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catheter directed thrombolysis

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https://www.readbyqxmd.com/read/29157527/catheter-directed-therapy-for-pulmonary-embolism-patient-selection-and-technical-considerations
#1
REVIEW
Bedros Taslakian, Akhilesh K Sista
Acute pulmonary embolism (PE) is the third most common cause of death among hospitalized patients. Treatment escalation beyond anticoagulation therapy is necessary in patients with cardiogenic shock and may be of benefit in select normotensive patients with right heart strain. Percutaneous catheter-based techniques (catheter-directed mechanical thrombectomy, clot maceration, and/or pharmacologic thrombolysis) as an alternative or adjunct to systemic thrombolysis can rapidly debulk central clot in patients with shock...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29152468/dual-mechanical-thrombectomy-for-recanalization-of-a-resistant-acute-posterior-circulation-stroke
#2
Ahmet Peker, Ayça Akgoz, Ethem Murat Arsava, Mehmet Akif Topçuoglu, Anil Arat
A 71-year-old man with acute basilar artery occlusion was referred for endovascular treatment 6 hours after the onset of stroke with a Glasgow Coma Score of 3 and National Institutes of Health Stroke Scale of 27. A cerebral arteriogram revealed occlusion of the left vertebral artery proximally and thromboembolic occlusion of the basilar tip. Direct aspiration and mechanical thrombectomy with various stent retrievers failed to reconstitute arterial flow in the basilar artery. Thrombolysis in cerebral infarction 2b recanalization was achieved only after placement of double Catch Mini stent retrievers through 2 microcatheters, on both side branches of the basilar bifurcation in a kissing fashion and retrieving them simultaneously...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29133351/efficacy-and-safety-outcomes-of-recanalisation-procedures-in-patients-with-acute-symptomatic-pulmonary-embolism-systematic-review-and-network-meta-analysis
#3
David Jimenez, Carlos Martin-Saborido, Alfonso Muriel, Javier Zamora, Raquel Morillo, Deisy Barrios, Frederikus A Klok, Menno V Huisman, Victor Tapson, Roger D Yusen
BACKGROUND: We aimed to review the efficacy and safety of recanalisation procedures for the treatment of PE. METHODS: We searched PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through 31 July 2015 and included randomised clinical trials that compared the effect of a recanalisation procedure versus each other or anticoagulant therapy in patients diagnosed with PE. We used network meta-analysis and multivariate random-effects meta-regression to estimate pooled differences between each intervention and meta-regression to assess the association between trial characteristics and the reported effects of recanalisation procedures versus anticoagulation...
November 13, 2017: Thorax
https://www.readbyqxmd.com/read/29132220/catheter-directed-thrombolysis-versus-standard-anticoagulation-for-acute-lower-extremity-deep-vein-thrombosis-a-meta-analysis-of-clinical-trials
#4
Yongming Lu, Linyi Chen, Jinhui Chen, Tao Tang
Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29128608/a-retrospective-comparison-of-survivors-and-non-survivors-of-massive-pulmonary-embolism-receiving-veno-arterial-extracorporeal-membrane-oxygenation-support
#5
Bennet George, Marc Parazino, Hesham R Omar, George Davis, Maya Guglin, John Gurley, Susan Smyth
INTRODUCTION: While the optimal care of patients with massive pulmonary embolism (PE) is unclear, the general goal of therapy is to rapidly correct the physiologic derangements propagated by obstructive clot. Extracorporeal membrane oxygenation (ECMO) in this setting is promising, however the paucity of data limits its routine use. Our institution expanded the role of ECMO as an advanced therapy option in the initial management of massive PE. The purpose of this project was to evaluate ECMO-treated patients with massive PE at an academic medical center and report shortterm mortality outcomes...
November 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/29128156/utility-of-a-power-aspiration-based-extraction-technique-as-an-initial-and-secondary-approach-in-the-treatment-of-peripheral-arterial-thromboembolism-results-of-the-multicenter-prism-trial
#6
Richard R Saxon, James F Benenati, Corey Teigen, George L Adams, Luke E Sewall
PURPOSE: To investigate the safety and initial efficacy of XTRACT, a power aspiration-based extraction technique for treatment of peripheral arterial thromboembolism with the use of the Penumbra/Indigo system. MATERIALS AND METHODS: A total of 79 patients were enrolled: 39 (49.4%) underwent XTRACT as the initial therapy and 40 (50.6%) underwent XTRACT after failed catheter-directed thrombolysis or other mechanical intervention or for removal of distal emboli that occurred during an intervention...
November 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29112470/safety-and-efficacy-of-catheter-directed-therapies-as-a-supplement-to-surgical-decompression-in-venous-thoracic-outlet-syndrome
#7
Omar Zurkiya, Dean M Donahue, T Gregory Walker, Suvranu Ganguli
OBJECTIVE: The purpose of this study is to evaluate the role of endovascular therapy in the management of venous thoracic outlet syndrome (TOS), with an emphasis on its role after surgical decompression. MATERIALS AND METHODS: This single-center retrospective review identified all patients who underwent conventional contrast-enhanced venography as a component of the imaging evaluation of clinically suspected venous TOS from January 2004 through September 2015. Eighty-one patients were identified, with a mean (± SD) age of 33 ± 12 years, of whom 59% (48/81) were women...
November 7, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29073366/catheter-directed-thrombolysis-for-intermediate-risk-pulmonary-embolism
#8
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/29070134/-comparison-of-therapeutic-efficacy-of-anticoagulation-and-its-combination-with-catheter-directed-thrombolysis-for-deep-venous-thrombosis-of-lower-extremities
#9
Shao-Fei Su, Yu-Feng Tian, Lin-Bao Chen, Bo Yan
OBJECTIVE: To investigate the therapeutic efficacy of anticoagulation(AC) and its combination with catheter-directed thrombolysis(CDT) for deep venous thrombosis of lower extremities. METHODS: One hundred and thirty-nine patients with deep venous thrombosis of early lower extremities treated in our hospital from May 2011 to September 2013 were selected and randomly divided into the AC group(n= 66) and CDT+AC group(n= 73). The thrombolytic effects, adverse reactions, post-thrombotic syndrome (PTS) and quality of life were evaluated...
October 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29068112/use-of-systemic-bivalirudin-with-catheter-directed-thrombolysis-in-a-patient-with-heparin-induced-thrombocytopenia-a-case-report
#10
Hisham A Badreldin, Jessica Rimsans, Jean M Connors, Stephen D Wiviott
In patients with submassive pulmonary embolism, the use of catheter-directed thrombolysis (CDT), using low-dose alteplase is associated with improvement in overall hemodynamics. The data for use of CDT in patients with heparin-induced thrombocytopenia are limited. We report a case of CDT in a patient with HIT using bivalirudin anticoagulation. Data of the use of bivalirudin and argatroban for systemic anticoagulation with CDT are limited.
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29058996/successful-use-of-extracorporeal-membrane-oxygenation-in-a-child-with-obstructive-shock-due-to-massive-bilateral-pulmonary-embolism
#11
Aditya Badheka, Pradeep Bangalore Prakash, Veerajalandhar Allareddy
BACKGROUND: Acute massive pulmonary embolism (PE) is a very rare condition in children. We report the successful use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a lifesaving modality in a child with acute massive PE. CASE PRESENTATION: A nine-year-old female with spinal muscular atrophy type 1, chronic respiratory failure with tracheostomy and ventilator dependence presented with tachypnea and hypoxia. She had recent coiling of her pulmonary arterio-venous malformation...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29053904/a-direct-aspiration-first-pass-technique-adapt-for-acute-stroke-therapy-a-systematic-review-and-meta-analysis
#12
Benjamin Gory, Xavier Armoiry, Rotem Sivan-Hoffman, Michel Piotin, Mikael Mazighi, Bertrand Lapergue, Raphaël Blanc, Francis Turjman
BACKGROUND AND PURPOSE: ADAPT (A Direct Aspiration First Pass Technique), involving the first-line use of large-bore distal aspiration catheter, is a new strategy in the mechanical thrombectomy of acute ischemic stroke caused by large vessel occlusion. However, its impact on reperfusion rates, clinical outcomes, and complication rates is not fully examined. METHOD: We conducted a systematic review of the literature searching multiple databases for reports on thrombectomy of acute stroke with the ADAPT technique and performed meta-analyses of clinical and radiographic outcomes...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29034038/catheter-directed-thrombolysis-in-the-treatment-of-acute-ischemia-in-lower-extremities-is-safe-and-effective-especially-with-concomitant-endovascular-treatment
#13
Lærke Urbak, Louise de la Motte, Peter Rørdam, Aamir Siddiqi, Henrik Sillesen
Objective: To evaluate the influence of pre-procedural characteristics on immediate and late results as well as the safety of catheter-directed thrombolysis (CDT) in acute ischemia of the lower extremity. Materials and Methods: A retrospective study comprising 249 patients treated by CDT from January 2006 to December 2012. Outcomes were primary patency, haemorrhagic complications, amputation and mortality. Results: Primary patency for CDT alone was 68%, for CDT plus endovascular treatment 87% and for successful CDT with supplementary surgery 62% giving an overall primary patency of 76%...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29029714/catheter-directed-therapy-for-acute-submassive-pulmonary-embolism-summary-of-current-evidence-and-protocols
#14
REVIEW
Andrew Kesselman, William T Kuo
Treatment of acute submassive pulmonary embolism (PE) with thrombolytic therapy remains an area of controversy. For patients who fail or who have contraindications to systemic thrombolysis, catheter-directed therapy (CDT) may be offered depending on the patient's condition and the available institutional resources to perform CDT. Although various CDT techniques and protocols exist, the most studied method is low-dose catheter-directed thrombolytic infusion without mechanical thrombectomy. This article reviews current protocols and data on the use of CDT for acute submassive pulmonary embolism...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029713/techniques-and-devices-for-catheter-directed-therapy-in-pulmonary-embolism
#15
REVIEW
Alok Bhatt, Ramsey Al-Hakim, James F Benenati
The clinical presentation of a patient with acute pulmonary embolism (PE) can be classified into 3 categories: low-risk, submassive (presence of right heart strain), and massive (hemodynamic compromise). Massive PE is associated with high morbidity or mortality and typically treated with systemic intravenous thrombolysis. Over the last 2 decades, however, catheter-directed techniques have become an increasingly popular treatment modality for patients with a contraindication to systemic thrombolysis or without clinical improvement after systemic thrombolysis...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29026412/the-role-of-manual-thrombectomy-in-cardiovascular-outcome-among-patients-with-total-cutoff-vessel-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#16
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28980513/early-clinical-outcomes-of-a-novel-rheolytic-directional-thrombectomy-technique-for-patients-with-iliofemoral-deep-vein-thrombosis
#17
Jörn F Dopheide, Tim Sebastian, Rolf P Engelberger, Axel Haine, Nils Kucher
BACKGROUND: Rheolytic thrombectomy (RT) for acute iliofemoral deep vein thrombosis (DVT) with first-generation techniques is often incomplete and adjunctive conventional catheter-directed thrombolysis (CDT) is required in more than half of patients to achieve venous patency. PATIENTS AND METHODS: From the prospective Bern Venous Stent Registry, we investigated rates of primary treatment success, primary patency, and post-thrombotic syndrome (PTS) from 40 consecutive patients (mean age 51 ± 19 years, 45 % women) with acute iliofemoral DVT, treated with a novel directional RT technology and stent placement...
October 5, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28971664/should-ct-pulmonary-angiography-be-routinely-performed-after-ultrasound-facilitated-catheter-directed-thrombolysis-in-intermediate-high-risk-pulmonary-embolism
#18
Andrea Rubboli, Valerio Lanzilotti, Pier C Pavesi, Gianni Casella, Giuseppe DI Pasquale
No abstract text is available yet for this article.
December 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28956501/express-catheter-directed-therapy-for-submassive-pulmonary-embolism-after-unsuccessful-systematic-thrombolysis
#19
Chang Dong, Shunfen Jiang, Donghua Ji, Yingqun Ji, Zhonghe Zhang
No abstract text is available yet for this article.
January 1, 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28951796/iatrogenic-ivc-perforation-after-successful-catheter-directed-thrombolysis
#20
Ata Firoozi, Jamal Moosavi, Omid Shafe, Parham Sadeghipour
Central vein perforation as a rare complication of venous interventions is considered a nightmare if occurring in thoracic cage but behaves benignly in abdominal or pelvic region. This is not a rule, as we unfortunately encountered during the procedure of venous intervention in our patient. Although mechanical control of iatrogenic perforation or rupture is the first and most critical step during interventional procedures, the importance of anticoagulant and thrombolytic agents reversal should not be overlooked...
2017: Case Reports in Vascular Medicine
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