Document Detail


Intra-arterial tissue plasminogen activator: an effective adjunct following microsurgical venous thrombosis.
MedLine Citation:
PMID:  17992145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluates the efficacy of our protocol using intra-arterial infusion of tissue plasminogen activator (TPA) on free flap salvage following venous thrombosis. A retrospective review was conducted of every free flap performed by a single surgeon since the beginning of his practice. Free flap salvage rates were documented following flap exploration, intra-arterial infusion of TPA, and revision of the venous anastomosis, with or without vein grafting. One hundred twenty-two free tissue transfers were performed from July 2003 through April 2006. Twelve anastomotic complications occurred in 11 flaps (1 arterial thrombosis, 11 venous thromboses). One free muscle flap failed due to arterial thrombosis. All venous thromboses were salvaged using the TPA protocol, although one revision thrombosed on postoperative day 1 and required a second venous revision, leading to its ultimate salvage. We believe that intra-arterial TPA is an effective adjunct in the treatment of microsurgical venous thrombosis and may increase salvage rates following anastomotic complications.
Authors:
William J Casey; Randall O Craft; Alanna M Rebecca; Anthony A Smith; Sung Yoon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  59     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-09     Completed Date:  2008-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-5     Citation Subset:  IM    
Affiliation:
Division of Plastic and Reconstructive Surgery, Mayo Clinic Arizona, Scottsdale, AZ 85255, USA. Casey.williamjoseph@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arteries / pathology*
Female
Humans
Mammaplasty / methods
Microsurgery / methods*
Middle Aged
Reconstructive Surgical Procedures / methods
Retrospective Studies
Skin Transplantation / methods*
Surgical Flaps
Tissue Plasminogen Activator / metabolism*
Venous Thrombosis / drug therapy*
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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