Intra-arterial thrombolysis in acute popliteal artery occlusion is a safe and effective technique reducing the rate of open surgery
| Autor: | Tarek Boudjelit, Patrick Lermusiaux, Marine Bordet, Philippe Tresson, Antoine Millon, Nellie Della Schiava, Alessia Moia, Matthieu Arsicot, Iris Naudin |
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| Přispěvatelé: | Laboratoire de Génie Electrique et Ferroélectricité (LGEF), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA), Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL) |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment [SDV]Life Sciences [q-bio] Ischemia 030204 cardiovascular system & hematology Thrombophilia Amputation Surgical Popliteal aneurysm 03 medical and health sciences Peripheral Arterial Disease 0302 clinical medicine Fibrinolytic Agents medicine Clinical endpoint Humans Infusions Intra-Arterial Popliteal Artery Thrombolytic Therapy Hospital Mortality Vascular Patency Aged Retrospective Studies business.industry Retrospective cohort study General Medicine Thrombolysis medicine.disease Limb Salvage Urokinase-Type Plasminogen Activator 3. Good health Surgery Treatment Outcome 030228 respiratory system Amputation Etiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of cardiovascular surgery The Journal of cardiovascular surgery, 2020, ⟨10.23736/s0021-9509.20.11121-2⟩ |
| ISSN: | 1827-191X |
| DOI: | 10.23736/s0021-9509.20.11121-2⟩ |
| Popis: | BACKGROUND: Acute popliteal artery occlusion is a frequent clinical entity with a risk of major amputation. Several attitudes are possible and treatment is not standardized. The purpose of this study is to demonstrate safety and effectiveness of intra-arterial thrombolysis in acute popliteal artery occlusion. METHODS: This is a retrospective analysis of a prospective database of patients treated by intra-arterial thrombolysis for acute lower-limb ischemia due to popliteal artery occlusion between 2001 and 2014.The primary endpoint was technical and clinical success. Etiologies and etiologic treatment, amputation-free survival, in-hospital mortality and bleeding complications rates were secondary endpoints. RESULTS: Seventy-one patients, with a mean 6-day-old ischemic time before thrombolysis, were analyzed. Technical and clinical success was 90% and 87% respectively. Etiology was embolic in 33 patients (cardiac n = 14, aortic = 6, unknown = 13) and thrombotic in 38 (atheromatous n = 19, entrapment n= 4, popliteal aneurysm n = 11, Buerger n = 2, thrombophilia n = 1, hyperhomocysteinemia n = 1). Survival and amputation-free survival at 30 days were 97% and 94% respectively. There were no major bleeding complications. CONCLUSIONS: Intra-arterial thrombolysis of acute popliteal artery occlusion is an effective technique which reduces the rate of open surgery. The risk of bleeding complications is very low. |
| Databáze: | OpenAIRE |
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