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[PMID]:29298357
[Au] Autor:Chen Y; Deng X; Shan X; Xing Y
[Ad] Endereço:Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
[Ti] Título:Study of helical flow inducers with different thread pitches and diameters in vena cava.
[So] Source:PLoS One;13(1):e0190609, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary embolism is a severe, potentially life-threatening condition. Inferior vena cava filters have been used to prevent recurrent pulmonary embolisms. However, the build-up of thrombosis in vena cava filters after deployment presents a severe problem to patients. Previous studies proposed that filters with helical flow are beneficial and capable of alleviating this problem. In this study, the hemodynamic performances of four typical helical flow inducers in the vena cava are determined using computational fluid dynamics simulations (steady-state and pulsatile flow) and compared. Pilot in vitro experiments were also conducted. The simulation results demonstrate that large-diameter inducers produce helical flow. Among inducers with identical diameter, those with a smaller thread pitch are more likely to induce increased helical flow. We also observed that the small thread pitch inducers can yield higher shear rates. Furthermore, a large diameter, small thread pitch helical flow inducer increases the time-averaged wall shear stress and reduces the oscillating shear index and relative residence time on the vessel wall in the vicinity of the helical flow inducer. In vitro experiments also verify that large diameter inducers generate a helical flow. A notable observation of this study is that the diameter is the key parameter that affects the induction of a helical flow. This study will likely provide important guidance for the design of interventional treatments and the deployment of filters associated with helical flow in the vena cava.
[Mh] Termos MeSH primário: Embolia Pulmonar/prevenção & controle
Filtros de Veia Cava
[Mh] Termos MeSH secundário: Desenho de Equipamento
Hemodinâmica
Seres Humanos
Técnicas In Vitro
Modelos Cardiovasculares
Projetos Piloto
Embolia Pulmonar/patologia
Recidiva
Tomografia Computadorizada por Raios X
Filtros de Veia Cava/efeitos adversos
Veia Cava Inferior/diagnóstico por imagem
Veia Cava Inferior/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190609


  2 / 2605 MEDLINE  
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[PMID]:27771319
[Au] Autor:Davies RS
[Ad] Endereço:The Department of Vascular Surgery, Leicester Royal Infirmary, Leicester, UK. Electronic address: robert.davies@uhl-tr.nhs.uk.
[Ti] Título:Commentary on 'Retrievable Inferior Cava Filters in Trauma Patients: Prevalence and Management of Thrombus Within the Filter'.
[So] Source:Eur J Vasc Endovasc Surg;52(6):838, 2016 12.
[Is] ISSN:1532-2165
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Kava
Filtros de Veia Cava
[Mh] Termos MeSH secundário: Remoção de Dispositivo
Seres Humanos
Prevalência
Embolia Pulmonar
Trombose
Veia Cava Inferior
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  3 / 2605 MEDLINE  
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[PMID]:29180170
[Au] Autor:Carlin MN; Daneshpajouh A; Catino J; Bukur M
[Ad] Endereço:Department of Trauma & Critical Care, Delray Medical Center, Nova Southeastern University, Delray Beach, Florida; Department of General Surgery, Larkin Community Hospital, Nova Southeastern University, South Miami, Florida. Electronic address: margoca@pcom.edu.
[Ti] Título:Money well spent? A cost and utilization analysis of prophylactic inferior vena cava filter placement in high-risk trauma patients.
[So] Source:J Surg Res;220:105-111, 2017 Dec.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Inferior vena cava filters (IVCF) for venous thromboembolic prophylaxis in high-risk trauma patients is a controversial practice. Utilization of IVCF prophylaxis was evaluated at a level 1 trauma center. Daily cost of IVCF prophylaxis, time to IVCF, duration between IVCF and chemoprophylaxis, and number of patients needed to treat (NNT) to prevent pulmonary embolism (PE) was calculated. METHODS: A retrospective review of prophylactic IVCF over a 5-year period (2010-2014). Demographic, physiologic, injury, procedural, and outcome data were abstracted from the administrative trauma database. Medicare fees and days without chemoprophylaxis were used to determine daily IVCF cost. NNT was calculated using PE events in a cohort without IVCF. RESULTS: Over the 5-year period, 146 patients with mean age 56.3 y (SD ± 24.2), 67.8% male, underwent prophylactic IVCF. Predominant mechanisms of injuries were falls (45.9%) and motor vehicle accidents (20.5%) with median Injury Severity Score of 25 (intraquartile range [IQR] 16-29) and head Abbreviated Injury Score of 3 (IQR 3-5). Most common operative interventions required in 24.7% were orthopedic (25.3%) and neurosurgical (21.9%). Median time to IVCF was 78 h (IQR 48-144). Most common IVCF indications were closed head injury (48.6%) and spinal injuries (30.8%). Median time to administration of chemoprophylaxis was 96 h after IVCF (IQR 24-192) in 57.5%. Median IVCF cost was $759/d (IQR $361-$1897) compared with $4.32 for chemoprophylaxis. PE occurred in 0.26% without IVCF. PE did not occur with prophylactic IVCF. Estimated NNT was 379 (95% CI 265, 661). CONCLUSIONS: Prophylactic IVCF placement is a costly practice with relatively low benefit. Anticipated time without chemoprophylaxis and patient criteria should be considered before routine IVCF placement.
[Mh] Termos MeSH primário: Custos e Análise de Custo
Embolia Pulmonar/prevenção & controle
Filtros de Veia Cava/economia
Filtros de Veia Cava/utilização
Veia Cava Inferior/cirurgia
[Mh] Termos MeSH secundário: Acidentes por Quedas/economia
Acidentes de Trânsito/economia
Adulto
Idoso
Idoso de 80 Anos ou mais
Anticoagulantes/uso terapêutico
Feminino
Traumatismos Cranianos Fechados/cirurgia
Seres Humanos
Escala de Gravidade do Ferimento
Masculino
Medicare
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Traumatismos da Coluna Vertebral/cirurgia
Fatores de Tempo
Centros de Traumatologia/economia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29029715
[Au] Autor:Steinberger JD; Genshaft SJ
[Ad] Endereço:Dotter Interventional Institute, Oregon Health Sciences University, Portland, OR. Electronic address: steinbej@ohsu.edu.
[Ti] Título:The Role of Inferior Vena Cava Filters in Pulmonary Embolism.
[So] Source:Tech Vasc Interv Radiol;20(3):197-205, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary embolism (PE) is a cause of significant morbidity and mortality, with an estimated 600,000 cases of clinically significant PE in the United States annually, and roughly 200,000 deaths per annum directly attributable to PE. By far the most frequent cause of PE is deep vein thrombosis originating in the lower extremities, which travels to the pulmonary vasculature. The mainstay of treatment is anticoagulation, but multiple additional treatments exist for patients in whom anticoagulation is inadequate or contraindicated. The absolute indications for inferior vena cava (IVC) filtration are narrow, but many filters are placed in patients with relative indications. There is growing concern for overuse of IVC filters, with a relatively low rate of retrieval. It is essential for interventional radiologists to understand the appropriate and correct use and retrieval of IVC filters. Familiarity with placement techniques, protocols and techniques for retrieval, current and emerging technologies, and the clinical model for management of venous thromboembolism, will ensure that interventional radiologists remain an integral member of the care team for these often complex patients.
[Mh] Termos MeSH primário: Embolia Pulmonar/terapia
Filtros de Veia Cava
Veia Cava Inferior
[Mh] Termos MeSH secundário: Remoção de Dispositivo
Seres Humanos
Flebografia
Desenho de Prótese
Embolia Pulmonar/diagnóstico
Embolia Pulmonar/fisiopatologia
Radiografia Intervencionista
Fatores de Risco
Resultado do Tratamento
Veia Cava Inferior/diagnóstico por imagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


  5 / 2605 MEDLINE  
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[PMID]:29029711
[Au] Autor:Shemin RJ
[Ad] Endereço:Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA. Electronic address: Rshemin@mednet.ucla.edu.
[Ti] Título:Surgical Embolectomy for Massive and Submassive Pulmonary Embolism and Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension.
[So] Source:Tech Vasc Interv Radiol;20(3):175-178, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Surgical therapy for massive acute pulmonary embolism has improved with the use of rapid response teams and selective bedside extracorporeal membrane oxygenation initiation. The chronic consequence of unresolved pulmonary embolism is a treatable form of pulmonary hypertension. Pulmonary thromboendarterectomy is a curative operation in selected cases, operated upon in an experienced center with the multidisciplinary team including imaging, pulmonary medicine, and cardiothoracic surgery.
[Mh] Termos MeSH primário: Embolectomia
Endarterectomia
Hipertensão Pulmonar/cirurgia
Artéria Pulmonar/cirurgia
Embolia Pulmonar/cirurgia
Trombectomia
[Mh] Termos MeSH secundário: Doença Crônica
Angiografia por Tomografia Computadorizada
Embolectomia/efeitos adversos
Embolectomia/mortalidade
Endarterectomia/efeitos adversos
Endarterectomia/mortalidade
Hemodinâmica
Seres Humanos
Hipertensão Pulmonar/diagnóstico
Hipertensão Pulmonar/mortalidade
Hipertensão Pulmonar/fisiopatologia
Equipe de Assistência ao Paciente
Artéria Pulmonar/diagnóstico por imagem
Artéria Pulmonar/fisiopatologia
Embolia Pulmonar/diagnóstico por imagem
Embolia Pulmonar/mortalidade
Embolia Pulmonar/fisiopatologia
Recidiva
Fatores de Risco
Trombectomia/efeitos adversos
Trombectomia/mortalidade
Fatores de Tempo
Resultado do Tratamento
Filtros de Veia Cava
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


  6 / 2605 MEDLINE  
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[PMID]:29029709
[Au] Autor:Hsu N; Wang T; Friedman O; Barjaktarevic I
[Ad] Endereço:Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, Los Angeles, CA.
[Ti] Título:Medical Management of Pulmonary Embolism: Beyond Anticoagulation.
[So] Source:Tech Vasc Interv Radiol;20(3):152-161, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary embolism (PE) is a common medical condition that carries significant morbidity and mortality. Although diagnosis, anticoagulation, and interventional clot-burden reduction strategies represent the focus of clinical research and care in PE, appropriate risk stratification and supportive care are crucial to ensure good outcomes. In this chapter, we will discuss the medical management of PE from the time of presentation to discharge, focusing on the critical care of acute right ventricular failure, anticoagulation of special patient populations, and appropriate follow-up testing after acute PE.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Coagulação Sanguínea/efeitos dos fármacos
Insuficiência Cardíaca/terapia
Embolia Pulmonar/terapia
Disfunção Ventricular Direita/terapia
[Mh] Termos MeSH secundário: Doença Aguda
Testes de Coagulação Sanguínea
Terapia Combinada
Cuidados Críticos
Monitoramento de Medicamentos
Insuficiência Cardíaca/etiologia
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Valor Preditivo dos Testes
Embolia Pulmonar/sangue
Embolia Pulmonar/complicações
Embolia Pulmonar/diagnóstico
Respiração Artificial
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Triagem
Filtros de Veia Cava
Disfunção Ventricular Direita/etiologia
Disfunção Ventricular Direita/fisiopatologia
Função Ventricular Direita
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


  7 / 2605 MEDLINE  
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[PMID]:28935036
[Au] Autor:Bikdeli B; Chatterjee S; Desai NR; Kirtane AJ; Desai MM; Bracken MB; Spencer FA; Monreal M; Goldhaber SZ; Krumholz HM
[Ad] Endereço:Division of Cardiology, Department of Medicine, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut. Electronic address: bb2813@cumc.columbia.edu.
[Ti] Título:Inferior Vena Cava Filters to Prevent Pulmonary Embolism: Systematic Review and Meta-Analysis.
[So] Source:J Am Coll Cardiol;70(13):1587-1597, 2017 Sep 26.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. OBJECTIVES: The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. METHODS: The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE. Inverse variance fixed-effects models with odds ratio (OR) as the effect measure were used for primary analyses. Main outcomes included subsequent PE, PE-related mortality, all-cause mortality, and subsequent deep vein thrombosis (DVT). RESULTS: The authors' search retrieved 1,986 studies, of which 11 met criteria for inclusion (6 RCTs and 5 prospective observational studies). Quality of evidence for RCTs was low to moderate. Overall, patients receiving IVC filters had lower risk for subsequent PE (OR: 0.50; 95% confidence interval [CI]: 0.33 to 0.75); increased risk for DVT (OR: 1.70; 95% CI: 1.17 to 2.48); nonsignificantly lower PE-related mortality (OR: 0.51; 95% CI: 0.25 to 1.05); and no change in all-cause mortality (OR: 0.91; 95% CI: 0.70 to 1.19). Limiting the results to RCTs showed similar results. Findings were substantively similar across a wide range of sensitivity analyses. CONCLUSIONS: Very few prospective controlled studies, with limited quality of evidence, exist regarding the efficacy and safety of IVC filters. Overall, filters appear to reduce the risk of subsequent PE, increase the risk for DVT, and have no significant effect on overall mortality.
[Mh] Termos MeSH primário: Embolia Pulmonar/prevenção & controle
Filtros de Veia Cava
Tromboembolia Venosa/complicações
[Mh] Termos MeSH secundário: Seres Humanos
Embolia Pulmonar/etiologia
Veia Cava Inferior
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170923
[St] Status:MEDLINE


  8 / 2605 MEDLINE  
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[PMID]:28807405
[Au] Autor:Carroll BJ; Pemberton H; Bauer KA; Chu LM; Weinstein JL; Levarge BL; Pinto DS
[Ad] Endereço:Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Initiation of a Multidisciplinary, Rapid Response Team to Massive and Submassive Pulmonary Embolism.
[So] Source:Am J Cardiol;120(8):1393-1398, 2017 Oct 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary embolism (PE) can result in rapid clinical decompensation in many patients. With increasing patient complexity and advanced treatment options for PE, multidisciplinary, rapid response teams can optimize risk stratification and expedite management strategies. The Massive And Submassive Clot On-call Team (MASCOT) was created at our institution, which comprised specialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. MASCOT offers rapid consultation 24 hours a day with a web-based conference call to review patient data and discuss management of patients with high-risk PE. We reviewed patient data collected from MASCOT's registry to analyze patient clinical characteristics and outcomes and describe the composition and operation of the team. Between August 2015 and September 2016, MASCOT evaluated 72 patients. Seventy of the 72 patients were admitted to our institution, accounting for 32% of all patients discharged with a primary diagnosis of PE. Average age was 62 ± 17 years with a female predominance (63%). Active malignancy (31%), recent surgery or trauma (21%), and recent hospitalization (24%) were common. PE clinical severity was massive in 16% and submassive in 83%. Patients were managed with anticoagulation alone in 65% (n = 46), systemic fibrinolysis in 11% (n = 8), catheter-directed therapy in 18% (n = 13), extracorporeal membrane oxygenation in 3% (n = 2), and an inferior vena cava filter was placed in 15% (n = 11). Thirteen percent (n = 9) experienced a major bleed with no intracranial hemorrhage. Survival to discharge was 89% (64% with massive PE and 93% with submassive PE). In conclusion, multidisciplinary, rapid response PE teams offer a unique coordinated approach to patient care.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Oxigenação por Membrana Extracorpórea/métodos
Equipe de Assistência ao Paciente/normas
Embolia Pulmonar/terapia
Trombectomia/métodos
Terapia Trombolítica/métodos
Filtros de Veia Cava
[Mh] Termos MeSH secundário: Feminino
Seguimentos
Seres Humanos
Masculino
Massachusetts/epidemiologia
Meia-Idade
Embolia Pulmonar/mortalidade
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE


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[PMID]:28676581
[Au] Autor:Tao MJ; Roche-Nagle G
[Ad] Endereço:Division of Vascular Surgery (Tao, Roche-Nagle), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network; Faculty of Medicine (Tao), University of Toronto, Toronto, Ont.
[Ti] Título:Complications after long-term inferior vena cava filter placement.
[So] Source:CMAJ;189(26):E892, 2017 07 04.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Embolia Pulmonar/prevenção & controle
Filtros de Veia Cava/efeitos adversos
Veia Cava Inferior
Trombose Venosa/etiologia
[Mh] Termos MeSH secundário: Adulto
Inibidores do Fator Xa/uso terapêutico
Seres Humanos
Masculino
Pirazóis/uso terapêutico
Piridonas/uso terapêutico
Tomografia Computadorizada por Raios X
Trombose Venosa/diagnóstico por imagem
Trombose Venosa/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridones); 3Z9Y7UWC1J (apixaban)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.161031


  10 / 2605 MEDLINE  
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[PMID]:28566600
[Au] Autor:Takahashi N; Isoda K; Hiki M; Fujimoto S; Daida H
[Ad] Endereço:Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
[Ti] Título:Thrombolytic Therapy and Aspiration of Clots were Effective in the Removal of a Transient Inferior Vena Cava (IVC) Filter that Captured a Large Thrombus.
[So] Source:Intern Med;56(11):1369-1373, 2017.
[Is] ISSN:1349-7235
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:A 37-year-old woman presented at 37 weeks of gestation with a history of heaviness in her left leg. Enhanced computed tomography revealed a left extensive ileofemoral thrombus, and we employed a transient inferior vena cava (IVC) filter (t-IVCF) before delivery. Although we attempted to remove the t-IVCF on the day after delivery, a large thrombus was captured in the filter. We therefore performed thrombolytic therapy for one week, but a few small clots remained within the t-IVCF. We were ultimately able to remove the t-IVCF under constant negative pressure by aspiration from a side-hole of the sheath. We herein describe the effectiveness of this aspiration technique in our case.
[Mh] Termos MeSH primário: Terapia Trombolítica/métodos
Filtros de Veia Cava
Trombose Venosa/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.2169/internalmedicine.56.8175



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