Evaluation of Balloon Catheter-Guided Intra-Arterial Thrombolysis for Acute Peripheral Arterial Occlusion

Dakhil, Bassel; Lacal, Pierre; Abdesselam, Ali Ben; Couffinhal, Jean-Claude; Gordienco, A.; Bagan, Patrick

doi:10.1016/j.avsg.2012.11.011

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…If thrombosis occurs in those arteries, adjuvant therapies are needed, such as catheter-guided thrombolysis, balloon dilation, and even CDT. 20,21 What’s more, it is not applicable to the artery with serious calcification because the calcified thrombus could easily damage the wall of the artery. Thus it might result in arterial rupture.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of percutaneous mechanical thrombectomy in the treatment of acute thromboembolic occlusions of lower extremity

et al. 2020

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Objectives The objective of this study was to evaluate the effectiveness of percutaneous mechanical thrombectomy as the initial thrombus removal method in the treatment of acute lower extremity ischemia. Methods The patients with acute lower limb ischemia who underwent percutaneous mechanical thrombectomy between August 2016 and February 2018 were retrospectively reviewed. The patients were diagnosed by clinical examination and computed tomography angiography. The percutaneous mechanical thrombectomy was performed as the initial thrombus removal method, followed by anticoagulation therapy. The patients were followed up by clinical examination, imaging, and ankle brachial index (ABI) examination. Results Thirty-two patients (21 males, 11 females; average age of 68.53 ± 8.05; three cases of grade III, 29 cases of grade IIB) were reviewed. Recanalization of the thromboembolic occlusions were achieved in all patients. ABI significantly ( p < 0.01) increased postoperatively (preoperative ABI: 0.51 ± 0.13; postoperative ABI: 0.85 ± 0.65, ABI at three months postoperatively: 0.84 ± 0.66). Eleven patients underwent balloon dilation and three patients had stent placement. Complete thrombus removal was achieved in all patients. The primary patency at 3 months, 6 months, and 12 months postoperatively was 90%, 85%, and 56%, respectively. The secondary patency at 3 months, 6 months, and 12 months postoperatively was 93%, 87%, and 65%, respectively. Conclusions The immediate result appeared to be effective to use percutaneous mechanical thrombectomy as the first thrombus removal method in the treatment of acute thromboembolic occlusions in the lower extremity, while the midterm result needs to be further improved.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of percutaneous mechanical thrombectomy in the treatment of acute thromboembolic occlusions of lower extremity

et al. 2020

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“…This means, that a multidisciplinary approach should be used, involving anesthesiologists, haematologists, interventional radiologists and vascular surgeons to significantly improve the clinical outcome of CDT therapy.(30). Another possibility for improving the clinical outcome is to use intra-arterial thrombolysis guided with a balloon catheter ( 9 ). It's possible to enhance local thrombolysis through this method, to use smaller quantities of a thrombolysis agent and to improve the outcome for even relatively old arterial thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and Complications after Intraarterial Thrombolysis for Limb Ischemia: a 4 Year Study at a Single Centre

Ligers

Ivanova

Bergs

et al. 2016

Acta Chirurgica Latviensis

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3 Summary Introduction. The reason for using thrombolytic therapy is to eliminate vascular thrombosis and promote vascular permeability. Acute limb ischemia is associated with significant morbidity and mortality. ROCHESTER, STILE and TOPAS studies showed that thrombolytic therapy for acute limb ischemia decreases the rate of surgical interventions and significantly increases the rate of limb salvage. Aim of the Study. The purpose of this study is to assess the efficacy and outcomes of intra-arterial thrombolysis in the treatment of acute occlusions of the lower limb over a four-year period. Material and Methods. We analysed 103 patients who had been treated in our department. There were acute ischemias of stage IIa and IIb according to the Rutherford classification. The data prior to, and after thrombolysis was analysed. We used Alteplase as a thrombolytic agent (mean dose 62 mg ±23.5). Procedural success was based on angiographic and clinical outcomes. Statistics were calculated by SPSS 16. Results. The mean duration of symptoms prior to hospitalisation was 2.5 days (IQR 5-96 hours). The mean age at the time of thrombolysis was 63±11 for males 69±10 years for females. The success of intraarterial thrombolysis was defined by angiographic and clinical outcomes (successful in 86.4% and failed in 13.6%). Adjunctive angioplasty was performed on 39 (37.9%) patients, and immediate reconstructive surgery was required on 19 (18.4%) patients. The incidence of complications was 17,4 %, with the most common being-bleeding from the puncture side, the urinary tract or the gastrointestinal tract. Overall mortality was 8.7%. The women who required thrombolysis were older (p=0,034) and with a higher death rate (p=0.047). A CDT (catheter-directed thrombolysis) for an abdominal aorta thrombosis carries a significantly high mortality rate (p=0.00013). There were no statistically significant differences between the duration of symptoms and limb amputation and between other analysed data. Conclusions. Intraarterial thrombolysis is an effective treatment method in acute limb ischemia for selected patients, as long as accurate procedural monitoring is ensured. Thrombolysis often leads to the discovery of underlying vascular lesions. A CDT for an abdominal aorta thrombosis carries a significantly high mortality rate.

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“…Several treatment approaches have been developed, including anticoagulation therapy with therapeutic agents (8)(9)(10), catheter-directed intra-thrombus thrombolysis (CDIT) (11,12), and pharmacomechanical catheter-directed thrombolysis (PCDT) (13)(14)(15). Clinical trials have proved that the combined use of a balloon catheter and thrombolytic drugs helps to reduce thrombolytic drug dosage and improve thrombolytic effect (16)(17)(18)(19)(20). The thrombi tend to slip and yield in the dilatation process of using a conventional glossy balloon due to their smooth surface.…”

Section: Introductionmentioning

confidence: 98%

Anin-vitrostudy on corn-shaped balloon-enhanced thrombolysis

Yan

Song

2014

Minimally Invasive Therapy & Allied Technologies

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Evaluation of Balloon Catheter-Guided Intra-Arterial Thrombolysis for Acute Peripheral Arterial Occlusion

Cited by 4 publications

References 9 publications

The effectiveness of percutaneous mechanical thrombectomy in the treatment of acute thromboembolic occlusions of lower extremity

The effectiveness of percutaneous mechanical thrombectomy in the treatment of acute thromboembolic occlusions of lower extremity

Outcomes and Complications after Intraarterial Thrombolysis for Limb Ischemia: a 4 Year Study at a Single Centre

Anin-vitrostudy on corn-shaped balloon-enhanced thrombolysis

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