In Situ Thrombolysis for Late Occlusion of Suprafemoral Prosthetic Grafts

Endovascular treatment of surgically implanted arterial graft thrombosis by using manual aspiration thrombectomy

“…We used curved tip catheters in addition to straight tip catheters for the same reason. Our rate of distal embolization due to MAT (16.7%) was not more than the reported rate of 2%-18% for current peripheral arterial thrombectomy devices and 15%-25% for surgery (5,6,8).…”

“…It is usually effective in dissolving the thrombus and unmasking the underlying lesion, but has limitations, such as failure to reestablish flow in 20% to 40% of cases, which then mandates surgical thrombectomy, a complication rate of 15%-25%, distal embolization, and required infusions for 12-48 hours (5,6). Percutaneous mechanic thrombectomy is used as an alternative or adjunct to pharmacologic thrombolysis and/ or surgical thrombectomy for management of acute thrombotic and thromboembolic arterial and venous occlusions.…”

Successful treatment of delayed aortobifemoral graft thrombosis with manual aspiration thrombectomy

“…Treatment of the underlying cause is critical, as thrombolysis alone is not an adequate approach to therapy (1). Local (intrathrombus) thrombolysis is usually effective in dissolving the thrombus and unmasking the underlying lesion, but has many limitations, such as failure to reestablish flow in 20%-40% of cases, which then mandates surgical thrombectomy, a complication rate of 15%-25%, distal embolization, and required infusions for 12-48 hours (5,6). The long infusion times required for the use of a local thrombolytic agent may also cause delays in the treatment and may place the extremities of the patient in danger.…”

What Is the Secondary Patency of Thrombosed Bypasses of the Lower Limbs Cleared by Fibrinolysis In Situ?

“…The use of this technique has since been the subject of numerous publications that report a percentage of success of clearance of bypasses of over 70% (2)(3)(4)(5)(6)(7)(8)(9) . In our centers a specific protocol for LIF, established and unchanged since more than 25 years, has similarly demonstrated its effectiveness (10,11) . Primary patency of different bypasses of the lower limbs has already exhaustively been reported in the literature.…”