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Biomedical subjects

P Asseman

Publications and source records attributed to P Asseman.

64 records · Page 4Linked to original sources

Mechanical thrombectomy in patients with deep venous thrombosis.

PURPOSE: To report our experience with mechanical thrombectomy in proximal deep vein thrombosis (DVT). METHODS: Eighteen patients with a mean (+/- SD) age of 37.6 +/- 16.1 years who presented with DVT in the iliac and femoral vein (n = 3), inferior vena cava (n = 5), or inferior vena cava and iliac vein (n = 10), were treated with the Amplatz Thrombectomy Device after insertion of a temporary caval filter. RESULTS: Successful recanalization was achieved in 15 of 18 patients (83%). Overall, the percentage of thrombus removed was 66 +/- 29%: 73 +/- 30% at caval level and 55 +/- 36% at iliofemoral level. Complementary interventions (seven patients) were balloon angioplasty (n = 2), angioplasty and stenting (n = 2), thrombo-aspiration alone (n = 1), thrombo-aspiration, balloon angioplasty, and permanent filter (n = 1), and permanent filter alone (n = 1). There was one in-hospital death. Follow-up was obtained at a mean of 29.6 months; three patients had died (two cancers, one myocardial infarction); 10 had no or minimal sequelae; one had post-phlebitic limb. CONCLUSION: Mechanical thrombectomy is a potential therapeutic option in patients presenting with proximal DVT.

Adult↗

Right atrial thrombi: percutaneous mechanical thrombectomy.

The current therapeutic options for right atrial thrombi-surgical embolectomy and thrombolysis-are associated with high mortality and such patients often have contraindications to these therapeutic options. The purpose of this study was to evaluate the feasibility of endovascular right atrial embolectomy. Two patients with contraindications to thrombolysis and surgery were treated by a femoral approach. A catheter was placed in the right atrium, under fluoroscopic control, and a basket device was used to trap the thrombus. The location and extent of the thrombus was established before the procedure by transesophageal echocardiography (TEE) and the procedure was performed with TEE and fluoroscopy. Thrombi were withdrawn in the basket into the inferior vena cava (IVC) and a filter was inserted by a jugular approach and positioned in the IVC, just above the thrombi. The basket was removed leaving the thrombus below the filter. One patient died immediately after the procedure. In conclusion, endovascular extraction of right atrial thrombi may represent a potential therapeutic alternative, particularly in patients with contraindications to thrombolysis and surgery.

Aged↗

[2 cases of aortocaval fistula].

We report two cases of fistula between the aorta and inferior vena cava that were admitted recently to the Intensive Care Department of this hospital. They are a perfect illustration of the aetiologies most frequently encountered in this disorder, viz. The spontaneous rupture of an atheromatous aneurysm in the vena cava and the occurrence of an aorto-caval fistula following surgery for a herniated disc. Aorto-caval fistula is a serious condition without typical presenting signs, so that diagnostic errors are frequent and appropriate treatment often delayed. It is at any event a true cardiovascular emergency for which surgery is the only answer.

Aorta, Abdominal↗

[Effects of hormone replacement treatment of menopause on the risk of venous thromboembolic disease].

Post-menopausal hormone replacement therapy increases the risk of venous thrombo-embolism 2- to 4-fold. The risk is highest in the beginning of the exposure to hormones and disappears rapidly after interruption of treatment. However, the increased risk remains low in absolute value and has to be weighed against coronary artery disease and post-menopausal osteoporosis.

Estrogen Replacement Therapy↗