Publications by authors named "Bashir Riyaz"
Article Synopsis
- Exercise intolerance after a pulmonary embolism can stem from lingering blockages in the lungs, leading to a condition known as chronic thromboembolic pulmonary disease, potentially with pulmonary hypertension.
- The case study showcases a methodical way to assess functional limitations resulting from these blockages.
- It highlights the importance of using cardiopulmonary exercise testing to evaluate the severity and impact of the residual obstruction on exercise capacity.
Article Synopsis
- Chronic thromboembolic pulmonary hypertension (CTEPH) can occur when acute pulmonary embolism does not fully resolve, and the study investigates whether changes in CT Hounsfield Unit gradient (HU-Δ) can indicate low cardiac index (CI).
- A retrospective analysis of 237 CTEPH patients revealed that higher HU-Δ values between the main pulmonary artery (MPA) and both the left atrium (LA) and left ventricle (LV) were associated with low CI, showing distinct statistical differences.
- The study found that certain HU-Δ thresholds could effectively predict low CI, demonstrating high sensitivity and reproducibility, suggesting these measurements might be useful markers in clinical
Article Synopsis
- Catheter-based treatments are becoming important for both acute and chronic pulmonary blood clots, making it essential to understand the anatomy of pulmonary arterial branches.* -
- A study of 179 patients undergoing angiography showed a variety of branching patterns in the pulmonary arteries, with a total of 7 patterns in the right upper lobe, 3 in the right middle lobe, and so on across the left lobes.* -
- Notably, only 2-3 branching patterns per lobe were responsible for over 90% of the observed variations, offering valuable insights for medical professionals and future research in pulmonary interventions.*
Article Synopsis
- - Since the first case series over 30 years ago, balloon pulmonary angioplasty (BPA) has evolved into a safe and effective treatment for chronic thromboembolic pulmonary hypertension.
- - Despite its safety, BPA still carries a small risk of complications that need quick identification and management.
- - The main complications linked to BPA include pulmonary vascular injury and reperfusion pulmonary edema.
Article Synopsis
- - The study analyzed outcomes of intravascular ultrasound (IVUS) versus non-IVUS in patients undergoing peripheral vascular intervention (PVI) using data from the National Readmission database between 2016 and 2019.
- - It involved a large cohort (434,901 hospitalizations) and found no significant difference in major amputation rates at 6 months between both groups, with amputation rates being 2.17% for IVUS and 2.71% for non-IVUS.
- - However, in specific subgroups, namely patients with rest pain, those receiving iliac interventions, or those with drug-eluting stents, IVUS use was associated with significantly lower major amputation rates.
Pelvic venous obstruction (PVO), defined as greater than 50% stenosis or occlusion of pelvic veins, is a known risk factor for deep vein thrombosis (DVT). DVT is a known risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), but the prevalence of PVO in CTEPH is unknown. This cross-sectional study at Temple University's tertiary referral center for Pulmonary Hypertension, Right Heart Failure, and CTEPH sought to identify the presence of PVO in patients with CTEPH who underwent cardiac catheterization, pulmonary angiography, and venography.
View Article and Find Full Text PDFImpact of reperfusion therapies on clot resolution and long-term outcomes in patients with pulmonary embolism.
J Vasc Surg Venous Lymphat Disord
May 2024
Objective: Major progress in reperfusion strategies has substantially improved the short-term outcomes of patients with pulmonary embolism (PE), however, up to 50% of patients report persistent dyspnea after acute PE.
Methods: A retrospective study of the PE response team registry and included patients with repeat imaging at 3 to 12 months. The primary outcome was to determine the incidence of residual pulmonary vascular obstruction following acute PE.
Racial and gender disparities in the management of acute pulmonary embolism.
J Vasc Surg Venous Lymphat Disord
May 2024
Article Synopsis
- The study evaluated differences in treatment and outcomes for acute pulmonary embolism (PE) based on race and sex among 129,445 patients from 2016 to 2019.
- Results showed that Black and Hispanic patients, along with female patients, faced higher odds of in-hospital mortality, major bleeding events, and longer hospital stays compared to White male patients.
- Additionally, these minority groups were significantly less likely to receive catheter-directed thrombolysis (CDT), indicating a need for improved healthcare equity and intervention strategies.
Article Synopsis
- The inferior vena cava (IVC) and superior vena cava play crucial roles in returning blood from the body to the heart, and interruptions in these vessels can lead to stasis and increased risk of deep vein thrombosis (DVT) and pulmonary embolism (PE).
- This study reviewed causes of IVC and superior vena cava interruption, including congenital issues like IVC agenesis, which heightens the risk of DVT, especially in younger patients.
- Modern management predominantly involves vena cava filters for patients at risk of thromboembolism who cannot take anticoagulants, moving away from older surgical methods that posed significant risks and complications.
Article Synopsis
- * Results showed a significant decrease in occlusions: segmental occlusions dropped from 40.5% to 11.7% and proximal occlusions from 28.7% to 11.0% within 48 hours post-treatment.
- * The improvement in segmental artery occlusions was linked to a reduction in right ventricular size, indicating a potential benefit of PM-CDT in lowering mortality risk associated with PE.
Racial and ethnic disparities in inferior vena cava filter placement for deep vein thrombosis in the United States.
J Vasc Surg Venous Lymphat Disord
January 2024
Article Synopsis
- The study aimed to investigate racial and ethnic disparities in the rates of inferior vena cava filter (IVCF) placements among Black and Latino patients with acute proximal lower extremity deep vein thrombosis (DVT) in the U.S. from 2016 to 2019.
- It analyzed data from 134,499 DVT patients, finding that 14.1% received IVCFs, with the majority being White (67.3%), followed by Black (18.8%) and Latino (8.9%) patients.
- The results showed a decrease in IVCF placements across all groups over time, with significant statistical disparities in placement rates, particularly noting that Black patients had higher rates (11-12/100,000
Association of vena cava filters and catheter-directed thrombolysis for deep vein thrombosis with hospital readmissions.
J Vasc Surg Venous Lymphat Disord
January 2024
Background: Acute deep vein thrombosis (DVT) affects >350,000 patients each year in the United States. Contemporary rehospitalization rates and predictors of acute DVT have not been well-characterized. We aimed to evaluate the all-cause 30-day readmission rate and its association with catheter-directed thrombolysis and vena cava filters in patients with proximal and caval DVT.
View Article and Find Full Text PDFHigh-risk acute pulmonary embolism (PE), defined as acute PE associated with hemodynamic instability, remains a significant contributor to cardiovascular morbidity and mortality in the United States and worldwide. Historically, anticoagulant therapy in addition to systemic thrombolysis has been the mainstays of medical therapy for the majority of patients with high-risk PE. In efforts to reduce the morbidity and mortality, a wide array of interventional and surgical therapies has been developed and employed in the management of these patients.
View Article and Find Full Text PDFAcute limb ischemia (ALI) has been a rare complication of acute myocardial infarction (AMI), however, with the increasing use of mechanical circulatory devices it is seen more frequently. The incidence and predictors of ALI in patients with AMI in contemporary clinical practice are unknown. A retrospective review of patients with index hospitalization for AMI in the Nationwide Readmission Database from 2016 to 2019 was done.
View Article and Find Full Text PDFObjectives: We sought to evaluate the efficacy and safety of refined balloon pulmonary angioplasty (BPA) in the treatment of patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Background: BPA is rapidly evolving therapeutic option for patients with nonsurgical CTEPH. There are few US studies that have reported on the outcomes of this novel therapeutic option.
Introduction: Right ventricular dysfunction (RVD) is a key component in the process of risk stratification in patients with acute pulmonary embolism (PE). Echocardiography remains the gold standard for RVD assessment, however, measures of RVD may be seen on CTPA imaging, including increased pulmonary artery diameter (PAD). The aim of our study was to evaluate the association between PAD and echocardiographic parameters of RVD in patients with acute PE.
View Article and Find Full Text PDFSpontaneous coronary artery dissection (SCAD) is an important cause of acute myocardial infarction (AMI); however, the prevalence of SCAD and its predictors in AMI are unknown. We sought to derive and validate a simple score that can help predict SCAD in patients with AMI. We analyzed the Nationwide Readmissions Database and created a risk score for SCAD in patients with an index hospitalization for AMI.
View Article and Find Full Text PDFObjective: The mainstay of therapy for patients with venous thromboembolic disease (VTE) is anticoagulation. In the inpatient setting, majority of these patients are treated with heparin or low molecular weight heparin. The prevalence and outcomes of heparin-induced thrombocytopenia (HIT) in hospitalized patients with venous thromboembolic disease (VTE) is unknown.
View Article and Find Full Text PDFObjective: Pulmonary infarction is a common clinical and radiographic finding in acute pulmonary embolism (PE), yet the clinical relevance and prognostic significance of pulmonary infarction remain unclear. The study aims to investigate the clinical features, radiographic characteristics, impact of reperfusion therapy and outcomes of patients with pulmonary infarction.
Design, Setting And Participants: A retrospective cohort study of 496 adult patients (≥18 years of age) diagnosed with PE who were evaluated by the PE response team at a tertiary academic referral centre in the USA.
Article Synopsis
- Pulmonary embolism (PE) can show a wide range of symptoms, from none at all to severe hemodynamic collapse, despite similar appearances of clots in imaging tests.
- The authors aimed to find a link between the age of the blood clots and the patients' clinical symptoms by examining the clots under a microscope.
- They studied 13 thrombectomy samples from PE patients to determine the age of the thrombus based on its microscopic features and how it related to the patients' clinical outcomes.
Objective: To describe the incidence and predictors of acute limb ischemia (ALI) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS).
Methods: Patients with index hospitalizations for AMI complicated by cardiogenic shock from 2016 to 2019 in the US National Readmission Database were identified. We evaluated the incidence of ALI and its associated mortality, length of stay, and cost of hospitalization.
Background: Catheter-directed thrombolysis (CDT) has been associated with rapid recovery of right ventricular (RV) function. The Bashir catheter was developed for enhanced thrombolysis in large vessels such as the pulmonary arteries (PAs) with lower doses of tissue plasminogen activator (tPA).
Objectives: The aim of this study was to evaluate the efficacy and safety of tPA infused using a pharmacomechanical (PM) CDT device called the Bashir endovascular catheter in patients with intermediate-risk acute pulmonary embolism (PE).