TCT-362 A novel fully percutaneous thrombectomy technique with balloon occlusion guiding catheter and over-the-wire Fogarty catheter for acute limb ischemia

Purpose The guiding role of the Fogarty catheter was investigated among patients suffering from limb ischemia due to acute femoropopliteal bypass graft occlusion. Methods A total of 27 patients with a history of femoropopliteal bypass operation who was admitted with acute limb ischemia were enrolled in this retrospective study. In cases in which the Fogarty catheter could not be passed through the popliteal anastomosis, the popliteal region was explored and a new bypass or patch plasty was performed for the distal anastomosis. The cases in which the blood circulation was observed in the graft, but in which the Fogarty catheter balloon was stuck in the native vessels on the proximal and distal side of the graft and the balloon could be withdrawn by deflation, were referred to conventional angiography. The stenosis observed in native vessels was managed by endovascular stent grafting and/or balloon dilatation. Findings Graft patency was achieved in all patients. In 11 patients, conventional angiography was implemented following embolectomy. In these patients, all the occlusions found as significant on angiography were removed by percutaneous transluminal angioplasty. Conclusion Effective use of Fogarty catheter is safe in acute femoropopliteal bypass graft occlusions and in particular, in the planning of further treatment following thrombectomy.

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Acute limb ischemia after femoral arterial closure with a vascular sealing device: Successful endovascular treatment

VASA ◽

10.1024/0301-1526.33.4.252 ◽

2004 ◽

Vol 33 (4) ◽

pp. 252-256 ◽

Cited By ~ 9

Author(s):

Schiele ◽

Rademacher ◽

Meissner ◽

Klauss ◽

Hoffmann

Keyword(s):

Therapeutic Option ◽

Limb Ischemia ◽

Acute Limb Ischemia ◽

Distal Embolization ◽

Percutaneous Catheter ◽

Percutaneous Coronary ◽

The Right ◽

Crural Arteries ◽

Percutaneous Thrombectomy ◽

Sealing Device

We report on successful catheter therapy of acute occlusions of popliteal and crural arteries due to distal embolization from a vascular sealing device. A 45 years-old male patient underwent percutaneous coronary angiography. After primary successful closure of the right femoral artery by a sealing device the patient developed acute ipsilateral lower limb ischemia, most probably due to embolization of a collagen/thrombin plug. Occlusions of the popliteal and crural vessels were successfully treated by percutaneous thrombectomy, thrombolysis and ballon angioplasty. Combined percutaneous catheter therapy is a therapeutic option for occlusions of popliteal and crural vessels due to embolization from a vascular sealing device.

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TCTAP C-215 “Pseudo Fogarty Thrombectomy” Using Sheathless OPTIMO (Temporary Occlusion Balloon Guiding Catheter) in Patient with Acute Limb Ischemia Due to Thrombotic Occlusion in Artificial Graft

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2016.03.430 ◽

2016 ◽

Vol 67 (16) ◽

pp. S361-S362

Author(s):

Ryo Fukui ◽

Hitoshi Anzai

Keyword(s):

Limb Ischemia ◽

Acute Limb Ischemia ◽

Thrombotic Occlusion ◽

Occlusion Balloon ◽

Artificial Graft ◽

Temporary Occlusion ◽

Guiding Catheter

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Is Surgical Thrombo-Embolectomy in Acute Limb Ischemia Still Advantageous in Patients More Than 65 Years of Age?

The Heart Surgery Forum ◽

10.1532/hsf.4157 ◽

2021 ◽

Vol 24 (6) ◽

pp. E988-E995

Author(s):

Ali Cemal Duzgun ◽

Ekin Ilkeli

Keyword(s):

Older Patients ◽

Cox Regression ◽

Limb Ischemia ◽

Ease Of Use ◽

Acute Limb Ischemia ◽

Fogarty Catheter ◽

First Line ◽

Iodinated Contrast ◽

Vital Parameters ◽

Leg Ischemia

Objective: In this study, we investigated the benefits of using Fogarty balloon catheterization in the treatment of acute leg ischemia with respect to amputation, fasciotomy, and mortality in older patients. Methods: A total of 102 patients age >65 who had a Fogarty thrombo-embolectomy for acute thromboembolic limb ischemia were investigated retrospectively. Patients were evaluated based on Rutherford IIa and IIb criteria and duration of ischemia. Duration of ischemia was divided into 3 categories (as 0 to 4, 4 to 8, and >8 hours) to evaluate the effect of ischemia period on vital parameters and mortality. Analysis with Cox regression showed that 30-day mortality was associated with older age and number of comorbidities such as amputation and fasciotomy. Results: In 102 patients >65 years of age who underwent embolectomy, rates were 7.2% fasciotomy (n = 7) and 13.7% amputation (n = 14), and 10 patients died (9.8%). According to multiple regression analysis, the surgical risk increases 1074 times when each year is added to the chronological age of over 65 years. Conclusion: In a majority of cases, limb salvage can be obtained via simple embolectomy rather than risking intravenous iodinated contrast. Although alternatives in older patients are limited, the Fogarty catheter should be regarded as a first-line treatment because of its ease of use and low complication rate.

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Arterial Thrombosis Induced By Coagulopathy Due To Coronavirus Infection Concomitant With Heparin Resistance: A Case Report

Heart Science Journal ◽

10.21776/ub.hsj.2021.002.04.8 ◽

2021 ◽

Vol 2 (4) ◽

pp. 36-39

Author(s):

Irma Kamelia ◽

Heny Martini ◽

Novi Kurnianingsih ◽

Indra Prasetya

Keyword(s):

Femoral Artery ◽

Severe Pneumonia ◽

Patient Discharge ◽

Limb Ischemia ◽

High Dose ◽

Acute Limb Ischemia ◽

Fogarty Catheter ◽

Antegrade Approach ◽

Heparin Resistance ◽

The Right

Background : A newly emerging pandemic of Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory coronavirus 2 is responsible for significant morbidity and mortality worldwide. As one of the effects is hematological changes related to the COVID-19 infection causing patient tend to thrombosis than hemorrhagic. Current review of evidence and statements on management of coagulopathy and thrombotic complications related to this novel disease is needs to be explored Case : Male 53 years old referred from Private Hospital, due to Severe pneumonia due to COVID-19 and Acute Limb Ischemia. This patient was assessed as Pneumonia COVID-19 severe with acute limb ischemia bilateral grade IIB and performed bilateral surgical thrombectomy with antegrade approach using fogarty catheter with the result was thrombus 10cm along the left femoral artery and thrombus 2cm in the right femoral artery. Discussion : With consideration of atherosclerotic diseases in this patient, we decided to give rivaroxaban as an anticoagulant combined with aspilet and statin high dose. But due to lack of source in our hospital, and patient also denied for further management, treatment for the patient cannot be optimal, so the patient discharge with unresolved limb ischemia. Conclusion : This case showed that the increase risk of heparin resistance in SARS-CoV-2 patient, it is recommend- ed to monitor heparin activity of UFH treatment based on anti-Xa levels instead of aPTT alone.

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Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽

10.1024/0301-1526/a000876 ◽

2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Marina Di Pilla ◽

Stefano Barco ◽

Clara Sacco ◽

Giovanni Barosi ◽

Corrado Lodigiani

Keyword(s):

Systematic Review ◽

Case Report ◽

Lower Limb ◽

Limb Ischemia ◽

Acute Limb Ischemia ◽

Review Of The Literature ◽

Heparin Induced Thrombocytopenia ◽

Lower Limb Ischemia ◽

Vein Thrombosis ◽

Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

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