Could mechanical thrombectomy replace thrombolysis in the treatment of acute and subacute limb ischemia?

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F19%3A43917056" target="_blank" >RIV/00216208:11120/19:43917056 - isvavai.cz</a>

Výsledek na webu

<a href="https://doi.org/10.23736/S0026-4725.18.04770-9" target="_blank" >https://doi.org/10.23736/S0026-4725.18.04770-9</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.23736/S0026-4725.18.04770-9" target="_blank" >10.23736/S0026-4725.18.04770-9</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Could mechanical thrombectomy replace thrombolysis in the treatment of acute and subacute limb ischemia?

Popis výsledku v původním jazyce

Acute limb ischemia is a vascular emergency defined as a sudden decrease in limb perfusion associated with a risk of loss of viability of the affected extremity. Surgical treatment (Fogarty thromboembolectomy) is indicated only in suprainguinal occlusions. Other cases of acute and subacute limb ischemia should be managed percutaneously. Catheter-based treatment involves local thrombolysis and percutaneous mechanical thrombectomy (PMT). There are several devices in use for PMT; of them, the Rotarex system appears to be the most useful. There are no randomized studies comparing thrombolysis and PMT. Only indirect comparison is possible. The immediate and long-term results of PMT using the Rotarex device are probably more favourable than those following thrombolysis. Particularly for older and polymorbid patients, it may be significant that PMT, in comparison with thrombolysis, can restore blood flow faster and in one session; no contraindications for PMT in contrast to potentially life-threatening complications in thrombolysis exist, and there is also no need for observation in intensive care unit after PMT. Hospital stay after PMT is shorter. There is only one exception when thrombolysis cannot be replaced by Rotarex PMT-in the case of crural arteries involvement-due to the catheter size. In our opinion, PMT is superior to thrombolysis in the treatment of acute and subacute limb ischemia. Thrombolysis should be considered only in special cases, e.g. in crural arteries occlusions or in failure of mechanical thrombectomy.

Název v anglickém jazyce

Could mechanical thrombectomy replace thrombolysis in the treatment of acute and subacute limb ischemia?

Popis výsledku anglicky

Acute limb ischemia is a vascular emergency defined as a sudden decrease in limb perfusion associated with a risk of loss of viability of the affected extremity. Surgical treatment (Fogarty thromboembolectomy) is indicated only in suprainguinal occlusions. Other cases of acute and subacute limb ischemia should be managed percutaneously. Catheter-based treatment involves local thrombolysis and percutaneous mechanical thrombectomy (PMT). There are several devices in use for PMT; of them, the Rotarex system appears to be the most useful. There are no randomized studies comparing thrombolysis and PMT. Only indirect comparison is possible. The immediate and long-term results of PMT using the Rotarex device are probably more favourable than those following thrombolysis. Particularly for older and polymorbid patients, it may be significant that PMT, in comparison with thrombolysis, can restore blood flow faster and in one session; no contraindications for PMT in contrast to potentially life-threatening complications in thrombolysis exist, and there is also no need for observation in intensive care unit after PMT. Hospital stay after PMT is shorter. There is only one exception when thrombolysis cannot be replaced by Rotarex PMT-in the case of crural arteries involvement-due to the catheter size. In our opinion, PMT is superior to thrombolysis in the treatment of acute and subacute limb ischemia. Thrombolysis should be considered only in special cases, e.g. in crural arteries occlusions or in failure of mechanical thrombectomy.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2019

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Minerva Cardioangiologica

ISSN

0026-4725

e-ISSN

—

Svazek periodika

67

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

IT - Italská republika

Počet stran výsledku

12

Strana od-do

234-245

Kód UT WoS článku

000470998400007

EID výsledku v databázi Scopus

2-s2.0-85066481216