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1.
JACC Case Rep ; 27: 102047, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38094736

RESUMO

The cases presented herein describe the interventional treatment of deep vein thrombosis and related clinical considerations for 2 young patients in early pregnancy. Treatment decisions made collaboratively with obstetricians aimed to prioritize the safety of the mother and fetus and were primarily informed by the patients' clinical and social status.

2.
Cardiovasc Intervent Radiol ; 46(11): 1571-1580, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37580422

RESUMO

PURPOSE: Mechanical thrombectomy for the treatment of deep vein thrombosis (DVT) is being increasingly utilized to reduce symptoms and prevent postthrombotic syndrome (PTS), but more data on clinical outcomes are needed. Mechanical thrombectomy was studied in the ClotTriever Outcomes (CLOUT) registry with 6-month full analysis outcomes reported herein. MATERIALS AND METHODS: The CLOUT registry is a prospective, all-comer study that enrolled 500 lower extremity DVT patients across 43 US sites treated with mechanical thrombectomy using the ClotTriever System. Core-lab assessed Marder scores and physician-assessed venous patency by duplex ultrasound, PTS assessment using Villalta score, venous symptom severity, pain, and quality of life scores through 6 months were analyzed. Adverse events were identified and independently adjudicated. RESULTS: All-cause mortality at 30 days was 0.9%, and 8.6% of subjects experienced a serious adverse event (SAE) within the first 30 days, 1 of which (0.2%) was device related. SAE rethrombosis/residual thrombus incidence was 4.8% at 30 days and 8.0% at 6 months. Between baseline and 6 months, venous flow increased from 27.2% to 92.5% of limbs (P < 0.0001), and venous compressibility improved from 28.0% to 91.8% (P < 0.0001), while median Villalta scores improved from 9.0 at baseline to 1.0 at 6 months (P < 0.0001). Significant improvements in venous symptom severity, pain, and quality of life were also demonstrated. Outcomes from iliofemoral and isolated femoral-popliteal segments showed similar improvements. CONCLUSION: Outcomes from the CLOUT study, a large prospective registry for DVT, indicate that mechanical thrombectomy is safe and demonstrates significant improvement in symptoms and health status through 6 months. Level of Evidence 3: Non-randomized controlled cohort/follow-up study.


Assuntos
Síndrome Pós-Trombótica , Trombose Venosa , Humanos , Trombectomia/efeitos adversos , Veia Femoral , Seguimentos , Qualidade de Vida , Veia Ilíaca , Resultado do Tratamento , Grau de Desobstrução Vascular , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/terapia , Terapia Trombolítica/efeitos adversos
3.
Chest ; 160(5): 1844-1852, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34273391

RESUMO

Acute pulmonary embolism (PE) is associated with significant morbidity and mortality. The management paradigm for acute PE has evolved in recent years with wider availability of advanced treatment modalities ranging from catheter-directed reperfusion therapies to mechanical circulatory support. This evolution has coincided with the development and implementation of institutional pulmonary embolism response teams (PERT) nationwide and internationally. Because most institutions are not equipped or staffed for advanced PE care, patients often require transfer to centers with more comprehensive resources, including PERT expertise. One of the unmet needs in current PE care is an organized approach to the process of interhospital transfer (IHT) of critically ill PE patients. In this review, we discuss medical optimization and support of patients before and during transfer, transfer checklists, defined roles of emergency medical services, and the roles and responsibilities of referring and receiving centers involved in the IHT of acute PE patients.


Assuntos
Transferência de Pacientes/organização & administração , Embolia Pulmonar/terapia , Risco Ajustado/métodos , Doença Aguda , Humanos , Administração dos Cuidados ao Paciente/métodos
4.
Clin Appl Thromb Hemost ; 25: 1076029619853037, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31185730

RESUMO

Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations in recommendations by different clinical guidelines, as well as lack of robust clinical trials, make clinical decisions challenging. The Pulmonary Embolism Response Team Consortium is an international association created to advance the diagnosis, treatment, and outcomes of patients with PE. In this consensus practice document, we provide a comprehensive review of the diagnosis, treatment, and follow-up of acute PE, including both clinical data and consensus opinion to provide guidance for clinicians caring for these patients.


Assuntos
Embolia Pulmonar/diagnóstico , Embolia Pulmonar/terapia , Doença Aguda , Consenso , Seguimentos , Humanos , Embolia Pulmonar/diagnóstico por imagem , Medição de Risco
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