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9. Predictors of Residual Pulmonary Vascular Obstruction after Acute Pulmonary Embolism Based on Patient Variables and Treatment Modality.

Author

Ho, Truong-An Andrew, Pescatore, Jay, Lio, Ka U., Rali, Parth, Criner, Gerard, and Gayen, Shameek

Subjects
RIGHT ventricular dysfunction, PULMONARY embolism, UNIVARIATE analysis, LUNG diseases, CHRONIC diseases
Abstract

Background: Residual Pulmonary Vascular Obstruction (RPVO) is an area of increasing focus in patients with acute pulmonary embolism (PE) due to its association with long-term morbidity and mortality. The predictive factors and the effect catheter-directed therapies (CDT) have on RPVO are still under investigation. Methods: This is a single-center retrospective review between April 2017 and July 2021. Patients with intermediate risk of PE were included. Patient variables associated with RPVO were analyzed and the degree of clot burden was quantified using the Qanadli score. Results: A total of 551 patients with acute PE were identified, 288 were intermediate risk and 53 had RPVO based on CT or V/Q scan three months post-PE. Baseline clot burden was higher in patients who received CDT compared to those who received anticoagulation alone (Qanadli score 45.88% vs. 31.94% p < 0.05). In univariate analysis, treatment with CDT showed a HR of 0.32 (95% CI 0.21–0.50, p < 0.001) when compared with anticoagulation alone. Patient variables including intermediate-high risk, sPESI ≥ 1, elevated biomarkers, RV dysfunction on imaging, malignancy, history of or concurrent DVT were also significantly associated with development of RPVO in univariate analysis. In multivariable analysis, only baseline Qanadli score (HR 13.88, 95% CI 1.42–135.39, p = 0.02) and concurrent DVT (HR 2.53, 95% CI 1.01–6.40, p = 0.04) were significantly associated with the development of RPVO. Conclusions: Catheter-directed therapy may be associated with a reduced risk of RPVO at 3 months; however, quantitative clot burden scores, such as the Qanadli score, may be stronger predictors of the risk of developing RPVO at 3 months. Further prospective studies are required [ABSTRACT FROM AUTHOR]

Published
2024
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10. Pulmonary endarterectomy

Author

Mangukia, Chirantan, Rali, Parth, Desai, Parag, Ku, Tse-Shuen Jade, Brann, Stacey, Patel, Shrey, Sunagawa, Gengo, Minakata, Kenji, Kehara, Hiromu, and Toyoda, Yoshiya

Published
2021
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13. Epidemiology of Pulmonary Embolism

Author

Alashram, Rami, Male, Eneida, Rali, Parth, Rounds, Sharon I.S., Series Editor, Dixon, Anne, Series Editor, Schnapp, Lynn M., Series Editor, Rivera-Lebron, Belinda, editor, and Heresi, Gustavo A., editor

Published
2020
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14. Incidence of venous thromboembolism in coronavirus disease 2019: An experience from a single large academic center

Author

Mishkin, Aaron, Abba, Abbas, Pathak, Abhijit S., Rastogi, Abhinav, Diamond, Adam, Satti, Aditi, Simon, Adria, Soliman, Ahmed, Braveman, Alan, Mamary, Albert J., Pandya, Aloknath, Goldberg, Amy, Kambo, Amy, Gangemi, Andrew, Vaidya, Anjali, Davison, Ann, Basil, Anuj, Kosmider, Beata, Bakhos, Charles T., Cornwell, Bill, Sanguily, Brianna, Corso, Brittany, Grabianowski, Carla, Sedlock, Carly, Myers, Catherine, Bakhos, Charles, Reddy Mandapati, Chenna Kesava, Erkmen, Cherie, Gangireddy, Chethan, Lin, Chih-ru, Burks, Christopher T., Raab, Claire, Crabbe, Deborah, Chen, Crystal, Edmundowicz, Daniel, Sacher, Daniel, Salerno, Daniel, Simon, Daniele, Ambrose, David, Ciccolella, David, Gillman, Debra, Fehrle, Dolores, Morano, Dominic, Bassler, Donnalynn, Cronin, Edmund, Dominguez, Eduardo, Randhawa, Ekam, Randhawa, Ekamjeet, Hamad, Eman, Male, Eneida, Narewski, Erin, Cordova, Francis, Jaffe, Frederic, Kueppers, Frederich, Dikengil, Fusun, Galli, Jonathan, Garfield, Jamie, Jones, Gayle, Calendo, Gennaro, Criner, Gerard, D'Alonzo, Gilbert, Marmolejos, Ginny, Gordon, Matthew, Millio, Gregory, Gupta, Rohit, Gustavo, Fernandez, Simborio, Hannah, Scott, Harwood, Shore-Brown, Heidi, Alvarado, Hernan, Yeung, Ho-Man, Yousef, Ibraheem, Oriaku, Ifeoma, Lee, Iris Jung-won, Whitman, Isaac, Brown, James, Garfield, Jamie L., Mokha, Janpreet, Gallagher, Jason, Stewart, Jeffrey, Murray, Jenna, Tang, Jessica, Gonzalez, Jeyssa, Wu, Jichuan, Thomas, Jiji, Murrett, Jim, Beros, Joanna, Travaline, John M., Varghese, Jolly, Senchak, Jordan, Lambert, Joseph, Ramzy, Joseph, Cooper, Joshua, Song, Jun, Chowdhury, Junad, Kennedy, Kaitlin, Bahmed, Karim, Loukmane, Karim, Shenoy, Karthik, Brennan, Kathleen, Johnson, Keith, Carney, Kevin, Schreyer, Kraftin, Criner, Kristin, Kumaran, Maruti, Miller, Lauren, Jameson, Laurie, Johnson, Laurie, Kilpatrick, Laurie, Criner, Lii-Yoong, Zhang, Lily, McGann, Lindsay K., Samuels, Llera A., Diamon, Marc, Kerper, Margaret, Sanchez, Maria Vega, Marcinkienwicz, Mariola, Pedlar, Maritza, Aksoy, Mark, Weir, Mark, Wolfson, Marla R., Wolfson, Marla, Marron, Robert, Keane, Martin, Zantah, Massa, Zheng, Mathew, Delfiner, Matthew, Patel, Maulin, Healy, Megan, Darnell, Melinda, Navaro, Melissa, Brisco-Bacik, Meredith A., Bromberg, Michael, Gannon, Michael, Jacobs, Michael, Mandal, Mira, Gou, Nanzhou, Marchetti, Nathaniel, Xander, Nathaniel, Kaur, Navjot, Nadpara, Neil, Desai, Nicole, Mills, Nicole, Shigemura, Norihisa, Rehbini, Ohoud, O'Corragain, Oisin, Sheriff, Omar, Arosarena, Oneida, Abramian, Osheen, Stanley, Paige, Desai, Parag, Rali, Parth, Mulhall, Patrick, Patil, Pravin, Varghe, Priju, Dubal, Puja, Patel, Puja, Blair, Rachael, Rengan, Rajagopalan, Alashram, Rami, Hooper, Randol, Armbruster, Rebecca A., Sheriden, Regina, Caricchio, Roberto, Thomas, Rogers, Soans, Rohit, Petrov, Roman, Prosniak, Roman, Fajardo, Romulo, Bhutani, Ruchi, Townsend, Ryan, Islam, Sabrina, Pettigrew, Samantha, Wallace, Samantha, Sehgal, Sameep, Krachman, Samuel, Dhungana, Santosh, Hoang, Sarah, Duffy, Sean, Rani, Seema, William, Shapiro, Weaver, Sheila, Benny, Shelu, George, Sheril, Sun, Shuang, Srivastava-Malhotra, Shubhra, Brictson, Stephanie, Spivack, Stephanie, Tittaferrante, Stephanie, Yerkes, Stephanie, Priest, Stephen, Codella, Steve, Kelsen, Steven G., Houser, Steven, Verga, Steven, Bolla, Sudhir, Kotnala, Sudhir, Karhadkar, Sunil, Johnson, Sylvia, Shariff, Tahseen, Jacobs, Tammy, Hooper, Thomas, Rogers, Tom, Reed, Tony S., Ku, Tse-Shuen, Sajjan, Uma, Kim, Victor, Cabey, Whitney, Chatila, Wissam, Li, Wuyan, Dorey-Stein, Zach, Dorey-Stein, Zachariah, Repanshek, Zachary D., Oresanya, Lawrence, Yu, Daohai, Weiss, Robert, Ali, Nadia, Stack, Anthony, Lubitz, Andrea L., Panaro, Joseph, Bashir, Riyaz, Lakhter, Vladimir, Dass, Chandra, Maruti, Kumaran, Lu, Xiaoning, Rao, A. Koneti, Cohen, Gary, Criner, Gerard J., and Choi, Eric T.

Published
2021
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33. Asthma: Newer Tx options mean more targeted therapy: It's an exciting era of asthma management, with the introduction of several novel modalities, including biological therapy and bronchial thermoplasty

Author

Rali, Parth M., Baffour-Awuah, Nana Yaa, Gupta, Rohit, Rali, Grishma, and Rali, Mayur

Subjects
United States. Food and Drug Administration -- Management, BT Group PLC -- Management, Reslizumab -- Health aspects, Anti-inflammatory agents -- Health aspects, Tiotropium -- Health aspects, Benralizumab -- Health aspects, Indacaterol -- Health aspects, Olodaterol -- Health aspects, Omalizumab -- Health aspects, Asthma -- Drug therapy, Telecommunications industry -- Health aspects, Inflammation, Inhalers, Respiratory system agents, Corticosteroid drugs, Immunotherapy, Telecommunications services industry, Company business management, Health
Abstract

Recent advances in our understanding of asthma pathophysiology have led to the development of new treatment approaches to this chronic respiratory condition, which affects 25 million Americans or nearly 8% [...]

Published
2020

35. Barriers and facilitators to interhospital transfer of acute pulmonary embolism: An inductive qualitative analysis

Author

DeBerry, Jacob, Rali, Parth, McDaniel, Michael, Kabrhel, Christopher, Rosovsky, Rachel, Melamed, Roman, Friedman, Oren, Elwing, Jean M., Balasubramanian, Vijay, Sahay, Sandeep, Bossone, Eduardo, Farmer, Mary Jo S., Klein, Andrew J. P., Hamm, Megan E., Ross, Charles B., Rivera-Lebron, Belinda N., Deberry, Jacob, Rali, Parth, Mcdaniel, Michael, Kabrhel, Christopher, Rosovsky, Rachel, Melamed, Roman, Friedman, Oren, Elwing, Jean M, Balasubramanian, Vijay, Sahay, Sandeep, Bossone, Eduardo, Farmer, Mary Jo S, Klein, Andrew J P, Hamm, Megan E, Ross, Charles B, and Rivera-Lebron, Belinda N

Subjects
catheter–directed thrombolysi, interhospital transfer, pulmonary embolism response team, pulmonary embolism, surgical embolectomy, General Medicine
Abstract

BackgroundInterhospital transfer (IHT) of patients with acute life-threatening pulmonary embolism (PE) is necessary to facilitate specialized care and access to advanced therapies. Our goal was to understand what barriers and facilitators may exist during this transfer process from the perspective of both receiving and referring physicians.MethodsThis qualitative descriptive study explored physician experience taking care of patients with life threatening PE. Subject matter expert physicians across several different specialties from academic and community United States hospitals participated in qualitative semi-structured interviews. Interview transcripts were subsequently analyzed using inductive qualitative description approach.ResultsFour major themes were identified as barriers that impede IHT among patients with life threatening PE. Inefficient communication which mainly pertained to difficulty when multiple points of contact were required to complete a transfer. Subjectivity in the indication for transfer which highlighted the importance of physicians understanding how to use standardized risk stratification tools and to properly triage these patients. Delays in data acquisition were identified in regards to both obtaining clinical information and imaging in a timely fashion. Operation barriers which included difficulty finding available beds for transfer and poor weather conditions inhibiting transportation. In contrast, two main facilitators to transfer were identified: good communication and reliance on colleagues and dedicated team for transferring and treating PE patients.ConclusionThe most prominent themes identified as barriers to IHT for patients with acute life-threatening PE were: (1) inefficient communication, (2) subjectivity in the indication for transfer, (3) delays in data acquisition (imaging or clinical), and (4) operational barriers. Themes identified as facilitators that enable the transfer of patients were: (1) good communication and (2) a dedicated transfer team. The themes presented in our study are useful in identifying opportunities to optimize the IHT of patients with acute PE and improve patient care. These opportunities include instituting educational programs, streamlining the transfer process, and formulating a consensus statement to serve as a guideline regarding IHT of patients with acute PE.

Published
2023

39. Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism

Author

O’Corragain, Oisin, primary, Alashram, Rami, additional, Millio, Gregory, additional, Vanchiere, Catherine, additional, Hwang, John Hojoon, additional, Kumaran, Maruti, additional, Dass, Chandra, additional, Zhao, Huaqing, additional, Panero, Joseph, additional, Lakhter, Vlad, additional, Gupta, Rohit, additional, Bashir, Riyaz, additional, Cohen, Gary, additional, Jimenez, David, additional, Criner, Gerard, additional, and Rali, Parth, additional

Published
2023
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41. Pharmacomechanical Catheter-Directed Thrombolysis With the Bashir Endovascular Catheter for Acute Pulmonary Embolism

Author

Bashir, Riyaz, primary, Foster, Malcolm, additional, Iskander, Ayman, additional, Darki, Amir, additional, Jaber, Wissam, additional, Rali, Parth M., additional, Lakhter, Vladimir, additional, Gandhi, Ripal, additional, Klein, Andrew, additional, Bhatheja, Rohit, additional, Ross, Charles, additional, Natarajan, Kannan, additional, Nanjundappa, Aravinda, additional, Angle, John F., additional, Ouriel, Kenneth, additional, Amoroso, Nancy E., additional, Firth, Brian G., additional, Comerota, Anthony J., additional, Piazza, Gregory, additional, Rosenfield, Kenneth, additional, and Sista, Akhilesh K., additional

Published
2022
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42. Reply

Author

Bashir, Riyaz, primary, Piazza, Gregory, additional, Rali, Parth M., additional, Lakhter, Vladimir, additional, and Sista, Akhilesh, additional

Published
2022
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47. Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis

Author

Fleitas Sosa, Derlis, primary, Lehr, Andrew L., additional, Zhao, Huaqing, additional, Roth, Stephanie, additional, Lakhther, Vlad, additional, Bashir, Riyaz, additional, Cohen, Gary, additional, Panaro, Joseph, additional, Maldonado, Thomas S., additional, Horowitz, James, additional, Amoroso, Nancy E., additional, Criner, Gerard J., additional, Brosnahan, Shari B., additional, and Rali, Parth, additional

Published
2022
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