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catheter directed thrombolysis

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https://www.readbyqxmd.com/read/28054903/massive-pulmonary-embolism-treated-with-catheter-therapy-and-extracorporeal-membrane-oxygenation
#1
Nicholas R Teman, Jianzhou T Xiao, Curtis G Tribble
Massive pulmonary embolism (PE) is associated with significant morbidity and mortality.  Treatment for massive PE can include systemic thrombolysis and catheter-directed therapy. We present the case of a patient with massive PE successfully treated with catheter-directed therapy, using extracorporeal membrane oxygenation for hemodynamic support, and discuss some of the potential complications associated with this therapy.
21, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28042562/surgical-thrombectomy-for-phlegmasia-cerulea-dolens
#2
Shin-Seok Yang, Woo-Sung Yun
Phlegmasia cerulea dolens (PCD) is a medical emergency that can lead to venous gangrene of the lower extremity. Early diagnosis and prompt treatment is crucial for limb salvage. There are two treatment options (endovascular or surgical). In the endovascular era, catheter-directed thrombolysis is the treatment of choice to achieve venous outflow. However, surgical thrombectomy is indicated in certain cases. The authors report successful surgical thrombectomy in a 75-year-old man with PCD and review the treatment of PCD...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28031648/successful-retrieval-of-the-detached-porous-metallic-tip-of-a-mechanical-aspiration-catheter-during-thrombectomy-in-a-case-with-may-thurner-syndrome-a-case-report
#3
Alpaslan Yavuz, Çagatay Andiç, Ali Kemal Gür, Cemil Göya, Aydın Bora, Mehmet Beyazal
Modern, minimally invasive techniques used to treat deep venous thrombosis, such as percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis, have gained worldwide acceptance. PMT has the advantage of speed and is also associated with improved outcomes, shortened hospital stays, and low complication rates. The main complications associated with PMT have been primarily due to iatrogenic vascular damage resulting in perforation, embolic occlusion, and arteriovenous fistula formation; to date, there has been no publication in the literature describing complications resulting from device failure...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28025027/catheter-directed-thrombolysis-and-pharmacomechanical-thrombectomy-improve-midterm-outcome-in-acute-iliofemoral-deep-vein-thrombosis
#4
Tzu-Ting Kuo, Chun-Yang Huang, Chiao-Po Hsu, Chiu-Yang Lee
BACKGROUND: Aggressive and early thrombus removal strategy has been widely used as a treatment for iliofemoral deep vein thrombosis (DVT). We compared the long-tem venous outcome, including postthrombotic syndrome (PTS), in patients undergoing catheter-directed thrombolysis (CDT) and pharmacomechanical thrombectomy (PMT). METHODS: From January 2009 to December 2013, 61 patients with acute proximal DVT were enrolled in this prospective study. Thirty-one patients underwent CDT and 30 patients underwent PMT, and each patient was followed for at least 2 years after treatment...
December 23, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27999507/the-penumbra-5max-ace-catheter-is-safe-efficient-and-cost-saving-as-a-primary-mechanical-thrombectomy-device-for-large-vessel-occlusions-in-acute-ischemic-stroke
#5
Gabriel A Vidal, James M Milburn
BACKGROUND: Reperfusion of large vessel occlusions in acute stroke can improve patient outcomes. The purposes of this study were to assess the safety and efficacy of the Penumbra 5MAX ACE catheter for revascularization of large vessels and to compare its cost to the cost of stent retrievers. METHODS: In this retrospective, single-center case review study, data were captured on consecutive patients treated with the Penumbra 5MAX ACE as first-line therapy during an 11-month period...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27998957/multicenter-experience-with-the-new-sofia-plus-catheter-as-a-primary-local-aspiration-catheter-for-acute-stroke-thrombectomy
#6
M A Möhlenbruch, C Kabbasch, A Kowoll, E Broussalis, M Sonnberger, M Müller, M Wiesmann, J Trenkler, M Killer-Oberpfalzer, W Weber, A Mpotsaris, M Bendszus, S Stampfl
INTRODUCTION: The direct aspiration first pass technique (ADAPT) has been introduced as a rapid and safe endovascular treatment strategy in patients with ischemic stroke. OBJECTIVE: To determine the technical feasibility, safety, and functional outcome with ADAPT using the new large-bore 6F SOFIA Plus catheter. METHODS: A retrospective analysis of prospectively collected data from six university hospitals was performed. The following parameters of all acute stroke procedures (June 2015- January 2016) using the SOFIA Plus catheter were analyzed: accessibility of the thrombus with the catheter, recanalization success (Thrombolysis in Cerebral Infarction ≥2b), time to recanalization, procedure-related complications...
December 20, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27970166/tct-779-catheter-directed-thrombolysis-vs-systemic-thrombolysis-in-acute-pe-a%C3%A2-single-center-experience
#7
Jeffrey Fowler, Stephen D'Auria, Andrew Althouse, Jeffrey McKibben, Belinda Rivera-Lebron, Efthimios Avgerinos, Catalin Toma
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970160/tct-773-thrombolysis-catheter-directed-systemic-in-pulmonary-embolism-predictors-and-etiologies-of-readmissions
#8
Prashant Patel, Shilpkumar Arora, Sopan Lahewala, Nilay Patel, Byomesh Tripathi, Purav Shah, Jaimin Trivedi, Harshil Shah, Chirag Bambhroliya, Smit Patel, Sidakpal Panaich, Abhishek Deshmukh, Apurva Badheka
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970158/tct-769-ultrasound-assisted-catheter-directed-thrombolysis-in-the-treatment-of-high-risk-pulmonary-embolism-a-meta-analysis
#9
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/27913777/risk-factors-for-major-bleeding-in-the-seattle-ii-trial
#10
Immad Sadiq, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure...
December 1, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27899519/initial-clinical-experience-using-the-two-stage-aspiration-technique-tsat-with-proximal-flow-arrest-by-a-balloon-guiding-catheter-for-acute-ischemic-stroke-of-the-anterior-circulation
#11
Hiroyuki Matsumoto, Hirokazu Nishiyama, Yoshiaki Tetsuo, Hideki Takemoto, Naoyuki Nakao
BACKGROUND: Our initial experience using the two-stage aspiration technique (TSAT) with proximal flow arrest by a balloon guiding catheter is presented. In TSAT, aspiration is applied with the 5MAX ACE and also with the 3MAX catheter with a Penumbra aspiration pump, while arresting proximal flow by balloon inflation. METHODS: In patients treated with TSAT, clinical data including National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge, as well as procedural data including the Thrombolysis in Cerebral Infarction (TICI) score, procedural time, and complications were analyzed...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#12
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27867284/ekosonic-thrombolysis-as-a-therapeutic-adjunct-in-venous-occlusive-disease
#13
D S Zaghlool, R W Franz, J Jenkins
The use of ultrasound waves in conjunction with local thrombolysis may accelerate clot resolution and serve as an important therapeutic adjunct in the treatment of venous occlusive disease. Our goal was to provide a larger sample population over a 5-year period to evaluate our experience with the EkoSonic endovascular system (EKOS, EKOS Corporation, Bothell, WA). We suspected that ultrasound-accelerated thrombolysis (UAT) using EKOS would provide excellent thrombolysis and midterm patency rates with minimal thrombolytic complications...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27863366/early-versus-late-thrombolysis-in-acute-arterial-occlusion-of-lower-extremity
#14
Hyun Gee Moon, Sang Cheol Cho, Sang Woo Jeong, Gyu Ik Lee, Young Eun Jo, Boram Youn, Won Yu Kang, Sun Ho Hwang, Wan Kim, Weon Kim
BACKGROUND: Acute arterial occlusion in lower extremity is an urgent condition which occurs when there is an abrupt interruption of blood flow into an extremity. Reperfusion through early intervention can increase limb salvage and decrease mortality. There was no common agreement when is the best to start thrombolysis in treating acute arterial occlusion. This study was designed to study the efficacy of an early thrombolysis compared with a late thrombolysis. METHOD: We identified all patients discharged from the Gwangju Veterans hospital with a diagnosis of acute arterial occlusion between 2006 and 2014...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27860129/the-postthrombotic-syndrome-current-evidence-and-future-challenges
#15
REVIEW
A Rabinovich, S R Kahn
Post thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT), which develops in 20%-50 % of patients. PTS manifests as a spectrum of symptoms and signs of chronic venous insufficiency that can impose significant morbidity and have a negative impact on quality of life. Chronic venous hypertension caused by a combination of residual venous obstruction and valvular reflux is believed to play a major role in the pathophysiology of PTS. The Villalta scale is the most widely applied clinical scale used to diagnose and define PTS...
November 18, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27830895/thrombolysis-for-acute-deep-vein-thrombosis
#16
REVIEW
Lorna Watson, Cathryn Broderick, Matthew P Armon
BACKGROUND: Standard treatment for deep vein thrombosis aims to reduce immediate complications. Use of thrombolysis or clot dissolving drugs could reduce the long-term complications of post-thrombotic syndrome (PTS) including pain, swelling, skin discolouration, or venous ulceration in the affected leg. This is the third update of a review first published in 2004. OBJECTIVES: To assess the effects of thrombolytic therapy and anticoagulation compared to anticoagulation alone for the management of people with acute deep vein thrombosis (DVT) of the lower limb as determined by the effects on pulmonary embolism, recurrent venous thromboembolism, major bleeding, post-thrombotic complications, venous patency and venous function...
10, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27826790/direct-stenting-in-patients-with-acute-lower-limb-arterial-occlusions-immediate-and-long-term-results
#17
Nikolaos Galanakis, Nikolaos Kontopodis, Ioannis Peteinarakis, Elias Kehagias, Christos V Ioannou, Dimitrios Tsetis
PURPOSE: The purpose of this study is to accentuate the efficacy of direct stenting (stent placement without predilatation of the lesion) in patients with acute lower limb arterial ischemia (ALLI). MATERIALS AND METHODS: Between January 2010 and September 2015, 16 patients (11 men and 5 women) underwent direct stenting of acute arterial occlusions. All patients had contraindication for surgical revascularization or catheter-directed thrombolysis. According to SVS/ISCVS Classification, six patients had IIa and ten patients IIb ALLI...
November 8, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27818112/endovascular-management-of-may-thurner-syndrome-in-adolescents-a-single-center-experience
#18
Roger E Goldman, Victoria A Arendt, Nishita Kothary, William T Kuo, Daniel Y Sze, Lawrence V Hofmann, Matthew P Lungren
PURPOSE: To report a single-center experience in regard to the technique, safety, and clinical outcomes of endovascular therapy for treatment of May-Thurner syndrome (MTS) in adolescent patients. MATERIALS AND METHODS: A retrospective review identified 10 patients (6 female; mean age, 16 y; range, 12-18 y; mean weight, 73 kg; range, 50-116 kg) treated by endovascular therapy for MTS from 1998 to 2015. Clinical presentations consisted of acute thrombotic MTS (n = 6) and nonthrombotic MTS (n = 4)...
January 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27814432/pharmacomechanical-thrombectomy-for-iliofemoral-deep-vein-thrombosis
#19
REVIEW
Lindsay Robertson, Olivia McBride, Anne Burdess
BACKGROUND: Deep venous thrombosis (DVT) occurs in approximately one in 1000 adults every year, and has an annual mortality of 14.6%. In particular, iliofemoral DVT can lead to recurrent thrombosis and post-thrombotic syndrome (PTS), a painful condition which can lead to chronic venous insufficiency, oedema, and ulceration. It causes significant disability, impaired quality of life, and economic burden. Early thrombus removal techniques have been advocated in patients with an iliofemoral DVT in order to improve vein patency, prevent valvular dysfunction, and reduce future complications, such as post-thrombotic syndrome and venous ulceration...
4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27793619/patterns-in-the-management-of-acute-limb-ischemia-a-vess-survey
#20
Matthew R Smeds, Harleen K Sandhu, Samuel S Leake, Charles C Miller, Kristofer M Charlton-Ouw
BACKGROUND: Treatment strategies for acute limb ischemia (ALI) are abundant with few established guidelines. We sought to determine nationwide ALI treatment patterns in the modern era. METHODS: Anonymous electronic surveys examining the management of ALI involving native vessel and bypass occlusion were sent to all members of the Vascular and Endovascular Surgery Society (n = 738). Treatment options included catheter-directed lysis (CDL) or pharmacomechanical (PMT) thrombolysis and open surgery...
January 2017: Annals of Vascular Surgery
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