Deep Vein Thrombosis: Update on Mechanical Thrombectomy and                     Intravascular US

Sailer, Anne; Revzin, Margarita V.; Pollak, Jeffrey; Ayyagari, Raj; Mojibian, Hamid; Chockalingam, Arun; Pellerito, John S.

doi:10.1148/rg.220031

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…A multi-side-hole catheter is placed within the clot, a continuous infusion of a plasminogen activator is administered into the clot at 0.5–1.0 mg/hr of tPA over 12–72 h using an intravenous pump ( 9 – 12 ). Ultrasound-enhanced thrombolysis: After the clot is traversed with a multi-side-hole catheter that has ultrasound emitters present, an infusion of a low-dose plasminogen activator is administered into the clot with concomitant ultrasound activation over 12–72 h at 0.5 to 1 mg/hr for tPA ( 9 , 13 ). The penetration of the drug and clot dissolution are mediated by stable cavitation or sustained bubble activity induced by the ultrasound frequency.…”

Section: Introductionmentioning

confidence: 99%

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Endovascular management of acute and subacute venous thoracic outlet syndrome

Davies,

Hart

2024

Front. Surg.

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Approximately 3% of all patients presenting with Thoracic Outlet Syndrome have a venous etiology (vTOS), which is considered “effort thrombosis”. These patients will present with symptomatic deep venous thrombosis or focal subclavian vein (SCV) stenosis. Endovascular management of vTOS occurs in several phases: diagnostic, preoperative therapeutic intervention before decompression, postoperative interventions after decompression, and delayed interventions in the follow-up after decompression. In the diagnostic phase, dynamic SCV venography can establish functional vTOS. Approximately 4,000 patients have been treated for vTOS and reported in the literature since 1970. Declotting of the SCV was followed by surgical decompression in 53% of patients, while in the remainder, surgical decompression alone (18%), endovascular intervention alone (15%), or conservative therapy with anticoagulation (15%) was performed. The initial intervention was predominantly catheter-directed thrombolysis, with <10% of cases undergoing concomitant balloon angioplasty. 93% of cases were successful. In the postoperative phase, balloon angioplasty was performed to correct residual intrinsic SCV disease after vTOS decompression in under 15% of cases. Stents were rarely deployed. Symptom relief was reported as 94 ± 12% (mean ± SD) and 90 ± 23%, respectively for declotting with decompression and declotting alone. In the delayed phase, balloon angioplasty was performed in under 15% of cases to re-establish patency.

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Section: Introductionmentioning

confidence: 99%

“…Percutaneous thrombectomy catheters are delivered percutaneously to the site of the clot and, in a thrombolytic independent manner, disrupt and retrieve blood clots by capturing the clot in a wire mesh basket system or directly aspirating out the clot. These systems come in both large-bore and small-bore designs ( 13 , 17 ).…”

Section: Introductionmentioning

confidence: 99%