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catheter directed thrombolysis

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https://www.readbyqxmd.com/read/28497223/successful-endovascular-treatment-of-popliteal-artery-entrapment-syndrome-a-case-report-with-3-years-follow-up
#1
Xiaodong Wang, Hongkun Zhang, Jin Yan, Ziying Lu
Popliteal artery entrapment syndrome (PAES) is a rare cause of lower extremity arterial ischemia, especially in elder patients. At present, the role of the endovascular technique for PAES is still mainly auxiliary, there is no successful case treated successfully by endovascular treatment without open surgery, and also the long-term follow-up after endovascular treatment are lacking. We successfully treated a 51-year-old man with pale, cold right foot by endovascular therapy only, including percutaneous transluminal angioplasty and catheter directed thrombolysis...
May 11, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28479088/ultrasound-and-intra-clot-microbubbles-enhanced-catheter-directed-thrombolysis-in%C3%A2-vitro-and-in%C3%A2-vivo
#2
Shunji Gao, Qiong Zhu, MengJiao Guo, Yuan Gao, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
Insufficient penetration of microbubbles (MBs) into the vessel-obstructing thrombi significantly reduces the effectiveness of ultrasound thrombolysis (UT). The widely performed catheter-directed therapy (CDT) makes it possible to increase the local concentration of MBs in the clot. In an occluded vessel with a bypass, treatment of fresh human whole blood clots with CDT-based UT (intra-clot injection of MBs and urokinase, with ultrasound exposure) resulted in a significantly higher percentage of weight loss (35...
May 4, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28474654/pulmonary-artery-catheter-directed-thrombolysis-for-intermediate-high-risk-acute-pulmonary-embolism
#3
Abhijeet Singh, Ayush Gupta, Jagdish Chander Suri
A case of 60-year-old male with acute pulmonary embolism without hypotension but signs of right ventricular dysfunction and elevated cardiac biomarkers is reported in this study. The patient comes under intermediate high-risk category and was successfully thrombolysed with alteplase infused through pulmonary artery catheter. Catheter-directed thrombolysis (CDT) can be considered as much safer and effective alternative to systemic thrombolysis in such patients with lower risk of bleeding. This novel bedside method of pulmonary artery CDT with the advantage of no radiation exposure and real time monitoring of pulmonary artery pressures as an end-point of thrombolysis can be utilized in the near future...
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28474644/catheter-directed-thrombolysis-for-acute-pulmonary-embolism-where-do-we-stand
#4
EDITORIAL
Stefano Barco, Stavros V Konstantinides
No abstract text is available yet for this article.
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28471007/catheter-directed-thrombolysis-of-acute-entire-limb-deep-vein-thrombosis-from-below-the-knee-access-a-retrospective-analysis-of-a-single-center-experience
#5
Guang Liu, Xaiobing Liu, Ruihua Wang, Kaichuang Ye, Minyi Yin, Xintian Huang, Min Lu, Weimin Li, Xinwu Lu, Mier Jiang
PURPOSE: To evaluate the safety and efficacy of below the knee (BTK) approach in the treatment of entire limb deep vein thrombosis (DVT). MATERIALS AND METHODS: Retrospective analysis of consecutive CDT treatment of acute entire limb DVT using a BTK approach (September 2010-February 2016) was performed. The patients included 51 men and 28 women with a mean age of 54 years. RESULTS: CDT was performed by accessing the ipsilateral the small saphenous vein (SSV) and posterior tibial vein (PTV; 24 via incision and 64 via puncture)...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28470393/aortic-aneurysm-rupture-after-urokinase-treatment-for-acute-limb-ischemia-in-two-patients-after-evar
#6
Davy R Sudiono, Rigo Hoencamp, Jaap Ottevanger, Daniel Eefting, Edwin van der Linden
Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. These cases suggest a relation between thrombolytic therapy and aortic rupture after EVAR, and we should therefore be aware of this possible complication...
May 3, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28440041/ultrasound-assisted-versus-conventional-catheter-directed-thrombolysis-for-acute-ilio-femoral-deep-vein-thrombosis-one-year-follow-up-data-of-a-randomized-controlled-trial
#7
Rolf P Engelberger, Anna Stuck, David Spirk, Torsten Willenberg, Axel Haine, Daniel Périard, Iris Baumgartner, Nils Kucher
BACKGROUND: In patients with acute ilio-femoral deep vein thrombosis (IFDVT), catheter-directed thrombolysis (CDT) aims to prevent the post-thrombotic syndrome (PTS). Adding intravascular high-frequency, low-power ultrasound energy to CDT does not seem to improve the immediate thrombolysis results but its impact on clinical outcomes at 12 months is not known. PATIENTS/METHODS: In this randomized-controlled trial, 48 patients (mean age 50±21 years, 52% women) with acute IFDVT were randomized to conventional CDT (n=24) or ultrasound-assisted CDT (USAT; n=24)...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28431023/safety-and-efficacy-of-the-sofia-6f-plus-distal-access-reperfusion-catheter-in-the-endovascular-treatment-of-acute-ischemic-stroke
#8
Hussain Shallwani, Hakeem J Shakir, Leonardo Rangel-Castilla, Jason M Davies, Ashish Sonig, Mithun G Sattur, Bernard R Bendok, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Neuroendovascular intervention has become a key treatment option for acute ischemic stroke. The Sofia (6F) PLUS catheter was designed for neurovascular access for diagnostic or therapeutic interventions. OBJECTIVE: To report the first series describing use of the Sofia PLUS intermediate/distal access reperfusion catheter in the treatment of acute ischemic stroke. METHODS: In this retrospective study, 41 stroke cases were identified in which the catheter was utilized for thrombolysis/thrombectomy...
April 19, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28429658/sex-differences-in-utilization-and-outcomes-of-catheter-directed-thrombolysis-in-patients-with-proximal-lower-extremity-deep-venous-thrombosis-insights-from-the-nationwide-inpatient-sample
#9
Vladimir Lakhter, Chad J Zack, Yevgeniy Brailovsky, Saurav Chatterjee, Vikas Aggarwal, Koneti A Rao, Deborah Crabbe, Huaqing Zhao, Eric Choi, Raghu Kolluri, Riyaz Bashir
Catheter-directed thrombolysis (CDT) is being increasingly used for the treatment of proximal lower extremity (LE) deep venous thrombosis (DVT). However, sex differences in utilization and safety outcomes of CDT in these patients are unknown. The Nationwide Inpatient Sample (NIS) database was used to identify all patients with a principal discharge diagnosis of proximal LE or caval DVT who underwent CDT between January 2005 and December 2011 in the United States. We evaluated the comparative safety outcomes of CDT among a propensity-matched group of 1731 men versus 1731 women...
April 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28429033/clinics-in-diagnostic-imaging-176-acute-embolic-occlusion-of-the-coeliac-artery
#10
Chinthaka Appuhamy, Justin Kwan, Martin Weng Chin H'ng, Sriram Narayanan, Sundeep Punamiya
A 52-year-old man, who had a background of chronic heart disease and atrial fibrillation, as well as non-compliance with warfarin therapy, presented with a two-week history of worsening upper abdominal pain. Computed tomography mesenteric angiography showed complete embolic occlusion of the coeliac artery with resultant segmental splenic infarction, and thrombus within the left ventricle. A decision was made to proceed with catheter-directed thrombolysis. Subsequent follow-up angiogram at 12 hours showed successful treatment with complete dissolution of the coeliac embolus...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28417266/guided-longer-pulses-from-a-diagnostic-ultrasound-and-intraclot-microbubble-enhanced-catheter-directed-thrombolysis-in-vivo
#11
Shunji Gao, Qiong Zhu, Xiaoxiao Dong, Zhong Chen, Zheng Liu, Feng Xie
The mechanism of ultrasound thrombolysis (UT) is generally attributed to cavitation. The insufficiency of microbubbles (MB) to serve as cavitation nuclei in the vessel-obstructing thrombi significantly reduces the effectiveness of UT. Taking advantage of the widely performed catheter-directed therapy (CDT), in a thrombo-embolized rabbit IVC model with a simultaneous catheter directed rt-PA thrombolysis procedure, guided moderate mechanical index longer pulses from a modified diagnostic ultrasound transducer, combined with an intraclot infusion of MB, significantly accelerated the thrombolysis process...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28412100/risk-of-acute-kidney-injury-after-percutaneous-pharmacomechanical-thrombectomy-using-angiojet-in-venous-and-arterial-thrombosis
#12
Guillermo A Escobar, Dillon Burks, Matthew R Abate, Mohammed F Faramawi, Ahsan T Ali, Lewis C Lyons, Mohammed M Moursi, Matthew R Smeds
BACKGROUND: Percutaneous mechanical thrombectomy (PMT) is commonly used to treat acute thrombotic syndromes. Angiojet (AJ) forcibly sprays fibrinolytics to fragment and aspirate thrombus. It's known to cause hemolysis and gross hematuria, yet potential consequences to renal function after AJ remain unstudied. We sought to determine the risk of acute kidney injury (AKI) after AJ when compared to other lysis techniques. METHODS AND RESULTS: We retrospectively reviewed patients treated with thrombolysis over 5 years...
April 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#13
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/28401327/pulmonary-embolism-response-teams
#14
REVIEW
Maya Serhal, Ihab S Haddadin, Gustavo A Heresi, Deborah A Hornacek, Mehdi H Shishehbor, John R Bartholomew
Pulmonary embolism (PE) is a common thrombotic event that is variable in its presentation. Depending on the patients' risk for mortality, guidelines provide several treatment strategies including thrombolysis, catheter-directed therapies, pulmonary embolectomy, anticoagulation, and inferior vena cava filters. However, there is considerable disagreement between guidelines regarding the optimal treatment strategy for patients, particularly for those with intermediate-risk PE. In order to provide rapid and individualized care, PE response teams (PERT) have been developed...
April 11, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28400063/first-case-of-ischemic-stroke-which-happened-during-continuous-intravenous-infusion-of-rt-pa
#15
Anna Zurawska, Jaroslaw Czeczotka, Jacek J Rozniecki
Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus...
May 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28398633/intracranial-hemorrhage-in-a-patient-with-sub-massive-pulmonary-embolism-treated-with-ekosonic-endovascular-system-directed-thrombolysis
#16
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
#17
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/28381215/a-case-of-successful-reperfusion-through-a-combination-of-intracoronary-thrombolysis-and-aspiration-thrombectomy-in-st-segment-elevation-myocardial-infarction-associated-with-an-ectatic-coronary-artery
#18
Yonggu Lee, Eunjin Kim, Bae Keun Kim, Jeong-Hun Shin
BACKGROUND: Large thrombus burdens in ectatic coronary arteries that remain after aspiration thrombectomy can negatively impact outcomes following percutaneous coronary interventions in patients with acute myocardial infarction. CASE PRESENTATION: A 53-year-old man presented with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed an ectatic right coronary artery (RCA) that was completely occluded in the mid portion by a large amount of thrombus...
April 5, 2017: BMC Cardiovascular Disorders
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
#19
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...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28369771/intervention-radiology-for-venous-thrombosis-early-thrombus-removal-using-invasive-methods
#20
REVIEW
Ana I Casanegra, Robert D McBane, Haraldur Bjarnason
The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation...
April 2017: British Journal of Haematology
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