Prolonged intracoronary urokinase infusion for acute stent thrombosis

Bilodeau, Luc; Hearn, James A.; Dean, Larry S.; Roubin, Gary S.

doi:10.1002/ccd.1810300211

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…If the portal vein had been completely obstructed by inflammatory changes and the obstructed segments were too great in length [30] treatment other than angioplasty would have been chosen.…”

Section: Discussionmentioning

confidence: 99%

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

Meillat¹,

Ewald²,

Piana³

et al. 2017

J Clin Case Rep

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A rare case of refractory ascites caused by benign portal vein stenosis after pancreatoduodenectomy (PD) is reported. A dogma claims that ascites is found in portal hypertension with an intrahepatic block only. However, in the postoperative state, the pathophysiologic condition is altered, which made diagnosis difficult.A 69-year-old man who had undergone PD for lower bile duct carcinoma in situ, developed in postoperative course a pseudoaneurysm of the common hepatic artery successfully treated by stent graft. Six months later, the patient developed refractory ascites. CT scan revealed a severe stricture in the main trunk of the portal vein, probably due to extrinsic compression by the stent in the hepatic artery. Percutaneous transhepatic portography was performed and stent-graft was placed over the stenotic segment. Portal blood flow was corrected immediately. One week after the stenting procedure the patient was free of ascites and control physical and biochemical examination three years later is completely normal.

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Section: Discussionmentioning

confidence: 99%

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

Meillat¹,

Ewald²,

Piana³

et al. 2017

J Clin Case Rep

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show abstract

“…Because of a continued area of haziness in the LAD, as well as persistent thrombus in the mid and distal LAD, a Fastracker-18 MX (Target Therapeutics, Fremont, CA) perfusion catheter was placed into the stent. Urokinase was then infused at 50,000 U/h through the perfusion catheter, after disengaging the guide catheter from the coronary ostium, similar to that previously reported by Bilodeau et al [11]. Upon repeat angiography 24 h later, the patient had a widely patent stent site with no evidence of intraluminal thrombus (Fig.…”

Section: Case Reportmentioning

confidence: 89%

Stent thrombosis in a patient receiving chemotherapy

Smith

Winters

Lasala

1997

Cathet. Cardiovasc. Diagn.

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“…If the portal vein had been completely obstructed by inflammatory changes and the obstructed segments were wider than an inch in length as occurred in our previous cases [15,16] , treatments other than angioplasty would have been chosen. In addition, it was possible to dilate the stricture and secure a lumen of 8 mm in diameter using a balloon dilator.…”

Section: Treatment Of Jejunal Varices Caused By Extrahepatic Obliteramentioning

confidence: 99%

“…In addition, it was possible to dilate the stricture and secure a lumen of 8 mm in diameter using a balloon dilator. This mechanically-forced dilation could inadvertently interfere with an immediate correction of portal blood flow, however, a urokinase infusion through the portal vein to resolve thrombi attached was valuable [15,16] . Another unsolved issue using this intervention is the duration of patency of the stent-grafts.…”

Section: Treatment Of Jejunal Varices Caused By Extrahepatic Obliteramentioning

confidence: 99%

Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture: A case report

Ichihara

Sato²,

Miyazawa³

et al. 2007

WJG

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To treat postoperative bleeding after hepato-pancreatobiliary surgery, interventional radiology has become essential. We report a case of coincidental pseudoaneurysm and jejunal varices that were both successfully treated by stent-grafts. After a pancreaticoduodenectomy, the patient developed a pseudoaneurysm in the hepatic artery and a stenosis in its periphery. After establishing hepatic arterial flow by placing stent-grafts over both the pseudoaneurysm and the stenosis, the pseudoaneurysm was embolized with microcoils. Nine months later, the patient developed jejunal varices caused by a severe stricture in the main trunk of the portal vein. Percutaneous transhepatic portography was performed and stent-grafts were placed over the stenotic segment. A venoplasty using stent-grafts normalized the portal blood flow and the jejunal varices vanished. Although stenosis occurred due to scarred tissues from leakage after pancreaticoduodenectomy, stent-grafts were useful for managing jejunal bleeding post-operatively.

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Prolonged intracoronary urokinase infusion for acute stent thrombosis

Cited by 7 publications

References 24 publications

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

Refractory Ascites after Pancreato-Duodenectomy - Time to Rethink an Old Dogma

Stent thrombosis in a patient receiving chemotherapy

Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture: A case report

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