Thrombolytic therapy for femoral artery thrombosis after pediatric cardiac catheterization

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

“…Risk factors have included smaller patient size, compromised patient hemodynamic status, operator technique, larger introducer size, and longer procedural duration. 606 Intense surveillance can indeed identify a higher incidence of vascular compromise after the procedure. A 33% incidence of arterial occlusion after cardiac catheterization was demonstrated by Taylor et al 607 in 58 children >5 years of age using arterial duplex scanning and lower-extremity radiographs of bone length 5 to 14 years after arterial studies.…”

“…The study by Ino et al, 606 undertaken to assess the efficacy of thrombolytic therapy for this complication, included a total of 526 consecutive infants and children prospectively evaluated after cardiac catheterization and 42 patients evaluated retrospectively who required femoral artery thrombectomy between 1975 and 1985. There were no serious complications of surgery.…”

O uso da estreptoquinase no tratamento da oclusão arterial aguda pós-cateterização da artéria femoral em crianças com menos de 10 kg

“…O ponto importante com relação ao uso das medicações fibrinolíticas são suas complicações 7,[55][56][57][58] . Viuse, acima, que as complicações decorrentes do uso da estreptoquinase são difíceis de ser previstas mediante avaliação laboratorial do paciente no transcorrer da sua infusão endovenosa.…”

“…Porém, freqüente-mente evolui para déficit de crescimento (Figura 1) [3][4][5] . O tratamento de eleição nas oclusões arteriais agudas por trombose secundária, causada pelo cateter ou lesão da parede arterial, é a cirurgia; entretanto, os resultados não são satisfatórios em crianças, devido ao reduzido calibre dos vasos [6][7][8][9][10] . Por esse motivo, foi iniciada a utilização de medicamentos trombolíticos e anticoagulantes, por via sistêmica ou injeção direta intra-arterial 5,8,11 .…”

Magnetic resonance imaging of the iliofemoral arteries after balloon dilation angioplasty of aortic arch obstructions in children.

“…In a report of the experience from this institution between 1984 and 1987, 29 of 64 patients (45%) undergoing balloon aortic valvuloplasty or balloon dilation angioplasty of coarctation restenosis had clinical evidence of femoral arterial injury.2 Despite aggressive medical and surgical management, 38% of symptomatic patients and 17% of all patients had clinical findings of iliofemoral arterial obstruction at the time of hospital discharge. Others have reported a higher success rate for medical therapy of femoral arterial thrombosis.4 5 The incidence of clinical sequelae, including leg length discrepancy and claudication after cardiac catheterization, is disputed.15419,20…”