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Outcomes After Catheter Direct Thrombolysis for Acute Limb Ischaemia - Single Center Experience

Tiago Soares1, João Rocha Neves1, Ricardo Castro Ferreira1

  • 1Centro Hospitalar São João, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular
|April 28, 2018
PubMed

Insights

Catheter directed thrombolysis (CDT) offers effective treatment for acute lower limb ischaemia, with good mid-term outcomes across various causes. This minimally invasive approach reduces the need for open surgery in many patients.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Acute lower limb ischaemia presents a significant clinical challenge.
  • Understanding outcomes based on aetiology is crucial for treatment selection.

Purpose of the Study:

  • To evaluate the efficacy of catheter directed thrombolysis (CDT) in treating acute lower limb ischaemia.
  • To assess CDT outcomes stratified by the underlying cause of ischaemia.

Main Methods:

  • Retrospective analysis of 128 CDT procedures in 106 patients (2011-2017).
  • Categorization of ischaemia aetiologies including native artery thrombosis, PTFE graft thrombosis, and others.
  • Evaluation of reintervention rates, amputation-free survival, and mortality.

Main Results:

  • Overall, 22% of patients required reintervention.
  • Reintervention rates varied by aetiology: 27.6% for native artery thrombosis, 65.2% for PTFE graft thrombosis, and 18.2% for intra-stent thrombosis.
  • Amputation-free survival was 83.3% at 27 months, with no significant differences between aetiology groups.

Conclusions:

  • Catheter directed thrombolysis demonstrates favourable mid-term clinical outcomes for acute lower limb ischaemia.
  • CDT is a viable alternative to open surgical treatment for diverse ischaemic causes.
  • The findings support CDT as a valuable therapeutic option in managing acute limb ischaemia.
Abstract

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