A 23 year old woman presented with sudden onset retrosternal chest pain following an attempt to move a heavy object from her vehicle. Multiple fractured struts of an inferior vena cava filter were identified in the distal right and left pulmonary artery branches, and in the free wall of the right ventricle. A small pericardial effusion was noted. Because of the depth of penetration into the right ventricle, it was perceived not to be amenable to endovascular retrieval. Over several days of observation, she continued to have progressive retrosternal and left shoulder pain. She underwent exploratory sternotomy and extraction of a strut that was partially protruding from the right ventricle and abrading the diaphragmatic pericardium. The patient recovered quite well and was discharged on the third postoperative day.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0183-8) contains supplementary material, which is available to authorized users.
A 53 year-old male presented with a one-day history of a swollen arm and dull, aching pain in the right upper extremity. The patient reported commencing exercising daily over the prior week with a modified, oscillating dumbbell; commonly referred to as a Shake Weight. Imaging revealed an occlusive thrombus in the right axillary, proximal brachial and basilic veins. The patient was treated with a 24-hour tPA infusion followed by mechanical thrombectomy, balloon angioplasty, and stent placement for a residual thrombus and stenosis. The patient was discharged the following day on warfarin and aspirin. This is the first report of effort-induced thrombosis of the upper extremity following the use of a modified, oscillating dumbbell. Due to the growing popularity of modified dumbbells and the possible risk for axillary vein thrombosis, consideration should be made to caution consumers of this potential complication.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-015-0264-3) contains supplementary material, which is available to authorized users.
the study has completed enrollment from 17 surgeons at 11 sites in Germany, the UK, France and Spain. Followup at 1 month, 3 months and 6 months was completed by 67, 56 and 39 patients, respectively. The study reported enrollment of 72% male and 90% white patients with a median body mass index of 28.5 and age of 64 years. Most patients (72%) were predialysis with 76% of patients on dialysis using a central venous catheter. No device-related complications were reported to date. Maturation rate was achieved in 92% of patients at the 3-month follow-up with 6-month primary patency of 88%. Subsequent 6-month interim analysis of the fully enrolled cohort will be completed by June 2020.Conclusions: This interim analysis of a multinational European study expands on the previous prospective study by demonstrating high patency and maturation rates for both brachiocephalic and radiocephalic patients. Interim results from completed 6-month follow-up are expected to be ready for presentation by June 2020.
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