Regional thrombolysis in lower limb ischemia: new pharmacological and nonpharmacological aspects

Verhaeghe, Raymond

doi:10.1159/000073585

Cited by 1 publication

(1 citation statement)

References 21 publications

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“…Interventional procedures, such as pharmacological thrombolysis (PT) [ 2 , 3 ] and mechanical thrombectomy (MT) [ 4 ], have become a mainstay for the management of ALI. PT involves the use of medications to dissolve the blood clot [ 3 ], while MT uses different mechanical devices to physically remove the clot from the artery [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of interventional treatment of acute limb ischemia in Germany 2021

Bastian,

Nadjiri,

Wessendorf

et al. 2023

CVIR Endovasc

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Purpose Interventional procedures have become a mainstay in the therapy of acute limb ischemia caused by embolism or arterial thrombosis. Treatment options include pharmacological thrombolysis (PT) and mechanical thrombectomy (MT). The aim of this study was to evaluate success and major complication rates of interventional radiological treatments of arterial embolism and thrombosis in Germany in 2021 and to compare their results with accepted international quality standards. Materials and methods Data for PT and MT for 2021 was obtained from the quality management system of the German interventional radiological society (DeGIR). 2431 PT and 1582 MT procedures were documented for 2021, with 459 combinations of PT and MT. Data was analysed for technical and clinical success rates, as well as major complication rates such as intracranial bleeding, major bleeding, distal embolization, aneurysm formation, organ-failure and cardiac-decompensation. Results PT alone had technical and clinical success rate of 90.21% and 81.08%, respectively. MT alone had technical and clinical success rates of 97.41% and 95.39%, respectively. MT&PT had technical and clinical success rates of 91.07% and 84.75%, respectively. Major complications were: distal embolization (PT:2.02%; MT:1.74%; PT&MT:2.61%), major bleeding (PT:0.94%; MT:1.14%; PT&MT:0.87%), aneurysm formation (PT:0.33%;MT: 1.14%;PT&MT: 0%), intracranial bleeding (PT:0.16%;MT:0%;PT&MT:0.22%), cardiac-decompensation (PT:0.21%;MT: 0.06%;PT&MT:0%) and organ-failure (PT:0%;MT:0.06%;PT&MT:0.22%). Technical and clinical success rates were higher, while complication rates were lower than the corresponding threshold recommended by the Society of Interventional Radiology for percutaneous management of acute lower-extremity ischemia. Conclusion Treatment of arterial embolism and thrombosis performed by interventional radiologists in Germany is effective and safe with outcomes exceeding internationally accepted standards.

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