A Guitaring Technique with 035 Wire and Perforated Coronary Balloon for Thrombolysis in the Treatment of Acute Deep Vein Thrombosis

Arokiaraj, Mark Christopher

doi:10.2478/jce-2019-0012

Cited by 3 publications

(3 citation statements)

References 7 publications

(7 reference statements)

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“…The guitaring technique has been shown to be useful for mechanical dislodgement of clots in the femoral vessels, using 035 Terumo hydrophilic wire [ 15 ] . In this case, the dislodgement of a clot was made using 014 BMW wire using the guitaring technique and thrombolysis was performed using a punctured balloon.…”

Section: Discussionmentioning

confidence: 99%

Thrombolysis Through Punctured Coronary Balloon and 014 Wire Mediated Guitaring After IVC Filter Insertion in Iliofemoral Deep Vein Thrombosis

Arokiaraj

2023

European Journal of Case Reports in Internal Medicine

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This is a report of a patient who presented with iliofemoral deep vein thrombosis, and was treated with pharmaco-invasive and pharmaco- mechanic methods using coronary balloon and mechanical disruption of clots with coronary 014 wire. A 65-year-old male presented with acute deep vein thrombosis extending from the left common iliac to the popliteal vein. The patient had signi cant swelling and pain. An inferior vena cava (IVC) lter was inserted, and catheter-directed thrombolysis was planned. A technical dif culty was encountered entering the proximal common iliac vein. Hence, a 014 balance middle weight (BMW) wire with coronary balloon support was introduced through a Cordis® 6 F. diagnostic catheter, and the 014 wire was advanced with guitaring technique up to the femoral vein. Thereafter, the coronary balloon was ruptured at high pressure, and thrombolysis using streptokinase was performed along the balloon tract up to the ostium of the common iliac vein. The patient symptomatically improved signi cantly and is currently on anticoagulants. Follow-up after one year showed minimal residual oedema, and less pain in the ankle region. Pharmaco-mechanical treatment is possible using coronary balloon dilatations and thrombolysis through a ruptured coronary balloon. Mechanical disruption of clots to some extent is feasible using 014 wire by a guitaring technique.

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Section: Discussionmentioning

confidence: 99%

Thrombolysis Through Punctured Coronary Balloon and 014 Wire Mediated Guitaring After IVC Filter Insertion in Iliofemoral Deep Vein Thrombosis

Arokiaraj

2023

European Journal of Case Reports in Internal Medicine

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“…The guitaring technique has been shown to be useful for mechanical dislodgement of clots in the femoral vessels, using 035 Terumo hydrophilic wire. 15 In this case report, the dislodgement of clot was made using 014 BMW wire using the guitaring technique and thrombolysis was performed using punctured balloon. It is preferable to insert IVC filter prior to the procedure, since during thrombolysis possibility of dislodgement of the clots are high, which could lead to pulmonary embolism during thrombolysis.…”

Section: Discussionmentioning

confidence: 99%

Thrombolysis Through Punctured Coronary Balloon and 014 wire mediated guitaring after IVC filter insertion in Ilio-femoral Deep Vein Thrombosis

Arokiaraj¹

2022

Preprint

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Background/AimsDeep vein thrombosis (DVT) is common in clinical practice and it is associated with systemic illnesses and frequently associated with complications. The classic presentation is unilateral limb oedema associated with pain. Acute pulmonary embolism is common which is life threatening. Long-term complications like post thrombotic syndrome, recurrent deep vein thrombosis, chronic venous ulcers and cellulitis are common and debilitating. There are many treatment pharmaco-mechanical and pharmaco-invasive treatment methods in DVT. This is a case report of a patient who presented with iliofemoral deep vein thrombosis, and was treated with pharmaco-invasive and pharmaco-mechanic methods using coronary balloon and mechanical disruption of clots with coronary 014 wire using the guitaring technique.Case presentationA 65-year male presented with acute deep vein thrombosis extending from left common iliac to the popliteal vein. The patient had significant swelling and pain in the left lower limb. IVC filter was inserted, and catheter-directed thrombolysis was planned. The technical difficulty was encountered entering the proximal common iliac vein. Hence, a 014 BMW wire with coronary balloon support was introduced through Cordis 6F diagnostic catheter, and the 014 wire was advanced with guitaring technique up to the femoral vein. Thereafter, the coronary balloon was ruptured at high pressure, and thrombolysis using streptokinase was performed along the balloon tract till the ostium of the common iliac vein. The patient symptomatically improved significantly and is currently on anticoagulants. Follow-up after one year showed minimal residual oedema, and pain in the ankle region.Conclusion Deep vein thrombosis is a common disease associated with life-threatening and chronic complications. In iliofemoral thrombosis with significant symptoms, pharmaco-invasive treatment by catheter-directed thrombolysis is beneficial. If the difficulty is encountered crossing the proximal iliac vein obstructions crossing the lesion with 014 wire and coronary balloon support is a helpful technique which was used in this case. Pharmaco-mechanical treatment is possible using coronary balloon dilatations and thrombolysis through a ruptured coronary balloon. Mechanical disruption of clots to some extent is feasible using 014 wire by guitaring technique.

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“…In certain cases where 035 could not be crossed, even 014 BMW can be used to cross the lesion, and dilatations can be given with coronary balloons in peripheral venous drainage. 19…”

Section: Introductionmentioning

confidence: 99%

Off-label Uses of Cordis 6F Right Coronary Diagnostic Catheters During Peripheral Interventions

Arokiaraj

2023

Preprint

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The Cordis 6F Thrulumen Judkins right coronary diagnostic catheters can be used in peripheral interventions involving various circumstances. The author describes certain clinical situations, wherein these catheters were used for off-label indications in various peripheral arterial and venous interventional procedures. In certain cases, there are technical advantages in treating the lesion like quick engagement, accessibility and lesion crossing characteristics’, and in some cases backed up by reduction in interventional procedure time and contrast volume. In these cases’ 6F right Judkins (RCA) catheter was used when the target artery dimension was about 5.5mm or less.

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A Guitaring Technique with 035 Wire and Perforated Coronary Balloon for Thrombolysis in the Treatment of Acute Deep Vein Thrombosis

Cited by 3 publications

References 7 publications

Thrombolysis Through Punctured Coronary Balloon and 014 Wire Mediated Guitaring After IVC Filter Insertion in Iliofemoral Deep Vein Thrombosis

Thrombolysis Through Punctured Coronary Balloon and 014 Wire Mediated Guitaring After IVC Filter Insertion in Iliofemoral Deep Vein Thrombosis

Thrombolysis Through Punctured Coronary Balloon and 014 wire mediated guitaring after IVC filter insertion in Ilio-femoral Deep Vein Thrombosis

Off-label Uses of Cordis 6F Right Coronary Diagnostic Catheters During Peripheral Interventions

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