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Safety and Efficacy of Catheter Direct Thrombolysis in Management of Acute Iliofemoral Deep Vein Thrombosis: A Systematic Review
Ahmed Elbasty,James Metcalf
- , 2017, DOI: 10.5758/vsi.2017.33.4.121
Abstract:
Diagnosis and Treatment Options for Pulmonary Embolism (PE) in the Acute Care Setting  [PDF]
Simona Campa, Raymund Gantioque
World Journal of Cardiovascular Diseases (WJCD) , 2018, DOI: 10.4236/wjcd.2018.82015
Abstract: Thromboembolic diseases continue to be one of the most prevalent medical problems today and can lead to life-threatening conditions, such as pulmonary embolism (PE). Currently, PE diagnosis and treatment are a challenge because of acute onset right ventricular strain with right-sided heart failure, sudden death, pulmonary infarction, and cardiogenic shock, which limit the time for therapeutic success.？The aim of this study was to evaluate our perception, knowledge, and concerns regarding PE, discuss the importance of promptly diagnosing PE to provide appropriate treatment options for this life-threatening condition, list the most common clinical manifestations present when PE is suspected, and review the clinical approach to patients with suspected PE in an inpatient setting.？In addition, this study reviews the risk stratification of patients with PE and treatment options beyond anticoagulation, compares new treatment options for patients presenting with acute symptomatic PE, and compares aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter (Vascular Solutions, Minneapolis, MN)) and ultrasound-assisted catheter-directed thrombolysis (USAT) versus systemic thrombolysis.This literature review was limited by the quality and number of studies available regarding new treatment options for patients presenting with acute symptomatic PE. Thus, more studies are needed to prove the validity of newer treatment options being trialed, such as aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter) and USAT, with the hope that further studies will guide patient management and increase our understanding of next generation aspiration catheters, which may provide novel insights on treating acute symptomatic PE.
Keep it simple? Half
Jay Giri,Rim Halaby
- , 2019, DOI: 10.1177/1358863X18824653
Abstract:
Does Catheter-Directed Thrombolysis Prevent Postthrombotic Syndrome?
Shin-Seok Yang,Woo-Sung Yun,Young-Ah Kim
- , 2018, DOI: 10.5758/vsi.2018.34.2.26
Abstract:
Catheter-directed thrombolysis of deep vein thrombosis: literature review and practice considerations
Drew Fleck,Fadi Shamoun,Grace Knuttinen,Hassan Albadawi,Rahmi Oklu,Sailendra Naidu
- , 2017, DOI: 10.21037/cdt.2017.09.15
Abstract:
Implante direto de stent através de cateter guia 5F por técnica transradial
Coelho, Wilson Miguel Cecim;Jacob, José Luiz Balthazar;Araujo Filho, José Dalmo de;Frederico, Sumaira Faitarone;Cabbaz, Ivone Eduarda Campos;
Arquivos Brasileiros de Cardiologia , 2004, DOI: 10.1590/S0066-782X2004001500007
Abstract: objective: to assess stent implantation without previous dilation with a conventional balloon catheter to treat coronary artery obstructions, by using low profile guiding catheters and the transradial approach. methods: the transradial approach is attractive due to the possibility of avoiding the trauma caused by the balloon, its shorter time of performance, reduced exposure to radiation, and the use of lower quantities of contrast medium than those usually required in this type of procedure. results: the initial experience of direct stent implantation with low profile guiding catheters and the transradial approach was analyzed in 45 patients, whose mean age was 65 years. all procedures were successful, with no major complications in the in-hospital phase. conclusion: the results obtained with the population studied proved that the transradial approach is safe, effective, and has very few risks of complications.
Thrombectomy Combined with Indwelling-catheter Thrombolysis is more Effective than Pure Thrombectomy for the Treatment of Lower Extremity Deep Venous Thrombosis
Dunyuan Xu,Tao Fang,Wenli Wang,Yanfang Wu
- , 2017, DOI: 10.1515/med-2017-0026
Abstract: This study was a retrospective analysis of the efficacy of thrombectomy plus local catheter-directed thrombolysis (CDT) for the treatment of lower extremity deep venous thrombosis (LDVT)
Apixaban or Rivaroxaban Versus Warfarin for Treatment of Submassive Pulmonary Embolism After Catheter
Belinda N. Rivera-Lebron,Lara M. Groetzinger,Mark T. Gladwin,Roy E. Smith,Ryan M. Rivosecchi,Taylor J. Miller
- , 2018, DOI: 10.1177/1076029618755311
Abstract: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017. Hospital LOS and major and minor bleeding events were recorded during hospitalization and at 90 days. Sixty-two patients met the inclusion criteria, 36 in warfarin group and 26 in the DOAC group. Overall, patients receiving rivaroxaban or apixaban had a shorter median hospital LOS compared to warfarin (4.0 vs 6.1 days, P = .002). In the multivariate regression analysis, administration of DOAC was an independent predictor of decreased hospital LOS, β: ？2.1, 95% confidence interval (？3.5 to ？0.7). Among patients with submassive PE, initiation of a DOAC shortly after CDT may result in a decreased hospital LOS compared to parenterally bridged warfarin
Catheter
Jinhui Chen,Linyi Chen,Tao Tang,Yongming Lu
- , 2018, DOI: 10.1177/1076029617739703
Abstract: Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis. Compared with anticoagulant alone, CDT was shown to significantly increase the percentage patency of the iliofemoral vein (P < .00001; I2 = 44%) and reduce the risk of PTS (P = .0002; I2 = 79%). In subgroup analysis of randomized controlled trials, CDT was not shown to prevent PTS (P = .2; I2 = 59%). A reduced PTS risk was shown, however, in nonrandomized trials (P < .00001; I2 = 47%). Meta-analysis showed that CDT can reduce severe PTS risk (P = .002; I2 = 0%). However, CDT was not indicated to prevent mild PTS (P = .91; I2 = 79%). A significant increase in bleeding events (P < .00001; I2 = 33%) and pulmonary embolism (PE) (P < .00001; I2 = 14%) were also demonstrated. However, for the CDT group, the duration of stay in the hospital was significantly prolonged compared to the anticoagulant group (P < .00001; I2 = 0%). There was no significant difference in death (P = .09; I2 = 0%) or recurrent venous thromboembolism events (P = .52; I2 = 58%). This meta-analysis showed that CDT may improve patency of the iliofemoral vein or severe PTS compared with anticoagulation therapy alone, but measuring PTS risk remains controversial. However, CDT could increase the risk of bleeding events, PE events, and duration of hospital stay
Catheter
Chang Dong,Donghua Ji,Shufen Jiang,Yingqun Ji,Zhonghe Zhang
- , 2018, DOI: 10.1177/2045893217736262
Abstract: Catheter-directed therapy (CDT) has emerged as an important treatment for pulmonary embolism (PE). We present a patient with life-threatening submassive PE with transient hypotension, progressive right ventricular dysfunction, and respiratory failure who failed anticoagulation and had little improvement with systemic thrombolysis, but responded well to catheter-directed therapy
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