Thrombolysis for indwelling catheter related thrombosis and superior vena cava obstruction in cystic fibrosis: a case series

Hassan, Tidi; Chotirmall, Sanjay H.; Low, Teck Boon; Flynn, Michael G.; McElvaney, Noel G.; Gunaratnam, Cedric

doi:10.1007/s11845-010-0488-0

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…They also observed that catheter-related SVCS demonstrated a better response to thrombolysis, which was attributed to the earlier detection of symptoms secondary to catheter dysfunction, the absence of extrinsic compression, and the ability to infuse the thrombolytic agent directly to the site of the thrombus via the existing catheter [41]. Caution should be exercised in patients with cystic fibrosis because an increased risk of hemoptysis and gastrointestinal bleeding has been reported in this patient population [43].…”

Section: Thrombolysismentioning

confidence: 99%

“…In these patients, a trial of systemic anticoagulation or, in the acute setting, thrombolysis can be attempted by using thrombolytic agents delivered at the site of the clot through a catheter, which allows more effective local action. Reports of systematic administration of thrombolytic agents have also been described [43]. By reducing the thrombus load, the length of the obstruction can often be reduced, thus reducing the number of stents needed.…”

Section: Thrombolysismentioning

confidence: 99%

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Superior Vena Cava Syndrome: Role of the Interventionalist

Rachapalli

Boucher

2014

Can Assoc Radiol J

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Superior vena cava syndrome results from the obstruction of blood flow through the superior vena cava and is most often due to thoracic malignancy. However, benign etiologies are on the rise secondary to more frequent use of intravascular devices such as central venous catheters and pacemakers. Although rarely a medical emergency, the symptoms can be alarming, particularly to the patient. Traditionally, superior vena cava syndrome has been managed with radiotherapy and chemotherapy. But interventional endovascular techniques have made inroads that offer a safe, rapid, and durable response. In many cases, it may be the only reasonable treatment. Because of this, an approach to endovascular treatment of this condition must be in the armamentarium of the interventional radiologist. This review will provide the reader with an insight into the etiology, pathophysiology, and various management principles of superior vena cava syndrome. The focus will be on understanding the techniques used during various endovascular interventions, including angioplasty, stenting, and pharmacomechanical thrombolysis. Discussion will also be centred on possible complications and current evidence as well as controversies regarding these approaches.

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Section: Thrombolysismentioning

confidence: 99%

Section: Thrombolysismentioning

confidence: 99%

Superior Vena Cava Syndrome: Role of the Interventionalist

Rachapalli

Boucher

2014

Can Assoc Radiol J

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“…C. albicans is capable of causing oral and genital candidiasis and vascular device infections in CF (62,79). It is frequently isolated from CF sputum.…”

Section: Seminars For Cliniciansmentioning

confidence: 99%

Antibiotic Management of Lung Infections in Cystic Fibrosis. II. Nontuberculous Mycobacteria, Anaerobic Bacteria, and Fungi

et al. 2014

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Airway infections are a key component of cystic fibrosis (CF) lung disease. Whereas the approach to common pathogens such as Pseudomonas aeruginosa is guided by a significant body of evidence, other infections often pose a considerable challenge to treating physicians. In Part I of this series on the antibiotic management of difficult lung infections, we discussed bacterial organisms including methicillin-resistant Staphylococcus aureus, gram-negative bacterial infections, and treatment of multiple bacterial pathogens. Here, we summarize the approach to infections with nontuberculous mycobacteria, anaerobic bacteria, and fungi. Nontuberculous mycobacteria can significantly impact the course of lung disease in patients with CF, but differentiation between colonization and infection is difficult clinically as coinfection with other micro-organisms is common. Treatment consists of different classes of antibiotics, varies in intensity, and is best guided by a team of specialized clinicians and microbiologists. The ability of anaerobic bacteria to contribute to CF lung disease is less clear, even though clinical relevance has been reported in individual patients. Anaerobes detected in CF sputum are often resistant to multiple drugs, and treatment has not yet been shown to positively affect patient outcome. Fungi have gained significant interest as potential CF pathogens. Although the role of Candida is largely unclear, there is mounting evidence that Scedosporium species and Aspergillus fumigatus, beyond the classical presentation of allergic bronchopulmonary aspergillosis, can be relevant in patients with CF and treatment should be considered. At present, however there remains limited information on how best to select patients who could benefit from antifungal therapy.

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