Experimental Endoscopic Endovascular Cannulation: A Novel Approach to Thrombolysis in Retinal Vessel Occlusion

Hattenbach, Lars‐Olof; Puchta, Joachim; Hilgenberg, Ingo

doi:10.1167/iovs.11-8486

Cited by 7 publications

(9 citation statements)

References 34 publications

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“…The importance of visual feedback is undescribed by Hattenbach et al. () who performed ex vivo cannulations with a glass microneedle connected to an endoscope. They reported to be successful in cannulating retinal veins on different locations next to and away from the optic disc.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the cannulations performed at the optic disc border were all successful and very well controlled with a clear direct view on the needle tip, targeted vessel and intraluminal tip advancement. The importance of visual feedback is undescribed by Hattenbach et al (2012) who performed ex vivo cannulations with a glass microneedle connected to an endoscope. They reported to be successful in cannulating retinal veins on different locations next to and away from the optic disc.…”

Section: Discussionmentioning

confidence: 99%

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Robot‐assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model

Willekens

Gijbels

Schoevaerdts

et al. 2017

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Robot‐assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model

Willekens

Gijbels

Schoevaerdts

et al. 2017

Acta Ophthalmologica

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“…Other authors have noted that limited visualization during retinal vessel cannulation can also complicate the procedure and have proposed an endoscopically guided puncture of retinal vessels to facilitate the procedure (Hattenbach et al. ). However, we did not find visualization to be a major problem during our study.…”

Section: Discussionmentioning

confidence: 99%

“…Cannulation requiring multiple injection attempts, due to displacement of the vein and the surgeon's inexperience, might have contributed to these complications. Other authors have noted that limited visualization during retinal vessel cannulation can also complicate the procedure and have proposed an endoscopically guided puncture of retinal vessels to facilitate the procedure (Hattenbach et al 2012). However, we did not find visualization to be a major problem during our study.…”

Section: Learning Curvementioning

confidence: 99%

Updated cannulation technique for tissue plasminogen activator injection into peripapillary retinal vein for central retinal vein occlusion

Overdam

Missotten

Spielberg

2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To update the surgical technique in which a vitrectomy is performed and a retinal branch vein is cannulated and infused with recombinant tissue plasminogen activator (RTPA) to treat central retinal vein occlusion (CRVO) in patients who present with very low visual acuity (VA). Methods: Twelve consecutive patients (12 eyes) with CRVO and low VA (logMAR >1.00) at presentation were treated using this method. Results: Cannulation of a peripapillary retinal vein and stable injection of RTPA was successfully performed without surgery-related complications in all 12 eyes. At 12 months after surgery, 8 of the 12 patients (67%) experienced at least one line of improvement in best corrected visual acuity; 6 of the 12 (50%) improved ≥5 lines and 2 (17%) improved ≥8 lines. After additional grid laser and/or subconjunctival or intravitreal corticosteroids, the mean decrease in central foveal thickness was 260 lm, and the mean total macular volume decreased from 12.10 mm 3 to 9.24 mm 3 . Four patients received panretinal photocoagulation to treat either iris neovascularization (n = 2) or neovascularization of the retina and/or disc (n = 2). Conclusion: Administration of RTPA via a peripapillary vein using this updated technique provides an alternative or additional treatment option for patients with very low VA after CRVO.

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“…244,245 A trial of rt-PA is also planned. 246 Access to the occluded retinal circulation by interventional methods has been proposed for local delivery of a PA. 247,248…”

Section: Retinal Vascular Thrombosismentioning

confidence: 99%

Plasminogen Activators and Ischemic Stroke: Conditions for Acute Delivery

Zoppo

2013

Semin Thromb Hemost

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Appropriate acute treatment with plasminogen activators (PAs) can significantly increase the probability of minimal or no disability in selected ischemic stroke patients. There is a great deal of evidence showing that intravenous recombinant tissue PAs (rt-PA) infusion accomplishes this goal, recanalization with other PAs has also been demonstrated in the development of this treatment. Recanalization of symptomatic, documented carotid or vertebrobasilar arterial territory occlusions have also been achieved by local intra-arterial PA delivery, although only a single prospective double-blinded randomized placebo-controlled study has been reported. The increase in intracerebral hemorrhage with these agents by either delivery approach underscores the need for careful patient selection, dose-appropriate safety and efficacy, proper clinical trial design, and an understanding of the evolution of cerebral tissue injury due to focal ischemia. Principles underlying the evolution of focal ischemia have been expanded by experience with acute PA intervention. Several questions remain open that concern the manner in which PAs can be applied acutely in ischemic stroke and how injury development can be limited.

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Experimental Endoscopic Endovascular Cannulation: A Novel Approach to Thrombolysis in Retinal Vessel Occlusion

Cited by 7 publications

References 34 publications

Robot‐assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model

Robot‐assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model

Updated cannulation technique for tissue plasminogen activator injection into peripapillary retinal vein for central retinal vein occlusion

Plasminogen Activators and Ischemic Stroke: Conditions for Acute Delivery

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