Echo-Doppler Predictors of Residual Pulmonary Hypertension After Pulmonary Thromboendarterectomy.

Pulmonary thromboendarterectomy (PTE) remains the preferred treatment for surgical accessible thrombus in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, residual pulmonary hypertension (PH) can persist post-PTE. A retrospective single-center analysis of patients that underwent PTE between 2013 and 2023.

Management of Complications of Balloon Pulmonary Angioplasty.

Since the publication of the first case series reporting the outcomes of patients with chronic thromboembolic pulmonary hypertension who underwent treatment with balloon pulmonary angioplasty more than 30 years ago, significant improvements to the procedural technique have made balloon pulmonary angioplasty (BPA) a safe and effective therapy that we know today. Nevertheless, BPA carries a small risk of complications, which require rapid recognition and immediate management. The most commonly seen complications associated with BPA include pulmonary vascular injury and reperfusion pulmonary edema.

Uterine Fibroids and Their Association with Acute and Chronic Venous Thromboembolic Disease-An Expert Review of the Literature.

Venous thromboembolism is significantly affected by hormonal and reproductive factors that pose unique challenges in women. Among various risk factors, the role of uterine fibroids, which are the most common benign tumors in women, is not well understood. The relationship between venous thromboembolism and fibroids is mainly attributed to the physical compression caused by large fibroids on pelvic veins, particularly the iliac veins, leading to venous stasis and thrombosis.

Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: Results of an International Multicenter Prospective Registry.

Background: Chronic thromboembolic pulmonary hypertension results from mechanical obstruction of major pulmonary artery lumina with fibrotic tissue. Main treatment has been pulmonary endarterectomy, a complex surgical procedure removing vascular obstruction. However, at least 40% of patients are not candidates for pulmonary endarterectomy because of technical inoperability, comorbidities, or limited access to surgery.

Sarcopenia in Patients with Chronic Thromboembolic Pulmonary Hypertension.

Background: Sarcopenia, or loss of skeletal muscle mass, has been associated with poor outcomes (e.g., functional decline, increased mortality, and low quality of life), but its role in CTEPH remains unclear.

Safety and Feasibility of On-the-Table Pharmacomechanical Lysis for Acute Intermediate-Risk Pulmonary Embolism: The RESCUE-II Study.

Background: Acute pulmonary embolism (PE) is a leading cause of morbidity and mortality. Pharmacomechanical lysis (PML) with the Bashir endovascular catheter has been shown to reduce the right ventricular/left ventricular (RV/LV) ratio in patients with intermediate-risk (IR) PE. Nevertheless, the original protocol required a 5-hour postprocedural infusion of recombinant tissue plasminogen activator (r-tPA) and intensive care unit monitoring.

Evolution and New Perspectives of Balloon Pulmonary Angioplasty in CTEPH.

Chronic thromboembolic pulmonary disease (CTEPD) and chronic thromboembolic pulmonary hypertension (CTEPH) are debilitating complications of acute pulmonary embolism (PE) that are characterized by fibrosis and organization of the thrombotic material within pulmonary artery branches. This pathology leads to increased right ventricular afterload and dead space ventilation, posing a risk of progressive pulmonary hypertension, right-sided heart failure, and potentially death if left untreated. Pulmonary endarterectomy (PTE) is a technically complex open-heart surgery considered to be a first-line treatment as it is a potentially curative therapy.

Invasive Cardiopulmonary Exercise Testing in Chronic Thromboembolic Pulmonary Disease; Obesity and the V/VCO Relationship.

: Invasive cardiopulmonary exercise testing (iCPET) provides valuable insight into dyspnea in patients with chronic thromboembolic pulmonary disease, in part through an increased relationship of minute ventilation to CO production (V/VCO). Obesity lowers the V/VCO in patients without cardiopulmonary disease; however, whether this holds true in obese subjects with chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) is unknown. : Report on the iCPET findings of patients with CTEPH and CTEPD and investigate the relationship between obesity and gas exchange parameters, especially V/VCO in these patients.

Pelvic Vein Obstruction in Chronic Thromboembolic Pulmonary Hypertension: A Novel Association.

Pelvic venous obstruction (PVO), defined as greater than 50% stenosis or occlusion of pelvic veins, is a known risk factor for deep vein thrombosis (DVT). DVT is a known risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), but the prevalence of PVO in CTEPH is unknown. This cross-sectional study at Temple University's tertiary referral center for Pulmonary Hypertension, Right Heart Failure, and CTEPH sought to identify the presence of PVO in patients with CTEPH who underwent cardiac catheterization, pulmonary angiography, and venography.

Impact of reperfusion therapies on clot resolution and long-term outcomes in patients with pulmonary embolism.

Objective: Major progress in reperfusion strategies has substantially improved the short-term outcomes of patients with pulmonary embolism (PE), however, up to 50% of patients report persistent dyspnea after acute PE.

Methods: A retrospective study of the PE response team registry and included patients with repeat imaging at 3 to 12 months. The primary outcome was to determine the incidence of residual pulmonary vascular obstruction following acute PE.

Association of vena cava filters and catheter-directed thrombolysis for deep vein thrombosis with hospital readmissions.

Background: Acute deep vein thrombosis (DVT) affects >350,000 patients each year in the United States. Contemporary rehospitalization rates and predictors of acute DVT have not been well-characterized. We aimed to evaluate the all-cause 30-day readmission rate and its association with catheter-directed thrombolysis and vena cava filters in patients with proximal and caval DVT.

Advanced Treatment of Hemodynamically Unstable Acute Pulmonary Embolism and Clinical Follow-up.

High-risk acute pulmonary embolism (PE), defined as acute PE associated with hemodynamic instability, remains a significant contributor to cardiovascular morbidity and mortality in the United States and worldwide. Historically, anticoagulant therapy in addition to systemic thrombolysis has been the mainstays of medical therapy for the majority of patients with high-risk PE. In efforts to reduce the morbidity and mortality, a wide array of interventional and surgical therapies has been developed and employed in the management of these patients.

Incidence and Predictors of Acute Limb Ischemia in Patients With Acute Myocardial Infarction-Insight from National Readmission Database.

Acute limb ischemia (ALI) has been a rare complication of acute myocardial infarction (AMI), however, with the increasing use of mechanical circulatory devices it is seen more frequently. The incidence and predictors of ALI in patients with AMI in contemporary clinical practice are unknown. A retrospective review of patients with index hospitalization for AMI in the Nationwide Readmission Database from 2016 to 2019 was done.

Refined Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: Initial Results of U.S. Regional Program.

Objectives: We sought to evaluate the efficacy and safety of refined balloon pulmonary angioplasty (BPA) in the treatment of patients with chronic thromboembolic pulmonary hypertension (CTEPH).

Background: BPA is rapidly evolving therapeutic option for patients with nonsurgical CTEPH. There are few US studies that have reported on the outcomes of this novel therapeutic option.

Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism.

Introduction: Right ventricular dysfunction (RVD) is a key component in the process of risk stratification in patients with acute pulmonary embolism (PE). Echocardiography remains the gold standard for RVD assessment, however, measures of RVD may be seen on CTPA imaging, including increased pulmonary artery diameter (PAD). The aim of our study was to evaluate the association between PAD and echocardiographic parameters of RVD in patients with acute PE.