Abstract:
PURPOSE:Catheter-directed thrombolysis (CDT) is a relatively new therapy for pulmonary embolism that achieves the superior clot resolution compared to systemic thrombolysis while avoiding the high bleeding risk intrinsically associated with that therapy. In order to examine the efficacy and safety of CDT, we conducted a retrospective cohort study of patients undergoing ultrasound-assisted CDT at our institution. METHODS:The charts of 30 consecutive patients who underwent CDT as a treatment of pulmonary embolism at our institution were reviewed. Risk factors for bleeding during thrombolysis were noted. Indicators of the right heart strain on computed tomography and echocardiogram, as well as the degree of pulmonary vascular obstruction, were recorded before and after CDT. Thirty-day mortality and occurrence of bleeding events were recorded. RESULTS:Nine (30%) patients had 3 or more minor contraindications to thrombolysis and 14 (47%) had major surgery in the month prior to CDT. Right ventricular systolic pressure and vascular obstruction decreased significantly after CDT. There was a significant decrease in the proportion of patients with right ventricular dilation or hypokinesis. Decrease in pulmonary vascular obstruction was associated with nadir of fibrinogen level. No patients experienced major or moderate bleeding attributed to CDT. CONCLUSION:Catheter-directed thrombolysis is an effective therapy in rapidly alleviating the right heart strain that is associated with increased mortality and long-term morbidity in patients with pulmonary embolism with minimal bleeding risk. Catheter-directed thrombolysis is a safe alternative to systemic thrombolysis in patients with risk factors for bleeding such as prior surgery. Future studies should examine the safety of CDT in patients with contraindications to systemic thrombolysis.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Mohan PP,Manov JJ,Contreras F,Langston ME,Doshi MH,Narayanan Gdoi
10.1177/1538574418757400subject
Has Abstractpub_date
2018-04-01 00:00:00pages
195-201issue
3eissn
1538-5744issn
1938-9116journal_volume
52pub_type
杂志文章abstract::Endovascular embolization of visceral arteries is commonly performed as treatment for aneurysms, pseudoaneurysms, and emboloradiation of liver tumors; while considered relatively safe, it is not without complications. We are reporting 2 cases of coil migration into the gastrointestinal tract. Patients were successfull...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574418805224
更新日期:2019-02-01 00:00:00
abstract::Although renal arteriovenous fistula (AVF) is an uncommon condition, it may lead to high cardiac output heart failure and renal insufficiency. Recently, percutaneous transcatheter embolization has replaced traditional surgery as the first line of treatment. We report a case of a 68-year-old male who presented with a r...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574414561230
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abstract:PURPOSE:To evaluate the effect of balloon-occluded transvenous obliteration (BRTO) on the model for end-stage liver disease (MELD) and the Child-Pugh (C-P) score and their individual components. METHODS:A retrospective review of patients undergoing only BRTO without transjugular intrahepatic portosystemic shunt was pe...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574413485646
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abstract::Aortic dissection represents the most common aortic emergency, affecting 3 to 4 per 100,000 people per year and is still associated with a high mortality. Twenty percent of the patients with aortic dissection die before reaching hospital and 30% die during hospital admission. Aortic dissections may be classified in 3 ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574410362118
更新日期:2010-04-01 00:00:00
abstract::Renal vein compression syndromes are rare causes of hematuria and can be divided into anterior and posterior nutcracker syndrome. When the left renal vein is compressed between the aorta and the superior mesenteric artery it causes anterior nutcracker syndrome. The posterior nutcracker syndrome is very rare and is con...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411419376
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abstract:AIM:The aim of the study is to determine whether presentation and outcomes of inflammatory abdominal aortic aneurysms (IAAA) have changed over the last five decades. METHODS:Comparison of current outcomes (January 2001 to December 2007) with results of the earliest report from our unit in 1972. RESULTS:In contemporar...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574409335915
更新日期:2009-08-01 00:00:00
abstract::The aim of this study was to report the results of high-energy endovenous laser treatment to measure the relationship between the fluence and the outcome in terms of recanalization. In 97 patients, 129 great saphenous veins were treated with endovenous laser treatment, using a 980-nm diode laser. Follow-up visits were...
journal_title:Vascular and endovascular surgery
pub_type: 临床试验,杂志文章
doi:10.1177/1538574407311107
更新日期:2008-04-01 00:00:00
abstract::Treatment of juxtarenal abdominal aortic aneurysms (AAAs) remains challenging. A 79-year-old male who had infrarenal endovascular repair of abdominal aortic aneurysm (EVAR) 13 years previously presented with leaking juxtarenal AAA. Emergency fenestrated EVAR (FEVAR) was performed utilizing a stent graft designed and b...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574416655897
更新日期:2016-08-01 00:00:00
abstract::Insufficient renal artery length for renal sympathetic denervation (RDN) is defined as having a main renal artery shorter than 20 mm in length. Such an anatomy is considered a contraindication for most of the currently available endovascular RDN devices. The concern stems from the need to distribute the ablation point...
journal_title:Vascular and endovascular surgery
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journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574408315203
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journal_title:Vascular and endovascular surgery
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doi:10.1177/153857440503900208
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abstract:OBJECTIVE:The baroreceptor at the carotid body plays an important role in hemodynamic autoregulation. Manipulation of the baroreceptor during carotid endarterectomy (CEA) or radial force from carotid artery angioplasty and/or stenting (CAS) may cause both intraoperative and postoperative hemodynamic instability. The pu...
journal_title:Vascular and endovascular surgery
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abstract::The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year peri...
journal_title:Vascular and endovascular surgery
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更新日期:2012-02-01 00:00:00
abstract::Leiomyosarcoma of the vascular origin is a rare malignant tumor. It originates from the smooth muscle cells of the media with intra- or extraluminal growth, and in most cases it arises in the inferior vena cava. The diagnosis is often delayed because the clinical symptoms of this disease are often nonspecific. Accurat...
journal_title:Vascular and endovascular surgery
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更新日期:2016-04-01 00:00:00
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abstract::Recent reports have documented poor long-term results following endovascular aneurysm repair (EVAR) of large abdominal aortic aneurysms (AAA). EVAR of small AAAs may result in improved long-term results compared to large AAAs. It is not known whether the frequency of anatomic suitability for EVAR is increased for smal...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440503900502
更新日期:2005-09-01 00:00:00
abstract::The objective of this study was to evaluate the clinical and duplex outcome after carotid endarterectomy (CEA) in recently symptomatic patients aged 80 years or older. Information was assembled from a prospective data collection of all CEAs performed from January 1986 to December 1999. Included were all patients with ...
journal_title:Vascular and endovascular surgery
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abstract::The authors report the microbiology and outcomes following an individualized treatment algorithm for extracavitary (EC) prosthetic graft infection, including the use of graft preservation and in situ graft replacement techniques. A retrospective 8-year review of 87 patients treated for EC prosthetic graft infections w...
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journal_title:Vascular and endovascular surgery
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pub_type: 杂志文章
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更新日期:2014-04-01 00:00:00
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abstract::Acute arterial disruptions of the thoracic aorta are rare and often lethal. They are most often due to blunt trauma and occur most commonly just distal to the left subclavian artery origin in the setting of multisystem injuries. The very proximal nature of the lesion in survivors makes open surgical repair hazardous, ...
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更新日期:2004-07-01 00:00:00
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