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Thrombolytic therapy in the setting of arterial line-induced ischemia.

AbstractPURPOSE:
To evaluate the use of percutaneous transcatheter thrombolysis in the treatment of thrombosis due to radial artery cannulation.
METHODS AND RESULTS:
Seven patients (4 women; age range 41-62 years) with symptomatic cannulation-induced thrombosis and failure to improve after systemic anticoagulation underwent 8 catheter-directed thrombolytic infusions at our institution over a 3-year period. Access was either antegrade through the brachial artery or retrograde through the femoral artery. Thrombolytic infusions with urokinase began 2 to 12 days (average 6) after removal of the radial artery catheter. The thrombolytic infusion was successful in 5 of 7 patients based on angiographic flow restoration with <20% residual thrombus and significant clinical improvement in the ischemia.
CONCLUSIONS:
When systemic anticoagulation has failed, percutaneous catheter-directed thrombolytic infusion appears to be effective in the treatment of most patients with severe ischemic hand symptoms due to thrombosis after radial artery cannulation.
AuthorsJean-François H Geschwind, Mandeep S Dagli, Drew L Lambert, Hicham Kobeiter
JournalJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 10 Issue 3 Pg. 590-4 (Jun 2003) ISSN: 1526-6028 [Print] United States
PMID12932173 (Publication Type: Journal Article)
Chemical References
  • Plasminogen Activators
  • Urokinase-Type Plasminogen Activator
Topics
  • Adult
  • Catheterization (adverse effects)
  • Female
  • Hand (blood supply)
  • Humans
  • Ischemia (drug therapy, etiology)
  • Male
  • Middle Aged
  • Plasminogen Activators (therapeutic use)
  • Radial Artery
  • Retrospective Studies
  • Thrombolytic Therapy
  • Thrombosis (drug therapy, etiology)
  • Urokinase-Type Plasminogen Activator (therapeutic use)

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