Percutaneous aspiration of a thromboembolus.
Percutaneous aspiration of a thromboembolus was successfully performed in 12 out of 13 patients with in situ thrombosis (4 patients), distal embolization (7 patients), or both (2 patients). The flow was improved from TIMI 0 (10 patients, no flow) or TIMI 1 (2 patients, impaired flow) to TIMI 3 (10 patients, normal flow) or TIMI 2 (2 patients, normal but slower flow). A custom-made 8 F Teflon-coated sheath was introduced in the superficial femoral and proximal below-the-knee arteries to aspirate the debris. Distal embolization in below-the-knee arteries was concomitantly treated with short-term intraarterial Urokinase in nine patients. Complications included one in-hospital (not procedure related) death, two patients with below-the-knee amputations (above-the-knee amputation averted), and one transmetatarsal amputation (prior established gangrene present and below-the-knee amputation avoided). The remaining nine patients left the hospital with improved limb status and peripheral pulses. This technique is a rapid, reliable, and efficient method to treat in-situ clot or procedure-related distal embolization as an adjuvant or complement to lytic treatment.
Dorros
G
G
Department of Cardiology, St. Luke's Medical Center, Milwaukee.
Jamnadas
P
P
Lewin
R F
RF
Sachdev
N
N
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001161:Arteriosclerosis / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy; D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy; D007511:Ischemia / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013396:Suction / Q000295:instrumentation; D013923:Thromboembolism / Q000628:therapy*; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D014568:Urokinase-Type Plasminogen Activator