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thromboembolic events in metastatic testicular cancer treated with cisplatin-based chemotherapy

World Journal of Clinical Oncology 2021年第3期12卷 183-194页

作者： Lisa B E Shields Michael W Daniels Nataliya Mar Arash Rezazadeh Kalebasty Norton Neuroscience Institute Norton HealthcareLouisvilleKY 40202United States Department of Bioinformatics and Biostatistics University of LouisvilleLouisvilleKY 40292United States Division of Hematology/Oncology Department of MedicineUCI Medical CenterOrangeCA 92868United States

BACKGROUND Testicular germ cell tumor(TGCT)is the most curable solid tumor and most common cancer among men 18-39 years.While cisplatin-based chemotherapy has significantly lengthened the survival of patients with TGCT,it is associated with a high rate of thromboembolic events(TEE).AIM To summarize our single-center experience highlighting patients who were diagnosed with TGCT and received platinum-based chemotherapy,with special attention to those patients who suffered a TEE.METHODS A retrospective analysis of the medical records and imaging studies of 68 consecutive individuals who were diagnosed with TGCT and received platinumbased chemotherapy at our Institution in a metropolitan community between January 1,2014 and December 31,2019.RESULTS A total of 19(28%)patients experienced a TEE following orchiectomy which occurred during chemotherapy in 13(68%)of these patients.Patients with a higher pathologic stage(stage III)were significantly(P=0.023)more likely to experience a TEE compared to patients who had a lower stage.Additionally,patients who were treated with 3 cycles of bleomycine,etoposide,and cisplatin and 1 cycle of etoposide and cisplatin or 4 cycles of etoposide and cisplatin were significantly 5(P=0.02)times more likely to experience a TEE compared to patients who were treated with only 3 cycles of bleomycine,etoposide,and cisplatin.CONCLUSION Due to numerous factors that predispose to a TEE such as large retroperitoneal disease,higher clinical stage,greater number of chemotherapy cycle,central venous catheter,cigarette smoking,and possible cannabis use,high-risk ambulatory patients with TGCT treated with cisplatin-based chemotherapy may benefit from prophylactic anticoagulation.Randomized studies to evaluate the safety and efficacy of prophylactic anticoagulants are warranted in this young patient population generally devoid of medical co-morbidities.

关键词： Oncology Testicular cancer thromboembolic Cisplatin Pulmonary embolism Thromboprophylaxis

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Chronic thromboembolic pulmonary hypertension(CTEPH):outcomes of surgical effect in patients with unilateral main pulmonary artery occlusion

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中国循环杂志 2018年第S1期33卷 149-150页

作者： Wu Song Sheng Liu Jiade Zhu Ziqi Yue Yunhu Song Department of Cardiac Surgery National Center for Cardiovascual r DiseasesFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

Objective To summarize the clinical characteristics and the effect of pulmonary endarterectomy(PEA)in CTEPH patients with unilateral main pulmonary artery occlusion.Methods Of 160 CTEPH patients operated between January2004 and March 2018 at our center,13(8.1%)had complete main pulmonary artery occlusion.Patients were included if the ventilation/perfusion(V/Q)scan revealed nonperfusion of an entire lung and the pathological examination showed chronic thromboembolic.

关键词： pulmonary endarterectomy Chronic thromboembolic pulmonary hypertension unilateral main pulmonary artery occlusion

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Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension: How can patients be better selected?

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World Journal of Cardiology 2013年第3期5卷 18-21页

作者： Juan C Grignola Enric Domingo Department of Pathophysiology Faculty of Medicine University of the Republic Pulmonary Hypertension Unit Maciel Hospital Ministry of the Public Health Area of the Heart University Hospital of Vall d' Hebron Department of Physiology University Autonoma of Barcelona Campus de Bellaterra

Chronic thromboembolic pulmonary hypertension (CTEPH) comprises organizing thrombotic obstructions in the pulmonary arteries by nonresolving thromboemboli, formation of fibrosis and remodeling of pulmonary blood vessels. Surgical pulmonary endarterectomy (PEA) is the therapy of choice for patients with surgically accessible CTEPH, which leads to a profound improvement in hemodynamics, functional class and survival. Select- ing the candidates that will benefit from surgery is still a challenging task. Criteria for surgical suitability have been described but the decision-making for or against surgical intervention remains still subjective. The optimal characterization of the reciprocal contribution of large vessel and small vessel disease in the elevation of pulmonary vascular resistance is crucial for the indication and outcome of PEA. Recently, Toshner et al intended to validate the partition resistance into small and large vessels compartments (upstream resistance:Rup) by the occlusion technique in the preoperative assessment of PEA. We discuss the advantages and disadvantages of Rup and compare it with other hemodynamic predictor to evaluate operative risk in CTEPH patients.

关键词： Pulmonary endarterectomy Operability Chronic thromboembolic pulmonary hypertension Pulmonary artery occluded pressure Pulmonary vascular resistance

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Open Journal of Respiratory Diseases 2012年第2期2卷 17-24页

作者： Manuel Lopez-Meseguer Río Aguilar Carles Bravo Víctor Monforte Laura Dos Carmen P. Simeon Enric Domingo Antonio Roman Cardiology Department Hospital Universitari de Bellvitge Hospitalet de Llobregat Spain Cardiology Department Hospital Universitari Vall d’Hebron Institut de Recerca del Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona Barcelona Spain Department of Physiology Universitat Autonòma de Barcelona Barcelona Spain Internal Medicine Department Hospital Universitari Vall d’Hebron Institut de Recerca del Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona Barcelona Spain Respiratory Department Hospital Universitari Vall d’Hebron Institut de Recerca del Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona Barcelona Spain

Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are serious diseases with similar pathophysiologic aspects. The prognosis of patients with these conditions is highly uncertain, particularly incident cases. Methods: A Cox proportional hazards model was applied to a group of 85 patients (81% women, mean age 52 (18 - 82) years) with PAH (80%) and non-surgical CTEPH (20%) to evaluate risk factors for mortality. The following variables were included in the model: age, etiology, baseline 6-minute walk test (6 mWT), cardiac index, and improvement in the 6 mWT following initiation of first medical treatment. Results: In the multivariate analysis, the response to treatment, assessed by an improvement on the 6 mWT, was the most relevant prognostic factor in these patients (RR, 4.832 (95% CI, 1.888 - 12.364);p = 0.001). The remaining variables studied in this model had less influence on the prognosis: age > 50 years (RR, 0.744 (95% CI, 0.26 - 2.133);p = 0.582);etiology of connective tissue disease-associated PAH (RR, 3.145 (95% CI, 0.995-9.946);p = 0.051) or CTEPH (RR, 0.654 (95% CI, 0.179 - 2.387);p = 0.521) with respect to idiopathic PAH;baseline 6 mWT (RR, 1.173 (95% CI, 0.599 - 4.895);p = 0.315);or cardiac index (RR, 2.295 (95% CI, 0.793 - 6.642);p = 0.125). Conclusions: There is a high degree of uncer-tainty regarding the prognosis of PAH and CTEPH at the start of appropriate treatment. Our results support the idea that the initial treatment response is of paramount importance as prognostic factor in these patients.

关键词： Pulmonary Arterial Hypertension Chronic thromboembolic Pulmonary Hypertension Survival Risk Factors

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Risk of Major Hemorrhage in Bilateral Lung Transplantation for Chronic thromboembolic Pulmonary Hypertension: A Case Report

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Open Journal of Organ Transplant Surgery 2013年第4期3卷 65-67页

作者： Tomoyuki Nakagiri Masato Minami Masayoshi Inoue Soichiro Funaki Yasushi Shintani Meinoshin Okumura Department of General Thoracic Surgery Osaka University Graduate School of Medicine Osaka Japan

Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the indications for lung transplantation. When patients with CTEPH undergo transplantation, massive bleeding can occur because of severe pleural adhesions and collateral vessels that develop from the thoracic wall to the lungs. However, there has been no previous case report that has discussed the bleeding risk in detail. We report the case of a patient having CTEPH who underwent bilateral lung transplantation with massive blood loss (11,730 mL) in the first operation and required repeat operations for hemostasis. The patient underwent left upper lobectomy because compromised blood flew to the left upper lobe. He recovered from the operations by postoperative day 9;however, he died from pyothorax from an intractable air leak 56 days after transplantation.

关键词： Lung Transplantation Chronic thromboembolic Pulmonary Hypertension Massive Bleeding Control

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Chronic thromboembolic pulmonary hypertension related to hemangiolymphangioma

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Case Reports in Clinical Medicine 2014年第1期3卷 36-37页

作者： Tsuneyuki Nakamura Keita Tamanuki Giyo Ko Masato Oguri Chisato Akita Chika Kitaoka Toshimi Nakamura Yutaka Saikawa Department of Pediatrics Kanazawa Medical University Ishikawa Japan

Hemangiolymphangioma (HL) is a congenital anomaly and histologically benign tumor, which was composed of both the lymphatic and the blood vessels. We report an adult case of HL complicated by chronic thromboembolic pulmonary hypertension (CTEPH) in a 20-year-old female. Gastrointestinal bleeding scintigraphy and operative findings elucidate a close relationship between CTEPH and residual HL. This case indicates that HL survivors with remaining left-to-right shunt might lead to CTEPH during the long-term follow-up.

关键词： Hemangiolymphangioma Chronic thromboembolic Pulmonary Hypertension Long-Term Follow-Up

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The clinical characteristics of antiphospholipid syndrome associated with chronic thromboembolic pulmonary hypertension

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China Medical Abstracts(Internal Medicine) 2019年第2期36卷 95-96页

作者：李粲 Dept Rheumatol PUMC HospPUMC & CAMS

Objective To analyze the clinical characteristics ofantiphospholipid syndrome (APS) patients with chronicthromboembolic pulmonary hypertension ( CTEPH ).Methods A total of 22 APS patients with CTEPH wereenrolled in our study,who were admitted in PekingUnion Medical College Hospital from January 2012 toAugust 2018. Diagnoses were confirmed by computed to-mographic pulmonary angiography (CTPA),or pulmonaryangiography. Demographic characteristics, clinicalmanifestations,laboratory tests,therapy,World HealthOrganization (WHO) functional class were retrospectivelycollected. Results There were 15 females and 7 maleswith a median age of 29-year-old. Chest pain (6 cases),dyspnea on exertion (22 cases),cough (6 cases) andhemoptysis ( 9 cases) were the most common clinicalmanifestations. Lupus anticoagulant ( LA),anticardiolipin(ACL) antibodies and anti-beta 2 glycoprotein Ⅰ(anti-β2 GPⅠ) antibodies were all positive in 12 patients,two of three antibodies positive in 5 patients,onlyone positive in 5 patients.

关键词： PTE APS antiphospholipid syndrome associated chronic thromboembolic pulmonary hypertension

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Comparison of long-term outcome between patients aged 〈 65 years vs. ≥ 65 years after atrial fibrillation ablation

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Journal of Geriatric Cardiology 2017年第9期14卷 569-574页

作者： Zsuzsanna Kis Anna ME Noten Mihran Martirosyan Astrid A Hendriks Rohit Bhagwandien Tamas Szili-Torok Department of Cardiology Erasmus MC University Medical Center Rotterdam the Netherlands

Background Atrial fibrillation （AF） is the most frequent arrhythmia, and its prevalence is increasing with aging. We aimed to com-pare the long-term outcome data of patients 〈 65 years vs.≥ 65 years who underwent catheter ablation （CA） for drug-refractory AF. MethodsConsecutive patients with primary pulmonary vein isolation performed between March 2001 and December 2011, and those who completeda five-year of follow-up were divided into two groups： patients aged 〈 65 years into group 1, and patients aged ≥ 65 into group 2. Long-termoutcome data concerning mortality, thromboembolic events （TE） and success rates were compared between these groups. Results A totalnumber of 390 patients were included, group 1 contained 310 patients, and 80 patients in group 2. In group 2, patients had more often impairedrenal function （P 〈 0.001） and thyroid disease （P = 0.047）. A total of fifteen patients died during the 6.63 ± 2.1 years of follow-up, with a sig-nificantly higher incidence in the older group （8/80 vs. 7/310 patients, P = 0.004）. The majority of fatal outcome was due to cancerous dis-eases in both groups. No difference was observed concerning the long-term TE rate （12/310 vs. 4/80 patients, P = 0.75）. Rhythm controlfailed in 25.9% of the patients, with no difference between the groups： 26.4% in group 1 vs. 23.7% in group 2 （P = 0,67）, ConclusionsDespite growing prevalence of AF in aging population, the elderly patients are underrepresented in CA procedures. Similar clinical successand TE complication rate are observed between the age-groups. Our data suggest more liberal criteria might be applied while selecting pa-tients for AF ablation.

关键词： Atrial fibrillation Catheter ablation Clinical outcome The elderly thromboembolic complication

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Associations between SARS-CoV-2 infections and thrombotic complications necessitating surgical intervention:A systematic review

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World Journal of Methodology 2022年第6期12卷 476-487页

作者： Jennifer J Ferraro Allie Reynolds Sylvia Edoigiawerie Michelle Y Seu Sydney R Horen Amir Aminzada Alireza Hamidian Jahromi Division of Plastic and Reconstructive Surgery Department of SurgeryRush University Medical CenterChicagoIL 60612United States Medical School University of ChicagoChicagoIL 60637United States Department of Surgery Temple University HospitalPhiladelphiaPA 19140United States

BACKGROUND Several unique clinical features of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the cause of coronavirus disease 2019(COVID-19)infection,have been identified and characterized.One such feature,mostly among patients with severe COVID-19 infection,has become known as COVID-19-induced coagulopathy.Surgical patients with a history of or active COVID-19 infection bear a significantly higher risk for postoperative thrombotic complications.These patients may require surgical intervention to treat severe thrombotic complications.Few studies have been carried out to better characterize this association.The purpose of this study was to perform a systematic review and meta-analysis of the literature on COVID-19 infections that led to thrombotic complications necessitating surgical intervention.We hypothesized that patients with recent or active COVID-19 infection would have high rates of thromboembolic complications both arterial and venous in origin.AIM To perform a systematic review and meta-analysis of the literature on COVID-19 infections that led to thrombotic complications necessitating surgical intervention.METHODS The current systematic review implemented an algorithmic approach to review all the currently available English medical literature on surgical interventions necessitated by COVID-19 thrombotic complications using the preferred reporting items for systematic reviews and metaanalysis principles.A comprehensive search of the medical literature in the“PubMed”,“Scopus”,“Google Scholar”top 100 results,and archives of Plastic and Reconstructive Surgery was performed using the key words“COVID-19”AND“surgery”AND“thromboembolism”AND“complication”.The search string was generated and the records which were not specific about surgical interventions or thrombotic complications due to COVID-19 infection were excluded.Titles and abstracts were screened by two authors and full-text articles were assessed for eligibility and inclusion.Finally,results were further refined to focus on articles that

关键词： thromboembolic COVID-19 SARS-CoV-2 Surgical intervention Complications Surgery

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Pancreatic cancer:A model cancer for the study of the therapeutic effects of anticoagulants

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World Journal of Gastrointestinal Oncology 2009年第1期1卷 38-40页

作者： Anthony Maraveyas The Queen's Centre for Oncology and Haematology Hull and York Medical SchoolCastle Hill Hospital

Cancer-related thromboembolic disease is a well recognized syndrome since first described by Armand Trousseau in 1865.Preventing the morbidity and mortality related to thromboembolism in these patients is becoming a priority research area with the advent of new anti-coagulants.It is only recently that randomized trials of improved quality are been undertaken to study this question.Many of these trials however are still not accounting for the heterogeneity of "cancer" in terms of anatomical site,histology,stage and treatment.This editorial review highlights why pancreatic cancer may serve as a model malignancy to study this question.

关键词： Pancreatic Cancer Vascular Thromboembolism Vascular thromboembolic disease Heparin Anticoagulants

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