Document Detail


Controlled localized thrombolysis with the "turbo" trellis to treat acute arterial occlusions following major surgery.
MedLine Citation:
PMID:  15174917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To present the management of acute arterial ischemia following major abdominal and orthopedic surgery using a percutaneous thrombectomy device and a low dose of thrombolytic agent. CASE REPORT: A 38-year-old woman with T-8 paraplegia from a traumatic fall developed pelvic osteomyelitis, for which a left hemipelvectomy, hysterectomy, and partial vaginal resection were performed. Twelve hours after the procedure, the patient developed an ischemic left leg. Computed tomographic angiography demonstrated an occlusion of the left external iliac and common femoral arteries. A Turbo Trellis percutaneous thrombectomy device was used to lyse the left external iliac artery thrombosis using 1 mg of tissue plasminogen activator infused between the proximal and distal occluding balloons of the device. Total dispersion time was 5 minutes. There was complete thrombus removal without any significant bleeding complications. At 6 months, the artery remains widely patent. CONCLUSIONS: Combination therapy with mechanical thrombectomy devices and low dose thrombolytic agents can be used to treat acute arterial occlusions at a single setting. The increased speed of the Turbo Trellis may allow for smaller doses of thrombolytic agents and shorter treatment times.
Authors:
Frank R Arko; Eugene Lee; Christopher K Zarins; Thomas J Fogarty
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  11     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-03     Completed Date:  2004-10-18     Revised Date:  2005-07-31    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  339-43     Citation Subset:  IM    
Affiliation:
Stanford University, California, USA. farko@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Arterial Occlusive Diseases / drug therapy*,  radiography
Balloon Dilatation / instrumentation*
Combined Modality Therapy
Device Approval
Dose-Response Relationship, Drug
Female
Femoral Artery* / radiography
Hemipelvectomy
Humans
Hysterectomy
Iliac Artery* / radiography
Ischemia / drug therapy*
Leg / blood supply*
Osteomyelitis / surgery
Postoperative Complications / drug therapy*,  radiography
Stents
Thrombectomy / instrumentation*
Thrombolytic Therapy / instrumentation*
Tissue Plasminogen Activator / administration & dosage*
Tomography, X-Ray Computed
Vagina / surgery
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator

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


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