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Ultrasound assisted thrombolysis

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https://www.readbyqxmd.com/read/29073366/catheter-directed-thrombolysis-for-intermediate-risk-pulmonary-embolism
#1
David Furfaro, R Scott Stephens, Michael B Streiff, Roy Brower
Intermediate risk pulmonary embolism is common and carries a risk of progression to hemodynamic collapse and death. Catheter directed thrombolysis is an increasingly utilized treatment option, based largely on the assumptions that it is more efficacious than anticoagulation alone, and safer than systemic thrombolysis. In this review, we critically analyze the published data regarding catheter directed thrombolysis for the treatment of intermediate risk pulmonary embolism. Catheter directed thrombolysis reduces right heart strain and lowers pulmonary artery pressures more quickly than anticoagulation alone...
October 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28945176/patency-rate-and-quality-of-life-after-ultrasound-accelerated-catheter-directed-thrombolysis-for-deep-vein-thrombosis
#2
Alexander Gombert, Ricarda Gombert, Mohammad E Barbati, Philipp Bruners, Andras Keszei, Cees Wittens, Houman Jalaie, Jochen Grommes
Purpose Studies on ultrasound-accelerated, catheter-directed thrombolysis of acute deep vein thrombosis emphasize good patency rates and low complication rates. Therefore, we analyzed quality of life besides technical success and patency in our patients after ultrasound-accelerated, catheter-directed thrombolysis. Methods Between 2009 and 2014, 42 patients suffering from iliofemoral deep vein thrombosis received ultrasound-accelerated, catheter-directed thrombolysis. Follow-up included clinical exanimation and ultrasound...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28944131/ultrasound-assisted-catheter-directed-thrombolysis-of-acute-pulmonary-embolism-a-review-of-current-literature
#3
REVIEW
Muhammad A Mangi, Hiba Rehman, Vikas Bansal, Omer Zuberi
Pulmonary embolism continues as a very common and also presumably life-threatening disorder. For affected individuals with intermediate- as well as high-risk pulmonary embolism, catheter-based revascularization procedures have developed a possible substitute for systemic thrombolysis or for surgical embolectomy. Ultrasound-assisted catheter-directed thrombolysis is an innovative catheter-based approach; which is the main purpose of the present review article. Ultrasound-assisted catheter-directed thrombolysis is much more efficacious in reversing right ventricular dysfunction as well as dilatation in comparison to anticoagulation alone in individuals at intermediate risk...
July 19, 2017: Curēus
https://www.readbyqxmd.com/read/28891451/fibrinolytic-and-anticoagulation-therapy-in-patients-undergoing-ultrasound-assisted-catheter-directed-thrombolysis-for-pulmonary-embolism
#4
Kimberly Terry, Leo F Buckley, Ahmed Aldemerdash, John Fanikos, Heather Dell Orfano
BACKGROUND: Ultrasound-assisted, catheter-directed thrombolysis (UA-CDT) relieves right ventricular stress without a significant increase in the risk of bleeding compared to systemic thrombolysis. Although concomitant anticoagulation is provided to prevent thrombus expansion, the optimal anticoagulation regimen in patients receiving UA-CDT remains unknown. OBJECTIVE: We sought to describe anticoagulation practices for patients receiving UA-CDT. METHODS: Patients receiving UA-CDT for acute pulmonary embolism (PE) between Jan 1, 2013 to Sept 30, 2014 at a single center were analyzed...
September 7, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28743779/treatment-of-pulmonary-embolism-with-argatroban-and-ultrasound-assisted-catheter-directed-thrombolysis-with-alteplase-in-a-patient-with-heparin-induced-thrombocytopenia
#5
Brittany T Bethea, John W Elliot, John B Richardson, Mustafa I Ahmed
PURPOSE: Successful ultrasound-assisted catheter-directed thrombolysis (USAT) with low-dose alteplase and argatroban in a patient with bilateral pulmonary embolism (PE) secondary to heparin-induced thrombocytopenia (HIT) is reported. SUMMARY: HIT is a life-threatening complication associated with a high risk of thromboembolism. Systemic anticoagulation for the treatment of thrombosis may not be sufficient in the presence of PE. Catheter-directed treatment may be indicated in patients with PE and associated right ventricular dysfunction...
August 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28668312/ultrasound-assisted-catheter-directed-thrombolysis-in-pulmonary-embolism-in%C3%A2-transit
#6
Andrew Boshara, Sushruth Edla, Saroj Neupane, Howard Rosman, Antonious Attallah
No abstract text is available yet for this article.
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#7
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of acute cardiovascular mortality and long-term morbidity. Right ventricular (RV) dysfunction is the key determinant of prognosis in the acute phase of PE, and residual RV dysfunction is associated with the development of post-PE functional impairment, chronic thromboembolic disease, and higher costs of treatment over the long term. Patients with clinically overt RV failure, i.e. hemodynamic collapse at presentation (high-risk PE), necessitate immediate thrombolytic treatment to relieve the obstruction in the pulmonary circulation; surgical or catheter-directed removal of the thrombus can be an alternative option...
June 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28538271/pulmonary-transplant-salvage-using-ultrasound-assisted-thrombolysis-of-subacute-occlusive-main-pulmonary-artery-embolus
#8
John R Spratt, Prashant Shrestha, Gabriel Loor, Jagadish M Patil, Marshall I Hertz, Gosta B Pettersson, Michael S Rosenberg
A 53-year-old woman who underwent bilateral lung transplantation 14 months before presented with 2 to 3 weeks of severe exertional dyspnea. Workup revealed a complete embolic occlusion of her left main pulmonary artery related to a femoral deep venous thrombosis. The occlusion did not respond to systemic anticoagulation, and a trial of catheter-directed thrombolysis was pursued. Flow to the left lower lobe was restored after 2 days of thromobolytic therapy. The patient is alive and well at more than 1 year of follow-up...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28498107/ultrasound-assisted-thrombolysis-of-an-occluded-transjugular-portosystemic-shunt
#9
Nicholas Hilliard, Teik Choon See, Nadeem Shaida
Transjugular intrahepatic portosystemic shunt (TIPS) insertion is commonly performed for refractory ascites or variceal bleeding. However, TIPS dysfunction can be seen in both early and late settings, with shunt thrombosis a particular problem. Treatment of shunt dysfunction commonly involves angioplasty and re-lining, with or without embolectomy, mechanical thrombectomy, or thrombolysis. Ultrasound-assisted thrombolysis has been shown to be successful for treatment of pulmonary embolism, deep vein thrombosis, and peripheral arterial thromboembolism, but has not been described before for TIPS occlusion...
July 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28440041/ultrasound-assisted-versus-conventional-catheter-directed-thrombolysis-for-acute-iliofemoral-deep-vein-thrombosis-1-year-follow-up-data-of-a-randomized-controlled-trial
#10
R P Engelberger, A Stuck, D Spirk, T Willenberg, A Haine, D Périard, I Baumgartner, N Kucher
Essentials Acute iliofemoral deep vein thrombosis can be treated with catheter-directed thrombolysis (CDT). We performed a randomized trial comparing conventional CDT versus ultrasound-assisted CDT (USAT). Clinical and duplex sonographic outcomes at 12 months were similar in the CDT and USAT groups. In both groups, incidence of postthrombotic syndrome was very low with good quality of life. SUMMARY: Background In patients with acute iliofemoral deep vein thrombosis (IFDVT), catheter-directed thrombolysis (CDT) aims to prevent the postthrombotic syndrome (PTS)...
July 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#11
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Elizabeth Genovese, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This study aimed to identify factors associated with CDI failure and to describe anticipated complications. METHODS: Consecutive patients who underwent CDI for massive or submassive PE between 2009 and 2015 were identified; outcomes and complications were retrospectively collected...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28398633/intracranial-hemorrhage-in-a-patient-with-sub-massive-pulmonary-embolism-treated-with-ekosonic-endovascular-system-directed-thrombolysis
#12
Sarju Ganatra, Arjun Majithia, Yun-Ting Eric Yeh, Michael S Levy
Ultrasound-assisted catheter-directed thrombolysis therapy has emerged more recently as a management strategy for patients with intermediate risk pulmonary embolism and has shown promising results in clinical trials by early reversal of right ventricle dilation, reduced pulmonary hypertension, and decreased anatomic thrombus burden. This therapeutic strategy requires a small fraction of the systemic fibrinolytic dose and is therefore associated with a reduced bleeding risk. Although intracranial hemorrhage has not been reported in clinical trials, it is a possible complication...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28393706/ultrasound-assisted-catheter-directed-thrombolysis-in-high-risk-and-intermediate-high-risk-pulmonary-embolism-a-meta-analysis
#13
Cihangir Kaymaz, Özgür Yaşar Akbal, Ibrahim Halil Tanboğa, Aykun Hakgör, Fatih Yilmaz, Selçuk Öztürk, Nertila Poçi, Sevim Türkday, Nihal Özdemir, Stavros Konstantinides
Catheter-directed Ultrasound-Assisted Thrombolysis (USAT) is a novel technology providing a high efficacy with a reduced bleeding risk in patients with pulmonary embolism (PE). We performed a meta-analysis based on presented or published PE series in which USAT was utilized. We searched the MEDLINE, EMBASE and the Cochrane Library for trials published up to December 2015. The primary outcomes were mean pulmonary artery pressure (PAMP), right to left ventricle diameter ratio (RV/LV ratio) and computed tomography (CT) obstruction score...
April 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28372484/single-center-retrospective-review-of-ultrasound-accelerated-versus-traditional-catheter-directed-thrombolysis-for-acute-lower-extremity-deep-venous-thrombosis
#14
COMPARATIVE STUDY
Tony Lu, Thomas M Loh, Hosam F El-Sayed, Mark G Davies
Objective Systemic anticoagulation remains the standard for acute lower extremity (LE) deep venous thrombosis (DVT), but growing interest in catheter-directed thrombolysis (CDT) and its potential to reduce the incidence of post-thrombotic syndrome (PTS) has led to advent of ultrasound-accelerated CDT (US-CDT). Few studies to date have examined the outcomes of US-CDT against traditional CDT (T-CDT). Methods This is a retrospective, single-center review of all patients treated for acute LE DVT over a five-year period with either US- and T-CDT...
October 2017: Vascular
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#15
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#16
REVIEW
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#17
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28121338/a-meta-analysis-of-efficacy-and-safety-of-catheter-directed-interventions-in-submassive-pulmonary-embolism
#18
B-H Lou, L-H Wang, Y Chen
OBJECTIVE: Catheter-directed interventions, such as catheter-directed thrombolysis (CDT), are becoming a popular therapeutic option for patients with hemodynamically stable pulmonary embolism (PE) and right ventricle (RV) dysfunction (submassive PE). We wished to quantitatively assess therapeutic efficacy and safety of catheter-directed interventions in submassive PE. MATERIALS AND METHODS: PubMed, Embase, Cochrane and Scopus were searched for studies on catheter-directed interventions and submassive PE...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27970158/tct-769-ultrasound-assisted-catheter-directed-thrombolysis-in-the-treatment-of-high-risk-pulmonary-embolism-a-meta-analysis
#19
Georges El Hayek, Michael McDaniel, Henry Liberman, Chandan Devireddy, Pete Fong, Gautam Kumar, Wissam Jaber
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27774968/-ultrasound-assisted-catheter-directed-thrombolysis-of-acute-pulmonary-embolism-via-the-subclavian-vein-alternative-access-path
#20
Veysel Özgür Barış, Evren Özçınar, Özgür Ulaş Özcan, Mustafa Şırlak
Routinely, the femoral vein is used for access in ultrasound-assisted, catheter-directed thrombolysis (USAT). Presently described is a case of bilateral femoral venous occlusion caused by chronic thrombosis, successfully treated with USAT, using subclavian vein for access.
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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