Document Detail


Mechanical thrombolysis of acute occlusion of both the superficial and the deep femoral arteries using a thrombectomy device.
MedLine Citation:
PMID:  9574579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our objective was to evaluate the efficacy of the Amplatz thrombectomy device for recanalization of acute occlusions of both the superficial and the deep femoral arteries. MATERIALS AND METHODS: Eighteen patients with acute occlusions of the femoral arteries (eight male, 10 female; 10-87 years old) were treated using the Amplatz thrombectomy clot macerator. The duration of occlusion was 16 +/- 8 hr. Eighteen patients underwent treatment of the deep femoral artery, and 16 patients had additional involvement of the superficial femoral artery. After primary recanalization of the deep femoral artery, the superficial femoral artery was also recanalized using the Amplatz thrombectomy device. Nine patients required additional aspiration thrombectomy of the tibial arteries, five patients required additional aspiration thrombectomy of side branches of the deep femoral artery, and 12 patients required additional local thrombolysis with urokinase. RESULTS: In 14 (78%) of 18 patients, recanalization of the deep femoral artery was complete without demonstrable residual thrombi. Arterial spasms were observed in five patients (28%). The rate of limb salvage was 94% at a mean follow-up interval of 8.9 +/- 4.1 months. In the 18 patients, the ankle-brachial pressure index went from a median value of 0.56 before therapy to a median value of 0.91 after therapy. No severe complications occurred. CONCLUSION: Mechanical thrombolysis in the deep femoral artery with the Amplatz thrombectomy device is an effective, rapid method of treatment and is rarely associated with complications. In cases of concomitant occlusion of the tibial arteries, recanalization should always be attempted because the deep femoral artery may provide a functionally decisive collateral artery between the iliac and tibial vasculature.
Authors:
J Görich; N Rilinger; R Sokiranski; S Krämer; V Mickley; A Schütz; H J Brambs; R Pamler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  170     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-05-19     Completed Date:  1998-05-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1177-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, University of Ulm, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Arterial Occlusive Diseases / surgery*
Blood Pressure / physiology
Brachial Artery / physiology
Child
Collateral Circulation / physiology
Combined Modality Therapy
Female
Femoral Artery / pathology,  physiopathology,  surgery*
Follow-Up Studies
Humans
Iliac Artery / physiopathology
Leg / blood supply
Male
Middle Aged
Plasminogen Activators / therapeutic use
Popliteal Artery / physiopathology,  surgery
Suction
Thrombectomy / adverse effects,  instrumentation*,  methods
Thromboembolism / surgery*
Thrombolytic Therapy
Tibial Arteries / physiopathology,  surgery
Time Factors
Urokinase-Type Plasminogen Activator / therapeutic use
Vasoconstriction / physiology
Chemical
Reg. No./Substance:
EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

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


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