A new endovascular strategy utilizing a hybrid procedure for long segmental occlusion by acute arterial thromboembolism in the lower extremity

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Abstract

Purpose: To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy. Materials and methods: In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients. Data were retrospectively collected from 24 consecutive procedures in 23 patients treated with the conventional strategy (Group B). Result: The technical success of Groups A and B was 24/24 and 20/24, respectively (p = 0.11). Major amputation or mortality was not observed in Group A, whereas 3 major amputations and 4 deaths occurred in Group B. Clinical failure in Groups A and B was 0/24 and 7/24, respectively (p < 0.05). Continuous urokinase (UK) infusion was needed in 1/24 in Group A and 14/24 in Group B (p < 0.05). Mean procedure time was 4 h 17 min for Group A and 21 h 30 min for Group B (p < 0.05). Conclusion: The hybrid procedure may be faster and more effective than the conventional treatment in long segmental arterial thromboembolisms, while the conventional treatment is still effective for short segmental occlusions.

Original languageEnglish
Pages (from-to)494-502
Number of pages9
JournalJapanese Journal of Radiology
Volume34
Issue number7
DOIs
Publication statusPublished - 2016 Jul 1

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Thromboembolism
Lower Extremity
Endovascular Procedures
Amputation
Urokinase-Type Plasminogen Activator
Mortality
Therapeutics

Keywords

  • Acute arterial thromboembolism
  • Endovascular treatment
  • Thrombectomy
  • Thrombolysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "A new endovascular strategy utilizing a hybrid procedure for long segmental occlusion by acute arterial thromboembolism in the lower extremity",
abstract = "Purpose: To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy. Materials and methods: In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients. Data were retrospectively collected from 24 consecutive procedures in 23 patients treated with the conventional strategy (Group B). Result: The technical success of Groups A and B was 24/24 and 20/24, respectively (p = 0.11). Major amputation or mortality was not observed in Group A, whereas 3 major amputations and 4 deaths occurred in Group B. Clinical failure in Groups A and B was 0/24 and 7/24, respectively (p < 0.05). Continuous urokinase (UK) infusion was needed in 1/24 in Group A and 14/24 in Group B (p < 0.05). Mean procedure time was 4 h 17 min for Group A and 21 h 30 min for Group B (p < 0.05). Conclusion: The hybrid procedure may be faster and more effective than the conventional treatment in long segmental arterial thromboembolisms, while the conventional treatment is still effective for short segmental occlusions.",
keywords = "Acute arterial thromboembolism, Endovascular treatment, Thrombectomy, Thrombolysis",
author = "Kwak, {Jung Won} and Chung, {Hwan Hoon} and Lee, {Seung Hwa} and Kim, {Yun Hwan} and Cho, {Sung Bum} and Tae-Seok Seo and Won-Min Jo and Shin, {Jae Seung}",
year = "2016",
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doi = "10.1007/s11604-016-0542-6",
language = "English",
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pages = "494--502",
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T1 - A new endovascular strategy utilizing a hybrid procedure for long segmental occlusion by acute arterial thromboembolism in the lower extremity

AU - Kwak, Jung Won

AU - Chung, Hwan Hoon

AU - Lee, Seung Hwa

AU - Kim, Yun Hwan

AU - Cho, Sung Bum

AU - Seo, Tae-Seok

AU - Jo, Won-Min

AU - Shin, Jae Seung

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Purpose: To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy. Materials and methods: In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients. Data were retrospectively collected from 24 consecutive procedures in 23 patients treated with the conventional strategy (Group B). Result: The technical success of Groups A and B was 24/24 and 20/24, respectively (p = 0.11). Major amputation or mortality was not observed in Group A, whereas 3 major amputations and 4 deaths occurred in Group B. Clinical failure in Groups A and B was 0/24 and 7/24, respectively (p < 0.05). Continuous urokinase (UK) infusion was needed in 1/24 in Group A and 14/24 in Group B (p < 0.05). Mean procedure time was 4 h 17 min for Group A and 21 h 30 min for Group B (p < 0.05). Conclusion: The hybrid procedure may be faster and more effective than the conventional treatment in long segmental arterial thromboembolisms, while the conventional treatment is still effective for short segmental occlusions.

AB - Purpose: To evaluate a new endovascular strategy utilizing a hybrid procedure for long segmental arterial thromboembolism in a lower extremity by historical comparison with conventional endovascular strategy. Materials and methods: In a new endovascular strategy, a hybrid procedure was performed for long segmental thromboembolism (longer than 15 cm) and an endovascular procedure for short segmental thromboembolism. The new strategy group (Group A) consisted of 24 procedures (13 hybrid procedures, 11 endovascular procedures) in 19 patients. Data were retrospectively collected from 24 consecutive procedures in 23 patients treated with the conventional strategy (Group B). Result: The technical success of Groups A and B was 24/24 and 20/24, respectively (p = 0.11). Major amputation or mortality was not observed in Group A, whereas 3 major amputations and 4 deaths occurred in Group B. Clinical failure in Groups A and B was 0/24 and 7/24, respectively (p < 0.05). Continuous urokinase (UK) infusion was needed in 1/24 in Group A and 14/24 in Group B (p < 0.05). Mean procedure time was 4 h 17 min for Group A and 21 h 30 min for Group B (p < 0.05). Conclusion: The hybrid procedure may be faster and more effective than the conventional treatment in long segmental arterial thromboembolisms, while the conventional treatment is still effective for short segmental occlusions.

KW - Acute arterial thromboembolism

KW - Endovascular treatment

KW - Thrombectomy

KW - Thrombolysis

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JF - Japanese Journal of Radiology

SN - 1867-1071

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