Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors describe an unusual variant of inferior vena cava duplication, with azygos continuation of the right vena cava and hemiazygos continuation of the left vena cava, discovered at cavography in a patient with pulmonary embolism. Following unsuccessful attempts to advance titanium Greenfield filters through tortuous iliac veins, bilateral Bird's Nest filters were placed successfully.
 ...
PMID:Placement of dual bird's nest filters in an unusual case of duplicated inferior vena cava. 144 33

The Greenfield vena cava filter is an established therapeutic option in the prevention of pulmonary embolism. The development of a 12 French modified titanium Greenfield filter (TGF) has made it possible to insert the filter percutaneously and to have a low complication rate. We report our initial experience with percutaneous insertion of the 12-French titanium Greenfield vena cava filter for 6 patients who all had major extensive deep venous thrombosis (DVT) and contraindications to anticoagulation. The inferior vena cava (IVC) filters were inserted in all the 6 patients via the internal jugular route without difficulty. There was no bruising, haematoma or bleeding complications despite the use of the 12 French system. The IVC filter was opened without cross-snaring of the filter legs in all 6 patients. This was confirmed with cranio-caudal, left anterior oblique and right anterior oblique views of the deployed filter. There was however some asymmetry of the filter leg positions but it did not cause any significant angulation of the filter in relation to the IVC. The IVC filters were firmly secured with no filter migration immediately post-procedure. The 12-French titanium Greenfield vena cava filter was safely deployed percutaneously with no complications in our small series of patients. With the use of titanium in the design of Greenfield filter, the clinical effectiveness and performance is maintained while providing for easier insertion and reduction of patient discomfort.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The new titanium Greenfield vena cava filter: initial experience and review. 776 90

Pulmonary embolism (PE) is a devastating complication in patients with traumatic spinal cord injury (SCI). Prophylactic measures such as venous compression hose or low-dose heparin are only partially protective in reducing the risk of venous thromboembolism and are contraindicated in some patients. Because of extended perturbations in fibrinolytic activity, catecholamine effects on platelet aggregation, increased activity of complement and acute phase reactants, abnormally high factor VIII concentrations, and persistent venous stasis with ongoing endothelial damage, the patient with an SCI remains at prolonged risk for venous thromboembolism. A retrospective 5-year review at the Medical Center Hospital of Vermont revealed seven patients with eight documented PEs (three fatal; 2.7%) in 111 SCI patients (6.3%). Six PEs (75%) occurred after discharge from the acute care facility. Median time to PE after injury was 78 days (range, 9-5993). Although comprising only 4% of all trauma admissions, SCI accounted for 31% of all PEs in the total trauma population (2525 patients). Beginning in July 1991, a new prophylaxis protocol was instituted, which included the percutaneous insertion of vena cava filters under local anesthesia in all SCI patients with paraplegia or quadriplegia. Fifteen patients have undergone the insertion of titanium filters. Impedance plethysmography was performed weekly to detect deep venous thrombosis. No complications were associated with vena cava filter insertion. No patients developed deep venous thrombosis during their acute hospitalization (median, 22 d), and no patients have developed PE after filter insertion.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Prophylactic vena cava filter insertion in patients with traumatic spinal cord injury: preliminary results. 796 30

Screening and prophylaxis of the population at risk is the most correct approach to thromboembolic disease. Caval filters play a major role in the prevention of pulmonary embolism, but their use remains widely controversial, even if they are an alternative or additional method to medical therapy and not antithetical to it. July, 1990, to September, 1995, seventy-seven permanent vena cava filters (59 LGM, 13 Filcard and 5 titanium-Greenfield), 22 short-duration temporary vena cava filters (11 LGT, 6 Filcard, 3 Filcard-Emanuelli and 2 Lysofilter) and 10 mid-duration temporary vena cava filters (Tempofilter) were inserted in 109 patients (55 men and 54 women) aged 17-88 years. An inferior vena cavogram was always made before filter insertion to "map" the inferior vena cava and its tributaries (renal veins) and to assess caval size. This is a mandatory step to exclude or confirm the presence of endocaval thrombi. Sixty-eight filters were inserted percutaneously via a right internal transjugular approach, 40 via a common transfemoral approach (34 right and 6 left) using the same route as inferior cavography and digital pneumoangiography. One temporary filter was inserted via a right transhumeral approach. Sixty-three patients (57.8%) (44 with a permanent filter, 14 with a temporary filter and 5 with a Tempofilter) had medical diseases, 7 patients (6.4%) (4 with a permanent filter, one with a temporary filter and 2 with a Tempofilter) had surgical conditions; 10 patients (9.2%) (7 with a permanent filter and 3 with a Tempofilter) were surgical-orthopedic patients. Twenty-seven patients (24.8%) (22 with a permanent and 5 with a temporary filter) had cancer. Two patients (1.8%) with a temporary filter were breast feeding. All the patients had deep venous thrombosis of the lower limbs, including the inferior vena cava and the right renal vein in two patients. A proximal floating thrombus and a pulmonary thromboembolism was diagnosed in 41 (37.6%) and 34 (31.2%) cases, respectively. The temporary filters remained in situ 1-4 days and the Tempofilters 3-5 weeks. A pelvic hematoma developed (because of heparin?) after the insertion of a temporary filter and a Tempofilter branch detached and migrated into a lower branch of the left pulmonary artery were reported as immediate and short-term consequences. There were no early or late consequences for the patients. An axillary hemorrhage was observed in the site of previous surgery, during fibrinolysis with a Lysofilter, as well as the incomplete opening of a titanium-Greenfield filter and of two permanent LGM filters, partly trapped within endocaval thrombi. No further consequences to the patients due to permanent filters were observed, nor any case of symptomatic pulmonary thromboembolism, in patients with permanent or temporary filters. With reference to the relative literature and to their own experience, the Authors propose a detailed and rational synthesis of the diagnostic-instrumental approach protocol to thromboembolic disease.
 ...
PMID:[Criteria for utilization and indications for use of permanent and short- and medium term temporary endocaval filters. Personal experience and review of the literature]. 904 46

A titanium Greenfield inferior vena cava filter was used for the treatment of 2 patients with unresectable renal cell carcinomas with tumor thrombi to prevent a fatal pulmonary embolism induced by tumor clots released during systemic interferon therapy and embolization of the primary tumor. After treatment, the size of the renal cell carcinomas at the primary site and the tumor thrombi decreased by 50%. There were no fatal pulmonary embolisms or complications related to the filter during the observation period (24 and 25 months) after therapy. This method may be useful in the prevention of a fatal pulmonary embolism induced by embolization and systemic interferon therapy in these patients.
 ...
PMID:Inferior vena cava filter used for unresectable renal cell carcinoma with tumor thrombi. 917 May 83

Vena caval filters in the prevention of pulmonary embolism All currently available caval filters can be implanted percutaneously in local anaesthesia. In the USA the FDA has approved the stainless steel Greenfield filter, the Titanium Greenfield filter, the Bird's Nest filter, the LGM or VenaTech filter and the Simon Nitinol filter. Some other caval filters are commercially available in Europe, but there exist only few clinical trials about them. The Greenfield filter is implanted since the early seventies and the greatest amount of data has been published about it. Standard indications for filter placement are recurrent pulmonary embolism despite adequate anticoagulation, in patients after pulmonary embolectomy, when there is a contraindication to anticoagulation (e.g. fresh surgical wound, active gastrointestinal bleeding, recent haemorrhagic stroke, major trauma,...) and when serious complications occur after thrombolysis or anticoagulation. In patients who suffer from severe cardiopulmonary disease both a caval filter and anticoagulation may be required. Follow-up investigations include plain abdominal radiography and duplex ultrasound, in special cases computed tomography, cavography, magnetic resonance imaging in newer filter types, and intravascular ultrasound. Complications include recurrent pulmonary embolism, caval obstruction, migration, fracture and perforation of filter struts. As clinically relevant complications are rare, in diligently selected cases the patient will benefit from implantation of a caval filter.
 ...
PMID:[Vena cava filter for prevention of pulmonary embolism]. 1061 42

Inferior vena cava filters have been used for prophylaxis of pulmonary embolism since the end of the sixties. Complication rates depend on the types of filters used and are reported to be 2% with the Guenther-Filter and 21% with the Titanium-Greenfield-Filter. Depending on the exact indication both filter types are useful instruments for the prevention of pulmonary embolism.
 ...
PMID:[Temporary and permanent vena cava filter for prevention of pulmonary embolism]. 1262 39

The purpose of this study was to evaluate the efficacy of thoracoscopic techniques applied for anterior spinal cord decompression and fusion in osteoporotic thoracolumbar vertebral pseudoarthrosis with paralysis that otherwise require open thoracotomy and diaphragm section. Thirteen patients (average age, 65.7 years old) underwent this operation. Unilateral lung ventilation, otherwise bilateral high frequency jet ventilation was applied for general anesthesia. Three ports were routinely prepared through the intercostal spaces. Minimal subperiosteal dissection of the diaphragm was made from its insertion to L1 vertebra by 2 cm. Following corpectomy procedure of collapsed vertebra, spinal cord was decompressed and spinal fusion was performed in either of one or two stages. Spinal cord decompression could be achieved under bright illumination and a magnified view by assistance of endoscope system. Anterior spinal reconstruction could be performed by a titanium mesh cage packed with local bone in 9, or by autogenic iliac strut bone graft in 4 cases. There was no mortality and no major endoscope-related morbidity such as dural tear, spinal cord, lung, or major vascular injury except one case of pulmonary embolism. By avoiding open thoracotomy, thoracoscopic approach resulted in less postoperative wound pain and better respiratory function for such aged high-risk patients.
 ...
PMID:Spinal cord anterior decompression for delayed spinal cord paralysis after osteoporotic vertebral compression fracture: application of thoracoscopic approach. 1868 34

Pathologic fractures of the femur because of bone metastases seriously affect the quality of life of cancer patients. Different surgical options are indicated to achieve a durable and solid fixation, depending on several clinical, prognostic and mechanical factors. Locked intramedullary nailing is currently used to treat pathologic femoral fractures in patients with multiple metastases when the trochanteric region or shaft is mainly involved. This study evaluates intramedullary nailing for treatment of patients with pathologic femoral fractures, focussing on complications, clinical and functional outcomes and survival rates. The series included 80 pathologic fractures treated with a titanium alloy Proximal Nail (Standard or Antirotation) or Lateral Anterograde Femoral Nail (PFN, PFNA or LAFN, Synthes) inserted in a locked static mode. Acrylic cement was used to fill the bone cavity after nail insertion in eight patients; percutaneous cementoplasty was simultaneously performed in 11 cases of severe ipsilateral acetabular osteolysis. Postoperative outcomes focussed on pain relief, postoperative mobility and quality of life and they were analysed retrospectively using QOL-ACD and ECOG. Eleven patients (13.75%) suffered from non-fatal DVT post-surgery, with no pulmonary embolism. Six patients (7.5%) developed superficial wound infections and two patients (2.5%) developed pnaeumonia. There was no loss of reduction, breakage, screw pull out, or hardware or implant failure that required component substitution or revision. Lung histotype and the contemporary presence of cerebral and visceral metastases appeared to be predisposing factors in reducing survival time. All patients attained satisfactory pain relief, early deambulation and a marked clinical improvement during the first 6-10 postoperative months, with gradual worsening thereafter from deterioration of their general condition due to cancer progression. The patients' survival rate was 40% at 1 year, 25% at 2 years and 15% at 3 years. Results confirm that multiple factors related to patients and primary cancer may affect survival rate after femoral fracture. Intramedullary nailing should be indicated for pathologic fractures at femoral diaphysis and metaphysis when cancer is in an advanced stage. This procedure offers good and durable stability, and enables pain relief, early postoperative mobilisation and weight-bearing, thus improving the quality of life of cancer patients.
...
PMID:Intramedullary nailing for treatment of pathologic femoral fractures due to metastases. 2411 52