive patients who underwent primary PCI were enrolled. Aspiration was done only when thrombus burden was considered significant. After completion of procedure angiographic and electrocardiographic signs were recorded and clinical follow up was documented up to 1 year. Results: No significant difference among the groups was found in age, height, weight and other risk factors like Hypertension, Diabetes Mellitus and Smoking. In general, left anterior descending artery was culprit in 65 % of patients and more than 90 % of culprit vessels had visible thrombus. Multivessel disease was present in 38 % of patients and 22.7% had past history of myocardial infarction. Out of 150 patients 117 (78%) underwent thrombus aspiration. No significant difference was found in ST resolution within 60 minutes (72.6 vs 81.8 %; P<0.285) and myocardial blush grade II and III (41.9 vs 27.3 %; P<0.128). No difference in event free survival was observed among the two groups (80.3 vs 84.8 %; P<0.708) at one year. Conclusion: Selective thrombus aspiration in definite thrombus laden arteries and no aspiration in low or negligible thrombus burden vessels may be a safe and effective strategy in patients undergoing primary PCI. Overall poor risk profile of our patients as compared to western population necessitates further evaluation of this matter in randomized studies. (author)

  3. A case of bilateral superior vena cava with variations in the azygos system and in the heart.

    Science.gov (United States)

    Ortale, J R; Grill, E H

    1994-08-01

    A case of bilateral superior vena cava is described in an adult cadaver of undetermined sex and age. The persistent left superior vena cava had a larger diameter approximately equal to that of the right superior vena cava ending in a wide caliber coronary sinus. Variations in the azygos system were also found. The ventricles show thin walls with trabeculae carneae forming one to five strata in the left ventricle, and from one to three strata in the right ventricle. PMID:8085654

  4. PATHOPHYSIOLOGY STROKE NON-HEMORRHAGIC ET CAUSA THROMBUS

    Directory of Open Access Journals (Sweden)

    Aji Kristianto Wijaya

    2013-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Stroke is one of the most common cause of death worldwide and the third leading cause of death in the United States. Stroke composed 90,000 deaths of women and 60,000 men each year. In Indonesia, 8 of 1000 people suffered a stroke. Stroke is divided into two, non-hemorrhagic stroke and hemorrhagic stroke. Most of them (80% is non-hemorrhagic stroke. Non-hemorrhagic stroke can be caused by thrombi or emboli. Understanding the pathophysiology of non-hemorrhagic stroke caused by a thrombus is very important in regard with providing appropriate patient management. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  5. Platelet receptor interplay regulates collagen-induced thrombus formation in flowing human blood.

    Science.gov (United States)

    Siljander, Pia R-M; Munnix, Imke C A; Smethurst, Peter A; Deckmyn, Hans; Lindhout, Theo; Ouwehand, Willem H; Farndale, Richard W; Heemskerk, Johan W M

    2004-02-15

    The platelet glycoproteins (GPs) Ib, integrin alpha(2)beta(1), and GPVI are considered central to thrombus formation. Recently, their relative importance has been re-evaluated based on data from murine knockout models. To examine their relationship during human thrombus formation on collagen type I fibers at high shear (1000 s(-1)), we tested a novel antibody against GPVI, an immunoglobulin single-chain variable fragment, 10B12, together with specific antagonists for GPIb alpha (12G1 Fab(2)) and alpha(2)beta(1) (6F1 mAb or GFOGER-GPP peptide). GPVI was found to be crucial for aggregate formation, Ca(2+) signaling, and phosphatidylserine (PS) exposure, but not for primary adhesion, even with more than 97% receptor blockade. Inhibiting alpha(2)beta(1) revealed its involvement in regulating Ca(2+) signaling, PS exposure, and aggregate size. Both GPIb alpha and alpha(2)beta(1) contributed to primary adhesion, showing overlapping function. The coinhibition of receptors revealed synergism in thrombus formation: the coinhibition of adenosine diphosphate (ADP) receptors with collagen receptors further decreased adhesion and aggregation, and, crucially, the complete eradication of thrombus formation required the coinhibition of GPVI with either GPIb alpha or alpha(2)beta(1). In summary, human platelet deposition on collagen depends on the concerted interplay of several receptors: GPIb in synergy with alpha(2)beta(1) mediating primary adhesion, reinforced by activation through GPVI, which further regulates the thrombus formation. PMID:14563646

  6. A thrombus susceptibility comparison of two pulsatile Penn State 50 cc left ventricular assist device designs.

    Science.gov (United States)

    Navitsky, Michael A; Deutsch, Steven; Manning, Keefe B

    2013-01-01

    Left ventricular assist devices (LVADs) have proven successful as bridge to transplant devices for patients awaiting donor organs. While survival rates continue to increase, destination therapy remains hindered by thrombus formation within the device. Research has shown that thrombosis is correlated to the fluid dynamics within the device and may be a result of sustained shear rates below 500 s(-1) on the polyurethane blood sac used in the Penn State pulsatile LVAD. Particle image velocimetry is used to compare flow within two 50 cc LVAD designs to assess fluid patterns and quantify wall shear rates in regions known from in vivo studies to be susceptible to thrombus formation. The two designs differ in their front face geometry. The V-1 model has an outward-facing "dome" whereas the face of the V-2 model is flat. A thrombus susceptibility metric, which uses measured wall shear rates and exposure times, was applied to objectively compare pump designs over the entire cardiac cycle. For each design, there are regions where wall shear rates remained below 500 s(-1) for the entire cardiac cycle resulting in high thrombus susceptibility potential. Results of this study indicate that the V-2 device had an overall lower propensity for thrombus formation in the current region of interest. PMID:22825798

  7. Endovascular Treatment of Phlegmasia Cerulea Dolens with Impending Venous Gangrene: Manual Aspiration Thrombectomy as the First-Line Thrombus Removal Method

    International Nuclear Information System (INIS)

    Purpose: Our purpose was to report the outcome of endovascular treatment with manual aspiration thrombectomy as the first-line thromboablative method for phlegmasia cerulea dolens. Methods: Between October 2006 and May 2010, seven consecutive patients (5 women, 2 men; age range, 31–80 years) with the diagnosis of phlegmasia cerulea dolens secondary to acute iliofemoral deep venous thrombosis had endovascular treatment with manual aspiration thrombectomy. Catheter-directed thrombolysis and stent placement were used as adjunctive procedures. Phlegmasia was left-sided in five and right-sided in two patients. Results: All patients had associated great saphenous vein thrombosis in addition to iliofemoral deep vein thrombosis (DVT). Aspiration thrombectomy completely removed the thrombus from the popliteal vein to the inferior vena cava (IVC) in all cases. Three patients with May-Thurner syndrome had stent placement in the left common iliac vein. Two patients had early recurrences. Repeated aspiration thrombectomy was unsuccessful in one patient. There were no complications related to the procedure. One patient who had been successfully treated died of sepsis and another patient who had unsuccessful repeated interventions had below-the-knee amputation. Overall, the clinical success and survival rates of patients in this study were 86%. On follow-up, three patients with successful treatment were asymptomatic with no deep venous insufficiency. One of these patients died during the 4-month follow-up period. Two patients had mild ankle swelling with deep venous insufficiency. Conclusions: Manual aspiration thrombectomy with adjunctive use of catheter-directed thrombolysis and stent placement is an effective endovascular treatment method with high clinical success and survival rates for phlegmasia cerulean dolens.

  8. Radiographic evaluation of caudal vena cava size in dogs

    International Nuclear Information System (INIS)

    Dilation of the caudal vena cava (CVC) on lateral thoracic radiographs is often interpreted as suggestive of right-sided congestive heart failure, To quantitate the clinical utility of evaluating CVC size as an indicator of right-sided heart disease, we compared the ratio of the diameter of the CVC as measured on a left lateral thoracic radiograph to the descending aorta (Ao), length of the thoracic vertebra above the tracheal bifurcation (VL), and width of the right fourth rib (R4) in 35 dogs with right heart disease and 35 control dogs, Each CVC ratio(CVC/Ao, CVC/VL, CVC/R4) was statistically larger in dogs with right heart disease, Response operating characteristic curves and likelihood ratios were used to determine ratios helpful in identifying dogs with right heart disease. A CVC/Ao > 1.50, CVC/VL > 1.30, or CVC/R4 > 3.50 are strongly suggestive of a right-sided heart abnormality in a patient

  9. Mesoaortic entrapment of a left inferior vena cava

    International Nuclear Information System (INIS)

    A persistent left inferior vena cava (IVC) is a rare anomaly, with a reported incidence of only 0.2-0.5%. When present, it courses between the superior mesenteric artery and the aorta to continue as the right IVC, similar to the course of a left renal vein (LRV). This anomaly is usually asymptomatic, but there may be vague abdominal complaints if the IVC is compressed in the mesoaortic angle. Although symptomatic compression of the LRV (anterior nutcracker syndrome) is well recognized, there has been only one report in the literature of a similar compression of a persistent left IVC. Because of its rarity, this anomaly may be missed or mistaken for other conditions on imaging. An accurate diagnosis is crucial as the presence of this anomaly may have implications for surgical treatment of aortic lesions or placement of an IVC filter. Magnetic resonance angiography and, more recently, multidetector computed tomography scan, can provide an exquisite three-dimensional demonstration of vascular abnormalities

  10. Inferior vena cava filter placement in orthopedic surgery.

    Science.gov (United States)

    Bass, Anne R; Mattern, Christopher J; Voos, James E; Peterson, Margaret G E; Trost, David W

    2010-09-01

    Inferior vena cava (IVC) filters were developed for the treatment of venous thromboembolism but in high-risk patients are often used for prophylaxis instead. In the study reported here, we reviewed all the orthopedic surgery cases in which IVC filters were used at our institution in 2005. Charts were analyzed and patients contacted by telephone for long-term follow-up. IVC filters were used in 90 (0.96%) of the 9,348 inpatient orthopedic surgeries. Sixty-one percent of filters were placed for prophylaxis, though only 42% of patients with prophylactic filters had a contraindication to anticoagulation. Eighty-one percent of patients with prophylactic filters who received anticoagulation received warfarin. Ratios of prophylactic-to-treatment filters were 3.25 for fracture surgeries, 2.1 for arthroplasties, and 0.89 for spine surgeries. Five percent of patients with prophylactic filters developed deep vein thrombosis. Fifty-two percent of filters were retrievable, but only 40% of those were removed a mean of 5.1 months (SD, 3.9 months) after placement. Filter removal was associated with complications in 11% of patients, and in another 10% the filter could not be removed. Forty-one patients were contacted a mean of 21 months (SD, 3 months) after filter placement. Only 32% of those who still had filters were on anticoagulation at follow-up. PMID:21290021

  11. Inferior vena cava filters: What radiologists need to know

    International Nuclear Information System (INIS)

    Inferior vena cava (IVC) filters are a controversial mechanical adjunct in the prevention of pulmonary embolism, the most serious result of venous thromboembolism. Despite modern IVC filters being in clinical use for more than 45 years, there is still uncertainty amongst many radiologists about the indications for IVC filter placement and their removal, particularly the more recent prophylactic use in patients without confirmed deep vein thrombosis (DVT) or pulmonary embolism (PE). Recently published guidelines on filter use from the National Institute of Health and Clinical Excellence (NICE) and other professional bodies are discussed. The vast majority of IVC filters in the UK are inserted by interventional radiologists, so radiologists may be the first point of contact for information requested by other clinicians. The increasing use of filters means that radiologists will encounter filters increasingly often during abdominal cross-sectional imaging. Awareness of common filter-related complications, such as tilting, thrombosis, and caval perforation, is useful to reassure or alert other clinicians. The potential role of filters in upper extremity DVT and requirement for concomitant anticoagulation is discussed

  12. Collateral circulation in ferrets (Mustela putorius) during temporary occlusion of the caudal vena cava.

    Science.gov (United States)

    Calicchio, Kristina W; Bennett, R Avery; Laraio, Leonard C; Weisse, Chick; Zwingenberger, Allison L; Rosenthal, Karen L; Johnston, Matthew S; Campbell, Vicki L; Solomon, Jeffrey A

    2016-05-01

    OBJECTIVE To determine whether extent of collateral circulation would change during temporary occlusion of the caudal vena cava (CVC) in ferrets (Mustela putorius), a pressure change would occur caudal to the occlusion, and differences would exist between the sexes with respect to those changes. ANIMALS 8 adult ferrets (4 castrated males and 4 spayed females). PROCEDURES Ferrets were anesthetized. A balloon occlusion catheter was introduced through a jugular vein, passed into the CVC by use of fluoroscopy, positioned cranial to the right renal vein, and inflated for 20 minutes. Venography was performed 5 and 15 minutes after occlusion. Pressure in the CVC caudal to the occlusion was measured continuously. A CBC, plasma biochemical analysis, and urinalysis were performed immediately after the procedure and 2 or 3 days later. RESULTS All 8 ferrets survived the procedure; no differences were apparent between the sexes. Vessels providing collateral circulation were identified in all ferrets, indicating blood flow to the paravertebral venous plexus. Complications observed prior to occlusion included atrial and ventricular premature contractions. Complications after occlusion included bradycardia, seizures, and extravasation of contrast medium. Mean baseline CVC pressure was 5.4 cm H2O. During occlusion, 6 ferrets had a moderate increase in CVC pressure (mean, 24.3 cm H2O) and 2 ferrets had a marked increase in CVC pressure to > 55.0 cm H2O. CONCLUSIONS AND CLINICAL RELEVANCE Caval occlusion for 20 minutes was performed in healthy ferrets with minimal adverse effects noted within the follow-up period and no apparent differences between sexes. The CVC pressure during occlusion may be prognostic in ferrets undergoing surgical ligation of the CVC, which commonly occurs during adrenal tumor resection. PMID:27111022

  13. Synthetic thrombus model for in-vitro studies of laser thrombolysis

    Science.gov (United States)

    Hermes, Robert E.; Trajkovska, Keti

    1998-05-01

    Laser thrombolysis is the controlled ablation of a thrombus (blood clot) blockage in a living arterial system. Theoretical modeling of the interaction of laser light with thrombi relies on the ability to perform in vitro experiments with well characterized surrogate materials. A synthetic thrombus formulation may offer more accurate results when compared to in vivo clinical experiments. We describe here the development of new surrogate materials based on formulations incorporating chicken egg, guar gum, modified food starch, and a laser light absorbing dye. The sound speed and physical consistency of the materials were very close to porcine (arterial) and human (venous) thrombi. Photographic and videotape recordings of pulsed dye laser ablation experiments under various experimental conditions were used to evaluate the new material as compared to in vitro tests with human (venous) thrombus. The characteristics of ablation and mass removal were similar to that of real thrombi, and therefore provide a more realistic model for in vitro laser thrombolysis when compared to gelatin.

  14. Metastatic Melanoma to the Pancreas with a Thrombus in the Splenic Vein and Superior Mesenteric Vein: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Seong Sook; Kim, Jung Hoon; Kwon, Kui Hyang; Choi, Duek Lin; Park, Sung Tae; Kim, Yong Jae; Goo, Dong Erk; Hwang, Jung Hwa [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2009-11-15

    Metastatic melanoma to the pancreas has been observed infrequently, and the presence of a thrombus in the splenic vein and superior mesenteric vein has rarely been seen for metastatic melanoma. We present the CT and MRI findings of a case of metastatic melanoma to the pancreas, which presented with diffuse multiple pancreatic metastatic nodules and a venous thrombus.

  15. Metastatic Melanoma to the Pancreas with a Thrombus in the Splenic Vein and Superior Mesenteric Vein: A Case Report

    International Nuclear Information System (INIS)

    Metastatic melanoma to the pancreas has been observed infrequently, and the presence of a thrombus in the splenic vein and superior mesenteric vein has rarely been seen for metastatic melanoma. We present the CT and MRI findings of a case of metastatic melanoma to the pancreas, which presented with diffuse multiple pancreatic metastatic nodules and a venous thrombus

  16. Severe reversible dilated cardiomyopathy associated with a large left ventricular thrombus in a young child with middle aortic syndrome

    OpenAIRE

    Ponniah, U; Overholt, E

    2014-01-01

    this article reports a case of a seven-year girl who presented with severe dilated cardiomyopathy (DCM) associated with a large thrombus in the left ventricle (LV). She had a long segment stenosis of the lower thoracic descending aorta, possibly due to non-specific aortitis and underwent successful stent angioplasty. The LV thrombus resolved after heparin without sequelae.

  17. Neuroimaging findings in neonates and infants from superior vena cava obstruction after cardiac operation

    International Nuclear Information System (INIS)

    Extraventricular obstructive hydrocephalus may develop after superior vena cava obstruction, an uncommon complication after cardiac surgery.Objective. To describe the neuroimaging findings in neonates and infants with superior vena cava thrombosis after cardiac surgery for congenital heart disease.Materials and methods. Between 1993 and 2001, 333 neonates and infants in our hospital underwent cardiac surgery, of whom 13 (3.9%) subsequently acquired superior vena cava syndrome. Eleven of these 13 children (7 boys, 4 girls) were evaluated by head ultrasound and computed tomography scans.Results. One child had normal findings on head ultrasound, and 10 children had extraventricular obstructive hydrocephalus (EVOH). In 6 children, aggravation of the hydrocephalus was noted up to 11.4 months after cardiac surgery; in 3 of them, the hydrocephalus was shunted to the peritoneum. One child had thrombosis of the dural sinuses, and 1 had hemorrhagic infarction. Two children died during follow-up.Conclusion. EVOH is a common complication of superior vena cava thrombosis, and head ultrasound should be performed in all neonates and infants with superior vena cava thrombosis after cardiac surgery. Long-term follow-up is needed, as the hydrocephalus may worsen even months after surgery. (orig.)

  18. The limitation of MRA reconstruction imaging evaluating intraluminal thrombus on endovascular exclusion for abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    Objective: To investigate the effect of pitfall MRA reconstruction imaging without intraluminal thrombus on endovascular exclusion for abdominal aortic aneurysm. Methods: Comparing the MRA reconstruction imaging with the MRA cross-section imaging, all of 22 patients underwent endovascular exclusion from Jan 2002 to Oct 2002 were included. Results: Intraluminal thrombus possessed the merit of clinical treatment, otherwise would mislead the evaluation of the procedure. Conclusions: It is important to use MRA reconstruction imaging evaluating abdominal aortic aneurysm combining MRA cross-section imaging

  19. A comparison of radiolabelled agents for thrombus imaging using a rabbit model

    International Nuclear Information System (INIS)

    The quantitative uptakes of five potential thrombus-localizing radiopharmaceuticals in experimental thrombi of the rabbit jugular vein have been compared to assist with the selection of a thrombus imaging agent for clinical use. Three hours after injection, 111In-platelets were clearly the agent of choice but at 18 h sup(99m)Tc-fibrinogen had more favourable characteristics. Both agents were superior to sup(99m)Tc-plasmin or its acyl derivatives, including sup(99m)Tc-streptokinase-activated anisoylplasminogen. The ease of preparation coupled with favourable biological properties suggest that sup(99m)Tc-fibrinogen should be of value in the clinical situation. (author)

  20. Novel use of the AngioVac® system to remove thrombus during simultaneous extracorporeal membrane oxygenation life support.

    Science.gov (United States)

    Griffith, Kevin E; Jenkins, Eric; Copenhaver, William; Williams, David M

    2016-03-01

    Extracorporeal membrane oxygenation (ECMO) was introduced to clinical medicine over 40 years ago. While initially used as a treatment for acute respiratory failure in infants, the use of ECMO has grown to include respiratory and circulatory failure in both children and adults, cardiogenic shock, pulmonary embolism, sepsis, trauma, malignancy, pulmonary hemorrhage and as a treatment for hypothermic drowning.(1) Recent technological improvements in ECMO circuitry make it possible to minimize anticoagulation of the ECMO patient, decreasing the incidence of bleeding. Thrombus deposition within the ECMO circuit can be a life-threating complication. ECMO circuit thrombus can be contained in the circuit, adherent to cannula and deposited within the patient. The ability to remove thrombus while the patient remains on ECMO support could be a life-saving measure for some patients. The present case report outlines use of the AngioVac(®) thrombus removal system in concert with ECMO to remove a large thrombus adherent to an ECMO cannula. PMID:26034197

  1. Pituitary Tumors

    Science.gov (United States)

    ... Tumors Oligoastrocytoma Oligodendroglioma Pineal Tumor Pituitary Tumor PNET Schwannoma Risk Factors Brain Tumor Facts Brain Tumor Dictionary ... Tumors Oligoastrocytoma Oligodendroglioma Pineal Tumor Pituitary Tumor PNET Schwannoma Risk Factors Brain Tumor Facts Brain Tumor Dictionary ...

  2. Thrombus aspiration in patients with large anterior myocardial infarction : A Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia trial substudy

    OpenAIRE

    Calais, Fredrik; Lagerqvist, Bo; Leppert, Jerzy; James, Stefan K; Frobert, Ole

    2016-01-01

    Background The TASTE trial did not demonstrate clinical benefit of thrombus aspiration (TA). High-risk patients might benefit from TA. Methods The TASTE trial was a multicenter, randomized, controlled, open-label trial obtaining end points from national registries. Patients (n = 7,244) with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) were randomly assigned 1: 1 to TA and PCI or to PCI alone. We assessed the 1-year clinical effect of T...

  3. Evaluation of the superior vena cava system in children with digital subtraction angiography

    International Nuclear Information System (INIS)

    The authors report a new pediatric application of digital subtraction angiography (DSA) that is the evaluation of the superior vena cava system. 22 children have been explored. All of them had a history of previous central venous catheter placement for parenteral nutrition (13), hemodialysis (5), chemotherapy or antibiotic therapy (4). The aim of the examination was to obtain a venous mapping before a new catheter placement (14 cases) or to look for a venous thrombosis origin of superior vena cava syndrom or septicemia (8 cases). Except failure of two examinations because of absence of venous injection site, DSA showed thrombosis of one vein in 7 cases and of multiple veins in 11 cases. A pulmonary embolus was also discovered. The authors conclude that this non invasive method yields very valuable information on superior vena cava system

  4. Temporary Inferior Vena Cava Filters: How Do We Move Forward?

    Science.gov (United States)

    Arous, Edward J; Messina, Louis M

    2016-05-01

    Despite their widespread use, the indications for the selective use of temporary inferior vena cava (IVC) filters remains uncertain with few trials supporting their use. Additionally, the risks of long-term temporary IVC filter insertion are being increasingly discussed amongst the mainstream media and through multiple class action lawsuits. Retrievable IVC filters were specifically designed to have a less secure implantation in order to facilitate retrieval. However, multiple reports have demonstrated significant filter-related complications, most commonly related to duration of implantation. Furthermore, the risk is not isolated to one manufacturer alone. The incidence of filter-related complications is linearly related to its duration of time on the market. Currently, the FDA recommends that IVC filters be removed within 25-54 days of their implantation. Unfortunately, little evidence exists to show that this recommendation is followed routinely. Recently, the PRESERVE Trial (NCT02381509) was initiated as a multicenter non-randomized open label study to determine the safety and effectiveness of commercially available IVC filters (both temporary and permanent) in individuals who require mechanical prophylaxis against pulmonary embolism. Until such evidence is developed, temporary IVC filters should be implanted based on best available evidence and routinely removed within the guidelines of the FDA of 25-54 days. A fair question at this point is whether the design features themselves that are required to manufacture a low profile removable IVC filter can achieve effective prophylaxis against pulmonary embolism at a low rate of short and long-term complications. PMID:27012891

  5. Determinants of survival after inferior vena cava trauma.

    Science.gov (United States)

    Kuehne, J; Frankhouse, J; Modrall, G; Golshani, S; Aziz, I; Demetriades, D; Yellin, A E

    1999-10-01

    Inferior vena cava (IVC) injuries continue to be associated with mortality rates of 21 to 66 per cent despite advances in prehospital, surgical, and critical care. The purpose of this study was to evaluate outcome of patients with IVC injury after treatment at a major urban trauma center and to identify factors predictive of survival. Between 1989 and 1995, 158 patients presented to the Los Angeles County + University of Southern California Medical Center with IVC injuries. One hundred thirty-six patient records were available for review, and 69 data points were collected and analyzed. Mean age was 26 years (range, 6-54), and 122 (90%) patients were male. Mechanism of injury included gunshot in 88 (65%) patients, stab in 23 (17%) patients, shotgun in 7 (5%) patients, and blunt trauma in 18 (13%) patients. The mean Injury Severity Score was 25. Seventy (52%) patients were hypotensive. Eleven (8%) patients died before surgical intervention, and 25 (18%) patients died before operative repair. Repair (79), ligation (20), or observation (1) was accomplished in 100 (74%) patients. Overall survival was 48 per cent and 65 per cent in the 100 patients surviving to operative repair, including 5 of 20 patients requiring IVC ligation. Significant differences (Pthoracotomy, blood loss, level of injury, tamponade, and associated aortic injury. Logistic regression analysis identified hypotension, anatomic level of injury, and associated aortic injury as significant predictors of outcome (P = 0.001). Survival is predominantly determined by severity and anatomic accessibility of the IVC injury and by the absence of associated major vascular injuries. Ligation may control otherwise exsanguinating injuries and should be considered early in the management of complex injuries. PMID:10515547

  6. Endovascular stenting for the management of port-a-cath associated superior vena cava syndrome.

    Science.gov (United States)

    Kostopoulou, Vasiliki; Tsiatas, Marinos L; Kelekis, Dimitrios A; Dimopoulos, Meletios-Athanasios; Papadimitriou, Christos A

    2009-03-01

    Port-a-cath systems are often essential for the administration of long-term chemotherapy in the treatment of malignancies because they improve venous access, but they are associated with complications, mainly thrombosis of central veins. In the present report, we describe a case of right subclavian and superior vena cava port-a-cath-related thrombosis causing superior vena cava syndrome (SVCS) in a patient affected by Hodgkin's disease. The patient underwent percutaneous revascularization with stent positioning, experiencing immediate relief of symptoms. Endovascular procedures for the treatment of nonmalignant SVCS seem to represent a challenging therapeutic option. PMID:18322718

  7. Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

    Directory of Open Access Journals (Sweden)

    Christian Steinberg

    2013-01-01

    Full Text Available Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

  8. Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic

    Directory of Open Access Journals (Sweden)

    Sakir Ongun

    2014-01-01

    Full Text Available A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.

  9. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma.

    Science.gov (United States)

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-05-01

    Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patients whose condition is unstable in the setting of blunt thoracic trauma regardless of imaging conclusions. PMID:27106431

  10. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma

    OpenAIRE

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-01-01

    International audience Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patien...

  11. Animal experimental study of safety for a self-made vena cava stent-filter

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety of a self-made vena cava stent-filter(VCSF)for prevention of pulmonary embolism. Methods: Fusiform unmhrella-like vena cava filter was made of Nitinol wires and stainless steel metal pole, and then ten mongrel dogs were implanted with these self-made filters and divided into 5 groups according to the different periods (2, 3, 4, 5 and 6 w) of filter placement, with 2 dogs in each group. After the VCSFs were placed in inferior vena cava via the right femoral vein approach, the dogs in each group were bred for 2-6 weeks, respectively. The blood flow of inferior vena cava and the position of the filters were inspected by inferior vena-cavography according to the indwelling periods. Finally the metal pole was retrieved via the femoral vein, leaving the VCSF as permanent venousz stent. The feasibility of retrieval and the free state of filter net with the adhering vascular wall were evaluated. Laparotomies were performed to remove the inferior vena cava from the animals for gross and electron microscopic examinations of the inferior vena cava intimal changes of the involved segment. Results: All 10 VCSFs were placed at the right positions of the dogs successfully. Angiography showed patent inferior vena cava without filter thrombosis at 2-6 weeks. There were no tilting and migration of the filter and all the metal poles were successfully retrieved. The superior and inferior extremities of filter nets could be set free with all the filters turning into venous stents. Postmortem displayed retroperitoneal hemorrhage and caval thrombosis. The barbs of the filters penetrated over the caval adventitial coat. Under electron microscope, a thin layer of neointima already covered the braiding net of VCSFs at 2 weeks after the deployment. The tunica intima became slightly thick at 3-4 weeks and with moderate proliferation at 5-6 weeks. Conclusions: The self-made vena cava stent-filter possesses rather long indwelling period according to the

  12. Acute ischaemic stroke secondary to a mobile thrombus in the common carotid artery - case report

    Directory of Open Access Journals (Sweden)

    Bajkó Zoltán

    2015-04-01

    Full Text Available A mobile thrombus in the carotid arteries is a very rare ultrasonographic finding and is usually diagnosed after a neurological emergency, such as a transient ischemic attack or cerebral infarction. We present the case of a 54-year-old man with vascular risk factors (a heavy smoker, untreated hypertension who was admitted to the emergency unit with right sided hemiparesis and aphasia. A cerebral CT scan showed a left middle cerebral artery territory infarction. The duplex ultrasound examination revealed mild atherosclerotic changes in the right common and internal carotid arteries, right-sided complete subclavian steal phenomenon and a complicated hypoechoic atherosclerotic plaque in the left common carotid artery with a large mobile thrombus. Due to the high embolization risk, the patient was hospitalised and prescribed Aspirin together with low molecular weight Heparin. We recorded an improvement in the patient’s neurological status and the control duplex scan revealed disappearance of the thrombus. The presence of floating thrombus in a patient with clinical and imagistic evidence of stroke is a major therapheutic challenge for the neurologist. The treatment strategies are not standardized and must be individualized, however in our case parenteral anticoagulation proved to be successful.

  13. A Case of Carbon Monoxide Poisoning with Thrombus in Right Atrium

    OpenAIRE

    Choi, Hyoin; Kim, Dae-Hee; Sun, Byung Joo; Kim, Joon-Seok; Yang, Jeeeun; Kim, Sun-Mok; Park, So Young; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan

    2012-01-01

    Carbon monoxide is a nonirritant, odorless, colorless gas. Its effects are prominent in organs most sensitive to oxygen deprivation, such as the heart, brain, and kidney. Although less frequently, an association between thromboembolic events and carbon monoxide poisoning has been shown in the literatures. In this case, we report a case of atrial thrombus associated with carbon monoxide poisoning.

  14. A Thrombus Generation Model Applied to Aneurysms Treated with Shape Memory Polymer Foam and Metal Coils

    Science.gov (United States)

    Horn, John; Ortega, Jason; Hartman, Jonathan; Maitland, Duncan

    2015-11-01

    To prevent their rupture, intracranial aneurysms are often treated with endovascular metal coils which fill the aneurysm sac and isolate it from the arterial flow. Despite its widespread use, this method can result in suboptimal outcomes leading to aneurysm recurrence. Recently, shape memory polymer foam has been proposed as an alternative aneurysm filler. In this work, a computational model has been developed to predict thrombus formation in blood in response to such cardiovascular implantable devices. The model couples biofluid and biochemical phenomena present as the blood interacts with a device and stimulates thrombus formation. This model is applied to simulations of both metal coil and shape memory polymer foam treatments within an idealized 2D aneurysm geometry. Using the predicted thrombus responses, the performance of these treatments is evaluated and compared. The results suggest that foam-treated aneurysms may fill more quickly and more completely with thrombus than coil-filled aneurysms, potentially leading to improved long-term aneurysm healing. This work was performed in part under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  15. Successful Medical Management of a Left Ventricular Thrombus and Aneurysm Following Failed Thrombolysis in Myocardial Infarction

    OpenAIRE

    Oyedeji, Adebayo T.; Christopher Lee; Owojori, Olukolade O.; Ajegbomogun, Olabanji J; Adeseye A Akintunde

    2013-01-01

    We report the case of a patient with an extensive anterior myocardial infarction complicated by left ventricular systolic dysfunction, left ventricular apical thrombus and an apical left ventricular aneurysm following failed thrombolysis. We obtained serial two-dimensional echocardiograms at short intervals in the acute phase and also during the months of recovery and follow up. The patient was successfully and exclusively medically managed.

  16. Balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    Shao-Feng Shui

    2014-01-01

    Full Text Available Background and Purpose: This study aimed to investigate the efficacy and safety of balloon dilatation and thrombus extraction for the treatment of cerebral venous sinus thrombosis (CVST. Materials and Methods: Twenty-six cases of digital subtraction angiography-confirmed CVST were treated with balloon dilatation and thrombus extraction. Active treatment of primary disease was carried out after cerebral venous sinus recanalization, and the subsequent anticoagulant therapy lasted for 6 months. Results: Recanalization of the cerebral venous sinus was achieved in all 26 patients, and no endovascular treatment-related complications occurred during or after the procedure. At discharge, the Glasgow Coma Scale (GCS of the patients had improved from an average of 12.3 points to 15 points, and clinical symptoms were improved in 100% of the patients. Follow-up times ranged from 12-62 months (mean follow-up time of 42.3 months and no thrombus re-formation or new neurological deficits occurred during that time. Conclusion: Based on our small study population, balloon dilatation and thrombus extraction appears to be a safe and effective treatment for cerebral venous sinus thrombosis. However, further research is needed to confirm this.

  17. Experiência preliminar com novo filtro de veia cava: resultados de 15 implantes Preliminary experience with a new vena cava filter: results of 15 implantations

    Directory of Open Access Journals (Sweden)

    Winston B. Yoshida

    2008-09-01

    Full Text Available Este estudo apresenta resultados preliminares obtidos com um novo filtro permanente de veia cava, baseado no desenho de Greenfield, com três hastes prolongadas de um total de seis, para dar estabilidade central ao filtro na luz da veia cava. Neste artigo, relatamos sua avaliação clínica preliminar quanto à aplicabilidade, eficácia e segurança. De agosto de 2004 a dezembro de 2006, 15 filtros foram implantados em nove homens e seis mulheres, com idades variando de 38 a 79 anos (média de 57,8 anos. O acesso foi feito sempre por via transjugular. As indicações foram: trombose venosa proximal, com contra-indicação de anticoagulação em 12 pacientes; complicações hemorrágicas com anticoagulação em dois pacientes; e embolia pulmonar, apesar de anticoagulação adequada, em um paciente. Os filtros foram avaliados quanto à liberação, inclinação, mau posicionamento e perfuração de cava. No seguimento, avaliou-se trombose no local de acesso, tromboembolismo venoso recorrente, migração do filtro e trombose de cava pelo ultra-som. Nenhum paciente recebeu anticoagulantes no seguimento. O filtro foi liberado com sucesso em todos os casos sem mau posicionamento, inclinação, perfuração ou trombose de acesso. Os pacientes foram seguidos entre 3 e 23 meses (média de 11 meses. Nenhum paciente teve recorrência de tromboembolismo venoso. Não houve casos de trombose de veia cava ou migração do filtro. Óbito ocorreu em sete casos, todos relacionados com a moléstia de base. Os resultados preliminares indicam potencial eficácia e segurança do uso do novo filtro no período estudado.This study presents preliminary results obtained from a new permanent filter, based on Greenfield's filter design, with prolongations on three of six struts to stabilize it centrally in the vena caval lumen. The preliminary clinical evaluation of the filter with regard to feasibility, efficacy and safety is reported. From August 2004 to December 2006

  18. Echocardiographic detection of free-floating thrombus in left ventricle during coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Jagadeesh N Vaggar

    2015-01-01

    Full Text Available We report an incident of detection of a free-floating thrombus in the left ventricle (LV using intraoperative two-dimensional (2D and three-dimensional (3D transesophageal echocardiography (TEE during proximal coronary artery bypass graft anastomosis. A 58-year-old man presented to us with a 6-month history of chest pain without any history suggestive of myocardial infarction or transient ischemic attacks. His preoperative echocardiography revealed the systolic dysfunction of LV, mild hypokinesia of basal and mid-anterior wall, and the absence of an aneurysm. He was scheduled for on-pump coronary artery bypass surgery. On intraoperative TEE before establishing cardiopulmonary bypass (CPB, a small immobile mass was found attached to LV apical area. After completion of distal coronary artery grafting, when the aortic cross-clamp was removed, the heart was filled partially and beating spontaneously. TEE examination using 2D mode revealed a free-floating mass in the LV, which was suspected to be a thrombus. Additional navigation using biplane and 3D modes confirmed the presence of the thrombus and distinguished it from papillary muscles and artifact. The surgeon opened the left atrium after re-establishing electromechanical quiescence and removed a thrombus measuring 1.5 cm Χ 1 cm from the LV. The LV mass in the apical region was no longer seen after discontinuation of CPB. Accurate TEE-detection and timely removal of the thrombus averted disastrous embolic complications. Intraoperative 2D and recent biplane and 3D echocardiography modes are useful monitoring tools during the conduct of CPB.

  19. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide.

    Science.gov (United States)

    Korkmaz, Levent; Acar, Zeydin; Dursun, Ihsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-03-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  20. Inflammatory Myofibroblastic Tumor of the Right Atrium

    Directory of Open Access Journals (Sweden)

    Neerod K. Jha

    2010-01-01

    Full Text Available Cardiac inflammatory myofibroblastic tumor (IMT is a rare entity and is associated with distinct clinical, pathological and molecular features. The clinical behavior, natural history, biological potential, management and prognosis of such tumors are unclear. We present herewith an adolescent girl who presented with similar entity involving the junction of the right atrium and the inferior vena cava (IVC in association with thrombocytosis and IVC thrombosis leading to obstruction of blood flow. Diagnostic tools included imaging and immuno-histopathology studies. Surgical management included resection of the tumor and thrombo-embolectomy of the IVC under cardiopulmonary bypass. This case is unique due to association of complete obstruction of IVC caused by the strategic location of the tumor, thrombosis of vena cava and association of thrombocytosis. These features have not been reported yet in relation to the cardiac IMT. This report will help in better understanding and management of similar cases in terms of planning cannulation of femoral veins or application of total hypothermic circulatory arrest during cardiopulmonary bypass and prompt us to look for recurrence or metastasis during follow up using echocardiography and laboratory investigations. The possibility of IMT should be kept in the differential diagnosis of cardiac tumors especially in children and adolescents.

  1. White matter change on CT associated with superior vena cava syndrome: a case report

    International Nuclear Information System (INIS)

    An 11-year-old Japanese girl with nephrotic syndrome developed superior vena cava syndrome associated with hypercoagulability and an indwelling catheter. Cranial CT revealed diffuse low-density lesions in paraventricular white matter. Thrombectomy brought prompt relief of symptoms and correction of CT abnormalities. (orig.)

  2. Thrombosis caused by polyurethane double-lumen subclavian superior vena cava catheter and hemodialysis

    DEFF Research Database (Denmark)

    Wanscher, Maria Rørbæk; Frifelt, J J; Smith-Sivertsen, C;

    1988-01-01

    During an 18-month period, 82 consecutive patients (37 women and 45 men), with a mean age of 50 yr (range 15 to 74), underwent hemodialysis with 91 polyurethane double-lumen subclavian superior vena cava catheters inserted via the right subclavian vein. Upon catheter removal, venograms were...

  3. Origin of the infrarenal part of the caudal vena cava in the pig.

    Science.gov (United States)

    Cornillie, P; Van Den Broeck, W; Simoens, P

    2008-10-01

    The vascular topography in the lumbar region of pig embryos and young fetuses was three-dimensionally reconstructed to study some controversial aspects of the origin and development of the infrarenal part of the caudal vena cava. Contrary to general belief, it was found that the supracardinal veins, which form the azygos veins in the thorax, do not take part in the construction of the caudal vena cava in the lumbar region. These veins do appear in the abdomen, but they are only involved in the formation of the lumbar and ascending lumbar veins. The infrarenal part of the caudal vena cava arises from the lumbar part of the right caudal cardinal vein. Whilst this venous pattern is established, the lumbar part of the left caudal cardinal vein disappears and its former location is occupied by large lymphatic connections between the cysterna chyli and the retroperitoneal mesenteric lymphatic sac. On the basis of these findings, a number of hypotheses on the development of anatomical variations of the caudal vena cava should be reconsidered. PMID:18537942

  4. White matter change on CT associated with superior vena cava syndrome: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, M. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Nagai, T. (Department of Neurology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kamiyama, Y. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kawamura, K. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Kawahara, K. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan)); Honda, M. (Department of Nephrology, Metropolitan Kiyose Children' s Hospital, Tokyo (Japan))

    1993-03-01

    An 11-year-old Japanese girl with nephrotic syndrome developed superior vena cava syndrome associated with hypercoagulability and an indwelling catheter. Cranial CT revealed diffuse low-density lesions in paraventricular white matter. Thrombectomy brought prompt relief of symptoms and correction of CT abnormalities. (orig.)

  5. Kirurgisk radikal resektion af leiomyosarkom i retrohepatiske vena cava med intrakardial tumortrombosering

    DEFF Research Database (Denmark)

    Arendrup, Henrik C; Larsen, Peter Nørgaard; Rasmussen, Allan; Pedersen, Christian Ross

    2005-01-01

    1 x 1 cm in the wall of the vena cava while the intracaval tumour was 12 cm long with a diameter of 5 cm and 1.5 cm in the right atrium. Using venovenous bypass with circulatory support, the tumour was excised in toto and the caval vein closed with a pericardial patch. The patient was discharged in...

  6. The clinical application of the implantation of retrievable filters in superior vena cava

    International Nuclear Information System (INIS)

    Objective: To investigate the safety of the placement of Tulip retrievable filter in superior vena cava and to discuss the prevention of pulmonary embolism (PE). Methods: Implantation of Tulip retrievable filter in superior vena cava was performed in ten patients (6 males and 4 females, aged 42-60 years) with acute or subacute deep venous thrombosis in upper extremity or cephalo-cervical region. After the placement of filter, the local via-catheter thrombolysis was conducted. The clinical results, such as the improvement of venous obstructed symptoms at upper extremity or cephalo-cervical region, were recorded. The filter's shape and location were checked. The possible occurrence of pulmonary embolism was observed. Results: The filter was successfully implanted in supper vena cava in all patients, and the deep venous thrombosis at upper extremity and cephalo-cervical region responded well to the local via-catheter thrombolysis. The filters showed no displacement or tilting. The swelling at upper extremity and cephalo-cervical region was markedly faded away. No symptomatic pulmonary embolism occurred. the filter was successfully retrieved via the femoral vein in four patients. Conclusion: Tulip filter can be safety implanted in superior vena cava and can be smoothly retrieved. The occurrence of pulmonary embolism can be effectively prevented if corresponding local via-catheter thrombolysis is carried out. (authors)

  7. Role of 5-hydroxytryptamine in platelet thrombus formation and mechanisms of inhibition of thrombus formation by 5-hydroxytryptamine2A antagonists in rabbits.

    Science.gov (United States)

    Takano, S

    1995-01-01

    The role of 5-hydroxytryptamine (5-HT) in platelet thrombus formation and in the mechanisms of inhibition of thrombus formation by 5-HT2A antagonists was investigated using a turbidimetric method. Collagen-induced platelet aggregation occurred simultaneously with a release of 5-HT from the platelets. The supernatant of collagen-aggregated platelets induced a further aggregation volume-dependently. This supernatant-induced aggregation was inhibited by either 5-HT2A antagonists or adenosine-diphosphate (ADP) scavenging. 5-Hydroxytryptamine and a small amount of the supernatant shifted the dose-response curves of collagen to the left. The aggregation velocity and the onset of aggregation by collagen were significantly increased by the supernatant, but not by 5-HT. The 5-HT2A antagonists, ketanserin and MCI-9042, returned the dose-response curves of the maximum aggregation and of the aggregation velocity of collagen, which were already amplified by the supernatant, to the original values. The onset of aggregation was delayed by the antagonists, but was not completely returned to the original points. There were distinct differences between the effects of endogenous 5-HT, derived from platelets which were stimulated by collagen, and those of exogenous 5-HT on both extensive platelet activation and amplification of the collagen-induced aggregation. These findings suggest that endogenous 5-HT activates platelets in synergism with ADP. The 5-HT2A antagonists used, block the synergism via 5-HT2A receptors and lead to inhibition of a positive feedback loop of thrombus formation. PMID:8836449

  8. Covered stent placement for the treatment of malignant superior vena cava syndrome: Is unilateral covered stenting and effective?

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Hoon; Gwon, Dong Il; Ko, Gi Young; Ko, Heung Kyu; Kim, Jin Hyoung; Shin, Ji Hoon; Yoon, Hyun Ki; Sung, Kyu Bo [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2014-02-15

    To evaluate the safety and efficacy of unilateral covered stent placement in patients with malignant superior vena cava (SVC) syndrome. Between October 2008 and November 2012, expanded polytetrafluoroethylene-covered stent placement for malignant SVC syndrome was performed in 40 consecutive patients (35 men and five women; mean age, 61.4 years; range, 35-81 years). All covered stents were unilaterally placed within the SVC or across the venous confluence when needed to relieve venous obstruction and prevent tumor overgrowth, regardless of patency of contralateral brachiocephalic veins. Stent placement was technically successful in all patients. There were no major complications. Of the 37 patients symptomatic prior to stent placement, 34 (92%) experienced complete symptomatic relief 1-8 days after stent placement. Of the 29 patients who underwent covered stent placement across the venous confluence, nine patients had patent contralateral brachiocephalic veins prior to stent placement. However, no sign of SVC obstruction or contralateral upper extremity venous thrombosis was observed during the follow-up period. Kaplan-Meier analysis revealed median patient survival of 163 days. Stent occlusion occurred in four (10%) of 40 patents. Cumulative stent patency rates at 1, 3, 6, and 12 months were 95%, 92%, 86%, and 86%, respectively. Unilateral covered stent placement appears to be a safe and effective method for treating malignant SVC syndrome, despite the location of SVC occlusion.

  9. Covered stent placement for the treatment of malignant superior vena cava syndrome: Is unilateral covered stenting and effective?

    International Nuclear Information System (INIS)

    To evaluate the safety and efficacy of unilateral covered stent placement in patients with malignant superior vena cava (SVC) syndrome. Between October 2008 and November 2012, expanded polytetrafluoroethylene-covered stent placement for malignant SVC syndrome was performed in 40 consecutive patients (35 men and five women; mean age, 61.4 years; range, 35-81 years). All covered stents were unilaterally placed within the SVC or across the venous confluence when needed to relieve venous obstruction and prevent tumor overgrowth, regardless of patency of contralateral brachiocephalic veins. Stent placement was technically successful in all patients. There were no major complications. Of the 37 patients symptomatic prior to stent placement, 34 (92%) experienced complete symptomatic relief 1-8 days after stent placement. Of the 29 patients who underwent covered stent placement across the venous confluence, nine patients had patent contralateral brachiocephalic veins prior to stent placement. However, no sign of SVC obstruction or contralateral upper extremity venous thrombosis was observed during the follow-up period. Kaplan-Meier analysis revealed median patient survival of 163 days. Stent occlusion occurred in four (10%) of 40 patents. Cumulative stent patency rates at 1, 3, 6, and 12 months were 95%, 92%, 86%, and 86%, respectively. Unilateral covered stent placement appears to be a safe and effective method for treating malignant SVC syndrome, despite the location of SVC occlusion.

  10. Malignant thrombosis of the superior vena cava caused by non-small-cell lung cancer treated with radiation and erlotinib: a case with complete and prolonged response over 3 years

    Directory of Open Access Journals (Sweden)

    Wang JY

    2013-07-01

    Full Text Available Jianyang Wang,1 Jun Liang,1 Wenqing Wang,1 Han Ouyang,2 Luhua Wang11Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 2Department of Diagnostic Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of ChinaAbstract: Most cases of superior vena cava (SVC syndrome resulting from neoplasm, especially from lung cancer, remain a serious challenge to treat. Here, for the first time as far as we are aware, we report the case of a non-small-cell lung cancer patient with a massive SVC malignant thrombosis who was treated with thoracic irradiation and erlotinib. The treatment regimen consisted of erlotinib 150 mg/day and a total dose of 66 Gy/33 fractions delivered to the tumor, malignant thrombosis, and metastasis mediastinal lymph nodes. The malignant thrombosis responded dramatically and the combined regimen was well tolerated. After discharge, the erlotinib was prescribed as maintenance therapy. The patient was followed closely for the next 3 years. During this time, positron emission tomography/computed tomography scans and serum tumor marker screens were undertaken. By 6 months, the primary tumor showed complete response and by 9 months, the SVC thrombosis had disappeared. No sign of relapse has been found to date.Keywords: superior vena cava syndrome, radiotherapy, thoracic irradiation, neoplasm

  11. Superior vena cava obstruction in small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: To identify prognostic or treatment factors influencing the response of superior vena cava obstruction (SVCO), time to SVCO recurrence, and overall survival of SCLC patients with SVCO at presentation; and to assess the role of retreatment in patients with SVCO at recurrent or persistent disease. Methods and Materials: Between January 1983 and November 1993, 76 consecutive patients who had small-cell lung cancer (SCLC) with SVCO were treated in our institution. Analysis was done according to the disease status at diagnosis of SVCO. The first analysis concerned a group of 50 patients who had SVCO at initial presentation. The second analysis concerned a group who had SVCO as a manifestation of persistent or recurrent disease. Results: In the first analysis, 93% had significant improvement in symptoms of SVCO after chemotherapy and 94% after mediastinal radiation. Response is almost universal despite a wide range of radiation fractionation and total dose used. Seventy percent remained SVCO-free before death. Thirty percent developed recurrence of SVCO symptoms 1-16 months (median 8) after the start of initial treatment. Those who received combined chemotherapy and radiation had a longer time to SVCO recurrence (p = 0.018) compared to those who received chemotherapy alone. This effect is mainly seen in limited-stage patients. The presence of SVCO recurrence tends to have an adverse effect on the overall survival (p = 0.077) irrespective of the time when the recurrences occurred (p = 0.296). The median survival of this whole group of 50 patients in the first analysis was 9.5 months, and the 2-year survival was 10%. Stage was strongly predictive of survival (p < 0.001). Sixteen percent (3 of 19) of the patients with limited-stage diseases were long-term survivors (two patients survived 35 months and one survived 70 months). The early mortality from SVCO was 2%. In the second analysis, 85% had previously been treated with chemotherapy alone. The response rate of

  12. MOBILE RIGHT HEART THROMBUS WITH PULMONARY EMBOLISM IN A PATIENT WITH POLYCYTHEMIA RUBRA VERA AND SPLANCHNIC VEIN THROMBOSIS

    OpenAIRE

    Panduranga, Prashanth; Mukhaini, Mohammed; Saleem, Muhammad; Al-Delamie, Taha; Zachariah, Sunny; Al-Taie, Saqar

    2010-01-01

    Splanchnic vein thrombosis in patients with polycythemia rubra vera is well-known. Development of mobile right heart thrombus in these patients has not been reported previously. We describe a young patient with Polycythemia rubra vera and splanchnic vein thrombosis with ischemic bowel who underwent small bowel resection. He developed a large mobile right atrial thrombus and bilateral pulmonary embolism. He also had upper gastrointestinal bleed. His management was complicated and challenging d...

  13. Paraphenylene diamine exacerbates platelet aggregation and thrombus formation in response to a low dose of collagen.

    Science.gov (United States)

    Zaid, Younes; Marhoume, Fatimazahra; Senhaji, Nezha; Kojok, Kevin; Boufous, Hicham; Naya, Abdallah; Oudghiri, Mounia; Darif, Youssef; Habti, Norddine; Zouine, Soukaina; Mohamed, Fekhaoui; Chait, Abderahmane; Bagri, Abdellah

    2016-02-01

    Paraphenylene daimine (PPD) is an aromatic amine that is widely used in several industrial products; however, its toxicity has been reported in several cases of cardiac arrests. As platelets play a key role in cardiovascular diseases, we aimed to determine the impact of PPD in vitro and in vivo on platelet function. Our findings demonstrated that platelet activation and aggregation were strongly enhanced by PPD. Treatment with PPD primed human platelets that became more reactive in response to low doses of collagen. Furthermore, PPD exacerbated thrombus formation in rats in comparison with those untreated. Our results suggest that PPD is an important platelet primer predisposing platelets to promote thrombus formation in response to vascular injury. This should prompt the authorities to consider controlling the marketing of this product. PMID:26763399

  14. [A Case of Carotid Free-Floating Thrombus Treated by Carotid Ultrasonography-Guided Endovascular Approach].

    Science.gov (United States)

    Otawa, Masato; Kinkori, Takeshi; Watanabe, Kenichi; Ando, Ryo; Tambara, Masao; Arima, Toru

    2016-06-01

    We experienced a case of carotid free-floating thrombus treated by carotid ultrasonography-guided endovascular approach. A 63-year-old man was brought to our hospital with the chief complaint of sudden onset left hemiplegia. MRI revealed acute infarction of the right MCA territory due to the right M1 occlusion. Carotid ultrasonography showed a pedunculated, polypoid mobile plaque floating with the cardiac beat. We attempted ultrasonography-guided endovascular treatment. Under proximal balloon protection, the floating plaque was successfully aspirated into the Penumbra aspiration catheter. Carotid stent was also placed to stabilize the residual pedicle of the plaque. Aspirated plaque was identified as fresh thrombus by pathological examination. Carotid ultrasonography-guided endovascular approach was effective for getting the picture of real-time dynamics of the carotid FFT. PMID:27270147

  15. Impact of poroelasticity of intraluminal thrombus on wall stress of abdominal aortic aneurysms

    OpenAIRE

    Polzer Stanislav; Gasser T; Markert Bernd; Bursa Jiri; Skacel Pavel

    2012-01-01

    Abstract Background The predictions of stress fields in Abdominal Aortic Aneurysm (AAA) depend on constitutive descriptions of the aneurysm wall and the Intra-luminal Thrombus (ILT). ILT is a porous diluted structure (biphasic solid–fluid material) and its impact on AAA biomechanics is controversially discussed in the literature. Specifically, pressure measurements showed that the ILT cannot protect the wall from the arterial pressure, while other (numerical and experimental) studies showed t...

  16. Late Thrombolytic Treatment In A Patient With Ischemic Stroke Caused By Biatrial Thrombus

    OpenAIRE

    Cinarka, Halit; Karatas, Mevlut; Ozyurt, Songul; Gumus, Aziz; Unal Sahin; Kayhan, Servet

    2015-01-01

    Venous thromboembolism is a preventable disease when necessary precautions are taken and it occurs along with deep vein thrombosis and pulmonary embolism. Mortality related to venous thromboembolism may be high in the acute phase of the disease and it may become chronic. Intracardiac thrombus may be detected in some venous thromboemboli cases. Cardiac embolism is responsible for most of the ischemic strokes which can be very mortal or may cause serious morbidity when they are not treated in t...

  17. Haemostatic factors and intraluminal thrombus thickness in abdominal aortic aneurysm. Is secondary fibrinolysis relevant?

    Science.gov (United States)

    Siennicka, A; Drozdzynska, M; Chelstowski, K; Cnotliwy, M; Jastrzebska, M

    2013-06-01

    Many circulating haemostatic markers have been investigated in relation to the abdominal aortic aneurysm (AAA) size, growth as well as intraluminal thrombus (ILT) size. However, the results of these studies seem to be uncertain and inconsistent. The first aim of the present study was to compare the haemostatic parameters of fibrinolysis and some of thrombotic markers in patients with AAA and controls. We also examined the relationship between those parameters and both maximum aneurysm diameter and intraluminal thrombus thickness. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), fibrinogen (Fb), D-dimer, prothrombin fragments 1 and 2 (F1+2), thromboxane B2 (TXB2) and lipids profile were measured in 36 patients with AAA and 30 controls. The mean maximum aortic diameter in patients with the AAA was 59±12 mm (range 42-100). The mean ILT thickness was 32±10 mm (range 8-56). Among haemostatic factors, t-PA and D-dimer levels, but not PAI-1, were significantly higher in subjects with the AAA. There was a strong positive correlation between thickness of intraluminal thrombus and maximum aneurysm size (r=0.69, paneurysm diameter (r= -0.38, p=0.023). Higher plasma concentrations of t-PA and D-dimer support the hypothesis that the secondary fibrinolysis plays an important role in the pathogenesis of the aortic abdominal aneurysm formation. In addition, the negative correlation between t-PA plasma level and ILT thickness suggests that thrombotic/fibrinolysis imbalance may favour accelerated formation of intraluminal thrombus and possibly aneurysm progression. PMID:23959729

  18. Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

    OpenAIRE

    Khalil Al-Farsi; Siddiqui, Aftab A.; Yasser W. Sharef; Al-Belushi, Ali K.; Hakeem Al-Hashim; Mohammed Al-Ghailani; William J Johnsto

    2013-01-01

    Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation ...

  19. Effect of wood smoke exposure on vascular function and thrombus formation in healthy fire fighters

    OpenAIRE

    Hunter, Amanda L; Unosson, Jon; Bosson, Jenny A.; Langrish, Jeremy P; Pourazar, Jamshid; Raftis, Jennifer B; Miller, Mark R; Lucking, Andrew J.; Boman, Christoffer; Nyström, Robin; Donaldson, Kenneth; Flapan, Andrew D; Shah, Anoop; Pung, Louis; Sadiktsis, Ioannis

    2014-01-01

    Background Myocardial infarction is the leading cause of death in fire fighters and has been linked with exposure to air pollution and fire suppression duties. We therefore investigated the effects of wood smoke exposure on vascular vasomotor and fibrinolytic function, and thrombus formation in healthy fire fighters. Methods In a double-blind randomized cross-over study, 16 healthy male fire fighters were exposed to wood smoke (~1 mg/m3 particulate matter concentration) or filtered air for on...

  20. Thrombus aspiration during primary percutaneous coronary intervention associated with reduced platelet activation

    OpenAIRE

    Sahin, Muslum; Acar, Goksel; Kalkan, Mehmet E.; Acar, Rezzan D; Kilicgedik, Alev; Teymen, Burak; Arslantas, Ugur; Kirma, Cevat

    2015-01-01

    Objectives: To determine the effect of thrombectomy on platelet function in patients undergoing primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI). Methods: This retrospective study included 413 consecutive STEMI patients who underwent PPCI between March 2012 and September 2013 at Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey that were assigned to the thrombus aspiration (TA) group or the non-TA group. Pl...

  1. Multi-parameter assessment of thrombus formation on microspotted arrays of thrombogenic surfaces

    OpenAIRE

    sprotocols

    2014-01-01

    Authors: Susanne de Witt, Frauke Swieringa, Judith Cosemans & Johan Heemskerk ### Abstract Thrombus formation by adhering and aggregating blood platelets is fundamental to hemostasis and is a prerequisite for vascular occlusion in pathological thrombosis. The parallel-plate flow chamber technique has been extensively used to measure platelet adhesion and activation in vitro at arterial or venous flow conditions. Here, we describe the use of brightfield and confocal fluorescence mi...

  2. Flow effect on thrombus formation in stenosed coronary arteries: a computational study

    OpenAIRE

    Papadopoulos, Konstantinos

    2015-01-01

    Thrombotic complications often occur in stenosed coronary artery, causing permanent damage and even death. Although the exact factors and events leading to thrombus formation are not entirely known, the local rheological conditions as well as the different tendency for clotting of the blood of each individual are considered to have an important role both in progress of the disease and the relevant complications. Recently a statistical correlation between the exact location of the stenosis and...

  3. Proximal small bowel obstruction caused by a massive intraluminal thrombus from a stress ulcer

    OpenAIRE

    Siddiky, AH; GUPTA, P.

    2012-01-01

    We describe a case of proximal small bowel obstruction caused by an occlusive thrombus as a result of bleeding from a duodenal ulcer, which is likely to be stress induced. Initial presentation was confused as a bleeding duodenal ulcer and resultant ileus. Such reports are incredibly rare in the literature and never has one been reported as a result of a stress ulcer. Obstructive symptoms in the acute postoperative patient may be confused for an ileus but mechanical causes must be excluded. Th...

  4. Long-term follow-up of protection efficacy of vena cava filters in the prevention of pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To analyze the protection efficacy of the vena cava filter from pulmonary thromboembolism and report the problems and complications after filter placement. Methods: Fifty-five Vena Tech-LGM filters (VTF) and 6 Titanium-Greenfield filters (TGF) were placed in 61 patients. Follow-up was obtained by means of duplex sonography of the inferior vena cava and abdominal radiography in 38 patients, and by means of computed tomography in 11 patients. Results: One case of pulmonary embolism was seen following filter placement. Filter thrombosis occurred in 9 cases. There had been 1 case of incomplete filter opening and one case of filter tilting. Filter migration was noted in 1 case. Conclusion: This experience suggests that vena cava filter is safe and effective for the prevention of pulmonary embolism. A vena cava filter should only be inserted in a patient when there is strict proof of the indication

  5. Evaluation of intracoronary administration of urokinase and tirofiban in treating acute myocardial infarction with massive thrombus

    International Nuclear Information System (INIS)

    Objective: To assess the safety and efficacy of intracoronary administration of both urokinase and tirofiban for the treatment of acute myocardial infarction (AMI) with massive thrombus during emergency percutaneous coronary intervention in AMI patients. Methods: During the period of June 2008 June 2009 percutaneous coronary intervention was carried out in 85 patients with AMI, of whom seven patients showed high-burden thrombus in the infarct-related artery (IRA). Intracoronary infusion with urokinase and tirofiban was performed. During hospitalization and follow-up period the TIMI flow grade and myocardial perfusion were determined, side-effects of the drugs and major adverse cardiac events were observed, and cardiac color Doppler ultrasonography was employed for follow-up checkups. The clinical data were analyzed and therapeutic results were evaluated. Results: After stent deployment neither 'no-reflow' nor 'slow flow' phenomenon was observed and the grade of IRA flow was improved to TIMI 2-3 grade. During hospitalization no major adverse cardiac events such as death,re-infarction, target vessel revascularization, etc. occurred, and severe bleeding complications didn't occur either. During the follow-up period of 3-9 months, no major adverse cardiac events developed and the cardiac color Doppler ultrasonography showed that the left ventricle had an excellent performance in all cases. Conclusion: During emergency percutaneous coronary intervention for patients with AMI, intracoronary administration of both urokinase and tirofiban is safe and effective for AMI patients with massive thrombus. (authors)

  6. The EP3 Agonist Sulprostone Enhances Platelet Adhesion But Not Thrombus Formation Under Flow Conditions.

    Science.gov (United States)

    Pasterk, Lisa; Philipose, Sonia; Eller, Kathrin; Marsche, Gunther; Heinemann, Akos; Schuligoi, Rufina

    2015-01-01

    Platelets express the EP2, EP3 and EP4 receptors. Prostaglandin (PG) E2 has a biphasic effect on platelets. Low concentrations of PGE2 enhance platelet aggregation through the activation of the EP3 receptors, while at high concentrations it attenuates aggregation via the EP4 receptor. Consequently, EP3 receptor inhibition was shown to inhibit artherothrombosis, but had no influence on bleeding time in vivo. In this study, we investigated the role of the EP3 receptor in adhesion and thrombus formation under flow conditions in vitro. The EP3 agonist sulprostone caused an increase in the adhesion of washed platelets to fibrinogen as well as to collagen under low shear stress, an effect that was blocked by the EP3 antagonist L-798106. In contrast, when whole blood was perfused over collagen-coated surfaces, sulprostone did not enhance binding and thrombus formation of platelets on collagen; at high concentrations it even attenuated this response. We conclude that in more physiological models of thrombus formation, the role for EP3 receptors is limited, indirectly suggesting that the primary action of PGE2 in haemostasis might be an inhibitory one. PMID:26228833

  7. Large Right Atrial Thrombus Associated with Central Venous Catheter Requiring Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Nasir Hussain

    2012-01-01

    Full Text Available Central venous catheters (CVC are used commonly in clinical practice. Incidences of CVC-related right atrial thrombosis (CRAT are variable, but, when right atrial thrombus is present, it carries a mortality risk of 18% in hemodialysis patients and greater than 40% risk in nonhemodialysis patients. Different pathogenic mechanisms have been postulated for the development of CRAT, which includes mechanical irritation of the myocardial wall, propagation of intraluminal clot, hypercoagulability, and hemodynamics of right atria. Presentation of CRAT may be asymptomatic or may be associated with one of the complications of CRAT like pulmonary embolism, systemic embolism, infected thrombi, or hemodynamic compromise. There are no established treatment guidelines for CRAT. We describe an interesting case of a 59-year-old asymptomatic male successfully treated with open heart surgery after failure of medical treatment for a large CRAT discovered during a preoperative evaluation for a kidney transplant. Our case underscores that early detection of CRAT may carry a favorable prognosis as opposed to waiting until catastrophic complications arise. It also underscores the importance of transesophageal echocardiography in the detection of thrombus and perhaps guides clinicians on which treatment modality to be used according to the size of the thrombus.

  8. Left ventricular thrombus in patients with acute myocardial infarction: Case report and Caribbean focused update

    Directory of Open Access Journals (Sweden)

    CR Potu

    2012-03-01

    Full Text Available Despite the well documented benefit of echocardiography in acute coronary syndromes, its wide-scale use in the Caribbean is limited by access, health literacy and affordability. Because of the limited use of echocardiography in the region, routine complications of acute myocardial infarction (AMI are not fully appreciated and may go unrecognized, further contributing to increased cardiovascular morbidity and mortality. It is therefore necessary to bring focus to this common clinical condition and highlight the clinical utility of echocardiography in facilitating timely and accurate diagnosis. We report here a case of large left ventricular (LV thrombus in a patient with AMI. Coronary angiography showed completely occluded left anterior descending artery (LAD with angiographically normal remaining vessels. Immediate anticoagulation was commenced with heparin and overlapped with warfarin. No Primary Angioplasty (PA was done based on the evidence from occluded artery trial. LV thrombus was completely resolved on echocardiography at three months. No evidence of thrombo-embolism was found during the resolution of LV thrombus.

  9. [Duplication of the superior vena cava and other malformations discovered at insertion of a port-a-cath].

    Science.gov (United States)

    Hammerer, V; Jeung, M; Mennecier, B; Demian, M; Pauli, G; Quoix, E

    2005-09-01

    We report a clinical case of a persistent left superior vena cava discovered in a 50-year-old female patient when a port-a-cath was inserted. This already seldom malformation was associated with an arteria lusoria and polysplenia with left inferior vena cava with hemiazygos continuation, right-sided stomach, short pancreas, preduodenal portal vein and intestinal malrotation, but without any cardiac abnormalities. PMID:16208194

  10. Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena cava in Pediatric Patients

    OpenAIRE

    Gholamhossein Ajami; Khobiar Zare; Hamid Amoozgar; Mohammad Borzoee; Saeed Abtahi

    2010-01-01

    Objective: Paucity of data exists between mean right atrial pressure (RAP) and inferior vena cava (IVC) size and collapsibility in pediatric patients with congenital heart disease.Methods: In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4...

  11. Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

    OpenAIRE

    Rahman, Nik Hisamuddin NA; Ahmad, Rashidi; Kareem, Meera Mohaideen; Mohammed, Mohammad Iqhbal

    2016-01-01

    Background We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) measured ultrasonographically to detect class 1 hypovolemic shock with blood loss less than 15%.ᅟ Methods The aim of this study was to determine the changes in the diameter of inferior vena cava and abdominal aorta in blood donors by using ultrasound, pre and post blood donation....

  12. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    International Nuclear Information System (INIS)

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  13. Dialysis catheter-related superior vena cava syndrome with patent vena cava: Long term efficacy of unilateral viatorr stent-graft avoiding catheter manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Quaretti, Pietro; Galli, Franco; Maramarco, Lorenzo Paplo; Corti, Riccardo; Leati, Giovanni; Fiorina, Ilaria; Maestri, Marcello [IRCCS Policlinico San Matteo Foundation, Pavia (Italy)

    2014-06-15

    Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later.

  14. Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Catherine; Trad, Clovis Simao [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Trad, Henrique Simao, E-mail: hstrad@terra.com.br [Central de Diagnostico Ribeirao Preto (CEDIRP), SP (Brazil); Universidade de Sao Paulo (HC-FMRPUSP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Mendonca, Silvana Machado [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil)

    2013-06-15

    Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. (author)

  15. Multidisciplinary Approach to Wilms’ Tumor: A Retrospective Analytical Study of 53 Patients

    International Nuclear Information System (INIS)

    Aim of the Work: The aim of this work was to assess the epidemiologic aspects, clinico-pathological features and the results of multidisciplinary treatment of Wilms' tumor (WT) in pediatric patients treated at the National Cancer Institute (NCI), Cairo University, between January 2002 and December 2004. Patients and Methods: This study included 53 patients, all under the age of 16 years, with previously untreated WT. Initial evaluation of all patients comprised laboratory investigations and radiological assessment which included chest X-ray and CT, abdomin-opelvic ultrasonography and CT. Doppler study of the renal vein and vena cava and bone scan were done when needed. Neoadjuvant chemotherapy was given to patients suffering from poor general condition, extensive tumor thrombus in the renal vein, irresectable and bilateral (stage V) nephroblastoma. Otherwise, up-front nephrectomy was the standard therapeutic approach in this study. Results: The age of the patients ranged from 2 to 108 months with a mean of 39.9 months ( ± 22.56). Males and females were almost equal in number (50.9% and 49.1% respectively). Tumors were located in the left kidney in 52.8%, right kidney in 41.5% and bilaterally in only 5.7% of the cases. An abdominal mass was the most common clinical presentation (77.4%). Favorable histology was found in 86.3% while unfavorable histology was elicited in 13.7% of the cases. Congenital anomalies were recorded in 4 patients. Stage I and III were the most common (29.4% each), followed by stage II and IV (17.7% each), and finally by stage V (5.9%). Neoadjuvant chemotherapy was given to 27 cases while up-front nephrectomy was undertaken in 26 cases. Intra-operative spillage occurred in 12% of patients who had preoperative chemotherapy and 31% of those who had up front nephrectomy. Postoperative abdominal radiotherapy was given to 32 patients. Twenty five patients underwent renal bed irradiation only, while in the other 7 whole abdominal irradiation was

  16. Sensitivity of 3D gradient recalled echo susceptibility-weighted imaging technique compared to computed tomography angiography for detection of middle cerebral artery thrombus in acute stroke

    Directory of Open Access Journals (Sweden)

    Amit Agarwal

    2014-11-01

    Full Text Available We aimed at comparing the sensitivity of magnetic resonance (MR susceptibility-weighted imaging (SWI with computed tomography angiography (CTA in the detection of middle cerebral artery (MCA thrombus in acute stroke. Seventy-nine patients with acute MCA stroke was selected using our search engine software; only the ones showing restricted diffusion in the MCA territory on diffusion-weighted images were included. We finally selected 35 patients who had done both MRI (including SWI and CTA. Twenty random subjects with completely normal MRI (including SWI exam were selected as control. Two neuroradiologists (blinded to the presence or absence of stroke reviewed the SW images and then compared the findings with CT angiogram (in patients with stroke. The number of MCA segments showing thrombus in each patient was tabulated to estimate the thrombus burden. Thrombus was detected on SWI in one or more MCA segments in 30 out of 35 patients, on the first review. Of the 30, SWI showed thrombus in more than one MCA segments in 7 patients. CTA depicted branch occlusion in 31 cases. Thrombus was seen on both SWI and CTA in 28 patients. Thrombus was noted in two patients on SWI only, with no corresponding abnormality seen on CTA. Two patients with acute MCA showed no vascular occlusion or thrombus on either CTA or SWI. Only two case of false-positive thrombus was reported in normal control subjects. Susceptibility-weighted images had sensitivity and specificity of 86% and 90% respectively, with positive predictive value 94%. Sensitivity was 86% for SWI, compared with 89% for CTA, and this difference was statistically insignificant (P>0.05. Of all the positive cases on CTA (31 corresponding thrombus was seen on SWI in 90% of subjects (28 of 31. Susceptibility-weighted imaging has high sensitivity for detection of thrombus in acute MCA stroke. Moreover, SWI is a powerful technique for estimation of thrombus burden, which can be challenging on CTA.

  17. Incremental Value of Three-Dimensional Transesophageal Echocardiography over the Two-Dimensional Technique in the Assessment of a Thrombus in Transit through a Patent Foramen Ovale.

    Science.gov (United States)

    Thind, Munveer; Ahmed, Mustafa I; Gok, Gulay; Joson, Marisa; Elsayed, Mahmoud; Tuck, Benjamin C; Townsley, Matthew M; Klas, Berthold; McGiffin, David C; Nanda, Navin C

    2015-05-01

    We report a case of a right atrial thrombus traversing a patent foramen ovale into the left atrium, where three-dimensional transesophageal echocardiography provided considerable incremental value over two-dimensional transesophageal echocardiography in its assessment. As well as allowing us to better spatially characterize the thrombus, three-dimensional transesophageal echocardiography provided a more quantitative assessment through estimation of total thrombus burden. PMID:25827179

  18. Creating a Fontan fenestration in a child with dextrocardia and interrupted inferior vena cava

    Directory of Open Access Journals (Sweden)

    Pradeepkumar Charlagorla

    2016-01-01

    Full Text Available Plastic bronchitis is a rare life-threatening complication of the Fontan operation. Transcatheter Fontan fenestration can ameliorate symptoms by decompressing elevated venous pressures. Transcatheter creation of a fenestration can be technically challenging in cases with complex venous anatomy. We report a case of a 5-year-old boy with heterotaxy, dextrocardia with unbalanced atrioventricular canal (AVC, atrial and visceral situs inversus, left-sided superior vena cava (SVC, and left-sided interrupted inferior vena cava (IVC with azygos continuation. With few modifications to the equipment, a successful Fontan fenestration with stent implantation was performed via transjugular approach. At 2-year follow-up, his symptoms of plastic bronchitis improved significantly.

  19. Persistent Left Superior Vena Cava: A Rare Case with Clinical Significance

    Science.gov (United States)

    Kumar, Raj; Yadav, Sankalp; Verma, Deepak

    2016-01-01

    Persistent Left Superior Vena Cava (PLSVC) is a rare congenital vascular anomaly (incidence of 0.3-0.5% of the general population) which being mostly asymptomatic in its presentation, is usually detected incidentally. There are many practical clinical implications associated with it including arrhythmias. We report a rare case of PLSVC with absent Right Superior Vena Cava (RSVC) (isolated PLSVC), in a 55-year-old lady who had complete heart block followed by sepsis and was diagnosed to have this condition during the permanent cardiac pacemaker implantation and central venous catheter insertion showing an abnormal path of the catheter/pacing leads. The authors also give an insight into its clinical relevance. PMID:27437282

  20. Superior vena cava syndrome from an invasive thymoma with transcaval invasion to the right atrium.

    Science.gov (United States)

    Afzal, Ashwad; Wong, Ivan; Korniyenko, Aleksandr; Ivanov, Alex; Worku, Berhane; Gulkarov, Iosif

    2016-01-01

    Invasive thymoma with transcaval extension to the right atrium is a rare cause of superior vena cava syndrome. We present a case on a 74-year-old female presenting with dyspnea on exertion, and facial and upper extremity swelling. Physical examination revealed mild facial swelling, non-pitting edema involving the upper extremities and distention of superficial veins of the anterior chest wall and jugular veins. An echocardiogram showed moderate right atrial dilation with a mobile mass in the atrial cavity prolapsing through the tricuspid valve. Cardiac magnetic resonance imaging revealed a 9.9 × 4.3 cm heterogeneous mass in the anterior mediastinum compressing the superior vena cava and endovenously extending into the right atrium. Tissue biopsy of the mediastinal mass revealed a type B1 thymoma, further staged as a Masaoka IVa invasive thymoma that underwent successfulen blocresection followed by removal of intracaval and right atrial mass. PMID:27099229

  1. Agenesis of Ductus Venosus Presenting with Dilated Inferior Vena Cava with Favorable Outcome

    Directory of Open Access Journals (Sweden)

    Omer Dai

    2014-04-01

    Full Text Available The ductus venosus regulates the distribution of oxygen and placental nutrients by restricting the centralization of blood flow in fetal circulation. The ductus venosus is a small vein transmitting oxygen-rich blood from the umbilical vein to the fetal heart.. Increasing numbers of case reports are being published about ductus venosus agenesis with cardiac structural abnormalities, other malformations, chromosomal abnormalities, and stillbirth. Heart failure, hydrops and unexplained polyhydramnios could also be associated with ductus venosus agenesis. In the follow-up of fetuses with ductus venosus agenesis, care must be taken to examine for hydrops and heart failure. The agenesis of ductus venosus is often only found in fetuses by coincidentally. Herein we discuss the prenatal diagnosis of isolated agenesis of the ductus venosus presenting with a dilated inferior vena cava and without any disturbance of fetal hemodynamics and any other malformation. In conclusion a dilated inferior vena cava can be a sign of ductus venosus agenesia.

  2. Totally endoscopic robotic resection of left atrial myxoma with persistent left superior vena cava.

    Science.gov (United States)

    Tarui, Tatsuya; Ishikawa, Norihiko; Ohtake, Hiroshi; Watanabe, Go

    2016-07-01

    A 68-year old man with a cardiac tumour was admitted for robotic tumour resection using the da Vinci S Surgical System. While undergoing preoperative examination, he was found to have a persistent left superior vena cava. After general anaesthesia and single-lung ventilation, cardiopulmonary bypass was established, with venous drainage through bilateral internal jugular and right femoral veins and arterial return through the right femoral artery. Robotic tumour resection was performed by four ports in the right chest. There were no difficulties during the operation, and successful tumour resection was achieved with satisfactory margins. He was discharged without complications. Persistent left superior vena cava is very rare, but if diagnosed preoperatively and an appropriate operative plan is made, robotic cardiac surgery can be performed safely. With robotic surgery, cardiac tumour resection can be feasibly performed, with cosmetic benefits. PMID:26989070

  3. Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    LI Dong-bao; HUA Qi; LIU Zhi; LI Jing; XU Li-qing; WANG Shan; JIN Wei-ying

    2009-01-01

    Background Inflammatory mechanisms had played an important role in the occurrence and prognosis of acute myocardial infarction,inflammatory mediators was associated with adverse outcomes of acute myocardial infarction.This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation,neutrophil count and high-sensitivity C-reactive protein are predictive of angiographic morphologic features that indicate thrombus formation in the infarct-related artery.Methods This retrospective study included 182 consecutive patients with acute myocardial infarction and ST-segment elevation.Patients were assigned to a thrombus-formation group(n=77)and a non-thrombus-formation group(n=106).All patients had a Killip's classification≤3 and onset<12 hours prior to presentation.All the cases were going to undergo coronary angiography,including primary percutaneous coronary intervention,simple coronary angiography,or thrombolysis in a coronary artery(or arteries)or coronary artery bypass graft(s).Blood samples for measurement of high-sensitivity C-reactive protein and for routine blood laboratory studies were collected prior to coronary angiography.Results The levels of high-sensitivity C-reactive protein,total leukocyte counts,neutrophil counts,and neutrophil/lymphocyte ratios were substantially higher in the thrombus-formation group than in the non-thrombus-formation group patients(for each,P<0.05).Stepwise Logistic regression analyses identified high-sensitivity C-reactive protein,neutrophil count,and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery(for each,P<0.05).Conclusions In patients with acute myocardial infarction,higher neutrophil counts,neutrophil/lymphocyte ratio,and levels of high-sensitivity C-reactive protein are predictors to indicate thrombus formation.

  4. The CAVA corpus: synchronised stereoscopic and binaural datasets with head movements

    OpenAIRE

    Arnaud, Elise; Christensen, Heidi; Lu, Yan-Chen; Barker, Jon; Khalidov, Vasil; Hansard, Miles; Holveck, Bertrand; Mathieu, Herve; Narasimha, Ramya; Taillant, Elise; Forbes, Florence; Horaud, Radu

    2008-01-01

    International audience This paper describes the acquisition and content of a new multi-modal database. Some tools for making use of the data streams are also presented. The Computational Audio- Visual Analysis (CAVA) database is a unique collection of three synchronised data streams obtained from a binaural microphone pair, a stereoscopic camera pair and a head tracking device. All recordings are made from the perspective of a person; i.e. what would a human with natural head movements see...

  5. Treatment of pacemaker-induced superior vena cava syndrome by balloon angioplasty and stenting.

    LENUS (Irish Health Repository)

    Klop, B

    2011-01-01

    Superior vena cava (SVC) syndrome is a rare but serious complication after pacemaker implantation. This report describes three cases of SVC syndrome treated with venoplasty and venous stenting, with an average follow-up of 30.7 (±3.1) months. These cases illustrate that the definitive diagnosis, and the extent and location of venous obstruction, can only be determined by venography.

  6. Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage

    International Nuclear Information System (INIS)

    Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach. (orig.)

  7. Bullet embolisation from injured inferior cava vein to the right ventricle

    OpenAIRE

    Zenelaj, A; M Brati; Kerci, M

    2010-01-01

    Gunshot injuries of the human body challenge surgical teams in the emergency department. Since such injuries do not follow any rule, every patient should be considered a special case. Our case, of bullet embolism from injured inferior cava vein to the right heart ventricle is a rare one. Such cases make us be more alert for diagnosis and treatment of this kind of injury. Well equipped hospitals and experienced medical teams are necessary for successful outcome.

  8. A sulfated polysaccharide of Ecklonia cava inhibits the growth of colon cancer cells by inducing apoptosis

    OpenAIRE

    Ahna, Ginnae; Lee, WonWoo; Kim, Kil-Nam; Lee, Ji-Hyeok; Heo, Soo-Jin; Kang, Nalae; Lee, Seung-Hong; Ahnf, Chang-Bum; Jeon, You-Jin

    2015-01-01

    We investigated anticancer effects of the crude polysaccharides (CPs) isolated from Ecklonia cava enzymatic extracts using AMG, Viscozyme, Protamex, and Alcalase enzyme against a colon cancer cell line, CT26 cells. Among them, the CP of Protamex extract (PCP) contained the highest fucose and sulfated group contents and showed the highest growth inhibitory effect against CT-26 cells. In addition, PCP dose-dependently increased the formation of apoptotic body and the percentage of Sub-G1 DNA co...

  9. Ecklonia cava Inhibits Glucose Absorption and Stimulates Insulin Secretion in Streptozotocin-Induced Diabetic Mice

    OpenAIRE

    Hye Kyung Kim

    2012-01-01

    Aims of study. Present study investigated the effect of Ecklonia cava (EC) on intestinal glucose uptake and insulin secretion. Materials and methods. Intestinal Na+-dependent glucose uptake (SGU) and Na+-dependent glucose transporter 1 (SGLT1) protein expression was determined using brush border membrane vesicles (BBMVs). Glucose-induced insulin secretion was examined in pancreatic β-islet cells. The antihyperglycemic effects of EC, SGU, and SGLT1 expression were determined in streptozotocin ...

  10. Cement Embolus Trapped in the Inferior Vena Cava Filter during Percutaneous Vertebroplasty

    OpenAIRE

    Li, Zhi; Ni, Rui-fang; Zhao, Xin; Yang, Chao; Li, Ming-Ming

    2013-01-01

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and p...

  11. Corylucinine, a new Alkaloid from Corydalis cava (Fumariaceae), and its Cholinesterase Activity

    Czech Academy of Sciences Publication Activity Database

    Novák, Z.; Chlebek, J.; Opletal, L.; Jiroš, Pavel; Macáková, K.; Kuneš, J.; Cahlíková, L.

    2012-01-01

    Roč. 7, č. 7 (2012), s. 859-860. ISSN 1934-578X Grant ostatní: SVV UK(CZ) 265002; SVV UK(CZ) 265001; FRVŠ(CZ) 664/2011; UNCE UK(CZ) 17/2012/ Institutional research plan: CEZ:AV0Z40550506 Keywords : Corydalis cava * corylucinine * 8-trichloromethyl-7,8-dihydropalmatine * acetylcholinesterase * butyrylcholinesterase * Alzheimer's disease Subject RIV: CC - Organic Chemistry Impact factor: 0.956, year: 2012

  12. Dilated coronary sinus in a dog with persistent left cranial vena cava

    International Nuclear Information System (INIS)

    This paper describes the electrocardiographic, echocardiographic (two-dimensional, M-mode, contrast and Doppler) and non-selective angiocardiographic features in a 3 year old female Beagle with dilated coronary sinus due to persistent left cranial vena cava. Negative P waves in leads III and aVR and a positive P wave in lead aVL were seen, Echocardiographically, a hipoechoic circular structure was seen between the left atrium and the pericardium in the area where the coronary sinus islocated, A velocity pattern with two peaks was obtained, one systolicwith velocity = 0.44 +/- 0.05 m/sec and the other diastolic with velocity = 0.27 +/- 0.01 m/sec, By M-mode echocardiography, at level of the aorta and the left atrium, a linear structure was identified betweenthe left atrium and the pericardium; this structure was characterizedby phasic movements of the anterior wall during the cardiac cycle, Following a left cephalic vein injection of saline, bubbles were seen within the coronary sinus; when saline was injected into the right cephalic vein, bubbles were also seen within the coronary sinus and right atrium and ventricle, Non-selective angiocardiography confirmed a dilated coronary sinus with persistent left cranial vena cava, The right cranial vena cava was absent, The dog was clinically normal and the unusual vessel was an incidental finding

  13. Safety and Efficacy of the Gunther Tulip Retrievable Vena Cava Filter: Midterm Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Hoffer, Eric K., E-mail: eric.k.hoffer@hitchcock.org; Mueller, Rebecca J.; Luciano, Marcus R.; Lee, Nicole N.; Michaels, Anne T.; Gemery, John M. [Dartmouth-Hitchcock Medical Center, Department of Radiology, Section of Vascular and Interventional Radiology (United States)

    2013-08-01

    PurposeTo evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.MethodsA retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59 % were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86 % of patients; 14 % were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.ResultsMean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3 %). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4 %). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8 %) at a mean of 731 days revealed a single (0.3 %) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5 %), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4 %) at a mean 757 days.ConclusionThe Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters.

  14. Safety and Efficacy of the Gunther Tulip Retrievable Vena Cava Filter: Midterm Outcomes

    International Nuclear Information System (INIS)

    PurposeTo evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.MethodsA retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.8 years, and 59 % were men. Venous thromboembolic disease and a contraindication to or complication of anticoagulation were the indications for filter placement in 86 % of patients; 14 % were placed for prophylaxis in patients with a mean of 2.3 risk factors. Follow-up was obtained by review of medical and radiologic records.ResultsMean clinical follow-up was 780 days. New or recurrent pulmonary embolus occurred in 12 patients (3.3 %). New or recurrent deep-vein thrombosis occurred in 53 patients (14.4 %). There were no symptomatic fractures, migrations, or caval perforations. Imaging follow-up in 287 patients (77.8 %) at a mean of 731 days revealed a single (0.3 %) asymptomatic fracture, migration greater than 2 cm in 36 patients (12.5 %), and no case of embolization. Of 122 patients with CT scans, asymptomatic perforations were identified in 53 patients (43.4 %) at a mean 757 days.ConclusionThe Gunther Tulip filter was safe and effective at 2-year follow-up. Complication rates were similar to those reported for permanent inferior vena cava filters

  15. Comparison of the Effectiveness of Three Methods of Recanalization in a Model of the Middle Cerebral Artery: Thrombus Aspiration via a 4F Catheter, Thrombus Aspiration via the GP Thromboaspiration Device, and Mechanical Thrombectomy Using the Solitaire Thrombectomy Device

    Directory of Open Access Journals (Sweden)

    Christopher Tennuci

    2011-01-01

    Full Text Available Introduction. This paper compares different approaches to recanalization in a model of the middle cerebral artery (MCA. Methods. An occlusive thrombus (lamb's blood was introduced into the MCA of a model of the cerebral circulation perfused with Hartmann's solution (80 pulsations/min, mean pressure 90 mm Hg. Three methods of clot retrieval were tested: thrombus aspiration via a 4F catheter (n=26, thrombus aspiration via the GP thrombus aspiration device (GPTAD (n=30, and mechanical thrombectomy via the Solitaire Device (n=30. Results. Recanalization rate was similar for all 3 approaches (62%, 77%, and 85%. Time to recanalization was faster with aspiration devices (41 SD 42 s for 4F and 61 SD 21 s for GPTAD than with the Solitaire (197 SD 64 s P<.05 Kruksal-Wallis. Clot fragmentation was the same in the Solitaire (23% and the GPTAD (23%, but higher with the 4F (53%, P<.05. Conclusion. In this model, thrombus aspiration was faster than mechanical thrombectomy, and similarly effective at recanalization. These results should be confirmed in vivo.

  16. Brachytherapy with Iodine-125 seeds strand for treatment of main portal vein tumor thrombi: an experimental study in a rabbit model

    OpenAIRE

    Zhang, Wen; Luo, Jianjun; Liu, Qingxin; Ma, Jingqin; Qu, Xudong; Yang, Minjie; Yan, Zhiping; Wang, Jianhua

    2016-01-01

    This study aims to establish an animal model of implanted main portal vein tumor thrombus (MPVTT) and to evaluate safety and efficacy of brachy therapy with Iodine-125 (125I) seeds strand to treat MPVTT of rabbit. VX2 tumor thrombus was implanted in main portal vein (MPV) of 32 New Zealand white rabbits. These rabbits were randomly divided into treatment group (Group T, T1-T16) and control group (Group C, C1-C16). 125I seeds and blank seeds strand were implanted in MPV of rabbits in Group T a...

  17. Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

    International Nuclear Information System (INIS)

    Aortic calcification and thrombus have been postulated to worsen outcome following endovascular abdominal aortic aneurysm repair (EVAR). The purpose of this study was to assess the association of abdominal aortic aneurysm (AAA) calcification and thrombus volume with outcome following EVAR using a reproducible, quantifiable computed tomography (CT) assessment protocol. Patients with elective EVAR performed between January 2002 and 2012 at the Townsville Hospital, Mater Private Hospital (Townsville) and Royal Brisbane and Women's Hospital (RBWH) were included if preoperative CTAs were available for analysis. AAA calcification and thrombus volume were measured using a semiautomated workstation protocol. Outcomes were assessed in terms of clinical failure, endoleak (type I, type II) and reintervention. Univariate and multivariate analyses were performed. Median follow-up was 1.7 years and the interquartile range 1.0-3.8 years. One hundred thirty-four patients undergoing elective EVAR were included in the study. Rates of primary clinical success and freedom from reintervention were 82.8 % and 88.9 % at the 24-month follow-up. AAA calcification and thrombus volume were not associated with clinical failure, type I endoleak, type II endoleak or reintervention. AAA calcification and thrombus volume were not associated with poorer outcome after EVAR in this study. (orig.)

  18. Adjunctive manual thrombus aspiration during ST-segment elevation myocardial infarction: a meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Song-Bai Deng

    Full Text Available The aim of this study was to synthesize evidence by examining the effects of manual thrombus aspiration on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI.A total of 26 randomized controlled trials (RCTs, enrolling 11,780 patients, with 5,869 patients randomized to manual thrombus aspiration and 5,911 patients randomized to conventional percutaneous coronary intervention (PCI, were included in the meta-analysis. Separate clinical outcome analyses were based on different follow-up periods. There were no statistically reductions in the incidences of mortality (risk ratio [RR], 0.86 [95% confidence interval [CI]: 0.73 to 1.02], reinfarction (RR, 0.62 [CI, 0.31 to 1.32] or target vessel revascularization (RR, 0.89 [CI, 0.75 to 1.05] in the manual thrombus aspiration arm at 12 to 24 months of follow-up. The composite major adverse cardiac events (MACEs outcomes were significantly lower in the manual thrombus aspiration arm over the long-term follow-up (RR, 0.76 [CI, 0.63 to 0.91]. A lower incidence of reinfarction was observed in the hospital to 30 days (RR, 0.59 [CI, 0.37 to 0.92].The present meta-analysis suggested that there was no evidence that using manual thrombus aspiration in patients with STEMI could provide distinct benefits in long-term clinical outcomes.

  19. Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

    Energy Technology Data Exchange (ETDEWEB)

    Rai, Divyajeet; Velu, Ramesh; Tosenovsky, Patrik; Quigley, Francis [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); The Townsville Hospital, Department of Vascular and Endovascular Surgery, Douglas (Australia); Wisniowski, Brendan; Walker, Philip J. [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); University of Queensland, School of Medicine and Centre for Clinical Research, Department of Vascular Surgery, Royal Brisbane and Women' s Hospital, Herston, QLD (Australia); Bradshaw, Barbara [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); Golledge, Jonathan [James Cook University, Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, Townsville, Queensland (Australia); The Townsville Hospital, Department of Vascular and Endovascular Surgery, Douglas (Australia); University of Queensland, School of Medicine and Centre for Clinical Research, Department of Vascular Surgery, Royal Brisbane and Women' s Hospital, Herston, QLD (Australia)

    2014-08-15

    Aortic calcification and thrombus have been postulated to worsen outcome following endovascular abdominal aortic aneurysm repair (EVAR). The purpose of this study was to assess the association of abdominal aortic aneurysm (AAA) calcification and thrombus volume with outcome following EVAR using a reproducible, quantifiable computed tomography (CT) assessment protocol. Patients with elective EVAR performed between January 2002 and 2012 at the Townsville Hospital, Mater Private Hospital (Townsville) and Royal Brisbane and Women's Hospital (RBWH) were included if preoperative CTAs were available for analysis. AAA calcification and thrombus volume were measured using a semiautomated workstation protocol. Outcomes were assessed in terms of clinical failure, endoleak (type I, type II) and reintervention. Univariate and multivariate analyses were performed. Median follow-up was 1.7 years and the interquartile range 1.0-3.8 years. One hundred thirty-four patients undergoing elective EVAR were included in the study. Rates of primary clinical success and freedom from reintervention were 82.8 % and 88.9 % at the 24-month follow-up. AAA calcification and thrombus volume were not associated with clinical failure, type I endoleak, type II endoleak or reintervention. AAA calcification and thrombus volume were not associated with poorer outcome after EVAR in this study. (orig.)

  20. Primary melanoma tumor inhibits metastasis through alterations in systemic hemostasis.

    Science.gov (United States)

    Kirstein, Jennifer M; Hague, M Nicole; McGowan, Patricia M; Tuck, Alan B; Chambers, Ann F

    2016-08-01

    Progression from a primary tumor to distant metastases requires extensive interactions between tumor cells and their microenvironment. The primary tumor is not only the source of metastatic cells but also can also modulate host responses to these cells, leading to an enhancement or inhibition of metastasis. Tumor-mediated stimulation of bone marrow can result in pre-metastatic niche formation and increased metastasis. However, a primary tumor can also inhibit metastasis through concomitant tumor resistance-inhibition of metastatic growth by existing tumor mass. Here, we report that the presence of a B16F10 primary tumor significantly restricted numbers and sizes of experimental lung metastases through reduction of circulating platelets and reduced formation of metastatic tumor cell-associated thrombi. Tumor-bearing mice displayed splenomegaly, correlated with primary tumor size and platelet count. Reduction in platelet numbers in tumor-bearing animals was responsible for metastatic inhibition, as restoration of platelet numbers using isolated platelets re-established both tumor cell-associated thrombus formation and experimental metastasis. Consumption of platelets due to a B16F10 primary tumor is a form of concomitant tumor resistance and demonstrates the systemic impact of a growing tumor. Understanding the interplay between primary tumors and metastases is essential, as clarification of concomitant tumor resistance mechanisms may allow inhibition of metastatic growth following tumor resection. Key messages Mice with a primary B16F10 tumor had reduced metastasis vs. mice without a primary tumor. Tumor-bearing mice had splenomegaly and fewer platelets and tumor-associated thrombi. Restoring platelets restored tumor-associated thrombi and increased metastasis. This work shows the impact that a primary tumor can have on systemic metastasis. Understanding these interactions may lead to improved ways to inhibit metastasis. PMID:27048169

  1. Rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases following combined loco-regional therapy

    International Nuclear Information System (INIS)

    This manuscript describes an unusual case of rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases occurring 1 month after combined chemoembolization and radiofrequency ablation. Inferior vena cava and portal vein invasion tumor thrombus was also detected, possibly accounting for the mechanism of disease dissemination route of disease.

  2. Rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases following combined loco-regional therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Dept. of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore (Singapore)

    2013-08-15

    This manuscript describes an unusual case of rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases occurring 1 month after combined chemoembolization and radiofrequency ablation. Inferior vena cava and portal vein invasion tumor thrombus was also detected, possibly accounting for the mechanism of disease dissemination route of disease.

  3. Rapid Intra-Hepatic Dissemination of Hepatocellular Carcinoma with Pulmonary Metastases Following Combined Loco-Regional Therapy

    OpenAIRE

    Pua, Uei

    2013-01-01

    This manuscript describes an unusual case of rapid intra-hepatic dissemination of hepatocellular carcinoma with pulmonary metastases occurring 1 month after combined chemoembolization and radiofrequency ablation. Inferior vena cava and portal vein invasion tumor thrombus was also detected, possibly accounting for the mechanism of disease dissemination route of disease.

  4. Artificial aortic valve dysfunction due to pannus and thrombus – different methods of cardiac surgical management

    Science.gov (United States)

    Marcinkiewicz, Anna; Kośmider, Anna; Walczak, Andrzej; Zwoliński, Radosław; Jaszewski, Ryszard

    2015-01-01

    Introduction Approximately 60 000 prosthetic valves are implanted annually in the USA. The risk of prosthesis dysfunction ranges from 0.1% to 4% per year. Prosthesis valve dysfunction is usually caused by a thrombus obstructing the prosthetic discs. However, 10% of prosthetic valves are dysfunctional due to pannus formation, and 12% of prostheses are damaged by both fibrinous and thrombotic components. The authors present two patients with dysfunctional aortic prostheses who were referred for cardiac surgery. Different surgical solutions were used in the treatment of each case. Case study 1 The first patient was a 71-year-old woman whose medical history included arterial hypertension, stable coronary artery disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and hypercholesterolemia; she had previously undergone left-sided mastectomy and radiotherapy. The patient was admitted to the Cardiac Surgery Department due to aortic prosthesis dysfunction. Transthoracic echocardiography revealed complete obstruction of one disc and a severe reduction in the mobility of the second. The mean transvalvular gradient was very high. During the operation, pannus covering the discs’ surface was found. A biological aortic prosthesis was reimplanted without complications. Case study 2 The second patient was an 87-year-old woman with arterial hypertension, persistent atrial fibrillation, and COPD, whose past medical history included gastric ulcer disease and ischemic stroke. As in the case of the first patient, she was admitted due to valvular prosthesis dysfunction. Preoperative transthoracic echocardiography revealed an obstruction of the posterior prosthetic disc and significant aortic regurgitation. Transesophageal echocardiography and fluoroscopy confirmed the prosthetic dysfunction. During the operation, a thrombus growing around a minor pannus was found. The thrombus and pannus were removed, and normal functionality of the prosthetic valve was restored

  5. Assessment of thrombus imaging potency of thrombin-targeting recombinant hirudin in vitro and in vivo

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate the effect of recombinant hirudin HV2 (rHHV2) as a thrombus imaging agent. 125I-rHHV2 and 125I-Th were prepared with Chloramine method, the labeling rate were 86.64% and 62.20%, with the radioactive purity of 89.70% and 91.22%, with the specific activity of 22.4 TBq/mmol and 94.43 TBq/mmol respectively. The competitive radioassay showed that the Th-fibrin complex formation did not affect the ability of rHHV2 binding with Th. In the complex, the molecular binding ratio of rHHV2 to Th and fibrinogen was 14:14:1. 99mTc-rHHV2 was prepared by 2-iminothiolane modified method, the labeled rate was 94%, with the radioactive purity of 93.90%, with the specific activity of 2.30 TBq/mmol. It was used to image fresh thrombi on arteries and veins of dog or rabbit (30 μg/kg). In SPECT images, all thrombin were clearly visible, arterial thrombosis imaging can be seen clearly within 45 min after injection and fade away slowly, venous thrombosis imaging also can be seen within 30 min after injection and quantitative imaging ratios between the thrombus and opposite vessel increased following the time. Biodistribution studies in mouse demonstrated that rHHV2 was excreted from kidneys. These data indicate that Th in Th-fibrin complex could be a potent target for diagnosis of thrombus and 99mTc-rHHV2 could be a new thrombotic imaging agent. (authors)

  6. A multimodality vascular imaging phantom of an abdominal aortic aneurysm with a visible thrombus

    Energy Technology Data Exchange (ETDEWEB)

    Allard, Louise; Chayer, Boris; Qin Zhao [Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Quebec H2L 2W5 (Canada); Soulez, Gilles [Department of Radiology, University of Montreal Hospital (CHUM), Quebec H2L 2M1 (Canada); Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Quebec H3T 1J4 (Canada); Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada); Roy, David [Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada); Cloutier, Guy [Laboratory of Biorheology and Medical Ultrasonics, Research Center, University of Montreal Hospital (CRCHUM), Quebec H2L 2W5 (Canada); Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Quebec H3T 1J4 (Canada); Institute of Biomedical Engineering, University of Montreal, Quebec H3T 1J4 (Canada)

    2013-06-15

    Purpose: With the continuous development of new stent grafts and implantation techniques, it has now become technically feasible to treat abdominal aortic aneurysms (AAA) with challenging anatomy using endovascular repair with standard, fenestrated, or branched stent-grafts. In vitro experimentations are very useful to improve stent-graft design and conformability or imaging guidance for stent-graft delivery or follow-up. Vascular replicas also help to better understand the limitation of endovascular approaches in challenging anatomy and possibly improve surgical planning or training by practicing high risk clinical procedures in the laboratory to improve outcomes in the operating room. Most AAA phantoms available have a very basic anatomy, which is not representative of the clinical reality. This paper presents a method of fabrication of a realistic AAA phantom with a visible thrombus, as well as some mechanical properties characterizing such phantom. Methods: A realistic AAA geometry replica of a real patient anatomy taken from a multidetector computed tomography (CT) scan was manufactured. To demonstrate the multimodality imaging capability of this new phantom with a thrombus visible in magnetic resonance (MR) angiography, CT angiography (CTA), digital subtraction angiography (DSA), and ultrasound, image acquisitions with all these modalities were performed by using standard clinical protocols. Potential use of this phantom for stent deployment was also tested. A rheometer allowed defining hyperelastic and viscoelastic properties of phantom materials. Results: MR imaging measurements of SNR and CNR values on T1 and T2-weighted sequences and MR angiography indicated reasonable agreement with published values of AAA thrombus and abdominal components in vivo. X-ray absorption also lay within normal ranges of AAA patients and was representative of findings observed on CTA, fluoroscopy, and DSA. Ultrasound propagation speeds for developed materials were also in

  7. Aneurysmal dilatation of persistent vitelline vein with thrombus in a neonate

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Kun Woo; Sung, Deuk Jae; Park, Beom Jin; Kim, Min Ju; Cho, Sung Bum [Korea University College of Medicine, Department of Radiology, Anam Hospital, Seoul (Korea, Republic of)

    2014-07-15

    The paired vitelline veins selectively involute and form a part of the portal vein during embryonic development. The presence of a persistent vitelline vein segment after birth is very rare and can be confused with anomalies of the portal and umbilical veins. We present sonographic, CT and MRI findings of aneurysmal dilatation of a persistent vitelline vein with thrombus in a neonate; this case was first misdiagnosed as an umbilical vein varix by prenatal US. MRI was used to identify the persistent vitelline vein segment and the remnant umbilical vein segment. (orig.)

  8. A multimodality vascular imaging phantom of an abdominal aortic aneurysm with a visible thrombus

    International Nuclear Information System (INIS)

    Purpose: With the continuous development of new stent grafts and implantation techniques, it has now become technically feasible to treat abdominal aortic aneurysms (AAA) with challenging anatomy using endovascular repair with standard, fenestrated, or branched stent-grafts. In vitro experimentations are very useful to improve stent-graft design and conformability or imaging guidance for stent-graft delivery or follow-up. Vascular replicas also help to better understand the limitation of endovascular approaches in challenging anatomy and possibly improve surgical planning or training by practicing high risk clinical procedures in the laboratory to improve outcomes in the operating room. Most AAA phantoms available have a very basic anatomy, which is not representative of the clinical reality. This paper presents a method of fabrication of a realistic AAA phantom with a visible thrombus, as well as some mechanical properties characterizing such phantom. Methods: A realistic AAA geometry replica of a real patient anatomy taken from a multidetector computed tomography (CT) scan was manufactured. To demonstrate the multimodality imaging capability of this new phantom with a thrombus visible in magnetic resonance (MR) angiography, CT angiography (CTA), digital subtraction angiography (DSA), and ultrasound, image acquisitions with all these modalities were performed by using standard clinical protocols. Potential use of this phantom for stent deployment was also tested. A rheometer allowed defining hyperelastic and viscoelastic properties of phantom materials. Results: MR imaging measurements of SNR and CNR values on T1 and T2-weighted sequences and MR angiography indicated reasonable agreement with published values of AAA thrombus and abdominal components in vivo. X-ray absorption also lay within normal ranges of AAA patients and was representative of findings observed on CTA, fluoroscopy, and DSA. Ultrasound propagation speeds for developed materials were also in

  9. Transitory lupus anticoagulant antibodies leading to a quickly resolvable left ventricular thrombus in a young female patient on peritoneal dialysis.

    Science.gov (United States)

    Koch, M; Beckmann, R

    2009-05-01

    We present a 38-year-old female patient on peritoneal dialysis for 3 years due to mesangioproliferative glomerulonephritis since early adolescence and chronic failure of the right kidney transplants. In early 2006 she was treated with high-dose cortisone due to cryptogenic, organized pneumonia. During a routine echocardiographic examination performed because of occurrence of cerebral symptoms such as diminished visual and auditory acuity in the patient, we detected a mobile, left ventricular thrombus of unusual large size, along with serologically measured Lupus anticoagulant antibodies (LA). The thrombus could be completely lyzed within only 12 hours by urokinese and antithrombotic danaparoid sodium therapy without surgical intervention. Successful treatment was proven by negative LA antibody activity as well as by echocardiography. The general clinical health was greatly improved after rehabilitation 2 months after lysis. We assume that the patient may have had infection- or cortisone-triggered transitory LA antibodies causing the serious heart thrombus with hypokinesia in the apex cordis. PMID:19473621

  10. Risk factors for development of left ventricular thrombus after first acute anterior myocardial infarction-association with anticardiolipin antibodies

    Directory of Open Access Journals (Sweden)

    Okuyan Ertuğrul

    2010-09-01

    Full Text Available Abstract Background Left ventricular thrombus(LVT] formation is a frequent complication in patients with acute anterior myocardial infarction(MI. LVT is associated with increased risk of embolism and higher mortality rates after acute MI. Anticardiolipin antibodies (ACA are immunoglobulins that react with phospholipid-binding proteins interfering with the prothrombin activator complex. The effects of phospholipids on pathophysiology of cardiovascular thrombotic events are well known. In this study, we aimed to evaluate the importance of clinical and biochemical parameters including anticardiolipin antibodies on left ventricular thrombus formation after acute anterior MI. Methods and Results Seventy patients with a first anterior AMI were prospectively and consecutively enrolled. Patients with previous MI, autoimmune disease, collagen vascular disease and arterial or venous thrombosis history were excluded from this study. At the time of hospitalization, key demographic and clinical characteristics were collected including age, gender, ethanol intake and presence of traditional risk factors for atherosclerosis (hypertension, diabetes, smoking, hyperlipidemia, positive family history. Patients were evaluated for echocardiographic data, blood chemistry and ACA. Two-dimensional and Doppler echocardiographic examinations were performed in all patients within the first week and at 14 days after MI. LV thrombus was detected in 30 (42.8% patients. ACA IgM levels were significantly higher in the patient group with LV thrombus than in the group without thrombus (12.44 ±4.12 vs. 7.69 ± 4.25 mpl, p = 0,01. ACA IgG levels were also found higher in the group with LV thrombus (24.2 ± 7.5 vs.17.98 ± 6.45 gpl, p = 0.02. Multivariate analyses revealed diabetes mellitus, higher WMSI, lower MDT and higher ACA IgM and higher ACA IgG levels as independent predictors of left ventricular thrombus formation. Conclusions Our data demonstrate that beside the low

  11. Engineering of plasminogen activators for targeting to thrombus and heightening thrombolytic efficacy.

    Science.gov (United States)

    Absar, S; Gupta, N; Nahar, K; Ahsan, F

    2015-09-01

    Thrombotic occlusion of the coronary artery, which triggers acute myocardial infarction, is one of the major causes of death in the USA. Currently, arterial occlusions are treated with intravenous plasminogen activators (PAs), which dissolve the clot by activating plasminogen. However, PAs indiscriminately generate plasmin, which depletes critical clotting factors (fibrinogen, factor V, and factor VIII), precipitates a lytic state in the blood, and produces bleeding complications in a large patient population. PAs have been extensively investigated to achieve thrombus specificity, to attenuate the bleeding risk, and to widen their clinical applications. In this review, we discuss various strategies that have been pursued since the beginning of thrombolytic therapy. We review the biotechnological approaches that have been used to develop mutant and chimeric PAs for thrombus selectivity, including the use of specific antibodies for targeting thrombi. We discuss particulate carrier-based systems and triggered-release concepts. We propose new hypotheses and strategies to spur future studies in this research arena. Overall, we describe the approaches and accomplishments in the development of patient-friendly and workable delivery systems for thrombolytic drugs. PMID:26074048

  12. Segmentation, Reconstruction, and Analysis of Blood Thrombus Formation in 3D 2-Photon Microscopy Images

    Directory of Open Access Journals (Sweden)

    Xu Zhiliang

    2010-01-01

    Full Text Available We study the problem of segmenting, reconstructing, and analyzing the structure growth of thrombi (clots in blood vessels in vivo based on 2-photon microscopic image data. First, we develop an algorithm for segmenting clots in 3D microscopic images based on density-based clustering and methods for dealing with imaging artifacts. Next, we apply the union-of-balls (or alpha-shape algorithm to reconstruct the boundary of clots in 3D. Finally, we perform experimental studies and analysis on the reconstructed clots and obtain quantitative data of thrombus growth and structures. We conduct experiments on laser-induced injuries in vessels of two types of mice (the wild type and the type with low levels of coagulation factor VII and analyze and compare the developing clot structures based on their reconstructed clots from image data. The results we obtain are of biomedical significance. Our quantitative analysis of the clot composition leads to better understanding of the thrombus development, and is valuable to the modeling and verification of computational simulation of thrombogenesis.

  13. On the Impact of Intraluminal Thrombus Mechanical Behavior in AAA Passive Mechanics.

    Science.gov (United States)

    Riveros, Fabián; Martufi, Giampaolo; Gasser, T Christian; Rodriguez-Matas, Jose F

    2015-09-01

    Intraluminal thrombus (ILT) is a pseudo-tissue that develops from coagulated blood, and is found in most abdominal aortic aneurysms (AAAs) of clinically relevant size. A number of studies have suggested that ILT mechanical characteristics may be related to AAA risk of rupture, even though there is still great controversy in this regard. ILT is isotropic and inhomogeneous and may appear as a soft (single-layered) or stiff (multilayered fibrotic) tissue. This paper aims to investigate how ILT constitution and topology influence the magnitude and location of peak wall stress (PWS). In total 21 patient-specific AAAs (diameter 4.2-5.4 cm) were reconstructed from computer tomography images and biomechanically analyzed using state-of-the-art modeling assumptions. Results indicated that PWS correlated stronger with ILT volume (ρ = 0.44, p = 0.05) and minimum thickness of ILT layer (ρ = 0.73, p = 0.001) than with maximum AAA diameter (ρ = 0.05, p = 0.82). On average PWS was 20% (SD 12%) higher for FE models that used soft instead of stiff ILT models (p soft and stiff thrombus tissue, can considerably influence stress in the AAA wall. The present study is limited to identification of influential biomechanical factors, and how its findings translate to an AAA rupture risk assessment remains to be explored by clinical studies. PMID:25636600

  14. Left ventricular assist device inflow cannula thrombus: characterization with two-dimensional transthoracic echocardiography.

    Science.gov (United States)

    Missov, Emil

    2013-01-01

    Thrombotic complications are inherent to current generation nonpulsatile left ventricular assist devices. The clinical expression of device thrombosis ranges from catastrophic failure to protracted and indolent. We report the case of a 79-year-old patient who received a left ventricular assist device as destination therapy and presented only with vague clinical symptoms. He was found to have a large thrombus in close proximity with the inflow cannula at the left ventricular apex, raising the question of mechanical obstruction. We describe the step-by-step contrast-enhanced two-dimensional transthoracic echocardiographic examination which allowed to obtain diagnostic acoustic tomograms of the inflow cannula and obviated the need for any additional imaging modalities. Transthoracic echocardiography (TTE) is the most common imaging modality used in the clinical follow-up of left ventricular assist device recipients. A frequent clinical indication for TTE is to exclude left ventricular apical thrombus near the inflow cannula. Imaging of the inflow cannula at the left ventricular apex in the traditional apical 4 chamber, apical 2 chamber, and parasternal long axis views is challenging by TTE mainly because of poor acoustic windows, image artifacts, large body habitus, and operator experience. PMID:24172272

  15. Right Ventricular Thrombus and Cerebral Artery Aneurysm in a Patient with Behçet's Disease.

    Science.gov (United States)

    Sabzi, Feridoun; Mirzaei, Samaneh; Faraji, Reza

    2016-05-01

    We report a 35-year-old woman referred to the Imam Ali Hospital, Kermanshah, Iran, in July 2014 for evaluation of postoperative dyspnoea after neurosurgery performed seven days previously for a ruptured cerebral artery aneurysm. She was known to have Behçet's disease with a history of recurrent oral and genital aphthous ulcers and uveitis. At referral, her symptoms included vertigo, dysarthria, palpitations and chest pain. Transthoracic echocardiography (TTE) revealed a large thrombus in her right ventricle outflow tract and open-heart surgery was performed eight days after the previous surgery to remove the clot. The postoperative period was complicated by transient acute renal failure, which resolved spontaneously. The patient was discharged 13 days after the cardiac surgery on warfarin, prednisolone, azathioprine and cyclophosphamide. Cyclophosphamide and azathioprine were discontinued after three months as the symptoms had completely resolved; however, prednisolone was continued due to recurrent uveitis. A 10-month follow-up TTE scan revealed no thrombus recurrence and treatment with warfarin and prednisolone was continued. PMID:27226921

  16. Transjugular intrahepatic portosystemic shunt for the treatment of portal vein thrombus:its current status

    International Nuclear Information System (INIS)

    The prevalence of portal vein thrombosis in the general population is about 1.1%, while it is about 10%-25% in the cirrhotic patients. The severe clinical complication in patients with acute portal vein thrombosis is ischemic intestinal infarction when the thrombus extends to the mesenteric venous arch. The complications include bleeding due to gastroesophageal varices, ascites and deterioration of live function in the patients with chronic portal vein thrombosis. The recently-published Practice Guidelines indicate that the treatment of portal vein thrombosis includes anticoagulation,thrombolysis, transjugular intrahepatic portosystemic shunt (TIPS) and surgical thrombectomy. TIPS has some advantages in treating portal vein thrombus. It can directly and effectively re-canalize the occluded portal vein. Moreover, it can accelerate portal flow and prevent recurrent thrombosis after the shunt is well-established. The disadvantages of TIPS include technical difficulties and potential complications. However, percutaneous transhepatic, transsplenic and transmesenteric approaches well facilitate the TIPS procedure. Additionally, preoperative evaluation of portal vein anatomy can provide a safe and effective choice in treating patients with portal cavernoua caver who are going to receive TIPS. Nevertheless, in the absence of relevant prospective studies, the application of TIPS for the management of portal vein thrombosis is still limited. (authors)

  17. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven; Jensen, Leif P; Bækgaard, Niels

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  18. Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report.

    Science.gov (United States)

    Emmiler, Mustafa; Kocogullari, Cevdet Ugur; Yilmaz, Sezgin; Cekirdekci, Ahmet

    2008-01-01

    Abdominal vascular injuries are among the most challenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic materials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal contaminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo-fascial graft. The authors have used APF graft in traumatic inferior vena cava injury for the first time. PMID:18667465

  19. On-and offshore tephrostratigraphy and -chronology of the southern Central American Volcanic Arc (CAVA)

    Science.gov (United States)

    Schindlbeck, J. C.; Kutterolf, S.; Hemming, S. R.; Wang, K. L.

    2015-12-01

    Including the recently drilled CRISP sites (IODP Exp. 334&344) the deep sea drilling programs have produced 69 drill holes at 29 Sites during 9 Legs at the Central American convergent margin, where the Cocos plate subducts beneath the Caribbean plate. The CAVA produced numerous plinian eruptions in the past. Although abundant in the marine sediments, information and data regarding large late Cenozoic explosive eruptions from Costa Rica, Nicaragua, Honduras, El Salvador, and Guatemala remain very sparse and discontinuous on land. We have established a tephrostratigraphy from recent through Miocene times from the unique archive of ODP/IODP sites offshore Central America in which we identify tephra source regions by geochemical fingerprinting using major and trace element glass shard compositions. Here we present first order correlations of ­~500 tephra layers between multiple holes at a single site as well as between multiple sites. We identified ashes supporting Costa Rican (~130), Nicaraguan (17) and Guatemalan (27) sources as well as ~150 tephra layers from the Galápagos hotspot. Within our marine record we also identified well-known marker beds such as the Los Chocoyos tephra from Atitlán Caldera in Guatemala and the Tiribi Tuff from Costa Rica but also correlations to 15 distinct deposits from known Costa Rican and Nicaraguan eruptions within the last 4.1 Ma. These correlations, together with new radiometric age dates, provide the base for an improved tephrochronostratigraphy in this region. Finally, the new marine record of explosive volcanism offshore southern CAVA provides insights into the eruptive history of long-living volcanic complexes (e.g., Barva, Costa Rica) and into the distribution and frequency of large explosive eruptions from the Galápagos hotspot. The integrated approach of Ar/Ar age dating, correlations with on land deposits from CAVA, biostratigraphic ages and sediment accumulation rates improved the age models for the drilling sites.

  20. Digital subtraction phlebography of the arm veins and vena cava superior

    International Nuclear Information System (INIS)

    We report on the results of 40 digital subtraction phlebograms of the great veins of the upper extremities and the mediastinum in 32 patients. In all cases diagnostic satisfactory examinations were achieved that demonstrated the anatomy of the veins in question. The method can be either used for the primary diagnosis or for controls during lysis of thrombotic lesions. The v. cava superior could be opacified even after ipsilateral injection of diluted contrast media in one-sided thrombotic occlusions of these veins. (orig.)

  1. Absent right superior caval vein (vena cava) with normal atrial arrangement.

    OpenAIRE

    Choi, J. Y.; Anderson, R H; Macartney, F J

    1987-01-01

    Eight cases of absent right superior caval vein (vena cava) with normal atrial arrangement from the Great Ormond Street database were reviewed. In each case the right subclavian vein and jugular vein drained into a persistent left superior caval vein through a bridging vein. In six cases the left superior caval vein drained into the right atrium by way of the coronary sinus, and in two cases it drained into the left atrium directly because of the complete unroofing of the coronary sinus. The ...

  2. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Li, Zhi; Ni, Rui Fang; Zhao, Xin; Yang, Chao; Li, Ming Ming [First Affiliated Hospital of Soochow University, Suzhou (China)

    2013-06-15

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  3. Primary mediastinal melanoma presenting as superior vena cava syndrome: A case study

    Directory of Open Access Journals (Sweden)

    Ann C Gaffey

    2016-03-01

    Full Text Available The rates of melanoma have increased over the past 30 years. Malignant melanoma most commonly occurs in the skin with secondary involvement of other organs. Here, we present an extremely rare case of malignant melanoma of the mediastinum with presentation of superior vena cava syndrome without clinical evidence of extrathoracic disease. The incidence of this clinical presentation is uncommon, resulting in only a handful of case reports in the literature. [Arch Clin Exp Surg 2016; 5(1.000: 56-58

  4. Azygos Tip Placement for Hemodialysis Catheters in Patients with Superior Vena Cava Occlusion

    International Nuclear Information System (INIS)

    Chronic central venous access is necessary for numerous life-saving therapies. Repeated access is complicated by thrombosis and occlusion of the major veins, such as the superior vena cava (SVC), which then require novel vascular approaches if therapy is to be continued. We present two cases of catheterization of the azygos system in the presence of an SVC obstruction. We conclude that the azygos vein may be used for long-term vascular access when other conduits are unavailable and that imaging studies such as magnetic resonance venography, contrast-enhanced computed tomography or conventional venography can be employed prior to the procedure to aid with planning and prevent unforeseen complications

  5. Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty

    International Nuclear Information System (INIS)

    A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation.

  6. Extracorporeal Lung Support as a Bridge to Airway Stenting and Radiotherapy for Airway-Obstructing Pancoast Tumor.

    Science.gov (United States)

    McLenon, Melissa; Bittle, Gregory J; Jones, Kevin; Menaker, Jay; Pham, Si M; Iacono, Aldo T; Sachdeva, Ashutosh; Rajagopal, Keshava

    2016-07-01

    Venovenous (V-V) extracorporeal membrane oxygenation (ECMO) is used for respiratory failure that is suspected to be reversible (bridge to recovery), or as a bridge to lung transplantation. Patients with proximal airway obstruction due to endobronchial malignancy can develop acute respiratory failure, and may benefit from V-V ECMO as a bridge to airway intervention, further treatment, and eventual recovery. We describe a case of a superior sulcus tumor with tracheobronchial and superior vena cava invasion causing both respiratory failure and superior vena cava syndrome. This was treated successfully with V-V ECMO, bronchial stenting, and radiotherapy. PMID:27343540

  7. Large cell non-Hodgkin's lymphoma masquerading as renal carcinoma with inferior vena cava thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Weissman Alan

    2011-06-01

    Full Text Available Abstract Introduction Many cancers are associated with inferior vena cava (IVC obstruction, but very few cancers have the ability to propagate within the lumen of the renal vein or the IVC. Renal cell carcinoma is the most common of these cancers. Renal cancer with IVC extension has a high rate of recurrence and a low five year survival rate. Case presentation A 62-year-old Caucasian woman previously in good health developed the sudden onset of severe reflux symptoms and right-sided abdominal pain that radiated around the right flank. A subsequent ultrasound and CT scan revealed a right upper pole renal mass with invasion of the right adrenal gland, liver, left renal vein and IVC. This appeared to be consistent with stage III renal cancer with IVC extension. Metastatic nodules were believed to be present in the right pericardial region; the superficial anterior abdominal wall; the left perirenal, abdominal and pelvic regions; and the left adrenal gland. The pattern of these metastases, as well as the invasion of the liver by the tumor, was thought to be atypical of renal cancer. A needle biopsy of a superficial abdominal wall mass revealed a surprising finding: The malignant cells were diagnostic of large-cell, B-cell non-Hodgkin's lymphoma. The lymphoma responded dramatically to systemic chemotherapy, which avoided the need for nephrectomy. Conclusion Lymphomas only rarely progress via intraluminal vascular extension. We have been able to identify only one other case report of renal lymphoma with renal vein and IVC extension. While renal cancer would have been treated with radical nephrectomy and tumor embolectomy, large-cell B-cell lymphomas are treated primarily with chemotherapy, and nephrectomy would have been detrimental. It is important to remember that, rarely, other types of cancer arise from the kidney which are not derived from the renal tubular epithelium. These may be suspected if an atypical pattern of metastases or unusual

  8. Endovascular treatment of an iatrogenic superior vena cava perforation caused by the placement of a hemodialysis catheter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, See Hyung; Kim, Young Hwan; Keum, Dong Yoon [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-01-15

    The perforation of superior vena cava during the placement of a tunneled hemodialysis catheter, via the subclavian vein, is a rare complication, and is manifested by hemothorax or hemopericardium. The treatment of this complication requires an early diagnosis and open thoracic surgery. Herein, we report a patient with hemothorax due to the perforation of the superior vena cava during the placement of a tunneled hemodialysis catheter via the right subclavian vein which was successfully treated by embolization by way of a coil and histoacryl.

  9. Relationship between encephalopathy and portal vein-vena cava shunt:Value of computed tomography during arterial portography

    Institute of Scientific and Technical Information of China (English)

    Qian Chu; Zhen Li; Su-Ming Zhang; Dao-Yu Hu; Ming Xiao

    2004-01-01

    AIM: To assess the value of computed tomography during arterial portography (CTAP) in portal vein-vena cava shunt,and analysis of the episode risk in encephalopathy.METHODS: Twenty-nine patients with portal-systemic encephalopathy due to portal hypertension were classified by West Haven method into grade Ⅰ(29 cases), gradeⅡ(16 cases), grade Ⅲ(10 cases), grade Ⅳ( 4 cases). All the patients were scanned by spiral-CT. Plane scans, artery phase and portal vein phase enhancement scans were performed, and the source images were thinly reconstructed to 1.25 mm. We reconstructed the celiac trunk, portal vein,inferior vena cava and their branches and subjected them to three-dimensional vessel analysis by volume rendering(VR) technique and multiplanar volume reconstruction(MPVR) technique. The blood vessel reconstruction technique was used to evaluate the scope and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery- portal vein. The relationship between the episode risk of portal-systemic encephalopathy and the scope and extent of portal vein-vena cava shunt,portal vein emboli and fistula of hepatic artery- portal vein was studied.RESULTS: The three-dimensional vessel reconstruction technique of spiral-CT could display celiac trunk, portal vein,inferior vena cava and their branches at any planes and angles and the scope and extent of portal vein-vena cava shunt, portal vein emboli and the fistula of hepatic artery- portal vein. In twenty-nine patients with portal-systemic encephalopathy, grade Ⅰ accounted for 89.7% esophageal varices, 86.2% paragastric varices; grade Ⅱ accounted for68.75% cirsomphalos, 56.25% paraesophageal varices,62.5% retroperitoneal varices and 81.25% dilated azygos vein; grade Ⅲ accounted for 80% cirsomphalos, 60%paraesophageal varices, 70% retroperitoneal varices, 90%dilated azygos vein, and part of the patients in grades Ⅱand Ⅲ had portal vein emboli and fistula of hepatic arteryportal vein

  10. Right-sided superior vena cava draining into the left atrium: a rare anomaly of systemic venous return

    Energy Technology Data Exchange (ETDEWEB)

    Aminololama-Shakeri, Shadi; Wootton-Gorges, Sandra L.; Reyes, Melissa; Moore, Elizabeth H. [University of California Davis, Medical Center and Children' s Hospital, Department of Radiology, Sacramento, CA (United States); Pretzlaff, Robert K. [University of California Davis, Medical Center and Children' s Hospital, Department of Pediatrics, Sacramento, CA (United States)

    2007-03-15

    The most commonly encountered systemic thoracic venous anomaly is a persistent left superior vena cava that drains into the right atrium via the coronary sinus. A much rarer systemic venous anomaly is that of isolated anomalous drainage of a normally positioned right superior vena cava (RSVC) into the left atrium (LA). This has been reported in approximately 20 patients with the diagnosis usually being made by cardiac catheterization. We report the case of a toddler with asymptomatic hypoxemia resulting from anomalous drainage of a normal RSVC into his LA. This was diagnosed non-invasively by contrast-enhanced chest CT. (orig.)

  11. Paroxysmal Nocturnal Hemoglobinuria Presenting with a Left Intraventricular Thrombus in a Patient with Prior Thymoma and Aplastic Anemia

    OpenAIRE

    Yazan Migdady; Olszewski, Adam J.

    2011-01-01

    We report the case of a 37-year old man presenting with a left ventricular cardiac thrombus in the setting of subclinical paroxysmal nocturnal hemoglobinura (PNH) developing two years after immunosuppressive therapy for thymoma-associated aplastic anemia. The literature regarding the interplay between autoimmunity and immunosuppression, aplastic anemia, thymoma and the emergence of PNH is reviewed.

  12. Methylglyoxal induces platelet hyperaggregation and reduces thrombus stability by activating PKC and inhibiting PI3K/Akt pathway.

    Directory of Open Access Journals (Sweden)

    Karin Hadas

    Full Text Available Diabetes is characterized by a dysregulation of glucose homeostasis and platelets from patients with diabetes are known to be hyper-reactive and contribute to the accelerated development of vascular diseases. Since many of the deleterious effects of glucose have been attributed to its metabolite methylgyloxal (MG rather than to hyperglycemia itself, the aim of the present study was to characterize the effects of MG on platelet function. Washed human platelets were pre-incubated for 15 min with MG and platelet aggregation, adhesion on matrix-coated slides and signaling (Western blot were assessed ex vivo. In vivo, the effect of MG on thrombus formation was determined using the FeCl3-induced carotid artery injury model. MG potentiated thrombin-induced platelet aggregation and dense granule release, but inhibited platelet spreading on fibronectin and collagen. In vivo, MG accelerated thrombus formation but decreased thrombus stability. At the molecular level, MG increased intracellular Ca(2+ and activated classical PKCs at the same time as inhibiting PI3K/Akt and the β3-integrin outside-in signaling. In conclusion, these findings indicate that the enhanced MG concentration measured in diabetic patients can directly contribute to the platelet dysfunction associated with diabetes characterized by hyperaggregability and reduced thrombus stability.

  13. Local Quantification of Wall Thickness and Intraluminal Thrombus Offer Insight into the Mechanical Properties of the Aneurysmal Aorta.

    Science.gov (United States)

    Martufi, Giampaolo; Satriano, Alessandro; Moore, Randy D; Vorp, David A; Di Martino, Elena S

    2015-08-01

    Wall stress is a powerful tool to assist clinical decisions in rupture risk assessment of abdominal aortic aneurysms. Key modeling assumptions that influence wall stress magnitude and distribution are the inclusion or exclusion of the intraluminal thrombus in the model and the assumption of a uniform wall thickness. We employed a combined numerical-experimental approach to test the hypothesis that abdominal aortic aneurysm (AAA) wall tissues with different thickness as well as wall tissues covered by different thrombus thickness, exhibit differences in the mechanical behavior. Ultimate tissue strength was measured from in vitro tensile testing of AAA specimens and material properties of the wall were estimated by fitting the results of the tensile tests to a histo-mechanical constitutive model. Results showed a decrease in tissue strength and collagen stiffness with increasing wall thickness, supporting the hypothesis of wall thickening being mediated by accumulation of non load-bearing components. Additionally, an increase in thrombus deposition resulted in a reduction of elastin content, collagen stiffness and tissue strength. Local wall thickness and thrombus coverage may be used as surrogate measures of local mechanical properties of the tissue, and therefore, are possible candidates to improve the specificity of AAA wall stress and rupture risk evaluations. PMID:25631202

  14. Thrombus Degradation by Fibrinolytic Enzyme of Stenotrophomonas sp. Originated from Indonesian Soybean-Based Fermented Food on Wistar Rats

    Science.gov (United States)

    Tjandrawinata, Raymond R.

    2016-01-01

    Objective. To evaluate thrombus degrading effect of a fibrinolytic enzyme from food origin Stenotrophomonas sp. of Indonesia. Methods. Prior to animal study, the enzyme safety was tested using cell culture. The effect on expression of tissue plasminogen activator was also analysed in the cell culture. For in vivo studies, 25 Wistar rats were used: normal control, negative control, treatment groups with crude and semipurified enzyme given orally at 25 mg/kg, and positive control group which received Lumbrokinase at 25 mg/kg. Blood clot in the tail was induced by kappa carrageenan injection at 1 mg/kg BW. Results. Experiment with cell culture confirmed the enzyme safety at the concentration used and increased expression of tPA. Decreasing of thrombus was observed in the positive group down to 70.35 ± 23.11% of the negative control animals (100%). The thrombus observed in the crude enzyme treatment was down to 56.99 ± 15.95% and 71.5 ± 15.7% for semipurified enzyme. Scanning electron microscopy showed clearly that bood clots were found in the animals injected with kappa carrageenan; however, in the treatment and positive groups, the clot was much reduced. Conclusions. Oral treatment of enzyme from Stenotrophomonas sp. of Indonesian fermented food was capable of degrading thrombus induced in Wistar rats.

  15. Simulation of platelet, thrombus and erythrocyte hydrodynamic interactions in a 3D arteriole with in vivo comparison.

    Directory of Open Access Journals (Sweden)

    Weiwei Wang

    Full Text Available Cylindrical blood vessels, ellipsoid platelets and biconcave-shaped deformable erythrocytes (RBCs are important participants in hemostasis and thrombosis. However, due to the challenge of combining these components in simulation tools, few simulation studies have included all of them in realistic three-dimensional models. In the present study, we apply a recently developed simulation model to incorporate these components and analyze the flow in a thrombotic tubular arteriole, particularly the detailed hydrodynamic interactions between the thrombus shape, RBCs and platelets. It was found that at certain azimuth positions, the velocity drops in the proximity of both the upstream and downstream edge of the thrombus, which is accompanied by a rapid velocity increase in the narrowed region. The RBCs alter the flow profiles significantly from the typical low Reynolds (Re number flow, and also enhance the deposition of free flowing platelets onto the thrombus. By evaluating the platelet-thrombus interaction and platelet-RBC interaction together, several mechanisms of platelet deposition augmentation are identified. With in vivo data comparison, our model illustrates the potential of future thrombosis studies that incorporate detailed receptor-ligand adhesion modules.

  16. The role of Nox1 and Nox2 in GPVI-dependent platelet activation and thrombus formation

    Directory of Open Access Journals (Sweden)

    T.G. Walsh

    2014-01-01

    Conclusion: Together these results demonstrate a novel role for Nox1 in regulating GPVI-induced ROS production, which is essential for optimal p38 activation and subsequent TxA2 production, providing an explanation for reduced thrombus formation following Nox1 inhibition.

  17. Robot-assisted laparoscopic excision of a retroperitoneal paracaval tumor.

    Science.gov (United States)

    Wei, Tzu-Chun; Chung, Hsiao-Jen; Lin, Alex T L; Chen, Kuang-Kuo

    2013-12-01

    During the past few years, robotic surgical systems have been rapidly developed. The progress and advantages of these systems include three-dimensional vision and enhanced ergonomics. These advantages have helped a new generation of minimally invasive surgery to evolve. The da Vinci Surgical System seems to greatly resolve problems (e.g., wide exposure and retraction of peritoneal organs) that are confronted by traditional laparoscopic surgeries for retroperitoneal tumors that are near great vessels. There have been few reported cases concerning laparoscopic excision of retroperitoneal tumors situated between the inferior vena cava, the right renal vessel, and the kidney. We report the use of a robotic surgical system for this type of treatment. A 54-year-old female patient had a hypoechoic lesion near the inferior vena cava and superior to the right renal vessels. It was incidentally found by ultrasound during a health check-up examination. The computed tomography (CT) scan revealed a heterogeneous contrast-enhanced retroperitoneal mass approximately 4.4 cm medial to the right kidney with the inferior vena cava slightly deviated to the left. Robot-assisted laparoscopic excision of the retroperitoneal tumor was performed on October 15, 2010 with an operation time of 135 minutes and an estimated blood loss of less than 30 mL. The J-Vac drainage tube was removed on postoperative Day 3, and the patient was discharged in a stable condition the following day. The pathology of the tumor was retroperitoneal schwannoma. A re-evaluation was arranged postoperatively for the 15-month ambulatory visit. No local recurrence or distal metastasis was present. PMID:24079977

  18. Endovascular Treatment of Malignant Superior Vena Cava Syndrome: Results and Predictive Factors of Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    Fagedet, Dorothee, E-mail: DFagedet@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de medecine interne, Pole Pluridisciplinaire de Medecine (France); Thony, Frederic, E-mail: FThony@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Timsit, Jean-Francois, E-mail: JFTimsit@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de reanimation, Pole Medecine Aiguee Communautaire (France); Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Monnin-Bares, Valerie, E-mail: v-monnin@chu-montpellier.fr [CHRU Arnaud de Villeneuve, Imagerie Medicale Thoracique Cardiovasculaire (France); Ferretti, Gilbert R., E-mail: GFerretti@chu-grenoble.fr [CHU de Grenoble, Clinique universitaire de radiologie et imagerie medicale, Pole d' Imagerie (France); Vesin, Aurelien; Moro-Sibilot, Denis, E-mail: DMoro.pneumo@chu-grenoble.fr [University Grenoble 1 e Albert Bonniot Institute, Inserm U823 (France)

    2013-02-15

    To demonstrate the effectiveness of endovascular treatment (EVT) with self-expandable bare stents for malignant superior vena cava syndrome (SVCS) and to analyze predictive factors of EVT efficacy. Retrospective review of the 164 patients with malignant SVCS treated with EVT in our hospital from August 1992 to December 2007 and followed until February 2009. Endovascular treatment includes angioplasty before and after stent placement. We used self-expandable bare stents. We studied results of this treatment and looked for predictive factors of clinical efficacy, recurrence, and complications by statistical analysis. Endovascular treatment was clinically successful in 95% of cases, with an acceptable rate of early mortality (2.4%). Thrombosis of the superior vena cava was the only independent factor for EVT failure. The use of stents over 16 mm in diameter was a predictive factor for complications (P = 0.008). Twenty-one complications (12.8%) occurred during the follow-up period. Relapse occurred in 36 patients (21.9%), with effective restenting in 75% of cases. Recurrence of SVCS was significantly increased in cases of occlusion (P = 0.01), initial associated thrombosis (P = 0.006), or use of steel stents (P = 0.004). Long-term anticoagulant therapy did not influence the risk of recurrence or complications. In malignancy, EVT with self-expandable bare stents is an effective SVCS therapy. These results prompt us to propose treatment with stents earlier in the clinical course of patients with SVCS and to avoid dilatation greater than 16 mm.

  19. The clinical implications of variants of vena cava inferior and aorta on retroperitoneal surgery

    Directory of Open Access Journals (Sweden)

    S. V. Mukhtarulina

    2014-12-01

    Full Text Available Objective: to study variants of retroperitoneal vascular structure and its clinical implications on retroperitoneal surgery in patients with cervical cancer IA–IIB stage.Materials and methods. 101 patients who underwent paraaortic and bilateral pelvic lymphadenectomy were included in this study. 10 patients of the first group with anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were compared with 91 patients of the second group without anomalies.Results. Variants of major retroperitoneal vascular structure were present in 10 (9.9 % patients. Supernumerary renal arteries and veins observed in 5 (4.9 % patients; retroaortic left renal vein type I and II – in 3 (3.0 % patients. Double vena cava inferior detected in 1 (1.0 % patient. Patients with variants of retroperitoneal vascular structures hadn’t vessel injury. There was no difference in intraoperative hemorrhage, transfusion red blood cell, rate of intraoperative hemoglobin and removed paraaortic lymph nodes between the groups. Risk factors for intraoperative bleeding in patients with cervical cancer, depending on the presence or absence of anomalies of retroperitoneal vessels had no significant difference.Conclusion. Despite the fact that the variants of retroperitoneal vascular structures are rare (9.9 %, the success of retroperitoneal surgery is associated with the knowledge of vascular variations which decrease serious, life-threatening complications.

  20. CT of inferior vena cava filters: normal presentations and potential complications.

    Science.gov (United States)

    Georgiou, Nicholas A; Katz, Douglas S; Ganson, George; Eng, Kaitlin; Hon, Man

    2015-12-01

    With massive pulmonary embolism (PE) being the first or second leading cause of unexpected death in adults, protection against PE is critical in appropriately selected patients. The use of inferior vena cava (IVC) filters has increased over the years, paralleling the increased detection of deep venous thrombosis (DVT) and PE by improved and more available imaging techniques. The use of IVC filters has become very common as an alternative and/or as a supplement to anticoagulation, and these filters are often seen on routine abdominal CT, including in the emergency setting; therefore, knowledge of the normal spectrum of findings of IVC filters by the radiologist on CT is critical. Additionally, CT can be used specifically to identify complications related to IVC filters, and CT may alternatively demonstrate IVC filter-related problems which are not specifically anticipated clinically. With multiple available IVC filters on the US market, and even more available outside of the USA, it is important for the emergency and the general radiologist to recognize the different models and various appearances and positioning on CT, as well as their potential complications. These complications may be related to venous access, but also include thrombosis related to the filter, filter migration and penetration, and problems associated with filter deployment. With the increasing number of inferior vena cava filters placed and their duration within patients increasing over time, it is critical for emergency and other radiologists to be aware of these findings on CT. PMID:26183040

  1. Endovascular stenting in superior vena cava syndrome: utility of a through-and-through guidewire technique

    Energy Technology Data Exchange (ETDEWEB)

    Clark, T.W.I. [Dalhousie Univ., Queen Elizabeth II Health Sciences Centre, Section of Interventional Radiology, Dept. of Diagnostic Imaging, Halifax, NS (Canada)

    2000-08-01

    Objective: To describe an ancillary technique when a conventional femoral approach to superior vena cava (SVC) stent placement is not feasible because of buckling of balloon catheters or stent-deployment systems during device advancement. Patients and methods: Three patients in whom device advancement across the SVC lesion from a femoral or axillary approach was unsuccessful were managed by accessing the right jugular vein; SVC lesions were crossed from an antegrade direction, and the jugular guidewire was secured at the femoral access site to create a through-and-through guidewire. Results: Countertraction on the through-and-through guidewire during stent placement and dilation permitted unhindered advancement of stent delivery systems and catheters across the SVC. Technical and clinical success was achieved in each patient with relief of SVC syndrome within 24-72 hours. Survival ranged from 26 to 137 days. Conclusion: A through-and-through guidewire technique is useful when stenting a highly stenotic or thrombosed SVC in patients with superior vena cava syndrome. (author)

  2. Accidental implantation of hemodialysis catheter in persistent left superior vena cava

    International Nuclear Information System (INIS)

    The implantation of central catheters for hemodialysis in patients with renal failure is a common practice. The venous access to the internal jugular vein through percutaneous puncture is the most recommended procedure because it produces the lowest percentage of stenosis. The right internal jugular vein puncture is the most appropriate one because it goes directly in vertical direction into the right atrium, but in some cases its canalization is impossible making it necessary to puncture the left internal jugular vein, the one next to the innominated vein that ends in the superior cava, with the result that its path is much curved. 3 cases in which the left intern jugular catheter that was inserted to perform hemodialysis accidentally canalized the anomaly in the persistent left superior vena cava were presented. In all the cases and before proceeding with the hemodialysis it was demonstrated by the gases of the punctuated vessel, echocardiogram or contrast medium that the catheter was positioned in the venous system that drains in the right atrium.

  3. Statins improve the resolution of established murine venous thrombosis: reductions in thrombus burden and vein wall scarring.

    Directory of Open Access Journals (Sweden)

    Chase W Kessinger

    Full Text Available Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT will develop the post-thrombotic syndrome (PTS. Improving the long-term outcome of DVT patients at risk for PTS will therefore require new approaches. Here we investigate the effects of statins--lipid-lowering agents with anti-thrombotic and anti-inflammatory properties--in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice. Treatment of mice with daily atorvastatin or rosuvastatin significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi compared similarly to the therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1, tissue factor, neutrophils, myeloperoxidase, neutrophil extracellular traps (NETs, and macrophages, and these effects were most notable in the earlier timepoints after DVT formation. In addition, statins reduced DVT-induced vein wall scarring by 50% durably up to day 21 in stasis VT, as shown by polarized light microscopy of picrosirius red-stained vein wall collagen. The overall results demonstrate that statins improve VT resolution via profibrinolytic, anticoagulant, antiplatelet, and anti-vein wall scarring effects. Statins may therefore offer a new pharmacotherapeutic approach to improve DVT resolution and to reduce the post-thrombotic syndrome, particularly in subjects who are ineligible for anticoagulation therapy.

  4. Radiolabelled anti-human fibrin antibody: a new thrombus-detecting agent

    International Nuclear Information System (INIS)

    Rabbit anti-human fibrin globulin (A.F.G.) was labelled with iodine (131I) and used as a thrombus-detecting agent. 131I-A.F.G. labelled thrombi were displayed by means of a gamma scintillation camera. Normal subjects and patients with thrombo-phlebitis of legs, acute fibrin depositions other than thrombi, and chronic varicosities were examined. The 131I-A.F.G. technique detected both formed thrombi and those that were forming and could discriminate between acute thrombosis and chronic varicosities. Thrombo-phlebitis and extravascular fibrin depositions were best demonstrated between 24 and 72 hours after 131I-A.F.G. injection. Radiolabelled A.F.G. in normal veins and chronic varicosities was best displayed within 6 hours of injection. (author)

  5. Late Thrombolytic Treatment In A Patient With Ischemic Stroke Caused By Biatrial Thrombus

    Directory of Open Access Journals (Sweden)

    Halit CINARKA

    2015-07-01

    Full Text Available Venous thromboembolism is a preventable disease when necessary precautions are taken and it occurs along with deep vein thrombosis and pulmonary embolism. Mortality related to venous thromboembolism may be high in the acute phase of the disease and it may become chronic. Intracardiac thrombus may be detected in some venous thromboemboli cases. Cardiac embolism is responsible for most of the ischemic strokes which can be very mortal or may cause serious morbidity when they are not treated in time. In this report, we aimed to present the results of late antithrombolytic treatment in a 77-year old patient who developed deep vein thrombosis, biatrial thrombosis and ischemic stroke following hydrocephalus shunt operation. Key words: Venous thromboembolism; ischemic stroke; thrombolytic therapy

  6. Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Khalil Al-Farsi

    2013-01-01

    Full Text Available Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation at the time of presentation. Gradual introduction of anticoagulation coupled with a multidisciplinary team approach advocating careful daily clinical assessment of the patient and regular echocardiographic and neuroimaging studies have resulted in a better management and achievement of therapeutic goals.

  7. Asymptomatic type B right atrial thrombus in a case with protein S deficiency

    Directory of Open Access Journals (Sweden)

    Rajinder Singh Rawat

    2014-01-01

    Full Text Available Thirty seven year old asymptomatic male underwent routine medical examination which revealed an abnormal mass in the right atrium. Family history was not suggestive of any cardiac or malignant disease. Detailed investigation detected deficiency of protein S, which is a vitamin K dependent protein and a cofactor for activated protein C mediated cleavage of factor Va and VIIIa. The deficiency of protein S predisposes to venous thrombosis. Further investigation revealed that it was an organized calcified thrombus in right atrium occupying almost whole of the cavity. Various approaches including surgical excision, thrombolysis and anticoagulation has been used to manage such thrombosis. However therapeutic approach is still a question of debate. Atriotomy and excision of mass was done using cardiopulmonary bypass.

  8. Glaucocalyxin A inhibits platelet activation and thrombus formation preferentially via GPVI signaling pathway.

    Directory of Open Access Journals (Sweden)

    Wei Li

    Full Text Available Platelets play a pivotal role in atherothrombosis and the antiplatelet agents have been proved to be useful in preventing onset of acute clinical events including myocardial infarction and stroke. Increasing number of natural compounds has been identified to be potential antiplatelet agents. Here we report the antiplatelet effect of glaucocalyxin A (GLA, an ent-diterpenoid that we isolated and purified from the aerial parts of Rabdosia japonica (Burm. f. var. glaucocalyx (Maxim. Hara, and investigate the molecular mechanisms by which GLA inhibits platelet activation and thrombus formation. The effect of GLA on platelet activation was measured using platelets freshly isolated from peripheral blood of healthy donors. Results showed that pretreatment of human platelets with lower concentrations of GLA (0.01 μg/ml, 0.1 μg/ml significantly inhibited platelet aggregation induced by collagen (P<0.001 and CRP (P<0.01, a synthetic GPVI ligand, but not by ADP and U46619. Accordingly, GLA inhibited collagen-stimulated tyrosine phosphorylation of Syk, LAT, and phospholipase Cγ2, the signaling events in collagen receptor GPⅥ pathway. GLA also inhibited platelet p-selectin secretion and integrin activation by convulxin, a GPVI selective ligand. Additionally, GLA was found to inhibit low-dose thrombin-induced platelet activation. Using a flow chamber device, GLA was found to attenuate platelet adhesion on collagen surfaces in high shear condition. In vivo studies showed that GLA administration increased the time for complete occlusion upon vascular injury in mice, but did not extend tail-bleeding time when mice were administered with relatively lower doses of GLA. Therefore, the present results provide the molecular basis for the inhibition effect of GLA on platelet activation and its in vivo effect on thrombus formation, suggesting that GLA could potentially be developed as an antiplatelet and antithrombotic agent.

  9. Dramatic response of follicular thyroid carcinoma with superior vena cava syndrome and tracheal obstruction to external-beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Wilford, M.R.; Chertow, B.S.; Lepanto, P.B.; Leidy, J.W. Jr. (Section of Endocrinology, Marshall University School of Medicine, Huntington, West Virginia (USA))

    1991-06-01

    We report a patient with follicular thyroid carcinoma progressing to superior vena cava (SVC) syndrome and tracheal obstruction despite multiple doses of radioactive iodine therapy but subsequently responding dramatically to external-beam radiotherapy (RT). Although RT is not considered to be the treatment of choice for follicular carcinoma, RT in our patient produced unequivocal improvement of SVC syndrome and tracheal obstruction.

  10. Long-term follow-up of patients with inferior vena cava filters in the prevention of pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the long-term safety, efficacy and complications of placement vena cava filter in prevention of pulmonary embolism. Methods: Seventy-three patients with proven diagnosis of deep venous thrombosis (DVT) and (or) pulmonary embolism (PE) by Doppler ultrasonography, DSA, CT or MRI, received percutaneous inferior vena cava filters (IVCF) from January 1994 to June 2005. The clinical data and imaging findings were evaluated retrospectively. The patients underwent telephone interview or questionnaire, abdominal X-rays, Doppler ultrasonography, computed tomographic pulmonary angiography (CTPA) or indirect CT venography (CTV) after a follow-up duration of 5 months to 11 years. Results: Seventy-eight vena cava filters were used. There was 1 case of incomplete filter opening when placing filter. In follow-up, thrombi were trapped in the filter in 2 cases, filter tilting happened in 1 case, and there were no filter migration, filter disruption, filter perforation. Five of 73 cases were lost in follow-up visit, 14 patients died after implantation (5 days to 41 months, average 14.5 months). Among the 54 living patients, the identified recurrent PE was not noted. Three cases of recurrent DVT, 1 case of inferior vena caval thrombosis and 1 case of thrombosed filters were seen in follow-up. Conclusion: Inferior vena cava filter is safe and effective for the long-term prevention pulmonary embolism, and the long-term major complications after filter placement are not frequent. (authors)

  11. Synergistic antitumor efficacy of combined DNA vaccines targeting tumor cells and angiogenesis.

    Science.gov (United States)

    Yin, Xiaotao; Wang, Wei; Zhu, Xiaoming; Wang, Yu; Wu, Shuai; Wang, Zicheng; Wang, Lin; Du, Zhiyan; Gao, Jiangping; Yu, Jiyun

    2015-09-18

    To further enhance the antitumor efficacy of DNA vaccine, we proposed a synergistic strategy that targeted tumor cells and angiogenesis simultaneously. In this study, a Semliki Forest Virus (SFV) replicon DNA vaccine expressing 1-4 domains of murine VEGFR2 and IL12 was constructed, and was named pSVK-VEGFR2-GFc-IL12 (CAVE). The expression of VEGFR2 antigen and IL12 adjuvant molecule in 293T cells in vitro were verified by western blot and enzyme-linked immune sorbent assay (ELISA). Then CAVE was co-immunized with CAVA, a SFV replicon DNA vaccine targeting survivin and β-hCG antigens constructed previously. The antitumor efficacy of our combined replicon vaccines was evaluated in mice model and the possible mechanism was further investigated. The combined vaccines could elicit efficient humoral and cellular immune responses against survivin, β-hCG and VEGFR2 simultaneously. Compared with CAVE or CAVA vaccine alone, the combined vaccines inhibited the tumor growth and improved the survival rate in B16 melanoma mice model more effectively. Furthermore, the intratumoral microvessel density was lowest in combined vaccines group than CAVE or CAVA alone group. Therefore, this synergistic strategy of DNA vaccines for tumor treatment results in an increased antitumor efficacy, and may be more suitable for translation to future research and clinic. PMID:26253468

  12. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  13. OptEase and TrapEase Vena Cava Filters: A Single-Center Experience in 258 Patients

    International Nuclear Information System (INIS)

    We aimed to evaluate the efficacy and safety of the OptEase and TrapEase (both from Cordis, Roden, Netherlands) vena cava filters in the prevention of pulmonary embolism (PE). Between May 2004 and December 2008, OptEase (permanent/retrievable; n = 228) or TrapEase (permanent; n = 30) vena cava filters were placed in 258 patients (160 female and 98 male; mean age 62 years [range 22 to 97]). Indications were as follows: prophylaxis for PE (n = 239), contraindication for anticoagulation in the presence of PE or DVT (n = 10), and development of PE or DVT despite anticoagulation (n = 9). Medical records were retrospectively reviewed for indications, clinical results, and procedure-related complications during placement and retrieval. Clinical PE did not develop in any of the patients. However, radiologic signs of segmental PE were seen in 6 of 66 patients with follow-up imaging data. Migration or fracture of the filter or cava perforation was not seen in any of the patients. Except for a single case of asymptomatic total cava thrombosis, no thrombotic occlusion was observed. One hundred forty-one patients were scheduled to undergo filter removal; however, 17 of them were not suitable for such based on venography evaluation. Removal was attempted in 124 patients and was successful in 115 of these (mean duration of retention 11 days [range 4 to 23]). Nine filters could not be removed. Permanent/retrievable vena cava filters are safe and effective devices for PE prophylaxis and for the management of venous thromboembolism by providing the option to be left in place.

  14. CECT EVALUATION OF AN ISOLATED LONG SEGMENT IVC THROMBUS IN A PATIENT WITH ACUTE ON CHRONIC PANCREATITIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Pronami

    2015-10-01

    Full Text Available Isolated Inferior vena cava (IVC thrombosis is a rare vascular complication of Pancreatitis. Vascular complications associated with Pancreatitis are more commonly seen in peripancreatic vessels like Splenic, portal or mesenteric veins. We report a case of isolated IVC thrombosis in a patient with chronic pancreatitis on acute exacerbation. Awareness of this rare complication will help in early diagnosis & treatment as well as prevent further dreaded complication like pulmonary embolism.

  15. Relation between early mitral regurgitation and left ventricular thrombus formation after acute myocardial infarction: results of the GISSI-3 echo substudy

    OpenAIRE

    L. Ascione; Antonini-Canterin, F; Macor, F; Cervesato, E; Chiarella, F; Giannuzzi, P; Temporelli, P L; Gentile, F.; Lucci, D.; Maggioni, A. P.; Tavazzi, L; Badano, L.; Stoian, I; Piazza, R.; Bosimini, E

    2002-01-01

    Objective: To evaluate the prevalence and correlates of left ventricular thrombosis in patients with acute myocardial infarction, and whether the occurrence of early mitral regurgitation has a protective effect against the formation of left ventricular thrombus.

  16. Echocardiographic diagnosis, management and monitoring of pulmonary embolism with right heart thrombus in a patient with myotonic dystrophy: a case report

    Directory of Open Access Journals (Sweden)

    Baumann Gert

    2010-05-01

    Full Text Available Abstract Acute pulmonary embolism (PE is a common disease which frequently results in life-threatening right ventricular (RV failure. High-risk PE, presenting with hypotension, shock, RV dysfunction or right heart thrombus is associated with a high mortality, particularly during the first few hours. Accordingly, it is important to commence effective therapy as soon as possible. In the case described in this report, a 49-year-old woman with myotonic dystrophy type 1 presented with acute respiratory failure and hypotension. Transthoracic echocardiography showed signs of right heart failure and a mobile right heart mass highly suspicious of a thrombus. Based on echocardiographic findings, acute thrombolysis was performed resulting in hemodynamic stabilization of the patient and complete resolution of the right heart thrombus. This case underscores the important role of transthoracic echocardiography for the diagnosis, management and monitoring of PE and underlines the efficacy and safety of thrombolysis in the treatment of PE associated with right heart thrombus.

  17. Diagnosis of portal vein thrombosis discontinued with liver tumors in patients with liver cirrhosis and tumors by contrast-enhanced US: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Song Zezhou; Huang Min [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Jiang Tianan, E-mail: tiananjiang@hzcnc.co [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Zhao Qiyu [Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (China); Yao Lei; Mou Yun; Zhao Junkang; Ao Jianyang [Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China); Chen Fen [Department of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (China); Chen Yan [Department of Ultrasound, First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province (China)

    2010-08-15

    Aims: We assessed the role of contrast-enhanced ultrasound (CEUS) in the differential diagnosis between benign and malignant portal vein thrombosis (PVT) in patients who had liver tumors. Methods: Seventeen consecutive patients who had cirrhosis, liver tumors, and PVT were prospectively studied with CEUS. CEUS was performed at low mechanical index after intravenous administration of a second-generation contrast agent (SonoVue, Bracco, Milan, Italy). Presence or absence of thrombus enhancement on CEUS were considered diagnostic for malignant or benign PVT. Five patients also underwent percutaneous portal vein fine-needle biopsy under US guidance. All patients were followed-up. Shrinkage of the thrombus and/or recanalization of the vessels on CDUS during follow-up were considered definitive evidence of the benign nature of the thrombosis, whereas the enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered consistent with malignancy. Results: Follow-up showed signs of malignant thrombosis in 14 of 17 patients. CEUS showed early arterial enhancement of the PVT in 14 patients of 14 malignant PVT, 1 patient of 3 benign PVT and the absence of thrombus enhancement in 2 patients of 3 benign PVT. FNB confirmed the results for malignant PVT in four of five patients, for benign granulomatous inflammation PVT in one of five patients in which CEUS showed early arterial enhancement of the PVT. The sensitivity, specificity and accuracy is 100%, 66.7% and 93.3% at diagnosis of malignant PVT using CEUS. In one patient with intrahepatic bile duct stone, CEUS were positive for malignant PVT, whereas FNB was negative (benign granulomatous inflammation PVT); follow-up examination confirmed benign PVT. Conclusion: CEUS seems to be the pretty sensitive and specific test for diagnosing malignant portal vein thrombosis in patients with cirrhosis and tumors.

  18. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    Energy Technology Data Exchange (ETDEWEB)

    Kiseleva, I.P.; Podzolkov, V.P.; Ivanitskij, A.V.; Mal' sagov, G.U. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Serdechno-Sosudistoj Khirurgii; Tsentral' nyj Inst. Usovershenstvovaniya Vrachej, Moscow (USSR))

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography.

  19. X-ray examination in diagnosis of hepatic segment deficiency of inferior cava

    International Nuclear Information System (INIS)

    Data on clinical and X-ray examination of 29 patients aged 2 weeks to 66 years with vena cava inferior hepatic segment deficiency are presented. The blood outflow from the lower part of the body was effected through the azygos vein in 17 patients, and through the hemiazygos one in 12 patients. The data obtained were in all cases correlated with the results of intracardiac research methods (the right and left heart cavities catherization and angiocardiography), with intraoperative and autopsy findings. An anomaly was found to prevail in patients (89.6%) with different types of abnormal heart position in the thoracic cavity. Along with examination of the cardiovascular system, the abdominal organs study was carried out: standard roentgenoscopy and radiography, both aiming to detect the liver position, gastrointestinal tract examination, and cholecystography

  20. Patency of the inferior vena cava after placement of Simon nitinol filter

    International Nuclear Information System (INIS)

    This paper reports on Simon nitinol filters (SNFs) placed in 33 patients (11 male, 22 female; mean age, 67 years; range, 38-88 years) since February 1988. MR imaging and US were performed in 18 of these patients to evaluate patency of the inferior vena cava (IVC) 2-9 months after SNF placement. Six patients were imaged twice with MR and US, for a total of 24 studies. Duplex Doppler US was used. For MR imaging, spin-echo sequences were used for six examinations in five patients, and fast low-angle shot sequences in the remaining 18. The results were as follows for MR imaging versus US: adequate visualization of the IVC, 23 versus 10 studies; partial visualization, one versus five; nonvisualization, zero versus nine; normal IVC, 16 versus 10; occlusions of IVC, five (three patients) versus zero; partial occlusion, two (asymptomatic patients) versus zero; and nondiagnostic findings, one versus 14

  1. Liver transplantation with preservation of the inferior vena cava in case of symptomatic adult polycystic disease.

    Science.gov (United States)

    Lerut, Jan; Ciccarelli, Olga; Rutgers, Matthieu; Orlando, Giuseppe; Mathijs, Jules; Danse, Etienne; Goffin, Eric; Gigot, Jean-François; Goffette, Pierre

    2005-05-01

    Adult polycystic liver disease (APLD) is a rare disorder of the liver parenchyma, the treatment of which is still controversial. Conservative surgery may have a significant morbidity and is often ineffective in the long run. Liver replacement may be indicated in case of incapacitating hepatomegaly. Patients (one male, five females) undergoing liver transplantation for symptomatic APLD is presented in this study. The particular nature of this series is the fact that successful transplantation was performed in all cases with preservation of the recipient's inferior vena cava and without use of veno-venous bypass despite massive hepatomegaly and previous extensive liver surgery (in three cases). There was minimal morbidity and no mortality. All patients have excellent quality of life with a median follow-up of 41 months (range: 12-58) as testified by a median Karnofsky score of 90% (range: 80-100%). PMID:15819798

  2. Trimodality Therapy for an Advanced Thymic Carcinoma With Both Aorta and Vena Cava Invasion.

    Science.gov (United States)

    Momozane, Tohru; Inoue, Masayoshi; Shintani, Yasushi; Funaki, Soichiro; Kawamura, Tomohiro; Minami, Masato; Shirakawa, Yukitoshi; Kuratani, Toru; Sawa, Yoshiki; Okumura, Meinoshin

    2016-08-01

    A case of locally advanced thymic carcinoma that was successfully resected with the great vessels after chemoradiation therapy is reported. A 57-year-old man with Masaoka stage III thymic carcinoma received two cycles of cisplatin/docetaxel and 60 Gy irradiation. The response was stable disease with 19% size reduction, and a radical resection with the ascending aorta and superior vena cava with the patient under circulatory arrest with the use of cardiopulmonary bypass was performed. The postoperative course was uneventful, and the patient has been free of disease for 28 months. Trimodality therapy with use of a cardiovascular surgical procedure might be a valuable option in locally advanced thymic carcinoma. PMID:27449450

  3. CT of anomalies of the inferior vena cava and left renal vein

    International Nuclear Information System (INIS)

    Incidence of anomalies of the inferior vena cava (IVC) and left renal vein (LRV) was examined with post-contrast abdominal CT studies in the last five years and seven months retrospectively. Of the total 1100 cases, right retrocaval ureter was noted in two cases (0.2 %), left IVC was two (0.2 %) and bilateral IVC was twelve (1.1 %) about anomalies of the IVC. As to anomalies of the LRV, retroaortic LRV was four (0.4 %) and circumaortic LRV was six (0.5 %). These results did not always agree with those of previous reports on dissection cases. Particularly, incidence of anomalies of the LRV on CT was much lower than that on dissection. We speculated that racial difference was one of its causes. Clinical usefulness of CT for evaluation of anomalies of the IVC and LRV was stressed. (author)

  4. Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

    Directory of Open Access Journals (Sweden)

    Thomas Strecker

    2014-01-01

    Full Text Available Introduction. For patients with terminal heart failure, heart transplantation (HTX has become an established therapy. Before transplantation there are many repeated measurements with a pulmonary artery catheter (PAC via the superior vena cava (SVC necessary. After transplantation, endomyocardial biopsy (EMB is recommended for routine surveillance of heart transplant rejection again through the SVC. Case Presentation. In this report, we present a HTX patient who developed a SVC syndrome as a possible complication of all these procedures via the SVC. This 35-year-old Caucasian male could be successfully treated by balloon dilatation/angioplasty. Conclusion. The SVC syndrome can lead to pressure increase in the venous system such as edema in the head and the upper part of the body and further serious complications like cerebral bleeding and ischemia, or respiratory problems. Balloon angioplasty and stent implantation are valid methods to treat stenoses of the SVC successfully.

  5. Surgical repair for giant ascending aortic aneurysm to superior vena cava fistula with positive syphilitic test.

    Science.gov (United States)

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro

    2015-10-01

    Syphilitic aortitis is usually associated with thoracic aortic saccular aneurysm, aortic regurgitation and coronary ostial stenosis. However, syphilitic aneurysms have rarely been reported today. Here, we report a patient with ascending aortic aneurysm with aorta-superior vena cava (SVC) fistula with positive syphilitic test. A 52-year-old man was admitted to our institution with a giant ascending aortic aneurysm complicated with SVC syndrome. Computed tomography revealed a giant ascending aneurysm 79 mm in diameter. The result of serodiagnostic tests for syphilis had not been judged yet preoperatively. Total arch replacement concomitant with elephant trunk was performed. Intraoperatively, we detected the ascending aorta to SVC fistula. Postoperatively, we suspected the syphilitic aneurysm strongly, because preoperative serodiagnostic test was concluded to be positive. However, histological examination did not show typical syphilitic features. The patient remains asymptomatic 1 year later. Although extremely rarely today, syphilitic aneurysm should be still considered in the differential diagnosis of ascending aortic aneurysm. PMID:24000069

  6. Impact of thrombus aspiration during ST-Elevation Myocardial Infarction : a six month composite endpoint and risk of stroke analyses of the TASTE trial

    OpenAIRE

    Olivecrona, Goran K.; Lagerqvist, Bo; Frobert, Ole; Gudnason, Thorarinn; Maeng, Michael; Ramunddal, Truls; Haupt, Jan; Kellerth, Thomas; Stewart, Jason; Sarno, Giovanna; Jensen, Jens; Östlund, Ollie; James, Stefan K

    2016-01-01

    Background: Routine thrombus aspiration during primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) did not reduce the primary composite endpoint in the "A Randomised Trial of Routine Aspiration ThrOmbecTomy With PCI Versus PCI ALone in Patients With STEMI Undergoing Primary PCI" (TOTAL) trial. We aimed to analyse a similar endpoint in "The Thrombus Aspiration in ST-Elevation myocardial infarction in Scandinavia" (TASTE) trial up to 180 days. Methods:...

  7. ‘Mother-in-child’ thrombectomy technique: a novel and effective approach to decrease intracoronary thrombus burden in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Dauvergne, Christian; Araya, Mario [Department of Cardiology, Clinica Alemana, Santiago (Chile); Uriarte, Polentzi [Department of Cardiology, Instituto Nacional del Torax, Santiago (Chile); Novoa, Oscar; Novoa, Lilian [Department of Cardiology, Clinica Alemana, Santiago (Chile); Maluenda, Gabriel, E-mail: gabrielmaluenda@gmail.com [Department of Cardiology, Clinica Alemana, Santiago (Chile)

    2013-01-15

    Background: The presence of large thrombus burden in patients presenting with acute myocardial infarction (AMI) is common and associated with poor prognosis. This study aimed to describe the feasibility and safety of the novel ‘mother-in-child’ thrombectomy (MCT) technique in patients presenting with AMI and large thrombus burden undergoing percutaneous coronary intervention (PCI). Methods: We studied 13 patients presenting with AMI who underwent PCI with persistent large intracoronary thrombus after standard thrombectomy. The procedure was performed using a 5 F ‘Heartrail II-ST01’ catheter (Terumo Medical) into a 6 F guiding system. Angiographic assessment of thrombus burden and coronary flow was obtained at baseline, immediately after thrombectomy and at the end of the procedure. Results: The mean age was 55.9 ± 13.0 years and involved mostly males (76.9%). All patients underwent PCI via radial approach. Following MCT Thrombolysis In Myocardial Infarction (TIMI) flow improved by 2 or more degrees in 11 patients (84.5%), while visible angiographic thrombus was reduced in 11 patients (84.5%). In the final angiogram, normal TIMI flow was restored in 11 patients (84.5%), with normal myocardial ‘blush’ in 7 patients (53.8%) and total clearance of a visible thrombus in 7 patients (53.8%). Overall, 6 patients received thrombectomy as ‘stand-alone’ procedure. All patients were discharged alive after a mean of 5.6 ± 2 days. Conclusion: This initial report suggests that significant reduction in thrombus burden and improvement of the coronary flow can be safely achieved in patients presenting with AMI and large thrombus burden by using the novel MCT technique.

  8. Thrombus formation patterns in the HeartMate II ventricular assist device: clinical observations can be predicted by numerical simulations.

    Science.gov (United States)

    Chiu, Wei-Che; Slepian, Marvin J; Bluestein, Danny

    2014-01-01

    Postimplant device thrombosis remains a life-threatening complication and limitation of continuous-flow ventricular assist devices (VADs). Using advanced computational fluid dynamic (CFD) simulations, we successfully depicted various flow patterns, recirculation zones, and stagnant platelet trajectories which promote thrombus formation and observed that they matched actual thrombus formation patterns observed in Thoratec HeartMate II VADs explanted from patients with pump thrombosis. Previously, these small eddies could not be captured by either digital particle image velocimetry or CFD due to insufficient resolution. Our study successfully demonstrated the potential capability of advanced CFD to be adopted for device optimization, leading to enhanced safety and efficacy of VADs for long-term destination therapy. PMID:24399065

  9. Left atrial appendage thrombus with resulting stroke post-RF ablation for atrial fibrillation in a patient on dabigatran.

    LENUS (Irish Health Repository)

    Lobo, R

    2015-11-01

    Dabigatran etexilate is licensed for use in prevention of deep venous thromboembolism and in prevention of stroke and systemic embolism in nonvalvular atrial fibrillation (AF). It has also been used in patients for other indications as a substitute for warfarin therapy because it requires no monitoring; one group being patients undergoing radiofrequency (RF), ablation for AF, although there have been no consensus guidelines with regards to dosage and timing of dose. We report the case of a patient with documentary evidence of left atrial appendage (LAA) thrombus formation and neurological sequelae post-RF ablation despite being on dabigatran. This case highlights the concern that periprocedural dabigatran may not provide adequate protection from development of LAA thrombus and that a standardised protocol will need to be developed and undergo large multicentre trials before dabigatran can be safely used for patients undergoing RF-ablation.

  10. Ir-CPI, a coagulation contact phase inhibitor from the tick Ixodes ricinus, inhibits thrombus formation without impairing hemostasis

    OpenAIRE

    Decrem, Yves; Rath, Géraldine; Blasioli, Virginie; Cauchie, Philippe; Robert, Severine; Beaufays, Jerome; Frere, Jean-Marie; Feron, Olivier; Dogne, Jean-Michel; Dessy, Chantal; Vanhamme, Luc; Godfroid, Edmond

    2009-01-01

    Blood coagulation starts immediately after damage to the vascular endothelium. This system is essential for minimizing blood loss from an injured blood vessel but also contributes to vascular thrombosis. Although it has long been thought that the intrinsic coagulation pathway is not important for clotting in vivo, recent data obtained with genetically altered mice indicate that contact phase proteins seem to be essential for thrombus formation. We show that recombinant Ixodes ricinus contact ...

  11. M-Guard Stent in Stemi Patients with High Thrombus Burden Lesions: A Prospective, Single Arm Study

    Directory of Open Access Journals (Sweden)

    Mohammad Zade Shabestari M

    2014-04-01

    Full Text Available Introduction: Primary PCI is the preferred modality to restore blood perfusion in STEMI patients, but myocardial reperfusion is sometimes lower than optimal. Distal embolization seems to play the leading role. There is rare evidence suggestive of M-Guard stents; a recent innovation which protects against distal embolization may be beneficial in this circumstance. Materials and Methods:This was a prospective single arm study. Patients with acute STEMI admitted at the Cardiac Emergency Unit of Imam Reza Hospital from July 2011 to November  2012 who had a large bulk of thrombus in their angiogram, underwent M-Guard stenting and were followed up for six months for chest pain and secondary revascularization. Results: The 23 patients, aged between 34 and 84; 65.2%, were male and had undergone primary PCI, mechanical thrombus aspiration, and M-Guard stenting. Left Anterior Descending (LAD (63.9% and Right Coronary Artery (RCA (39.1% were most commonly involved. 78.2%, 13.1%, and 8.9% of patients had primary Thrombolysis in Myocardial Infarction (TIMI Thrombus grade five, four, and three. Among them, 86.9% achieved TIMI Flow grade three and 13.04% TIMI Flow grade two. The rate of transient "no-reflow" phenomenon was 21%. One patient died after stenting in the setting of cardiogenic shock. There was one case of in-stent restenosis five months after the procedure. Of the other 15 accessible patients, after six months, none experienced a second angioplasty or any ischemic symptoms. Conclusion: Using M-Guard stents in acute STEMI patients having undergone primary PCI with high thrombus burden is probably associated with lower rates of the "no-reflow" phenomenon and improved vessel reperfusion.  

  12. The role of Nox1 and Nox2 in GPVI-dependent platelet activation and thrombus formation ☆

    OpenAIRE

    Walsh, T. G.; Berndt, M C; Carrim, N.; Cowman, J; Kenny, D; Metharom, P.

    2014-01-01

    Background: Activation of the platelet-specific collagen receptor, glycoprotein (GP) VI, induces intracellular reactive oxygen species (ROS) production; however the relevance of ROS to GPVI-mediated platelet responses remains unclear. Objective: The objective of this study was to explore the role of the ROS-producing NADPH oxidase (Nox)1 and 2 complexes in GPVI-dependent platelet activation and collagen-induced thrombus formation. Methods and results: ROS production was measured by quan...

  13. 生物可降解腔静脉滤器的制备及其性能研究%The preparation of biodegradable vena cava filter and the study of its properties

    Institute of Scientific and Technical Information of China (English)

    张肖; 肖越勇; 杨杰; 马旭阳; 刘士榕; 任超; 王小平

    2012-01-01

    目的 对采用左旋聚乳酸(PLLA)制备生物可降解腔静脉滤器(BVCF)进行研究,并评估其机械力学性能、可输送性能、捕获血栓性能及其生物相容性.方法 利用三维设计软件设计BVCF外形,采用分子量为100 000 U的PLLA制作BVCF,通过体外实验,对其主要性能进行测试.采用中华小型猪12只,随机分为4组(每组3只),第1~3组为实验组,第4组为对照组.将9枚BVCF置入第1~3组实验小型猪下腔静脉内,1周后对所有小型猪行血栓注入实验.每组的3只小型猪下腔静脉分别注入2、5和8条血栓.注入血栓后l、6、12周行影像检查,观察滤器情况及小型猪肺动脉栓塞情况.每次影像检查后,牺牲1组实验组动物行病理检查.结果 制备出一种带中心线型的可降解滤器,通过体外实验测试滤器径向支撑力1.6N,能够捕获直径>5 mm的栓子,易于释放.通过动物实验证实该滤器能够捕获注入的致命性栓子,9只实验组小型猪均存活,其中2只栓子注入过程中出现轻度呼吸、心率加快;对照组小型猪注入血栓后不同程度地出现呼吸频率加快、气促等症状,注入8条血栓的小型猪,在血栓注入后当天死亡.术后影像及病理检查显示,实验组出现症状的小型猪发生周围性肺动脉栓塞,对照组死亡小型猪发生中央性肺动脉栓塞.显微镜下显示滤器置入术后1周,BVCF侧支部分被内膜覆盖;6周后完全被内膜覆盖,血管壁结构正常,未见明显炎性细胞浸润;术后12周BVCF侧支内膜情况无明显变化,滤器侧支部分降解.结论 BVCF具有良好的机械强度和可输送性能,对致命性大栓子有较高的捕获率,并具有良好的生物相容性,但其降解性能尚需进一步研究.%Objective To investigate the preparation of biodegradable vena cava filter(BVCF) with poly-l-lactic acid (PLLA),and to evaluate its mechanical properties,delivery performance,the ability of capturing thrombus

  14. Catheter-Related Right Atrial Thrombus and Pulmonary Embolism: A Case Report and Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Karen EA Burns

    2009-01-01

    Full Text Available Central venous catheters (CVCs are commonly used in clinical practice. One of the foremost complications associated with their use is the potential for symptomatic or asymptomatic thrombosis. CVC thrombosis, in turn, may not only result in vascular and catheter occlusion but also infection, pulmonary embolism, and formation of right heart thromboemboli. Thrombi within cardiac chambers are associated with an increased risk of mortality due to their potential for embolization to the pulmonary vasculature. We describe the case of a 77-year-old man, who was successfully thrombolyzed following detection of a right atrial thrombus and hemodynamically significant pulmonary embolism resulting from thrombus formation on the tip of a peripherally inserted central catheter (PICC. The present article is the first report of a PICC-related right atrial thrombus in an adult treated with thrombolysis. A systematic review of the literature suggests that the true incidence of this complication may be underestimated because the diagnosis may not be considered in asymptomatic and symptomatic patients, or may be missed by transthoracic echocardiography. The present case highlights the importance of maintaining a high index of suspicion for thromboembolic complications and heparin-induced thrombocytopenia in patients with CVCs or a PICC. It also underscores the important role of transesophageal echocardiography and thrombolysis in the diagnosis and management, respectively, of right heart thromboemboli with associated pulmonary embolism.

  15. Relative permittivity measurement during the thrombus formation process using the dielectric relaxation method for various hematocrit values.

    Science.gov (United States)

    Asakura, Yuta; Sapkota, Achyut; Maruyama, Osamu; Kosaka, Ryo; Yamane, Takashi; Takei, Masahiro

    2015-12-01

    The relative permittivity ε' and the dielectric loss ε″ for various hematocrit values H for static bovine blood condition have been measured using the dielectric relaxation method to detect thrombosis in real time. The suitable measurement frequency f m ranged within 60 kHz to 1 MHz, and the relaxation frequency of red blood cells (RBCs) f rc was observed to be 2 MHz. In the f m, the temporal change of normalized ε' exhibited a minimum (called as bottom point). The bottom point was observed to be exponentially shortened as H increased. This characteristic of the ε'* minimum is discussed from three viewpoints: during fibrin formation, direct thrombus formation, and rouleaux formation processes. ε'* during the fibrin formation process decreased over time, irrespective of f. However, ε'* in f m during the direct thrombus formation process and during the aggregation formation process increased immediately and rapidly over time. Therefore, the ε'* bottom point in f m might be the indication of micrometer-scale thrombus formation by RBC aggregation due to fibrin formation. PMID:26058831

  16. Application of catheter directed thrombolysis in the treatment of Budd-Chiari syndrome with inferior vena cava thrombosis%置管溶栓术在治疗布加综合征合并下腔静脉血栓中的应用

    Institute of Scientific and Technical Information of China (English)

    党晓卫; 李素新; 李路豪; 李海; 徐韶凯; 许培钦

    2014-01-01

    Objective To investigate the feasibility and safety of catheter thrombolysis in the treatment of Budd-Chiari syndrome (B-CS) with inferior vena cava(IVC) thrombosis.Methods A retrospective analysis of the clinical data of 21 cases of B-CS with IVC thrombosis in the First Affiliated Hospital of Zhengzhou University from January 2011 to September 2014 was conducted.They were divided into 2 groups,12 cases of fresh thrombus group,while 9 cases of old thrombus group.All cases were couducted with catheter directed thrombolysis through the right femoral vein,then regularly with color doppler examination,evaluating thrombolytic effect.When thrombus disappearing,intervention or (and) operation treatment was conducted,then postoperative following-up.Results There were 16 cases in which thrombus dissolving completely within 15 days(9 cases of fresh thrombus and 7 cases of old thrombus,P =0.536).In 1 case,thrombosis dissolved completely 20 days later.There were 3 cases combined with pre-dilating technology (thrombosis dissolved completely).When thrombosis completely dissolved,the mean catheterization time of fresh thrombus group was (10.78 ± 2.97)d,while the old thrombus group was (14.13 ± 3.41)d(P =0.06).The short-term (less than 15 days) dissolution rate was 76.19% (16/21),and the total efficiency rate was 90.48% (19/21).Complications occurred in 4 cases.The incidence of severe complications was 4.76% (1/21).Postoperative follow-up with Color Doppler ultrasound in 1 to 12 months,1 case recurred after 5 months.The rest did not recurred.the recurrence rate was 4.76% (1/21) within following up time.Conclusions The catheter thrombolysis is an important link in the treatment of B-CS with thrombosis of IVC,which is simple,safe and effective,with low incidence of complications.It can be used as the preferred treatment for this type of B-CS.%目的 探讨置管溶栓术在治疗布加综合征合并下腔静脉血栓中的可行性及安全性.方法 回顾性分析

  17. Leiomiosarcoma endovascular en vena cava inferior con síndrome de Budd-Chiari asociado: a propósito de un caso Endovascular Leiomyosarcoma ofthe Inferior Vena Cava with Budd-Chiari syndrome: a case report

    Directory of Open Access Journals (Sweden)

    David Ibáñez Muñoz

    2011-09-01

    Full Text Available Presentamos el caso de una mujer de 56 años de edad, que acude al Servicio de Urgencias de nuestro centro por un cuadro de distensión y dolor abdominal difuso con edemas en extremidades inferiores. En los estudios de imagen realizados (ecografía y TC se demostró la existencia de ocupación intraluminal de la vena cava inferior, por una masa que se extendía desde el drenaje de las venas renales hasta su confluencia en la aurícula derecha, con signos de obstrucción de las venas suprahepáticas. El diagnóstico anatomopatológico final fue de leiomiosarcoma con síndrome de Budd-Chiari asociado. El leiomiosarcoma de vena cava inferior es una patología poco frecuente y su asociación con síndrome de Budd-Chiari es aún más excepcional.We report the case of a 56-year-old woman who presented at our Emergency Department with symptoms ofdiffuse abdominal pain and distention with lower-extremity edema. Imaging studies (ultrasound and computed tomography showed an intraluminar inferior vena cava mass extending from the renal veins drain to their confluence at the right atrium, with signs of obstruction of the suprahepatic veins. The final pathology diagnosis was leiomyosarcoma with Budd-Chiari syndrome. The leiomyosarcoma of the inferior vena cava is an infrequent pathology and its association with Budd-Chiari syndrome is even rarer.

  18. Impact of poroelasticity of intraluminal thrombus on wall stress of abdominal aortic aneurysms

    Directory of Open Access Journals (Sweden)

    Polzer Stanislav

    2012-08-01

    Full Text Available Abstract Background The predictions of stress fields in Abdominal Aortic Aneurysm (AAA depend on constitutive descriptions of the aneurysm wall and the Intra-luminal Thrombus (ILT. ILT is a porous diluted structure (biphasic solid–fluid material and its impact on AAA biomechanics is controversially discussed in the literature. Specifically, pressure measurements showed that the ILT cannot protect the wall from the arterial pressure, while other (numerical and experimental studies showed that at the same time it reduces the stress in the wall. Method To explore this phenomenon further a poroelastic description of the ILT was integrated in Finite Element (FE Models of the AAA. The AAA model was loaded by a pressure step and a cyclic pressure wave and their transition into wall tension was investigated. To this end ILT’s permeability was varied within a microstructurally motivated range. Results The two-phase model verified that the ILT transmits the entire mean arterial pressure to the wall while, at the same time, it significantly reduces the stress in the wall. The predicted mean stress in the AAA wall was insensitive to the permeability of the ILT and coincided with the results of AAA models using a single-phase ILT description. Conclusion At steady state, the biphasic ILT behaves like a single-phase material in an AAA model. Consequently, computational efficient FE single-phase models, as they have been exclusively used in the past, accurately predict the wall stress in AAA models.

  19. A Case Report: An Acute Thrombus in the Femoral Artery following Total Hip Arthroplasty

    Science.gov (United States)

    GBS, Varun; N, Muralidhar; Bharathidasan, Kavya

    2016-01-01

    Introduction: Vascular complications post-operative to a total hip arthroplasty are a very rare phenomenon. Only a few isolated cases have been reported to date. Diagnosis of such a case in a timely manner so as to preserve the limb is also difficult due to the subtle signs with which the patient presents. We report a case of complete occlusion of the common femoral artery following total hip arthroplasty due to acute thrombus formation. Case Presentation: A 56 year old Indian male patient underwent a cemented total hip replacement. Three hours post-operatively, the patient’s left lower limb was found to be pale and pulseless. Angiography showed complete occlusion of the left common femoral artery. Thrombectomy was carried out immediately and the patient recovered well. Conclusion: Vascular injuries are highly unusual findings following a total hip arthroplasty. Careful pre-operative and immediate post-operative monitoring of the patient is essential. Signs such as limb ischemia, absence of pulses, etc. must be recognized as early as possible and the necessary investigations and procedures should be carried out without any delay. PMID:27299128

  20. Quantification of volume, mass, and density of thrombus formation using brightfield and differential interference contrast microscopy

    Science.gov (United States)

    Baker-Groberg, Sandra M.; Phillips, Kevin G.; McCarty, Owen J. T.

    2013-01-01

    Flow chamber assays, in which blood is perfused over surfaces of immobilized extracellular matrix proteins, are used to investigate the formation of platelet thrombi and aggregates under shear flow conditions. Elucidating the dynamic response of thrombi/aggregate formation to different coagulation pathway perturbations in vitro has been used to develop an understanding of normal and pathological cardiovascular states. Current microscopy techniques, such as differential interference contrast (DIC) or fluorescent confocal imaging, respectively, do not provide a simple, quantitative understanding of the basic physical features (volume, mass, and density) of platelet thrombi/aggregate structures. The use of two label-free imaging techniques applied, for the first time, to platelet aggregate and thrombus formation are introduced: noninterferometric quantitative phase microscopy, to determine mass, and Hilbert transform DIC microscopy, to perform volume measurements. Together these techniques enable a quantitative biophysical characterization of platelet aggregates and thrombi formed on three surfaces: fibrillar collagen, fibrillar collagen +0.1 nM tissue factor (TF), and fibrillar collagen +1 nM TF. It is demonstrated that label-free imaging techniques provide quantitative insight into the mechanisms by which thrombi and aggregates are formed in response to exposure to different combinations of procoagulant agonists under shear flow.

  1. Primary germ cell tumor of the mediastinum - presenting as a huge mass

    Directory of Open Access Journals (Sweden)

    Usha Dalal

    2014-01-01

    Full Text Available Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type. We are reporting a case in 20-year young male diagnosed as giant benign cystic teratoma which was adherent to superior vena cava. The patient underwent surgical excision. In follow up of 2 years, the patient is not having any complaints.

  2. Primary germ cell tumor of the mediastinum - presenting as a huge mass.

    Science.gov (United States)

    Dalal, Usha; Jora, Manjit Singh; Dalal, Ashwani K; Attri, Ashok K; Singal, Rikki; Gupta, Samita

    2014-02-01

    Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type. We are reporting a case in 20-year young male diagnosed as giant benign cystic teratoma which was adherent to superior vena cava. The patient underwent surgical excision. In follow up of 2 years, the patient is not having any complaints. PMID:24627752

  3. Long-term success of endovascular treatment of benign superior vena cava occlusion with chylothorax and chylopericardium

    Energy Technology Data Exchange (ETDEWEB)

    Veroux, Pierfrancesco; Veroux, Massimiliano; Bonanno, Maria Giovanna; Tumminelli, Maria Giuseppina [Department of Surgery and Transplantation, University Hospital, Via S. Sofia, 78, 95123 Catania (Italy); Baggio, Elda [Department of Surgery and Gastroenterological Sciences, University Hospital of Verona (Italy); Petrillo, Giuseppe [Department of Radiology, University Hospital, Via S. Sofia, 78, 95123 Catania (Italy)

    2002-07-01

    The most likely etiology of benign obstruction of the superior vena cava (SVC) include fibrosing mediastinitis and iatrogenic etiologies such as sclerosis and obstruction caused by pacemakers and central venous catheter. Percutaneous stenting of SVC has been used with success both in malignant and benign superior vena cava syndrome; however, long-term follow-up of endovascular procedures is not well known. We present a case of a patient with complete occlusion of SVC of benign etiology, presenting dramatically with bilateral chylothorax and chylopericardium with cardiac tamponade, who underwent successful vena caval revascularization with thrombolytic therapy and placement of self-expanding metallic stent. The 42-month follow-up could encourage endovascular procedures even in SVC syndrome of benign etiology. (orig.)

  4. Axitinib for preoperative downstaging of renal cell carcinoma with sarcomatoid differentiation and direct invasion of the duodenum and inferior vena cava: a case report

    Directory of Open Access Journals (Sweden)

    Yuki H

    2014-02-01

    Full Text Available Hideo Yuki,1,* Takao Kamai,1,* Keiichi Kubota,2 Hideyuki Abe,1 Daisaku Nishihara,1 Tomoya Mizuno,1 Akinori Masuda,1 Hironori Betsunoh,1 Masahiro Yashi,1 Yoshitatsu Fukabori,1 Ken-Ichiro Yoshida1 1Department of Urology, 2Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan *These authors contributed equally to this manuscript Background: Renal cell carcinoma (RCC with sarcomatoid differentiation is invasive, refractory to treatment, and has a higher mortality. Therefore, systemic therapy is still challenging, and the curative resection of localized or locally advanced RCC with sarcomatoid differentiation is very important. Axitinib is a potent and selective second-generation vascular endothelial growth factor receptor tyrosine kinase inhibitor with improved safety and tolerability. Axitinib is generally recommended as second-line therapy for advanced RCC because the phase III axitinib versus sorafenib in advanced RCC (AXIS trial demonstrated that it achieved longer progression-free survival than sorafenib in patients with metastatic RCC after failure of an approved first-line regimen. Methods: We present a 73-year-old man who had a large (13 cm in diameter right RCC with sarcomatoid differentiation that directly invaded the duodenum and inferior vena cava. The patient presented with gastrointestinal bleeding, was unable to eat solid food, and had become emaciated. Thus, his classification was poor risk with anemia, hypercalcemia, and poor performance status, according to the Memorial Sloan-Kettering Cancer Center criteria. He seemed unlikely to survive if radical nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed. To reduce the tumor burden and potential operative complications, we administered axitinib as first-line neoadjuvant therapy. Results: Six weeks of treatment reduced the tumor burden without causing severe toxicities. Subsequently, radical right nephrectomy, cavotomy

  5. Intraluminal Thrombus in Facilitated Versus Primary Percutaneous Coronary Intervention An Angiographic Substudy of the ASSENT-4 PCI (Assessment of the Safety and Efficacy of a New Treatment Strategy With Percutaneous Coronary Intervention) Trial

    OpenAIRE

    Zalewski, Jaroslaw; Bogaerts, Kris; Desmet, Walter; Sinnaeve, Peter; Berger, Peter; Grines, Cindy; Danays, Thierry; Armstrong, Paul; Werf, Frans

    2011-01-01

    Objectives This study investigated the occurrence of intraluminal thrombus and its potential implications with facilitated percutaneous coronary interventions (fPCIs). Background The effect of fPCI on the presence and consequences of intraluminal thrombus is unknown. Methods Thrombolysis In Myocardial Infarction (TIMI) flow grade, frame count, and thrombus grade; distal embolization; and slow flow in the infarct-related artery were assessed in a blinded fashion on coronary angiograms in 1,342...

  6. Bilhemia: a fatal complication following percutaneous placement of a transhepatic inferior vena cava catheter in a child

    International Nuclear Information System (INIS)

    A transhepatic central venous catheter was implanted in a 2-year-old child with a history of multiple venous access procedures and superior and inferior vena cava thrombosis. After 2 weeks, inadvertent dislodgement of the catheter was complicated by a biloma. The biloma was percutaneously drained, but a biliary-venous fistula led to a rapidly progressive and fatal bilhemia. We report this case as an infrequent complication of transhepatic catheterization. (orig.)

  7. Bilhemia: a fatal complication following percutaneous placement of a transhepatic inferior vena cava catheter in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sierre, Sergio; Lipsich, Jose; Questa, Horacio [Hospital de Pediatria Prof JP Garrahan, Department of Interventional Radiology, Buenos Aires (Argentina)

    2007-05-15

    A transhepatic central venous catheter was implanted in a 2-year-old child with a history of multiple venous access procedures and superior and inferior vena cava thrombosis. After 2 weeks, inadvertent dislodgement of the catheter was complicated by a biloma. The biloma was percutaneously drained, but a biliary-venous fistula led to a rapidly progressive and fatal bilhemia. We report this case as an infrequent complication of transhepatic catheterization. (orig.)

  8. Congenital Aortocaval Fistula from Right Subclavian Artery to Superior Vena Cava in an Adult with Tetralogy of Fallot

    Directory of Open Access Journals (Sweden)

    Soheila Chamanian

    2014-11-01

    Full Text Available Congenital   aortocaval   fistula in association with complex congenital heart disease has never been described before. We represent an adult with tetralogy of fallot and an undiagnosed subclavian artery to superior vena cava fistula in previous catheterisms. He underwent surgical correction, successfully. After 8 months post operation he was doing well with improved functional capacity and no cyanosis.

  9. Renal Artery Stump to Inferior Vena Cava Fistula: Unusual Clinical Presentation and Transcatheter Embolization with the Amplatzer Vascular Plug

    International Nuclear Information System (INIS)

    Fistulous communication between the renal artery stump and inferior vena cava following nephrectomy is rare. We describe the case of a 52-year-old man with a fistula detected on investigation for hemolytic anemia in the postoperative period. The patient had had a nephrectomy performed 2 weeks prior to presentation for blunt abdominal trauma. The fistula was successfully occluded percutaneously using an Amplatzer vascular plug. The patient recovered completely and was discharged 2 weeks later.

  10. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    OpenAIRE

    Luo, Xiao-Li; Qian, Gen-Nian; Xiao, Hui; Zhao, Chun-Lei; Zhou, Xiao-Dong

    2012-01-01

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by b...

  11. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    International Nuclear Information System (INIS)

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography.

  12. Innominate vein-right atrial bypass for relief of superior vena cava syndrome due to pacemaker lead thrombosis.

    Science.gov (United States)

    Deo, Salil V; Burkhart, Harold M; Araoz, Philip A; Brady, Peter A

    2010-11-01

    We present a patient with superior vena cava (SVC) obstruction due to multiple intraluminal pacemaker leads. Previous attempts at balloon dilatation of the SVC and surgical angioplasty did not provide a long-term solution. A Gore-Tex (W. L. Gore & Associates, Flagstaff, AZ, USA) conduit interposed between the innominate vein and right atrial appendage has resulted in symptomatic relief at a follow-up of 6 months. PMID:21039859

  13. GCS as a predictor of mortality in patients with traumatic inferior vena cava injuries: a retrospective review of 16 cases

    OpenAIRE

    Cudworth, Michael; Fulle, Angelo; Ramos, Juan P; Arriagada, Ivette

    2013-01-01

    Introduction Recent research has determined Glasgow Coma Scale (GCS) to be an independent predictor of mortality in patients with traumatic inferior vena cava (IVC) injuries. The aim of this study was to evaluate the use of GCS, as well as other factors previously described as determinants of mortality, in a cohort of patients presenting with traumatic IVC lesions. Methods A 7-year retrospective review was undertaken of all trauma patients presenting to a tertiary care trauma center with trau...

  14. A prebiotic effect of Ecklonia cava on the growth and mortality of olive flounder infected with pathogenic bacteria.

    Science.gov (United States)

    Lee, WonWoo; Ahn, Ginnae; Oh, Jae Young; Kim, Seung Min; Kang, Nalae; Kim, Eun A; Kim, Kil-Nam; Jeong, Joon Bum; Jeon, You-Jin

    2016-04-01

    Olive flounder (Paralichthys olivaceus), also known as the Japanese flounder in Japan, is one of the most important commercial marine finfish species cultured in Korea and Japan. The purpose of this study was to evaluate how a species of brown algae (Ecklonia cava, E. cava) affects the growth rate of olive flounder and its immune response to pathogenic bacteria. First, the experimental fish were divided into four groups: the control group was fed the diet containing only 1.0% Lactobacillus plantarum (L. plantarum), group I was fed 1.0% L. plantarum and 1.0% E. cava (EC), group II was fed 1.0% L. plantarum and 0.1% ethanol extract of EC (EE), and group III was fed 1.0% L. plantarum and 0.5% EE. The diets fed to the fish twice a day for 16 weeks. The results indicated that supplementation with 1.0% EC and 0.1% EE improved the growth and body weight of olive flounder, and decreased its mortality. This diet, however, did not significantly affect the biochemical profiles of the experimental flounder. The supplementation of 1.0% EC also enhanced the innate immune response of the fish, as evidenced by the high respiratory burst, and increased serum lysozyme and myeloperoxidase activity. The addition of 1.0% EC and either 0.1% or 0.5% EE also decreased the accumulative mortality of olive flounder infected by pathogenic bacteria (Edwardsiella tarda, Streptococcus iniae, and Vibrio harveyi). Overall, these results suggest that E. cava can act as a prebiotic by improving the innate immune response in fish infected with pathogenic bacteria as increased the growth of the probiotic. PMID:26921543

  15. Electrophysiological characteristics of paroxysmal atrial fibrillation originating from superior vena cava: a clinical analysis of 30 cases

    OpenAIRE

    Shi, Xiang-min; YUAN, HONG-TAO; Guo, Hong-Yang; Guo, Jian-Ping; Shan, Zhao-Liang; Wang, Yu-tang

    2015-01-01

    To analyze characteristics of electrocardiogram (ECG), electrophysiological intracardiac mapping and radiofrequency ablation (RF) of paroxysmal atrial fibrillation (PAF) originating from superior vena cava (SVC), aiming to investigate electrophysiological characteristics of PAF with SVC origin. Clinical data of 30 subjects (18 men and 12 women, aged, 58.6 ± 15.5 years) with PAF of SVC origin were retrospectively analyzed; All patients underwent RF during 2006.9-2012.7. ECG of AF and atrial pr...

  16. Inferior vena cava filter placement for the prevention of pulmonary embolism and the complications related to the filter placement

    International Nuclear Information System (INIS)

    Objective: To investigate the effects of inferior vena cava (IVC) filter placement for the prevention of fatal pulmonary embolism and to discuss the management of complications related to the filter placement. Methods: Seventy patients with proved deep vein thrombosis of lower extremity underwent inferior vena cava filter placement.A total of 72 IVC filters were implanted,which included 20 Trap Ease filters, 31 Vena Tech filters, 13 retrievable OptEaseTM filters and 8 Tempo II filters. One filter was deployed above the orifice of renal vein and the remaining 71 were deployed below the orifice of renal vein. Results: All the patients were followed up for 8-72 months after the procedure. During the follow-up period no fatal pulmonary embolism occurred except that some complications related to the filter placement occurred in 6 cases. Conclusion: Inferior vena cava filter placement can effectively prevent the occurrence of pulmonary embolism. Of course, this treatment should be strictly applied according to the indications. (authors)

  17. Persistent left superior vena cava draining to the left atrium: A case report and review of the literature

    International Nuclear Information System (INIS)

    Persistent left superior vena cava is a rare but important congenital vascular anomaly. However, PLSVC with absent RSVC (isolated PLSVC) is a very rare venous malformation We report on a rare case of persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC). This venous malformation was identified incidentally in a 69-year-old woman during chest multi-detector computed tomography (MDCT). On chest MDCT, the SVC was noted on the left side. A bridging vein drained the right jugular and right subclavian veins and joined the left brachiocephalic vein in order to form the PLSVC, which descended on the left side of the mediastinum and drained into the left atrium (LA). The patient had no additional cardiac anomaly. Isolated PLSVC is usually asymptomatic but it can pose difficulties for establishing central venous access, pacemaker implantation and cardiothoracic surgery. This condition is also associated with an increased incidence of congenital heart disease, arrhythmias and conduction disturbances. A wide spectrum of clinicians should be aware of this anomaly, its variations and possible complications

  18. Polyphenol-Rich Fraction of Ecklonia cava Improves Nonalcoholic Fatty Liver Disease in High Fat Diet-Fed Mice

    Directory of Open Access Journals (Sweden)

    Eun-Young Park

    2015-11-01

    Full Text Available Ecklonia cava (E. cava; CA is an edible brown alga with beneficial effects in diabetes via regulation of various metabolic processes such as lipogenesis, lipolysis, inflammation, and the antioxidant defense system in liver and adipose tissue. We investigated the effect of the polyphenol-rich fraction of E. cava produced from Gijang (G-CA on nonalcoholic fatty liver disease (NAFLD in high-fat diet (HFD-fed mice. C57BL6 mice were fed a HFD for six weeks and then the HFD group was administered 300 mg/kg of G-CA extracts by oral intubation for 10 weeks. Body weight, fat mass, and serum biochemical parameters were reduced by G-CA extract treatment. MRI/MRS analysis showed that liver fat and liver volume in HFD-induced obese mice were reduced by G-CA extract treatment. Further, we analyzed hepatic gene expression related to inflammation and lipid metabolism. The mRNA expression levels of inflammatory cytokines and hepatic lipogenesis-related genes were decreased in G-CA-treated HFD mice. The mRNA expression levels of cholesterol 7 alpha-hydroxylase 1 (CYP7A1, the key enzyme in bile acid synthesis, were dramatically increased by G-CA treatment in HFD mice. We suggest that G-CA treatment ameliorated hepatic steatosis by inhibiting inflammation and improving lipid metabolism.

  19. Magnetic resonance venography to assess thrombus resolution with edoxaban monotherapy versus parenteral anticoagulation/warfarin for symptomatic deep vein thrombosis: A multicenter feasibility study.

    Science.gov (United States)

    Piazza, Gregory; Mani, Venkatesh; Goldhaber, Samuel Z; Grosso, Michael A; Mercuri, Michele; Lanz, Hans J; Schussler, Steven; Hsu, Ching; Chinigo, Amy; Ritchie, Bruce; Nadar, Venkatesh; Cannon, Kevin; Pullman, John; Concha, Mauricio; Schul, Marlin; Fayad, Zahi A

    2016-08-01

    The feasibility of magnetic resonance venography (MRV) for measuring change in thrombus volume with a novel anticoagulation regimen versus standard anticoagulation in patients with symptomatic deep vein thrombosis (DVT) has not been assessed. Our aim was to study the feasibility of MRV to measure change in thrombus volume in patients with acute symptomatic objectively confirmed proximal DVT in an open-label multicenter trial (edoxaban Thrombus Reduction Imaging Study, eTRIS). We randomized patients in a 2:1 allocation ratio to edoxaban 90 mg/day for 10 days followed by 60 mg/day versus parenteral anticoagulation bridging to warfarin for 3 months. The primary efficacy outcome was a surrogate end point of the relative change in MRV-quantified thrombus volume from baseline to Day 14-21. A total of 85 eligible patients from 26 study sites were randomized to edoxaban monotherapy (n=56) versus parenteral anticoagulation as a 'bridge' to warfarin (n=29). The mean relative change in MRV-quantified thrombus volume from baseline to Day 14-21 was similar in patients treated with edoxaban and parenteral anticoagulation as a 'bridge' to warfarin (-50.1% vs -58.9%; 95% confidence interval of treatment difference, -12.7%, 30.2%). However, thrombus extension was observed in eight patients in the edoxaban monotherapy group and in none in the warfarin group. Rates of recurrent venous thromboembolism (3.6% vs 3.6%, p=0.45) and clinically relevant non-major bleeding (5.4% vs 7.1%, p=0.34) were also similar. No major bleeds occurred in either on-treatment group during the study period. In conclusion, MRV can assess change in thrombus volume in patients with acute DVT randomized to two different anticoagulant regimens.ClinicalTrials.gov IDENTIFIER NCT01662908: INVESTIGATIONAL NEW DRUG IND APPLICATION EDOXABAN IND # 63266. PMID:27165711

  20. Gas hazard assessment in a densely inhabited area of Colli Albani Volcano (Cava dei Selci, Roma)

    Science.gov (United States)

    Carapezza, M. L.; Badalamenti, B.; Cavarra, L.; Scalzo, A.

    2003-04-01

    The northwestern flank of the Colli Albani, a Quaternary volcanic complex near Rome, is characterised by high pCO 2 values and Rn activities in the groundwater and by the presence of zones with strong emission of gas from the soil. The most significant of these zones is Cava dei Selci where many houses are located very near to the gas emission site. The emitted gas consists mainly of CO 2 (up to 98 vol%) with an appreciable content of H 2S (0.8-2%). The He and C isotopic composition indicates, as for all fluids associated with the Quaternary Roman and Tuscany volcanic provinces, the presence of an upper mantle component contaminated by crustal fluids associated with subducted sediments and carbonates. An advective CO 2 flux of 37 tons/day has been estimated from the gas bubbles rising to the surface in a small drainage ditch and through a stagnant water pool, present in the rainy season in a topographically low central part of the area. A CO 2 soil flux survey with an accumulation chamber, carried out in February-March 2000 over a 12 000 m 2 surface with 242 measurement points, gave a total (mostly conductive) flux of 61 tons/day. CO 2 soil flux values vary by four orders of magnitude over a 160-m distance and by one order of magnitude over several metres. A fixed network of 114 points over 6350 m 2 has been installed in order to investigate temporal flux variations. Six surveys carried out from May 2000 to June 2001 have shown large variations of the total CO 2 soil flux (8-25 tons/day). The strong emission of CO 2 and H 2S, which are gases denser than air, produces dangerous accumulations in low areas which have caused a series of lethal accidents to animals and one to a man. The gas hazard near the houses has been assessed by continuously monitoring the CO 2 and H 2S concentration in the air at 75 cm from the ground by means of two automatic stations. Certain environmental parameters (wind direction and speed; atm P, T, humidity and rainfall) were also

  1. Tocotrienols-induced inhibition of platelet thrombus formation and platelet aggregation in stenosed canine coronary arteries

    Directory of Open Access Journals (Sweden)

    Papasian Christopher J

    2011-04-01

    .7 μg/mL in plasma and 3.8 vs 3.9 μg/mL in platelets. Conclusions The present results indicate that intravenously administered tocotrienols inhibited acute platelet-mediated thrombus formation, and collagen and ADP-induced platelet aggregation. α-Tocotrienols treatment induced increases in α-tocopherol levels of 4-fold and 6-fold in plasma and platelets, respectively. Interestingly, tocotrienols (TRF treatment induced a less pronounced increase in the levels of tocotrienols in plasma and platelets, suggesting that intravenously administered tocotrienols may be converted to tocopherols. Tocotrienols, given intravenously, could potentially prevent pathological platelet thrombus formation and thus provide a therapeutic benefit in conditions such as stroke and myocardial infarction.

  2. Thrombus Formation After Percutaneous Catheterization and Manual Compression of the Femoral Artery in Heparinized Sheep

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly platelet-fibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

  3. Does manual thrombus aspiration help optimize stent implantation in ST-segment elevation myocardial infarction?

    Institute of Scientific and Technical Information of China (English)

    Diego; Fernández-Rodríguez; Luis; Alvarez-Contreras; Victoria; Martín-Yuste; Salvatore; Brugaletta; Ignacio; Ferreira; Marta; De; Antonio; Montserrat; Cardona; Vicens; Martí; Juan; García-Picart; Manel; Sabaté

    2014-01-01

    AIM: To evaluate the impact of thrombus aspiration(TA) on procedural outcomes in a real-world ST-segment elevation myocardial infarction(STEMI) registry.METHODS: From May 2006 to August 2008, 542 consecutive STEMI patients referred for primary or rescue percutaneous coronary intervention were enrolled and the angiographic results and stent implantation characteristics were compared according to the performance of manual TA.RESULTS: A total of 456 patients were analyzable and categorized in TA group(156 patients; 34.2%) and non-TA(NTA) group(300 patients; 65.8%). Patientstreated with TA had less prevalence of multivessel disease(39.7% vs 54.7%, P = 0.003) and higher prevalence of initial thrombolysis in myocardial infarction flow < 3(P < 0.001) than NTA group. There was a higher rate of direct stenting(58.7% vs 45.5%, P = 0.009), with shorter(24.1 ± 11.8 mm vs 26.9 ± 15.7 mm, P = 0.038) and larger stents(3.17 ± 0.43 mm vs 2.93 ± 0.44 mm, P < 0.001) in the TA group as compared to NTA group. The number of implanted stents(1.3 ± 0.67 vs 1.5 ± 0.84, P = 0.009) was also lower in TA group. CONCLUSION: In an “all-comers” STEMI population, the use of TA resulted in more efficient procedure leading to the implantation of less number of stents per lesion of shorter lengths and larger sizes.

  4. Computed tomography angiography intraluminal filling defect is predictive of internal carotid artery free-floating thrombus

    Energy Technology Data Exchange (ETDEWEB)

    Jaberi, A.; Lum, C.; Stefanski, P.; Iancu, D. [University of Ottawa, Faculty of Medicine, Ottawa, Ontario (Canada); The Ottawa Hospital, Department of Radiology, Neuroradiology Section, Ottawa, Ontario (Canada); Thornhill, R. [Neurosciences and Clinical Epidemiology Program/Methods Centre, Ottawa Hospital Research Institute, Ottawa, Ontario (Canada); The Ottawa Hospital, Department of Radiology, Neuroradiology Section, Ottawa, Ontario (Canada); Petrcich, W. [Neurosciences and Clinical Epidemiology Program/Methods Centre, Ottawa Hospital Research Institute, Ottawa, Ontario (Canada); Momoli, F. [Children' s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario (Canada); University of Ottawa, Department of Epidemiology and Community Medicine, Ottawa, Ontario (Canada); Torres, C.; Dowlatshahi, D. [University of Ottawa, Faculty of Medicine, Ottawa, Ontario (Canada); University of Ottawa, Division of Neurology, Department of Medicine, Ottawa, Ontario (Canada)

    2014-01-15

    Filling defects at the internal carotid artery (ICA) origin in the work-up of stroke or transient ischemic attack may be an ulcerated plaque or free-floating thrombus (FFT). This may be challenging to distinguish, as they can appear morphologically similar. This is an important distinction as FFT can potentially embolize distally, and its management differs. We describe a series of patients with suspected FFT and evaluate its imaging appearance, clinical features, and evolution with therapy. Between 2008 and 2013, we prospectively collected consecutive patients with proximal ICA filling defects in the axial plane surrounded by contrast on CT/MR angiography. We defined FFT as a filling defect that resolved on follow-up imaging. We assessed the cranial-caudal dimension of the filling defect and receiver operating characteristics to identify clinical and radiological variables that distinguished FFT from complex ulcerated plaque. Intraluminal filling defects were identified in 32 patients. Filling defects and resolved or decreased in 25 patients (78 %) and felt to be FFT; there was no change in 7 (22 %). Resolved defects and those that decreased in size extended more cranially than those that remained unchanged: 7.3 mm (4.2-15.9) versus 3.1 mm (2.7-3.7; p = 0.0038). Receiver operating characteristic analysis established a threshold of 3.8 mm (filling defect length), sensitivity of 88 %, specificity of 86 %, and area under the curve of 0.86 (p < 0.0001) for distinguishing FFT from plaque. Filling defects in the proximal ICA extending cranially >3.8 mm were more likely to be FFT than complex ulcerated plaque. Further studies evaluating filling defect length as a predictor for FFT are warranted. (orig.)

  5. Nanoliposomal Growth Hormone and Sodium Nitrite Release from Silicone Fibers Reduces Thrombus Formation Under Flow.

    Science.gov (United States)

    Salehi-Nik, Nasim; Amoabediny, Ghassem; Banikarimi, Seyedeh Parnian; Pouran, Behdad; Malaie-Balasi, Zahra; Zandieh-Doulabi, Behrouz; Klein-Nulend, Jenneke

    2016-08-01

    Biocompatibility of artificial lungs can be improved by endothelialization of hollow fibers. Bioavailability of growth-inducing and anti-thrombotic agents on the hollow fiber-blood interface inhibits thrombosis. We investigated if nanoliposomal growth-inducing growth hormone (nGH) and anti-thrombotic sodium nitrite (nNitrite) incorporation into collagen-coating on silicone hollow fibers improves blood biocompatibility by increasing endothelial cell growth and nitrite bioavailability under flow. Nitrite production rate was assessed under varying flow conditions. Finite element (FE) modeling was used to simulate nitrite transport within the parallel-plate flow chamber, and nitrite bioavailability on the fiber-blood interface at 1-30 dyn/cm(2) shear stress. Endothelial cell number on fibers coated with nNitrite-nGH-collagen conjugate was 1.5-fold higher than on collagen-coated fibers. For collagen-coated fibers, nitrite production reached a maximum at 18 dyn/cm(2) shear stress. When fibers were coated with nNitrite-nGH-collagen conjugate, nitrite production increased continuously by increasing shear stress. FE modeling revealed that nitrite concentrations at the fiber-blood interface were affected by shear stress-induced nitrite production, and diffusion/convection-induced nitrite removal. Highest nitrite concentrations and lowest thrombus deposition were observed on fibers coated with nNitrite-nGH-collagen conjugate exposed to 6-12 dyn/cm(2) shear stress. In conclusion, our results suggest that nNitrite-nGH-Col conjugate coatings promote endothelialization of silicone hollow fibers in biohybrid artificial lungs. PMID:26762283

  6. Visualization and analysis of biomaterial-centered thrombus formation within a defined crevice under flow.

    Science.gov (United States)

    Jamiolkowski, Megan A; Pedersen, Drake D; Wu, Wei-Tao; Antaki, James F; Wagner, William R

    2016-07-01

    The blood flow pathway within a device, together with the biomaterial surfaces and status of the patient's blood, are well-recognized factors in the development of thrombotic deposition and subsequent embolization. Blood flow patterns are of particular concern for devices such as blood pumps (i.e. ventricular assist devices, VADs) where shearing forces can be high, volumes are relatively large, and the flow fields can be complex. However, few studies have examined the effect of geometric irregularities on thrombus formation on clinically relevant opaque materials under flow. The objective of this study was to quantify human platelet deposition onto Ti6Al4V alloys, as well as positive and negative control surfaces, in the region of defined crevices (∼50-150 μm in width) that might be encountered in many VADs or other cardiovascular devices. To achieve this, reconstituted fresh human blood with hemoglobin-depleted red blood cells (to achieve optical clarity while maintaining relevant rheology), long working optics, and a custom designed parallel plate flow chamber were employed. The results showed that the least amount of platelet deposition occurred in the largest crevice size examined, which was counterintuitive. The greatest levels of deposition occurred in the 90 μm and 53 μm crevices at the lower wall shear rate. The results suggest that while crevices may be unavoidable in device manufacturing, the crevice size might be tailored, depending on the flow conditions, to reduce the risk of thromboembolic events. Further, these data might be used to improve the accuracy of predictive models of thrombotic deposition in cardiovascular devices to help optimize the blood flow path and reduce device thrombogenicity. PMID:27156141

  7. A low-dose, dual-phase cardiovascular CT protocol to assess left atrial appendage anatomy and exclude thrombus prior to left atrial intervention.

    Science.gov (United States)

    Lazoura, Olga; Ismail, Tevfik F; Pavitt, Christopher; Lindsay, Alistair; Sriharan, Mona; Rubens, Michael; Padley, Simon; Duncan, Alison; Wong, Tom; Nicol, Edward

    2016-02-01

    Assessment of the left atrial appendage (LAA) for thrombus and anatomy is important prior to atrial fibrillation (AF) ablation and LAA exclusion. The use of cardiovascular CT (CCT) to detect LAA thrombus has been limited by the high incidence of pseudothrombus on single-pass studies. We evaluated the diagnostic accuracy of a two-phase protocol incorporating a limited low-dose delayed contrast-enhanced examination of the LAA, compared with a single-pass study for LAA morphological assessment, and transesophageal echocardiography (TEE) for the exclusion of thrombus. Consecutive patients (n = 122) undergoing left atrial interventions for AF were assessed. All had a two-phase CCT protocol (first-past scan plus a limited, 60-s delayed scan of the LAA) and TEE. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) were calculated for the detection of true thrombus on first-pass and delayed scans, using TEE as the gold standard. Overall, 20/122 (16.4 %) patients had filling defects on the first-pass study. All affected the full delineation of the LAA morphology; 17/20 (85 %) were confirmed as pseudo-filling defects. Three (15 %) were seen on late-pass and confirmed as true thrombi on TEE; a significant improvement in diagnostic performance relative to a single-pass scan (McNemar Chi-square 17, p true LAA anatomy and thrombus in patients undergoing LA intervention. PMID:26420491

  8. Early and Late Retrieval of the ALN Removable Vena Cava Filter: Results from a Multicenter Study

    International Nuclear Information System (INIS)

    Retrieval of removable inferior vena cava (IVC) filters in selected patients is widely practiced. The purpose of this multicenter study was to evaluate the feasibility and results of percutaneous removal of the ALN removable filter in a large patient cohort. Between November 2003 and June 2006, 123 consecutive patients were referred for percutaneous extraction of the ALN filter at three centers. The ALN filter is a removable filter that can be implanted through a femoral/jugular vein approach and extracted by the jugular vein approach. Filter removal was attempted after an implantation period of 93 ± 15 days (range, 6-722 days) through the right internal jugular vein approach using the dedicated extraction kit after control inferior vena cavography. Following filter removal, vena cavograms were obtained in all patients. Successful extraction was achieved in all but one case. Among these successful retrievals, additional manipulation using a femoral approach was needed when the apex of the filter was close to the IVC wall in two patients. No immediate IVC complications were observed according to the postimplantation cavography. Neither technical nor clinical differences between early and late filter retrieval were noticed. Our data confirm the safety of ALN filter retrieval up to 722 days after implantation. In infrequent cases, additional endovenous filter manipulation is needed to facilitate extraction.

  9. Downhill oesophageal varices resulting from superior vena cava graft occlusion after resection of a thymoma†

    Science.gov (United States)

    Inoue, Yoshimasa; Sakai, Shoji; Aoki, Teruhiro

    2013-01-01

    Downhill oesophageal varices (DEV) may occur as a rare complication of superior vena cava (SVC) obstruction. DEV are usually associated with SVC obstruction caused by systemic vasculitis or mediastinal tumours. In this report, we describe a very rare case of DEV resulting from SVC graft occlusion after resection of a thymoma. A 66-year old man with an invasive thymoma was treated by radical resection and bypass grafting from the right brachiocephalic vein to the right atrium. Occlusion of the SVC graft was diagnosed postoperatively; however, the patient could be managed conservatively. Although there had been no significant findings in the oesophagus in previous endoscopic examinations, grade F2 varices were found in the proximal oesophagus in the 19th postoperative month, and DEV caused by SVC graft occlusion was diagnosed. Until now, 2 years since the diagnosis, no apparent symptoms or deterioration of the DEV have been observed. The possible development of DEV should be borne in mind during the follow-up of patients with postoperative SVC graft occlusion. PMID:23686892

  10. Dynamic Limb Bioimpedance and Inferior Vena Cava Ultrasound in Patients Undergoing Hemodialysis.

    Science.gov (United States)

    Tiba, Mohamad H; Belmont, Barry; Heung, Michael; Theyyunni, Nik; Huang, Robert D; Fung, Christopher M; Pennington, Amanda J; Cummings, Brandon C; Draucker, Gerard T; Shih, Albert J; Ward, Kevin R

    2016-01-01

    Assessment of volume status in critically ill patients poses a challenge to clinicians. Measuring changes in the inferior vena cava (IVC) diameter using ultrasound is becoming a standard tool to assess volume status. Ultrasound requires physicians with significant training and specialized expensive equipment. It would be of significant value to be able to obtain this measurement continuously without physician presence. We hypothesize that dynamic changes in limb's bioimpedance in response to respiration could be used to predict changes in IVC. Forty-six subjects were tested a hemodialysis session. Impedance was measured via electrodes placed on the arm. Simultaneously, the IVC diameter was assessed by ultrasound. Subjects were asked to breathe spontaneously and perform respiratory maneuvers using a respiratory training device. Impedance (dz) was determined and compared with change in IVC diameter (dIVC; r = 0.76, p < 0.0001). There was significant relationship between dz and dIVC (p< 0.0001). Receiver-operator curves for dz at thresholds of dIVC (20% to70%) demonstrated high predictive power with areas under the curves (0.87-0.99, p < 0.0001). This evaluation suggests that real-time dynamic changes in limb impedance are capable of tracking a wide range of dynamic dIVC. This technique might be a suitable surrogate for monitoring real-time changes in dIVC to assess intravascular volume status. PMID:26919184

  11. Radiological diagnosis of total anomalous pulmonary venous connection with right superior vena cava

    International Nuclear Information System (INIS)

    Objective: To evaluate radiographic diagnosis in total anomalous pulmonary venous connection with right superior vena cava (RSVC-TAPVC) and analyze the variant of its pulmonary venous connection and the influence on surgical operation. Methods: In 11 patients who were diagnosed by angiocardiography and confirmed by surgical operation, all chest radiographs were studied retrospectively and compared with their angiocardiography and surgical results. The variant of pulmonary venous connection was analyzed and the influence on surgical operation was also discussed. Results: 6 patients showed 'right hemi-snowman sign' in posteroanterior view and 3 showed a pre-tracheal density on the lateral view or other sign caused by drainage vein. 6 of 9 angio-cardiographs showed pulmonary or drainage venous stenosis. There were 2, 4 and 3 cases respectively whose right pulmonary veins connected with common pulmonary or drainage veins in one, two, and three branches. 2 of 3 died cases were caused by mistaken ligation of right superior pulmonary vein during the operation. Conclusion: About 82% cases of the RSVC-TAPVC can be diagnosed by chest radiograph because of the 'right hemi-snowmen sign' and other supplementary signs. In about 78% cases, the right pulmonary veins join right drainage (or connecting) vein in two or more branches at separate levels and this variant has surgical implications

  12. Persistent left superior vena cava mistaken for nodal metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Papandrinopoulou Dimitra

    2010-06-01

    Full Text Available Abstract Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.

  13. Catheterobronchial fistula due to vena cava superior thrombosis as a late complication of ventriculoatrial shunt.

    Science.gov (United States)

    Parízek, J; Nytra, T; Zemánková, M; Eliás, P; Sercl, M; Nĕmecková, J; Jakubec, J

    1994-09-01

    A case of a catheterobronchial fistula as a rare late complication of a ventriculoatrial shunt is reported. The ventriculoatrial shunt was implanted in a 4-month-old boy suffering from extreme postinfectious hydrocephalus. During the following years, twelfth nerve palsy on the right, vertebralgias, and salty taste sensations in the mouth associated with intermittent coughing and swelling of the neck and supraclavicular region on the right side developed. Valvography established a diagnosis of fistula 12 years after the implantation of a shunt. Ultrasonography of the neck and mediastinum and contrast-enhanced dynamic computed tomographic scanning demonstrated a catheterobronchial fistula to the subsegmental bronchus of the anterior segment of the right upper lung lobe, a thrombosis of the right internal jugular and both right and left brachiocephalic veins and the superior vena cava, and an extensive collateral venous system mainly draining into the azygos vein. Normalization of cerebrospinal fluid and blood flow and pressure allowed extraction of the "atrial" catheter without complications. One year after surgery the boys is in good health and without signs of shunt dependence. PMID:7842439

  14. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

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    Avradip Santra

    2016-07-01

    Full Text Available Superior vena cava (SVC syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.

  15. Titanium greenfield inferior vena cava filter; effectiveness of percutaneous placement for prevention of pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Bong Gak; Hahn, Seong Tai; Jung, Jung Im; Lee, Sang Hoon; Koh, Ki Young; Park, Seog Hee; Shinn, Kyung Sub [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2000-11-01

    To evaluate the effectiveness of percutaneous placement of a Greenfield titanium filter in the inferior vena cava (IVC) for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Twelve patients with DVT underwent percutaneous Greenfield titanium filter placement. The indications included recurrent pulmonary embolism or failed anticoagulation therapy in six patients, extensive PE in three, and prophylaxis for high risk of PE in the remaining three. In all cases the filter was positioned after confirming the anatomy, patency, and presence of thrombosis of the IVC and renal veins by inferior vena cavography. Long-term follow-up study involved clinical evaluation, plain radiography, Doppler ultrasonography and CT scanning. Filter placement [infrarenal in ten patients (83%) and suprarenal in two (17%)] was technically successful in all cases (100%). The venous approach involved the right femoral vein in eight patients (67%) and the right internal jugular vein in four (33%). Complications included overlapping of the filter legs in three patients (25%), and misplacement in one (8%). After filter placement, no further PE developed. In all of five patients followed up for two years, the IVC maintained patency without evidence of caval perforation or occlusion. In patients with DVT, percutaneous placement of a Greenfield titanium filter is a safe and effective method for the prevention of PE.

  16. Role of inferior vena cava filter implantation in preventing pulmonary embolism

    International Nuclear Information System (INIS)

    A retrospective review of all patients undergoing IVC filter implantation at Shifa International Hospital, Islamabad, from June 2004 to June 2006 was conducted to study the indications of inferior vena cava (IVC) filter use and impact on short-term morbidity/mortality. A total of 17 patients received IVC filters. Five patients were excluded due to data loss. One month clinical followup was available for 12 patients and 6 months follow-up was also available for 4 of 12 patients. The underlying disease was deep venous thrombosis (DVT) with pulmonary embolism (PE) in 6 (50%), DVT without PE in 4 (33.3%) and PE with negative duplex scan for DVT in 2 (16.6%) patients, respectively. Indications for IVC filter implantation were DVT and/or PE with contraindication to anticoagulation in 8 (66.7%) and DVT and/or PE with complications of anticoagulation in 4 (33.3%) patients. No procedure-related complications were noted in all 17 patients. Three patients (25%) died of non-PE related causes during the 1st month. There were no PE related mortalities at 6 months. This data set indicates that IVC filter implantation is a safe procedure with no short-term morbidity/mortality and potential long-term mortality benefit. (author)

  17. Titanium greenfield inferior vena cava filter; effectiveness of percutaneous placement for prevention of pulmonary embolism

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of percutaneous placement of a Greenfield titanium filter in the inferior vena cava (IVC) for the prevention of pulmonary embolism (PE) in patients with deep vein thrombosis (DVT). Twelve patients with DVT underwent percutaneous Greenfield titanium filter placement. The indications included recurrent pulmonary embolism or failed anticoagulation therapy in six patients, extensive PE in three, and prophylaxis for high risk of PE in the remaining three. In all cases the filter was positioned after confirming the anatomy, patency, and presence of thrombosis of the IVC and renal veins by inferior vena cavography. Long-term follow-up study involved clinical evaluation, plain radiography, Doppler ultrasonography and CT scanning. Filter placement [infrarenal in ten patients (83%) and suprarenal in two (17%)] was technically successful in all cases (100%). The venous approach involved the right femoral vein in eight patients (67%) and the right internal jugular vein in four (33%). Complications included overlapping of the filter legs in three patients (25%), and misplacement in one (8%). After filter placement, no further PE developed. In all of five patients followed up for two years, the IVC maintained patency without evidence of caval perforation or occlusion. In patients with DVT, percutaneous placement of a Greenfield titanium filter is a safe and effective method for the prevention of PE

  18. Bird's nest versus the Kimray-Greenfield inferior vena cava filter: Randomized clinical study

    International Nuclear Information System (INIS)

    A randomized clinical study was conducted comparing the percutaneously introduced bird's nest inferior vena cava (IVC) filter and the Kimray-Greenfield IVC filter. Study end points included recurrent pulmonary embolism, new or worse leg venous stasis symptoms, IVC thrombosis, and ease of filter introduction. Of the 109 patients in the study, 58 were randomly assigned to the BN and 51 to the KG filter. Demographic factors were comparable between the two groups. Follow-up entailed cavography, noninvasive assessment of the femoral veins, and standardized telephone interviews. The follow-up period was extended to 1 year after filter insertion. Results for the bird's nest versus the Kimray-Greenfield filter respectively were as follows: death due to massive pulmonary embolism, 3% versus 5%; recurrent pulmonary embolism, 1.5% versus 7.5%; filter migration, 1.1% versus 0.0%; IVC thrombosis, 6% versus 2.5%; new or worse leg edema, 28.5% versus 22%; ease of introduction (qualitative), maximal versus minimal; patient discomfort (qualitative), minimal versus maximal. The authors conclude the bird's nest filter is better than the Kimray-Greenfield filter in terms of prevention of recurrent pulmonary embolism and ease of introduction. In terms of venous stasis, the bird's nest filter is not better and may be worse than the Kimray-Greenfield filter. Filter migration is a problem with the bird's nest filter

  19. On determining the characteristics of a Greenfield Inferior Vena Cava Filter using CFD

    Science.gov (United States)

    Swaminathan, Tirumani; Hu, Howard; Patel, Aalpen

    2004-11-01

    In those patients with deep venous thrombosis (DVT) or those at a high risk for DVT, and who have contraindications to or are unresponsive to anticoagulation therapy, vena cava filters are often used to prevent recurrent pulmonary emboli. Ideally, the filter should be efficacious while being non-thrombogenic and non-impeding to the blood flow. In reality, the filter has to establish a balance between clot capture efficiency and flow impedance before and after clot capture. The development and use of numerical tools to study the characteristics of filters and its application to the case of a Greenfield filter has been presented here. A detailed model resolving the flow field around the filter to a fine detail is described. The thrombogenecity of the filter in un-occluded flows is determined by analyzing plots of shear stresses and velocity fields. To evaluate a filter's clot capturing efficacy, a Thin Wire Model (TWM) has been developed and used in conjunction with a moving finite element scheme to study the probability of clot capturing for the Greenfield filter.

  20. Fluoroscopy-Guided Resolution of Ingested Thrombus Leading to Functional Disturbance of a Continuous-Flow Left Ventricular Assist Device

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    Jens Garbade

    2012-01-01

    Full Text Available The third generation of left ventricular assist devices (LVADs has been shown to improve outcome and quality of life in patients suffering from acute and chronic heart failure. However, VAD-associated complications are still a challenge in the clinical practice. Here we report the resolution of a mobile thrombus formation in the proximity of the inflow cannula of a third generation of LVADs (HVAD Pump, HeartWare, Inc. in a patient with chronic heart failure 4 months after implantation.

  1. MRI discriminates thrombus composition and ST resolution after percutaneous coronary intervention in patients with ST-elevation myocardial infarction.

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    Ignasi Barba

    Full Text Available Histological composition of material obtained by thrombus aspiration during percutaneous coronary intervention (PCI in patients with ST-segment elevation acute myocardial infarction (STEMI is highly variable. We aimed to characterize this material using magnetic resonance imaging (MRI and to correlate MRI findings with the success of PCI in terms of ST-segment resolution. Thrombus aspiration during primary or rescue PCI was attempted in 100 consecutive STEMI patients, of whom enough material for MRI was obtained in 59. MR images were obtained at 9.4T and T1 and T2 values were measured. Patients with (n = 31 and without (n = 28 adequate ST resolution 120 min after PCI (≥70% of pre-PCI value had similar baseline characteristics except for a higher prevalence of diabetes mellitus in the latter (10 vs. 43%, p = 0.003. T1 values were similar in both groups (1248±112 vs. 1307±85 ms, respectively, p = 0.7. T2 values averaged 31.2±10.3 and 36.6±12.2 ms; in thrombus from patients with and without adequate ST resolution (p = 0.09. After adjusting for diabetes and other baseline characteristics, lower T2 values were significantly associated with inadequate ST resolution (odds ratio for 1 ms increase 1.08, CI 95% 1.01-1.16, p = 0.027. Histology classified thrombus in 3 groups: coagulated blood (n = 38, fibrin rich (n = 9 and lipid-rich (n = 3. Thrombi composed mostly of coagulated blood were characterized as being of short (n = 10, intermediate (n = 15 or long evolution (n = 13, T2 values being 34.0±13.2, 31.9±8.3 and 31.5±7.9 ms respectively (p = NS. In this subgroup, T2 was significantly higher in specimens from patients with inadequate perfusion (35.9±10.3 versus 28.6±6.7 ms, p = 0.02. This can be of clinical interest as it provides information on the probability of adequate ST resolution, a surrogate for effective myocardial reperfusion.

  2. Tumor vaccines

    International Nuclear Information System (INIS)

    Tumor vaccines have several potential advantages over standard anticancer regiments. They represent highly specific anticancer therapy. Inducing tumor-specific memory T-lymphocytes, they have potential for long-lived antitumor effects. However, clinical trials, in which cancer patients were vaccinated with tumor vaccines, have been so far mainly disappointing. There are many reasons for the inefficiency of tumor vaccines. Most cancer antigens are normal self-molecules to which immune tolerance exists. That is why the population of tumor-specific lymphocytes is represented by a small number of low-affinity T-lymphocytes that induce weak antitumor immune response. Simultaneously, tumors evolve many mechanisms to actively evade immune system, what makes them poorly immunogenic or even tolerogenic. Novel immunotherapeutic strategies are directed toward breaking immune tolerance to tumor antigens, enhancing immunogenicity of tumor vaccines and overcoming mechanisms of tumor escape. There are several approaches, unfortunately, all of them still far away from an ideal tumor vaccine that would reject a tumor. Difficulties in the activation of antitumor immune response by tumor vaccines have led to the development of alternative immunotherapeutic strategies that directly focus on effector mechanisms of immune system (adoptive tumor- specific T-lymphocyte transfer and tumor specific monoclonal antibodies). (author)

  3. Implante intencional de filtros de veia cava em ambas as veias ilíacas comuns: relato de caso e revisão da literatura Intentional placement of vena cava filters in both iliac veins: case report and literature review

    Directory of Open Access Journals (Sweden)

    Daniel Queiroz Neves

    2010-12-01

    Full Text Available Os filtros de veia cava são utilizados para impedir a passagem de êmbolos dos membros inferiores para as artérias pulmonares e, normalmente, são colocadas imediatamente abaixo das veias renais. Em alguns casos, no entanto, existem dificuldades técnicas incomuns que devem ser superadas para tratar adequadamente alguns pacientes. Relatamos o caso de uma paciente em cujas veias ilíacas comuns foram implantados filtros de veia cava devido à baixa implantação das veias renais e da veia cava inferior curta.Vena cava filters are used to prevent the passage of emboli from the lower limbs to the pulmonary arteries and normally are placed immediately below the renal veins. In some cases however there are unusual technical difficulties that must be overcome to properly treat some patients. We report a case of a patient in whose common iliac veins vena cava filters were deployed, due to the lower implantation of renal veins and a short inferior vena cava.

  4. Patterns of ST segment resolution after guidewire passage and thrombus aspiration in primary percutaneous coronary intervention (PPCI) for acute myocardial infarction

    Science.gov (United States)

    Russhard, Paul; Al Janabi, Firas; Parker, Michael; Clesham, Gerald J

    2016-01-01

    Background ST segment elevation allows the rapid identification of patients with acute myocardial infarction who benefit from emergency reperfusion. Primary percutaneous coronary intervention (PPCI) has emerged as the preferred perfusion strategy for patients presenting with ST segment elevation myocardial infarction (STEMI). Methods and results We studied the effects of the simple passage of an angioplasty guidewire followed by mechanical thrombus aspiration on the ST segment displacement in 289 patients presenting with acute STEMI. Simple guidewire passage led to a statistically significant fall in the mean ST elevation from 5.9 to 4.9 mm (p<0.001), but the mean ST displacement after subsequent mechanical thrombus aspiration was 4.8 mm, not statistically significantly different from guidewire passage. When compared with simple guidewire passage, thrombus aspiration resulted in more patients achieving more than 50% ST resolution (21.8% vs 15.2%, p=0.009), but a higher proportion had a worsening of ST elevation compared to baseline (19.7% vs 13.5%, p=0.041). Conclusions Mechanical thrombus aspiration in acute STEMI did not improve the mean ST resolution compared with simple guidewire passage. Thrombus aspiration increased the proportion achieving 50% resolution but also increased the proportion who had a worsening of ST elevation. These data may help explain some of the uncertainties surrounding the routine use of thrombus aspiration in STEMI and potentially supports the use of ‘time to angioplasty guidewire passage’ as one of the ways to judge the promptness of PPCI services. PMID:27335657

  5. Real-Time Observation of Thrombus Growth Process in an Impeller of a Hydrodynamically Levitated Centrifugal Blood Pump by Near-Infrared Hyperspectral Imaging.

    Science.gov (United States)

    Sakota, Daisuke; Murashige, Tomotaka; Kosaka, Ryo; Fujiwara, Tatsuki; Nishida, Masahiro; Maruyama, Osamu

    2015-08-01

    Understanding the thrombus formation in cardiovascular devices such as rotary blood pumps is the most important issue in developing more hemocompatible devices. The objective of this study was to develop a hyperspectral imaging (HSI) method to visualize the thrombus growth process within a rotary blood pump and investigate the optical properties of the thrombus. An in vitro thrombogenic test was conducted using fresh porcine blood and a specially designed hydrodynamically levitated centrifugal blood pump with a transparent bottom. The pump rotating at 3000 rpm circulated the blood at 1.0 L/min. The bottom surface of the pump was illuminated with white light pulsed at the same frequency as the pump rotation, and the backward-scattered light was imaged using the HSI system. Using stroboscopic HSI and an image construction algorithm, dynamic spectral imaging at wavelengths ranging from 608 to 752 nm within the rotating pump was achieved. After completing the experiment, we collected the red thrombus formed in the pump impeller and quantified the thrombus hemoglobin concentration (Hbthrombus ). The spectrum changed around the center of the impeller, and the area of change expanded toward the impeller flow path. The shape corresponded approximately to the shape of the thrombus. The spectrum change indicated that the light scattering derived from red blood cells decreased. The Hbthrombus was 4.7 ± 1.3 g/dL versus a total hemoglobin of 13 ± 0.87 g/dL. The study revealed that Hbthrombus was reduced by the surrounding blood flow. PMID:26234451

  6. Safety and efficacy of transarterial chemoembolization plus sorafenib for hepatocellular carcinoma with portal venous tumour thrombus

    International Nuclear Information System (INIS)

    Aim: To evaluate the safety and efficacy of combined therapy with transarterial chemoembolization (TACE) and sorafenib for hepatocellular carcinoma (HCC) with portal venous tumour thrombus (PVTT). Materials and methods: This study was approved by the institutional review board. From May 2009 to May 2012, 170 consecutive patients were newly diagnosed with advanced-stage HCC and treated with TACE plus sorafenib. Among them, 41 patients with PVTT were retrospectively enrolled in the study. The adverse events (AEs), overall survival (OS), time to progression (TTP), and prognostic factors were analysed. Statistical analysis was performed with the Kaplan–Meier method using the log-rank test and Cox regression models. Results: The most common AEs were hand–foot skin reaction related to sorafenib and fever related to TACE. Procedure-related mortality and grade 4 AEs were not observed. Grade 3 AEs were observed in five patients. During the median follow-up period of 13.5 months (range 1.4–45 months), the 6-month and 1-year survival rates were 87.7% and 53.6%, respectively. The median OS was 13 months (range 1.4–44.8 months), and the median TTP was 7 months (range 1–18.6 months). The Child–Pugh class (p = 0.022), extrahepatic metastasis (p = 0.009), and gross morphological type (nodular type versus diffuse type; p = 0.008) were prognostic factors related to OS in the multivariate analysis. Conclusion: TACE plus sorafenib in an interrupted therapeutic scheme was well tolerated and might improve OS for HCC patients with PVTT, especially in those with Child–Pugh class A, no extrahepatic metastasis, or nodular-type HCC. - Highlights: • We introduce the safety of TACE plus sorafenib for patients with advanced HCC and PVTT. • We suggest that the combined therapy might prolong the TTP and OS than sorafenib alone. • Clinic benefit determinations with the Child-Pugh class, extrahepatic metastasis or gross type

  7. Mammary tumors

    International Nuclear Information System (INIS)

    Mammary neoplasia is one of the more common malignancies affecting domestic species. Despite their importance, they are often over- diagnosed, undertreated and subject to several misconceptions propagated by veterinarians and pet owners alike. Mammary neoplasia is the most frequent tumor type encountered in the female accounting for almost half of all malignancies reported. The canine has the highest incidence of mammary tumors of all domestic species. In the dog, about 65 percent of mammary tumors are benign mixed tumors, and 25 percent are carcinomas. The rest are adenomas, myoepitheliomas, and malignant mixed tumors. The age distribution of mammary tumors closely follows the age distribution of most tumors in the dog. Mammary tumors are rare in dogs 2 years old, but incidence begins to increase sharply at approximately 6 years of age. Median age at diagnosis is about 10 years. No breed predilection has been consistently reported

  8. Laser-Activated Shape Memory Polymer Microactuator for Thrombus Removal Following Ischemic Stroke: Preliminary In Vitro Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Small, W; Metzger, M F; Wilson, T S; Maitland, D J

    2004-09-23

    Due to the narrow (3-hour) treatment window for effective use of the thrombolytic drug recombinant tissue-type plasminogen activator (rt-PA), there is a need to develop alternative treatments for ischemic stroke. We are developing an intravascular device for mechanical thrombus removal using shape memory polymer (SMP). We propose to deliver the SMP microactuator in its secondary straight rod form (length = 4 cm, diameter = 350 {micro}m) through a catheter distal to the vascular occlusion. The microactuator, which is mounted on the end of an optical fiber, is then transformed into its primary corkscrew shape by laser heating (diode laser, {lambda} = 800 nm) above its soft phase glass transition temperature (T{sub gs} = 55 C). Once deployed, the microactuator is retracted and the captured thrombus is removed to restore blood flow. The SMP is doped with indocyanine green (ICG) dye to increase absorption of the laser light. Successful deployment of the microactuator depends on the optical properties of the ICG-doped SMP and the optical coupling efficiency of the interface between the optical fiber and the SMP. Spectrophotometry, thermal imaging, and computer simulation aided the initial design effort and continue to be useful tools for optimization of the dye concentration and laser power. Thermomechanical testing was performed to characterize the elastic modulus of the SMP. We have demonstrated laser-activation of the SMP microactuator in air at room temperature, suggesting this concept is a promising therapeutic alternative to rt-PA.

  9. The programmed nursing care for lower extremity deep venous thrombus patients receiving interventional thrombolysis: its effect on living quality

    International Nuclear Information System (INIS)

    Objective: Tu study the effect of comprehensive programmed nursing intervention on the living quality in patients with lower extremity deep venous thrombus who receive interventional thrombolysis therapy. Methods: A total of 60 patients receiving interventional thrombolysis due to lower extremity deep venous thrombus were randomly and equally divided into two groups. Patients in study group (n=30) was treated with comprehensive programmed nursing intervention in addition to the conventional therapy and routine nursing care, while patients in control group (n=30) was treated with the conventional therapy and routine nursing care only. The conventional therapy and routine nursing care included the nursing assessment before the operation, observation of the vital signs and the cooperation psychological care during the operation, the performance of medication according to the doctor's orders after the operation, etc. The comprehensive programmed nursing intervention included the nursing assessment of the patient before operation and the scientifically making of the nursing plan, which mainly referred to the cognitive behavior, the psychological care and the health education. They were systematically carried out during the perioperative period. One month after discharge the patients were asked to pay a return visit. The living quality was evaluated with relevant standards, and the results were compared between the two groups. Results: The score of living quality in the study group was significantly higher than that in the control group (P<0.01). Conclusion: The comprehensive programmed nursing intervention can significantly improve the living quality of lower extremity deep venous thrombosis patients who receive interventional thrombolysis therapy. (authors)

  10. Right Ventricular Thrombus and Cerebral Artery Aneurysm in a Patient with Behçet’s Disease

    Science.gov (United States)

    Sabzi, Feridoun; Mirzaei, Samaneh; Faraji, Reza

    2016-01-01

    We report a 35-year-old woman referred to the Imam Ali Hospital, Kermanshah, Iran, in July 2014 for evaluation of postoperative dyspnoea after neurosurgery performed seven days previously for a ruptured cerebral artery aneurysm. She was known to have Behçet’s disease with a history of recurrent oral and genital aphthous ulcers and uveitis. At referral, her symptoms included vertigo, dysarthria, palpitations and chest pain. Transthoracic echocardiography (TTE) revealed a large thrombus in her right ventricle outflow tract and open-heart surgery was performed eight days after the previous surgery to remove the clot. The postoperative period was complicated by transient acute renal failure, which resolved spontaneously. The patient was discharged 13 days after the cardiac surgery on warfarin, prednisolone, azathioprine and cyclophosphamide. Cyclophosphamide and azathioprine were discontinued after three months as the symptoms had completely resolved; however, prednisolone was continued due to recurrent uveitis. A 10-month follow-up TTE scan revealed no thrombus recurrence and treatment with warfarin and prednisolone was continued. PMID:27226921

  11. Right Ventricular Thrombus and Cerebral Artery Aneurysm in a Patient with Behçet’s Disease

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2016-05-01

    Full Text Available We report a 35-year-old woman referred to the Imam Ali Hospital, Kermanshah, Iran, in July 2014 for evaluation of postoperative dyspnoea after neurosurgery performed seven days previously for a ruptured cerebral artery aneurysm. She was known to have Behçet’s disease with a history of recurrent oral and genital aphthous ulcers and uveitis. At referral, her symptoms included vertigo, dysarthria, palpitations and chest pain. Transthoracic echocardiography (TTE revealed a large thrombus in her right ventricle outflow tract and open-heart surgery was performed eight days after the previous surgery to remove the clot. The postoperative period was complicated by transient acute renal failure, which resolved spontaneously. The patient was discharged 13 days after the cardiac surgery on warfarin, prednisolone, azathioprine and cyclophosphamide. Cyclophosphamide and azathioprine were discontinued after three months as the symptoms had completely resolved; however, prednisolone was continued due to recurrent uveitis. A 10-month follow-up TTE scan revealed no thrombus recurrence and treatment with warfarin and prednisolone was continued.

  12. Estrutura, ultraestrutura e morfometria da veia cava de paca (Cuniculus paca Linnaeus, 1766 criada em cativeiro

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    Sérgio Pinter Garcia Filho

    2013-05-01

    Full Text Available A paca (Cuniculus paca é o segundo maior roedor da fauna brasileira. Apresenta carne de excelente qualidade, o que incentiva a criação comercial. Além disso, este animal pode tornar-se uma opção válida em experimentação embora poucas sejam as informações detalhadas sobre sua morfologia. Assim, objetivou-se descrever a morfologia, morfometria e ultraestrutura de segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca adultas excedentes do plantel do Setor de Animais Silvestres do Departamento de Zootecnia da FCAV-Unesp. Os segmentos venosos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Foram mensuradas as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia e analisou-se os resultados pela estatística descritiva, teste "T" pareado (p<0,05. Em relação à espessura das túnicas estudadas, comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional.

  13. Seapolynol Extracted from Ecklonia cava Inhibits Adipocyte Differentiation in Vitro and Decreases Fat Accumulation in Vivo

    Directory of Open Access Journals (Sweden)

    Hui-Jeon Jeon

    2015-12-01

    Full Text Available Seapolynol (SN is a polyphenol mixture derived from Ecklonia cava. We evaluated the effects of SN on lipid accumulation in adipocytes, zebrafish, and mice. SN effectively inhibited lipid accumulation in three experimental models by suppressing adipogenic factors. Triglyceride synthetic enzymes such as diacylglycerol acyltransferase 1 (DGAT1 and GPAT3 were also downregulated by SN. This SN-induced inhibition of adipogenic factors was shown to be due to the regulatory effect of SN on early adipogenic factors; SN downregulated the expression of Krueppel-like factor 4 (KLF4, KLF5, CCAAT-enhancer-binding protein β (C/EBPβ, C/EBPδ, and Protein C-ets-2 (ETS2, while KLF2, an anti-early adipogenic factor, was upregulated by SN. SN-mediated inhibition in early adipogenesis was closely correlated with the inhibition of mitotic clonal expansion via cell cycle arrest. SN inhibited cell cycle progression by suppressing cell cycle regulators, such as cyclin A, cyclinD, and pRb but increased p27, a cell cycle inhibitor. In a mouse study, SN effectively reduced body weight and plasma lipid increases induced by a high-fat diet; triglycerides, total cholesterol, and low-density lipoprotein (LDL levels were markedly reduced by SN. Moreover, SN remarkably improved high-fat-diet-induced hepatic lipid accumulation. Furthermore, SN activated AMP-activated protein kinase-α (AMPKα, an energy sensor, to suppress acetyl-coA carboxylase (ACC, inhibiting lipid synthesis. Our study suggests that SN may be an edible agent that can play a positive role in prevention of metabolic disorders.

  14. Seapolynol Extracted from Ecklonia cava Inhibits Adipocyte Differentiation in Vitro and Decreases Fat Accumulation in Vivo.

    Science.gov (United States)

    Jeon, Hui-Jeon; Choi, Hyeon-Son; Lee, Yeon-Joo; Hwang, Ji-Hyun; Lee, Ok-Hwan; Seo, Min-Jung; Kim, Kui-Jin; Lee, Boo-Yong

    2015-01-01

    Seapolynol (SN) is a polyphenol mixture derived from Ecklonia cava. We evaluated the effects of SN on lipid accumulation in adipocytes, zebrafish, and mice. SN effectively inhibited lipid accumulation in three experimental models by suppressing adipogenic factors. Triglyceride synthetic enzymes such as diacylglycerol acyltransferase 1 (DGAT1) and GPAT3 were also downregulated by SN. This SN-induced inhibition of adipogenic factors was shown to be due to the regulatory effect of SN on early adipogenic factors; SN downregulated the expression of Krueppel-like factor 4 (KLF4), KLF5, CCAAT-enhancer-binding protein β (C/EBPβ), C/EBPδ, and Protein C-ets-2 (ETS2), while KLF2, an anti-early adipogenic factor, was upregulated by SN. SN-mediated inhibition in early adipogenesis was closely correlated with the inhibition of mitotic clonal expansion via cell cycle arrest. SN inhibited cell cycle progression by suppressing cell cycle regulators, such as cyclin A, cyclinD, and pRb but increased p27, a cell cycle inhibitor. In a mouse study, SN effectively reduced body weight and plasma lipid increases induced by a high-fat diet; triglycerides, total cholesterol, and low-density lipoprotein (LDL) levels were markedly reduced by SN. Moreover, SN remarkably improved high-fat-diet-induced hepatic lipid accumulation. Furthermore, SN activated AMP-activated protein kinase-α (AMPKα), an energy sensor, to suppress acetyl-coA carboxylase (ACC), inhibiting lipid synthesis. Our study suggests that SN may be an edible agent that can play a positive role in prevention of metabolic disorders. PMID:26690099

  15. Radiation dose is associated with prognosis of small cell lung cancer with superior vena cava syndrome

    Science.gov (United States)

    Wang, Zhen-Bo; Ning, Fang-Ling; Wang, Xiao-Le; Cheng, Yu-Feng; Dong, Xin-Jun; Liu, Chang-Min; Chen, Shao-Shui

    2015-01-01

    Approximately 10% of small cell lung cancer (SCLC) cases develop superior vena cava syndrome (SVCS). Many SCLC patients with SVCS have relatively limited disease, requiring curative rather than palliative treatment. Besides chemotherapy, radiotherapy is important for treating SCLC with SVCS. We retrospectively evaluated the influence of radiotherapy dose on the prognosis of 57 patients with SCLC with SVCS treated with concurrent chemoradiotherapy. The mean biological equivalent radiation dose was 71.5 Gy. We administered etoposide/cisplatin as sequential and concurrent chemotherapy. All patients received at least one cycle of concurrent chemotherapy. All patients had partial or complete response; SVCS-associated symptoms were reduced in 87.7% (50/57) of patients within 3-10 days after treatment. Radiation dose did not affect 2-year local control (74.2% vs. 80.8%). Patients who received high-dose radiation had a lower 2-year overall survival rate than those who received low-dose radiation (11.6 vs. 33%; P = 0.024). The high dose group median survival was 15.0 months (95% confidence interval [CI]: 11.2-19.0) compared with 18.7 months (95% CI: 13.9-23.6) in the low dose group. Grade 3/4 neutropenia occurred in 22/26 high dose patients (84.6%) and 21/31 low dose patients (67.7%). In the high dose group, 30.8% of patients had grade 3/4 esophagitis compared with 19.4% of low dose patients. Only 29.0% of low dose patients received < 4 cycles of chemotherapy in the first 12 weeks after treatment began compared with 46.2% of high dose patients. Concurrent chemoradiotherapy is a tolerable modality for treating stage IIIA/IIIB SCLC with SVCS. Moderate-dose radiotherapy is preferable. PMID:26064339

  16. Circulating microRNA profile in patients with membranous obstruction of the inferior vena cava

    Science.gov (United States)

    SUN, GUI-XIANG; SU, YONG; LI, YING; ZHANG, YA-FENG; XU, LI-CHUN; ZU, MAO-HENG; HUANG, SHUI-PING; ZHANG, JIN-PENG; LU, ZHAO-JUN

    2016-01-01

    Membranous obstruction of the inferior vena cava (MOVC) is a common type of Budd-Chiari syndrome. However, the pathogenesis of MOVC has not been fully elucidated. Recent studies demonstrated that microRNAs (miRNAs or miRs) are involved in multiple diseases. To the best of our knowledge, specific changes in the expression of miRNAs in MOVC patients have not been previously assessed. The present study used a microarray analysis, followed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) validation, with the aim to access the miRNA expression levels in the plasma of 34 MOVC patients, compared with those in healthy controls. The results revealed a total of 16 differentially expressed miRNAs in MOVC patients. Subsequently, RT-qPCR analysis verified the statistically consistent expression of 5 selected miRNAs (miR-125a-5p, miR-133b, miR-423-5p, miR-1228-5p and miR-1266), in line with the results of the microarray analysis. These 5 miRNAs, which were described as crucial regulators in numerous biological processes and vascular diseases, may play an important role in the pathogenesis of MOVC. Bioinformatics analysis of target genes of the differentially expressed miRNAs revealed that these predicted targets were significantly enriched and involved in several key signaling pathways important for MOVC, including the ErbB, Wnt, MAPK and VEGF signaling pathway. In conclusion, miRNAs may involve in multiple signaling pathways contributing to the pathological processes of MOVC. The present study offers an intriguing new perspective on the involvement of miRNAs in MOVC; however, the precise underlying mechanisms require further validation. PMID:26997997

  17. Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review

    Directory of Open Access Journals (Sweden)

    Rachna Raman

    2011-12-01

    Full Text Available This study systematically reviews outcomes after inferior vena cava (IVC filtration in cancer-associated venous thromboembolism (VTE. A comprehensive review of the English language literature was performed using MEDLINE, COCHRANE library, Embase and CINAHL on outcomes (i.e., pulmonary embolism, recurrent DVT, postphlebitic syndrome and survival following IVC filtration in cancer-associated VTE. Fourteen studies with 2,154 cancer patients receiving IVC filters post-VTE were included. All were observational studies. The mean duration of followup was 0.7–38 months and mean patient age was 56.8– 68 years. Among study participants, 47–87% had stage 3 or 4 cancers. Of the 47–93% of filters inserted for contraindications to anticoagulation (AC, 10–33% were placed for relative contraindications. Recurrent PE was seen in 0–6%, fatal PE in 0–4.5%, recurrent DVT in 0–18.2%, postphlebitic syndrome (PPS in 0–2.7%, and IVC thrombosis (ICVT in 3% of cancer patients. Median survival post-filter insertion was 2–10 months. Evidence supporting the utility of IVC filter insertion in cancer-associated VTE is limited to observational studies only. Preliminary data demonstrate similar safety and efficacy of filters in cancer and noncancer populations. The combination of filters and anticoagulation is no more effective than either modality alone. Retrievable filters are an attractive option for prevention of VTE in the presence of temporary risk factors or temporary contraindications to anticoagulation in patients who have a reasonable life expectancy, but there is no evidence to support their preferential use in patients with advanced malignancy.

  18. Inferior vena cava filters in cancer patients: to filter or not to filter

    Directory of Open Access Journals (Sweden)

    Hikmat Abdel-Razeq

    2011-03-01

    Full Text Available Hikmat Abdel-Razeq1, Asem Mansour2, Yousef Ismael1, Hazem Abdulelah11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanPurpose: Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE; active cancer accounts for almost 20% of all newly diagnosed VTE. Inferior vena cava (IVC filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE or to avoid bleeding from systemic anticoagulation in high-risk situations. In this report, and utilizing a case study, we will address the appropriate utilization of such filters in cancer patients.Methods: The case of a 43-year-old female patient with rectal cancer, who developed deep vein thrombosis following a complicated medical course, will be presented. The patient was anticoagulated with a low molecular weight heparin, but a few months later and following an episode of bleeding, an IVC filter was planned. Using the PubMed database, articles published in English language addressing issues related to IVC filters in cancer patients were accessed and will be presented.Results: Many recent studies questioned the need to insert IVC filters in advanced-stage cancer patients, particularly those whose anticipated survival is short and prevention of PE may be of little clinical benefit and could be a poor utilization of resources.Conclusion: Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or pulmonary embolism is high, IVC filters can be utilized. However, placement of such filters should take into consideration the stage of disease and life expectancy of such patients.Keywords: anticoagulation, bleeding, chemotherapy

  19. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, ...

  20. Odontogenic Tumors

    OpenAIRE

    TAHSİNOĞLU, Melih

    2013-01-01

    DefinitionThe neoplasms that consist of the cells considered specialized for odontogenesis, and their product (dentin, enamel, cementum) are called odontogenic tumors.ClassificationTo initiate odontogenesis, epithelium is a must. Same rule holds for the odontogenic tumors: without odontogenic epithelium, odontogenic tumors cannot be, without the induction of odontogenic epithelium odontogenic mesenchyme cannot develop.

  1. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  2. Tumor Markers

    Science.gov (United States)

    ... guidelines on a variety of topics, including tumor markers for breast cancer, colorectal cancer, lung cancer, and others. The ... of recurrence 70-Gene signature (Mammaprint®) Cancer type: Breast ... Can tumor markers be used in cancer screening? Because tumor markers ...

  3. Urogenital tumors

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1994-03-01

    An overview is provided for veterinary care of urogenital tumors in companion animals, especially the dog. Neoplasms discussed include tumors of the kidney, urinary bladder, prostate, testis, ovary, vagina, vulva and the canine transmissible venereal tumor. Topics addressed include description, diagnosis and treatment.

  4. Wilms Tumor

    Science.gov (United States)

    ... Kids Up for Sports Pregnant? Your Baby's Growth Cerebral Palsy: Caring for Your Child All About Food Allergies Wilms Tumor KidsHealth > For Parents > Wilms Tumor Print A A A Text Size What's in this article? Signs and Symptoms Diagnosis Treatment Caring for Your Child en español Tumor ...

  5. Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

    International Nuclear Information System (INIS)

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC

  6. Use of a Trellis Device for Endovascular Treatment of Venous Thrombosis Involving a Duplicated Inferior Vena Cava

    Energy Technology Data Exchange (ETDEWEB)

    Saettele, Megan R., E-mail: SaetteleM@umkc.edu [University of Missouri, Kansas City, Department of Radiology, Saint Luke' s Hospital (United States); Morelli, John N., E-mail: dr.john.morelli@gmail.com [Texas A and M University Health Science Center, Department of Radiology, Scott and White Clinic and Hospital (United States); Chesis, Paul; Wible, Brandt C. [University of Missouri, Kansas City, Department of Interventional Radiology, Saint Luke' s Hospital (United States)

    2013-12-15

    Congenital anomalies of the inferior vena cava (IVC) are increasingly recognized with CT and venography techniques. Although many patients with IVC anomalies are asymptomatic, recent studies have suggested an association with venous thromboembolism. We report the case of a 62-year-old woman with extensive venous clot involving the infrarenal segment of a duplicated left IVC who underwent pharmacomechanical thrombectomy and tissue plasminogen activator catheter-directed thrombolysis with complete deep venous thrombosis resolution. To our knowledge this is the first reported case in the English literature of the use of a Trellis thrombectomy catheter in the setting of duplicated IVC.

  7. Influence of temperature during the second fermentation and aging of sparkling wine (Cava on the properties of the foam

    Directory of Open Access Journals (Sweden)

    Esteruelas Mireia

    2015-01-01

    Full Text Available The aim of this study was to determine the influence of temperature during the second fermentation and aging of spar- kling wines (AOC Cava on their foam properties. The results indicate that sparkling wines elaborated at 12 °C have a maximum height (HM and a stable height (HS of the foam significantly higher than the corresponding ones produced at 16 °C. This better foam properties observed in sparkling wines obtained at low temperature are probably related with their higher protein and oligosaccharide concentration.

  8. Two Stage Complex Embolization of an Arteriovenous Fistula between the Right Common Iliac Artery and the Inferior Vena Cava

    Directory of Open Access Journals (Sweden)

    Marc Gingell Littlejohn

    2009-01-01

    Full Text Available

    We  present an interesting case of a symptomatic high flow AV fistula between the right common iliac artery (CIA and the inferior vena cava (IVC, successfully treated by endovascular coil embolization. The patient was found to have a right lower polar renal artery crossing the ipsilateral ureter arising from the CIA, causing pelvi-ureteric junction (PUJ obstruction and recurrent pyelonephritis.  It is hypothesized that this fistula arising from the lower polar renal artery and entering the IVC, may have occurred as a result of trauma during a previous pyeloplasty, or a pathologically induced process of angiogenesis stemming from recurrent pyelonephritis.

  9. Real-time flow - determination of vena cava inferior on two different levels via 'RACE' pulse sequence in MR

    International Nuclear Information System (INIS)

    A new and simple parameter for quantiative evaluation of liver perfusion is outlined: Post-sinusoidal quantitative measurement of the entire liver venous flow: This is a result of the differences in evaluated flow volumes at two different levels in the inferior V.cava. The first level is the height of diaphragm, and the second is situated just cranial of the renal vessels. Normal values obtained from a group of healthy volunteers are presented. A gradient-echo pulse sequence called RACE, enabling flow measurements in real-time, is outlined. (orig.)

  10. Superior vena cava syndrome associated with right-to left shunt through systemic-to-pulmonary venous collaterals

    International Nuclear Information System (INIS)

    Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.

  11. Limitations of using synthetic blood clots for measuring in vitro clot capture efficiency of inferior vena cava filters

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    Robinson RA

    2013-05-01

    Full Text Available Ronald A Robinson, Luke H Herbertson, Srilekha Sarkar Das, Richard A Malinauskas, William F Pritchard, Laurence W GrossmanOffice of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USAAbstract: The purpose of this study was first to evaluate the clot capture efficiency and capture location of six currently-marketed vena cava filters in a physiological venous flow loop, using synthetic polyacrylamide hydrogel clots, which were intended to simulate actual blood clots. After observing a measured anomaly for one of the test filters, we redirected the focus of the study to identify the cause of poor clot capture performance for large synthetic hydrogel clots. We hypothesized that the uncharacteristic low clot capture efficiency observed when testing the outlying filter can be attributed to the inadvertent use of dense, stiff synthetic hydrogel clots, and not as a result of the filter design or filter orientation. To study this issue, sheep blood clots and polyacrylamide (PA synthetic clots were injected into a mock venous flow loop containing a clinical inferior vena cava (IVC filter, and their captures were observed. Testing was performed with clots of various diameters (3.2, 4.8, and 6.4 mm, length-to-diameter ratios (1:1, 3:1, 10:1, and stiffness. By adjusting the chemical formulation, PA clots were fabricated to be soft, moderately stiff, or stiff with elastic moduli of 805 ± 2, 1696 ± 10 and 3295 ± 37 Pa, respectively. In comparison, the elastic moduli for freshly prepared sheep blood clots were 1690 ± 360 Pa. The outlying filter had a design that was characterized by peripheral gaps (up to 14 mm between its wire struts. While a low clot capture rate was observed using large, stiff synthetic clots, the filter effectively captured similarly sized sheep blood clots and soft PA clots. Because the stiffer synthetic clots remained straight when approaching the

  12. Iliac vein thrombosis: a case report of treatment with inferior vena cava filter, urokinase and vascular stent

    International Nuclear Information System (INIS)

    Thrombolytic therapy and placement of vascular metallic stent can be used for the treatment of iliac venous stenosis and thrombosis, but these treatments increase the risk of pulmonary thromboembolism. Inferior vena cava filter was developed for the prevention of recurrent pulmonary thromboembolism due to lower extremity deep vein thrombosis and has been regarded as relatively safe and effective treatment modality. We experienced good result of combined treatment of inferior vena filter, thrombolytic therapy and placement of right iliac venous metallic stent in a patient with severe stenosis and thrombosis at both common iliac veins

  13. Focal Hepatic Hot Spot From Superior Vena Cava Occlusion Visualized on Ventilation/Perfusion Scintigraphy With Contrast-Enhanced CT Correlate.

    Science.gov (United States)

    Lawrence, Michael; Schuster, David M

    2016-05-01

    A 57-year-old woman with superior vena cava stenosis from repeated central line placements underwent ventilation/perfusion scanning after presenting with pleuritic chest pain. The ventilation/perfusion scan was not characteristic for pulmonary embolus, but perfusion images demonstrated abnormal radiotracer activity within hepatic segment 4, along with extensive collateral vessels as seen on SPECT/CT. Two months later, the patient presented with similar complaints and had a chest CT with contrast to evaluate for pulmonary embolus. This showed occlusion of the superior vena cava and arterial enhancement within segment 4 in a similar distribution to the radiotracer in the perfusion scan. PMID:26825208

  14. A Behcet’s Disease Patient with Right Ventricular Thrombus, Pulmonary Artery Aneurysms, and Deep Vein Thrombosis Complicating Recurrent Pulmonary Thromboembolism

    Directory of Open Access Journals (Sweden)

    Selvi Aşker

    2013-01-01

    Full Text Available Intracardiac thrombus, pulmonary artery aneurysms, deep vein thrombosis, and pulmonary thromboembolism are rarely seen symptoms of Behcet’s disease. A 20-year-old female patient was admitted for complaints of cough, fever, palpitations, and chest pain. On the dynamic thorax computed tomograms (CT obtained because of significantly enlarged hilar structures seen on chest radiograms, aneurysmal dilatation of the pulmonary artery segments bilaterally, chronic thrombus with collapse, and consolidation substances compatible with pulmonary embolism involving both lower lobes have been observed. It is learned that, four years ago, the patient had been diagnosed with Behcet’s disease and received colchicine treatment but not regularly. The patient was hospitalized. On the transthoracic echocardiogram, a thrombosis with a dimension of 4.2 × 1.6 cm was recognized in the right ventricle. On abdomen CT, aneurysmal iliac veins and deep vein thrombus on Doppler ultrasonograms were diagnosed. At the controls after three months of immunosuppressive and anticoagulant therapies, some clinical and radiological improvements were recognized. The patient suspended the treatment for a month and the thrombus recurred. We present our case in order to show the effectiveness of immunosuppressive and anticoagulant therapies and rarely seen pulmonary thromboembolism in recurrent Behcet’s disease.

  15. Upper terminal of the inferior vena cava and development of the heart atriums: a study using human embryos

    Science.gov (United States)

    Hwang, Si Eun; Rodríguez-Vázquez, José Francisco; Murakami, Gen; Cho, Baik Hwan

    2014-01-01

    In the embryonic heart, the primitive atrium is considered to receive the bilateral sinus horns including the upper terminal of the inferior vena cava (IVC). To reveal topographical anatomy of the embryonic venous pole of the heart, we examined horizontal serial paraffin sections of 15 human embryos with crown-rump length 9-31 mm, corresponding to a gestational age of 6-7 weeks or Carnegie stage 14-16. The IVC was often fixed to the developing right pulmonary vein by a mesentery-like fibrous tissue. Rather than the terminal portion of the future superior vena cava, the IVC contributed to form a right-sided atrial lumen at the stage. The sinus venosus or its left horn communicated with the IVC in earlier specimens, but in later specimens, the left atrium extended caudally to separate the sinus and IVC. In contrast, the right atrium consistently extended far caudally, even below the sinus horn, along the IVC. A small (or large) attachment between the left (or right) atrium and IVC in adult hearts seemed to be derived from the left (or right) sinus valve. This hypothesis did not contradict with the incorporation theory of the sinus valves into the atrial wall. Variations in topographical anatomy around the IVC, especially of the sinus valves, might not always depend on the stages but partly in individual differences. PMID:25548721

  16. Scimitar syndrome of atypical, rare drainage of venous vessel to the superior vena cava. A case report

    International Nuclear Information System (INIS)

    Scimitar syndrome is a rare and complex congenital anomaly characterized by partial or complete anomalous pulmonary venous return from the right or left lung into the inferior vena cava, through drainage into the hepatic vein, right atrium or left atrium. The syndrome is commonly associated with hypoplasia of the right lung and right pulmonary artery. We present an 11-year-old female with atypical and rare type of scimitar syndrome. The girl has had cough for 2 months before admission, without fever or abnormalities on medical examination. X-ray films revealed inflammatory and atelectatic changes with mediastinal shift to the right. CT and CT angiography – hypoplasia of the right lung with no visible interlobar fissures. No areas of consolidation in the pulmonary parenchyma. Mediastinum shifted to the right. Single wide venous vessels draining the upper part of the right lung entering the superior vena cava. In our patient, clinical symptoms are mild, but a thorough physical examination could have helped diagnose the syndrome earlier

  17. Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena cava in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Gholamhossein Ajami

    2010-06-01

    Full Text Available Objective: Paucity of data exists between mean right atrial pressure (RAP and inferior vena cava (IVC size and collapsibility in pediatric patients with congenital heart disease.Methods: In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96±4.05 years (30 male and 20 female. Patients were categorized into two groups according to their right atrial pressure (RAP as measured by cardiac catheterization: Group 1 (40 patients were those with mean RAP 8 mmHg when IVC diameter in inspiration was >3.6 (sensitivity of 100%, specificity of 47.5%, +LR=1.9 or if IVC diameter was >6mm in expiration (sensitivity of 70%, specificity of 87%, +LR=4.67.Conclusion: This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure.

  18. Long-Term Results of Vena Cava Filters: Experiences with the LGM and the Titanium Greenfield Devices

    International Nuclear Information System (INIS)

    Purpose: Vena cava filter (VCF) application is the method of choice to prevent recurrent pulmonary embolism in patients with deep venous thrombosis. Because of the reported complications after VCF placement we summarize our long-term follow-up results with the LGM and Titanium Greenfield (TG) devices. Methods: Eighty-seven LGM VCF and 17 TG VCF were placed in 104 patients (average age 64 years). The follow-up examinations were performed by color-coded duplex sonography, plain radiographs, cavography, and computed tomo-graphy (CT). The maximum observation time was 81 months. Results: Filter migration occurred in 11% (8/76) of the LGM VCF and 15% (2/13) of the TG VCF. Vena cava thrombosis was seen in 17% (13/76) of the patients with an LGM VCF and in 31% (4/13) of those with a TG VCF. The patency rate was 95% (72/76) for the LGM VCF and 92% (12/13) for the TG VCF. Pulmonary embolism was noted in 3 patients after LGM VCF insertion and in no patient after TG VCF insertion. Conclusion: A VCF should only be inserted in a patient after pulmonary embolism and when there is strict proof of the indication

  19. Estimation of Right Atrial Pressure from the Inspiratory Collapse of the Inferior Vena Cava in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Hamid Amoozgar

    2010-06-01

    Full Text Available Objective:Paucity of data exists between mean right atrial pressure (RAP and inferior vena cava (IVC size and collapsibility in pediatric patients with congenital heart disease.Methods:In a prospective study, fifty consecutive pediatric patients with different congenital heart diseases who had right side cardiac catheterization were studied, comparing right atrial pressure with simultaneous M-mode echocardiographic measurement of inferior vena cava diameter. Mean age of the patients was 4.96�4.05 years (30 male and 20 female. Patients were categorized into two groups according to their right atrial pressure (RAP as measured by cardiac catheterization: Group 1 (40 patients were those with mean RAP 8 mmHg when IVC diameter in inspiration was >3.6 (sensitivity of 100%, specificity of 47.5%, +LR=1.9 or if IVC diameter was >6mm in expiration (sensitivity of 70%, specificity of 87%, +LR=4.67.Conclusion:This study showed that measurement of IVC size in inspiration and expiration can be used as a reliable method for estimation of mean right atrial pressure.

  20. Endovascular treatment of thrombosed inferior vena cava filters: Techniques and short-term outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad Arabi

    2015-01-01

    Full Text Available Purpose: To present the techniques for endovascular treatment of thrombosed filter-bearing inferior vena cavae (IVCs, along with short-term clinical and imaging follow-up. Materials and Methods: A total of 45 consecutive patients (17 females and 28 males, aged 19-79 years (mean age of 49 years, who had IVC filter placement complicated by symptomatic acute or chronic iliocaval thrombosis and underwent endovascular therapy were studied. All patients presented with lower extremity swelling and/or pain. One patient also had bilateral lower extremity swelling and chronic gastrointestinal (GI bleeding which was secondary to chronic systemic to portal venous collaterals. Patients underwent one or more of the following endovascular treatments depending on the chronicity and extent of thrombosis: (a catheter-directed thrombolysis (CDT (n = 25, (b pharmacomechanical thrombolysis (PMT (n = 15, (c balloon angioplasty (n = 45, and/or (d stent placement across the filter (n = 42. In addition, 16 patients underwent groin arteriovenous fistula (AVF creation (36% and 3 (7% had femoral venous thrombectomy to improve flow in the recanalized iliac veins and IVCs. Results: Anatomical success was achieved in all patients. Follow-up was not available in 10 patients (lost to follow-up, n = 4; expired due to comorbidities, n = 2; lost to follow-up after re-intervention, n = 4. At a mean follow-up time of 13.3 months (range 1-48 months, clinical success was achieved in 27 patients (60%, i.e. in 21 patients without re-intervention and in 6 patients with re-intervention. Clinical success was not achieved despite re-intervention in eight patients. Higher clinical success was noted in patients who did not require repeat interventions (P = 0.03 and the time to re-intervention was significantly shorter in patients who had clinical failure (P = 0.01. AVF creation did not improve the clinical success rate (P = 1. There was no significant difference in clinical success between

  1. Safety and efficacy of interventional treatment for occlusion of the entire inferior vena cava

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of interventional treatment of occlusion of the entire inferior vena cava (IVC). Methods: The clinical data of 6 patients with entire IVC occlusion were analyzed retrospectively. All patients were diagnosed by color Doppler ultrasound and DSA. Venography was performed under local anesthesia via internal jugular vein and femoral vein approach. The occlusion of IVC and hepatic vein were treated with balloon dilatation and/or stent placement. Follow-up examination with color Doppler ultrasound was taken 1, 3, 6, 12 months after treatment and annually thereafter to assess the patency of IVC and hepatic vein. The pressure gradient of hepatic vein-right atrium and IVC-right atrium before and after interventional treatment were compared with paired t test. Results: In 5 cases, both IVC and 1 hepatic vein were recanalized successfully. In 1 case,recanalization of IVC failed,but the right hepatic vein was recanalized successfully. The mean pressure gradient of hepatic vein-right atrium decreased from (23.2 ± 2.0) cmH2O (1 cmH2O =0.098 kPa) before treatment to (8.7 ± 3.2) cmH2O after treatment in 6 cases (t=21.6, P<0.05). The mean pressure gradient of IVC-right atrium decreased from (26.6 ± 2.7) cmH2O before treatment to (9.4 ± 1.1) cmH2O after treatment (t=16.1, P<0.05). Abdominal pains occurred in 3 patients after stent implantation which disappeared in 24 hours. No other complications such as bleeding and death occurred. During a mean follow-up of (42 ± 27) months (16 to 90 months), hepatic vein patency was maintained in 6 cases and IVC patency was maintained in 5 cases. Conclusion: Interventional treatment of occlusion of the entire IVC is a safe and effective method. (authors)

  2. Obstruction of hepatic vein or inferior vena cava after liver transplantation: the diagnosis and interventional treatment

    International Nuclear Information System (INIS)

    Objective: To investigate the diagnosis and interventional therapeutic technology for the obstruction of hepatic vein (HV) or inferior vena cava (IVC) after liver transplantation. Methods: In the 831 patients who received orthotopic liver transplantation (OLT) and 26 patients who received living donor liver transplantation (LDLT), 11 cases were confirmed with HV or IVC obstruction by venography and received interventional treatment from 2 to 111 days after liver transplantation. Of the 11 patients, five had the obstruction of HV anastomosis, five had the obstruction of IVC anastomosis, and one had the obstruction of HV and IVC anastomosis. In the eleven patients, five patients underwent OLT, four patients underwent LDLT, and two pediatric patients underwent reduced-size OLT. Before interventional treatment, 9 patients function tests, clinical sympatom, and monitoring of HV or IVC flow. Pressure gradients before and after therapeutic technology of 11 cases were retrospectively analyzed. Results: In all 11 patients, CT or MRI could clearly show congested areas of the liver, and the location and degree of HV or IVC obstruction. Of the 11 patients, four with HV obstruction and five with IVC obstruction were treated with stent placement, one with HV obstruction was treated with percutaneous transluminal angioplasty (PTA), one with HV and IVC obstruction was treated with HV PTA and IVC stent placement. Interventional technical success was achieved in all patients. The venous pressure gradient across obstruction was significantly reduced from (16.5 ± 4.1) mm Hg (1 mm Hg =0.133 kPa) before the procedure to (2.9 ± 1.7) mm Hg after the procedure (t=11.5, P<0.01). Clinical improvement was noted in 10 patients except one pediatric patient who died of multiple-organs failure at the 9 th day after the treatment. During the follow-up period of 9 to 672 days, two patients with PTA treatment had recurrent HV stenosis within one month after treatment, no patient with stent

  3. Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis.

    Science.gov (United States)

    Kaw, Roop; Pasupuleti, Vinay; Wayne Overby, D; Deshpande, Abhishek; Coleman, Craig I; Ioannidis, John P A; Hernandez, Adrian V

    2014-01-01

    Background: Pulmonary embolism(PE)accounts for almost 40% of perioperative deaths after bariatric surgery.Placement of prophylactic inferior vena cava(IVC) filter before bariatric surgery to improve outcomes has shown varied results. We performed a meta-analysis to evaluate post- operative outcomes associated with the preoperative placement of IVC filters in these patients. Methods: A systematic review was conducted by three investigators independently in PubMed, EMBASE, the Web of Science and Scopus until February 28,2013.Our search was restricted to studies in adult patients undergoing bariatric surgery with and without IVC filters. Primary outcomes were postoperative deep vein thrombosis(DVT),pulmonary embolism (PE),and postoperative mortality. Meta-analysis used random effects models to account for heterogeneity,and Sidik- Jonkman method to account for scarcity of outcomes and studies. Associations are shown as Relative Risks(RR) and 95% Confidence Intervals(CI). Results: Seven observational studies were identified (n=102,767), with weighted average inci- dences of DVT(0.9%),PE(1.6%),and mortality(1.0%)for a follow-up ranging from 3 weeks to 3 months. Use of IVC filters was associated with an approximately 3-fold higher risk of DVT and death that was nominally significant for the former outcome, but not the latter (RR2.81,95%CI 1.33-5.97, p=0.007; and RR 3.27,95%CI0.78-13.64, p=0.1, respectively);there was no difference in the risk of PE(RR1.02,95%CI0.31-3.77,p=0.9). Moderate to high heterogeneity of effects was noted across studies. Conclusions: Placement of IVC filter before bariatric surgery Is associated with higher risk of postoperative DVT and mortality. A similar risk of PE inpatients with and without IVC filter placement cannot exclude a benefit, given the potential large imbalance in risk at baseline.Ran- domized trials are needed before IVC placement can be recommended. (SurgObesRelatDis 2015;11:268-269.) r 2015 American Society for Metabolic and

  4. Assessment of survey radiography and comparison with x-ray computed tomography for detection of hyperfunctioning adrenocortical tumors in dogs

    International Nuclear Information System (INIS)

    Results of abdominal survey radiography and x-ray computed tomography (CT) were compared in 13 dogs with hyperadrenocorticism histologically attributed to adrenocortical tumors. X-ray computed tomography enabled accurate localization of the tumor in all 13 dogs. Apart from 2 poorly demarcated irregular-shaped and mineralized carcinomas, there were no differences between adenoma (n = 3) and carcinoma (n = 10) on CT images. In 1 dog, invasion of the caudal vena cava by the tumor was suggested on CT images and was confirmed during surgery. Suspicion of adhesions between tumors of the right adrenal gland and the caudal vena cava on the basis of CT images was confirmed during surgery in only 2 of 6 dogs. Survey radiography allowed accurate localization of the tumor in 7 dogs (4 on the right side and 3 on the left). In 6 of these dogs, the tumor was visible as a well-demarcated soft tissue mass and, in the other dog, as a poorly demarcated mineralized mass. The smallest tumor visualized on survey radiographs had a diameter of 20 mm on CT images. Six tumors with diameter less than or equal to 20 mm were not visualized on survey radiographs. In 1 of these dogs, a mineralized nodule was found in the left adrenal region, without evidence of a mass. In a considerable number of cases, survey radiography can provide presurgical localization of adrenocortical tumors in dogs with hyperadrenocorticism; CT is redundant in these instances. In the absence of positive radiographic findings, CT is valuable for localization of adrenocortical tumors

  5. Influence of manual thrombus aspiration on left ventricular diastolic function in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Ilić Ivan

    2016-01-01

    Full Text Available Introduction. Data on effects of thrombus aspiration on left ventricular diastolic function in ST-elevation myocardial infarction (STEMI population are scarce. Objective. We sought to compare echocardiographic indices of the diastolic function and outcomes in STEMI patients treated with and without manual thrombus aspiration, in an academic, high-volume percutaneous coronary intervention (PCI center. Methods. A total of 433 consecutive patients who underwent primary PCI in 2011-2012 were enrolled in the study. Patients were not eligible for the study if they already suffered a myocardial infarction, had been previously revascularized, received thrombolytics, presented with cardiogenic shock, had significant valvular disease, atrial fibrillation or had previously implanted pacemaker. Comprehensive echocardiogram was performed within 48 hours. During follow-up patients’ status was assessed by an office visit or telephone interview. Results. Patients treated with thrombus aspiration (TA+, n=216 had similar baseline characteristics as those without thrombus aspiration (TA-, n=217. Groups had similar total ischemic time (319 ± 276 vs. 333±372 min; p=0.665, but TA+ group had higher maximum values of troponin I (39.5 ± 30.5 vs. 27.6 ± 26.9 ng/ml; p15, as a marker of severe diastolic dysfunction (TA+ 23.1% vs. TA- 15.2%; p=0.050. During average follow-up of 14Ѓ}5 months, major adverse cardiac/ cerebral events occurred at the similar rate (log rank p=0.867. Conclusion. Thrombus aspiration is associated with a greater incidence of severe diastolic dysfunction in unselected STEMI patients treated with primary PCI, but it doesn’t influence the incidence of major adverse cardiovascular events. [Projekat Ministarstva nauke Republike Srbije, br. 175099

  6. Predictors of thrombus burden and no-reflow of infarct-related artery in patients with ST-segment elevation myocardial infarction: importance of platelet indices.

    Science.gov (United States)

    Cakici, Musa; Cetin, Mustafa; Balli, Mehmet; Akturk, Erdal; Dogan, Adnan; Oylumlu, Muhammed; Abus, Sabri; Yildiz, Emrah; Sungur, Azmi; Celiker, Meral

    2014-10-01

    Preprocedural high-thrombus burden (HTB) of infarct-related artery (IRA) is a harbinger of procedural complications following primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). The HTB of IRA can lead to poor outcomes by various mechanisms, including no-reflow phenomenon, increased myocardial necrosis and with subsequent reduced survival benefit at follow-up. In this study, we investigated the relationship between all platelet indices on admission and thrombus burden and the no-reflow phenomenon after primary PCI of IRA in patients with STEMI. We retrospectively enrolled 475 patients with STEMI undergoing primary PCI. Study population was divided into two groups according to the thrombolysis in myocardial infarction thrombus grade of IRA as low-thrombus burden or HTB. There were no statistically significant differences in platelet indices, including platelet count, platelet-large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution with (PDW) among the groups. However, in the subgroup analysis, P-LCR, MPV and PDW were significantly higher in the no-reflow patients than reflow patients despite similar platelet count (P for all < 0.001). The cutoff value of P-LCR for predicting no-reflow was 26.5% with a sensitivity of 67.0% and a specificity of 62% (area under the curve, 0.689; 95% confidence interval, 0.614-0.765; P < 0.001). Furthermore, P-LCR, MPV and PDW had similar AUC (0.689, P < 0.001; 0.688, P < 0.001; and 0.677, P < 0.001; respectively) for predicting no-reflow phenomenon after primary PCI. As a result, all of the platelet indices have no effect on thrombus load of IRA, however, these parameters seem to impair epicardial perfusion after primary PCI. PMID:24806326

  7. The blood flow channel index as novel predictor of abdominal aortic aneurysm impending rupture based on the intraluminal thrombus angio-CT study

    International Nuclear Information System (INIS)

    Objective: In this study the hypothesis that the thickness of the thinnest part of the thrombus, combined with bleeding into the intraluminal thrombus (ILT), is associated with a possible higher risk of abdominal aortic aneurysm (AAA) rupture was investigated, independently of aneurysm diameter, by using angio-CT. This article describes blood flow channel index based on the CT imaging findings that may help identify impending rupture prior to complete rupture. Methods: Computed tomographic images of 310 hospitalized patients with infrarenal AAA, were collected over a three-year period. They were divided into two main groups: 125 with bleeding into the ILT and control group 185 without the presence of blood in the thrombus. Patients were also analyzed in subgroups with ruptured, symptomatic and asymptomatic AAAs. A blood flow channel index was formulated as: maximal/minimal thickness ratio of thrombus from the same CT scan. Results: In dissected ILT group blood flow channel index was over a twofold higher than in group with intact ILT (19.0 [1.2–89.3] vs. (9.7 [1.3–38.9]; p < 0.001), respectively. Median thickness at the thinnest part of the ILT in dissected thrombus group was lower (1.3 mm [0.3–16.0]) than in group with intact ILT (1.7 mm [0.2–23.4]; p < 0.003). Conclusion: An association between a high blood flow channel index and bleeding into the ILT based on angio-CT study was demonstrated, and can suggest the aneurysm propensity for rupture

  8. AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hakim, Ramsey, E-mail: ralhakim@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States); Patel, Komal, E-mail: kdpatel@mednet.ucla.edu [University of California, Department of Anesthesiology, Division of Cardiothoracic Anesthesiology (United States); Moriarty, John M., E-mail: jmoriarty@mednet.ucla.edu [University of California, Department of Radiology, Division of Interventional Radiology (United States)

    2015-06-15

    This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism.

  9. AngioVac Aspiration for Paradoxical Emboli Protection through a Fenestrated Fontan During Central Venous Thrombus Manipulation

    International Nuclear Information System (INIS)

    This case reports describes a 39-year-old female with a history of surgically repaired hypoplastic left heart syndrome who presented with a left peripherally inserted central catheter (PICC) with associated large volume subclavian and brachiocephalic vein thrombus. Due to the presence of a right-to-left shunt via a fenestrated Fontan, there was clinical concern for a paradoxical embolism during removal of the PICC. The AngioVac aspiration system was successfully utilized to aspirate thromboemboli from the level of the proximal Glenn shunt during manipulation and removal of the PICC. This is the first reported case to demonstrate the safe and effective use of the AngioVac aspiration system for protection of paradoxical emboli through a cardiac right-to-left shunt during a procedure at high risk for thromboembolism

  10. Mural thrombus and the progression of abdominal aortic aneurysms: a large population-based prospective cohort study

    DEFF Research Database (Denmark)

    Behr-Rasmussen, Carsten; Grøndal, Nikolaj Fibiger; Thomsen, Marie Dahl; Bramsen, Morten; Lindholt, Jes Sanddal

    2014-01-01

    area inside the media border (OA). The relative thrombus area was then calculated as ((OA-IA)/OU) × 100%. Four hundred and sixteen of the patients with AAA were eligible for analysis. RESULTS: The mean size of the AAA was 40.6 mm, and the mean observation time was 1.78 years. In the group with AAAs...... measuring 30-34 mm, 42% had ILT, with a mean relative size of 12% of the outer area. In the group with AAAs measuring >64 mm, the presence of ILT increased to 100%, with a mean relative size of 70% of the outer area. Univariate analysis showed relative ILT size, aortic diameter, smoking history, and...

  11. Successful Percutaneous Coronary Intervention through a Severely Bent Artificial Ascending Aorta Using the DIO Thrombus Aspiration Catheter

    Directory of Open Access Journals (Sweden)

    Akinori Fujikake

    2016-01-01

    Full Text Available A 66-year-old man was admitted to our institute because of chest pain. He had undergone replacement of the ascending aorta due to aortic dissection 9 years previously. We made a diagnosis of acute coronary syndrome, and coronary artery angiography was performed. Although the right coronary artery was successfully cannulated, a severe bend of the artificial aorta made it very difficult to advance the catheter into the left coronary artery. Ultimately, a DIO thrombus aspiration catheter was used to enter the left coronary artery, and a stent was implanted successfully. The DIO catheter is very useful when the selection of a guiding catheter is complicated, such as in the case of severe vessel tortuosity or a bend of the ascending aorta.

  12. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    International Nuclear Information System (INIS)

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  13. Retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep venous thrombosis in perinatal period

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)], E-mail: martin.kocher@seznam.cz; Krcova, Vera [Department of Hematooncology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Cerna, Marie [Department of Radiology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic); Prochazka, Martin [Department of Obstetrics and Gynaecology, University Hospital, I.P. Pavlova 6, 775 20 Olomouc (Czech Republic)

    2009-04-15

    Objectives: To evaluate the feasibility and efficacy of the retrievable Guenther Tulip Vena Cava Filter in the prevention of pulmonary embolism in patients with acute deep vein thrombosis in the perinatal period and to discuss the technical demands associated with the filter's implantation and retrieval. Methods: Between 1996 until 2007, eight women (mean age 27.4 years, range 20-42 years) with acute deep iliofemoral venous thrombosis in the perinatal period of pregnancy and increased risk of pulmonary embolism during delivery were indicated for retrievable Guenther Tulip Vena Cava Filter implantation. All filters were inserted and removed under local anesthesia from the jugular approach. Results: The Guenther Tulip Vena Cava Filter was implanted suprarenally in all patients on the day of caesarean delivery. In follow-up cavograms performed just before planned filter removal, no embolus was seen in the filter in any patient. In all patients the filter was retrieved without complications on the 12th day after implantation. Conclusions: Retrievable Guenther Tulip Vena Cava Filters can be inserted and removed in patients during the perinatal period without major complications.

  14. Renal Dysfunction on Admission Predicts No-Reflow Phenomenon in Patients Undergoing Manual Thrombus Aspiration during Primary Percutaneous Coronary Intervention

    Science.gov (United States)

    Sensoy, Baris; Uzunget, Sezen Baglan; Acikgoz, SadikKadri; Sensoy, Nur; Sen, Fatih; Acar, Burak; Canpolat, Uğur; Ozeke, Ozcan; Cay, Serkan; Maden, Orhan

    2016-01-01

    Background No-reflow is a frequent complication during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). Available data is limited regarding its impact on short-term outcomes in patients undergoing manual thrombus aspiration. Renal impairment is also associated with higher complication rates in STEMI. Herein, we aimed to evaluate the impact of baseline renal dysfunction on the no- reflow phenomenon and the association of no-reflow phenomenon with early clinical outcomes. Methods A total of 94 consecutive STEMI patients who underwent primary stent-based PCI and thrombus aspiration were enrolled. No-reflow was established by the use of angiographic and electrocardiographic reperfusion criteria, respectively. Additionally angiographic and clinical follow-up data were also recorded. Results In our study, the no-reflow phenomenon was observed in 10 patients (11%) angiographically and in 23 patients (24%) electrocardiographically. Whereas, the the estimated glomerular filtration rate (eGFR) [odds ratio (OR) 10.4], hypertension (OR 6.2), previous MI (OR 6.5), previous PCI history, (OR 4.2), predilatation (OR 7.2), final balloon pressure (OR 0.9) were found to be the significant predictors of angiographic no-reflow, only reperfusion time was the predictor of electrocardiographic no-reflow (OR 1.12) at univariate analysis. After adjustment, lower eGFR (OR 14.8) was found to be the independent predictor for angiographic no-reflow. In-hospital mortality was more common in patients with either no-reflow condition separately. Conclusions Longer ischemic time and lower initial eGFR values were associated with no-reflow phenomenon. Irrespective of poor reperfusion criteria, no-reflow phenomenon is associated with in-hospital outcome. Future efforts should be made to reduce the incidence of no-reflow especially in patients with lower initial eGFR values. PMID:27122949

  15. Clinical effect of selective thrombus aspiration during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Hai-wei LIU

    2015-06-01

    Full Text Available Objective To assess impact of selective thrombus aspiration (TA during primary percutaneous coronary intervention (pPCI on long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI. Methods  Between Jan. 2008 and Jan. 2014, a total of 2357 STEMI patients [429 in thrombus aspiration (TA group and 1928 in routine percutaneous coronsry intorventim (PCI group (control group] were eligible for the study criteria and candidates for pPCI were enrolled in this study. The reflow of the involved vessel in pPCI procedure, stent thrombosis and major adverse cardiac events (MACE were comparatively analyzed in the two groups during hospital stay and 12-month follow-up period. Results Although the success rate of TA procedure was significantly lower in TA group compared with that in control group (P<0.001, both the TIMI flow grade ≥2 after TA procedure and stent implantation occurred more frequently in TA group than in control group (P<0.05. The rates of MACE and stent thrombosis showed no difference between two groups during in-hospital and 12-month follow-up period (P>0.05. But the rates of total MACE and target vessel revascularization were significantly higher in control group than in TA group (P=0.04. Conclusion Selective TA procedure before primary PCI could improve final myocardial reperfusion, reduce the incidence of MACE and improve the 1-year clinical result for STEMI patients. DOI: 10.11855/j.issn.0577-7402.2015.04.04

  16. Targeting of tumor endothelial cells combining 2 Gy/day of X-ray with Everolimus is the effective modality for overcoming clinically relevant radioresistant tumors

    International Nuclear Information System (INIS)

    Radiotherapy is widely used to treat cancer because it has the advantage of physically and functionally conserving the affected organ. To improve radiotherapy and investigate the molecular mechanisms of cellular radioresistance, we established a clinically relevant radioresistant (CRR) cell line, SAS-R, from SAS cells. SAS-R cells continue to proliferate when exposed to fractionated radiation (FR) of 2 Gy/day for more than 30 days in vitro. A xenograft tumor model of SAS-R was also resistant to 2 Gy/day of X-rays for 30 days. The density of blood vessels in SAS-R tumors was higher than in SAS tumors. Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, sensitized microvascular endothelial cells to radiation, but failed to radiosensitize SAS and SAS-R cells in vitro. Everolimus with FR markedly reduced SAS and SAS-R tumor volumes. Additionally, the apoptosis of endothelial cells (ECs) increased in SAS-R tumor tissues when both Everolimus and radiation were administered. Both CD34-positive and tomato lectin-positive blood vessel densities in SAS-R tumor tissues decreased remarkably after the Everolimus and radiation treatment. Everolimus-induced apoptosis of vascular ECs in response to radiation was also followed by thrombus formation that leads to tumor necrosis. We conclude that FR combined with Everolimus may be an effective modality to overcome radioresistant tumors via targeting tumor ECs

  17. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

    Directory of Open Access Journals (Sweden)

    Alexander Alves da Silva

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Paciente do sexo masculino, 16 anos, ASA II, com diagnóstico prévio de comunicação interatrial (CIA tipo seio venoso superior com drenagem anômala parcial de veias pulmonares em programação para correção cirúrgica da cardiopatia. Após indução da anestesia geral foi realizado ecocardiograma transesofágico (ETE. O exame inicial mostrou dilatação das câmaras cardíacas direitas, CIA tipo seio venoso superior de 17 milímetros, drenagem anômala da veia pulmonar superior direita desembocando na veia cava superior (VCS direita e dilatação do seio coronário, o que aventou a possibilidade da persistência da veia cava superior esquerda. Para a confirmação da suspeita foram injetados no acesso venoso do braço esquerdo 10 mL de solução fisiológica a 0,9% (faz o papel de "contraste" no exame ecocardiográfico e imediatamente após foram visualizadas as microbolhas passando pelo seio coronário, teste positivo para o diagnóstico de VCS superior esquerda persistente. CONCLUSÕES: A ecocardiografia transesofágica rotineira no intraoperatório de pacientes com cardiopatia congênita tem fundamental importância como método auxiliar não só ao cirurgião, muitas vezes influenciando diretamente na técnica cirúrgica empregada, como também para o anestesiologista, que pode extrair do exame uma série de informações úteis no manuseio hemodinâmico do paciente.JUSTIFICATIVA Y OBJETIVOS: La persistencia de la vena cava superior izquierda ocurre

  18. Percutaneous biopsy for small lymphadenopathy around the abdominal aorta and inferior vena cava using the modified coaxial technique under CT guidance

    Energy Technology Data Exchange (ETDEWEB)

    Song, Chi Sung [Boramae Hospital, Seoul (Korea, Republic of)

    2006-03-15

    The author wanted to report the accuracy and safety of performing percutaneous biopsy of a small lymphadenopathy around the abdominal aorta and inferior vena cava (IVC) with using the modified coaxial technique (MCT) under CT guidance. Thirty-six cases of CT-guided biopsy using MCT were performed in 35 patients (15 men and 20 women, aged 21-80 years, mean age:56.5 years), who had small lymphadenopathy around the abdominal aorta and IVC. The maximum diameters of the target nodes were 11-20 mm in 21 cases, 21-30 mm in 14 cases and 31-40 mm in 1 case (mean diameter: 19.8 mm). The locations of the target lesions were the left or posterior side of the aorta (n=22), between the aorta and IVC (n=7), and the right or posterior side of the IVC (n=7). Using the modified coaxial technique, a guiding cannula was introduced precisely to the border of the target lesion. Fine needle aspiration biopsy was performed through the cannula and this was followed by multiple core biopsies (6-8 cores) using an automated biopsy gun. The pathologic results and complications were reviewed. The clinical course after biopsy and the histopathologic diagnosis were reviewed by following up the medical records. From examining the 36 biopsies, a definitive pathologic diagnosis was made in 33 cases (92%). The etiologies were as follows; 16 (44%) metastatic tumors, 11 (31%) lymphomas and 6 cases (17%) of tuberculosis with positive acid-fast bacilli (AFB). Two cases were reported as chronic granulomatous inflammation due to suspected tuberculosis, and they were treated with tuberculosis medication. One case was reported as chronic inflammation and so re-biopsy was performed; this resulted in the diagnosis of tuberculosis with positive AFB. Serious complications such as rupture of major vessels or bowel perforation did not occur. It is considered that performing percutaneous biopsy for small lymphadenopathy around the abdominal aorta and IVC with using the modified coaxial technique under CT guidance

  19. Análise de sensibilidade na otimização econômica de uma cava

    Directory of Open Access Journals (Sweden)

    Belisario Ascarza Flores

    2008-12-01

    Full Text Available Uma das variáveis que torna um projeto de mineração mais vulnerável à instabilidade econômica é a variação dos preços de venda dos minérios. Nesse trabalho, procedeu-se a uma análise de sensibilidade de cavas ótimas em relação à variação do preço de venda de um bem mineral. Foi gerada uma série de contornos de cavas ótimas com diferente valor presente líquido (VPL e diferentes quantidades de minério e estéril, a partir da aplicação de fatores de desconto sobre um preço de venda de minério tomado como base. Análises desse tipo são úteis para o estabelecimento do planejamento de produção de uma mina. Para esse estudo, foram utilizados dados da mina Morro da Mina da Rio Doce Manganês S.A. e, para a geração das cavas otimizadas, utilizou-se o módulo Pit Optimiser do Gemcom Surpac 6.0.One of the variables that makes the economic stability of a mining project more vulnerable is the variation of ore sale prices. In this work, a sensitivity analysis of optimum pits in relation to the variation of the sale price of ore was performed. It generated a set of optimal pits shells with different net present values (NPV and different amounts of ore and waste, and the application of discount factors of the ore's sale price was taken as the base. Analyses of this type are useful for the establishment of production planning of a mine. For this study, data obtained from the manganese mine of Morro da Mina of Rio Doce Manganês S.A. was used, and the modulate Pit Optimiser of the Gemcom Surpac 6.0 was applied to generate the optimum pits.

  20. Tumor de Krukenberg Krunkenberg's tumor

    Directory of Open Access Journals (Sweden)

    Daisy Hernández Durán

    2011-09-01

    Full Text Available El tumor de Krukenberg supone el 30-40 % de los cánceres metastásicos al ovario y el 1-2 % de todos los tumores malignos de ovario. En la actualidad, y pese a que el concepto de tumor de Krukenberg ha sido usado para referirse a todos los tumores metastásicos del ovario, se consideran como tal a los que tienen un origen digestivo. Su pronóstico es malo con raras supervivencias más allá del año. Se presenta un caso de una paciente femenina de 38 años de edad, que ingresa por ascitis moderada, anorexia y pérdida de peso, a la cual se le realizó una laparotomía con el posible diagnóstico de un proceso oncoproliferativo del ovario y el diagnóstico histopatológico arrojó un tumor de Krukenberg.Krukenberg's tumor accounts for 30-40 % of ovarian metastatic cancer and for the 1-2 % of all ovarian malignant tumors. Nowadays and in spite of the fact that the concept of Krukenberg' tumor has been used to refer to all ovarian metastatic tumors those with a digestive origin, its prognosis if bad with only a few survivals beyond one year. This is the case of a female patient aged 38 admitted due to a moderate ascites, anorexia and lose weight undergoes laparotomy with the possible diagnosis of a oncoproliferous ovarian process and the histopathological diagnosis showed a Krukenberg's tumor.