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Endovascular venous thrombolysis in children younger than 24 months.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2014 Aug; Vol. 25 (8), pp. 1158-64. Date of Electronic Publication: 2014 Jun 06. - Publication Year :
- 2014
-
Abstract
- Purpose: To evaluate the technical feasibility and safety of percutaneous endovascular thrombolysis for extremity deep venous thrombosis (DVT) in children < 24 months old.<br />Materials and Methods: A retrospective chart review of a clinical and imaging database was performed for pediatric patients who underwent endovascular therapy for DVT between January 2010 and July 2013. Indications, techniques, technical and clinical success, and complications were reviewed. Techniques for thrombolysis included catheter-directed therapy (CDT) using alteplase infusion via a multi-side hole catheter, mechanical thrombectomy, and angioplasty. Short-term outcomes were assessed using surgical and imaging follow-up examinations for patency of the targeted vessel. Patients included 11 children (mean age, 9 mo; range, 3 wk-23 mo) who consecutively underwent endovascular thrombolysis for upper extremity (n = 6) or lower extremity (n = 5) DVT. The most common indication was preservation of venous access for future cardiac surgery or medical therapy.<br />Results: The most common risk factor was the presence of a central venous catheter (10 of 11 patients). All patients with upper extremity DVT had congenital heart disease. CDT and angioplasty were performed in all patients. Venous patency was established in all patients. A grade III (95%-100%) thrombolysis response was achieved in seven patients, and a grade II (50%-95%) thrombolysis response was achieved in four patients. A major complication of pulmonary embolism occurred in one patient with upper extremity thrombolysis and was managed by intravenous systemic alteplase and heparin. No recurrence of thrombosis was found on average follow-up of 11.8 months (range, 1-41 mo).<br />Conclusions: Percutaneous endovascular thrombolysis for extremity DVT is safe and technically feasible in children < 24 months old.<br /> (Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Age Factors
Angioplasty, Balloon
Catheterization, Peripheral
Combined Modality Therapy
Feasibility Studies
Female
Fibrinolytic Agents adverse effects
Humans
Infant
Infant, Newborn
Infusions, Intravenous
Male
Phlebography
Retrospective Studies
Risk Factors
Thrombectomy
Time Factors
Tissue Plasminogen Activator adverse effects
Treatment Outcome
Upper Extremity Deep Vein Thrombosis diagnosis
Upper Extremity Deep Vein Thrombosis physiopathology
Vascular Patency
Venous Thrombosis diagnosis
Venous Thrombosis physiopathology
Endovascular Procedures adverse effects
Fibrinolytic Agents administration & dosage
Lower Extremity blood supply
Thrombolytic Therapy adverse effects
Tissue Plasminogen Activator administration & dosage
Upper Extremity Deep Vein Thrombosis therapy
Venous Thrombosis therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 25
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 24909354
- Full Text :
- https://doi.org/10.1016/j.jvir.2014.04.003