The use of embolic protection device in lower extremity catheter-directed thrombolysis

Irani, Zubin; Öklü, Rahmi

doi:10.1016/j.diii.2015.11.011

Cited by 5 publications

(4 citation statements)

References 5 publications

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“…However, major bleeding occurrences and no difference in recurrence of VTE and mortality prohibit systemic thrombolysis from becoming an acceptable standard of treatment. Subsequent percutaneous catheter and stent innovations for both arterial and venous disease have led to targeted treatment improvements which have reduced the complications encountered in systemic thrombolysis [55, 59, 60]. Targeted delivery increases drug exposure time to the actual thrombus and concomitantly limits drug exposure to that very same thrombus as compared to systemic treatment.…”

Section: Endovascular Management Of Vtementioning

confidence: 99%

Pathogenesis of Thromboembolism and Endovascular Management

et al. 2017

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Venous thromboembolism (VTE), a disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE), is associated with high mortality, morbidity, and costs. It can result in long-term complications that include postthrombotic syndrome (PTS) adding to its morbidity. VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US. The current standard of care for VTE is anticoagulation, though thrombolysis may be performed in patients with PE and threatened limb. This review discusses pathogenesis and medical treatment of VTE and then focuses on endovascular treatment modalities. Mechanical- and catheter-directed thrombolysis (CDT) is discussed, as well as patient selection criteria, and complications. The first prospective study (CaVenT) comparing CDT with anticoagulation alone in acute DVT, despite study shortcomings, corroborates the existing literature indicating improved outcomes with CDT. The potential of the ongoing prospective, multicenter, randomized ATTRACT trial is also highlighted.

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Section: Endovascular Management Of Vtementioning

confidence: 99%

Pathogenesis of Thromboembolism and Endovascular Management

et al. 2017

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“…Irani Z. introduced four Ali patients. In these patients, EPD was used during intra-arterial thrombolytic infusion, thereby reducing dissolution time and pain, while retaining the distal runoff blood vessels [ 4 ]. Puz P. aims to study carotid artery stenosis that can lead to brain tissue damage and microembolism complications related to intracranial arterial blood flow disorders.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Blood Vessel Stenosis Caused by Arterial Thrombosis of Lower Extremities by Ultrasound Based on the Mobile Information System

Wu¹,

Zhang²

2022

Journal of Healthcare Engineering

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The thrombosis process is a multifactorial evolution process that includes many genetic and environmental factors that interact with each other. It refers to the existence of blood deposits in the heart or blood vessel walls or abnormal blood clots in the circulatory blood flow during the survival period of humans or animals for some reason. This article aims to analyze the research of blood vessel stenosis caused by arterial thrombosis of the lower extremities under the diagnosis of cardiac ultrasound based on the mobile information system. This article first introduces the mobile information nursing system and its development process. The mobile nursing information system has experienced three stages of development and is an important application of the further development of science and technology in medical information technology. It also proposes a medical diagnosis method based on SRM on a mobile platform and gives a technical roadmap for heart sound analysis and processing. Then, based on the mobile information system, the formation of arterial thrombosis in the lower extremities was analyzed and discussed in the ultrasound diagnosis of the heart, and the vascular stenosis caused by the arterial thrombosis of the lower extremities was analyzed by imaging. Experimental results show that when there is >50% stenosis or complete occlusion, the CTA false positive is more prominent, especially when the calf artery type is complete stenosis. The main cause is that the circulation of the lower limbs is very poor, the blood entering the blood vessels of the lower limbs is scarce, the capillaries are weakly enhanced, and the quality cannot be improved.

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“…In such cases, popliteal artery exposure is necessary which needs general anesthesia, putting the patient at risk of major surgery. In cases of infragenicular occlusive arterial disease, thromboembolectomy presents the potential dangers of perforation of 235 tibial arteries with subsequent hemorrhage, pseudoaneurysm or arteriovenous fistula formation [3] Another reason for our selection of cases with distal thrombosis is the higher risk of distal embolization during iliofemoral thrombolysis, the risk of distal embolization in endovascular procedures of the superficial femoral artery (SFA) is around 10% [13] .…”

Section: Discussionmentioning

confidence: 99%

“…Distal embolization is reported as a complication of ilio-femoral thrombolysis. Until 2016, catheter-directed thrombolysis with concomitant use of embolic protection devices has not been previously reported in lower extremity arteries; Irani demonstrated the use of embolic protection device in lower extremity catheter-directed thrombolysis in four patients with SFA thrombosis [13] .…”

Section: Discussionmentioning

confidence: 99%

Catheter Directed Thrombolysis in Management of Acute Thrombotic Lower Limb Ischemia

Rahma

Kamhawy

2019

The Medical Journal of Cairo University

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Background: Acute limb ischemia is a limb threatening condition that require wise decision making to achieve limb salvage. Aim of Study: To evaluate the safety, efficacy and outcome of catheter directed thrombolysis (CDT) in management of acute thrombotic lower limb ischemia. Patients and Methods: 20 patients suffering from acute limb ischemia (ALI) due to infrainguinal arterial thrombosis were submitted to catheter directed thrombolysis under fluoroscopic guidance, treated by Actilyse "tissue plasminogen activator" during the period from April 2017 to April 2018, outcome was assessed by angiographic imaging "technical success" and clinical improvement "clinical success". Results: Overall thrombolysis success and limb salvage were achieved in 16 patients (80%), major amputation was performed in 4 cases (20%), surgical interference "thrombectomy" was needed in 2 cases (10%), complementary balloon angioplasty was done in 4 cases (20%). Regarding complications, peri-sheath hematoma was observed in 5 patients (25%), one case developed compartment syndrome (5%), epistaxis in 2 cases (10%) and hematuria in 3 cases (15%), no mortality recorded during hospital stay or two weeks follow-up. Conclusion: Catheter directed intra-arterial thrombolysis is a safe, effective management for thrombotic etiology of ALI.

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The use of embolic protection device in lower extremity catheter-directed thrombolysis

Cited by 5 publications

References 5 publications

Pathogenesis of Thromboembolism and Endovascular Management

Pathogenesis of Thromboembolism and Endovascular Management

Diagnosis of Blood Vessel Stenosis Caused by Arterial Thrombosis of Lower Extremities by Ultrasound Based on the Mobile Information System

Catheter Directed Thrombolysis in Management of Acute Thrombotic Lower Limb Ischemia

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