Dutch Randomized Trial Comparing Standard Catheter-Directed Thrombolysis and Ultrasound-Accelerated Thrombolysis for Arterial Thromboembolic Infrainguinal Disease (DUET)

Schrijver, A. Marjolein; Leersum, Marc van; Fioole, Bram; Reijnen, Michel M.P.J.; Hoksbergen, Arjan W.J.; Vahl, A.C.; Vries, Jean‐Paul P.M. de

doi:10.1177/1526602814566578

Cited by 46 publications

(35 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, there is no standardization of the therapeutic protocol in regard to dosing and duration of the thrombolytic agent or monitoring of the patient. When comparing standard thrombolysis with ultrasound-accelerated thrombolysis (UST), a multicenter Dutch trial showed a significantly reduced therapy time with UST, but with a substantial number of bleeding complications [31]. Large cohort studies or systematic meta-analyses to show clinical benefits are missing [31][32][33].…”

Section: Catheter-directed Thrombolysis (Cdt)mentioning

confidence: 99%

Current Treatment Options in Acute Limb Ischemia

Fluck

Augustin

Bley

et al. 2019

Fortschr Röntgenstr

View full text Add to dashboard Cite

Background Acute limb ischemia represents a clinical emergency with eventual limb loss and life-threatening consequences. It is characterized by a sudden decrease in limb perfusion. Acute ischemia is defined as a duration of symptoms for less than 14 days. Aging of the population increases the prevalence of acute limb ischemia. The two principal etiologies are arterial embolism and in situ thrombosis of an atherosclerotic artery. Immediate diagnosis, accurate assessment and urgent intervention when needed are crucial to save the limb and to prevent a major amputation. Delay in diagnosis and therapy may lead to irreversible ischemic damage. Method To assess the current treatment options in acute limb ischemia, this review is based on a selective literature search in PubMed representing the current state of research. Results and Conclusion Patients with acute limb ischemia should receive immediate anticoagulation. Treatment depends on the classification based on the degree of ischemia and limb viability. Especially acute (< 14 days symptom duration) Rutherford Categories IIa and IIb with marginally and immediately threatened limbs require definitive therapeutic intervention and are salvageable, if promptly revascularized. The current literature suggests that open surgical revascularization is more time effective then catheter-directed thrombolysis. However, with the advent of thrombolytic delivery systems and mechanical thrombectomy devices, treatment time can be minimized and successful utilization in patients with Category IIb (Rutherford Classification for Acute Limb Ischemia) has been reported with promising limb-salvage and survival rates. Large randomized studies are still missing, and guidelines suggest choosing the method of revascularization depending on anatomic location, etiology, and local practice patterns, with the time to restore the blood flow being an important factor to consider. Key points: Citation Format

show abstract

Section: Catheter-directed Thrombolysis (Cdt)mentioning

confidence: 99%

Current Treatment Options in Acute Limb Ischemia

Fluck

Augustin

Bley

et al. 2019

Fortschr Röntgenstr

View full text Add to dashboard Cite

show abstract

“…That makes the thrombus more permeable and allows the thrombolytic agent to penetrate deeper. The absorption of rt-PA in the thrombus is enhanced and thrombus lysis accelerates [48,49]. Additionally, in Trellis TM , the therapeutic catheter vibrates, further disrupting the thrombus [50].…”

Section: Complicationsmentioning

confidence: 99%

Treatment of acute lower limb ischaemia

Łukasiewicz

2016

Vasa

View full text Add to dashboard Cite

Summary: Acute lower limb ischaemia poses a major threat to limb survival. For many years surgical thromboembolectomy was the mainstay of treatment. Recent years have brought an endovascular revolution in the management of acute lower limb ischaemia. A wide range of endovascular procedures can nowadays be employed, providing results at least as good as the traditional surgical approach. This paper is an overview of currently utilised endovascular options as well as recent modifi cations of standard surgical techniques.

show abstract

“…Randomised comparisons show that the EKOS Endowave system indeed accelerates thrombolysis but that it also increases the risk of bleeding, because of the handling of the introducer sheath. 6 As with any new device, this approach will also face the challenge of defining its cost effectiveness.…”

mentioning

confidence: 99%