ABSTRACT
To describe an on-table modification of standard angiography catheters for use in directed arterial and venous thrombolysis. An angiogram is performed and the length of thrombosed vessel (artery or vein) is measured. A 5 or 6 Fr catheter (preferably straight/multi- purpose/vertebral catheter) is modified on table for use by making multiple holes with 23 G needle. After testing ex vivo with saline injection, the on table modified catheter is placed over a wire into the thrombosed segment of the vessel and thrombolytic agent infusion is commenced utilizing a syringe driver after giving a bolus dose of thrombolytic agent. Median duration of thrombolysis was 24 h in our study. We have utilized this method in twenty thrombosed vessels, without any catheter related complications. In our experience, this modification of a standard catheter as a multi-hole catheter is a readily available, simple, cheap, versatile and effective device for directed thrombolysis.
Subject(s)
Catheters/standards , Equipment Design/methods , Thrombolytic Therapy/instrumentation , Catheters/economics , Equipment Design/economics , Fibrinolytic Agents/administration & dosage , Humans , Syringes , Thrombolytic Therapy/methods , Thrombosis/therapyABSTRACT
Endovascular procedures carry an intrinsic risk of distal embolization. A large embolus may occlude major vessels with serious consequences. Endovascular procedures in the thoracic aorta may expose the entire visceral and lower limb circulation to this risk. We describe a method of using an endovascular filter to trap large emboli during thoracic aortic stenting using the Wallstent and describe its use in a case of primary aortic mural thrombus.
