Catheter-Directed Thrombolysis of Lower Limb Thrombosis

2010 ◽  
Vol 34 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Marcus J. Pianta ◽  
Kenneth R. Thomson
Keyword(s):  
Lower Limb ◽  
Catheter Directed Thrombolysis

Potential Benefits From Heating the High-Dose rtPA Boluses Used in Catheter-Directed Thrombolysis for Acute/Subacute Lower Limb Ischemia

2003 ◽  
Vol 10 (4) ◽  
pp. 739-744 ◽  
Author(s):  
Dimitrios K. Tsetis ◽  
Asterios N. Katsamouris ◽  
Athanasios D. Giannoukas ◽  
Adam A. Hatzidakis ◽  
Theodoros Kostas ◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
High Dose ◽  
Lower Limb Ischemia ◽  
Catheter Directed Thrombolysis ◽  
Potential Benefits

Referral patterns for catheter-directed thrombolysis for iliofemoral deep venous thrombosis

2021 ◽  
pp. 026835552097728
Author(s):  
Kirtan D Patel ◽  
Alison YY Tang ◽  
Ashik DJ Zala ◽  
Rakesh Patel ◽  
Kishan R Parmar ◽  
...  
Keyword(s):  
Lower Limb ◽  
Management Option ◽  
Venous Anatomy ◽  
Nice Guidelines ◽  
Patient Demographics ◽  
Radiology Reports ◽  
Catheter Directed Thrombolysis ◽  
Nice Guidance ◽  
Icd 10 ◽  
Venous Thromboses

Objectives Post thrombotic syndrome (PTS) is a serious complication of deep venous thromboses (DVTs). PTS occurs more frequently and severely following iliofemoral DVT compared to distal DVTs. Catheter directed thrombolysis (CDT) of iliofemoral DVTs may reduce PTS incidence and severity. We aimed to determine the rate of iliofemoral DVT within our institution, their subsequent management, and compliance with NICE guidelines. Methods Retrospective review of all DVTs diagnosed over a 3-year period was conducted. Cases of iliofemoral DVT were identified using ICD-10 codes from patient notes, and radiology reports of Duplex scans. Further details were retrieved, such as patient demographics and referrals to vascular services. NICE guidance was applied to determine if patients would have been suitable for CDT. A survey was sent to clinicians within medicine to identify awareness of CDT and local guidelines for iliofemoral DVT management. Results 225 patients with lower limb DVTs were identified. Of these, 96 were radiographically confirmed as iliofemoral DVTs. The median age was 77. 67.7% of iliofemoral DVTs affected the left leg. Right leg DVTs made up 30.2% and 2.1% were bilateral DVTs. Of the 96 iliofemoral DVTs, 21 were deemed eligible for CDT. Only 3 patients (14.3%) were referred to vascular services, and 3 received thrombolysis. From our survey, 95.5% of respondents suggested anticoagulation alone as management for iliofemoral DVT. Only one respondent recommended referral to vascular services. There was a knowledge deficiency regarding venous anatomy, including superficial versus deep veins. Conclusions CDT and other mechanochemical procedures have been shown to improve outcomes of patients post-iliofemoral DVT, however a lack of awareness regarding CDT as a management option results in under-referral to vascular services. We suggest closer relations between vascular services and their “tributary” DVT clinics, development of guidelines and robust care pathways in the management of iliofemoral DVT.

scholarly journals SURGICAL TREATMENT OF ACUTE THROMBOSIS ARTERIES OF INFRAPOPLITEAL SEGMENT

2021 ◽  
Vol 4 (18) ◽  
pp. 10-17
Author(s):  
Y. Hupalo ◽  
O. Nabolotnyi ◽  
B. Kulikovskyi ◽  
O. Shved ◽  
V. Shaprynskyi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Arterial Thrombosis ◽  
Artery Aneurysm ◽  
Surgical Interventions ◽  
Popliteal Artery Aneurysm ◽  
Acute Thrombosis ◽  
Endovascular Interventions ◽  
Catheter Directed Thrombolysis

Aim of the study. Aim of the study was to analyze the outcomes of surgical treatment of acute thrombosis of the popliteal-tibial segment arteries with various etiological factors of its occurrence. The analysis of the surgical treatment of 40 patients with acute thrombosis of the popliteal-tibial segment arteries was carried out for the period from 2014 to 2020. Depending on the pathogenesis of acute thrombosis of the popliteal-tibial segment arteries, the patients were divided into three groups: Group 1 – 17 (42.5%) patients with acute arterial thrombosis of the popliteal-tibial segment caused by embolism or thrombosis in the background of stenotic-occlusive diseases of the lower extremitiesvessels; Group 2 – 15 (37.5%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of thromboangiitisobliterans of the lower extremities (Buerger's disease); Group 3 – 8 (20%) patients with acute arterial thrombosis of the popliteal-tibial segment in the background of popliteal artery aneurysm. During the follow-up period of 2 months, the incidence of rethrombosis and amputation of the lower limb in the patients of Group A was 5.9% and 5.9%, respectively. In Group B, the incidence of rethrombosis and amputation of the lower limb was 73.3% and 40.0%, respectively. In group C, the incidence of rethrombosis and amputation of the lower limb was 12.5% and 12.5%, respectively. Conclusions. In patients with acute arterial thrombosis of the popliteal-tibial segment in the background of embolism or stenotic-occlusive diseases, combined endovascular or hybrid surgical interventions showed better results compared to open thrombectomy, in which rethrombosis was diagnosed in 14.3% of cases. In patients with thromboangiitis obliterans of the lower extremities, regional catheter-directed thrombolysis showed better (p=0,04) results compared to open thrombectomy and endovascular interventions, in which rethrombosis was diagnosed in 90% and 100% of cases, respectively. In patients with popliteal artery aneurysm, open surgical interventions or regional catheter-directed thrombolysis showed better results compared to endovascular interventions, in which rethrombosis was diagnosed in 50% of cases.

scholarly journals Thrombolysis of occluded femoropopliteal graft with locally delivered human plasmin

2014 ◽  
Vol 142 (5-6) ◽  
pp. 342-346
Author(s):  
Dragoslav Nenezic ◽  
Djordje Radak ◽  
Dario Jocic ◽  
Predrag Gajin ◽  
Slobodan Tanaskovic ◽  
...  
Keyword(s):  
Lower Limb ◽  
Open Surgery ◽  
Mechanical Thrombectomy ◽  
Bypass Graft ◽  
Limb Ischemia ◽  
Scar Tissue ◽  
Native Artery ◽  
Catheter Directed Thrombolysis ◽  
Risk Patients ◽  
Successful Thrombolysis

Introduction. Acute lower limb ischemia results from thrombosis or embolization of diseased native artery or previously implanted bypass graft. When this occurs, several options are available to restore blood flow: catheter-directed thrombolysis, mechanical thrombectomy or open surgery. Fundamental reasons to apply percutaneous interventions are avoiding open procedures in high risk patients, and avoiding difficult dissection through scar tissue. Case Outline. A 67-year-old male was admitted at our Institution for critical limb ischemia. After performed angiography the diagnosis of occluded femoropopliteal graft was established. Occlusion was resolved by catheter-directed thrombolysis with plasmin. Culprit lesions were treated by angioplasty. Conclusion. Our patient underwent a successful thrombolysis of occluded femoropopliteal graft with locally-delivered human plasmin.

scholarly journals Spontaneous spinal epidural haematoma following intra-arterial catheter-directed thrombolysis: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090674
Author(s):  
Nicholas Brian Shannon ◽  
Pradesh Kumar ◽  
Kiang Hiong Tay ◽  
Sia Yang Tan ◽  
Siew Ping Chng ◽  
...  
Keyword(s):  
Case Report ◽  
Early Detection ◽  
Lower Limb ◽  
Spinal Surgery ◽  
Epidural Haematoma ◽  
Arterial Catheter ◽  
Limb Ischaemia ◽  
Spinal Epidural Haematoma ◽  
Catheter Directed Thrombolysis ◽  
Spinal Epidural

A 79-year-old Chinese gentleman presented with unilateral acute lower limb ischaemia and received intra-arterial catheter-directed thrombolysis, initially with good result and reversal of the ischaemia. However, he developed an extensive spontaneous spinal epidural haematoma within hours of the procedure and was left with permanent paraplegia after being deemed unsuitable for decompressive spinal surgery. This report serves as a reminder of the risk of severe complications of catheter-directed thrombolysis by describing this rare but devastating side-effect that occurred even despite early detection from onset of symptoms.

scholarly journals Phlegmasia Cerulea Dolens: A Life- and Limb-threatening Disease

2021 ◽  
Vol 5 (0-2) ◽  
pp. 16
Author(s):  
Wan Nuraisyah Azzahrah Wan Zuki
Keyword(s):  
Venous Thrombosis ◽  
Lower Limb ◽  
Early Recognition ◽  
Vena Cava ◽  
Common Iliac Vein ◽  
Venous Thrombectomy ◽  
Catheter Directed Thrombolysis ◽  
Left Lower Limb ◽  
History Of ◽  
Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a rare syndrome caused by venous thrombosis and characterised by a triad of limb oedema, cyanosis and pain. It requires early recognition as delay of treatment can cause gangrene, limb amputation and in extreme cases, death. A 67- year-old Chinese lady, with underlying hypertension, diabetes mellitus and dyslipidaemia presented to the emergency department with a 2 days history of pain, oedema and bluish discoloration over the entire left leg. She had a history of fall 6 months prior and since then she used a walking stick for mobilization. This patient underwent ultrasound doppler left lower limb , which showed features suggestive of long-segment left lower limb deep vein thrombosis. A diagnosis of PCD was made. Subsequently, she went for a CT angiogram and venography of the left lower limb which confirmed thrombosis of the left calf vein extending to the long segment of the left common iliac vein. She was commenced on intravenous heparin infusion and then underwent inferior vena cava filter insertion and catheter directed thrombolysis. Repeat venogram showed successful catheter directed thrombolysis of the left lower limb deep venous thrombosis (DVT). Treatment should be initiated as soon as the diagnosis of PCD is suspected. Currently, guidelines for treatment are lacking however 3 therapeutic options are advocated alone or in combination: anticoagulants, thrombolytic therapy, and venous thrombectomy. An early recognition of PCD and appropriate decision regarding the treatment is essential to preserve the limb.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S16

Sign in / Sign up

Export Citation Format

Share Document