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The Pulmonary and Bronchial Vessels, Pulmonary Vascular Abnormalities including Embolism, Pulmonary and Bronchial Angiography, and A/V Malformations.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Acute embolism causes a sudden reduction in the pulmonary circulation to the affected part(s) or the lung. This may be accentuated by vascular spasm, perhaps due to sudden hypoxia in the affected lobe or lung. Reduced perfusion may lead to reduced fluid within the lung producing increased translucency, narrowing of the arteries on the affected side and contralateral dilatation. If the condition is bilateral, then the changes may be reflected in the vessels of the affected lobes. With major blockages, it is untrue to state, as often appears in text-books that the chest radiograph is likely to be normal. Westermark (1938), Shapiro and Rigler (1948) and Chang (1967) described the 'characteristic appearance of ischaemic lung' as the 'Westermark sign' i.e. - a marked increased radio-lucency of the involved lung, with elevation of the hemidiaphragm (from decreased lung volume), the hilar shadow being small, the descending pulmonary artery (and its branches) small and spastic - often accompanied by compensatory dilatation of the pulmonary vessels in the contralateral lung.
Immuno-Pathologic Basis of COVID-19 and the Management of Mild and Moderate Cases
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Debdeep Dasgupta, Srijan Goswami, Chiranjeeb Dey
The blockage may limit or stop blood flow. A clot that adheres to a vessel wall is called a thrombus, whereas an intravascular clot that floats in the blood is termed an embolus. Thus, a detached thrombus becomes an embolus. Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs (Cecil et al., 2012; Kumar et al., 2014; Hall, 2015; McPhee et al., 2021).
Complications of carotid endarterectomy
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Laura T. Boitano, Mark F. Conrad
A patient who is neurologically intact initially and develops a neurologic deficit in the post-anesthesia care unit or later in recovery should be managed differently than a patient who awakes in the OR with an immediate deficit. In this case, a stat duplex should be performed at the bedside. If there is evidence for stenosis, intimal flap, occlusion, or other abnormality, the patient should be taken immediately to the operating room for re-exploration. If there are no stat ultrasound capabilities at the hospital or there is no defect found on carotid duplex ultrasound, the patient should undergo a stat non-contrast CT of the head followed by a CTA head and neck. This will identify a hemorrhagic stroke and characterize the carotid system to find the cause of the problem such as a dissection, occlusion, or defect that has embolic potential (Figure 13.3). If there is an embolus, anticoagulation can be initiated, and the patient should be immediately taken to the angiography suite for clot retrieval. However, a hemorrhagic stroke warrants reversal of any anticoagulation and may require discussion with neurosurgery. Strokes are rare after carotid surgery, and early identification with a swift and deliberate response can limit the long-term sequelae of this dreaded complication.
Association between CHARGE-AF risk score and LA mechanics: LA reservoir strain can be a single parameter for predicting AF risk
Published in Acta Cardiologica, 2023
Turkan Seda Tan, Kubra Korkmaz, Irem Muge Akbulut, Kaan Akin, Yakup Yunus Yamanturk, Haci Ali Kurklu, Volkan Kozluca, Kerim Esenboga, Irem Dincer
Stroke is one of the main causes of death and disability worldwide. The global burden of stroke is rising due to the ageing population [1]. Ischaemic stroke, which is a prevalent type of stroke, can result from a variety of causes, such as atherosclerosis of the cerebral circulation, occlusion of small cerebral vessels, and cardiac embolism [2]. Given increases in life expectancy, the incidence of ischaemic stroke is expected to increase in the future [3]. Approximately one-third of ischaemic strokes remain cryptogenic after the standard evaluations of ischaemic strokes [4]. Due to the embolic nature of cryptogenic strokes, these strokes are classified as embolic stroke of undetermined source (ESUS) [5]. Causes of embolism may be due to artery-to-artery embolism, or emboli may originate directly from the heart. Long-term follow-up of cryptogenic stroke (CS) patients with continuous heart rhythm monitoring often reveals paroxysmal AF that was not apparent at the time of stroke [6]. With the hope that oral anticoagulant therapy can prevent most stroke in AF, the detection of patients who are at high risk for developing atrial fibrillation is essential for the primary prevention of stroke.
Detachment and embolization of totally implantable central venous access devices: diagnosis and management
Published in Acta Chirurgica Belgica, 2022
Halil Kara, Akif Enes Arikan, Onur Dulgeroglu, Cihan Uras, Gul Esen Icten, Burcin Tutar, Ulku Tuba Parlakkilic, Ozlem Sonmez
Many publications reported that most patients were asymptomatic and diagnosis was reached via routine chest X-ray [2,4]. Catheter malfunction was the most common finding in reviews by Surov et al. [10] and Cheng et al. [9]. Mirza et al. [8] reported the most common presentation as pain and/or swelling upon injection (60%). In addition to these findings, inability to withdraw blood from the catheter, extravasation, edema, and pain around the catheter and reservoir during infusion should also be considered. In the case of embolization to the right heart, ventricular arrhythmias may be expected [19]. Endocarditis and cardiac tamponade should be considered carefully. Cough, dyspnea, and chest pain may be more commonly seen in cases of pulmonary embolism. In our study, seven (58%) patients were asymptomatic, four (33.3%) patients had TIVAD malfunction, and one (8.3%) patient had pain and swelling at the port site after injection.
Intracranial microembolic signals might be a potential risk factor for cognitive impairment
Published in Neurological Research, 2021
Jing Yan, Zhaoxia Li, Melissa Wills, Gary Rajah, Xin Wang, Yaqiu Bai, Pei Dong, Xingquan Zhao
In our retrospective case control study, we found that MES detected in MCA was related to cognitive impairment among patients visiting outpatient clinics for diseases such as stroke, asymptomatic artery stenosis, migraine, and dizziness. The prevalence of MES varies between different diseases. Previous studies suggest that the prevalence of MES is 7% in acute ischemic stroke patients [14], 22.7% in TIA patients [15], 31% in patients with a history of embolic stroke of undetermined source [16], and 87.5% in patients undergoing carotid artery stenting [17]. The prevalence of MES in the whole population was 3.7% (50/1356). One of the reasons for the low MES rate in our study might be that most patients with stroke were not monitored at the early stage (within 72 hours). In addition, most patients have already been on antiplatelet treatment, which may reduce the incidence of emboli. Finally, patients without risk factors of atherosclerosis may be at a low risk of emboli.