Transcatheter Thrombolysis with High-Dose Bolus Tissue Plasminogen Activator in Iatrogenic Arterial Occlusion after Femoral Arterial Catheterization

Tsetis, Dimitrios; Kochiadakis, George E.; Hatzidakis, Adam; Skalidis, Emmanuel I.; Chryssou, Evangelia; Tritou, Ioanna; Vardas, Panos; Gourtsoyiannis, Nicholas

doi:10.1007/s00270-001-0061-3

Cited by 15 publications

(8 citation statements)

References 22 publications

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“…Balloon angioplasty or atherectomy of the CFA might be better alternatives to stenting if they provide an acceptable angiographic result. In a small series, six patients who developed critical limb ischemia after cardiac catheterization were treated with local thrombolysis followed by balloon angioplasty (n = 4) or stenting (n = 2) with good short‐term results 13 …”

Section: Discussionmentioning

confidence: 99%

“…Arterial access complications, such as bleeding, infection, arteriovenous fistula, neuropathy, pseudo‐aneurysm, and dissections, can complicate diagnostic and therapeutic cardiac catheterization. Even though multiple vascular access complication reports have been published, 1–12 most studies have focused on bleeding, pseudoaneurysms, arteriovenous fistulas, and thrombosis, with little data available on arterial access dissections 13 . The goal of this study was to examine the incidence, treatment, and the consequences of arterial dissections complicating transfemoral cardiac catheterization at a large, tertiary referral hospital with an active cardiology fellowship training program.…”

Section: Introductionmentioning

confidence: 99%

“…(J Interven Cardiol 2008;21:61-66) Address for reprints: Emmanouil S. Brilakis, M.D., bleeding, pseudoaneurysms, arteriovenous fistulas, and thrombosis, with little data available on arterial access dissections. 13 The goal of this study was to examine the incidence, treatment, and the consequences of arterial dissections complicating transfemoral cardiac catheterization at a large, tertiary referral hospital with an active cardiology fellowship training program.…”

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confidence: 99%

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Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac Catheterization

Prasad¹,

Compton²,

Prasad³

et al. 2007

J Interven Cardiology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac Catheterization

Prasad¹,

Compton²,

Prasad³

et al. 2007

J Interven Cardiology

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“…First the catheter must be extracted(6,7)and if there is no pulse in following four hours the thrombolytic drugs may be administrated including streptokinase,urokinaseandalteplase(12,13). Intravenous streptokinase is an effective and safe treatment for femoral artery thrombosis following cardiac catheterization in children(9,12,14). …”

Section: Introductionmentioning

confidence: 99%

The Effects of Ranitidine and Hydrocortisone on the Complications of Femoral Artery Obstruction Treated by Streptokinase Following Cardiac Catheterization in Pediatric Patients with Congenital Heart Diseases

Noori¹,

Miri‐Aliabad²,

Mohammadi³

et al. 2013

Iran Red Crescent Med J

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Background:The most important complication following cardiac catheterization required urgent therapeutic management is vessel obstruction and arterial thrombosis. The morbidity following this complication can be decreased by surgery intervention and/or thrombolytic drugs.Objectives:In this study we evaluated the effects of ranitidine and hydrocortisone on pediatric patients with congenital heart diseases who suffered from femoral artery obstruction following cardiac catheterization on decreasing the events after streptokinase administration.Materials and Methods:This semi experimental study was conducted on 47 patients among 600 cases who underwent cardiac catheterization from April 2002 to December 2011.The patients suffered from distal vessel obstruction following cardiac catheterization with no response to surgery intervention, were enrolled and divided in two groups. Streptokinase was administrated in both groups. Patients in group 2 (25 cases), received ranitidine and hydrocortisone before streptokinase administration. In group 1 (22 cases), the loading dose of streptokinase was 2000IU/kg/ in 20-30 minutes/ infusion and thereafter streptokinase was administrated 1000 IU /kg/hour. In group 2, the loading dose was 3000IU/kg in 20-30 minutes /infusion and 1500 IU/kg/hour as maintenance dose. The infusion dose of streptokinase was decreased and then terminated in 2-3 hours by the time arterial pulse was detected by pulse oximetry.Results:There were 13 (59, 1%) male and 9 (40.9%) female patients in group 1. In group 2, there were 15 (60%) male and 10 (40%) female cases (P = 0.949). Patients in both groups were matched well regarding age, body weight, height and the duration of streptokinase infusion (P < 0.05). The incidence of hematoma was higher in group 1 than group 2 (P = 0.032). the patients of Group 1 required more blood transfusion than group 2 because the incidence of bleeding was more in the first group (P = 0.042). 12 patients in group 1 required fresh frozen plasma transfusion versus 4 patients in group 2 (P = 0.049). Local oozing was detected more in group 1 (P = 0.042). Significant bleeding was occurred in 6 cases in group 1; however this event did not occurrin any patients in group 2 (P = 0.007). Although 4 patients in group 1 suffered from anaphylactic shock after streptokinase administration but no patients in group 2 did. (P = 0.041).Conclusions:Based on the results of this study, we concluded that streptokinase was able to remove the vessel thrombosis at the site of cardiac catheterization and ranitidine and hydrocortisone administration before streptokinase may be effective in order to reduce the complications related to thrombolytic drugs; however the experience of the performer is an issue of concern in this matter.

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“…1 Iatrogenic arterial dissection is an uncommon complication that usually occurs during guide wire passage through stenoses or occlusions. It is reported to occur in 0.42% of patients during arterial access of cardiac catheterization.…”

Section: Iatrogenic Flow Limiting Arterial Dissectionmentioning

confidence: 99%

Iatrogenic Flow Limiting Arterial Dissection

Funaki

2008

Semin intervent Radiol

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Transcatheter Thrombolysis with High-Dose Bolus Tissue Plasminogen Activator in Iatrogenic Arterial Occlusion after Femoral Arterial Catheterization

Abstract: Transcatheter thrombolysis with high-dose bolus rt-PA is a safe and effective treatment in patients with iatrogenic arterial occlusion after femoral catheterization. Underlying dissections should be treated by prolonged balloon dilatation but stent implantation is often required.

Cited by 15 publications

References 22 publications

Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac Catheterization

Incidence and Treatment of Arterial Access Dissections Occurring during Cardiac Catheterization

The Effects of Ranitidine and Hydrocortisone on the Complications of Femoral Artery Obstruction Treated by Streptokinase Following Cardiac Catheterization in Pediatric Patients with Congenital Heart Diseases

Iatrogenic Flow Limiting Arterial Dissection

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