共查询到20条相似文献,搜索用时 15 毫秒
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Rahul Bose MD James W. Choi MD FSCAI 《Catheterization and cardiovascular interventions》2010,76(2):198-201
Vertebroplasty cement embolization into the venous system has long been recognized as a potential complication, but the true incidence of systemic embolization is unknown. Clinical presentations range from patients who are asymptomatic or have incidental findings on imaging to massive pulmonary embolism resulting in death. Optimal treatment is controversial and the natural history is unknown. We present the case of an 85‐year‐old female undergoing combined laminectomy and vertebroplasty with subsequent pulmonary embolism of the cement which was successfully retrieved from a percutaneous approach. © 2010 Wiley‐Liss, Inc. 相似文献
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Habib N Maniatis T Ahmed S Kilkenny T Alkaied H Elsayegh D Chalhoub M Harris K 《Heart & lung : the journal of critical care》2012,41(5):509-511
BACKGROUND: Because of the aging of the American population, osteoporotic vertebral fractures are becoming a common problem in the elderly. Minimally invasive percutaneous vertebral augmentation techniques have gained a great deal of importance in relieving the pain associated with these fractures, and are becoming the standard of care. METHODS: These procedures involve the injection of polymethylmethacrylate (PMMA) into the vertebral body. However, these techniques have their complications, and among these, pulmonary embolism is one of the most feared. It is attributable to the passage of cement into the pulmonary vasculature. After encountering a case of PMMA embolism in our practice, we decided to highlight this topic and discuss the incidence, clinical presentation, diagnosis, and treatment of cement pulmonary embolisms. 相似文献
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Guler A Karabay CY Aung SM Pala S Kirma C 《Europace : European pacing, arrhythmias, and cardiac electrophysiology》2012,14(4):605
A rarely reported complication of pacemaker lead extraction is embolization of the pulmonary vasculature by a fragmented lead tip. The tip fractured and migrated to the right pulmonary artery during the extraction, and it was successfully retrieved percutaneously. Percutaneous retrieval is an important treatment option of an embolized fragmented lead tip as it could sometimes lead to disastrous complications. 相似文献
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Poulter NR 《Lancet》2000,355(9221):2088
This commentary addresses the New Zealand study (case report) of a fatal pulmonary embolism (PE) associated with oral contraceptive (OC) use by L. Parkin and colleagues. The study significantly adds to the knowledge on the relationship between fatal PE and OC use, because most of the evidence up to now has related to nonfatal venous thromboembolic events (VTE). Several areas of the study, however, are criticized. These include the method used, definition, and the adjustment of data. However, these criticisms have been offered explanations in this commentary. It is noted that data from the study indicated that OCs containing desogestrel or gestodene are associated with higher risks of fatal PE than are those containing levonorgestrel. This is consistent with most previous studies comparing the effects of second-generation progestogens on VTE. Overall, data support previous pragmatic recommendations that second-generation pills, which contain levonorgestrel, are the combined OCs of choice. 相似文献
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Marion-Audibert AM Schoeffler M Wallet F Duperret S Mabrut JY Bancel B Pere-Verge D Wander L Souquet JC 《Gastroentérologie clinique et biologique》2008,32(11):926-930
We report a case of massive pulmonary embolism during cyanoacrylate glue endoscopic injection in a patient with gastric varices from portal hypertension. A review of the literature and results in an animal model show the physiopathology and risk factors associated with this endoscopic procedure. 相似文献
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Clinical suspicion of fatal pulmonary embolism 总被引:18,自引:0,他引:18
BACKGROUND: Less than one third of patients with fatal pulmonary embolism (PE) are identified prior to autopsy. OBJECTIVE: To determine whether the clinical syndromes of acute PE are effective at identifying patients who die of this condition. METHOD: Seven hundred seventy-eight autopsy reports at the Buffalo General Hospital from 1991 to 1996 inclusive were reviewed. Inpatient medical records of 67 patients who were identified as having PE as the primary or major cause of death then were analyzed. RESULTS: Thirty patients (45% [95% confidence interval, 33 to 57%]) had received a diagnosis of PE prior to death, which was marginally higher than the number previously reported (p < 0.05). The diagnosis of PE was significantly lower (13%; p < 0.01) in patients with COPD or coronary artery disease (33%; p < 0.01). In contrast to the prospective investigation of PE diagnosis data, only a minority of patients (6%) presented with pleuritic pain or hemoptysis, while a significantly larger proportion (24%; p < 0.01) of our patients experienced circulatory collapse. Only 55% were identified as having PE from the following clinical syndromes of PE: isolated dyspnea; pleuritic pain and/or hemoptysis; and circulatory collapse. Among the 30 patients suspected of having PE, only 14 (47%) received IV heparin in therapeutic doses, despite clinical suspicion. CONCLUSION: Our results show a modest increase in the correct antemortem diagnosis of fatal PE. The current clinical syndromes used as markers for suspecting PE are not sufficient to detect patients who ultimately die of PE. Physicians should maintain a higher index of suspicion since fatal PE does not always present as one of the three clinical syndromes of PE. Once PE is suspected, heparin therapy should be started early. 相似文献
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De Giorgio F Abbate A Zoccai GB Pascali VL d'Aloja E Capelli A Arena V 《International journal of cardiology》2007,114(3):393-395
We report on a case of a fatal pulmonary embolism--an unexpected finding at autopsy of a 71-year-old man who had suffered from severe erosive gouty arthritis. Using morphological findings, medical history and histopathological results, we show the potentially devastating complications of this fairly common medical condition, occurring as a result of massive bone marrow erosion and detachment and finally leading to embolization of the lungs. 相似文献
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目的探讨经皮椎体成形术中骨水泥外渗原因及防范方法。方法 135例行经皮椎体成形术患者纳入本研究,共171个椎体。对患者进行术前VAS疼痛评分,根据Genant半量法对塌陷的椎体进行分级。按常规方法实施椎体成形术。结果 122例患者术后疼痛明显缓解。所有患者手术前、后疼痛评分分别为8.2±1.22和2.5±1.26。术中36例患者、共41个椎体出现骨水泥渗漏。在渗漏的41个椎体中,4个渗漏至椎管内,2个渗漏至神经根管周围,7个渗漏至椎旁或沿椎旁静脉扩散,9个渗漏至前纵韧带下及周围组织,17个渗漏至椎间隙,2个回渗至椎弓根。2例患者出现下肢神经症状,术后短期内恢复。骨水泥渗漏与总体疼痛缓解无明显相关性,但与术前椎体的压缩程度及手术技巧明显相关。结论椎体成形术是治疗某些椎体病损的有效方法,避免骨水泥渗漏的措施包括术前确认椎体的形态和穿刺技术等。 相似文献
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经皮冠状动脉介入治疗后致死性肺栓塞的临床分析 总被引:5,自引:0,他引:5
目的针对经皮冠状动脉介入治疗后并发致死性肺栓塞的患者,探讨其临床转归和处理方法。方法选择我科6年来所有冠状动脉介入术后并发致死性肺栓塞的病例,观察其发生、发展和转归。结果共7例患者(男5例,女2例)冠状动脉介入术后并发致死性肺栓塞;平均年龄(55.9±11.7)岁;其中单纯冠状动脉造影5例,介入治疗2例;所有患者均表现为冠状动脉介入术24 h 后下地时或排便时突发呼吸心跳停止。经紧急心肺复苏,除颤后仍直接死亡3例,4例恢复呼吸心跳。恢复呼吸心跳患者均行溶栓治疗,最终脑死亡1例,好转后出院3例,该3例经过6个月~6年随访均症状稳定,无再发肺栓塞。结论经皮冠状动脉介入治疗后致死性肺栓塞的发生罕见,急性期预后极差,如果抢救成功,远期预后较好。 相似文献
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Douglas H. Greenfield George K. McMullan Alfred F. Parisi Joseph Askenazi 《Catheterization and cardiovascular interventions》1978,4(1):87-90
Frequent use of central venous lines has led to an increasing problem with embolized catheter fragments which have become lodged in the right heart and pulmonary vasculature. Removal of catheter fragments is justified because of a high complication rate when they are left in situ. Using a snare retrieval apparatus catheter fragments may be quickly and easily removed. In the past year we have seen 3 patients with embolized catheter fragments. One case was unusual in that its transverse position in the pulmonary vasculature required initial dislodgement with a pigtail catheter before it could be successfully snared. The literature and our experience suggest that most, if not all, catheter fragments in the right heart and pulmonary circulation can be successfully retrieved without resorting to thoracotomy. 相似文献
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A 71-year-old woman presented with an acute, massive pulmonary embolism. As a Jehovah's Witness, she was not willing to accept thrombolysis because of the potential risk of bleeding requiring blood transfusion. The patient was successfully treated with catheter thrombectomy, using rheolytic and fragmentation devices. (CHEST 2000; 117:594-597) 相似文献
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Mateo PORRES‐AGUILAR Oscar C. MUNOZ Paola ALVAREZ Emilio GONZALEZ‐AYALA 《Respirology (Carlton, Vic.)》2010,15(3):576-579
Massive pulmonary embolism with haemodynamic instability has a high mortality. Traditionally these patients are treated with i.v. thrombolytic therapy. When this therapeutic approach is contraindicated, surgical embolectomy and most recently, percutaneous mechanical interventions are alternative treatment options. This case report presents a 73‐year‐old female with a residual hemiparesis secondary to a mengingioma resection 45 days previously, who presented with progressive shortness of breath, accompanied by oppressive chest pain, hypotension, tachycardia and severe hypoxaemia. CT pulmonary angiogram confirmed a massive pulmonary embolism extending into the lobar branches bilaterally. The patient was treated with percutaneous mechanical thrombectomy with excellent haemodynamic and clinical outcomes. 相似文献