Treatment of Aortic and Iliac Artery Occlusion by Catheter Thrombolysis Combined with Catheter Thrombectomy and Aortic Bifurcation Endovascular Stent Reconstruction

Aortoiliac occlusive disease (AIOD) is an occlusive disease of the infrarenal aorta and iliac arteries usually caused by stenosis or occlusion at the end of the abdominal aorta-common iliac artery. Herein, we reported a case of Trans-Atlantic Inter-Society Consensus- (TASC-) D AIOD with pale, cool, and intangible dorsalis pedis artery treated with catheter thrombolysis combined with catheter thrombectomy and aortic bifurcation endovascular stent reconstruction, which proved to be safe, effective, and minimally invasive approach. In the present paper, we discussed the physical and imaging manifestations, as well as treatments.

Acute Aorto-Illiac Occlusion with Bilateral Limb Ischemia Underwent Direct Catheter Thrombolysis in Older Patient: A Case Report

Background: Peripheral arterial diseases could be a major burden for the health system with a wide clinical spectrum from asymptomatic to limb-threatening. Sudden onset of limb deteriorations represent a vascular emergency and need proper treatment for limb preservation and life-saving. It is still challenging to choose proper management to reduce morbidity and mortality, despite the various advance in diagnostic and therapeutic tools were available. Objective: This case report aimed to elaborate on the management of acute aorto-illiac occlusion with bilateral limb ischemia underwent direct catheter thrombolysis in an older patient. Case Presentation: A 70-years-old man came to our hospital with a chief complaint of leg pain in both of his legs, suddenly since 18 hours before admission. He had paresthesia and paralysis in both of his legs. And the Doppler ultrasonography result was occlusion proximal to the right and left common iliac artery. Then we performed percutaneous intra-arterial thrombolysis using streptokinase with a successful outcome of peripheral revascular- ization but with gastrointestinal bleeding as an adverse event. Conclusion: Despite the various advancement of diagnostic and therapeutic tools available today, Acute Limb Ischemia (ALI) still proceed to be related to increasing major amputation and mortality rates in 20% of patients, more often due to the existing comorbidities such as other atherosclerotic diseases.

CATHETER-DIRECTED THROMBOLYSIS AS A METHOD OF CHOICE IN THE TREATMENT OF ACUTE THROMBOSIS OF DEEP VEINS OF THE LOWER EXTREMITIES

Summary. Introduction. Acute thrombosis of deep veins (DVT) of the lower extremities is a pathology that requires immediate treatment, but most thrombolytics do not work effectively, except for catheter-directed thrombolysis. Research aim. Rationalization of DVT treatment, determination of the catheter thrombolysis method as the most effective way to eliminate proximal thrombosis of deep veins. The analysis was based on the results of the treatment by different thrombolytic drugs the patients with the given pathology. Results and discussion. According to the analysis the most effective method of DVT treatment is catheter-guided administration of streptokinase, because streptokinase is the most effective anticoagulant, and its local action on the mass of the thrombus allows for complete elimination of the thrombus in a relatively short time without the counter allergic reaction to the infusion of streptokinase. Conclusions. Catheter-directed infusion of streptokinase as a method of treatment of acute thrombosis of the lower extremities has significantly better treatment results compared to other methods of treatment of this pathology.

Nursing Experience of Vena Cava Filter Combined with Catheter Thrombolysis in the Treatment of Deep Venous Thrombosis of Lower Limbs

Objective — To observe the curative effect of urokinase catheter thrombolysis in treating deep venous thrombosis of lower limbs after implantation of vena cava filter and explore nursing measures and nursing points. Methods — Perioperative nursing of 30 deep venous thrombosis patients with catheter thrombolysis treatment were summarized retrospectively. Results — 30 patients were conducted with catheter pumped urokinase to treat venous thrombus, and the swelling and pain of limbs disappeared. No patient had pulmonary embolism or hemorrhage. Conclusion — When we use urokinase catheter thrombolysis to treat deep venous thrombosis, a comprehensive preparation such as health education, psychological nursing, close observation on patients’ condition, proper fixation of catheter, nursing of thrombolytic drugs and prevention of infection can reduce the occurrence of complications and promote the patients rehabilitation.

Clinical Efficacy of Neurointerventional Catheter Thrombolysis for Cerebral Infarction

Objective: To analyze the clinical efficacy of neurointerventional catheter thrombolysis for cerebral infarction. METHODS: A total of 56 patients with cerebral infarction admitted to our hospital from April 2018 to June 2019 were enrolled for the experimental study. Two different treatments were applied to patients, and patients were divided into observation groups and controls according to different treatment methods. After grouped into two groups the control group was treated with intravenous thrombolysis. The observation group was treated with neurointerventional arterial catheter thrombolysis. The treatment effect, NIHSS score and BI index, neurological deficit score before and after treatment, and coagulation index were compared between the two groups. RESULTS: The therapeutic effect of the observation group (92.86%) was significantly different from that of the control group (67.86%), and the observation group was higher than the control group. The data of the observation group in the NIHSS score and the BI index were 5.42±1.77 and 95.64±2.15, respectively, which were better than the control group. The neurological deficit scores of the observation group before and after treatment were 19.88±6.24 and 9.14±5.81, respectively. After treatment, the difference was significant compared with the control group, p<0.05. The coagulation indexes of the observation group in FIB, PT, TT, etc. were respectively 3.68±1.04, 11.46±1.62, 15.37±2.46, all were better than the control group (2.13±0.47, 13.72±2.72, 19.85±2.62), P<0.05. Conclusion: the clinical efficacy of neurointerventional arterial catheter thrombolysis for cerebral infarction is significant, it can effectively promote the recovery of various functional conditions of patients with cerebral infarction, which is worthy of further application and promotion.