Catheter-Directed Thrombolysis in the Treatment of Acute Ischemia in Lower Extremities Is Safe and Effective, Especially with Concomitant Endovascular Treatment
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Catheter-Directed Thrombolysis in the Treatment of Acute Ischemia in Lower Extremities Is Safe and Effective, Especially with Concomitant Endovascular Treatment. / Urbak, Lærke; de la Motte, Louise; Rørdam, Peter; Siddiqi, Aamir; Sillesen, Henrik.
In: Annals of Vascular Surgery, Vol. 10, No. 2, 25.06.2017, p. 125-131.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Catheter-Directed Thrombolysis in the Treatment of Acute Ischemia in Lower Extremities Is Safe and Effective, Especially with Concomitant Endovascular Treatment
AU - Urbak, Lærke
AU - de la Motte, Louise
AU - Rørdam, Peter
AU - Siddiqi, Aamir
AU - Sillesen, Henrik
PY - 2017/6/25
Y1 - 2017/6/25
N2 - Objective: To evaluate the influence of pre-procedural characteristics on immediate and late results as well as the safety of catheter-directed thrombolysis (CDT) in acute ischemia of the lower extremity. Materials and Methods: A retrospective study comprising 249 patients treated by CDT from January 2006 to December 2012. Outcomes were primary patency, haemorrhagic complications, amputation and mortality. Results: Primary patency for CDT alone was 68%, for CDT plus endovascular treatment 87% and for successful CDT with supplementary surgery 62% giving an overall primary patency of 76%. Two (0.8%) patients suffered from cerebral haemorrhage during CDT. We found a significant correlation between 30 day amputation rate and no visual distal run-off at CDT start (OR 2.31; CI95% 1.09-4.91; p-value=0.02) and onset of symptoms to CDT start of 8-14 days (OR 4.09; CI95% 1.42-11.81; p-value=0.01). Lack of visualized distal run-off was also associated with a significant risk of 30 day mortality (OR 5.84; CI95% 1.26-27.00; p-value=0.02). Conclusion: Our results show that CDT is a feasible and safe treatment option especially when combined with angioplasty +/- stent. However, no distal run-off at primary angiography is associated with higher rates of amputation during follow-up and 30 day mortality.
AB - Objective: To evaluate the influence of pre-procedural characteristics on immediate and late results as well as the safety of catheter-directed thrombolysis (CDT) in acute ischemia of the lower extremity. Materials and Methods: A retrospective study comprising 249 patients treated by CDT from January 2006 to December 2012. Outcomes were primary patency, haemorrhagic complications, amputation and mortality. Results: Primary patency for CDT alone was 68%, for CDT plus endovascular treatment 87% and for successful CDT with supplementary surgery 62% giving an overall primary patency of 76%. Two (0.8%) patients suffered from cerebral haemorrhage during CDT. We found a significant correlation between 30 day amputation rate and no visual distal run-off at CDT start (OR 2.31; CI95% 1.09-4.91; p-value=0.02) and onset of symptoms to CDT start of 8-14 days (OR 4.09; CI95% 1.42-11.81; p-value=0.01). Lack of visualized distal run-off was also associated with a significant risk of 30 day mortality (OR 5.84; CI95% 1.26-27.00; p-value=0.02). Conclusion: Our results show that CDT is a feasible and safe treatment option especially when combined with angioplasty +/- stent. However, no distal run-off at primary angiography is associated with higher rates of amputation during follow-up and 30 day mortality.
U2 - 10.3400/avd.oa.16-00140
DO - 10.3400/avd.oa.16-00140
M3 - Journal article
C2 - 29034038
VL - 10
SP - 125
EP - 131
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
SN - 0890-5096
IS - 2
ER -
ID: 195960436