Document Detail


Clinical and economic evaluation of the trellis thrombectomy device for arterial occlusions: preliminary analysis.
MedLine Citation:
PMID:  14981448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This preliminary study examined the technical efficacy, safety, and cost of treating arterial occlusions with a single device that combines pharmacologic and mechanical thrombolysis. METHODS: The technical success, bleeding complications, and costs for the first 26 consecutive patients in whom lower extremity ischemia was treated with the Trellis infusion catheter (TIC) were analyzed. Procedure time, thrombolytic infusion time, technical success, bleeding complications (major and intracranial hemorrhage), interventional suite time, and 30-day amputation-free survival were evaluated. RESULTS: 15 of 26 patients (58%) who received treatment with the TIC had acute arterial occlusions, and 11 of 26 patients (42%) had nonacute arterial occlusions. Nineteen of 26 patients (73.1%) received treatment of an infrainguinal occlusion, and 7 of 26 patients (26.9%) received treatment of a suprainguinal occlusion. Lower extremity native arteries were treated in 18 of 26 patients (69%), and lower extremity bypass grafts in 8 of 26 patients (31%). The technical success rate with TIC treatment was 92%, and the 30-day amputation-free survival rate was 96%. There was no difference in technical success or amputation-free survival rate between acute versus nonacute arterial occlusions, native artery versus bypass grafts, and suprainguinal versus infrainguinal arterial occlusions. Procedure time was 2.1 +/- 0.9 hours, and infusion time was 0.3 +/- 0.2 hours. There were no bleeding complications; however, 3 of 26 patients (11.5%) required further intervention to treat distal embolization. The overall mean cost for patients with TIC treatment was $3216 +/- $1740. CONCLUSIONS: Early results of TIC treatment in patients with arterial occlusions suggest that it is as effective as traditional catheter-directed thrombolysis. Furthermore, there were no bleeding complications, likely the result of TIC requiring shorter procedure and infusion times.
Authors:
Timur P Sarac; Daniel Hilleman; Frank R Arko; Christopher K Zarins; Kenneth Ouriel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  39     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-24     Completed Date:  2004-03-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  556-9     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. SaracT@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arterial Occlusive Diseases / complications,  surgery*
Catheterization / adverse effects*,  economics,  instrumentation
Cost-Benefit Analysis
Female
Humans
Ischemia / surgery*
Lower Extremity / blood supply*
Male
Middle Aged
Postoperative Hemorrhage / etiology
Thrombectomy / economics,  instrumentation*
Thrombosis / complications,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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