Thrombolysis with tissue-plasminogen activator: Results with a high-dose transthrombus technique

Ward, A. S.; Andaz, Shahriyour; Bygrave, Sean

doi:10.1016/s0741-5214(94)70078-8

Cited by 35 publications

(7 citation statements)

References 26 publications

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“…There are reports showing thrombolysis acceleration with either the bolus or pulsespray methods, and thus these methods are more attractive when time is limited to reestablish antegrade flow. Some reports, however, show an increased rate of bleeding complications compared with continuous infusion, 43 whereas others do not. [44][45][46] There is concern about distal embolization with either method due to clot fragmentation and close monitoring is needed.…”

Section: Infusion Methods and Dosagesmentioning

confidence: 99%

Catheter-Directed Thrombolysis for Acute Limb Ischemia

Morrison

2006

Semin intervent Radiol

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Acute limb ischemia is a potentially life-threatening clinical event. Thrombosis in situ, bypass graft thrombosis, and embolic occlusion are the three major precipitating events leading to acute limb ischemia. Management of acute ischemia depends on the clinical status of the affected limb and patient comorbidities. Catheter-directed thrombolysis (CDT) is the treatment of choice for patients with relatively mild acute limb ischemia (Rutherford categories I and IIa) with no contraindications to thrombolytic therapy. Patients with severe acute limb ischemia (Rutherford category IIb) need emergent revascularization. CDT should be considered, nonetheless, if the relative risks compared with primary operation are favorable. CDT is a life-and limb-saving treatment for many patients despite limitations of efficacy and associated complications. This article is a review of the etiology of acute arterial occlusion; clinical triage of patients presenting with acute limb ischemia; catheter guide wire techniques, pharmacological agents, and devices in current use for CDT; as well as the outcomes of CDT.

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Section: Infusion Methods and Dosagesmentioning

confidence: 99%

Catheter-Directed Thrombolysis for Acute Limb Ischemia

Morrison

2006

Semin intervent Radiol

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“…Ward et al found FDP elevated in 3/4 patients with major hemorrhagic complications secondary to r-TPA. 23,24 Also, Cina et al, had suggested that bleeding risk correlates with the level of fibrin degradation products (FDP) rather than fibrinogen. 19 Ouriel K et al, had reported that FDP may act as an anti-platelet agent and as an anticoagulant producing an inhibitory effect on fibrin polymerization.…”

Section: Discussionmentioning

confidence: 99%

Catheter directed thrombolysis in management of early acute thrombotic ischemia: early experience

Ismail

Abdelfattah

2017

Int Surg J

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Background: To assess the effectiveness of catheter directed thrombolysis in management of early acute thrombotic ischemia.Methods: A prospective study was carried out on 18 patients (13 males, 5 females) with a mean age of 49 years (ranged from 45 - 69 years) suffered from acute thrombotic lower limb ischemia (Rutherford II- a) and submitted to catheter directed thrombolysis (CDT) using tissue plasminogen activator (TPA) between August 2015 to March 2017. The commonest thrombosed artery was superficial femoral artery (SFA). Major risk factors were diabetes and smoking (66% and 56%) respectively. The infusion method was lacing technique followed by continuous infusion.Results: Technical success was obtained in 15 patients (83%). Complementary revascularization was performed in 5/15 patients (33.3 %) by balloon angioplasty. Limb salvage rate at 6 months was (77.7%). Failure of thrombolysis occurred in 3 limbs (16.6%); one patient treated by femoro-popliteal bypass while the other two limbs ended by amputation. Regarding complications, bleeding (local groin hematoma or minimal retroperitoneal hematoma) occurred in 3 patients (16.6 %). No major bleeding was recorded. Amputation had performed in 2 cases (11%) while mortality rate within 6 months was 16.6 %.Conclusions: With proper patient selection, CDT should be considered the first-line treatment for patients with (Rutherford II- a) acute thrombotic limb ischemia.

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“…We should master contraindications for CDT in ALI in case of fatal haemorrhage [2,13]. Absolute contraindications to thrombolysis are well-known and include active bleeding, central nervous system injury, or major operative procedures within the preceding 2 weeks.…”

Section: Catheter Directed Thrombolysis (Cdt)mentioning

confidence: 99%

Endovascular Treatment Options of Acute Limb Ischemia

Zhang¹,

Lou²,

Chen³

et al. 2013

IJMPCERO

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Acute limb ischemia is an urgent condition which occurs when there is an abrupt interruption of blood flow into an extremity usually because of either embolic or thrombotic vascular occlusion. Restoration of perfusion through early intervention can decrease amputation and mortality. Contemporary treatment includes both surgery and endovascular techniques. There is a rapid progress in endovascular intervention therapy. This article aims to make a comprehensive review of the endovascular intervention options of acute limb ischemia.

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Thrombolysis with tissue-plasminogen activator: Results with a high-dose transthrombus technique

Cited by 35 publications

References 26 publications

Catheter-Directed Thrombolysis for Acute Limb Ischemia

Catheter-Directed Thrombolysis for Acute Limb Ischemia

Catheter directed thrombolysis in management of early acute thrombotic ischemia: early experience

Endovascular Treatment Options of Acute Limb Ischemia

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