Catheter-Directed Thrombolysis of Arterial Thrombosis

Abstract

Thrombotic or embolic arterial occlusive disease can lead to profound ischemia and, without emergent revascularization, is associated with significant morbidity and mortality. Significant advances in the management of arterial occlusive disease range from newer thrombolytic agents to innovative catheter designs to enhance thrombolysis and thrombectomy. Most of these advances have been directed toward the management of acute limb ischemia; therefore, we review the management of limb ischemia with emphasis on endovascular interventions.

Keywords

thrombosis - catheter-directed thrombolysis - artery

• References

• 1 Creager MA, Kaufman JA, Conte MS. Clinical practice. Acute limb ischemia. N Engl J Med 2012; 366 (23) 2198-2206
• 2 Jerjes-Sanchez C. Venous and arterial thrombosis: a continuous spectrum of the same disease?. Eur Heart J 2005; 26 (1) 3-4
• 3 Lijfering WM, Flinterman LE, Vandenbroucke JP, Rosendaal FR, Cannegieter SC. Relationship between venous and arterial thrombosis: a review of the literature from a causal perspective. Semin Thromb Hemost 2011; 37 (8) 885-896
• 4 Rauch U, Osende JI, Fuster V, Badimon JJ, Fayad Z, Chesebro JH. Thrombus formation on atherosclerotic plaques: pathogenesis and clinical consequences. Ann Intern Med 2001; 134 (3) 224-238
• 5 Borissoff JI, Spronk HM, ten Cate H. The hemostatic system as a modulator of atherosclerosis. N Engl J Med 2011; 364 (18) 1746-1760
• 6 Previtali E, Bucciarelli P, Passamonti SM, Martinelli I. Risk factors for venous and arterial thrombosis. Blood Transfus 2011; 9 (2) 120-138
• 7 Khadim G, Butler J, Migrino RQ. A complete guide to understanding and treating peripheral arterial disease. In: Dieter RS, Dieter Jr RA, Dieter III RA, , eds. Peripheral Arterial Disease. New York, NY: McGraw Hill Professional; 2009: 49-60
• 8 Weinberg I, Jaff MR. Nonatherosclerotic arterial disorders of the lower extremities. Circulation 2012; 126 (2) 213-222
• 9 Karnabatidis D, Spiliopoulos S, Tsetis D, Siablis D. Quality improvement guidelines for percutaneous catheter-directed intra-arterial thrombolysis and mechanical thrombectomy for acute lower-limb ischemia. Cardiovasc Intervent Radiol 2011; 34 (6) 1123-1136
• 10 Norgren L, Hiatt WR, Dormandy JA , et al; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg 2007; 33 (Suppl. 01) S1-S75
• 11 Walker TG. Acute limb ischemia. Tech Vasc Interv Radiol 2009; 12 (2) 117-129
• 12 Rutherford RB, Baker JD, Ernst C , et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997; 26 (3) 517-538
• 13 Comerota AJ, Weaver FA, Hosking JD , et al. Results of a prospective, randomized trial of surgery versus thrombolysis for occluded lower extremity bypass grafts. Am J Surg 1996; 172 (2) 105-112
• 14 Results of a prospective randomized trial evaluating surgery versus thrombolysis for ischemia of the lower extremity. The STILE trial. Ann Surg 1994; 220 (3) 251-266, discussion 266–268
• 15 Rajan DK, Patel NH, Valji K , et al; CIRSE and SIR Standards of Practice Committees. Quality improvement guidelines for percutaneous management of acute limb ischemia. J Vasc Interv Radiol 2009; 20 (7, Suppl) S208-S218
• 16 Patel N, Sacks D, Patel RI , et al; Society of Interventional Radiology Technology Assessment Committee. SIR reporting standards for the treatment of acute limb ischemia with use of transluminal removal of arterial thrombus. J Vasc Interv Radiol 2003; 14 (9 Pt 2) S453-S465
• 17 Disini L, Wilson P, Cockburn JF. Successful intra-arterial alteplase infusion is a predictor of 12-month limb survival in patients with lower limb arterial occlusion. Clin Radiol 2008; 63 (6) 636-641
• 18 Ouriel K, Veith FJ, Sasahara AA. Thrombolysis or Peripheral Arterial Surgery (TOPAS) Investigators. A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs. N Engl J Med 1998; 338 (16) 1105-1111
• 19 Lynch M, Littler WA, Pentecost BL, Stockley RA. Immunoglobulin response to intravenous streptokinase in acute myocardial infarction. Br Heart J 1991; 66 (2) 139-142
• 20 Perler B. Thrombolytic therapies: the current state of affairs. J Endovasc Ther 2005; 12 (2) 224-232
• 21 Berridge DC, Gregson RH, Hopkinson BR, Makin GS. Randomized trial of intra-arterial recombinant tissue plasminogen activator, intravenous recombinant tissue plasminogen activator and intra-arterial streptokinase in peripheral arterial thrombolysis. Br J Surg 1991; 78 (8) 988-995
• 22 McNamara TO, Fischer JR. Thrombolysis of peripheral arterial and graft occlusions: improved results using high-dose urokinase. AJR Am J Roentgenol 1985; 144 (4) 769-775
• 23 Robertson I, Kessel DO, Berridge DC. Fibrinolytic agents for peripheral arterial occlusion. Cochrane Database Syst Rev 2010; (3) CD001099
• 24 Sniderman KW, Bodner L, Saddekni S, Srur M, Sos TA. Percutaneous embolectomy by transcatheter aspiration. Work in progress. Radiology 1984; 150 (2) 357-361
• 25 Starck EE, McDermott JC, Crummy AB, Turnipseed WD, Acher CW, Burgess JH. Percutaneous aspiration thromboembolectomy. Radiology 1985; 156 (1) 61-66
• 26 Lang EV, Kulis AM, Villani M, Barnhart W, Balano R, Cohen R. Hemolysis comparison between the OmniSonics OmniWave Endovascular System and the Possis AngioJet in a porcine model. J Vasc Interv Radiol 2008; 19 (8) 1215-1221
• 27 Mathie AG, Bell SD, Saibil EA. Mechanical thromboembolectomy in acute embolic peripheral arterial occlusions with use of the AngioJet Rapid Thrombectomy System. J Vasc Interv Radiol 1999; 10 (5) 583-590
• 28 Dwarka D, Schwartz SA, Smyth SH, O'Brien MJ. Bradyarrhythmias during use of the AngioJet system. J Vasc Interv Radiol 2006; 17 (10) 1693-1695
• 29 Fontaine AB, Borsa JJ, Hoffer EK, Bloch RD, So CR, Newton M. Type III heart block with peripheral use of the Angiojet thrombectomy system. J Vasc Interv Radiol 2001; 12 (10) 1223-1225
• 30 Ballehaninna UK, Hingorani A, Ascher E , et al. Acute superior mesenteric artery embolism: reperfusion with AngioJet hydrodynamic suction thrombectomy and pharmacologic thrombolysis with the EKOS catheter. Vascular 2012; 20 (3) 166-169
• 31 Owens CA. Ultrasound-enhanced thrombolysis: EKOS EndoWave infusion catheter system. Semin Intervent Radiol 2008; 25 (1) 37-41