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Urokinase infusion catheter

Christina K Park, Bosco A Paes, Kim Nagel, Anthony K Chan, Prashanth Murthy
Thrombotic occlusion of central venous catheters (CVCs) is a common problem in newborns. No guideline systematically addresses the diagnosis, management, and prevention of this complication. The objective of this review is to establish evidence-based guidance for the management of CVC thrombosis. A comprehensive literature search was conducted from 1948 to 2012. Twenty-six articles fulfilling four criteria - humans, neonates aged less than 28 days, CVC insertion, and English language - were included for analysis...
July 29, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Chien-Boon Jong, Wei-Yung Lo, Mu-Yang Hsieh
We report our experience using catheter-directed thrombectomy/thrombolysis (CDT) to treat a patient with acute renal vein thrombosis (RVT) associated with systemic lupus erythematosus (SLE). A 34-year-old woman presented with persistent left flank pain, and a renal ultrasonography examination revealed an enlarged left kidney. Contrast-enhanced computed tomography confirmed the presence of acute left RVT. Because medical treatment failed to relieve her pain and the renal function was deteriorating, we attempted to salvage the occluded left renal vein using an endovascular approach...
April 18, 2016: Catheterization and Cardiovascular Interventions
Leslie Fiengo, Federico Bucci, Elias Khalil, Bruno Salvati
OBJECTIVE: The aim of the study was to discuss the results of catheter-directed thrombolysis and complementary procedures to treat acute iliofemoral deep vein thrombosis (DVT) evaluating the safety and effectivness of an easy access such as the Great Saphenous Vein. METHODS AND MATERIALS: A total of 22 consecutive patients with iliofemoral thrombosis and two patients with femoro-popliteal thrombosis on recent onset diagnosed with Ultrasound Doppler and contrast venography underwent intrathrombus drip infusion of urokinase while intravenous heparin was continued using saphenical access...
2015: Thrombosis Journal
G-Q Cao, L Li, Y-B Wang, Z-Z Shi, D-Y Fan, H-Y Chen
BACKGROUND AND OBJECTIVE: Patients with loculated tuberculous pleurisy (TBP) treated with urokinase suffer less from residual pleural thickening (RPT) than those treated with simple drainage. However, the role of intrapleural urokinase in free-flowing TBP patients remains unclear. METHODS: A total of 318 patients with presumed TBP were screened. The final 171 patients who participated in the study were randomly allocated to the urokinase group (n = 86) and the control group (n = 85)...
November 2015: International Journal of Tuberculosis and Lung Disease
Jung Tack Son, Sun Young Min, Jae Il Kim, Pyong Wha Choi, Tae Gil Heo, Myung Soo Lee, Chul-Nam Kim, Hong-Yong Kim, Seong Yoon Yi, Hye Ran Lee, Young-Nam Roh
PURPOSE: The management of central venous catheters (CVCs) and catheter thrombosis vary among centers, and the efficacy of the methods of management of catheter thrombosis in CVCs is rarely reported. We investigated the efficacy of bedside thrombolysis with urokinase for the management of catheter thrombosis. MATERIALS AND METHODS: We retrospectively reviewed data from patients who had undergone CVC insertion by a single surgeon in a single center between April 2012 and June 2014...
December 2014: Vascular Specialist International
Kyu Sung Choi, Ji Dae Kim, Hyo-Cheol Kim, Sang-Il Min, Seung-Kee Min, Hwan Jun Jae, Jin Wook Chung
OBJECTIVE: To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter...
July 2015: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Marcela Lara Mendes, Pasqual Barretti, Tricya Nunes Vieira da Silva, Daniela Ponce
Currently, permanent catheters (pCVC) are becoming an alternative vascular access for long-stay patients in whom arteriovenous access cannot be made. Occlusion is a commun mechanical complication related to pCVC, leading to inadequate dialysis dose and frequent changes of local catheter location, which can cause exclusion of vascular sites. The aim of this study was to perform a narrative review of treatment of pCVC thrombotic occlusion in HD patients. The treatment of CVCP thrombosis typically consists on the saline infusion or administration of thrombolytics such as tissue plasminogen activated, reteplase and urokinase...
April 2015: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Allan I Bloom, Adam Farkas, Yossi Kalish, Uriel Elchalal, Galia Spectre
PURPOSE: Pharmacomechanical catheter-directed thrombolysis (PCDT) is relatively contraindicated during pregnancy and postpartum. The purpose of this study was to evaluate outcomes of PCDT in this population. MATERIALS AND METHODS: Data for 11 consecutive patients (aged 21-35 y) undergoing PCDT at a tertiary center for symptomatic pregnancy-related iliofemoral deep vein thrombosis (DVT) were retrospectively reviewed. Details regarding patient presentation, location and extent of thrombus, the PCDT procedure, outcomes, frequency of postthrombotic syndrome (PTS), and subsequent pregnancies were recorded...
July 2015: Journal of Vascular and Interventional Radiology: JVIR
William T Kuo, Arjun Banerjee, Paul S Kim, Frank J DeMarco, Jason R Levy, Francis R Facchini, Kamil Unver, Matthew J Bertini, Akhilesh K Sista, Michael J Hall, Jarrett K Rosenberg, Miguel A De Gregorio
BACKGROUND: Systemic thrombolysis for acute pulmonary embolism (PE) carries up to a 20% risk of major bleeding, including a 2% to 5% risk of hemorrhagic stroke. We evaluated the safety and effectiveness of catheter-directed therapy (CDT) as an alternative treatment of acute PE. METHODS: One hundred one consecutive patients receiving CDT for acute PE were prospectively enrolled in a multicenter registry. Massive PE (n = 28) and submassive PE (n = 73) were treated with immediate catheter-directed mechanical or pharmacomechanical thrombectomy and/or catheter-directed thrombolysis through low-dose hourly drug infusion with tissue plasminogen activator (tPA) or urokinase...
September 2015: Chest
Heather Pascoe, Donald Robertson
BACKGROUND: Acute limb ischaemia (ALI) is commonly managed with surgical intervention but catheter-directed thrombolysis (CDT) is a proven treatment alternative. CDT as a treatment for ALI is not common and is dependent on local practice. All patients receiving urokinase infusions at our institution currently require a bed in the high-dependency unit (HDU). Administering the infusion requires significant nursing time and this can be accommodated in HDU where the nurse-to-patient ratio is higher than it is on general wards...
2014: Australasian Medical Journal
Bishav Mohan, Naved Aslam, Anil Kumar Mehra, Shibba Takkar Chhabra, Praneet Wander, Rohit Tandon, Gurpreet Singh Wander
BACKGROUND: Pulmonary embolism (PE) with more than 50% compromise of pulmonary circulation results significant right ventricular (RV) afterload leading to progressive RV failure, systemic hypotension and shock. Prompt restoration of thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy (PMT) prevents progressive hemodynamic decline. We report our single center experience in high risk PE patients treated with standard pigtail catheter mechanical fragmentation followed by intrapulmonary thrombolysis as a primary therapy...
May 2014: Indian Heart Journal
Shuofei Yang, Baochen Liu, Weiwei Ding, Changsheng He, Xingjiang Wu, Jieshou Li
PURPOSE: To assess the feasibility, effectiveness, and safety of catheter-directed thrombolysis and aspiration thrombectomy therapy by combined route of superior mesenteric vein and artery (SMV+SMA) for acute superior mesenteric venous thrombosis (ASMVT). METHODS: This retrospective study reviewed eight ASMVT patients with transcatheter direct thrombolysis and aspiration thrombectomy therapy via SMV and indirect thrombolysis via SMA during a period of 14 months...
February 2015: Cardiovascular and Interventional Radiology
Angela E Ballinger, Suetonia C Palmer, Kathryn J Wiggins, Jonathan C Craig, David W Johnson, Nicholas B Cross, Giovanni F M Strippoli
BACKGROUND: Peritonitis is a common complication of peritoneal dialysis (PD) that is associated with significant morbidity including death, hospitalisation, and need to change from PD to haemodialysis. Treatment is aimed to reduce morbidity and recurrence. This is an update of a review first published in 2008. OBJECTIVES: To evaluate the benefits and harms of treatments for PD-associated peritonitis. SEARCH METHODS: For this review update we searched the Cochrane Renal Group's Specialised Register to March 2014 through contact with the Trials Search Co-ordinator using search terms relevant to this review...
2014: Cochrane Database of Systematic Reviews
Harm P Ebben, Johanna H Nederhoed, Jeroen Slikkerveer, Otto Kamp, Geert W J M Tangelder, René J P Musters, Willem Wisselink, Kak K Yeung
BACKGROUND: The addition of local ultrasound (US) with a contrast agent to standard intra-arterial thrombolysis can accelerate the thrombolytic treatment of stroke and myocardial infarction. The contrast agent consists of microsized gas-filled bubbles that collapse when exposed to US, causing destabilization of the clot and making the clot surface more susceptible to fibrinolytics. In this study, we investigated the effect of additional US and microbubbles on standard low-dose intra-arterial thrombolysis in a porcine model of extensive peripheral arterial occlusion...
August 2015: Journal of Vascular Surgery
Hans Van Der Meersch, Dirk De Bacquer, Stefaan J Vandecasteele, Barbara Van den Bergh, Pieter Vermeiren, Jan De Letter, An S De Vriese
BACKGROUND: A complication of long-term use of tunneled cuffed catheters for hemodialysis is the high rate of infection and thrombus-related dysfunction. Specific mechanical features of tunneled cuffed catheters may improve hemodynamic performance and decrease thrombosis and infection rates. However, there currently is no proven advantage of one design over another. STUDY DESIGN: Single-center randomized clinical trial. SETTING & PARTICIPANTS: 302 hemodialysis patients who required a tunneled cuffed catheter as temporary or definite vascular access...
December 2014: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Johanna H Nederhoed, Jeroen Slikkerveer, Klaas W Meyer, Willem Wisselink, René J P Musters, Kak K Yeung
Acute peripheral arterial thrombosis can be threatening to life and limb. Dissolution of the thrombus local catheter-directed intra-arterial infusion of fibrinolytic agents such as urokinase is the standard therapy for thrombosis; however, this method is time-intensive, and amputation of the affected limb is still needed in 10-30% of cases. Furthermore, thrombolytic therapy carries the risk of bleeding complications. The use of small gas-filled bubbles, or ultrasound contrast agents (UCAs), in combination with ultrasound has been investigated as an improved thrombolytic therapy in acute coronary and cerebral arterial thrombosis...
March 2014: Lab Animal
Christina K Park, Bosco A Paes, Kim Nagel, Anthony K Chan, Prashanth Murthy
Thrombotic occlusion of central venous catheters (CVCs) is a common problem in newborns. There is no guideline that systematically addresses the diagnosis, management, and prevention of this complication. The objective of this review is to establish evidence-based guidance for the management of CVC-related thrombosis. A comprehensive search of the scientific literature was conducted from 1948 to 2012. Twenty-six articles fulfilling four criteria - humans, neonates aged below 28 days, CVC insertion, and English language - were included for analysis...
March 2014: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Guan-hua Xue, Xiao-zhong Huang, Meng Ye, Wei Liang, Hao Zhang, Ji-wei Zhang, Bai-gen Zhang
BACKGROUND: The purpose of this study was to evaluate the safety and effectiveness of catheter-directed thrombolysis (CDT) and stenting in the treatment of iliac vein compression syndrome (IVCS) with acute iliofemoral deep vein thrombosis (DVT). METHODS: A retrospective analysis was conducted in 61 patients (36 women, 25 men, age range 32-90 years, mean 64 years) who had IVCS with acute iliofemoral thrmobosis (≤10 days) and were treated by CDT and stenting between June 2006 and August 2011...
May 2014: Annals of Vascular Surgery
Patrick Bagan, Bassel Dakhil, Pierre Lacal, Jean Claude Couffinhal
PURPOSE: To assess the efficacy of a new in situ thrombolysis method using a low-pressure micro-porous balloon catheter (MPBC) compared to a traditional in situ infusion (ISI) of a fibrinolytic agent in the treatment of acute limb ischemia. METHODS: Between January 2010 and December 2011, 21 patients (14 men; mean age 64.6 years, range 40-92) treated for acute lower limb ischemia were prospectively enrolled in the study. Seven patients underwent in situ thrombolysis using the ISI method and 14 patients the MPBC method to deliver urokinase...
June 2013: Journal of Endovascular Therapy
Bishav Mohan, Shibba Takkar Chhabra, Naved Aslam, Gurpreet Singh Wander, Naresh Kumar Sood, Sumati Verma, Anil Kumar Mehra, Sarit Sharma
AIM: To assess role of combined modality of mechanical fragmentation and intralesional thrombolysis in patients with massive pulmonary embolism presenting subacutely. METHODS: Eight of 70 patients presenting in tertiary care centre of North India with massive pulmonary embolism within 4 years had subacute presentation (symptom onset more than 2 wk). These patients were subjected to pulmonary angiography with intention to treat basis via mechanical breakdown and intra lesional thrombolysis...
May 26, 2013: World Journal of Cardiology
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