scholarly journals Comparison of Ultrasound Accelerated Thrombolysis Versus Simple Infusion Catheter Directed Thrombolysis for Acute Arterial Thrombosis

2010 ◽  
Vol 52 (3) ◽  
pp. 803 ◽  
Author(s):  
Parth S. Shah ◽  
Anil Hingorani ◽  
Enrico Ascher ◽  
Uma Ballehaninna ◽  
Alexander Shiferson ◽  
...  
Keyword(s):  
Arterial Thrombosis ◽  
Infusion Catheter ◽  
Catheter Directed Thrombolysis

scholarly journals Acute Arterial Thrombosis after Covered Stent Exclusion of Bleeding Mycotic Pseudoaneurysm: Treatment Using Catheter-Directed Thrombolysis

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Sarah Palestrant ◽  
M. Grace Knuttinen ◽  
Ron C. Gaba ◽  
James T. Bui ◽  
Charles A. Owens
Keyword(s):  
Iliac Artery ◽  
Stent Placement ◽  
Arterial Thrombosis ◽  
Covered Stent ◽  
Management Approach ◽  
Unique Case ◽  
Mycotic Pseudoaneurysm ◽  
Systemic Sepsis ◽  
Catheter Directed Thrombolysis ◽  
Infected Pseudoaneurysm

Conventional absolute contraindications to catheter-directed thrombolysis include active or recent hemorrhage and the presence of local vascular infection, both of which increase the risk of procedure-related complications such as bleeding and systemic sepsis. For this reason, lytic therapy of arterial thromboembolism under these circumstances is generally precluded. Herein, we describe a unique case of safe catheter-directed lysis of an acutely thrombosed iliac artery following covered stent placement for treatment of an actively bleeding infected pseudoaneurysm. Our management approach is discussed.

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.

Successful Limb Salvage With Balloon Angioplasty and Catheter-Directed Thrombolysis (CDT) With Tenecteplase (TNK) in a Child With Brachial Arterial Thrombosis

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 351A
Author(s):  
Nisha Hakhu ◽  
Varsha Gharpure ◽  
Hong Andy Park ◽  
Annie Torres ◽  
William Goodell ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Balloon Angioplasty ◽  
Arterial Thrombosis ◽  
Catheter Directed Thrombolysis

scholarly journals Protein S deficiency complicated with repetitive peripheral arterial thrombosis successfully treated by mechanical thrombectomy device with Rotarex system

2017 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Wei-Sheng Liao ◽  
Wei-Tsung Wu ◽  
Nai-Yu Chi ◽  
Wen-Hsien Lee ◽  
Chun-Yuan Chu ◽  
...  
Keyword(s):  
Arterial Thrombosis ◽  
Mechanical Thrombectomy ◽  
Rare Complication ◽  
Protein S ◽  
Protein S Deficiency ◽  
Catheter Directed Thrombolysis ◽  
S Deficiency ◽  
Increased Risk ◽  
Thrombectomy Device ◽  
Peripheral Arterial

Protein S deficiency is an inherited thrombophilia associated with an increased risk of venous thromboembolism. However, arterial thrombosis is a relative rare complication of protein S deficiency and the prognosis of these patients was worse than those without protein S deficiency in the literature. Herein we reported a 43-year-old male with protein S deficiency experiencing several times acute peripheral arterial thrombosis of left leg. Surgical thrombectomy was performed initially but later endovascular treatment (EVT) was suggested. Although EVT was successfully performed by catheter-directed thrombolysis (CDT), arterial thrombosis still recurred three months later. CDT was tried again but thrombosis could not be treated by this strategy anymore. Therefore, we used mechanical thrombectomy device (Rotarex system) and successfully regained the straight-line blood flow to the foot after the procedure. Peripheral echo showed patent flow after 6 months follow-up. In conclusion, arterial thrombosis is a relative rare complication of protein S deficiency and prognosis was not well in the literature, our case reminds physicians that Rotarex system is a safe and highly efficient device for acute PAOD even in the patients with hypercoagulable state.

scholarly journals (More than) doubling down: Effective fibrinolysis at a reduced rt-PA dose for catheter-directed thrombolysis combined with histotripsy

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261567
Author(s):  
Samuel A. Hendley ◽  
Aarushi Bhargava ◽  
Christy K. Holland ◽  
Geoffrey D. Wool ◽  
Osman Ahmed ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Thrombolytic Therapy ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Vein Thrombosis ◽  
Clinical Dose ◽  
Infusion Catheter ◽  
Catheter Directed Thrombolysis ◽  
The Common ◽  
Deep Vein

Deep vein thrombosis is a major source of morbidity and mortality worldwide. For acute proximal deep vein thrombosis, catheter-directed thrombolytic therapy is an accepted method for vessel recanalization. Thrombolytic therapy is not without risk, including the potential for hemorrhagic bleeding that increases with lytic dose. Histotripsy is a focused ultrasound therapy that generates bubble clouds spontaneously in tissue at depth. The mechanical activity of histotripsy increases the efficacy of thrombolytic therapy at doses consistent with current pharmacomechanical treatments for venous thrombosis. The objective of this study was to determine the influence of lytic dose on histotripsy-enhanced fibrinolysis. Human whole blood clots formed in vitro were exposed to histotripsy and a thrombolytic agent (recombinant tissue plasminogen activator, rt-PA) in a venous flow model perfused with plasma. Lytic was administered into the clot via an infusion catheter at concentrations ranging from 0 (control) to 4.54 μg/mL (a common clinical dose for catheter-directed thrombolysis). Following treatment, perfusate samples were assayed for markers of fibrinolysis, hemolysis, and intact red blood cells and platelets. Fibrinolysis was equivalent between the common clinical dose of rt-PA (4.54 μg/mL) and rt-PA at a reduction to one-twentieth of the common clinical dose (0.23 μg/mL) when combined with histotripsy. Minimal changes were observed in hemolysis for treatment arms with or without histotripsy, potentially due to clot damage from insertion of the infusion catheter. Likewise, histotripsy did not increase the concentration of red blood cells or platelets in the perfusate following treatment compared to rt-PA alone. At the highest lytic dose, a refined histotripsy exposure scheme was implemented to cover larger areas of the clot. The updated exposure scheme improved clot mass loss and fibrinolysis relative to administration of lytic alone. Overall, the data collected in this study indicate the rt-PA dose can be reduced by more than a factor of ten and still promote fibrinolysis when combined with histotripsy.

scholarly journals Outcomes of accelerated catheter-directed thrombolysis in patients with acute arterial thrombosis

2016 ◽  
Vol 21 (5) ◽  
pp. 453-458 ◽  
Author(s):  
Aleksander Lukasiewicz ◽  
Wojciech Lichota ◽  
Maciej Thews
Keyword(s):  
Arterial Thrombosis ◽  
Catheter Directed Thrombolysis

Comparison of Ultrasound-Accelerated Versus Multi-Hole Infusion Catheter-Directed Thrombolysis for the Treatment of Acute Limb Ischemia

2019 ◽  
Vol 53 (7) ◽  
pp. 558-562 ◽  
Author(s):  
Jesse Chait ◽  
Afsha Aurshina ◽  
Natalie Marks ◽  
Anil Hingorani ◽  
Enrico Ascher
Keyword(s):  
Success Rate ◽  
Limb Ischemia ◽  
Limb Loss ◽  
Acute Limb Ischemia ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Technical Success Rate ◽  
Infusion Catheter ◽  
Catheter Directed Thrombolysis ◽  
The Mean

Objective: Thrombolytic therapy is widely used in the treatment of arterial occlusions causing acute limb ischemia (ALI); however, knowledge regarding the efficacy of the different catheter systems available is scarce. The objective of this study was to compare the safety and efficacy of 2 catheter-directed infusion systems for intra-arterial thrombolysis in the setting of ALI. Methods: A retrospective analysis was conducted to study all catheter-directed thrombolysis procedures performed over 32 months in patients diagnosed with ALI. Patients with thrombosis in both native arteries and bypass grafts were included. Patients with contraindications to thrombolysis, or those receiving thrombolysis for deep venous thrombosis, were excluded. The duration of thrombolysis, amount of thrombolytic agent, and technical success rate were recorded. Technical success was defined as complete or near-complete resolution of thrombus burden, allowing for further intervention. Data were stratified to include location of thrombus, procedural complications, mortality, and rates of limb loss. Results: Ninety-one patients met inclusion criteria. Among them, Uni-Fuse and EKOS catheters were used in 69 and 22 patients, respectively. The mean age of the population was 71 (standard deviation [SD]: ±1.5) for patients treated with the EKOS catheter and 70 years (SD: ±2.6) for patients receiving thrombolysis with Uni-Fuse. There was no significant difference in the mean infusion duration (1.65 vs 1.9 days), volume of tissue plasminogen activator (44.6 vs 48.2 mg), or technical success rate (72% vs 86%) between the Uni-Fuse and EKOS cohorts ( P > .3). Furthermore, there was no difference in major limb loss or compartment syndrome between each group ( P > .4). The overall complication rate was 14% in both groups, with a 30-day mortality rate of 4% when treated with either catheter system. Conclusion: This study suggests that a standard multi-hole infusion catheter demonstrates similar clinical safety and efficacy as the ultrasound-accelerated EKOS system in the treatment of ALI.

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