Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19
Purpose The aim of this study was to report the clinical effectiveness and safety of pharmacomechanical thrombectomy (PMT) for acute limb threatening lower extremity arterial thrombosis secondary to coronavirus disease 2019 (COVID-19). Methods In this retrospective study, the clinical and...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2022-12-01
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| Series: | Journal of Clinical Interventional Radiology ISVIR |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740459 |
| _version_ | 1798004765878124544 |
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| author | Rajesh Girdhardas Mundhada Atul Dharmaraj Rewatkar Anju Rajesh Mundhada Aishwarya Atul Rewatkar Nikita Navin Chandak |
| author_facet | Rajesh Girdhardas Mundhada Atul Dharmaraj Rewatkar Anju Rajesh Mundhada Aishwarya Atul Rewatkar Nikita Navin Chandak |
| author_sort | Rajesh Girdhardas Mundhada |
| collection | DOAJ |
| description | Purpose The aim of this study was to report the clinical effectiveness and safety of pharmacomechanical thrombectomy (PMT) for acute limb threatening lower extremity arterial thrombosis secondary to coronavirus disease 2019 (COVID-19).
Methods In this retrospective study, the clinical and imaging records of six patients (6 men, mean age 56 years) with COVID-19-related lower extremity arterial thrombosis and treated with PMT using the Angio-Jet device were reviewed. Patients presented with symptoms of acute pain in the affected limb, pallor, pulselessness, paresthesia, or paralysis. Thrombosis involved below knee arteries in all patients, and above knee arteries in three patients. Reteplase 18 mg was infused into the thrombus using the power pulse mode on the Angio-Jet device. This was followed by rheolytic thrombectomy and then, intra-arterial infusion of urokinase 100,000 IU/hour for 5 hours. All patients received systemic intravenous heparin. Technical success, clinical success, and complications of PMT were analyzed.
Results The mean thrombectomy duration was 190.83 ± 99.18 seconds. Adjuvant balloon angioplasty was performed in two patients. The mean hospital stay was 7.67 ± 4.50 days. PMT was technically successful in all (100%) patients. Five patients had excellent clinical outcome with at least one palpable pulse and no tissue loss. One patient required minor amputation. One patient developed self-limiting retroperitoneal hematoma.
Conclusion In our series, PMT with supplemental intra-arterial urokinase infusion was highly successful in treating acute peripheral arterial thrombosis secondary to COVID-19. |
| first_indexed | 2024-04-11T12:28:37Z |
| format | Article |
| id | doaj.art-fc063d85e99142d89b267969ae0b8688 |
| institution | Directory Open Access Journal |
| issn | 2456-4869 |
| language | English |
| last_indexed | 2024-04-11T12:28:37Z |
| publishDate | 2022-12-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Journal of Clinical Interventional Radiology ISVIR |
| spelling | doaj.art-fc063d85e99142d89b267969ae0b86882022-12-22T04:23:51ZengThieme Medical Publishers, Inc.Journal of Clinical Interventional Radiology ISVIR2456-48692022-12-01060317017610.1055/s-0041-1740459Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19Rajesh Girdhardas Mundhada0Atul Dharmaraj Rewatkar1Anju Rajesh Mundhada2Aishwarya Atul Rewatkar3Nikita Navin Chandak4Pulse Clinic and Hospital, Nagpur, Maharashtra, IndiaPulse Clinic and Hospital, Nagpur, Maharashtra, IndiaPulse Clinic and Hospital, Nagpur, Maharashtra, IndiaPulse Clinic and Hospital, Nagpur, Maharashtra, IndiaFinal Year Medical Student, King Edward Medical College, Mumbai, Maharashtra, IndiaPurpose The aim of this study was to report the clinical effectiveness and safety of pharmacomechanical thrombectomy (PMT) for acute limb threatening lower extremity arterial thrombosis secondary to coronavirus disease 2019 (COVID-19). Methods In this retrospective study, the clinical and imaging records of six patients (6 men, mean age 56 years) with COVID-19-related lower extremity arterial thrombosis and treated with PMT using the Angio-Jet device were reviewed. Patients presented with symptoms of acute pain in the affected limb, pallor, pulselessness, paresthesia, or paralysis. Thrombosis involved below knee arteries in all patients, and above knee arteries in three patients. Reteplase 18 mg was infused into the thrombus using the power pulse mode on the Angio-Jet device. This was followed by rheolytic thrombectomy and then, intra-arterial infusion of urokinase 100,000 IU/hour for 5 hours. All patients received systemic intravenous heparin. Technical success, clinical success, and complications of PMT were analyzed. Results The mean thrombectomy duration was 190.83 ± 99.18 seconds. Adjuvant balloon angioplasty was performed in two patients. The mean hospital stay was 7.67 ± 4.50 days. PMT was technically successful in all (100%) patients. Five patients had excellent clinical outcome with at least one palpable pulse and no tissue loss. One patient required minor amputation. One patient developed self-limiting retroperitoneal hematoma. Conclusion In our series, PMT with supplemental intra-arterial urokinase infusion was highly successful in treating acute peripheral arterial thrombosis secondary to COVID-19.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740459covid-19-related arterial thrombosisangio-jet thrombectomy system |
| spellingShingle | Rajesh Girdhardas Mundhada Atul Dharmaraj Rewatkar Anju Rajesh Mundhada Aishwarya Atul Rewatkar Nikita Navin Chandak Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 Journal of Clinical Interventional Radiology ISVIR covid-19-related arterial thrombosis angio-jet thrombectomy system |
| title | Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 |
| title_full | Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 |
| title_fullStr | Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 |
| title_full_unstemmed | Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 |
| title_short | Pharmacomechanical Thrombectomy for Acute Limb Threatening Lower Extremity Arterial Thrombosis Secondary to COVID-19 |
| title_sort | pharmacomechanical thrombectomy for acute limb threatening lower extremity arterial thrombosis secondary to covid 19 |
| topic | covid-19-related arterial thrombosis angio-jet thrombectomy system |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1740459 |
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