New York Methodist Hospital

About: New York Methodist Hospital is a healthcare organization based out in Brooklyn, New York, United States. It is known for research contribution in the topics: Myocardial infarction & Percutaneous coronary intervention. The organization has 948 authors who have published 936 publications receiving 29954 citations.

Lupus Anticoagulant Syndrome: A Case Report

Abstract: Thromboses of the deep veins (DVT) and potential complications are disorders with which physicians need to be well familiarized so they can be recognized and managed. Hypercoagulable states play a significant role in the development of DVT and these disorders must be suspect when thrombosis occurs, especially in the upper extremities. Antiphospholipid antibody syndrome (APS) is one such hypercoagulable state in which autoantibodies are formed against anionic phospholipid complexes. In vivo, these antibodies cause a hypercoagulable state through a number of proposed mechanisms, whereas in vitro they interfere with the assembly of phospholipid complexes, thereby inhibiting coagulation and prolonging various clotting times. Though appearing to be anticoagulated on ancillary testing, patients with APS are actually in a pro-thrombotic state requiring treatment with the anticoagulants heparin and warfarin. This case discussion focuses on the recognition and treatment of thrombotic events in the setting of APS.

Occlusion artérielle aiguë après injection écho-guidée de thrombine dans un faux anévrisme de l'artère fémorale commune à collet large et court

Abstract: L'injection echo-guidee de thrombine (IEGT) a emerge comme modalite de choix du traitement des faux anevrismes compliquant les interventions arterielles femorales percutanees. L'IEGT est sure et efficace, avec peu de complications. Une thrombose des arteres natives a rarement ete rapportee dans la litterature apres IEGT et habituellement attribuee a l'injection excessive de thrombine. Nous rapportons un cas de thrombose de l'artere femorale se produisant apres IEGT d'un faux anevrisme post-catheterisme de 4 cm avec un collet large et court traitee avec succes par intervention chirurgicale. La grande taille du collet de ce faux anevrysme a probablement contribue au developpement de cette complication.

Where's the flap?

Abstract: We present a case of aortic intramural hematoma (IMH) in an elderly woman who presented with sudden onset of mid-scapular pain. The patient underwent a series of multimodality imaging studies before the diagnosis of IMH was evident by cardiovascular magnetic resonance, which is rapidly becoming the gold standard in the evaluation of acute aortic disease due to its high spatial resolution and ability to characterize tissue composition. Early diagnosis and prompt treatment is critical in improving the outcome of patients with IMH.

Response to Letters Regarding Article, “Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound–Derived Coronary Atheroma Burden”

Abstract: We thank Dr Kaneda and Drs Sutton, Blumenthal, and Kapur for their interest and commentaries on our analysis.1 In response to Dr Kaneda’s request for sensitivity analyses, we applied the same conservative assumptions employed in the intravascular ultrasound (IVUS) analysis2 to all noncompleters and to those with ischemic events and found that statistically significant regression occurred in both percentage diameter stenosis (%DS) and minimum lumen diameter. With regard to the assessment of disease progression, as in previous quantitative coronary angiography (QCA) studies that we referenced,3 the prespecified outcome variable was the change in baseline stenoses >25%. This is very reasonable because some studies have shown that only progression of stenoses present at baseline was predictive of coronary events.4 In A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound–Derived Coronary Atheroma Burden (ASTEROID), 379 of the 507 randomized patients (75%) had both a baseline and a follow-up QCA study. Sixteen of these patients (4.2%) developed a new lesion of >25% stenosis that represented an increase of at least 20% from baseline. Of those 379 patients, the 292 (77%) with baseline …

Minimally Invasive Therapies for Hepatocellular Cancer: Catheter-Directed Therapies

Abstract: Techniques have been developed for catheter-directed delivery of therapy for hepatocellular carcinoma (HCC) since the 1980s, and are still undergoing evolution. Currently, this involves embolization with particles, as well as delivery of chemotherapeutic agents with a variety of materials, and is referred to as transarterial chemoembolization (TACE). TACE is made both feasible and effective due to the dual blood supply of the liver. Advances in catheter and guide wire technology have been accompanied by the development of techniques for the superselective placement of catheters for the safe and effective delivery of therapeutic agents to hepatic tumors. TACE is recommended for patients with Intermediate Stage, multi-nodular HCC (Okuda Stage 1–2; Childs-Pugh Stage A-B; Performance Status 0). Combination therapy with RFA and TACE may lead to more extensive tumor necrosis than mono-ablative therapy and may be a more effective treatment for HCC. Further study will be needed to determine the effectiveness of combining RFA and TACE, and in which order. The combination of TACE with antiangiogenic agents, such as sorafenib, is under investigation as well. The use of sorafenib may curtail the post-TACE rise in VEGF-mediated signaling, and simultaneously target tumor foci distant from the site of treatment. Selection parameters and treatment outcomes for locoregional therapies, alone or in combination, such as thermal ablation and TACE, with or without systemic chemotherapy agents will eventually be factored in generating Digital Patient Models (DPMs) to facilitate diagnosis, prognosis, and treatment selection, i.e. Model Guided Therapy (MGT) and Predictive, Preventive and Personalized Medicine (PPPM).