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[Thrombectomy : Stent retriever vs aspiration].
Radiologie (Heidelb)
January 2025
Klinik für Diagnostische und Interventionelle Radiologie, Städtisches Klinikum Lüneburg, Bögelstraße 1, 21339, Lüneburg, Deutschland.
Besides intravenous thrombolysis, endovascular therapy (EVT) is also a standard treatment option for acute ischemic stroke. The clinical efficacy and safety of this procedure was proven in 2015 by several randomized controlled trials. The aim of EVT is to achieve the fastest possible recanalization of an occluded artery supplying the brain and, thus, reperfusion of the brain tissue.
View Article and Find Full Text PDFEconomic Analysis of Catheter-Directed Thrombolysis for Intermediate-Risk Pulmonary Embolism.
Catheter Cardiovasc Interv
November 2024
Division of Cardiovascular Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Background: Pulmonary embolism is associated with a significant burden of morbidity, mortality, and health care costs. Catheter-directed thrombolysis has emerged as a promising option for patients with intermediate-risk pulmonary embolism which aims to improve outcomes over standard anticoagulation.
Methods: We constructed a decision-analytic model comparing the cost-effectiveness of catheter-directed thrombolysis to anticoagulation alone for the management of intermediate-risk pulmonary embolism.
Introduction Fibrinolysis is often wrongly believed to be due to tissue plasminogen activator (tPA) alone. Instead, both endogenous plasminogen activators are required, but only a mini bolus of tPA is needed to initiate fibrinolysis. This is due to tPA's unique high fibrin affinity binding site located on the fibrin D-domain.
View Article and Find Full Text PDFCatheter-Directed Thrombolysis in the Management of Thrombotic Peripheral Artery Occlusions-Acute and Mid-Term Clinical Outcomes.
J Clin Med
September 2024
University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Südring 15, 79189 Bad Krozingen, Germany.
Article Synopsis
- The study assessed the safety and effectiveness of catheter-directed thrombolysis (CDT) using rt-PA in patients with symptomatic peripheral artery disease from January 2013 to December 2020.
- Of the 1238 patients treated, serious adverse events occurred in 41.3%, with bleeding being the most common complication at 25.4%, and notable rates of limb salvage at 91.6% and 88.8% after 12 and 24 months, respectively.
- Key predictors for complications included increasing age, the use of certain medications (abciximab and alprostadil), and the duration of the lysis treatment, highlighting a significant risk associated with CDT despite its high success rate.
[Successful endovascular treatment of proximal deep vein thrombosis following May-Thurner syndrome].
Khirurgiia (Mosk)
September 2024
Oryol Regional Clinical Hospital, Orel, Russia.
We present two clinical cases of successful endovascular treatment of proximal deep vein thrombosis following May-Thurner syndrome. In the first case, 2-day regional catheter thrombolysis, percutaneous mechanical thrombectomy and venous stenting were required to restore hemodynamics in the left lower limb. In the second case, regional catheter thrombolysis continued for 3 days with subsequent thrombotic mass lysis.
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