Limb Salvage After Percutaneous Mechanical Thrombectomy in Patients with Acute Lower Limb Ischemia: A Retrospective Analysis from Two Institutions

2019 ◽  
Vol 58 ◽  
pp. 151-159 ◽  
Author(s):  
Siyuan Liang ◽  
Long Zhou ◽  
Kaichuang Ye ◽  
Xinwu Lu
2021 ◽  
Vol 6 (3) ◽  
pp. 1-7
Author(s):  
Francesco De Santis ◽  

Background: The aim of this report is to describe and discuss a unique case of acute lower limb ischemia presented in a recovered COVID-19 patient treated via percutaneous mechanical thrombectomy and catheter directed thrombolysis. Starting from this singular case a wide literature review regarding COVID-19-related thrombo-embolic complications has been accomplished. Methods: A 47-year-old male was admitted to the emergency unit with acute lower limb ischemia three weeks after testing positive for COVID-19. He had been isolated at home because of minor COVID-19-related symptoms. Angio-CT-imaging showed a segmental occlusion of the common iliac artery coupled with retro-articular popliteal artery and leg vessels thrombosis. The patient was first unsuccessfully submitted to trans-femoral iliac thrombo-embolectomy. Results: Instead of peripheral limb vessel re-thromboembolectomy, a percutaneous mechanical thrombectomy coupled with leg vessel catheter direct thrombolysis was performed. The completion angiography showed the recanalization of the popliteal artery and leg vessels as far as the ankle but with a reduced forefoot vascularization. The fibrinolytic treatment was continued for 8 hours post-operatively. A compartment syndrome complicated the early post-operative course. There was a progressive recovery of ischemic symptoms and at 6-month follow-up, peripheral pulses were palpable with an almost complete normalization of foot and toe perfusion and motility. Conclusion: Acute lower limb ischemia following COVID-19-related arterial thrombo-embolic events represents a severe complication of COVID-19 infection and may result in a high rate of revascularization failure. In these cases, Percutaneous Mechanical thrombectomy coupled with catheter directed thrombolysis might represent a less traumatic and more selective approach.


2021 ◽  
Vol 15 (9) ◽  
pp. 2239-2241
Author(s):  
Salman Jamil Noor ◽  
Nauman Imtiaz ◽  
Wishal Shaukat ◽  
Athar Abbas Gilani ◽  
Palwasha Shahid ◽  
...  

Aim: To compare the limb salvage rate in early versus late presenting patients of Rutherford class IIB acute lower extremity ischemia undergoing revascularization. Study Design: Comparative/observational study Place and duration of study: Department of Surgery, CMH Peshawar from January 2019 to March 2021 Methodology: Twenty eight patients of both genders with ages 20 to 70 years presented with Rutherford class IIB acute lower limb ischemia were enrolled in this study. Patients were divided into two groups. Group I (presented after 6 hours of onset of symptoms) consisted of 20 patients and group II (presented within 6 hours of onset of symptoms) consisted of 8 patients. All the patients underwent femoral embolectomy. Limb salvage rate between both groups was examined at postoperative 3rd month. Data was analyzed by SPSS 24.0. P-value <0.05 was taken as significant. Results: There were 16(80%) male and 4(20%) females with mean age 50.52±11.74 years in group I, in group II 6(75%) were male and 2(25%) were females with mean age 50.08±10.94 years. No significant difference was observed between both groups regarding age and gender with p-value >0.05. In group I, limb salvage found in 19(95%) patients while in group II limb salvage found in 5(62.5%) patients, a significant difference was observed regarding limb salvage rate between both groups (p-value <0.05). Mortality rate was high in group II (delayed presentation) as compared to group I (12.5% Vs 0%) with p-value <0.05. Conclusion: The limb salvage rate was high in early presenting patients than late presenting patients with a significant difference. 30 days mortality rate and amputation rate were significantly high in delayed presentation as compared to early presented cases. Keywords: Acute lower limb ischemia, revascularization, limb salvage


Angiology ◽  
1994 ◽  
Vol 45 (9) ◽  
pp. 797-804 ◽  
Author(s):  
Pekka J. Matsi ◽  
Hannu I. Manninen ◽  
Markku Laakso ◽  
Pekka Jaakkola

2007 ◽  
Vol 46 (4) ◽  
pp. 803-807 ◽  
Author(s):  
Osamu Iida ◽  
Shinsuke Nanto ◽  
Masaaki Uematsu ◽  
Takakazu Morozumi ◽  
Hirokuni Akahori ◽  
...  

2010 ◽  
Vol 6 (1) ◽  
pp. 45-53
Author(s):  
Sherif Essam Tawfik ◽  
Sherif Omar Elkerdawy ◽  
Hesham Adel Alaa-Eldin

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