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Outcome of thrombolysis and thrombectomy for thrombosed endografts inserted in the superficial femoral artery for occlusive disease.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2013 Dec; Vol. 20 (6), pp. 836-43. - Publication Year :
- 2013
-
Abstract
- Purpose: To evaluate the efficacy and outcome of thrombolysis and thrombectomy for thrombosed polytetrafluoroethylene stent-grafts inserted in the superficial femoral artery (SFA) for occlusive disease.<br />Methods: A retrospective review was conducted of 79 consecutive patients with a thrombosed SFA endograft between November 2001 and December 2011. Of these, 46 (58%) were treated with thrombolysis (n=40, 87%) or thrombectomy (n=6, 13%) and form the study group (33 men; median age 66.8 years, range 30-80). Median time from stent-graft insertion to thrombosis was 3 months (range 0-53).<br />Results: Thrombolysis was successful in 38 (95%) patients over a mean 24 hours (range 3-48); one patient had failed lysis and another died during lytic treatment. Thrombectomy was successful in all 6 patients. Thrombosis without a causal lesion was significantly more common in occlusions that presented <30 days after insertion (p=0.01). Over a median follow-up of 14 months (range 1-69), reinterventions were performed for restenosis in 12 patients and reocclusion in 14 patients, all within 18 months after thrombolytic treatment. More than a third of patients (16/45) had definitive failures (2/6 from the thrombectomy group); 4 were treated conservatively (no/minor symptoms) and 12 had bypass grafts. Three (7%) patients eventually required a major amputation. The primary, assisted primary, and secondary patency rates of thrombolysis at 6 months were 56%, 56%, and 68%, respectively. Secondary patency for the entire cohort was 58% at 1 year.<br />Conclusion: Thrombolysis and thrombectomy of thrombosed endografts in the SFA is effective and safe. Patency rates after treatment are moderate, but prolonged secondary patency can be achieved.
- Subjects :
- Adult
Aged
Aged, 80 and over
Arterial Occlusive Diseases diagnosis
Arterial Occlusive Diseases physiopathology
Blood Vessel Prosthesis Implantation adverse effects
Endovascular Procedures adverse effects
Female
Femoral Artery physiopathology
Graft Occlusion, Vascular diagnosis
Graft Occlusion, Vascular etiology
Graft Occlusion, Vascular physiopathology
Humans
Male
Middle Aged
Netherlands
Polytetrafluoroethylene
Prosthesis Design
Reoperation
Retrospective Studies
Thrombosis diagnosis
Thrombosis etiology
Time Factors
Treatment Outcome
Vascular Patency
Arterial Occlusive Diseases surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation instrumentation
Endovascular Procedures instrumentation
Femoral Artery surgery
Graft Occlusion, Vascular therapy
Stents
Thrombectomy adverse effects
Thrombolytic Therapy adverse effects
Thrombosis therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 20
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 24325702
- Full Text :
- https://doi.org/10.1583/13-4374MR.1