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catheter directed thrombolysis

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https://www.readbyqxmd.com/read/29784125/catheter-directed-thrombolysis-for-pulmonary-embolism-the-state-of-practice
#1
Xi Xue, Akhilesh K Sista
Acute pulmonary embolism (PE) is a major public health problem. It is the third most common cause of death in hospitalized patients. In the United States, there are up to 600,000 cases diagnosed per year with 100,000-180,000 acute PE-related deaths. Common risk factors include underlying genetic conditions, acquired conditions, and acquired hypercoagulable states. Acute PE increases the pulmonary vascular resistance and the load on the right ventricle (RV). Increased RV loading causes compensatory RV dilation, impaired contractility, tachycardia, and sympathetic activation...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784124/caval-thrombus-management-the-data-where-we-are-and-how-it-is-done
#2
Brittany Harrison, Frank Hao, Nii Koney, Justin McWilliams, John M Moriarty
Thromboses of the superior and inferior vena cava, either isolated or associated with distal deep venous thrombosis, are uncommon, but confer potentially serious morbidity and mortality. Incidence is increasing, especially with the prominence of intravascular devices. The range of treatment options is also expanding to include medical management, surgery, and endovascular techniques which are now frequently considered first line therapy due to lower reintervention rates and decreased periprocedural morbidity...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784123/endovascular-interventions-for-venous-disease
#3
REVIEW
Paul O'Connor, Robert Lookstein
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29772326/thrombolysis-in-acute-lower-limb-ischemia-review-of-the-current-literature
#4
REVIEW
Panagiotis G Theodoridis, Constantinos H Davos, Ilias Dodos, Nikolaos Iatrou, Anastasios Potouridis, Georgios M Pappas, Dimitrios Staramos, Paul Antoniadis, Vasilios Argitis, Konstantinos Dervisis
INTRODUCTION: Catheter directed thrombolysis (CDT) is a therapeutic option with acceptable results in patients with acute limb ischaemia (ALI) but with severe systemic or intracranial bleeding being the most significant clinical complication. The aim of the study is to collect and present direct results of CDT in patients treated for ALI. MATERIALS AND METHODS: Reports on CDT treatment in ALI until December 2016 searched in PubMed using the key words catheter direct thrombolysis, acute lower limb ischemia and any combination of these...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772323/endovascular-treatment-for-iliofemoral-vein-thrombosis-with-composite-stents
#5
Liangxi Yuan, Ye Lu, Guanglang Zhu, Tianchi Hu, Xiaoyu Sun, Junmin Bao, Qingsheng Lu, Zaiping Jing
OBJECTIVES: To evaluate the applicability of endovascular treatment for iliofemoral vein thrombosis with composite stents. METHODS: Between September 2013 and August 2016, 29 consecutive patients underwent endovascular therapy with composite stents for iliofemoral vein thrombosis and were followed up at our institution. All the patients with acute or chronic iliofemoral vein thrombosis enrolled in this study were evaluated by colour Doppler ultrasonography and diagnosed by venography...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29771696/the-future-of-anesthesia-for-interventional-radiology
#6
Annie Amin, Jason Scott Lane
PURPOSE OF REVIEW: To review novel procedures in interventional radiology and describe anesthetic implications. RECENT FINDINGS: Noninvasive treatment options for patients who are nonsurgical candidates are on the rise. The complication rate for patients receiving anesthesia in the interventional radiology suite is higher than other nonoperating room anesthetizing locations. The investigative use of catheter-directed thrombolysis for acute submassive pulmonary embolism will likely lead to an increased demand for anesthesia assistance...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29768935/catheter-directed-thrombolysis-with-a-continuous-infusion-of-low-dose-alteplase-for-subacute-proximal-venous-thrombosis-efficacy-and-safety-compared-to-urokinase
#7
Maofeng Gong, Xu He, Jinhua Song, Boxiang Zhao, Wanyin Shi, Guoping Chen, Jianping Gu
The purpose of this study was to compare the efficacy and safety associated with catheter-directed thrombolysis (CDT) using either recombinant tissue plasminogen activator (rt-PA) or urokinase (UK) for subacute deep venous thrombosis (DVT). From January 2014 to December 2016, we conducted a retrospective analysis on a total of 49 patients who underwent consistent CDT with either rt-PA (rt-PA-CDT group) or UK (UK-CDT group) treatment. The thrombolytic rate of the rt-PA-CDT group was significantly higher than that of the UK-CDT group (87...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29753382/may-thurner-syndrome
#8
Yub Raj Sedhai, Reshma Golamari, Aliaksei Salei, Joseph Alukal, Soney Basnyat, Sunil Pathak, Santosh Timalsina, Subtain Zia, Suraj Malhan, Priyanka T Bhatacharya
This single-center, retrospective review identified 6 patients (n = 6, 100% female) treated by endovascular therapy for May-Thurner syndrome from June 2013 to September 2015. Patients consisted of 3 African American, 2 Caucasian and 1 Asian; mean age was 53.50 ± 8.31 years, range: 39-63 years. Clinical presentations consisted of left lower extremity deep vein thrombosis in 4, left lower extremity deep vein thrombosis with pulmonary embolism in 1 and pulmonary embolism with left common iliac vein thrombosis in 1 patient...
May 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29748480/practice-trends-of-fibrinogen-monitoring-in-thrombolysis
#9
Claire Kaufman, Thomas Kinney, Keith Quencer
There is a lack of evidence or societal guidelines regarding the utility of fibrinogen monitoring during thrombolysis. The purpose of our study was to investigate the current use of monitoring fibrinogen levels during thrombolysis. A voluntary, anonymous online survey was sent to all physician members of the Society of Interventional Radiology, consisting of 23 questions related to practitioner demographics, thrombolysis protocol, and fibrinogen monitoring. There were 455 physician responses; 82% of respondents monitored fibrinogen levels during thrombolysis, of which 97% decreased or stopped tissue plasminogen activator based on the level...
May 10, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29745451/electronic-cardiac-arrest-triage-score-best-predicts-mortality-after-intervention-in-patients-with-massive-and-submassive-pulmonary-embolism
#10
Taishi Hirai, Steven Tate, Kathryn Dryer, Deshon Jones, Jonathan Rosenberg, Sandeep Nathan, Atman P Shah, Kyle Carey, Matthew Churpek, Dana Edelson, Janet Friant, Jonathan Paul, John E A Blair
OBJECTIVE: To determine if the cardiac arrest triage (CART) Score would better predict poor outcomes after pharmacomechanical therapy (PMT) for massive and submassive pulmonary embolism (PE) than traditional risk scores BACKGROUND: PMT for massive and submassive PE allows for clot lysis with minimal doses of fibrinolytics. Although PMT results in improved right ventricular function, and reduced pulmonary pressures and thrombus burden, predictors of poor outcome are not well-studied. METHODS: We conducted a retrospective analysis of all patients who underwent PMT for massive or submassive PE at a single institution from 2010 to 2016...
May 10, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743653/long-term-outcome-of-recoverable-stents-for-budd-chiari-syndrome-complicated-with-inferior-vena-cava-thrombosis
#11
Yonghua Bi, Hongmei Chen, Penxu Ding, Jianzhuang Ren, Xinwei Han
This study aimed to present long-term results of a 12-year patient follow-up of recoverable stents for BCS complicated by inferior vena cava (IVC) thrombosis. Forty consecutive patients with BCS complicated by IVC thrombosis were treated with recoverable stents. The median duration of symptoms was 24 months. Recoverable stents was placed after predilation of the obstructed IVC, and then agitation thrombolysis or catheter-directed thrombolysis of IVC was performed. The recoverable stents was removed eventually after thrombus disappeared...
May 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29715164/early-versus-delayed-use-of-ultrasound-assisted-catheter-directed-thrombolysis-in-patients-with-acute-submassive-pulmonary-embolism
#12
Sushruth Edla, Howard Rosman, Saroj Neupane, Andrew Boshara, Susan Szpunar, Edouard Daher, David Rodriguez, Thomas LaLonde, Hiroshi Yamasaki, Rajendra H Mehta, Antonious Attallah
OBJECTIVES: The effect of early vs delayed use of ultrasound-assisted catheter-directed thrombolysis (USAT) on invasive hemodynamics and in-hospital outcomes in patients with acute submassive pulmonary embolism (PE) is not well known. METHODS: We evaluated 41 patients with submassive PE to study the association of early USAT (≤24 hours; n = 21) vs delayed USAT (>24 hours; n = 20) with change in invasive hemodynamic measures from pre USAT to post USAT. RESULTS: Significantly greater improvement was observed in the early USAT group compared to the delayed group for median cardiac index (0...
May 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29709396/rivaroxaban-plus-percutaneous-catheter-directed-treatment-for-a-patient-with-massive-pulmonary-embolism-and-colporrhagia
#13
Wuchao Wang
Massive pulmonary embolism (PE) is defined by acute PE with sustained systemic arterial hypotension that is below 90 mm Hg for at least 15 min or requires inotropic agents (Jaff et al., 2011). For patients with absolute contraindications to thrombolysis, interventional treatment requires the removal of obstructing thrombi from the main pulmonary arteries to facilitate RV recovery and improve symptoms and survival (European Respiratory Society et al., 2014). For patients with acute PE, anticoagulation is recommended, with the objective of preventing both early death and recurrent symptomatic or fatal VTE...
April 19, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701417/surgical-thrombectomy-fibrinolysis-angioplasty-and-stenting-a-combined-approach-for-treatment-of-a-may-thurner-syndrome-presenting-as-phlegmasia-cerulea-dolens
#14
Carlos Veiga, João Gonçalves, Pedro Sousa, Carolina Vaz, Ivone Silva, Pedro Sá-Pinto, Rui Almeida
INTRODUCTION: Phlegmasia cerulea dolens (PCD) is a rare complication of deep venous thrombosis (DVT). Massive ileo-femoral DVT is usually the cause and prompt treatment is mandatory as it represents a medical emergency. Reported amputation rates range from 12% to 25% and mortality ranges from 25% to 40%. Limb ischemia results from obstruction to arterial inflow secondary to extreme levels of venous hypertension. Primary treatment goal is restoration of venous outflow and can be achieved by endovascular or surgical techniques...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701341/outcomes-after-catheter-direct-thrombolysis-for-acute-limb-ischaemia-single-center-experience
#15
Tiago Soares, João Rocha Neves, Ricardo Castro Ferreira, Pedro Almeida, Paulo Dias, Sérgio Sampaio, José Fernando Teixeira
INTRODUCTION: The aim of this study is to evaluate the outcome of catheter directed thrombolysis (CDT) in acute lower limb ischaemia depending on the underlying etiology. METHODS: Retrospective single center analysis of electronic clinical data on patients with acute lower limb ischaemia treated with CDT. Between January 2011 and September 2017, 128 procedures in 106 patients were included. The etiology of ischaemia was native artery thrombosis in 39 procedures (30,5%), PTFE graft thrombosis in 56 (43,8%), intra-stent thrombosis in 11 (8,6%), emboly in 9 (7%), popliteal aneurysm thrombosis in 9 (7%), vein graft thrombosis in 2 (1,6%) and popliteal artery entrapment in 2 (1,6%)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692529/portal-vein-thrombosis-after-donor-liver-biopsy-case-report
#16
Shahnawaz Bashir, Kartik Mittal, Rohit Khisti, Ankusha Yadav, Amar Mukund, Viniyendra Pamecha
Percutaneous plugged liver biopsy is a safe procedure with a low complication rate. Portal vein thrombosis has not been reported after percutaneous liver biopsy in the literature. We present a case of portal vein thrombosis after percutaneous plugged liver biopsy in a voluntary liver donor, which was subsequently treated with catheter-directed percutaneous transhepatic thrombolysis. In future, healthy patients undergoing liver biopsies are expected to increase for donor evaluation. More refinements of technique and hardware in the future may further decrease the rate of complications...
January 2018: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29661361/the-attractiveness-of-catheter-directed-thrombolysis
#17
EDITORIAL
Efthymios D Avgerinos, Rabih A Chaer
No abstract text is available yet for this article.
May 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29659045/surgical-pulmonary-embolectomy-and-catheter-directed-thrombolysis-for-treatment-of-submassive-pulmonary-embolism
#18
Ahmed A Kolkailah, Sameer Hirji, Gregory Piazza, Julius I Ejiofor, Fernando Ramirez Del Val, Jiyae Lee, Siobhan McGurk, Sary F Aranki, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Acute pulmonary embolism (PE) with preserved hemodynamics but right ventricular dysfunction, classified as submassive PE, carries a high risk of mortality. We report the results for patients who did not qualify for medical therapy and required treatment of submassive PE with surgical pulmonary embolectomy and catheter-directed thrombolysis (CDT). METHODS: Between October 1999 and May 2015, 133 submassive PE patients underwent treatment with pulmonary embolectomy (71) and CDT (62)...
April 16, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29655806/is-there-a-role-for-intervention-radiology-for-the-treatment-of-lower-limb-deep-vein-thrombosis-in-the-era-of-direct-oral-anticoagulants-a-comprehensive-review
#19
REVIEW
Marco Marietta, Elisa Romagnoli, Benilde Cosmi, Valeria Coluccio, Mario Luppi
Despite recent advances in the treatment of Deep Vein Thrombosis (DVT) provided by Direct Oral Anticoagulants (DOAC), a substantial proportion of lower limb DVT patients will develop some degree of post-thrombotic syndrome (PTS) within 2 years. Systemic thrombolysis, although effective in reducing the risk of PTS and leg ulceration, is associated with a high risk of major bleeding, making it unsuitable for the vast majority of patients. A local approach, aimed at delivering the fibrinolytic drug directly into, or near to, the thrombus surface, is attractive because of the possibility of lowering of the administered drug dose, thus reducing the bleeding risks...
April 11, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29623200/results-of-catheter-directed-thrombolysis-for-acute-ilio-femoral-deep-venous-thrombosis-a-retrospective-cohort-study
#20
Christina P Madsen, Jerzy Gesla, Radu L Vijdea, Maria A Serifi, Johnny K Christensen, Kim Houlind
Background: Catheter-directed thrombolysis may prevent post-thrombotic syndrome in patients with ilio-femoral deep venous thrombosis. We performed a retrospective review of prospectively collected follow-up data to evaluate the results of catheter-directed thrombolysis at our institution. Method: Patients admitted for venous thrombolysis were included in the study and their files screened for information regarding results and technical aspects of treatment and patient status on follow-up...
January 2018: JRSM Cardiovascular Disease
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