Document Detail


Isolated pharmacomechanical thrombolysis plus primary stenting in a single procedure to treat acute thrombotic superior vena cava syndrome.
MedLine Citation:
PMID:  20199277     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report a combined procedure that opens the acutely thrombosed superior vena cava (SVC) to rapidly alleviate symptoms in seriously ill patients with SVC syndrome. CASE REPORTS: Four patients aged 54 to 63 years old with underlying malignancies were referred for treatment of SVC syndrome. All received isolated pharmacomechanical thrombolysis (IPMT) with tissue plasminogen activator delivered in a Trellis Peripheral Infusion System that removed obstructive clot in minutes versus the 24 to 48 hours required for traditional catheter-directed thrombolysis. In each case, stents were inserted immediately following IPMT in a combined procedure lasting <1 hour. Patients exhibited near-immediate relief of debilitating symptoms; completion venography demonstrated patent vessels with excellent blood flow. CONCLUSION: Combining IPMT with immediate stenting during the same session is an effective method for managing acute thrombotic SVC syndrome and limiting the exposure time and number of interventions performed on seriously ill patients.
Authors:
Gerard J O'Sullivan; Jennifer Ni Mhuircheartaigh; David Ferguson; Eithne Delappe; Conor O'Riordan; Ann Michelle Browne
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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:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-04     Completed Date:  2010-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-23     Citation Subset:  IM    
Affiliation:
Section of Interventional Radiology, Department of Radiology, and, University College Hospital, Newcastle Road, Galway, Ireland. gerard.osullivan2@hse.ie
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon / instrumentation*
Anticoagulants / therapeutic use
Combined Modality Therapy
Constriction, Pathologic
Edema / etiology,  therapy
Equipment Design
Female
Fibrinolytic Agents / administration & dosage*
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Male
Middle Aged
Neoplasms / complications*
Phlebography
Recurrence
Stents*
Superior Vena Cava Syndrome / etiology,  physiopathology,  radiography,  therapy*
Thrombectomy / instrumentation*
Thrombolytic Therapy* / instrumentation
Time Factors
Tissue Plasminogen Activator / administration & dosage*
Treatment Outcome
Vascular Patency
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents; 0/Heparin, Low-Molecular-Weight; EC 3.4.21.68/Tissue Plasminogen Activator
Comments/Corrections
Comment In:
J Endovasc Ther. 2010 Feb;17(1):124-5   [PMID:  20199278 ]

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


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