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1

Griffin, Jane. Deep vein thrombosis and pulmonary embolism. London: Office of Health Economics, 1996.

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2

Patenaude, Jean-Victor. Les maladies thrombo-emboliques veineuses: Module d'auto-apprentissage : les thrombophlébites superficielles et profondes, les embolies pulmonaires. 2nd ed. Montréal: Presses de l'Université de Montréal, 1998.

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3

Sheares, Karen, and Joanna Pepke-Zaba. Venous thrombosis and pulmonary embolism. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0101.

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Venous thromboembolism (VTE) is a condition in which thrombus forms in a vein, commonly in the deep veins of the leg, termed deep-vein thrombosis (DVT). The thrombus may dislodge from the site of origin and be carried into the pulmonary vasculature, causing a pulmonary embolism (PE). Deep vein thrombosis and pulmonary embolism share similar predisposing factors; however, mortality is greater in those who present with PE than in those who present with DVT. Thrombi may form in other parts of the vasculature.
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4

Torbicki, Adam, Marcin Kurzyna, and Stavros Konstantinides. Pulmonary embolism. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0066.

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Pulmonary embolism is usually a consequence of deep vein thrombosis, and together the two conditions are known as venous thromboembolism. Non-thromboembolic causes of pulmonary embolism are rare. Pulmonary thromboembolism is a potentially life-threatening disease, if left untreated. This is due to a natural tendency towards early recurrence of pulmonary emboli which may lead to fatal right ventricular failure. In more severe cases, secondary right ventricular failure may result from myocardial ischaemia and injury caused by systemic hypotension and adrenergic overstimulation. Clinical presentation of pulmonary embolism is non-specific and may include dyspnoea, chest pain, haemoptysis, syncope, hypotension, and shock. Patients with suggestive history, symptoms, and signs require an immediate triage which determines further management strategy. Computerized tomographic angiography has become the mainstay of diagnosis. However, depending on the clinical presentation, treatment decisions may also be made based on results from other tests. In particular, in high-risk patients with persistent hypotension or shock, bedside echocardiography may be the only available test to identify patients in need of primary thrombolysis, surgical embolectomy, or percutaneous intervention which will stabilize the systemic cardiac output. For most normotensive patients, anticoagulation is sufficient as initial treatment. However, in the presence of signs of right ventricular dysfunction and myocardial injury monitoring is recommended to allow prompt rescue reperfusion therapy in case of haemodynamic decompensation.
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5

Torbicki, Adam, Marcin Kurzyna, and Stavros Konstantinides. Pulmonary embolism. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199687039.003.0066_update_001.

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Pulmonary embolism is usually a consequence of deep vein thrombosis, and together the two conditions are known as venous thromboembolism. Non-thromboembolic causes of pulmonary embolism are rare. Pulmonary thromboembolism is a potentially life-threatening disease, if left untreated. This is due to a natural tendency towards early recurrence of pulmonary emboli which may lead to fatal right ventricular failure. In more severe cases, secondary right ventricular failure may result from myocardial ischaemia and injury caused by systemic hypotension and adrenergic overstimulation. Clinical presentation of pulmonary embolism is non-specific and may include dyspnoea, chest pain, haemoptysis, syncope, hypotension, and shock. Patients with suggestive history, symptoms, and signs require an immediate triage which determines further management strategy. Computerized tomographic angiography has become the mainstay of diagnosis. However, depending on the clinical presentation, treatment decisions may also be made based on results from other tests. In particular, in high-risk patients with persistent hypotension or shock, bedside echocardiography may be the only available test to identify patients in need of primary thrombolysis, surgical embolectomy, or percutaneous intervention which will stabilize the systemic cardiac output. For most normotensive patients, anticoagulation is sufficient as initial treatment. However, in the presence of signs of right ventricular dysfunction and myocardial injury monitoring is recommended to allow prompt rescue reperfusion therapy in case of haemodynamic decompensation.
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6

Torbicki, Adam, Marcin Kurzyna, and Stavros Konstantinides. Pulmonary embolism. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0066_update_002.

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Pulmonary embolism is usually a consequence of deep vein thrombosis, and together the two conditions are known as venous thromboembolism. Non-thromboembolic causes of pulmonary embolism are rare. Pulmonary thromboembolism is a potentially life-threatening disease, if left untreated. This is due to a natural tendency towards early recurrence of pulmonary emboli which may lead to fatal right ventricular failure. In more severe cases, secondary right ventricular failure may result from myocardial ischaemia and injury caused by systemic hypotension and adrenergic overstimulation. Clinical presentation of pulmonary embolism is non-specific and may include dyspnoea, chest pain, haemoptysis, syncope, hypotension, and shock. Patients with suggestive history, symptoms, and signs require an immediate triage which determines further management strategy. Computerized tomographic angiography has become the mainstay of diagnosis. However, depending on the clinical presentation, treatment decisions may also be made based on results from other tests. In particular, in high-risk patients with persistent hypotension or shock, bedside echocardiography may be the only available test to identify patients in need of primary thrombolysis, surgical embolectomy, or percutaneous intervention which will stabilize the systemic cardiac output. For most normotensive patients, anticoagulation is sufficient as initial treatment. However, in the presence of signs of right ventricular dysfunction and myocardial injury monitoring is recommended to allow prompt rescue reperfusion therapy in case of haemodynamic decompensation.
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7

Torbicki, Adam, Marcin Kurzyna, and Stavros Konstantinides. Pulmonary embolism. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0066_update_003.

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Abstract:
Pulmonary embolism is usually a consequence of deep vein thrombosis, and together the two conditions are known as venous thromboembolism. Non-thromboembolic causes of pulmonary embolism are rare. Pulmonary thromboembolism is a potentially life-threatening disease, if left untreated. This is due to a natural tendency towards early recurrence of pulmonary emboli which may lead to fatal right ventricular failure. In more severe cases, secondary right ventricular failure may result from myocardial ischaemia and injury caused by systemic hypotension and adrenergic overstimulation. Clinical presentation of pulmonary embolism is non-specific and may include dyspnoea, chest pain, haemoptysis, syncope, hypotension, and shock. Patients with suggestive history, symptoms, and signs require an immediate triage which determines further management strategy. Computerized tomographic angiography has become the mainstay of diagnosis. However, depending on the clinical presentation, treatment decisions may also be made based on results from other tests. In particular, in high-risk patients with persistent hypotension or shock, bedside echocardiography may be the only available test to identify patients in need of primary thrombolysis, surgical embolectomy, or percutaneous intervention which will stabilize the systemic cardiac output. For most normotensive patients, anticoagulation is sufficient as initial treatment. However, in the presence of signs of right ventricular dysfunction and myocardial injury monitoring is recommended to allow prompt rescue reperfusion therapy in case of haemodynamic decompensation.
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8

Singer, Mervyn. Pathophysiology and causes of pulmonary embolism. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0170.

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Pulmonary embolus is predominantly due to thrombus breaking off from deep veins or from within the right heart, lodging within large or small vessels within the pulmonary vasculature, causing a variable degree of clinical features ranging from asymptomatic through to shock and cardiac arrest. Non-thrombotic causes include air or fat embolism. Outcome is predicated by the degree of right ventricular dysfunction. There are multiple risk factors including surgery, arrhythmias, prolonged immobility, venous stasis, pregnancy and an underlying pro-thrombotic tendency, either congenital or acquired. Numerous risk stratification scores have been developed derived from clinical features, imaging findings and biochemical markers of right ventricular strain and myocardial damage.
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9

Irani, Zubin, and Sara Zhao. Dual and Balloon-Assisted AngioJet Thrombectomy for Iliofemoral Deep Venous Thrombosis. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0038.

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Lower extremity deep venous thrombosis (DVT) may be complicated by pulmonary embolism, post-thrombotic syndrome, and phlegmasia cerulea dolens. Due to these complications, the American Venous Forum now recommends thrombus removal for large or symptomatic thrombus burden. The AngioJet Solent Proxy and Omni thrombectomy sets are indicated for use in iliofemoral and lower extremity veins with a diameter ≥3 mm. The device has quickly become a preferred device among the available mechanical thrombectomy options. The AngioJet system has been demonstrated as both efficacious and safe as a method of thrombectomy in lower extremity DVT. This chapter discusses two techniques to utilize the AngioJet device in iliofemoral DVT.
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10

Watson, Max, Caroline Lucas, Andrew Hoy, and Jo Wells. Palliative haematological aspects. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199234356.003.0023.

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This chapter on palliative haematological aspects covers anaemia in chronic disorders, blood transfusion, erythropoietin, bleeding and haemorrhage, blood products, bleeding directly related to cancer, haemoptysis, haematemesis, rectal bleeding, haematuria, massive terminal haemorrhage, thromboembolism, deep vein thrombosis (DVT), pulmonary embolism (PE), chronic venous thrombosis, warfarin in patients with cancer, and developing a good relation with haematology colleagues.
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11

Warwick, David. Prevention of thrombosis in orthopaedic surgery. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.0006.

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♦ The risk–benefit of thromboprophylaxis in orthopaedic surgery remains unclear♦ Some conditions, such as major trauma, carry a much higher risk than others, such as routine knee replacement♦ Some patients appear to be genetically more predisposed than others♦ In trials of efficacy of thromboembolism, the use of deep vein thrombosis as a surrogate endpoint for death from a pulmonary embolus may not be completely reliable♦ There is a variety of mechanical and chemical methods available, each of which has real and potential advantages as well as real and potential dangers♦ Even the length of time that a patient is at risk after major surgery is unclear♦ Clinicians should adhere to guidelines where possible.
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12

Patel, Mikin V., and Steven Zangan. Femoral Retrieval of Conical Filters. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0056.

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Inferior vena cava (IVC) filters are a safe, effective treatment option for the prevention of pulmonary embolism in patients who either have contraindication to or fail anticoagulation. However, filters pose long-term risks, such as IVC thrombosis, deep vein thrombosis, penetration of the IVC wall, filter fracture, and filter migration. IVC filters should be retrieved once the indication for placement has passed. However, cervical access frequently becomes compromised. This chapter reviews strategies for retrieving IVC filters from a femoral approach. Various techniques are discussed, including snaring the filter struts and the use of bilateral femoral sheaths to recapture the IVC filter.
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13

Plotnik, Adam N., and Stephen Kee. Femoral Flip Technique for Removal of the G2 Filter. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0055.

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The purpose of temporary retrievable inferior vena cava (IVC) filters is to provide protection from pulmonary emboli while the patient is at risk while simultaneously avoiding the long-term complications that result from permanent filters. In addition to the complications of filter fracture and caval penetration, there is an increasing incidence of recurrent deep vein thrombosis and caval occlusion following filter placement; therefore, whenever possible, retrieval of IVC filters should be attempted. The “femoral flip” technique may be employed for difficult G2 IVC filter retrievals where standard techniques have failed, usually due to either one of the legs or the hook becoming embedded in the wall.
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14

Wilson-MacDonald, James, and Andrew James. Complications of fractures. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012002.

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♦ Fat embolism syndrome is defined as the presence of globules of fat in the lungs and in other tissues and occurs occasionally in long bone fractures♦ Reflex sympathetic dystrophy is characterized by intense prolonged pain, vasomotor disturbance, delayed functional recovery, and trophic changes♦ Avascular necrosis typically affects intra-articular bone after fracture and can occur in up to 70% of displaced talar neck fractures♦ Immobility associated with recovery from fracture is associated with deep vein thrombosis, which carries a risk of pulmonary embolism, and should be treated with anti-coagulants♦ Gas gangrene is a rapidly-spreading infection of devitalized tissue, removal of the affected area and treatment with penicillin is required♦ Compartment syndrome within a closed compartment can result in tissue ischaemia and necrosis followed by fibrosis and muscle contracture
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15

Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for orthopaedic surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0007.

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Arthritis and falls are common in the elderly and hence lead to major bone and joint surgery. Elderly patients may suffer from significant cardiorespiratory, renal, and neurologic dysfunction, and they may be malnourished; therefore, preoperative assessment is essential. Both general and regional anaesthesia techniques are commonly used, but regional anaesthesia, with or without sedation, is preferred. The use of cement during surgery is known to be associated with intraoperative morbidities, as is the use of a tourniquet. Antibiotics are routinely used, but they must be administered before the tourniquet is inflated. The incidence of deep vein thrombosis and pulmonary embolism is high, and prophylaxis should be considered. Blood loss may be excessive, especially during revision surgery; measures should be taken to minimize blood loss. Regional technique, with or without opioids, provides good analgesia. Patient-controlled analgesia (PCA) with an opioid remains a useful method where possible.
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