The Surgical clinics of North America
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Surg. Clin. North Am. · Apr 2018
ReviewPulmonary Embolism: Current Role of Catheter Treatment Options and Operative Thrombectomy.
Pulmonary embolism remains a leading cause of death in the United States, with an estimated 180,000 deaths per year. Guideline-based treatment in most cases recommends oral anticoagulation for 3 months. ⋯ Treatment modalities to extract the thromboembolism and reduce pressure overload in the cardiopulmonary system include use of intravenous or catheter-directed thrombolytic agents, catheter-directed mechanical thrombectomy, and surgical embolectomy. This article discusses current minimally invasive and surgical methods for reducing embolic burden in patients with submassive, high-risk pulmonary embolism.
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Surg. Clin. North Am. · Apr 2018
ReviewInferior Vena Cava Filters: Current Indications, Techniques, and Recommendations.
The vena cava filter (VCF) is intended to prevent the progression of deep venous thrombosis to pulmonary embolism. Recently, the indications for VCF placement have expanded, likely due in part to newer retrievable inferior vena caval filters and minimally invasive techniques. This article reviews the available VCFs, the indications for use, the techniques for placement, and possible outcomes and complications.
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Surg. Clin. North Am. · Apr 2018
ReviewEvidence-Based Therapies for Pharmacologic Prevention and Treatment of Acute Deep Vein Thrombosis and Pulmonary Embolism.
Venous thromboembolism (VTE) remains a significant mortal and morbid disease. The major risks have not changed and many patients present with unprovoked VTE disease. ⋯ Treatment of VTE with parenteral anticoagulation followed by either a direct oral anticoagulant or warfarin is standard to reduce risk of VTE recurrence and death. Selected cases of iliofemoral deep vein thrombosis may be treated by pharmacomechanical thrombolysis, but more data are needed before this is standard of care.