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Bleeding Issues During Thrombolysis for Acute Leg Ischaemia
When we started testing catheter directed low dose thrombolysis (CDT) for acute leg ischaemia (ALI) in the 1980s, it was the first time endovascular intervention advanced beyond simple balloon angioplasty. In many respects, CDT kick started the endovascular revolution. Clots could be removed without surgery, and from arteries too small for embolectomy catheters to reach. But there was a price to pay: thrombolytic drugs caused bleeding, mainly from catheter puncture sites, but also from distant areas, such as haemorrhagic stroke.
Source: European Journal of Vascular and Endovascular Surgery - January 6, 2023 Category: Surgery Authors: Jonothan Earnshaw Tags: Invited Commentary Source Type: research

Recurrent arterial thrombosis in a patient with Fabry disease: case report
Resumo A doen ça de Fabry é definida como uma doença rara de depósito lisossomal ligada ao cromossomo X que apresenta sintomas multissistêmicos, incluindo comprometimento vascular com eventos trombóticos. Paciente do sexo feminino, 57 anos, com diagnóstico de doença de Fabry há 11 anos, apresentava hiper idrose, hipoacusia e angioqueratoma nas mãos. Na história patológica pregressa, relatou episódio de acidente vascular encefálico isquêmico prévio aos 40 anos de idade e trombose arterial crônica agudizada em membro inferior direito há 1 ano, a qual foi tratada por meio de angioplastia com u so de stent, a...
Source: Jornal Vascular Brasileiro - April 3, 2020 Category: Surgery Source Type: research

PC164 Fast-Track Thrombolysis for Acute Lower Extremity In-Stent Occlusions: A Novel Approach to Minimize Complications of Standard Thrombolytic Therapy
The role of catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity ischemia may require prolonged periods of time to achieve successful lysis. Prolonged thrombolysis infusion has demonstrated increased incidence of intracranial bleeding, stroke, and local complications. It is expensive and increases hospital length of stay. To minimize these potentially negative outcomes, we developed a fast track approach (FTA) that included the use of aggressive balloon angioplasty and stenting before the thrombus was completely lysed.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Syed Ali Rizvi, Anil Hingorani, Enrico Ascher, Natalie Marks Tags: C10: Poster Competition Source Type: research

Could advanced drug delivery systems be the future in cardiovascular revascularization medicine?
Abstract Acute myocardial infarction, stroke and pulmonary embolism required a prompt revascularization to restore the normal blood flow as soon as possible. Fibrinolytic treatment has gradually become both dated and underused in the treatment of acute myocardial infarction, after the wide diffusion of cathlab and percutaneous transluminal coronary angioplasty. Conversely, the use of systemic thrombolysis remained a benchmark in the treatment of both ischemic stroke and massive pulmonary embolism. In daily clinical practice, the use of thrombolytic agents is often limited by absolute and/or relative contraindicati...
Source: Vascular - December 5, 2016 Category: Surgery Authors: Zuin M, Rigatelli G, Faggian G, L'Erario R, Chinaglia M, Roncon L Tags: Vascular Source Type: research

Patching plus extended exposure and tacking of the common carotid cuff may reduce the late incidence of recurrent stenosis after carotid endarterectomy
The objective of this study was to determine whether routine patch angioplasty and precautions related to the common carotid cuff could reduce the risks for perioperative stroke, internal carotid artery (ICA) thrombosis, or recurrent carotid stenosis.Methods: The senior author (N.H.) performed 1959 consecutive isolated CEAs at the Cleveland Clinic from 1976 to 2004. This series can be divided into three distinct eras with respect to patching and management of the proximal common carotid cuff: (1) primary arteriotomy closure with selective patching in only 38 of 653 CEAs (5.8%) from 1976 to 1983 (group 1); (2) routine patch...
Source: Journal of Vascular Surgery - June 3, 2013 Category: Surgery Authors: Norman R. Hertzer, James F. Bena Tags: Clinical research studies Source Type: research