medigraphic.com

2021, Number 3

<< Back Next >>

Revista Cubana de Angiología y Cirugía Vascular 2021; 22 (3)

Catheter-directed thrombolysis in patients with acute peripheral arterial occlusion

Rojas GJC, González BC, Medina RA

Language: Spanish
References: 5
Page: 1-10
PDF size: 368.97 Kb.


ABSTRACT

Introduction: Acute peripheral arterial occlusions of less than 14 days and of embolic and thrombotic cause are associated with a high morbidity and mortality. Catheter-directed thrombolysis currently represents an effective treatment modality for the occlusion of infragenicular distal vessels, which has historically had poor results by conventional embolectomy, due to the pre-existing occlusion of collateral vessels and the mechanical damage to the endothelium, which this traditional technique entails. It was decided to present this case because it is the first time that this modality of treatment is practiced in Cuba. Objective: Present the results obtained with the application of fibrinolytic thrombolysis by catheter in a patient affected by acute peripheral arterial thrombosis. Case presentation: A 57-year-old male patient diagnosed with acute arterial thrombosis of the popliteal artery of the left lower limb, with more than 24 hours of evolution of ischemia and compromised viability of the limb. Fibrinolytic treatment was used, by infusion of 250,000 units of Heberkinase® in three hours and the improvement of the amputation level was achieved. Conclusions: Fibrinolytic treatment with Heberkinase® was useful in the treated patient because it reduced the level of amputation in the patient, who presented irreversible ischemia and initial criteria of high supracondylar amputation in the compromised limb.


REFERENCES

  1. Gener A, Quiñones-Baldrich WJ, Kashyap V. Trombólisis para oclusiones arteriales y de injertos: técnica y resultados. En: Lawrence PF, Oderich GS, editors. Cirugía Vascular y Endovascular. 9 ed. España: Elsevier; 2020. p. 514-39 [acceso 22/02/2020]. Disponible en: Disponible en: https://www.elsevier.com/books/cirugia-vascular-y-endovascular/moore/978-84-9113-556-2

  2. Güneş Y, Sincer I, Erdal E. Catheter directed intra-arterial thrombolysis for lower extremity arterial occlusions. Anatol J Cardiol. 2019 [acceso 25/02/2020];22(2):54-9. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735447/

  3. Koraen-Smith L, Wängberg M, Montán C, Gillgren P, Wahlgren CM. Safety of Intra-arterial catheter directed thrombolysis: Does level of care matter? European Journal of Vascular and Endovascular Surgery. 2016 [acceso 28/02/2020];51(5):718-23. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S1078588416000617

  4. Suckow BD, Stone DH. Graft thrombosis. In: Sidawy AN, and Perler BA, editores. Rutherford’s Vascular Surgery and Endovascular Therapy. Philadelphia, PA: Elsevier; 2019. p. 577-87. [acceso 28/02/2020. Disponible en: Disponible en: https://www.us.elsevierhealth.com/rutherfords-vascular-surgery-and-endovascular-therapy-2-volume-set-9780323427913.html

  5. Björck M, Earnshaw JJ, Stefan Acosta S, Bastos Gonçalves F, Cochennec F, Sebastian Debus E, et al. European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia. European Journal of Vascular and Endovascular Surgery. 2020 [acceso 28/02/2020];59(2):173-218. Disponible en: Disponible en: https://www.ejves.com/article/S1078-5884(19)31515-1/fulltext




2020     |     www.medigraphic.com