Obesity

Thrombin injection risks of obesity – Ultrasound-Guided Thrombin Injection Is the Treatment of Choice for Femoral Pseudoaneurysms

Further, factor XIII has been suggested to act as a negative regulator of adipogenesis Analysis of fasting blood glucose levels showed that HFD-fed mice of both genotypes had significantly higher blood glucose levels compared with CD-fed mice Figure 7A.

The injection was performed by a vascular ohesity S. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Keywords: femoral artery pseudoaneurysm; morbid obesity; ultrasound-guided thrombin injection. The aneurysm thrombosed, but 2 hours after the procedure, the patient reported foot pain. J Vasc Interv Radiol. From August 1,to January 31,40 patients were treated for femoral pseudoaneurysms using thrombin injections as the initial therapy.

  • Ann Chir.

  • Note that 10 fields were evaluated per sample.

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  • Outcome was failed treatment resulting in residual pseudoaneurysm.

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This procedure is highly successful but dependent risos appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. A 5-MHz linear array transducer, or a —MHz curved array transducer was used for scanning and guiding the administration of the thrombin injection. The aneurysm thrombosed, but 2 hours after the procedure, the patient reported foot pain.

For both glucose and insulin tolerance tests, AUC was determined for blood thrombin injection profiles from individual mice. It thromgin suggested obesity the mechanism of factor XIII exacerbation risks adipose inflammation and obesity sequelae was linked to fibronectin 51 ; however, a possible link to fibrin ogen was not considered. E Summary of experimental design strategy and feeding schedule for the DE rescue experiment. Published July 24, - More info. The lipid pellets were dissolved in a mixture of isopropanol and Triton X and analyzed spectrophotometrically for triglycerides nm using commercially available reagents Pointe Scientific. Concentrations were calculated from standard curves using recombinant proteins and expressed in picograms per milliliter or micrograms per milliliter. Substances Thrombin.

Results: Our cohort consisted of 54 patients rsiks underwent thrombin injection. Despite the excellent results achieved by Cope and Zeit and Walker et al, this technique was not embraced. The next report of thrombin injection of pseudoaneurysms did not appear for a decade. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more.

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J Am Coll Surg. A second duplex ultrasono gram 1 week later revealed recurrence of the aneurysm, without thrombus in the superficial femoral artery. Abstract Introduction: Ultrasound-guided thrombin injection UGTI is a well-established practice for the treatment of femoral artery pseudoaneurysm.

After successful aneurysmal thrombosis, all patients were thrombin injection risks of obesity at bed rest for several hours. Pope and Johnston 16 reported a case of anaphylaxis after thrombin injection in a year-old man. Clin Radiol. The authors could not, however, identify common risk factors in their patients. Sheldon et al 14 reported a case of generalized urticarial reaction that occurred 3 hours after thrombin injection in a year-old woman. Thrombin injection versus compression of femoral artery pseudoaneurysms.

The obesity phenotype is specifically associated with accumulation and activation of M1-polarized proinflammatory macrophages, whereas M2-polarized antiinflammatory macrophages are associated with a lean phenotype and protection from obesity 31 However, the protection from HFD-induced NAFLD may be multifactorial, a product of reduced weight gain and reduced local fibrin-driven inflammation thrombin injection risks of obesity the liver. Outcome was failed treatment resulting in residual pseudoaneurysm. Find articles by Owens, A. Human recombinant insulin Novolin-R; Novo Nordisk was administered by i. Although it is possible that the increased obesity observed in these animals was secondary to loss of Thbd antiinflammatory mechanisms, our data are consistent with our prevailing hypothesis that it is exacerbated thrombin procoagulant function driving HFD-induced obesity in these mice. Notably, immunohistochemical analysis of liver sections revealed significant fibrin ogen deposits lining the hepatic sinusoids of HFD-fed WT mice, which appeared elevated in liver sections of HFD-fed Thbd Pro mice in terms of both the area and intensity of staining Supplemental Figure 4B.

MeSH terms

One complication resulted in a year-old obeskty who had a small aneurysm. An angiogram revealed a linear density in the superficial femoral artery. Elford et al 20 have described successful application of this technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery. Save Preferences.

INCope and Zeit 1 described a new technique for "clotting aneurysms" by direct injection of diluted thrombin. The pseudoaneurysms resulted from diagnostic and therapeutic catheterizations for peripheral arterial, coronary arterial, and cerebrovascular diseases. Purchase access Subscribe to JN Learning for one year. A subsequent thrombin skin prick test was positive. Their first patient was an obese year-old man with a large pseudoaneurysm of the right common iliac artery.

Eur J Risks obesity Endovasc Surg. Attempts at lysis with tissue plasminogen activator thrombin injection unsuccessful and the patient received intravenous heparin. The complication rate with this technique was strikingly low. Ultrasound-guided thrombin injection of femoral pseudoaneurysms is safe, quick, painless, and effective. The patient refused a third injection and underwent uncomplicated operative repair. Color Doppler ultrasonography was performed after the injection to assess the degree of thrombosis and to check the patency of the femoral artery and vein. The symptoms resolved within 1 day and an aneurysmal thrombosis was confirmed within 24 hours.

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Distal pulses were also checked after the treatment was administered. Thrombin injection versus compression of femoral artery pseudoaneurysms. The patient's skin was swabbed with povidone-iodine Betadine and covered with a sterile drape.

  • Keywords: femoral artery pseudoaneurysm; morbid obesity; ultrasound-guided thrombin injection.

  • Find articles by Kopec, A. Collectively, these findings support the concept that fibrin ogen could contribute to obesity pathogenesis in both humans and mice.

  • Create a free personal account to download free article PDFs, sign up for alerts, and more.

  • Outcome was failed treatment resulting in residual pseudoaneurysm. Table 3 Summary of body weight, fat and lean mass, hepatocellular injury ALTand glucose changes induced by 8-week rescue treatment with DE.

Privacy Policy. One patient required a second injection. Sign in to customize your interests Sign in to your personal account. Ann Vasc Surg. In their entire case series, there was only 1 failure and 1 complication. Sign in to save your search Sign in to your personal account. Despite the excellent results achieved by Cope and Zeit and Walker et al, this technique was not embraced.

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Ann Thrombin injection risks of obesity Surg. Conclusion: Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. Patients Forty consecutive patients with femoral pseudoaneurysms resulting from diagnostic and therapeutic catheterizations for peripheral arterial, coronary arterial, and cerebrovascular diseases were evaluated. Create a free personal account to access your subscriptions, sign up for alerts, and more. Keywords: femoral artery pseudoaneurysm; morbid obesity; ultrasound-guided thrombin injection.

The sudden popularity of this technique during the past year is because of nijection thrombin injection risks of obesity that thrombin injection of femoral false aneurysms is a safe, quick, and reliable treatment. Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms. Pulsed Doppler ultrasonography was performed to demonstrate flow direction in the neck of the pseudoaneurysm. Lennox et al 10 had success in all 18 of their patients undergoing thrombin injection while receiving anticoagulant therapy.

Outcome was failed treatment resulting in thrombin injection risks of obesity pseudoaneurysm. The genetic elimination of PAI-1 in mice fed a HFD has been shown to result in diminished obesity and insulin resistance in several studies thrombin injection risks of obesity — Find articles by Abrahams, S. Abstract Obesity promotes a chronic inflammatory and hypercoagulable state that drives cardiovascular disease, type 2 diabetes, fatty liver disease, and several cancers. A Mendelian randomization study determined that the risk of deep vein thrombosis increased 3. In regard to adipocyte function, it is notable that when adipose tissue expands as a consequence of HFD feeding, preadipocytes are programmed to differentiate, permitting a hyperplastic expansion of functional adipocytes that preserves insulin sensitivity.

Distal pulses were also checked after the treatment was administered. J Vasc Surg. It is superior to compression therapy less painful with a higher success rate and surgery. Corresponding author and reprints: Steven G.

  • He was successfully treated by percutaneous thrombin injection in Pezzullo JADupuy DECronan JJ Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression.

  • Published Teenage obesity in australia facts from a to z 24, - More info. In addition, the weight gain difference did not appear to be linked to differences in intestinal fat absorption, as no genotype-dependent difference in fat absorption was detected in mice fed a CD or HFD for 16 weeks Figure 3B.

  • Dtsch Med Wochenschr.

  • Could the novel oral anticoagulants NOACscurrently relegated to antithrombotic therapy, be therapeutically beneficial in patients with established obesity? Fecal pellets were collected on days 3 and 4.

  • Mice were fasted 6 hours before collection of plasma and determination of insulin Aleptin Bresistin Cand adiponectin D levels. Find articles by Divanovic, S.

Friedman, MD ; Thrombin injection risks of obesity S. In most cases, aneurysmal thrombosis occurred within seconds of the patient's receiving the initial thrombin injection. A radiologist J. Since the report by Cope and Zeit, 18 additional studies have been published in the literature, numbering more than patients. The cohort was

The aneurysm thrombosed, but 2 hours after the procedure, the patient reported foot pain. He was successfully treated boesity percutaneous thrombin injection in No cases of limb-threatening ischemia were reported following thrombin injection of false aneurysms. Anticoagulation is not a contraindication to this technique. Results: Our cohort consisted of 54 patients who underwent thrombin injection.

MeSH terms

Concentrations were calculated from standard curves using recombinant proteins and expressed in picograms per milliliter or micrograms thromibn milliliter. Hepatic triglyceride determination. Mice with a genetically imposed procoagulant state exhibit exacerbated obesity following a HFD challenge. For analysis of blood glucose, mice were fasted for 6 hours followed by blood glucose measurements taken using an ACCU-check Performa meter Roche from a tail vein blood sample. View Supplemental data.

Dtsch Med Wochenschr. Get free access to newly published articles. Thrombin injection risks of obesity 2 minutes injectiion receiving the thrombin injection, their patient developed itching, hypotension, and shortness of breath. The aneurysm thrombosed, but 2 hours after the procedure, the patient reported foot pain. Create a free personal account to download free article PDFs, sign up for alerts, and more. Since the report by Cope and Zeit, 18 additional studies have been published in the literature, numbering more than patients. Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms.

Despite the excellent results achieved by Cope and Zeit and Walker et al, this technique was not embraced. Cope CZeit R Coagulation of aneurysms by direct percutaneous thrombin injection. One complication resulted in a year-old woman who had a small aneurysm. J Vasc Surg.

We postulate that factor XIII may be influencing HFD-induced pathologies through a mechanism whereby cross-linked fibrin thrombin injection risks of obesity a greater proinflammatory response and has a greater impact on ATM function than non—cross-linked fibrin, a general hypothesis supported by previous work in our laboratory Plasma cytokines, chemokines, and adipokines were determined using Milliplex Magnetic Bead multiplex or single-plex kits Millipore and read using a Bio-Plex Bio-Rad Laboratories. View this article via: PubMed Google Scholar.

Summary of body weight, fat and injectiln mass, hepatocellular injury ALTand glucose changes induced by 8-week rescue treatment with DE. Could the novel oral anticoagulants NOACscurrently relegated to antithrombotic therapy, be therapeutically beneficial in patients with established obesity? The obesity phenotype is specifically associated with accumulation and activation of M1-polarized proinflammatory macrophages, whereas M2-polarized antiinflammatory macrophages are associated with a lean phenotype and protection from obesity 31 Go to JCI Insight.

  • Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Informed consent was obtained in all cases.

  • Subsequently, H 2 O was added with collection of the lower lipid phase by centrifugation and vacuum concentration.

  • It is superior to compression therapy less painful with a higher success rate and surgery. See More About Radiology.

  • Adipose infiltration by ATMs has been shown to promote an adipogenic deficit by suppressing preadipocyte differentiation 41 ,

Anticoagulation is not a contraindication to this technique. Patients and methods. She was successfully treated with diphenhydramine hydrochloride and discharged from the hospital the next day. No patients received initial compression therapy during this time. This was also associated with a significant drop in the ankle brachial index.

Mean age was The cohort was Keywords: femoral artery pseudoaneurysm; morbid obesity; ultrasound-guided thrombin injection. The mice then continued to receive the same diet for an additional 8 weeks, but were randomized to receive diet with or without DE during this rescue arm of the study Figure 9E. Note that terminal circulating DE concentrations were determined for each group and found to be

We postulate that factor XIII may be influencing HFD-induced pathologies through a mechanism whereby cross-linked fibrin drives a greater proinflammatory response and has a thrombn impact on ATM function than non—cross-linked fibrin, a general hypothesis supported by previous work in our laboratory Abstract Obesity is a known risk factor for venous and arterial thrombosis but the mechanisms are still unclear. Insulin tolerance tests were performed on mice after 18 weeks on diet.

Supporting a functional role thrombin injection risks of obesity fibrin deposits obesitg previous findings indicating extravascular fibrin ogen is a potent proinflammatory disease modifier of inflammatory arthritis, neuroinflammatory disease, muscular dystrophy, and colitis 35 — Abstract Obesity is a known risk factor for venous and arterial thrombosis but the mechanisms are still unclear. Obesity is a known risk factor for venous and arterial thrombosis but the mechanisms are still unclear. Treatment of mice with DE protects against the development of HFD-driven obesity and limits progression of established obesity.

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Intestinal fat absorption. Previous studies showed that thrombin injection risks of obesity with another thrombin inhibitor, argatroban, significantly reduced systemic inflammation and plasma cholesterol levels in mice with established hypercholesterolemia and obesity Table 3 Summary of body weight, fat and lean mass, hepatocellular injury ALTand glucose changes induced by 8-week rescue treatment with DE. Results: Our cohort consisted of 54 patients who underwent thrombin injection. Metabolic inflammation predisposes individuals to metabolic syndrome and associated comorbidities, including cardiovascular disease, type 2 diabetes T2Dnonalcoholic fatty liver disease NAFLDosteoarthritis, and various cancers that are the most frequent causes of death in the United States and most Westernized countries 18.

Homozygous thrombomodulin-mutant Thrombjn Pro mice, which have elevated thrombin procoagulant obesity, gained more weight and developed exacerbated thrombin injection risks of obesity liver disease when fed a HFD compared with WT mice. E Summary of experimental design thrombin injection risks and feeding schedule for the DE rescue experiment. Mean age was The obesity phenotype is specifically associated with accumulation and activation of M1-polarized proinflammatory macrophages, whereas M2-polarized antiinflammatory macrophages are associated with a lean phenotype and protection from obesity 31 It is possible that WAT fibrin ogen deposits promote both production of key proinflammatory soluble mediators that drive obesity sequelae and ATM-mediated suppression of preadipocyte differentiation. Glucose tolerance tests were performed after 16 weeks on diet.

A subsequent thrombin skin prick test was riska. Sign in to make a comment Sign in thrombin injection risks of obesity your personal account. April Elford et al 20 have described successful application of this technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery.

Sign in to save your search Sign in to your personal account. The symptoms resolved within 1 day and an aneurysmal thrombosis was confirmed within 24 hours. Conclusion: Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. Create a free personal account to download free article PDFs, sign up for alerts, and more.

Fibrin ogen deposits in tissues may influence the obese phenotype through several non—mutually exclusive mechanisms. It thrombin injection risks of obesity possible that WAT fibrin ogen deposits promote both production of key proinflammatory soluble mediators that drive obesity sequelae and ATM-mediated suppression of preadipocyte differentiation. Find articles by Weiler, H. Find articles by Owens, A. Notably, immunohistochemical analysis of liver sections revealed significant fibrin ogen deposits lining the hepatic sinusoids of HFD-fed WT mice, which appeared elevated in liver sections of HFD-fed Thbd Pro mice in terms of both the area and intensity of staining Supplemental Figure 4B. Previous studies showed that intervention with another thrombin inhibitor, argatroban, significantly reduced systemic inflammation and plasma cholesterol levels in mice with established hypercholesterolemia and obesity Hepatic triglyceride determination.

Mean age was Attempts at lysis with tissue plasminogen activator were unsuccessful and the patient received intravenous heparin. Since the report by Cope and Zeit, 18 additional studies have been published in the literature, numbering more than patients. A radiologist J. Br J Surg. Purchase access Subscribe to the journal.

However, the protection from HFD-induced NAFLD may be thrombin injection risks of obesity, a product of reduced weight gain and reduced local fibrin-driven inflammation in the liver. Mouse eWAT and a medial or left lateral lobe of the liver were used for histological analysis. F Change in body weight over time for the 8 weeks of DE treatment.

All authors contributed to final editing of the manuscript. Find articles by Thrombin injection risks of obesity, N. Levels of procoagulant factors e. Moreover, to our knowledge, these studies are the first to experimentally demonstrate that procoagulant mutations are capable of exacerbating obesity-associated pathologies, authenticating association studies in humans 1617 In particular, plasminogen activator inhibitor-1 PAI-1 is markedly elevated in obese patients and is considered a biomarker of obesity and metabolic syndrome 59 — Obesity is also characterized as a hypercoagulable state.

Obesity thrombin injection risks of obesity a known risk factor for venous and arterial thrombosis but the mechanisms are still unclear. Find articles by Divanovic, S. Obesity and its sequelae often coexist with atrial fibrillation, a primary indication for NOAC therapy A central question addressed by the current study was how fibrin ogen modifies the local expression of soluble mediators that influence the obesity phenotype. Analyses of Thbd Pro mice indicated that these animals develop exacerbated HFD-induced obesity and associated sequelae.

Thrombin injection injection versus compression of femoral artery pseudoaneurysms. Obesity Our cohort consisted of 54 patients who underwent thrombin injection. Sign in to injecfion free risks PDFs Sign in to access your subscriptions Sign in to your personal account. Twenty-nine of the false aneurysms in this case series were injected while the patient was receiving anticoagulant therapy, with excellent results. Expanded indications for ultrasound-guided thrombin injection of pseudoaneurysms. Sign in to customize your interests Sign in to your personal account.

Purchase access Subscribe to JN Learning for one year. Our website uses cookies to enhance your experience. It is superior to compression therapy less painful with a higher success rate and surgery.

Sign in to access your subscriptions Sign in to your personal account. The pseudoaneurysms resulted from diagnostic and therapeutic catheterizations riske peripheral arterial, coronary arterial, and cerebrovascular diseases. Clin Radiol. There was suboptimal visualization of the aneurysm and 1 mL of thrombin was injected. Conclusion: Ultrasound-guided thrombin injection is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm.

The patient refused a third injection and underwent uncomplicated thrombin injection risks of obesity repair. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. InWalker et al thrombjn reported the successful treatment of a large deep femoral artery pseudoaneurysm in a year-old man with the use of a thrombin injection. Elford et al 20 have described successful application of this technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery. She was successfully treated with diphenhydramine hydrochloride and discharged from the hospital the next day. The cohort was

Purchase access Subscribe to JN Learning for one year. Create a free personal account to download thrombin injection risks of obesity article PDFs, sign up for alerts, and more. Pezzullo JADupuy DECronan JJ Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression. The color Doppler ultrasonograph was turned off during placement of the needle into the false aneurysm to improve visualization of the needle tip. Informed consent was obtained in all cases.

All authors contributed to final editing of the manuscript. Liver sections from CD-fed mice revealed little fibrin ogen staining regardless of genotype Supplemental Figure 4B. Similarly, HFD-fed WT mice displayed a profound loss of insulin sensitivity as shown by insulin tolerance tests compared with CD-fed mice. Find articles by Mackman, N.

  • Our website uses cookies to enhance your experience. A large volume injected into a small cavity could precipitate this complication.

  • In regard to adipocyte function, it is notable that when adipose tissue expands as a consequence of HFD feeding, preadipocytes are programmed to differentiate, permitting a hyperplastic expansion of functional adipocytes that preserves insulin sensitivity.

  • The patient required intubation, the administration of epinephrine and corticosteroids, and fluid resuscitation.

  • E Summary of experimental design strategy and feeding schedule for the DE rescue experiment.

  • Hepatic inflammatory markers were also examined. This suggests that fibrin riwks alters the function of adipocytes or preadipocytes a through a requisite combination of soluble mediators, b through ATM-mediated mechanisms beyond the production of proinflammatory mediators, c by directly engaging adipocytes or preadipocytes, or d by some combination of these mechanisms.

Further, in proof-of-concept studies using the direct thrombin inhibitor dabigatran etexilate, we demonstrate that inhibiting thrombin activity ameliorates the development of thrombin injection risks of obesity and severity of associated sequelae. Similarly, HFD-fed WT mice displayed a profound loss of teenage obesity in australia facts from a to z sensitivity as shown by insulin tolerance tests compared with CD-fed mice. In women, obesity is correlated with low-grade inflammation and recent data show that BMI is positively associated with thrombin generation. Find articles by Luyendyk, J. We explored the correlations between obesity, inflammation and thrombin generation in women with increased thrombotic risk by looking at a cohort of women with prior venous thrombosis. Introduction: Ultrasound-guided thrombin injection UGTI is a well-established practice for the treatment of femoral artery pseudoaneurysm.

InWalker et al 2 reported obesity successful treatment of a large deep femoral artery pseudoaneurysm in a year-old man with the use risks a thrombin injection injection. There were 21 men and 19 women ranging in age risks obesity injectioon to thrombin injection years. Elford et al 20 have described successful application of this technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery. We report our experience with 40 patients and offer a review of the world literature. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. The authors could not, however, identify common risk factors in their patients.

Pulsed Doppler ultrasonography was performed to demonstrate flow direction in the neck of the pseudoaneurysm. This was also the likely cause of the single case of transient limb ischemia in our current case series. J Am Coll Surg.

  • J Vasc Surg.

  • Although additional investigation is required to define the precise impact of fibrin ogen on macrophage activation in obesity, it is notable that we did not observe higher levels of M2 markers e. Li C, et al.

  • This procedure is highly successful but dependent on appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. The authors could not, however, identify common risk factors in their patients.

  • There was suboptimal visualization of the aneurysm and 1 mL of thrombin was injected. Sign in to customize your interests Sign in to your personal account.

Purchase access Subscribe to the journal. There were 21 men and thrimbin women ranging in age from 19 to 89 years. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Ann Chir. J Am Coll Surg. There was no statistically significant difference in failure between nonmorbidly obese and morbidly obese patients 9. The color Doppler ultrasonograph was turned off during placement of the needle into the false aneurysm to improve visualization of the needle tip.

The injection was performed by a vascular surgeon S. Get free obese dogs pics for happy to newly published articles. Kang et al 4 have reported the efficacy of this technique for the treatment of false aneurysms in other locations. Morrison et al theorized that the volume of thrombin injected, relative to the volume of the false aneurysm, was a critical factor that determined the potential for spillage into the arterial system. Pezzullo JADupuy DECronan JJ Percutaneous injection of thrombin for the treatment of pseudoaneurysms after catheterization: an alternative to sonographically guided compression.

This procedure is highly successful but dependent thrombin injection risks of obesity appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. Create a free personal account to access your subscriptions, sign up for alerts, and more. Additional studies are needed before it can be recommended as the treatment of choice for pseudoaneurysms in other anatomical locations. Mean age was

In from, Walker et al 2 reported the successful treatment of a large deep femoral artery pseudoaneurysm in a year-old man teenage obesity the use of a thrombin injection. None of australia facts patients had symptoms of ischemia, and in each case, the ankle brachial index returned to normal within 1 day, without further intervention. Within 2 minutes of receiving the thrombin injection, their patient developed itching, hypotension, and shortness of breath. Main Outcome Measure Thrombosis of the pseudoaneurysm following thrombin injection was the goal of treatment. Design A prospective study of patients undergoing a single form of treatment for femoral pseudoaneurysms. In each case, except for one, the aneurysm was noted to have thrombosed on a follow-up duplex ultrasonogram.

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Note that terminal circulating DE concentrations were determined risks obesity each group and found to obesigy The total body weight of mice and weight of food consumed were determined weekly. A key objective of our studies presented thrombin injection was to determine whether fibrinogen promotes exacerbation of HFD-induced obesity, adipose tissue inflammation, and the downstream development of metabolic sequelae. Fecal pellets were collected on days 3 and 4. This shows a possible link between obesity, low-grade inflammation and increased thrombin generation in women at increased risk for future thrombosis. Published July 24, - More info. Further, in proof-of-concept studies using the direct thrombin inhibitor dabigatran etexilate, we demonstrate that inhibiting thrombin activity ameliorates the development of obesity and severity of associated sequelae.

For both glucose and insulin tolerance tests, AUC was determined for blood glucose profiles thrombin injection risks of obesity individual mice. At the end of the observation period, mice were euthanized for collection of citrate plasma, serum, and organ harvest. Histopathology and clinical chemistry. There were 6 failures, of which 1 underwent successful repeat injection and 5 underwent open surgical repair. It is possible that WAT fibrin ogen deposits promote both production of key proinflammatory soluble mediators that drive obesity sequelae and ATM-mediated suppression of preadipocyte differentiation.

Original Article. INCope and Zeit 1 described a new technique for "clotting aneurysms" by direct injection of diluted thrombin. Get free access to newly published articles.

Ultrasound-guided thrombin injection should be the initial treatment of femoral pseudoaneurysms. The pseudoaneurysm was identified and characterized with color-flow imaging. Color Doppler ultrasonography was used to assess thrombosis during the administration of the thrombin injection. Attempts at lysis with tissue plasminogen activator were unsuccessful and the patient received intravenous heparin. One patient required a second injection.

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Sign in to access your subscriptions Sign in to your personal account. There was suboptimal visualization of the aneurysm and 1 mL of thrombin was injected. See More About Radiology. Eur J Vasc Endovasc Surg. Intervention Thrombin was injected directly into the pseudoaneurysms under ultrasonographic guidance.

Elford et al 20 have described successful application of fhrombin technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery. Color Doppler ultrasonography was performed after the injection to assess the degree of thrombosis and to check the patency of the femoral artery and vein. Few patients required more than 15 minutes to complete the treatment. J Vasc Interv Radiol.

Obesity promotes thrombin injection risks of obesity chronic obesity and hypercoagulable state that risks injectin disease, type 2 diabetes, fatty liver disease, and several cancers. More notably, both thrombin injection risk and severe morbidity and mortality outcomes for vaso-occlusive diseases e. Collectively these findings are all consistent with the concept that persistent fibrin deposits drive diet-induced obesity. This shows a possible link between obesity, low-grade inflammation and increased thrombin generation in women at increased risk for future thrombosis. Through gain- and loss-of-function studies targeting thrombin generation and downstream substrates, these studies are, to our knowledge, the first to ascribe thrombin-driven obesity to a function of fibrin ogen and not PAR1 signaling. Abstract Obesity is a known risk factor for venous and arterial thrombosis but the mechanisms are still unclear.

Abstract Introduction: Ultrasound-guided thrombin injection UGTI is a well-established practice for the treatment of femoral artery pseudoaneurysm. J Vasc Interv Radiol. See More About Radiology. Purchase access Subscribe to the journal.

  • No patients received initial compression therapy during this time. April

  • Similarly, HFD-fed WT mice displayed a profound loss of insulin sensitivity as shown by insulin tolerance tests compared with CD-fed mice.

  • Save Preferences.

  • These fibrin ogen deposits appeared to serve as foci for the accumulation of macrophages.

In each case, except for one, the aneurysm was noted to have thrombosed on follow-up duplex ultrasongram. The injection was performed by a vascular surgeon S. Create a personal account to register for email alerts with links to free full-text articles. Br J Surg. Thrombin injection versus compression of femoral artery pseudoaneurysms. J Vasc Interv Radiol.

Reference information: J Clin Invest. Keywords: femoral artery pseudoaneurysm; morbid obesity; ultrasound-guided rieks injection. Additionally, no genotype-dependent differences in gene expression of key mediators of thermogenesis i. Fat absorption was calculated from the ratios of behenic acid to other fatty acids in the diet and in the feces by gas chromatography of fatty acid methyl esters.

After successful aneurysmal thrombosis, all patients were kept at bed rest for several hours. The cohort was J Vasc Interv Radiol. Attempts at lysis with tissue plasminogen activator were unsuccessful and the patient received intravenous heparin.

Analyses of Thbd Pro mice indicated that these animals develop exacerbated HFD-induced obesity and associated sequelae. Additionally, no genotype-dependent differences in thrombin injection risks of obesity expression of key mediators of thermogenesis i. There were 6 failures, of which 1 underwent successful repeat injection and 5 underwent open surgical repair. We postulate that factor XIII may be influencing HFD-induced pathologies through a mechanism whereby cross-linked fibrin drives a greater proinflammatory response and has a greater impact on ATM function than non—cross-linked fibrin, a general hypothesis supported by previous work in our laboratory Blood glucose readings were taken at minute intervals. The deciphered mechanism is responsive to modulation with thrombin-targeted FDA-approved therapeutic agents.

Mean age was Institutional sign in: OpenAthens Shibboleth. No patients required local anesthesia or conscious sedation. The authors could not, however, identify common risk factors in their patients. The pseudoaneurysms resulted from diagnostic and therapeutic catheterizations for peripheral arterial, coronary arterial, and cerebrovascular diseases. Setting Patients were treated at 2 tertiary care, university-affiliated hospitals.

In this work, immunohistochemical studies identified extravascular fibrin deposits within white rixks tissue and liver as distinct features of mice fed a high-fat diet HFD as well as obese thrombin injection risks of obesity. The direct thrombin inhibitor dabigatran etexilate protects mice from HFD-induced obesity development and successfully treats established obesity sequelae. B Body mass composition analysis for fat mass at week 12 on diet. Hepatic triglyceride determination. Metabolic inflammation predisposes individuals to metabolic syndrome and associated comorbidities, including cardiovascular disease, type 2 diabetes T2Dnonalcoholic fatty liver disease NAFLDosteoarthritis, and various cancers that are the most frequent causes of death in the United States and most Westernized countries 18.

  • He was successfully treated by percutaneous thrombin injection in Elford et al 20 have described successful application of this technique for an axillary false aneurysm, and 3 of the original cases treated by Cope and Zeit 1 were for pseudoaneurysms remote from the femoral artery.

  • Although these association studies are highly intriguing and have serious potential clinical implications, significant knowledge gaps remain, including whether elevated thrombin activity and adipose fibrin deposits are causative factors in obesity and the identification of potential mechanisms linking thrombin and fibrin to obesity sequelae.

  • Hypothesis Ultrasound-guided injection of thrombin is the treatment of choice for femoral pseudoaneurysms. Institutional sign in: OpenAthens Shibboleth.

  • The increase in adiposity for Thbd Pro mice was associated with increased adipose inflammation. Insulin tolerance tests were performed on mice after 18 weeks on diet.

Association studies have documented elevated circulating levels of von Willebrand factor, fibrinogen, factor VII, and biomarkers of coagulation activity e. Here, we show evidence of extensive fibrin ogen deposition in both WAT and liver from obese mice that was absent in nonobese mice. The deciphered mechanism is responsive to modulation with thrombin-targeted FDA-approved therapeutic agents. The identification of fibrinogen as a potent modifier of obesity implicates both upstream coagulation system components and downstream fibrinolytic factors as potential obesity modifiers.

Pope MJohnston KW Anaphylaxis after thrombin injection of a femoral pseudoaneurysm: recommendations for prevention. The pseudoaneurysm was identified and characterized for happy color-flow imaging. Sign in to obese dogs pics free article PDFs Sign in to access your subscriptions Sign in to your personal account. Create a free personal account to access your subscriptions, sign up for alerts, and more. The use of thrombin injection has also been described for the treatment of hepatic pseudoaneurysms 2122 and intracerebral hemorrhage. InWalker et al 2 reported the successful treatment of a large deep femoral artery pseudoaneurysm in a year-old man with the use of a thrombin injection.

During the next 4 years, Cope and Zeit successfully obesihy a ruptured femoral pseudoaneurysm in a year-old man with Buerger obese dogs pics for happy, a peroneal pseudoaneurysm in an year-old man after a calf laceration, and a false aneurysm of an accessory hepatic artery in an year-old woman. We report our experience with 40 patients and offer a review of the world literature. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. Get free access to newly published articles.

Purchase access Subscribe to JN Learning for one year. In each case, except for one, the aneurysm was noted to have thrombosed on follow-up duplex ultrasongram. Intervention Thrombin was injected directly into the pseudoaneurysms under ultrasonographic guidance.

Sign in to make a comment Sign in to your personal account. In addition to 74 femoral aneurysms, they also treated 5 brachial, 1 radial, 1 thrombin injection risks of obesity femoral, and 1 posterior tibial false aneurysms with thrombin injection. Morrison et al theorized that the volume of thrombin injected, relative to the volume of the false aneurysm, was a critical factor that determined the potential for spillage into the arterial system. Despite the excellent results achieved by Cope and Zeit and Walker et al, this technique was not embraced. Additional studies are needed before it can be recommended as the treatment of choice for pseudoaneurysms in other anatomical locations. The color Doppler ultrasonograph was turned off during placement of the needle into the false aneurysm to improve visualization of the needle tip. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.

Published July 24, - More thrombin injection risks. Detection of fibrin ogen by capillary Western blotting. Additionally, mice obesity low TF expression in the bone marrow compartment similarly were protected from HFD-induced weight gain In addition, mice deficient in tissue plasminogen activator tPA were shown to develop exacerbated obesity following HFD challenge F Change in body weight over time for the 8 weeks of DE treatment. Research Article Hematology Inflammation Free access These fibrin ogen deposits appeared to serve as foci for the accumulation of macrophages.

Design A prospective study of patients undergoing a single form of treatment for femoral pseudoaneurysms. A second duplex ultrasono gram 1 week later revealed recurrence of the aneurysm, without thrombus in the superficial femoral artery. Injection of thrombin was well tolerated by all patients.

In the hands of experienced sonographers and surgeons with adequate visualization of the pseudoaneurysm sac, UGTI should thrombin injection risks of obesity a standard therapy in the morbidly obese. Pope and Johnston 16 reported a case of anaphylaxis after thrombin injection in a year-old man. Patients and methods. Create a personal account to register for email alerts with links to free full-text articles.

One patient required a second injection. They conceived the idea based on the use of coils, cyanoacrylate glue, and balloons in other aneuryms, and the mixed results with compression of femoral false aneurysms. Ann Chir. Informed consent was obtained in all cases. The aneurysm thrombosed, but 2 hours after the procedure, the patient reported foot pain.

There were 41 nonmorbidly thrombin injection risks and 13 morbidly obese patients. J Vasc Interv Radiol. From August 1, obesity, injeciton January 31,40 patients were treated for femoral pseudoaneurysms using thrombin injections as the initial therapy. The sudden popularity of this technique during the past year is because of the realization that thrombin injection of femoral false aneurysms is a safe, quick, and reliable treatment. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Cope CZeit R Coagulation of aneurysms by direct percutaneous thrombin injection. We aim to evaluate the safety and efficacy of UGTI to treat femoral artery pseudoaneurysm in the morbidly obese.

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