1/16. Non-surgical extraction of right cardiac "thrombus in transit".In two hemodynamically unstable patients, massive pulmonary embolism and free-floating right cardiac thrombi were diagnosed. thrombolytic therapy was contraindicated and surgical treatment was rejected. In these two cases, we describe a successful non-surgical, percutaneous extraction of mobile right cardiac thrombi. Cathet. Cardiovasc. Intervent. 51:316-319, 2000.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/16. orbital cellulitis and cavernous sinus thrombosis after cataract extraction and lens implantation.orbital cellulitis as a complication of ophthalmic surgery is uncommon. We treated a patient who had orbital cellulitis and cavernous sinus thrombosis three weeks after uncomplicated cataract extraction and lens implantation. Sinus x-rays showed sphenoid sinus opacification. Computed tomographic scan confirmed the sphenoid sinus disease, and no abscess was found. The patient recovered completely after treatment with intravenous antibiotics. Most orbital cellulitis is secondary to sinus disease. The trauma of surgery and the retrobulbar block must be considered possible causative factors in this patient, but sinus disease is still the most likely cause. Intraocular inflammation did not increase during the illness although the intraocular pressure rose from 14 to 23mmHg.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/16. Prophylactic antithrombin III administration during pregnancy immediately reduces the thrombin hyperactivity of congenital antithrombin iii deficiency by forming thrombin-antithrombin III complexes.We examined the changes of haemostatic molecular markers after antithrombin III (AT III) administration in a 22-year-old woman with congenital AT III deficiency in the third trimester of pregnancy who did not have thrombosis. Various markers including fibrinopeptide a (FPA), thrombin-antithrombin III complex (TAT), prothrombin fragment F1 2 (F1 2), plasmin-alpha 2antiplasmin, D-dimer, beta-thromboglobulin, and platelet factor 4 were measured before and just after 3,000 U of AT III concentrate, which was given three times per week from the 34 week of pregnancy until delivery. Just after AT III administration, F1 2 and FPA levels decreased on most occasions, while TAT sometimes increased. plasma FPA levels were markedly decreased on all 8 occasions when the plasma FPA levels was above 2.0 ng/ml before AT III administration. plasma FPA levels were always greater than or equal to 6.4 ng/ml before AT III administration on the 4 occasions when TAT increased to above 115%. The changes of plasma F1 2 levels were significantly correlated with the AT III level. These results suggest that prophylactic AT III administration in the third trimester immediately inactivates intravascular thrombin to form TAT and reduce the plasma FPA level. Thus, the transient TAT elevation following AT III administration may not only be due to extraction of thrombin from the fibrin clots of thrombi but also to intravascular thrombin which is not attached to thrombi. FPA is the best molecular marker for thrombin hyperactivity and it should be monitored in AT III-deficient pregnant women in the third trimester.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
4/16. Thrombus aspiration as a bailout procedure during percutaneous renal angioplasty.PURPOSE: To present a case in which thrombus aspiration, urokinase, and abciximab were used to recanalize a sudden acute thrombotic occlusion of the right renal artery during percutaneous renal angioplasty. CASE REPORT: A 72-year-old man with severe arterial hypertension, impaired renal function, and peripheral artery disease was referred for interventional renal revascularization of a proximal stenosis of the right renal artery. Predilation was unsuccessful, and stent placement was followed by immediate occlusion of the distal renal artery, probably due to dislocation of a mural thrombus. Since intra-arterial administration of urokinase (300,000 IU) was ineffective, thrombus aspiration was performed using the 7-F guiding catheter. After successful removal of the thrombus, abciximab was given intravenously. Control angiograms showed recanalization of the stented segment and patency of the distal renal arteries, an outcome confirmed 8 months later by duplex ultrasound. CONCLUSIONS: As demonstrated in our case, thromboembolic complications can be rapidly and successfully treated on the table by combined measures, such as catheter thrombus extraction and pharmacological strategies.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
5/16. Does a surgery for hepatocellular carcinoma with tumor thrombus highly occupying in the right atrium have significance? A case report and review of the literature.Hepatocellular carcinoma (HCC) advancing to the right atrium (RA) through the hepatic vein has generally been regarded as a terminal lesion of carcinoma. However, because tumor thrombus (TT) in the RA may cause sudden death by heart failure or pulmonary embolism, it is a pathologic condition that needs emergency extraction. Our case was a 55-year-old male. The HCC had a main lesion in the anterior region of the hepatic right lobe, accompanying TT highly occupying the region from the middle hepatic vein and inferior vena cava to the RA. For this tumor, we conducted an extended right anterior segmentectomy and extraction of the TT in the RA under an extracorporeal circulation. He was discharged on the 28th day after surgery, and at present, when 12 months have passed since the surgery, survives without any sign of its recurrence. There have been eight HCC cases including our case, reported regarding the simultaneous resections of a main tumor and TT under cardiopulmonary bypass. Because two patients among this group of eight survived for more than two years, resection is recommended even for advanced HCC highly infiltrating to the RA.- - - - - - - - - - ranking = 0.4keywords = extraction (Clic here for more details about this article) |
6/16. An uncommon complication of liver biopsy: obstructive jaundice from blood clots.INTRODUCTION: The AA. report on a case of one young woman who developed obstructive jaundice induced by hemobilia after percutaneous liver biopsy, successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) methods: An endoscopic sphincterotomy was performed with extraction of the clots OBSERVATIONS: Four weeks after ERCP the patient was healthy and asymptomatic, valuated as outpatient CONCLUSIONS: The role of ERCP in managing biliary sequelae of hemobilia is well established: biliary decompression is required if and intrabiliary lot causes obstructive jaundice and/or biliary colic. ERCP is feasible and leads to relief of symptoms in most cases, without the need of surgery.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
7/16. Successful extraction of renal cell carcinoma thrombus extending into the right atrium using extracorporeal circulation, profound hypothermia and cardiac arrest.The authors report a case of successful extraction of renal cell carcinoma thrombus extending into the inferior vena cava and right atrium in a 36-year-old female patient using extracorporeal circulation, profound hypothermia and cardiac arrest.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/16. Intraoperative streptokinase. An adjunct to mechanical thrombectomy in the management of acute ischemia.streptokinase was injected directly into the arterial tree following balloon-catheter embolectomy on 13 occasions to remove residual thrombus that could not be mechanically retrieved in 12 patients with imminent limb (ten patients) or kidney (two patients) necrosis. Effective lysis, confirmed by arteriography, pulse return, and increased ankle pressures, was achieved in 11 trials (85%). Bleeding complications, minor in three patients and severe in two patients, were ascribed to systemic lysis although other factors were contributory. One of five deaths was related to therapy. Six limbs were salvaged. The average total dose of streptokinase used, 110,000 units, was given in intermittent boluses of 25,000 to 50,000 units injected below a clamp placed to temporarily occlude distal circulation. Safe application of this technique requires intraoperative monitoring of coagulation parameters, aggressive replacement therapy, and prudent patient selection. This preliminary experience suggests that intraoperative lytic therapy (1) is an effective method for clearing thrombus not amenable to mechanical extraction and (2) may improve patency and tissue salvage.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
9/16. lens subluxation in homocystinuria. A case report.A 6-year-old girl had bilaterally subluxated lenses and liver and platelet dysfunctions. A cyanide-nitroprusside test of the urine was positive. serum and urinary levels of methionine and homocystine were high. cystathionine synthetase activity in the cultured skin fibroblasts was negligible. pyridoxine, 1000 mg/day orally, normalized the serum and urinary methionine and homocystine levels and the liver and platelet functions. Episodes of pupillary block glaucoma prompted lens extraction. The subluxated lenses were extracted under general anaesthesia after administration of pyridoxine and dextran to avoid thrombosis. A good result without serious complications was obtained. We believe that homocystinuria should not be considered a contra-indication to general anaesthesia. In the pyridoxine-responsive patient general anaesthesia is not hazardous if platelet function can be controlled by the vitamin.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
10/16. Thrombotic and hemorrhagic complications in children with the lupus anticoagulant.Endogenous circulating anticoagulants are unusual in children without a congenital factor deficiency. In particular, the lupus anticoagulant has only rarely been reported in children. Despite its functioning in vitro to prolong the partial thromboplastin time, patients more frequently have problems with thrombosis than bleeding, unless there is a coexistent prothrombin deficiency or thrombocytopenia. We report the cases of three children with the lupus anticoagulant. Two children had associated thromboses. One had a thrombosis of the iliofemoral system and the other had a partial budd-chiari syndrome, a thrombosis of the deep calf veins and ureteric obstruction. The third child had a concomitant prothrombin deficiency and bleeding after tooth extraction. Associated findings in these patients included a positive antinuclear antibody test in two, a positive anti-dna antibody test in two, a false-positive VDRL test in two, and an antiphospholipid antibody test in two.- - - - - - - - - - ranking = 0.2keywords = extraction (Clic here for more details about this article) |
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