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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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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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Mnemonic devices are cognitive tools that facilitate memory retention by linking new information to familiar patterns or organizational strategies. These techniques are beneficial for remembering complex or lengthy sets of information by simplifying and structuring them in easily retrievable ways.
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In most substances, the current flow is proportional to the voltage applied to it. A simple relationship between the values of current, voltage, and resistance is known as Ohm's law. Nonohmic devices do not exhibit a linear relationship between voltage and current. One such device is the semiconducting circuit element known as a diode. A diode is a circuit device that allows current flow in only one direction.
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Delayed Collapse of a Pipeline Embolization Device.

Rafael A Vega1, Grzegorz Brzezicki1, John F Reavey-Cantwell1

  • 1Department of Neurosurgery, Virginia Commonwealth University Health System, Medical College of Virginia, Richmond, Virginia.

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Summary

A rare complication of Pipeline Embolization Device (PED) treatment for carotid artery dissection involved stent collapse, requiring balloon angioplasty. This highlights the need for vigilance with flow diversion devices.

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Area of Science:

  • Endovascular neurosurgery
  • Interventional neuroradiology

Background:

  • The Pipeline Embolization Device (PED) is used for complex intracranial aneurysms and increasingly for cervical carotid artery dissection.
  • While promising, PEDs carry risks and complications that require awareness.

Purpose of the Study:

  • To report a rare postoperative complication in a patient treated with multiple overlapping PEDs for internal carotid artery dissection.

Main Methods:

  • A 53-year-old male with internal carotid artery dissection and pseudoaneurysm underwent treatment with PED.
  • Follow-up imaging at 3 months revealed stent collapse.

Main Results:

  • A cerebral angiogram showed central collapse of one PED in the cavernous segment, with preserved flow.
  • Balloon angioplasty achieved partial stent re-expansion; the patient remained asymptomatic.

Conclusions:

  • The use of PEDs is expanding to various vascular pathologies, leading to the discovery of new complications like stent collapse.
  • Management of unforeseen complications, such as collapsed PEDs, necessitates individualized approaches as device use becomes more common.