Abstract:
BACKGROUND:Deep vein thrombosis (DVT) occurs in up to 600,000 patients in the United States annually and can lead to long-term morbidity because of the post-thrombotic syndrome. The multicenter isolated-pharmacomechanical thrombolysis device (ISOL-8) study was designed to determine the safety and efficacy of the Trellis™-8 peripheral infusion system when used as the primary intervention to achieve DVT thrombolysis in patients with proximal lower-extremity occlusive DVT, and track the incidence and severity of the post-thrombotic syndrome (PTS) symptoms in patients 2 years after treatment. METHODS:Data were collected retrospectively from 6 centers on patients treated with the Trellis-8 system, an isolated-pharmacomechanical thrombolysis device (IPMTD). Patients with occlusive lower-extremity DVT involving at least the iliac and/or common femoral vein were included. Patient demographics, medical history, procedure outcomes, complications, and follow-up venous duplex and Venous Clinical Severity Score (VCSS) were collected through 24 months. Data analysis of outcomes were performed at 1 and 12 months. A 24-month analysis was not performed because of the small number of patients for whom 24-month data could be collected. RESULTS:A total of 151 limbs in 139 patients were treated with IPMTD. The mean ± standard deviation (SD) procedure time was 122.6 ± 63.4 min. Single session treatment was delivered in 69.9% (93 of 133) of cases. Occlusive DVT extended from the femoral into the external and/or common iliac vessel segments in most of the cases (113 of 151 limbs; 74.8%). Before treatment, 23.2% (35 of 151) of the treated limbs, based on a history of prior ipsilateral DVT or preoperative imaging revealing chronic venous scar, were expected to have some chronic venous disease despite presenting with acute symptoms. After treatment, 43.7% (66 of 151) of the limbs showed evidence of chronic thrombus. The average amount (mean ± SD) of thrombolysis, as determined by venogram, was highest in patients who had acute thrombus (81 ± 19.7%), compared with subacute thrombus (61 ± 22.5%) and complex cases involving acute and/or subacute thrombus on chronic scar (56 ± 26.5%). VCSS scoring showed the number of patients with none and/or mild pain, varicose veins, and skin changes at 1-month remained stable at 12 months whereas the percent of patients with none and/or mild venous edema improved from 71.7% at 1 month (38 of 53) to 86.8% (46 of 53) at 12 months. Twenty-four-month follow-up data were available for only 15% (23 of 151) of patients. No clinically significant pulmonary emboli or major periprocedural bleeding events were reported. CONCLUSIONS:Patients with acute lower-extremity DVT involving the proximal veins can be safely and successfully treated with IPMTD. Major procedural bleeding was absent. The occurrence of severe PTS after primary treatment with Trellis-8 system IPMTD is low. Further long-term follow-up data are needed to confirm the benefit of intervention for thrombus removal compared with standard medical management.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Gagne P,Khoury T,Zadeh BJ,Rajasinghe HAdoi
10.1016/j.avsg.2015.05.029subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1633-41issue
8eissn
0890-5096issn
1615-5947pii
S0890-5096(15)00602-0journal_volume
29pub_type
杂志文章,多中心研究abstract:BACKGROUND:The aim of our study was to describe outcomes of stand-alone use (i.e., without concomitant implantation of an aortic stent graft) of the Gore Excluder iliac branch endoprosthesis (IBE) for elective endovascular repair of isolated iliac artery aneurysms. METHODS:We evaluated all consecutive patients electiv...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.03.023
更新日期:2020-08-01 00:00:00
abstract::Performance of carotid endarterectomy for asymptomatic carotid stenosis has been restricted during recent years because of concern of reported complications in as high as 10-15% of patients, as well as limited long-term data on stroke protection. During the last 10 years, we have studied immediate and long-term result...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02016741
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:We report 2 cases of patients undergoing endovascular aneurysm repair (EVAR) using reentry devices to recanalize unilateral iliac artery occlusions and complete a bifurcated endovascular repair. METHODS:Patient 1 is a 70-year-old male with an enlarging 6.5-cm abdominal aortic aneurysm (AAA) and disabling le...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.05.008
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Case studies and reviews have shown that creatine supplementation can affect kidney function. The objective of this study is to verify the effects of 8 weeks of creatine supplementation on renal function (creatinine clearance: primary outcome) in patients with symptomatic peripheral arterial disease. METHOD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.avsg.2019.07.008
更新日期:2020-02-01 00:00:00
abstract::We report a case of a compassionate treatment of a ruptured thoracoabdominal aortic aneurysm in a 92-year-old patient. The patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomography angiography showed the presence of a thoracoabdominal aortic aneurysm with a c...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.102
更新日期:2017-04-01 00:00:00
abstract::Dissection is a recognized finding after blunt trauma to the abdominal aorta. Immediate and long-term prognosis is poor without surgical treatment especially since most patients present severe associated injuries. On the basis of encouraging results using endovascular techniques to treat experimental dissection of the...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900194
更新日期:1998-11-01 00:00:00
abstract::Extrahepatic portal vein aneurysm is a rare clinical entity. The two most common locations for aneurysmal formation are at the confluence of the superior mesenteric vein (SMV) and the splenic vein, and at main portal vein trunk, just above the SMV-splenic vein confluence. In this article, two cases of extrahepatic por...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.046
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Increasing evidence supports that urgent carotid endarterectomy (CEA), defined as CEA during the index hospitalization, may be undertaken in select patients with acute carotid-related neurologic symptoms to prevent recurrent ischemic events. We aimed to determine the effect of a stroke/vascular neurology ser...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.002
更新日期:2014-07-01 00:00:00
abstract::We report herein a feasibility study of a minimally invasive endovascular femoropopliteal bypass procedure. The steps include the following: (1) a small groin incision to expose the femoral artery, (2) guidewire passage and mechanical dilatation of the diseased superficial femoral artery, (3) semiclosed endarterectomy...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015314
更新日期:1995-01-01 00:00:00
abstract::This report details the case of a patient presenting with a periampullary cancer and an abdominal aortic aneurysm who underwent endovascular repair of the aneurysm prior to pancreaticoduodenectomy. Use of the endovascular approach avoided the need for two major operative interventions. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-005-9406-8
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Lymphatic interventions have recently been increasingly used for treating lymphatic leak of the abdomen and pelvis. This retrospective case study series and systematic review evaluated the efficacy and safety of lymphatic interventions for the treatment of postoperative lymphatic leak of the abdomen and pelv...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.063
更新日期:2020-10-01 00:00:00
abstract::The treatment for obturator bypass graft infection has been rarely reported and is a surgical challenge because it is difficult to debride infected tissue around the graft located in the deep route and to ensure an alternative revascularization route in patients with a history of inguinal infection. Percutaneous conti...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.04.039
更新日期:2019-11-01 00:00:00
abstract::Marjolin's ulcer is an aggressive form of squamous cell carcinoma that develops over time from chronic wounds and scars, including burns and chronic venous stasis ulcers. The incidence of malignant transformation is low, resulting in a delay in diagnosis and increased morbidity and mortality in these patients. We repo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.06.002
更新日期:2013-11-01 00:00:00
abstract::Spontaneous dissection of the superior mesenteric artery represents a rare cause of abdominal angina. Conservative or more aggressive treatments such as surgery or endovascular therapy depend on the symptoms. We present a case report of acute mesenteric ischemia due to spontaneous dissection of the superior mesenteric...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2008.12.004
更新日期:2009-07-01 00:00:00
abstract::Internal jugular vein (IJV) thrombosis is a rare vascular event. The most common causes of internal jugular vein thrombosis are prolonged central venous catheterization, infection, malignancy and ovarian hyperstimulation syndrome. We have presented here a case of an 82-year-old male with chronic kidney disease who pre...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.08.074
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The goal of this study was to describe and review the results of a technique in which reconstruction of the common and profunda femoral arteries is combined with a femoro-femoral crossover graft using the same synthetic graft. A synthetic bifurcated graft (such as the ones used for aortobifemoral reconstruct...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.10.014
更新日期:2013-07-01 00:00:00
abstract::We cultured bone marrow-derived endothelial progenitor cells by a simple ex vivo expansion method and observed the expansion efficacy. Bone marrow mononuclear cells from five mongrel adult dogs were cultured with EGM-2MV medium in culture flasks coated with fibronectin. Morphology was observed with phase contrast micr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9047-6
更新日期:2006-05-01 00:00:00
abstract::In this report we describe catheter-based bailout techniques for when the distal end of the ipsilateral leg of an Excluder endograft has remained undeployed due to a broken deployment string. We attempted to advance a percutaneous transluminal angioplasty (PTA) balloon into an undeployed leg via the brachial artery, b...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.06.024
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Risk factors for early catheter-directed intra-arterial thrombolysis failure in acute lower limb ischemia remain unclear. METHODS:One hundred forty-nine limbs with acute artery or bypass graft thrombosis underwent catheter-directed thrombolysis (maximum of 48 hours). A retrospective data analysis was carrie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.016
更新日期:2014-01-01 00:00:00
abstract::Twenty-two cases of vertebral arteriovenous fistulas treated by embolization are reported. Although such fistulas are usually asymptomatic they may be occasionally responsible for tinnitus. Neurologic complications are exceptional. Spontaneous fistulas have been found predominantly in the C1-C2 region (9 of 13 cases),...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60706-1
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND:Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access, and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This st...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.020
更新日期:2018-11-01 00:00:00
abstract::Pseudoaneurysm (PA) formation after carotid endarterectomy (CEA) is a very uncommon but dangerous complication, potentially responsible for cerebral embolism or rupture. Therefore, the PA treatment is imperative. Until few years ago, the treatment of choice was represented by open surgical repair, with a higher mortal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.051
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Postmenopausal women taking hormone replacement therapy (HRT) require secondary intervention after vascular reconstruction more frequently than women not taking HRT, often due to increased development of intimal hyperplasia (IH). Matrix metalloproteinases (MMPs) play a role in IH by degradation and remodelin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.010
更新日期:2013-04-01 00:00:00
abstract::Hybrid repair involves both open and endovascular interventions. This technique has been increasingly used in treating complex aortic aneurysms as an alternative to conventional open repairs, mainly because of the avoidance of aortic cross-clamping and the associated increased ischemia time to the viscera. We report a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.076
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Advanced age (≥ 80 years) has been associated with adverse outcomes after lower extremity bypass for critical limb ischemia (CLI), but endovascular therapy (ET) is reported to have comparable safety across age groups. Here, we assess the safety and effectiveness of advanced age on outcomes after ET for lifes...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.07.028
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Ehlers-Danlos syndrome (EDS) is a hereditary connective tissue disorder caused by mutations in genes involved with collagen matrix formation that results in weakened blood vessels. Endovascular therapy on patients with EDS is fraught with concerns of vessel dissection and access site complications. We descri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.028
更新日期:2012-01-01 00:00:00
abstract::Between October 1990 and June 2001, 121 patients underwent surgery for thoracoabdominal aortic aneurysm (TAAA)-99 procedures were elective and 22 were for ruptured aneurysms. Between October 1990 and September 1997, the clamp-and-go technique was used for all aneurysms (43 patients), and from October 1997, clamp-and-g...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0181-x
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Medical treatment of disabling intermittent claudication or critical limb-threatening ischemia causing rest pain often fails or has partial response. METHODS:In this pilot study, 36 patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2018.01.074
更新日期:2018-05-01 00:00:00
abstract::A retrospective analysis of 56 patients undergoing ruptured abdominal aortic aneurysm (AAA) repair was performed to find out if cell saver had any impact on postoperative morbidity and mortality. All patients but one were male. The mean age was 68 +/- 8 years (35-85 years). Cell saver was used in 40 patients (CS group...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0123-7
更新日期:2002-07-01 00:00:00
abstract::The objective of this study was to analyze the long-term outcome of 51 patients with brachial-jugular grafts for dialysis. Age, presence of diabetic nephropathy, complications of the angio-access, and therapeutic methods of treating complications were analyzed. All surgical procedures were performed under local anesth...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0028-5
更新日期:2001-09-01 00:00:00