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catheter directed thrombolysis

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https://www.readbyqxmd.com/read/28739471/comparison-of-low-dose-catheter-directed-thrombolysis-with-and-without-pharmacomechanical-thrombectomy-for-acute-lower-extremity-ischemia
#1
Sagar S Gandhi, Joseph A Ewing, Emily Cooper, Jose Mauro Chaves, Bruce H Gray
INTRODUCTION: Catheter directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) can dissolve/remove thrombus; PMT alone, however, may require the adjunctive use of CDT. The aim of this study was to compare the use of CDT with and without PMT for the treatment of acute limb ischemia (ALI). METHODS: We retrospectively reviewed all patients with ALI who underwent CDT with or without PMT between January 2008 and April 2014 (N=99). Patients with incomplete medical charts were excluded (n=16)...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739469/acute-venous-iliofemoral-thrombosis-early-surgical-thrombectomy-is-effective-and-durable
#2
Stefan Ockert, Matthias von Allmen, Michaela Heidemann, Juliette Brusa, Jan Duwe, Robert Seelos
BACKGROUND: The first-line recommendation for treatment of acute iliofemoral deep vein thrombosis (IFDVT) is catheter-directed or pharmaco-mechanical thrombolysis (CDT/PCDT). Recent analysis of surgical thrombectomy has shown comparable results. However this procedure is not commonly given as much importance as interventional techniques. We analyzed patient outcome of surgical thrombectomy using modern endovascular techniques in both the short and long term. METHODS: All consecutive patients who underwent surgical thrombectomy at our institution between April 2008 and April 2017 were included...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28736157/prevention-and-treatment-of-the-post-thrombotic-syndrome
#3
REVIEW
Oleg Pikovsky, Anat Rabinovich
Post-thrombotic syndrome (PTS) is a complication that develops in up to 50% of patients with deep vein thrombosis (DVT) and manifests as symptoms and signs of chronic venous insufficiency of varying severity. PTS negatively affects patient's quality of life and causes significant burden to the healthcare system. The risk for PTS development can be markedly reduced by preventing DVT and providing appropriate anticoagulation once it develops. Patients with extensive proximal (iliofemoral) DVT may benefit from invasive interventions, such as catheter-directed thrombolysis...
July 15, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28735935/catheter-directed-thrombolysis-in-a-child-with-bilateral-renal-artery-graft-thrombosis
#4
Raphael Yoo, Ahmad I Alomari, Raja Shaikh, Scott L Davis, Michael A Ferguson, Kashayar Vakili, Heung-Bae Kim, Gulraiz Chaudry
A 5-year-old boy with midaortic syndrome who had undergone aortic bypass and bilateral renal artery grafts presented to the emergency department 1 year after surgery with symptoms of nausea, vomiting, and abdominal pain. Because of delay in diagnosis of bilateral renal artery thrombosis, his condition progressed to anuric renal failure. He underwent catheter-directed thrombolysis 7 days after presentation with administration of tissue plasminogen activator and heparin infusion over a 24-hour period. There was successful resolution of thrombus and complete recovery of renal function to baseline...
August 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28730176/thrombectomy-combined-with-indwelling-catheter-thrombolysis-is-more-effective-than-pure-thrombectomy-for-the-treatment-of-lower-extremity-deep-venous-thrombosis
#5
Wenli Wang, Yanfang Wu, Tao Fang, Dunyuan Xu
This study was a retrospective analysis of the efficacy of thrombectomy plus local catheter-directed thrombolysis (CDT) for the treatment of lower extremity deep venous thrombosis (LDVT). The experimental group underwent thrombectomy plus LCDT, whereas the control group underwent thrombectomy plus systemic thrombolysis via the dorsalis pedis vein. Venography and vascular color Doppler ultrasound were performed 7 days after surgery and at follow-up. The differences in the thigh and calf circumferences of normal and affected limbs were compared between groups...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28719398/interventional-approaches-to-deep-venous-thrombosis
#6
Kristen A Lee, Raja S Ramaswamy
PURPOSE OF REVIEW: Catheter-directed therapy in deep vein thrombosis (DVT) is a beneficial adjunct treatment when anticoagulation alone does not provide an adequate therapeutic response. This review aims to deliver an up-to-date discussion behind the rationale, safety profile, and clinical outcomes in endovascular management of DVT. RECENT FINDINGS: Early studies have shown that the use of catheter-directed thrombolysis (CDT) to be successful in rapid thrombus removal, carry a lower incidence of postthrombotic syndrome (PTS), and improved quality of life...
July 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28668312/ultrasound-assisted-catheter-directed-thrombolysis-in-pulmonary-embolism-in%C3%A2-transit
#7
Andrew Boshara, Sushruth Edla, Saroj Neupane, Howard Rosman, Antonious Attallah
No abstract text is available yet for this article.
June 21, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28667425/effectiveness-of-catheter-directed-thrombolysis-and-stent-implantation-on-iliofemoral-vein-thrombosis-caused-by-iliac-vein-compression
#8
Zhi-Bing Ming, Wen-Dong Li, Rui-Fan Yuan, Xiao-Qiang Li, Wen-Bin Ding
The purpose of this study was to objectively assess the morbidity of post-thrombotic syndrome (PTS) in iliofemoral vein thrombosis treated with catheter-directed thrombolysis (CDT) and stenting under the protection of inferior vena cava (IVC) filter. All patients with an unprovoked episode of iliofemoral vein thrombosis combined with iliac vein compression syndrome (IVCS) during January 2011 and January 2015 were enrolled. Clinical records of all patients were evaluated. Firstly, cox regression was performed to find out the factors impacted the incidence of PTS...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28654852/adductor-canal-compression-syndrome-in-an-18-year-old-female-patient-leading-to-acute-critical-limb-ischemia-a-case-report
#9
Yi Zhou, Evan J Ryer, Robert P Garvin, Jeremy L Irvan, James R Elmore
BACKGROUND: Adductor canal compression syndrome is a rare non-atherosclerotic cause of arterial occlusion and limb ischemia. PRESENTATION OF CASE: The patient is an 18-year-old healthy female who presented to the emergency department with acute left lower extremity ischemia. Her symptoms began as sudden onset mild foot pain approximately two months ago. Over the 72h prior to presentation, she developed severe pain, pallor, paralysis, loss of pedal pulses, paresthesia, and poikilothermia...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#10
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28628412/stratification-imaging-and-management-of-acute-massive-and-submassive-pulmonary-embolism
#11
REVIEW
Akhilesh K Sista, William T Kuo, Mark Schiebler, David C Madoff
While pulmonary embolism (PE) causes approximately 100 000-180 000 deaths per year in the United States, mortality is restricted to patients who have massive or submassive PEs. This state of the art review familiarizes the reader with these categories of PE. The review discusses the following topics: pathophysiology, clinical presentation, rationale for stratification, imaging, massive PE management and outcomes, submassive PE management and outcomes, and future directions. It summarizes the most up-to-date literature on imaging, systemic thrombolysis, surgical embolectomy, and catheter-directed therapy for submassive and massive PE and gives representative examples that reflect modern practice...
July 2017: Radiology
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#12
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28618846/comparison-of-direct-iliofemoral-stenting-following-angiojet-rheolytic-thrombectomy-vs-staged-stenting-after-angiojet-rheolytic-thrombectomy-plus-catheter-directed-thrombolysis-in-patients-with-acute-deep-vein-thrombosis
#13
Guang Liu, Jinbao Qin, Chaoyi Cui, Kaichuang Ye, Huihua Shi, Xiaobing Liu, Minyi Yin, Xintian Huang, Min Lu, Mier Jiang, Weimin Li, Xinwu Lu
PURPOSE: To compare the treatment outcomes in patients with acute proximal deep vein thrombosis (DVT) and iliofemoral stenosis who underwent either direct stenting after AngioJet rheolytic thrombectomy or staged stenting after AngioJet thrombectomy plus catheter-directed thrombolysis with urokinase. METHODS: From June 2014 to February 2016, 91 DVT patients underwent 2 treatments for duplex-verified iliofemoral stenosis: direct stenting (n = 46; mean age 54.8 years; 32 men) or staged stenting (n = 45; mean age 56...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28595772/prevention-of-early-complications-and-late-consequences-after-acute-pulmonary-embolism-focus-on-reperfusion-techniques
#14
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/28580827/therapeutic-management-of-acute-pulmonary-embolism
#15
Cécile Tromeur, Liselotte M Van Der Pol, Francis Couturaud, Frederikus A Klok, Menno V Huisman
Acute pulmonary embolism (PE) is a potentially fatal manifestation of venous thromboembolism. Prompt anticoagulant treatment is crucial for PE patients, which can decrease morbidity and mortality. Risk assessment is the cornerstone of the therapeutic management of PE. It guides physicians to the most appropriate treatment and selects patients for early discharge or home treatment. Areas covered: Here, we review the current treatments of acute PE according to contemporary risk stratification strategies, highlighting each step of PE therapeutic management...
August 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28538271/pulmonary-transplant-salvage-using-ultrasound-assisted-thrombolysis-of-subacute-occlusive-main-pulmonary-artery-embolus
#16
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/28497223/successful-endovascular-treatment-of-popliteal-artery-entrapment-syndrome-a-case-report-with-3-years-follow-up
#17
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
#18
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
#19
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
#20
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
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