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Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Pulmonary Embolism I: Introduction01:19

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A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Pulmonary Embolism III: Nursing Management01:27

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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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Venous Thrombosis I: Introduction01:30

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Embolisation for pulmonary arteriovenous malformation.

Charlie C-T Hsu1, Gigi N C Kwan, Shane A Thompson

  • 1Department of Medical Imaging, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Queensland, Australia, 4102.

The Cochrane Database of Systematic Reviews
|January 31, 2015
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Summary
This summary is machine-generated.

Embolisation for pulmonary arteriovenous malformations lacks randomized controlled trial evidence. Observational data suggest it reduces morbidity, but more standardized reporting and registries are needed.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiology

Background:

  • Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary arteries and veins, causing right-to-left shunts.
  • PAVMs lead to significant morbidity and mortality due to paradoxical emboli, potentially causing stroke, cerebral abscess, pulmonary hemorrhage, and hypoxemia.
  • Embolisation is an endovascular procedure to occlude feeding arteries of PAVMs, aiming to eliminate shunting.

Purpose of the Study:

  • To evaluate the efficacy and safety of embolisation for pulmonary arteriovenous malformations.
  • To compare embolisation with surgical resection and different embolisation devices.

Main Methods:

  • Searched multiple clinical trial registries and databases up to July 2014.
  • Included randomized controlled trials comparing embolisation to no treatment, surgical resection, or different embolisation devices.
  • Two authors independently assessed study eligibility, with a third author reviewing exclusions.

Main Results:

  • No randomized controlled trials (RCTs) were identified for inclusion in the review.
  • One ongoing trial was identified that may be eligible for future inclusion.
  • No analysis was performed due to the absence of eligible trials.

Conclusions:

  • Currently, there is no evidence from RCTs supporting embolisation for PAVMs.
  • While RCTs are not always feasible, observational data indicate that embolisation may reduce morbidity.
  • Standardized reporting and long-term follow-up through registries are recommended to strengthen evidence in the absence of RCTs.