TY - JOUR
T1 - Initial results of catheter-directed ultrasound-accelerated thrombolysis for thromboembolic obstructions of the aortofemoral arteries
T2 - A feasibility study
AU - Schrijver, A. Marjolein
AU - Reijnen, Michel M.P.J.
AU - Van Oostayen, Jacques A.
AU - Hoksbergen, Arjan W.J.
AU - Lely, Rutger J.
AU - Van Leersum, Marc
AU - De Vries, Jean Paul P.M.
PY - 2012/4/1
Y1 - 2012/4/1
N2 - Purpose This article reports the 30-day technical and clinical outcome of ultrasound (US)-accelerated thrombolysis in patients with aortofemoral arterial thromboembolic obstructions. Methods A prospective cohort study was conducted from December 2008 to December 2009 of patients who were treated with US-accelerated thrombolysis for hromboembolic obstructions of aortofemoral arteries or bypasses. Urokinase was infused in a dosage of 100,000 IU per hour. Twice daily, a control angiography was performed. Thirtyday follow-up consisted of duplex scanning, combined with magnetic resonance angiography. Results The study included 21 consecutive patients (20 men; median age, 66 (range, 52-80) years) with 24% artery versus76% bypass occlusions. Median duration of symptoms was 11 (range, 7-140) days. Median occlusion length was 32 (range, 6-80) cm. In 20 patients (95%), an US-accelerated thrombolysis catheter could be successfully placed. In one patient, placement of an US-accelerated thrombolysis catheter was technically not feasible, and therefore a standard catheter was placed. Median thrombolysis time was 26.5(range, 8.5-72) hours.Complete thrombolysis ([95%lysis of thrombus) was achieved in 20 patients; in 9 patients within 24 hours. Median ankle-brachial index (ABI) increased from 0.28 (range, 0-0.85) to 0.91 (range, 0.58-1.35). One patient had a thromboembolic complication and needed surgical intervention. No hemorrhagic complications, and no eaths occurred. At 30-day follow-up, 17 of 21 patients (81%) had a patent artery or bypass. Conclusions This feasibility study showed a high technical success rate of US-accelerated thrombolysis for aortofemoral arterial obstructions. US-accelerated thrombolysis led to complete lysis within 24 hours in almost half of patients, with a low 30-day major complication rate.
AB - Purpose This article reports the 30-day technical and clinical outcome of ultrasound (US)-accelerated thrombolysis in patients with aortofemoral arterial thromboembolic obstructions. Methods A prospective cohort study was conducted from December 2008 to December 2009 of patients who were treated with US-accelerated thrombolysis for hromboembolic obstructions of aortofemoral arteries or bypasses. Urokinase was infused in a dosage of 100,000 IU per hour. Twice daily, a control angiography was performed. Thirtyday follow-up consisted of duplex scanning, combined with magnetic resonance angiography. Results The study included 21 consecutive patients (20 men; median age, 66 (range, 52-80) years) with 24% artery versus76% bypass occlusions. Median duration of symptoms was 11 (range, 7-140) days. Median occlusion length was 32 (range, 6-80) cm. In 20 patients (95%), an US-accelerated thrombolysis catheter could be successfully placed. In one patient, placement of an US-accelerated thrombolysis catheter was technically not feasible, and therefore a standard catheter was placed. Median thrombolysis time was 26.5(range, 8.5-72) hours.Complete thrombolysis ([95%lysis of thrombus) was achieved in 20 patients; in 9 patients within 24 hours. Median ankle-brachial index (ABI) increased from 0.28 (range, 0-0.85) to 0.91 (range, 0.58-1.35). One patient had a thromboembolic complication and needed surgical intervention. No hemorrhagic complications, and no eaths occurred. At 30-day follow-up, 17 of 21 patients (81%) had a patent artery or bypass. Conclusions This feasibility study showed a high technical success rate of US-accelerated thrombolysis for aortofemoral arterial obstructions. US-accelerated thrombolysis led to complete lysis within 24 hours in almost half of patients, with a low 30-day major complication rate.
KW - Peripheral arterial disease
KW - Thrombolysis
UR - http://www.scopus.com/inward/record.url?scp=84862902737&partnerID=8YFLogxK
U2 - 10.1007/s00270-011-0164-4
DO - 10.1007/s00270-011-0164-4
M3 - Article
C2 - 21534002
AN - SCOPUS:84862902737
VL - 35
SP - 279
EP - 285
JO - CardioVascular and Interventional Radiology
JF - CardioVascular and Interventional Radiology
SN - 7415-5101
IS - 2
ER -