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C-1373 - Endovascular management of acute limb ischemia: catheter directed thrombolysis versus percutaneous mechanical thrombectomy.

H. L. Leong1, A. Tan1, T. A. J. Urlings1, A. Patel1, F. G. Irani1, K. Damodharan2, S. Chandramohan3, A. Gogna1, K. H. Tay1; 1 Singapore/SG 2 singapore/SG 3 GLASGOW/UK Type: Scientific Exhibit
Area of Interests: Arteries / Aorta, Interventional vascular
Imaging Technique: Catheter arteriography
Procedures: Thrombolysis, Outcomes analysis, Catheters
Special Focus: Embolism / Thrombosis
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Aims and objectives: Acute limb is ischaemia (ALLI) is defined as any sudden decrease in, or worsening of, limb perfusion causing a threat to extremity mobility and viability that has been present for less than 14 days.    Early restoration of blood flow in ALLI is crucial to preserve the viability of the limb[...]

Methods and materials: Consecutive cases of endovascular treatment for ALLI between 2006 and 2015 were retrospectively reviewed. Demographic data was collected. Technical success (>99% clot removal without distal emboli resistant to minor additional clot removal techniques) , clinical success (return to premorbid Ruthe[...]

Results: Patient demongraphics 117 procedures were performed in 94 patients.  28 surgical bypass grafts, 31 stented arteries and 61 native vessels were treated. 29 cases (25%) were managed with PMT and 88 cases (75%) were managed with CDT.   PMT Devices used included Angiojet (Bost[...]

Conclusion: PMT is associated with a higher technical success and shorter duration of hospitalisation, with comparable terms of clinical success, limb salvage, and safety profile to CDT. ESRF seems to be a risk factor for poor clinical outcome in our cohort of patients treated for ALLI. As comparable clinical o[...]

Personal information: Acknowledgement - We would like to thank Win Hlaing Hlaing of Singapore General Hospital for her invaluable contributions to this study.

References: [1] Outcome and complications after intra-arterial thrombolysis for lower limb ischaemia with or without continuous heparin infusion. Grip O, Kuppala M, Acosta S et al. The British Journal of Surgery 2014;101(9):1105-12   [2] Endovascular Treatment Options of Acute Limb Ischemia. Zhang D, Lou W[...]

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