Interventional recanalization therapy in patients with non-cirrhotic, non-malignant portal vein thrombosis: comparison between transjugular versus transhepatic access

Abstract Purpose To compare the safety and outcome of transjugular versus percutaneous technique in recanalization of non-cirrhotic, non-malignant portal vein thrombosis. Methods We present a retrospective bicentric analysis of 21 patients with non-cirrhotic, non-malignant PVT, who were treated between 2016 and 2021 by interventional recanalization via different access routes (percutaneous [PT] vs. transjugular in transhepatic portosystemic shunt [TIPS] technique). Complication rates with a focus on periprocedural bleeding and patency as well as outcome were compared. Results Of the 21 patients treated (median age 48 years, range of 19–78), seven (33%) patients had an underlying prothrombotic condition. While 14 (57%) patients were treated for acute PVT, seven (43%) patients had progressive thrombosis with known chronic PVT. Nine patients underwent initial recanalization via PT access and twelve via TIPS technique. There was no significant difference in complete technical success rate according to initial access route (55.5% in PT group vs. 83.3% in TIPS group, p = 0.331). However, creation of an actual TIPS was associated with higher technical success in restoring portal venous flow (86.6% vs. 33.3%, p = 0.030). 13 (61.9%) patients received thrombolysis. Nine (42.8%) patients experienced hemorrhagic complications. In a multivariate analysis, thrombolysis (p = 0.049) and PT access as the first procedure (p = 0.045) were significant risk factors for bleeding. Conclusion Invasive recanalization of the portal vein in patients with PVT and absence of cirrhosis and malignancy offers a good therapeutic option with high recanalization and patency rates. Bleeding complications result predominantly from a percutaneous access and high amounts of thrombolytics used; therefore, recanalization via TIPS technique should be favored.

Download Full-text

Determination of Platelets Parameters among People Vaccinated with Oxford-AstraZeneca Vaccine - COVID Vaccine at Khartoum State -Sudan

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59a34301 ◽

2021 ◽

pp. 529-535

Author(s):

Wafa Salah Eldein Ibrahim Mohamed ◽

Elharam Ibrahim Abdallah ◽

Alaa Eltayeb Omer ◽

Lienda Bashier Eltayeb

Keyword(s):

Statistical Analysis ◽

Side Effects ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Muscle Pain ◽

Healthcare Providers ◽

Vein Thrombosis ◽

Significant Difference ◽

And Gender

Background: The global SARS-CoV-2 vaccination program has been hampered by the rare-and initially inexplicable emergence of vaccine-associated thrombosis, particularly venous territory strokes or other venous obstructions, including portal vein thrombosis, which has been dubbed Vaccine-Induced Thrombotic Thrombocytopenia (VITT). So, this study was conducted to determine platelets parameters among people vaccinated with the AstraZeneca vaccine at Khartoum state. Materials & Methods: A total of 50 AstraZeneca vaccinated participants (22 male and 26 female) were utilized as a case and 50 healthy non-vaccinated participants (21 male and 29 female) were used as control. The age of both groups ranged between (20-62) years with a mean of 34.6 ± 11.9. Platelets parameters were assayed for all patients using Sysmex KX-21. Results: The statistical analysis was performed by using SPSS. The results of the study showed that there was no significant difference in platelets count and platelets indices when compared according to vaccine intake and gender. Also, the most frequent symptoms among vaccinated people were: muscle pain at the site of puncture (56%), fatigue (54%), fever (34%), headache (22%), nausea (16%), and diarrhea (6%) respectively and developed no symptoms (30%). Conclusions: The study concludes that the side effects of the COVID-19 AstraZeneca vaccine in Khartoum state, Sudan was consistent with the manufacturers’ data. Healthcare providers and recipients of vaccines can be more confident about the safety of Oxford-AstraZeneca COVID-19 vaccines.

Download Full-text

Graft and patient survival in portal vein thrombosis in living donor liver transplantation

QJM ◽

10.1093/qjmed/hcaa050.070 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M Ramadan ◽

N M Hytham ◽

K K Mamdouh ◽

A M Fathy

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Lower Survival Rate ◽

Donor Liver Transplantation ◽

Vein Thrombosis ◽

Life Saving ◽

Significant Difference ◽

Group A ◽

Group B ◽

Stay Hospital

Abstract Background and Rational To date, only few studies have evaluated the benefits of anticoagulation in individuals with cirrhosis. An obvious goal of anticoagulation is PV recanalization: when cirrhotic individuals with PVT are treated with anticoagulation, complete recanalization has been described in 33–45% while partial PV recanalization is observed in 15–35% of cases. LDLT has emerged as the alternative life-saving treatment to DDLT. Over the past 2 decades, the number of LDLTs has steadily increased in many transplant centers, especially in Asia. The separation between occlusive and non-occlusive thrombosis is very important; in patients with partial PVT, post-transplant mortality outcomes are no different from non-PVT patients but it is significantly increased in patients with complete PVT. Patients and Methods This randomized prospective study will include 79 patients who will undergo LDLT in Ain Shams Specialized and Egypt Air hospitals, there are two groups of patients according to presence of portal vein thrombosis or not group A 39 patients of non PVT and group B 40 patient of PVT including different grades of PVT according Yerdel classification. Results In this study, there is no significant difference between groups regard age but Males were significantly associated with group B. In this study, there is no significant difference between groups regard CHILD and MELD scores and this findings. In our study there is no significantly difference between groups A and B regarding ICU stay, hospital stay and cell saver. In this study, comparisons of the PVT patients and controls showed no statistical significant differences regard HA thrombosis, post operative pulmonary embolism and biliary leak but PV rethrombosis is significantly associated with PVT patients, mortality sig associated with PVT patients. Conclusion The outcomes of patients with PVT who underwent LDLT are inferior to those without PVT. Patients with PVT has lower survival rate, higher postoperative PV rethrombosis.

Download Full-text

Comparison of Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Cirrhosis With or Without Portal Vein Thrombosis: A Retrospective Study

Frontiers in Medicine ◽

10.3389/fmed.2021.737984 ◽

2021 ◽

Vol 8 ◽

Author(s):

Hong-Liang Wang ◽

Wei-Jie Lu ◽

Yue-Lin Zhang ◽

Chun-Hui Nie ◽

Tan-Yang Zhou ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Variceal Bleeding ◽

Meld Score ◽

Refractory Ascites ◽

Complication Rates ◽

Vein Thrombosis ◽

Portosystemic Shunts ◽

Shunt Dysfunction ◽

End Stage

Aim: The purpose of our study was to conduct a retrospective analysis to compare the effectiveness of transjugular intrahepatic portosystemic shunts (TIPS) in the treatment of patients with cirrhosis with or without portal vein thrombosis (PVT).Methods: We included a total of 203 cirrhosis patients successfully treated with TIPS between January 2015 and January 2018, including 72 cirrhosis patients with PVT (35.5%) and 131 without PVT (64.5%). Our subjects were followed for at least 1 year after treatment with TIPS. Data were collected to estimate the mortality, shunt dysfunction, and complication rates after TIPS creation.Results: During the mean follow-up time of 19.5 ± 12.8 months, 21 (10.3%) patients died, 15 (7.4%) developed shunt dysfunction, and 44 (21.6%) experienced overt hepatic encephalopathy (OHE). No significant differences in mortality (P = 0.134), shunt dysfunction (P = 0.214), or OHE (P = 0.632) were noted between the groups. Age, model for end-stage liver disease (MELD) score, and refractory ascites requiring TIPS were risk factors for mortality. A history of diabetes, percutaneous transhepatic variceal embolization (PTVE), 8-mm diameter stent, and platelet (PLT) increased the risk of shunt dysfunction. The prevalence of variceal bleeding and recurrent ascites was comparable between the two groups (16.7 vs. 16.7% P = 0.998 and 2.7 vs. 3.8% P = 0.678, respectively).Conclusions: Transjugular intrahepatic portosystemic shunts are feasible in the management of cirrhosis with PVT. No significant differences in survival or shunt dysfunction were noted between the PVT and no-PVT groups. The risk of recurrent variceal bleeding, recurrent ascites, and OHE in the PVT group was generally similar to that in the no-PVT group. TIPS represents a potentially feasible treatment option in cirrhosis patients with PVT.

Download Full-text

Portal vein thrombosis post-splenectomy in thalassemia major patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1645 ◽

2019 ◽

Vol 10 (4) ◽

pp. 3356-3368

Author(s):

Kussay M. Abbas Zwain ◽

Samer M. Mohamed Al-Hakkak ◽

Alaa A. Al-Wadees ◽

Zainab Mahdi Majeed

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Female Gender ◽

Thalassemia Major ◽

Spleen Weight ◽

P Value ◽

Vein Thrombosis ◽

Significant Difference ◽

The Mean ◽

Wbc Count

β-thalassemia major is a chronic, inherited hematological disease that leads to chronic anemia in the affected children. One of the options of treatment in such patients was splenectomy; however, it is not without risk of many complications; one of them is the thrombotic events. A prospective study of 55 patients with β-thalassemia inscribes in this study. 14 patients (25.5%) had a normal thrombocyte count and 41 patients (74.5%) have an abnormally high thrombocytes count which was significantly associated with PVT (P. Value <0.001), Regarding the WBC count, it extended between 4000 to more than 30,000, in both genders with non-statistically significant differences between both genders, (P>0.05). Regarding the serum ferritin, the mean level was 2908.5 ± 1024.3 ng/ml. In males, the mean S. Ferritin was relatively higher than that of females, 3167.6 ± 1841.3 mg/dl, and 2573.8 ± 1150.6 ng/ml. The weight of the spleen was up to 1500 grams in 25 (80.6%) of males and 20 (83.3 %) of females while it was more than 1500 grams in the remaining and females and males, without a significant difference statistically in the spleen weight of, (P>0.05). The most frequent presenting symptom was abdominal pain. It was founded in 46 patients (83.6%), followed by fever in 76.4%, diarrhea in 58.2%, and Nausea and vomiting in 31 (56.4%). 3 patients out of the 55 (5.5%) developed portal vein thrombosis in their follow up period. Post splenectomy PVT in thalassemia the patient is relatively frequent (5.5%) complication that require a high degree of doubt for diagnosis early, especially in patients with postoperative pain of the abdomen within 2 months after surgery, Female gender, Large spleen and postoperative increase number of platelets are risk factors for PVT so one can initiate surveillance by Doppler ultrasound postoperatively and start antiplatelet prophylactic therapy immediately for such patients.

Download Full-text

Portal vein thrombosis in patients with hepatosplenic schistosomiasis who underwent oesophagogastric devascularization combined with splenectomy

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trab013 ◽

2021 ◽

Author(s):

Guilherme G L Cançado ◽

Mateus J Nardelli ◽

Fernanda A Barbosa ◽

Catherine F Silva ◽

Fernanda M F Osório ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Surgical Approach ◽

Odds Ratio ◽

Independent Risk Factor ◽

Hospital Admissions ◽

Vein Thrombosis ◽

Significant Difference ◽

Β Blocker ◽

Hepatosplenic Schistosomiasis

Abstract Background Portal vein thrombosis (PVT) has been described in nearly 50% of patients who underwent oesophagogastric devascularization combined with splenectomy (EGDS), but no previous study has compared its occurrence in surgical and non-surgical groups. This study aimed to investigate PVT in hepatosplenic schistosomiasis (HSS) and its association with EGDS and upper variceal bleeding (UVB). Methods Retrospectively, 104 HSS individuals were enrolled. Following EGDS, the occurrence of PVT, mesenteric vein thrombosis (MVT), hospital admissions and UVB were recorded. Results EGDS was performed in 27 (26%) patients. PVT and MVT were detected in 30 (33%) and 8 (9.8%) patients, respectively. Patients who underwent EGDS were at greater risk of PVT (63% vs 19.7%; odds ratio [OR] 6.12 [95% confidence interval {CI} 2.3 to 16.1], p<0.001) when compared with a non-surgical approach. There was no significant difference in UVB occurrence and β-blocker usage. PVT was associated with more hospital admissions (p=0.030) and higher alkaline phosphatase levels (p=0.008). UVB occurrence in patients with and without thrombosis was similar. In multivariate analysis, after adjustment, PVT was associated with the surgical approach (OR 4.56 [95% CI 1.55 to 13.38], p=0.006) and age at HSS diagnosis (OR 0.94 [95% CI 0.90 to 0.99], p=0.021). Conclusions EGDS was not associated with a decreased frequency of UVB when compared with the non-surgical approach but was an independent risk factor for PVT.

Download Full-text

Comparison of Non-Tumoral Portal Vein Thrombosis Management in Cirrhotic Patients: TIPS Versus Anticoagulation Versus No Treatment

Journal of Clinical Medicine ◽

10.3390/jcm10112316 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2316

Author(s):

Chenyang Zhan ◽

Vinay Prabhu ◽

Stella K. Kang ◽

Clayton Li ◽

Yuli Zhu ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Liver Function Tests ◽

Bleeding Complications ◽

Imaging Data ◽

Vein Thrombosis ◽

Intrahepatic Portosystemic Shunt ◽

Cirrhotic Patients ◽

Anticoagulated Patients

Background: There is a lack of consensus in optimal management of portal vein thrombosis (PVT) in patients with cirrhosis. The purpose of this study is to compare the safety and thrombosis burden change for cirrhotic patients with non-tumoral PVT managed by transjugular intrahepatic portosystemic shunt (TIPS) only, anticoagulation only, or no treatment. Methods: This single-center retrospective study evaluated 52 patients with cirrhosis and non-tumoral PVT managed by TIPS only (14), anticoagulation only (11), or no treatment (27). The demographic, clinical, and imaging data for patients were collected. The portomesenteric thrombosis burden and liver function tests at early follow-up (6–9 months) and late follow-up (9–16 months) were compared to the baseline. Adverse events including bleeding and encephalopathy were recorded. Results: The overall portomesenteric thrombosis burden improved in eight (72%) TIPS patients, three (27%) anticoagulated patients, and two (10%) untreated patients at early follow-up (p = 0.001) and in seven (78%) TIPS patients, two (29%) anticoagulated patients, and three (17%) untreated patients in late follow-up (p = 0.007). No bleeding complications attributable to anticoagulation were observed. Conclusion: TIPS decreased portomesenteric thrombus burden compared to anticoagulation or no treatment for cirrhotic patients with PVT. Both TIPS and anticoagulation were safe therapies.

Download Full-text

A221 CLINICAL CHARACTERISITICS OF PORTAL VEIN THROMBOSIS AMONG AN INPATIENT COHORT WITH CIRRHOSIS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.219 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 254-255

Author(s):

K Dadgar ◽

E M Kelly

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Bleeding Complications ◽

P Value ◽

Optimal Management ◽

Bacterial Peritonitis ◽

Vein Thrombosis ◽

Risk Of Bleeding ◽

Increased Risk ◽

Cirrhotic Patients

Abstract Background Portal vein thrombosis (PVT) has a reported prevalence ranging from 0.6 to 26% in cirrhotic patients and yet optimal management in these patients remains unclear [1]. PVT can lead to poor outcomes including increased risk of bleeding, intestinal injury, and deterioration in liver function. Conversely, treatment of PVT in cirrhotic patients increases their risk of bleeding complications, particularly in patients with known varices. Aims The aim of this study is to better characterize the prevalence and impact of PVT in cirrhotic inpatients. Methods We conducted a retrospective cohort study based on data collected on adult patients admitted to the Ottawa Hospital between January 1, 2011 and December 31, 2015. We included patients with a diagnosis of cirrhosis either before or during index admission. Patients with a radiology report indicating a PVT were compared to those without PVT. Non-Ontario residents were excluded and where there were multiple admissions per patient one admission was randomly selected to be used. Ethics approval was obtained from the Research Ethics Board at the University of Ottawa. Results This study found 34 patients with cirrhosis diagnosed with PVT during their hospitalization (3.73%). Of the patients with PVT, 23 were acute and 11 were chronic based on radiologic appearance. Mean age was similar between groups (PVT: 61.7, SD=9.8; No PVT: 62.3, SD=12.3). The mean Na-MELD was also similar (PVT: 17.6, no PVT: 17.3, p=0.82). Among patients with PVT, 11 patients presented with ascites, 10 with hepatic encephalopathy (HE), 5 with abdominal pain and 5 with an upper GI bleed. Spontaneous bacterial peritonitis (SBP) occurred in 11.76% of patients with PVT as compared to 3% of patients without PVT (p value= 0.006). There also seemed to be a trend towards more HE in the cohort with PVT (20.6% vs 10.7%, p value= 0.07). With regards to screening for varices, 2 patients had an EGD in the 6 months prior to admission, 11 had an EGD on admission, 1 after anticoagulation due to bleeding, and 18 had no screening in the 6 months prior to admission. Twelve patients were treated for PVT, 17 were untreated and 5 did not have documentation about treatment. Of the patients that were not treated, 9 were due to palliative goals of care, 1 due to bleeding, 1 due to thrombocytopenia, 2 due to chronicity on imaging and 4 did not have reasons documented. Conclusions PVT is a known complication of cirrhosis, however the clinical significance and optimal management of patients with PVT is poorly understood. Although prevalence of PVT was low in this cohort, our data suggests some possible association between liver related complications and PVT, including SBP and HE. Further research is needed to determine how to best manage patients with PVT. 1. Garcia-Pagan JC, Valla DC. Portal vein thrombosis: a predictable milestone in cirrhosis? Journal of hepatology. 2009 Oct 1;51(4):632–4. Funding Agencies None

Download Full-text

Assessment the Effect of Prophylaxis Therapy on Splenic and Portal Vein Thrombosis after Open Splenectomy: A Controlled Randomized Clinical Trial

Global Journal of Health Science ◽

10.5539/gjhs.v9n5p189 ◽

2016 ◽

Vol 9 (5) ◽

pp. 189

Author(s):

Amin Bahraini ◽

Majid Asnaashari ◽

Amir Ahmad Salmasi ◽

Mohamad Momen Gharibvand

Keyword(s):

Clinical Trial ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Intervention Group ◽

Control Group ◽

Open Splenectomy ◽

Vein Thrombosis ◽

Significant Difference ◽

Prophylaxis Therapy ◽

And Control

<p>Splenic and portal vein thrombosis (SPVT) is considered as a serious complication of splenectomy with potential life-threatening. Chemoprophylaxis may help to curb the incidence of SPVT after splenectomy. This clinical trial study was conducted to determine the incidence rate of SPVT after splenectomy and investigate the effect of chemoprophylaxis to reduce its incidence. Sixty six patients undergoing open splenectomy were included in this single-blind clinical randomized controlled trial (RCT). Patients were randomly assigned in two groups of intervention and control using block randomization to either d receive 40 mg of enoxaparin subcutaneously once a day for 5 days and then 100mg aspirin for one month or no postoperative drug. After one month, all patients over a week underwent Doppler ultrasonography of the splenic, portal and superior mesenteric veins for thrombosis. The mean age of patients was similar between intervention and control groups (28.3±14.5 and 25.6±14.9, respectively) (P value=0.9).Furthermore, two groups were matched regarding distribution of gender. None of patients in intervention group developed portal vein thrombosis, while of 23 patients in control group, 2 (8.69%) subjects were diagnosed with portal vein thrombosis. The two groups had no statistically significant difference in the rate of portal vein thrombosis (P=0.18). Based on the results of our study, prophylaxis therapy had no effects in preventing portal vein thrombosis developed in patients undergoing open splenectomy for any reason.</p>

Download Full-text

Transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis

Zeitschrift für Gastroenterologie ◽

10.1055/s-0043-121348 ◽

2017 ◽

Vol 56 (03) ◽

pp. 221-237 ◽

Cited By ~ 9

Author(s):

Christoph Klinger ◽

Bettina Riecken ◽

Arthur Schmidt ◽

Andrea De Gottardi ◽

Benjamin Meier ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Portosystemic Shunt ◽

Refractory Ascites ◽

Bleeding Complications ◽

Vein Thrombosis ◽

Cavernous Transformation ◽

Intrahepatic Portosystemic Shunt ◽

Intraperitoneal Bleeding

Abstract Purpose To determine safety and efficacy of transjugular portal vein recanalization with creation of intrahepatic portosystemic shunt (PVR-TIPS) in patients with chronic non-cirrhotic, non-malignant portal vein thrombosis (PVT). Methods This retrospective study includes 17 consecutive patients with chronic non-cirrhotic PVT (cavernous transformation n = 15). PVR-TIPS was indicated because of variceal bleeding (n = 13), refractory ascites (n = 2), portal biliopathy with recurrent cholangitis (n = 1), or abdominal pain (n = 1). Treatment consisted of a combination of transjugular balloon angioplasty, mechanical thrombectomy, and—depending on extent of residual thrombosis—transjugular intrahepatic portosystemic shunt and additional stenting of the portal venous system. Results Recanalization was successful in 76.5 % of patients despite cavernous transformation in 88.2 %. Both 1- and 2-year secondary PV and TIPS patency rates were 69.5 %. Procedure-related bleeding complications occurred in 2 patients (intraperitoneal bleeding due to capsule perforation, n = 1; liver hematoma, n = 1) and resolved spontaneously. However, 1 patient died due to subsequent nosocomial pneumonia. During follow-up, 3 patients with TIPS occlusion and PVT recurrence experienced portal hypertensive complications. Conclusions PVR-TIPS is safe and effective in selected patients with chronic non-cirrhotic PVT. Due to technical complexity and possible complications, it should be performed only in specialized centers with high experience in TIPS procedures.

Download Full-text

Efficacy and Safety of Ultrasound-Guided Repeat Access and Repeat Closure With an ExoSeal Vascular Closure System in Patients With Peripheral Arterial Disease

Vascular and Endovascular Surgery ◽

10.1177/15385744211045508 ◽

2021 ◽

pp. 153857442110455

Author(s):

Taira Kobayashi ◽

Masaki Hamamoto ◽

Takanobu Okazaki ◽

Mayu Tomota ◽

Takashi Fujiwara ◽

...

Keyword(s):

Success Rate ◽

Complication Rates ◽

Efficacy And Safety ◽

Closure System ◽

Technical Success ◽

Ultrasound Guided ◽

Access Site ◽

Technical Success Rate ◽

Significant Difference ◽

Procedural Success

Objective The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided repeat access and repeat closure with an ExoSeal vascular closure system. Methods A total of 123 endovascular therapy (EVT) procedures were performed in 59 patients (65 limbs) with ultrasound-guided repeat access and repeat implantation of an ExoSeal vascular closure system between January 2019 and March 2021. The procedural details and postprocedural outcomes of EVT with repeat access and use of ExoSeal (RE group) were compared with those of EVT with initial use of ExoSeal (IE group) in the same patients. In a subgroup analysis, these outcomes were also compared in early repeat (within 3 months) and late repeat (over 3 months) cases. Results The technical success rate of ultrasound-guided access in the RE group was 100%. The procedural success rate of EVT and deployment success rate of ExoSeal in the RE group were 93% and 94%, respectively, which were not significantly different to those in the IE group. Access site complications in the RE group occurred in 2 cases (2%), again with no significant difference with the IE group. The median puncture, procedural, and hemostasis times in the RE group were 3 [2-5], 36.5 [29-54], and 7 [5-10] min, respectively, which were not significantly longer than those in the IE group. In the RE group, early and late repeat closure was performed in 66 (54%) and 57 (46%) cases, respectively, and there were no significant differences in the technical success of ultrasound-guided access, procedural success of EVT, deployment success of ExoSeal, and access site complication rates in these cases. Conclusions Ultrasound-guided access facilitated higher technical success of repeat access and fewer access site complications in EVT with repeat use of ExoSeal, regardless of the interval between procedures.

Download Full-text