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A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis

OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of n...

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Autores principales: Kronlage, Mariya, Printz, Ilka, Vogel, Britta, Blessing, Erwin, Müller, Oliver J, Katus, Hugo A, Erbel, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402877/
https://www.ncbi.nlm.nih.gov/pubmed/28458517
http://dx.doi.org/10.2147/DDDT.S131503
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author Kronlage, Mariya
Printz, Ilka
Vogel, Britta
Blessing, Erwin
Müller, Oliver J
Katus, Hugo A
Erbel, Christian
author_facet Kronlage, Mariya
Printz, Ilka
Vogel, Britta
Blessing, Erwin
Müller, Oliver J
Katus, Hugo A
Erbel, Christian
author_sort Kronlage, Mariya
collection PubMed
description OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of non-randomized data. METHODS: A total of 202 patients, including 26 critically ill patients, underwent rotational thrombectomy (Rotarex(®)), local thrombolysis (recombinant tissue plasminogen activator), or combination of both at the University Hospital Heidelberg (2006–2015). The different interventional procedures were compared in terms of overall and amputation-free survival, as well as patency in a 1-year follow-up (Kaplan–Meier analysis). RESULTS: The study demonstrated a primary revascularization success of >98% in all groups. One year after revascularization, primary and secondary patency after mechanical thrombectomy alone were significantly better in comparison to local thrombolysis or a combination of Rotarex(®) and lysis (63% and 85%, P<0.05). Overall survival 12 months after intervention reached up to 96% in noncritically ill patients, and amputation-free survival was 94.3% in all three groups. Mean hospitalization duration and rate of major bleedings were significantly increased after thrombolysis compared to Rotarex(®) (P<0.05). CONCLUSION: In patients with (sub)acute limb ischemia, Rotarex(®) mechanical thrombectomy represents a safe and effective alternative to thrombolysis and is associated with a reduced rate of major bleedings, shorter hospitalization durations, and lower costs.
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spelling pubmed-54028772017-04-28 A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis Kronlage, Mariya Printz, Ilka Vogel, Britta Blessing, Erwin Müller, Oliver J Katus, Hugo A Erbel, Christian Drug Des Devel Ther Original Research OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of non-randomized data. METHODS: A total of 202 patients, including 26 critically ill patients, underwent rotational thrombectomy (Rotarex(®)), local thrombolysis (recombinant tissue plasminogen activator), or combination of both at the University Hospital Heidelberg (2006–2015). The different interventional procedures were compared in terms of overall and amputation-free survival, as well as patency in a 1-year follow-up (Kaplan–Meier analysis). RESULTS: The study demonstrated a primary revascularization success of >98% in all groups. One year after revascularization, primary and secondary patency after mechanical thrombectomy alone were significantly better in comparison to local thrombolysis or a combination of Rotarex(®) and lysis (63% and 85%, P<0.05). Overall survival 12 months after intervention reached up to 96% in noncritically ill patients, and amputation-free survival was 94.3% in all three groups. Mean hospitalization duration and rate of major bleedings were significantly increased after thrombolysis compared to Rotarex(®) (P<0.05). CONCLUSION: In patients with (sub)acute limb ischemia, Rotarex(®) mechanical thrombectomy represents a safe and effective alternative to thrombolysis and is associated with a reduced rate of major bleedings, shorter hospitalization durations, and lower costs. Dove Medical Press 2017-04-18 /pmc/articles/PMC5402877/ /pubmed/28458517 http://dx.doi.org/10.2147/DDDT.S131503 Text en © 2017 Kronlage et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Kronlage, Mariya
Printz, Ilka
Vogel, Britta
Blessing, Erwin
Müller, Oliver J
Katus, Hugo A
Erbel, Christian
A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title_full A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title_fullStr A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title_full_unstemmed A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title_short A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
title_sort comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402877/
https://www.ncbi.nlm.nih.gov/pubmed/28458517
http://dx.doi.org/10.2147/DDDT.S131503
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