Background: The use of thrombolytic therapy in the treatment of thrombosed infrainguinal native arteries and bypass grafts has increased over the years. Main limitation of this treatment modality, however, is the occurrence of bleeding complications. Low intensity ultrasound (US) has been shown to accelerate enzymatic thrombolysis, thereby reducing therapy time. So far, no randomized trials have investigated the application of US-accelerated thrombolysis in the treatment of thrombosed infra-inguinal native arteries or bypass grafts. The DUET study (Dutch randomized trial comparing standard catheter-directed thrombolysis versus Ultrasound-accElerated Thrombolysis for thrombo-embolic infrainguinal disease) is designed to assess whether US-accelerated thrombolysis will reduce therapy time significantly compared with standard catheter-directed thrombolysis.
Methods/design: Sixty adult patients with recently (between 1 and 7 weeks) thrombosed infrainguinal native arteries or bypass grafts with acute limb ischemia class I or IIa, according to the Rutherford classification for acute ischemia, will be randomly allocated to either standard thrombolysis (group A) or US-accelerated thrombolysis (group B). Patients will be recruited from 5 teaching hospitals in the Netherlands during a 2-year period. The primary endpoint is the duration of catheter-directed thrombolysis needed for uninterrupted flow in the thrombosed infrainguinal native artery or bypass graft, with outflow through at least 1 crural artery.
Discussion: The DUET study is a randomized controlled trial that will provide evidence of whether US-accelerated thrombolysis will significantly reduce therapy time in patients with recently thrombosed infrainguinal native arteries or bypass grafts, without an increase in complications.
Trial Registration: Current Controlled Trials ISRCTN72676102.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033836 | PMC |
| http://dx.doi.org/10.1186/1745-6215-12-20 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Poor adherence to ultrasound surveillance is associated with infrainguinal bypass graft failure - An ongoing challenge in Australia.
Vascular
December 2024
Department of Vascular Surgery, University Hospital Geelong, Geelong, Australia.
Backgrounds: Infra-inguinal bypass (IIB) surgery is a time-proven and reliable management avenue for the treatment of peripheral arterial disease (PAD). The importance of ultrasound surveillance in maintaining IIB graft patency is well-recognised, yet adherence rates are underreported. This study evaluates the impact of surveillance compliance on graft outcomes in an Australian setting.
View Article and Find Full Text PDFPost-Thrombotic Syndrome Morbidity in Mechanical Thrombectomy Versus Pharmacomechanical Catheter-Directed Thrombolysis of Iliofemoral Deep Venous Thrombosis.
Ann Vasc Surg
November 2024
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Article Synopsis
- Iliofemoral deep venous thrombosis is linked to post-thrombotic syndrome (PTS), and two main treatments are pharmacomechanical catheter-directed thrombolysis (PCDT) and mechanical thrombectomy (MT) with large-bore devices.
- A study analyzed 349 patients from 2007 to 2022, comparing PCDT and MT, focusing on PTS rates, vessel patency, and other outcomes, finding no significant differences in PTS rates between the two treatment groups.
- MT patients had better logistical outcomes, including greater likelihood of a single operating room visit and shorter ICU stay, but it was not associated with increased PTS risk or higher Villalta scores.
Association of Anemia and Transfusion with Major Adverse Cardiac Events and Major Adverse Limb Events in Patients Undergoing Open Infrainguinal Bypass.
Ann Vasc Surg
October 2024
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Southern California, Los Angeles, CA.
Article Synopsis
- Anemia is common in patients with peripheral vascular disease and can lead to serious complications and increased mortality after surgeries; transfusions, while sometimes necessary, are linked to their own risks, including infections and heart issues.
- This study analyzed data from the Society for Vascular Surgery Vascular Quality Initiative to determine how blood transfusions affect major adverse cardiac events (MACE) and major adverse limb events (MALE) in patients undergoing lower extremity bypass operations between 2003 and 2020.
- Results showed that patients with more severe anemia had higher rates of MACE and MALE, and the study evaluated the outcomes based on whether or not those patients received blood transfusions. *
Effect of Chronic Steroid Use on Postoperative Wound Complications in Patients Undergoing Arterial Bypass Surgery for Lower Extremity Peripheral Arterial Disease.
Ann Vasc Surg
November 2024
Division of Vascular and Endovascular Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address:
Background: While existing literature reports adverse effects of chronic steroid use on surgical wound outcomes, there remains lack of data exploring the effect of steroids on postoperative outcomes following lower extremity arterial bypass surgery. This study aims to explore the effect of chronic steroid use on surgical outcomes in patients undergoing open revascularization for lower extremity arterial occlusive disease.
Methods: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) files between 2005 and 2020, all patients receiving aortoiliac or infrainguinal arterial bypass for peripheral arterial disease (PAD) were identified by Current Procedural Terminology (CPT) codes.
Five-Year Experience of Interwoven Self-Expanding Stent Implantation in Stenotic Kinking of Below the Knee Prosthetic Bypasses.
Cardiovasc Intervent Radiol
May 2024
Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, Długa Street, 61-848, Poznan, Poland.
Purpose: The purpose of this study was to evaluate the 5-year real-world results of Supera stent implantation in below the knee prosthetic bypasses (BKPBs). All the procedures were performed because of a history of recurrent thrombosis of the graft and significant stenotic kinking of the prosthesis during knee flexion. A Supera stent was implanted to prevent the next potential BKPB thrombosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!