A retrospective study examining thrombolysis for occluded femoro-popliteal grafts – Is it worthwhile?

Abraham-Igwe, Chukwuma; Siddiqui, M.R.S.; Geddes, Lauren; Halls, James M.; Irvine, A.; Browning, Neil

doi:10.1016/j.ijsu.2011.07.431

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…In a study with similar patients, 60% (12/20) of successful CDT cases had an underlying stenotic lesion which required angioplasty. 15 In our study, in the remaining 15 cases, two underwent patch plasty for distal graft anastomosis in addition to surgical thrombectomy; two underwent thrombectomy and distal bypass, three underwent thrombectomy and patch plasty for distal graft anastomosis þ PTA/stenting and eight underwent thrombectomy þ PTA/stenting to achieve graft patency. So, CDT can be an alternative initial therapy instead of surgery, but it should be kept in mind that additional surgical or endovascular procedures are generally required in these patients with acute femoropopliteal graft occlusion.…”

Section: Discussionmentioning

confidence: 77%

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Advanced treatment of acute femoropopliteal bypass graft occlusion with Fogarty catheter guidance

et al. 2013

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Section: Discussionmentioning

confidence: 77%

“…In a study with similar patients, 60% (12/20) of successful CDT cases had an underlying stenotic lesion which required angioplasty. 15…”

Section: Discussionmentioning

confidence: 99%

Advanced treatment of acute femoropopliteal bypass graft occlusion with Fogarty catheter guidance

et al. 2013

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“…Clinical outcomes of CDT for chronic obstructions appeared to be encouraging. It’s reported that several week 13 or month-old 6 femoropopliteal occlusions can be canalized again by CDT with a high success rate. PTA of femoropopliteal arteries seems to have a better prognosis if combined with CDT, especially in longer occlusions.…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, CDT was seldom used for chronic femoropopliteal occlusive disease in literatures, except for acute ischemia. [11][12][13][14] This study aims to determine the safety and effectiveness of CDT for patients with chronic femoropopliteal occlusive disease during a 6-year period.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Percutaneous Transluminal Angiography With or Without Catheter-Directed Thrombolysis for Chronic Femoropopliteal Occlusive Disease

Guo

Gao

et al. 2021

Clin Appl Thromb Hemost

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Background: Catheter-directed thrombolysis (CDT) is seldom used for chronic femoropopliteal occlusive disease. Methods: Patients with chronic femoropopliteal occlusive disease enrolled between January, 2011 and April, 2017. Hospitalization expense, limb salvage rate and survival rate were calculated. Results: Twenty-nine patients were treated with CDT (CDT group) and 31 patients without CDT (Non-CDT group).The mean hospitalization expense (5.2 ± 0.5), balloon catheter (1.0 ± 0.2) and stents number (0.8 ± 0.2) in CDT group were significantly less compared to Non-CDT group ( P < 0.05). The short-term and long-term effect scales showed similar in both groups. The incidences of perioperative complications (10.3% vs. 19.4%), primary patency and second patency rate, limb salvage rate (14.8% vs. 16.1%) and survival rate were also similar ( P > 0.05). Six patients died in each group and only 2 disease related deaths were found in Non-CDT group. Conclusion: CDT is a safe and economic strategy for patients with chronic femoropopliteal occlusive disease, and should be served as blanket treatment for every patient without thrombolytic contradictions or a remedy for failure PTA to achieve a comparable clinical effect.

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“…Endovascular devices have improved dramatically in recent years, and the clinical data after EVT for ALI in today's clinical setting have considerably improved 1) . Previous reports demonstrated that the rates of postoperative complications in ALI patients after EVT with catheter-directed thrombolysis ranged from 11% to 30.3% and that the 30-day mortality rates were 8.2% or less [15][16][17][18][19][20][21][22][23][24] . De Athayde Soares et al 25) obtained similar limb salvage and overall survival estimates at 720 days in an open surgery group and EVT group (79.2% vs 90.6% [P 0.27] and 53.0% vs 60.8% [P 0.45], respectively).…”

Section: Advance Publication Journal Of Atherosclerosis and Thrombosismentioning

confidence: 99%

In-Hospital Outcomes after Endovascular Therapy for Acute Limb Ischemia: A Report from a Japanese Nationwide Registry [J-EVT Registry]

Tsujimura

Takahara

Iida

et al. 2021

JAT

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The aim of the current study was to describe the clinical profile, frequency of in-hospital complications, and predictors of adverse events in patients undergoing endovascular therapy (EVT) for acute limb ischemia (ALI), and to compare them with those of patients undergoing EVT for chronic symptomatic peripheral artery disease (PAD). Methods: The current study compared 2,398 cases of EVT for ALI with 74,171 cases of EVT for chronic symptomatic PAD performed between January 2015 and December 2018 in Japan. We first compared the clinical profiles of ALI patients with those of PAD patients. We then evaluated the proportion of in-hospital complications and investigated their risk factors in the ALI patients. The association of clinical characteristics with the risk of in-hospital complications was analyzed via logistic regression modeling. Results: Patients with ALI were older and had a higher prevalence of female sex, impaired mobility, and history of cerebrovascular disease, but a lower prevalence of cardiovascular risk factors and history of coronary artery disease. The proportion of in-hospital EVT-related complications in ALI was 6.1% and was significantly higher compared with those in chronic symptomatic PAD patients (2.0%, P 0.001). Bedridden status (adjusted odds ratio [aOR], 1.74 [1.14 to 2.66]; P 0.010), history of coronary artery disease (aOR, 1.80 [1.21 to 2.68]; P 0.004), and a suprapopliteal lesion (aOR, 1.70 [1.05 to 2.74]; P 0.030) were identified as independent risk factors for in-hospital complications. Conclusion: The current study demonstrated that ALI patients with significant comorbidities show a higher proportion of in-hospital complications after EVT. advances and an accumulation of experience in endovascular field. The latest clinical practice guidelines have shifted toward an endovascular-first approach as a revascularization strategy in patients with chronic symptomatic peripheral arterial disease

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A retrospective study examining thrombolysis for occluded femoro-popliteal grafts – Is it worthwhile?

Abstract: CDT can achieve reasonable results in this group of challenging patients and may be seen as a useful accessory in the vascular toolkit. However, precise indications for its use need further clarification.

Cited by 4 publications

References 20 publications

Advanced treatment of acute femoropopliteal bypass graft occlusion with Fogarty catheter guidance

Advanced treatment of acute femoropopliteal bypass graft occlusion with Fogarty catheter guidance

Comparison of Percutaneous Transluminal Angiography With or Without Catheter-Directed Thrombolysis for Chronic Femoropopliteal Occlusive Disease

In-Hospital Outcomes after Endovascular Therapy for Acute Limb Ischemia: A Report from a Japanese Nationwide Registry [J-EVT Registry]

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