The majority of patients who suffer acute ischemic stroke (AIS) from large vessel occlusion are at a significant risk for disability or death. Because patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO) are therapeutically anticoagulated, intravenous recombinant tissue plasminogen activator is contraindicated. For AIS management, these patients must undergo emergent intra-arterial therapy. Presented is a patient on VA ECMO who subsequently suffered a large vessel embolic stroke requiring emergent surgical intervention. The decision by our anesthetic team to perform the procedure under monitored anesthesia care is discussed.
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http://dx.doi.org/10.4103/aer.AER_95_17 | DOI Listing |
Int J Surg Case Rep
January 2025
Al-Neelain University, Faculty of Medicine, Khartoum, Sudan.
Introduction And Importance: Severe aortic stenosis (AS) and chronic obstructive pulmonary disease (COPD) significantly increase perioperative morbidity and mortality. This case report discusses the challenges of managing a 75-year-old male patient with severe AS and advanced COPD undergoing elective abdominal aortic aneurysm (AAA) repair.
Case Presentation: The patient presented with a 6.
Surg Open Sci
January 2025
Division of Breast Cancer Surgery, Department of Surgery, National Cancer Institute, Bangkok, Thailand.
Background: Breast cancer is the most common cancer among women. In response to the need to hospital stays and minimize waiting time for surgery, particularly during the COVID-19 pandemic, the National Cancer Institute developed the One Day Surgery with Breast cancer Home Recovery program (ODS BHR NCI). The aim of study is to assess the success rate of breast cancer surgeries conducted through this program and to evaluate the incidence of complications.
View Article and Find Full Text PDFObstet Gynecol Surv
January 2025
Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC.
Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.
Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.
Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.
Orphanet J Rare Dis
January 2025
Department of Critical Liver Diseases, Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Background: Homozygous familial hypercholesterolaemia (HoFH) increases risk of premature cardiovascular events and cardiac death. In severe cases of HoFH, clinical signs and symptoms cannot be controlled well by non-surgical treatments, liver transplantation (LT) currently represents the viable option.
Method: To assess the clinical efficacy, prognosis, and optimal timing of LT for HoFH, a retrospective analysis was conducted on the preoperative, surgical conditions, and postoperative follow-up of children who received an LT for HoFH at the Beijing Friendship Hospital over the period from December 2014 to August 2022.
Neurosurg Rev
January 2025
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
Awake craniotomy (AC) facilitates real-time brain mapping, maximizing tumor resection while preserving critical neurological functions. This study systematically reviews the efficacy of several anesthetic protocols under Monitored Anesthesia Care (MAC) during AC, focusing on clinical outcomes. A systematic review and meta-analysis were conducted using data from observational studies and randomized trials involving AC under MAC.
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