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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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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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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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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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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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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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Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
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Related Experiment Video

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Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model
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Pipeline embolization device thrombosis induced peri-construct collateral channels.

Albert Ho Yuen Chiu1, Thomas R Marotta2

  • 1St Michael's Neurovascular Program, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Journal of Neurointerventional Surgery
|November 26, 2015
PubMed
Summary

Flow diversion for brain aneurysms shows potential, but non-regressed remnants may still be active. Long-term MRI follow-up for these brain aneurysm treatments may require further validation.

Keywords:
AneurysmAngiographyBlood FlowFlow DiverterMRI

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Flow diversion is an emerging treatment for intracranial aneurysms.
  • Long-term outcomes and the nature of residual aneurysm tissue remain areas of investigation.

Observation:

  • A 22-year-old male with a dissecting anterior cerebral artery aneurysm presented with subarachnoid hemorrhage.
  • Treatment involved a Pipeline Embolization Device.
  • The patient self-discontinued dual antiplatelet therapy, leading to observed reperfusion of the aneurysm remnant.

Findings:

  • Magnetic Resonance Imaging (MRI) revealed reperfusion in a non-regressed, non-perfused aneurysmal remnant.
  • Angiography demonstrated new channels reconstituting distal flow, bypassing construct thrombosis.
  • The central thrombosis was not visualized on MRI, indicating potential limitations of the modality.

Implications:

  • Non-opacified, non-regressed aneurysmal remnants may remain biologically active.
  • This challenges the reliability of MRI for long-term surveillance of flow diverter-treated aneurysms.
  • Further research is needed to understand the behavior of aneurysmal remnants and optimize follow-up strategies.