Document Detail


Fluoroscopically assisted thromboembolectomy: an improved method for treating acute arterial occlusions.
MedLine Citation:
PMID:  8792986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We performed bilateral femoral artery dissections in a single 50 kg mongrel dog. Digital fluoroscopic arteriograms documented the luminal diameter of the left iliac and right superficial femoral arteries. Balloon thrombectomy catheter passage was performed through hemostatic sheaths by 12 surgeons. Embolectomy balloons were filled with radiographic contrast material and the balloon catheter diameter was compared with the underlying vessel diameter. The percentage of overdistention of the embolectomy balloon relative to the arterial wall was 23% +/- 5% in the iliac artery and 40% +/- 13% in the femoral artery. Over a 25-month period, we used fluoroscopically assisted thromboembolectomy to treat 21 patients with acute arterial or graft occlusions. As the balloon was gently withdrawn to extract intravascular thrombus, deformities of the compliant balloon profile caused by underlying arterial lesions were identified fluoroscopically and their locations recorded to facilitate further treatment. After initial clot removal in these 21 patients, 15 residual lesions were documented. Repeat thrombectomy (n = 8), balloon angioplasty (n = 3), and placement of intravascular stents (n = 4) eliminated all 15 lesions. Luminal continuity was successfully restored in all 21 of these patients, 10 of whom required distal open vascular reconstruction to correct existing outflow artery disease. Fluoroscopically assisted thromboembolectomy is a simple and safe method for treating acute arterial or graft occlusions in patients with diffuse arteriosclerosis. It minimizes arterial damage and blood loss during balloon thrombectomy and reduces the need for intravascular contrast agents. It also has the potential to facilitate accurate identification, localization, and treatment of significant underlying arterial lesions.
Authors:
R E Parsons; M L Marin; F J Veith; L A Sanchez; R T Lyòn; W D Suggs; P L Faries; M L Schwartz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  10     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-11-20     Completed Date:  1996-11-20     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  201-10     Citation Subset:  IM    
Affiliation:
Department of Surgery, Montefiore Medical Center, University Hospital, Albert Einstein College of Medicine, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon / instrumentation
Animals
Arterial Occlusive Diseases / radiography,  surgery*
Dogs
Embolectomy / instrumentation,  methods*
Female
Fluoroscopy
Graft Occlusion, Vascular / radiography,  surgery*
Humans
Male
Middle Aged
Stents
Thrombectomy / instrumentation,  methods*
Thrombosis / radiography,  surgery*
Grant Support
ID/Acronym/Agency:
HL 02990-03/HL/NHLBI NIH HHS

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


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