Mechanical Thrombectomy of Pulmonary Emboli With Use of the Indigo System and Lightning 12 Intelligent Aspiration

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

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Percutaneous mechanical thrombectomy in the treatment of acute and subacute occlusions of the peripheral arteries and bypasses

VASA ◽

10.1024/0301-1526/a000495 ◽

2016 ◽

Vol 45 (1) ◽

pp. 49-56 ◽

Cited By ~ 10

Author(s):

Frantisek Stanek ◽

Radoslava Ouhrabkova ◽

David Prochazka

Keyword(s):

Mechanical Thrombectomy ◽

Clinical Success ◽

Major Amputation ◽

Peripheral Arteries ◽

Duration Of Symptoms ◽

Efficient Treatment ◽

Percutaneous Mechanical Thrombectomy ◽

Single Centre Study ◽

Crural Arteries

Abstract. Background: The aim of this prospective single-centre study was to analyse the immediate results, failures and complications of percutaneous mechanical thrombectomy using the Rotarex catheter in the treatment of acute and subacute occlusions of peripheral arteries and bypasses, as well as to evaluate long-term outcomes of this method. Patients and methods: Patients with acute (duration of symptoms < 14 days) or subacute (duration of symptoms > 14 days and < 3 months) occlusions of peripheral arteries and bypasses were selected consecutively for treatment. The cohort consisted of 113 patients, aged 18 - 92 years (median 72 years). In all, 128 procedures were performed. Results: Angiographic success was obtained in 120 interventions (93.8 %). Reasons for failures were rethrombosis of a partially recanalised segment in six procedures, and embolism into crural arteries in one intervention - percutaneous aspiration thromboembolectomy (PAT) and/or thrombolysis were ineffective in all these cases. Breakage of the Rotarex catheter happened in one procedure. Embolisation into crural arteries as a transitory complication solvable with PAT and/or thrombolysis occurred in four cases. Rethrombosis was more frequent in bypasses than in native arteries (p = 0.0069), in patients with longer occlusions (p = 0.026) and those with poorer distal runoff (p = 0.048). Embolisation happened more often in patients with a shorter duration of symptoms (p = 0.0001). Clinical success was achieved in 82.5 %. Major amputation was performed in 10 % of cases. Cumulative patency rates were 75 % after one month, 71 % after six months, 38 % after 12 months, 33 % after 18 months and 30 % after 24, 30, 36 and 42 months. Conclusions: Rotarex thrombectomy has excellent immediate results with a low rate of failures and complications. In comparison to thrombolysis, it enables the fast and efficient treatment of acute and subacute occlusions of peripheral arteries in one session.

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Mechanical Thrombectomy in the Treatment of Acute Critical Limb Threatening Ischemia

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)88271-x ◽

1998 ◽

Vol 31 (2) ◽

pp. 521A ◽

Cited By ~ 2

Author(s):

J Silva

Keyword(s):

Mechanical Thrombectomy

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Mechanical thrombectomy as a first-line treatment for arterial occlusion

Seminars in Vascular Surgery ◽

10.1053/svas.2001.23169 ◽

2001 ◽

Vol 14 (2) ◽

pp. 123-131 ◽

Cited By ~ 14

Author(s):

Karthikeshwar Kasirajan ◽

John M. Marek ◽

Mark Langsfeld

Keyword(s):

Mechanical Thrombectomy ◽

Arterial Occlusion ◽

Line Treatment ◽

First Line ◽

First Line Treatment

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A Comparative Analysis of D-Dimer Assays in Patients with Clinically Suspected Pulmonary Embolism

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649595 ◽

1993 ◽

Vol 70 (03) ◽

pp. 408-413 ◽

Cited By ~ 43

Author(s):

Edwin J R van Beek ◽

Bram van den Ende ◽

René J Berckmans ◽

Yvonne T van der Heide ◽

Dees P M Brandjes ◽

...

Keyword(s):

Pulmonary Embolism ◽

Comparative Analysis ◽

High Probability ◽

Pulmonary Emboli ◽

Plasma Samples ◽

Suspected Pulmonary Embolism ◽

Lung Scan ◽

D Dimer

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.

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