Rheolytic Pharmacomechanical Thrombectomy in Experimental Chronic Deep Vein Thrombosis: Effect of L‐Arginine on Thrombogenicity and Endothelial Vasomotor Function

Lin, Peter H.; Okada, Tamuru; Steinberg, James L.; Wei, Zhou; Sayed, Hosam F. El; Rawat, A.; Kougias, Panos; Yao, Qizhi; Chen, Changyi

doi:10.1007/s00268-007-0733-5

Cited by 10 publications

(7 citation statements)

References 50 publications

(104 reference statements)

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“…The 1-year patency rates were assessed in only 1 study by Lin et al who documented a patency rate of 68%, using duplex scanning. 15 Arko et al reported a vein patency rate of 90% and notably normal valve function of 88% at 6 months using duplex scan. 11…”

Section: Resultsmentioning

confidence: 99%

“…The search yielded a total of 62 articles, including case reports, of which only 8 case series/registries (n ¼ 2528) were eligible for inclusion in this systematic review (see Figure 1). [11][12][13][14][15][16][17][18] These 8 case series specifically assessed the utility of a pharmacomechanical strategy utilizing either the Trellis or the Angio Jet system. The study periods were from 1998 to 2009, with all of them being retrospective analysis/registry data.…”

Section: Resultsmentioning

confidence: 99%

“…Four series (Gupta, Arko, Lin, and O'Sullivan) included patients with acute DVT-defined as DVT of <14 days duration. 2,11,15,16 Hilleman et al and Dietzek included patients with both acute and chronic (>14 days duration) DVT, whereas Rao et al included patients with only chronic DVT (>14 days duration). 13,17,18 Three series included only lower extremity DVTs and the other 3 included lower and upper extremity DVTs (although lower extremity DVT constituted the majority).…”

Section: Resultsmentioning

confidence: 99%

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Pharmacomechanical Thrombolysis of Acute and Chronic Symptomatic Deep Vein Thrombosis: A Systematic Review of Literature

2011

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Pharmacomechanical thrombolysis (PMT) is an emerging treatment option for symptomatic deep vein thrombosis (DVT). This may obviate the need for systemic or catheter-directed thrombolysis. PubMed, EMBASE, and Cochrane database search of PMT in acute and chronic symptomatic DVT was undertaken. Baseline demographic and clinical characteristics, procedural details, DVT characteristics, and procedural and clinical outcomes are presented. A total of 8 case series (n = 2528; 1998-2009) qualified for inclusion. Lower extremity symptomatic DVTs constituted the majority of the cases (>80%). Both acute (<14 days) and chronic (>14 days) DVTs were included. Procedural success was 59% to 100% and catheter-directed thrombolysis was used as an adjunct in 16% to 53%. No deaths or major bleeding complications were reported. Pharmacomechanical thrombolysis leads to the immediate resolution of clinical symptoms of DVT in the majority of patients. Pharmacomechanical thrombolysis may be a safe and novel method, when appropriate expertise and resources are available, for the treatment of symptomatic acute and chronic DVT.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Pharmacomechanical Thrombolysis of Acute and Chronic Symptomatic Deep Vein Thrombosis: A Systematic Review of Literature

2011

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“…Despite evidence of feasibility in multiple case series, the Angiojet system was associated with significant bradyarrhythmia, hypotension, and hypoxia due to presumed pulmonary hemorrhage with subsequent circulatory collapse [ 34 , 35 ]. Subsequent animal studies attributed these complications to significant vasoreactivity from AngioJet catheter placement resulting in significant release of bradykinin and adenosine [ 36 ]. While this device continues to have 510(k) clearance from the FDA for peripheral thrombus, the aforementioned concerns led to an FDA black box warning for intrapulmonary use and should be avoided.…”

Section: Catheter-based Embolectomymentioning

confidence: 99%

Management of Acute Pulmonary Embolism

Tice

Seigerman

Fiorilli

et al. 2020

Curr Cardiovasc Risk Rep

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Purpose of the Review Over 100,000 cardiovascular-related deaths annually are caused by acute pulmonary embolism (PE). While anticoagulation has historically been the foundation for treatment of PE, this review highlights the recent rapid expansion in the interventional strategies for this condition. Recent Findings At the time of diagnosis, appropriate risk stratification helps to accurately identify patients who may be candidates for advanced therapeutic interventions. While systemic thrombolytics (ST) is the mostly commonly utilized intervention for high-risk PE, the risk profile of ST for intermediate-risk PE limits its use. Assessment of an individualized patient risk profile, often via a multidisciplinary pulmonary response team (PERT) model, there are various interventional strategies to consider for PE management. Novel therapeutic options include catheter-directed thrombolysis, catheter-based embolectomy, or mechanical circulatory support for certain high-risk PE patients. Current data has established safety and efficacy for catheterbased treatment of PE based on surrogate outcome measures. However, there is limited long-term data or prospective comparisons between treatment modalities and ST. While PE diagnosis has improved with modern cross-sectional imaging, there is interest in improved diagnostic models for PE that incorporate artificial intelligence and machine learning techniques. Summary In patients with acute pulmonary embolism, after appropriate risk stratification, some intermediate and high-risk patients should be considered for interventional-based treatment for PE.

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“…The AngioJet Xpeedior thrombectomy device (Possis/ Medrad; Minneapolis, MN) is a 6F over-the-wire catheter, which creates thrombus aspiration force based on Venturi's principle. 55,56 The device permits a concomitant infusion of the thrombolytic agent, which creates a pharmacomechanical thrombectomy technique of thrombus dissolution by both thrombolysis and mechanical thrombectomy. The pharmacomechanical thrombectomy technique using this device is widely adapted in DVT interventions.…”

Section: Angiojet Rheolytic Thrombectomy Cathetermentioning

confidence: 99%

Endovascular Interventions for Acute Pulmonary Embolism

Lin¹,

Chen²,

Bechara³

et al. 2010

Perspectives in Vascular Surgery and Endovascular Therapy

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Massive pulmonary embolism (PE) is a highly lethal condition with clinical manifestations of hemodynamic instability, acute right ventricular (RV) failure, and cardiogenic shock. Submassive PE, as defined by RV failure or troponin elevation, can result in life-threatening sequelae if treatment is not initiated promptly. Current treatment paradigm in patients with massive PE mandates prompt risk stratification with aggressive therapeutic strategies. With the advent of endovascular technologies, various catheter-based thrombectomy and thrombolytic devices are available to treat patients with massive or submassive PE. In this article, a variety of endovascular treatment strategies for PE are analyzed. The authors' institutional experience with ultrasound-accelerated thrombolytic therapy as well as catheter-directed thrombolytic therapy in patients with acute massive PE during a recent 10-year period is discussed. Finally, clinical evidence on the utilization of catheter-based interventions in patients with massive and submassive PE is also analyzed.

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Rheolytic Pharmacomechanical Thrombectomy in Experimental Chronic Deep Vein Thrombosis: Effect of L‐Arginine on Thrombogenicity and Endothelial Vasomotor Function

Cited by 10 publications

References 50 publications

Pharmacomechanical Thrombolysis of Acute and Chronic Symptomatic Deep Vein Thrombosis: A Systematic Review of Literature

Pharmacomechanical Thrombolysis of Acute and Chronic Symptomatic Deep Vein Thrombosis: A Systematic Review of Literature

Management of Acute Pulmonary Embolism

Endovascular Interventions for Acute Pulmonary Embolism

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