Surgical approach for DVT. Division of Vascular Surgery Department of Surgery Seoul National University College of Medicine
|
|
- Gwendolyn Brown
- 5 years ago
- Views:
Transcription
1 Surgical approach for DVT Seung-Kee Min Division of Vascular Surgery Department of Surgery Seoul National University College of Medicine
2 Treatment Options for Venous Thrombosis Unfractionated heparin & oral anticoagulation LMWH Alternative anticoagulants Thrombolysis Venous thrombectomy IVC interruption Pulmonary embolectomy
3 Goals of DVT Treatment Rutherford (ed): Vascular Surgery (2000)
4
5
6 Clinical spectrum of acute DVT Anticoagulation therapy Proper treatment?
7 Anticoagulation only is not ENOUGH! Akesson et al (1990) ; Acute Iliofemoral DVT treated with anticoagulation only, 5 yr F/U 95 % ambulatory venous HT 90 % chronic venous insufficiency (CVI) Sx 15 % venous ulcer 15 % venous claudication Anticoagulation only = Inadequate Therapy
8 Strategy of thrombus removal Rationale for thrombus removal Pathophysiology of CVI ; ambulatory venous HT = venous valvular incompetence + luminal obstruction Thrombus removal elimination of luminal obstruction preservation of valve function Post-thrombotic syndrome avoided Method Surgical venous thrombectomy Catheter-directed thrombolysis Percutaneous pharmaco-mechanical thrombectomy
9 Flowchart of invasive treatment of DVT Liapise et al, European Manual of Medicine: Vascular Surgery
10 Treatment algorithm for iliofemoral DVT Comerota & Paolini. EJVES 2007;33:351-60
11 1. Catheter-directed Thrombolysis Aim To restore venous patency To preserve venous valve function Technique Ipsilateral popliteal vein or contralateral femoral vein approach Multisided-hole catheter Position the system directly into the thrombus Pulsed spray injection Thrombolytic agent Urokinase rtpa
12 2. Percutaneous mechanical thrombectomy Amplatz device Arrow-Trerotola device AngioJet device Trellis catheter (Segmental pharmacomechanical thrombolysis) EKOS LysUS system (Ultrasound-accelerated thrombolysis)
13 3. Iliofemoral Venous Thrombectomy Indications Phlegmasia cerulea dolens Impending venous gangrene Contraindication to thrombolysis treatment Good Prognostic Factor Young patient Symptom onset < 7 days, preferably < 72 hrs No systemic predisposing condition (malignancy, CHF)
14 Operative risks for thrombectomy General Anesthesia Perioperative fatal pulmonary embolism Rethrombosis Bleeding Valvular injury
15 Accurate preoperative evaluation is essential! Accurate preoperative evaluation General status of the patient Hypercoagulability ; acquired or congenital Imaging studies Duplex USG / CT venography Proximal and distal extent of the thrombi Underlying anatomic cause iliac vein compression syndrome, intraluminal web, stricture, chronic thrombosis sequelae Associated vascular anomali duplication, left-sided IVC, malformation
16 Technique of Venous Thrombectomy Exposure and prevention of clot embolization Groin incision CFV exposure & venotomy ; regional thrombus removal IVC occlusion balloon or IVC filter Evacuation of iliac vein thrombus Iliac thrombectomy balloon Intraop. Venography Removal of any residual thrombus Ouriel & Rutherford (eds): Atlas of Vasc Surg Clearance of thrombus below the venotomy site Milking technique ; compression along the leg from ankle Separate venotomy incision below knee, if needed.
17 Prevention of PE during thrombectomy Fatal pulmonary embolism during procedure mainly due to undetected IVC thrombus IVC control before thrombectomy!! Prevention Positive pressure ventilation or Valsalva maneuver Preop. IVC filter placement Double balloon technique Hallett et al (ed): Comprehensive Vasc Endovasc Surg. 2009
18 Temporary AVF formation End-to-Side anastomosis GSV branch - CFA The AVF is left open for 2 ~ 4 weeks Until venous re-endothelialization has occurred Fistula closure ; by endovascular or open CFA GSV branch Ouriel & Rutherford (eds): Atlas of Vasc Surg
19 Result of Venous Thrombectomy
20 Technical advances in venous thrombectomy Technique Old Contemporary Pretreatment phlebography / CT scan Occasionally always Venous thrombectomy catheter No Yes Operative fluoroscopy / phlebography No Yes Correct iliac vein stenosis No Yes Arteriovenous fistula No Yes Infrainguinal thrombectomy No Yes Intraoperative thrombolysis No Yes Full post op anticoagulation Occasionally Yes Catheter-directed anticoagulation No Yes Intermittent pneumatic compression No postop Yes Comerota & Paolini. EJVES 2007;33:351-60
21 Infrainguinal balloon catheter venous thrombectomy Comerota & Gale. JVS 2006;43:185-91
22 Intraoperative thrombolysis Vigorous irrigation with heparin-saline solution UK or rt-pa injection Comerota & Gale. JVS 2006;43:185-91
23 Axillo-Subclavian venous thrombosis Paget-Schroetter syndrome, effort thrombosis Venous manifestation of thoracic outlet compression Affects young, healthy, physically active individuals Symptom; sudden onset of severe & uniform selling of U/E Treatment Thrombolytic therapy first Confirm extrinsic compression or stricture If no stenosis, imaging studies with provocative maneuvers If vein compression(+), operative therapy is recommended ; first rib resection and subtotal scalenectomy If (-), anticoagulation for 3 ~6 months (+/- first rib resection)
24 Thank you for your attention.
Interventional Treatment VTE: Radiologic Approach
Interventional Treatment VTE: Radiologic Approach Hae Giu Lee, MD Professor, Dept of Radiology Seoul St. Mary s Hospital The Catholic University of Korea Introduction Incidence High incidence: 250,000-1,000,000/year
More informationVenous interventions in DVT
Venous interventions in DVT Sriram Narayanan Chief of Vascular and Endovascular Surgery, Tan Tock Seng Hospital A/Prof of Surgery, National University of Singapore ANTI-COAGULATION LMWH Warfarin x 6m Acute
More informationOptimal Utilization of Thrombolytics
April 8-9, 2011 New York LaGuardia Marriott COMPLETE MANAGEMENT OF VENOUS DISEASE Optimal Utilization of Thrombolytics Anthony J. Comerota, MD, FACS, FACC Director, Jobst Vascular Institute Adjunct Professor
More informationTHERE IS NO ROLE FOR SURGICAL THERAPY FOR DVT
THERE IS NO ROLE FOR SURGICAL THERAPY FOR DVT Tara D. Balint, MD FACS Sentara RMH Thursday, June 14, 2018 1 Objectives of treatment for DVT Prevent death from PE Prevent recurrent VTE Prevent post-thrombotic
More informationCopy Here. The Easy One.. What is the Role of Thrombus Removal in Acute Proximal DVT after ATTRACT? Deep Venous Thrombosis Spectrum
What is the Role of Thrombus Removal in Acute Proximal DVT after ATTRACT? Mitchell J. Silver DO FACC FSVM RPVI Director, Center for Critical Limb Care Riverside Methodist Hospital Ohio Health Heart and
More informationPharmaco-mechanical techniques stand alone procedures? Peter Neglén, MD, PhD SP Vascular Center Limassol Cyprus
Pharmaco-mechanical techniques stand alone procedures? Peter Neglén, MD, PhD SP Vascular Center Limassol Cyprus Faculty Disclosure Peter Neglén, M.D., Ph.D Stockholder/Founder of Veniti, Inc. Member, Medical
More informationAggressive endovascular management of ilio-femoral DVT. thrombotic syndrome. is the key in preventing post
CACVS 2017 Aggressive endovascular management of ilio-femoral DVT is the key in preventing post thrombotic syndrome ALI AMIN MD, FACS,FACC, RVT CHIEF OF ENDOVASCULAR INTERVENTIONS READING HEALTH SYSTEM
More informationMeissner MH, Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, et al. J Vasc Surg. 2012;55:
Early thrombus removal strategies for acute deep venous thrombosis: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum Meissner MH, Gloviczki P, Comerota AJ,
More informationIliofemoral DVT: Miminizing Post-Thrombotic Syndrome
Iliofemoral DVT: Miminizing Post-Thrombotic Syndrome Catherine K. Chang, MD FACS Vascular Surgery San Diego Southern California Permanente Medical Group Acute Deep Venous Thrombosis Incidence & Outcomes
More informationNot all Leg DVT s are the Same: Which Patients Benefit from Interventional Therapy? Case 1:
12/16/2015 Not all Leg DVT s are the Same: Which Patients Benefit from Interventional Therapy? Constantino S.Peña, FSIR, FSCCT, FAHA Interventional Radiologist Medical Director, Vascular Imaging Miami
More informationTechnique de recanalisation: mon expérience avec Aspirex
JFICV 2017, Deauville Thrombose veineuse profonde aiguë en 2017 Technique de recanalisation: mon expérience avec Aspirex Romaric LOFFROY Département de Radiologie Diagnostique et Thérapeutique CHU Hôpital
More informationIntervention for Deep Venous Thrombosis and Pulmonary Embolus
Intervention for Deep Venous Thrombosis and Pulmonary Embolus Michael R. Jaff, DO Paul and Phyllis Fireman Endowed Chair in Vascular Medicine Massachusetts General Hospital Professor of Medicine Harvard
More informationDEEP VENOUS THROMBOSIS A PRACTICAL APPROACH TO IMPROVING CLINICAL OUTCOMES
DEEP VENOUS THROMBOSIS A PRACTICAL APPROACH TO IMPROVING CLINICAL OUTCOMES Jose M. Borromeo M.D. Vascular Surgeon Iowa Heart Center Disclosures: AstraZeneca Pharmaceuticals Cook CVRx LeMaitre Vascular,
More informationPercutaneous Mechanical Thrombectomy for Acute Iliofemoral DVT with the Aspirex Catheter: The Dijon Experience
JFICV 2018, Beaune Percutaneous Mechanical Thrombectomy for Acute Iliofemoral DVT with the Aspirex Catheter: The Dijon Experience Prof. Romaric LOFFROY, MD, PhD, FCIRSE Chief, Department of Vascular and
More informationMichael Meuse, M.D. Vascular and Interventional Radiology
Michael Meuse, M.D. Vascular and Interventional Radiology Iliac Vein Compression Syndrome Left CIV compressed by right CIA Virchow 1851: DVT L>R May and Thurner 1954: venous spurs Cockett and Thomas 1965:
More information4/23/2009. September 15, 2008
The Current Treatment of Deep Venous Thrombosis: Are We Doing Enough? George H. Meier, MD Professor and Chief Division of Vascular Surgery University of Cincinnati College of Medicine Cincinnati, Ohio
More information4/3/2014. Disclosures. Venous Thoracic Outlet Syndrome: Our Approach and Results. Paget Schroetter Syndrome. Paget Schroetter Syndrome.
Disclosures No relevant financial relationships with commercial interests Venous Thoracic Outlet Syndrome: Our Approach and Julie A. Freischlag, M.D. Vice Chancellor for Human Health Sciences Dean of the
More informationAspirex for Upper and Lower Extremity DVT
Aspirex for Upper and Lower Extremity DVT Steven Kum MD Vascular & Endovascular Surgeon Director of Vascular Service Changi General Hospital Singapore Disclosure Speaker name:... I have the following potential
More informationResident Teaching Conference 3/12/2010
Resident Teaching Conference 3/12/2010 Goals Definition and Classification of Acute Limb Ischemia Clinical Assessment of the Vascular Patient History and Physical Diagnostic Modalities Management of Acute
More informationTreatment of Axillosubclavian Vein Thrombosis: A Novel Technique for Rapid Removal of Clot Using Low-Dose Thrombolysis
J ENDOVASC THER 733 RAPID COMMUNICATION Treatment of Axillosubclavian Vein Thrombosis: A Novel Technique for Rapid Removal of Clot Using Low-Dose Thrombolysis Frank R. Arko, MD; Paul Cipriano, MD; Eugene
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of Interventional procedure overview of ultrasound-enhanced, catheterdirected thrombolysis
More informationSuccessful recanalisation of venous thrombotic occlusions with Aspirex mechanical thrombectomy. Michael K. W. Lichtenberg
Successful recanalisation of venous thrombotic occlusions with Aspirex mechanical thrombectomy Michael K. W. Lichtenberg Disclosure Speaker name: Michael Lichtenberg... I have the following potential conflicts
More informationTreatment of Chronic DVT with EKOS: Reproducing ACCESS PTS Data in Every Day Clinical Practice
Treatment of Chronic DVT with EKOS: Reproducing ACCESS PTS Data in Every Day Clinical Practice Mert Dumantepe, MD Acibadem Altunizade Hospital, Istanbul, Turkey Department of Cardiovascular Surgery Disclosure
More informationChronic Iliocaval Venous Occlusive Disease
none Chronic Iliocaval Venous Occlusive Disease David Rigberg, M.D. Clinical Professor of Surgery Division of Vascular Surgery University of California Los Angeles Chronic Venous Occlusive Disease Chronic
More informationTechnique of contemporary iliofemoral and infrainguinal venous thrombectomy
TECHNICAL NOTE Technique of contemporary iliofemoral and infrainguinal venous thrombectomy Anthony J. Comerota, MD, FACS, a,b and Steven S. Gale, MD, FACS, a Toledo, Ohio, and Ann Arbor, Mich Patients
More informationVenous Thrombosis. Magnitude of the Problem. DVT 2 Million PE 600,000. Death 60,000. Estimated Cost of VTE Care $1.5 Billion/year.
Venous Thrombosis Magnitude of the Problem DVT 2 Million Postthrombotic Syndrome 800,000 PE 600,000 Death 60,000 Silent PE 1 Million Pulmonary Hypertension 30,000 Estimated Cost of VTE Care $1.5 Billion/year
More informationImplications from the ACCP 2012 Consensus Guidelines for the Management of Thrombosis: a case based approach
Implications from the ACCP 2012 Consensus Guidelines for the Management of Thrombosis: a case based approach Prof. I. Baumgartner Head Clinical and Interventional Angiology About the ACCP guidelines Widely
More informationShould We Be More Aggressive in the Treatment of Acute DVT?
DISCLOSURES Consultant Penumbra, Inc. UCSF Vascular Surgery Symposium April 6, 2017 K. Pallav Kolli, MD Assistant Professor of Clinical Radiology University of California, San Francisco 17 yo male, DVT
More informationThoracic Outlet Syndrome
Disclosures None relevant to this discussion The Management of Thoracic Outlet Syndrome: Acute Charles Eichler MD Professor, Department of Surgery Division of Vascular and Endovascular Surgery University
More informationUltrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Ultrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism A pulmonary embolism (PE) is
More informationDisclosures. DVT: Diagnosis and Treatment. Questions To Ask. Dr. Susanna Shin - DVT: Diagnosis and Treatment. Acute Venous Thromboembolism (VTE) None
Disclosures DVT: Diagnosis and Treatment None Susanna Shin, MD, FACS Assistant Professor University of Washington Acute Venous Thromboembolism (VTE) Deep Venous Thrombosis (DVT) Pulmonary Embolism (PE)
More informationPercutaneously Inserted AngioVac Suction Thrombectomy for the Treatment of Filter-Related. Iliocaval Thrombosis
Percutaneously Inserted AngioVac Suction Thrombectomy for the Treatment of Filter-Related Iliocaval Thrombosis Faiz D. Francis, DO; Gianvito Salerno, MD; Sabbah D. Butty, MD Abstract In the setting of
More informationTreatment of acute thrombosis of axillo-subclavian vein
Treatment of acute thrombosis of axillo-subclavian vein Yang Jin Park Vascular Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine CASE A 32-year-old male patient 3-day history of
More informationComplex Iliocaval Reconstruction PNEC. Seattle WA. Bill Marston MD Professor, Div of Vascular Surgery University of N.
Complex Iliocaval Reconstruction 2017 PNEC. Seattle WA Bill Marston MD Professor, Div of Vascular Surgery University of N. Carolina DISCLOSURES William Marston, MD Consultant/Advisory Board: Veniti, Cardinal
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of Interventional procedure overview of ultrasound-enhanced, catheterdirected thrombolysis
More informationBC Vascular Day. Contents. November 3, Abdominal Aortic Aneurysm 2 3. Peripheral Arterial Disease 4 6. Deep Venous Thrombosis 7 8
BC Vascular Day Contents Abdominal Aortic Aneurysm 2 3 November 3, 2018 Peripheral Arterial Disease 4 6 Deep Venous Thrombosis 7 8 Abdominal Aortic Aneurysm Conservative Management Risk factor modification
More informationDISORDERS OF VENOUS SYSTEM
DISORDERS OF VENOUS SYSTEM Varicose Veins Any dilated, elongated and tortuous vein irrespective of size Varicose veins are common in the superficial veins of the leg which are subject to high pressure
More informationRisk factors for DVT. Venous thrombosis & pulmonary embolism. Anticoagulation (cont d) Diagnosis 1/5/2018. Ahmed Mahmoud, MD
Risk factors for DVT Venous thrombosis & pulmonary embolism Ahmed Mahmoud, MD Surgery ; post op especially for long cases, pelvic operations (THR), Trauma ; long bone fractures, pelvic fractures (posterior
More informationVenous thrombosis & pulmonary embolism. Ahmed Mahmoud, MD
Venous thrombosis & pulmonary embolism Ahmed Mahmoud, MD Risk factors for DVT Surgery ; post op especially for long cases, pelvic operations (THR), Trauma ; long bone fractures, pelvic fractures (posterior
More informationPEARL Registry Update Overview Venous Arterial AV Access
PEARL Registry Update Overview Venous Arterial AV Access PEARL Registry Overview (as of 10 Sep12*) Overview Venous Arterial AV Access HOME Topic Data Support Comments Study Design Prospective, non-randomized,
More informationTechniques for thrombus removal in acute DVT Benefits of an Endovascular Approach for Rapid Flow Restoration in DVT
Techniques for thrombus removal in acute DVT Benefits of an Endovascular Approach for Rapid Flow Restoration in DVT Michael K. W. Lichtenberg, MD, FESC Vascular Centre Arnsberg, Germany Disclosure Speaker
More informationImproved clinical outcomes Evidence on venous mechanical thrombectomy followed by stenting
Improved clinical outcomes Evidence on venous mechanical thrombectomy followed by stenting Michael K. W. Lichtenberg, MD, FESC Vascular Centre Arnsberg, Germany German Venous Centre Arnsberg, Germany Disclosure
More informationCanadian Society of Internal Medicine Annual Meeting 2017 Toronto, ON
Canadian Society of Internal Medicine Annual Meeting 2017 Toronto, ON How to Prevent and Manage the Post-Thrombotic Syndrome? Jean-Philippe Galanaud Clinical Thromboembolism & Division of GIM Sunnybrook,
More informationSurgical Options in Thrombectomy for Non-Surgeons
Surgical Options in Thrombectomy for Non-Surgeons Shouwen Wang, MD, PhD, FASDIN AKDHC Ambulatory Surgery Center Arizona Kidney Disease and Hypertension Center Phoenix, Arizona Disclosure No relevant financial
More informationPrevention and management of deep venous thrombosis (DVT) John Fletcher Wound Care Association of New South Wales
Prevention and management of deep venous thrombosis (DVT) John Fletcher Wound Care Association of New South Wales Merimbula, 6 th November 2010 University of Sydney Department of Surgery Westmead Hospital
More informationA A U
PVD Venous AUC Rating Sheet 2nd Round 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Median I NI MADM Rating Agree Disagree Upper Extremity Venous Evaluation Table 1. Venous Duplex of the Upper Extremities for Patency
More informationCatheter direct thrombolysis: Role of actilyse in treatment of acute deep venous thrombosis
The Egyptian Journal of Radiology and Nuclear Medicine (2013) 44, 57 62 Egyptian Society of Radiology and Nuclear Medicine The Egyptian Journal of Radiology and Nuclear Medicine www.elsevier.com/locate/ejrnm
More informationNOTE: Deep Vein Thrombosis (DVT) Risk Factors
Deep Vein Thrombosis (DVT) Deep Vein Thrombosis (DVT) is the formation of a blood clot, known as a thrombus, in the deep leg vein. It is a very serious condition that can cause permanent damage to the
More informationWhat is New in Acute Pulmonary Embolism? Interventional Treatment. Prof. Nils Kucher University Hospital Bern Switzerland
What is New in Acute Pulmonary Embolism? Interventional Treatment Prof. Nils Kucher University Hospital Bern Switzerland nils.kucher@insel.ch Disclosure of Interest Dr. Kucher received research grants
More informationExpanding Horizons: AngioVac Suction Thrombectomy at UTHealth
Expanding Horizons: AngioVac Suction Thrombectomy at UTHealth Naveed Saqib, MD Assistant Professor Department of Cardiothoracic and Vascular Surgery McGovern Medical School The University of Texas Science
More informationSurgical disobliteration of postthrombotic deep veins endophlebectomy is feasible
Surgical disobliteration of postthrombotic deep veins endophlebectomy is feasible Alessandra Puggioni, MD, a,c Robert L. Kistner, MD, a,b Bo Eklof, MD, PhD, a,b,c and Fedor Lurie, MD, PhD, a,b,c Honolulu,
More informationImaging, it s central role in planning and guiding intervention. Prof. Luis Izquierdo. MD, PhD, FEBVS
Imaging, it s central role in planning and guiding intervention Prof. Luis Izquierdo. MD, PhD, FEBVS IMPORTANT INFORMATION: These materials are intended to describe common clinical considerations and procedural
More informationPEARL REGISTRY Post Market Registry
PEARL REGISTRY Post Market Registry Real World Use of the AngioJet Thrombectomy System in the Peripheral Vascular System PI-315422-AA JUN2015 Objectives AngioJet Action Enrollment General Indications &
More informationThe role of ultrasound duplex in endovenous procedures
The role of ultrasound duplex in endovenous procedures Neophytos A. Zambas MD, PhD Vascular Surgeon Polyclinic Ygia, Limassol, Cyprus ΚΕΑΕΧ ΚΥΠΡΙΑΚΗ ΕΤΑΙΡΕΙΑ ΑΓΓΕΙΑΚΗΣ ΚΑΙ ΕΝΔΑΓΓΕΙΑΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ Pre
More information4/30/2018 CLOT+ In patients with an acute proximal deep vein thrombosis, pharmacomechanical catheter-directed thrombolysis does not reduce t
In patients with an acute proximal deep vein thrombosis, pharmacomechanical catheter-directed thrombolysis does not reduce the rate of post-thrombotic syndrome Question In patients who have symptomatic
More informationIleo Femoral DVT Review and Update
Ileo Femoral DVT Review and Update Ammar Safar, MD, FSCAI, FACC, FACP, RPVI Interventional Cardiology & Endovascular Medicine Deep Vein Thrombosis Venous thromboembolism is a major national health problem,
More informationENHANCING YOUR OPTIONS
ANGIOJET ULTRA Thrombectomy System ENHANCING YOUR OPTIONS FOR RESTORING FLOW When you need the versatility and power to restore flow Refined from experience in over 700,000 cases worldwide, today s AngioJet
More informationHow to best approach chronic venous occlusions?
How to best approach chronic venous occlusions? Prof. Nils Kucher Director Venous Thromboembolism Reseach Group University Hospital Bern nilskucher.com Disclosure Speaker name: Nils Kucher X X I have the
More informationInterventional Management of Acute Pulmonary Embolism
Interventional Management of Acute Pulmonary Embolism Prof. Nils Kucher Angiology & Cardiology University Hospital Bern Inselspital nils.kucher@insel.ch DECLARATION OF CONFLICT OF INTEREST Consultant to
More informationUltrasound-assisted catheter-directed thrombolysis: Does it really work? The BERNUTIFUL trial
Ultrasound-assisted catheter-directed thrombolysis: Does it really work? The BERNUTIFUL trial Rolf P. Engelberger Division of Angiology CHUV, Lausanne & Inselspital, Bern Switzerland Disclosure Speaker
More informationDIAGNOSIS AND MANAGEMENT OF VENOUS THROMBOEMBOLISM
DIAGNOSIS AND MANAGEMENT OF VENOUS THROMBOEMBOLISM Evan C Lipsitz, MD Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY DVT / VTE Magnitude of the Problem DVT 2 Million Post-thrombotic
More informationIntended Learning Outcomes
2011 Acute Limb Ischemia Definition, Etiology & Pathophysiology Clinical Evaluation Management Ali SABBOUR Prof. of Vascular Surgery, Ain Shams University Acute Limb Ischemia Intended Learning Outcomes
More informationClinical Guide - Inferior Vena Cava Filters (Reviewed 2006)
Clinical Guide - Inferior Vena Cava Filters (Reviewed 2006) Principal Developer: V. Oliva Secondary Developers: W. Geerts Background The treatment of choice for deep venous thrombosis (DVT) and pulmonary
More informationJ Jpn Coll Angiol, 2009, 49:
Online publication August 27, 2009 1 2 J Jpn Coll Angiol, 2009, 49: 247 254 deep vein thrombosis, thrombolytic therapy, catheter-directed thrombolysis, inferior vena cava filter, pulmonary thromboembolism
More informationAcoustic Pulse Thrombolysis Treatment
Acoustic Pulse Thrombolysis Treatment BTGVascular.com SETTING THE STANDARD FOR VASCULAR THERAPIES Quickly & safely dissolve thrombus with the EKOS System. The Acoustic Pulse Difference Acoustic Pulse Thrombolysis
More informationHow to manage TAVI related vascular complications. Paul TL Chiam MBBS, FRCP, FESC, FACC, FSCAI
How to manage TAVI related vascular complications Paul TL Chiam MBBS, FRCP, FESC, FACC, FSCAI Definition VARC-2 consensus statement Complications caused by: Wire Catheter Anything related to vascular access
More informationStarting with deep venous treatment
Starting with deep venous treatment Carsten Arnoldussen, MD Interventional Radiologist Maastricht University Medical Centre, Maastricht VieCuri Medical Centre, Venlo The Netherlands Background Maastricht
More informationVIVO-EU Results: Prospective European Study of the Zilver Vena TM Venous Stent in the Treatment of Symptomatic Iliofemoral Venous Outflow Obstruction
VIVO-EU Results: Prospective European Study of the Zilver Vena TM Venous Stent in the Treatment of Symptomatic Iliofemoral Venous Outflow Obstruction Gerard J O Sullivan, M.D. and Jennifer McCann-Brown,
More informationStraub Endovascular System &
Straub Endovascular System & S t r a u b E n d o v a s c u l a r To o l s Straub Endovascular System Effective debulking in occluded arteries and veins Effective debulking in many indications Rotarex
More informationManagement of Post-Thrombotic Syndrome
Management of Post-Thrombotic Syndrome Thanainit Chotanaphuti Phramongkutklao College of Medicine Bangkok, Thailand President of CAOS Asia President of Thai Hip & Knee Society President of ASEAN Arthroplasty
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,700 108,500 1.7 M Open access books available International authors and editors Downloads Our
More informationEKOS. Interventional Vascular 3 February, Imagine where we can go.
EKOS Interventional Vascular 3 February, 2015 Imagine where we can go. Forward-looking statement This presentation and information communicated verbally to you may contain certain projections and other
More informationAn association between venous thrombosis and
Venous Emergencies in Cancer Patients Endovascular approaches for managing and treating emergent conditions. BY KEVIN SEALS, MD; SCOTT GENSHAFT, MD; RAMSEY AL-HAKIM, MD; BRIAN DUBIN, MD; AND STEPHEN KEE,
More informationRadRx Your Prescription for Accurate Coding & Reimbursement Copyright All Rights Reserved.
Interventional Radiology Coding Case Studies Prepared by Stacie L. Buck, RHIA, CCS-P, RCC, CIRCC, AAPC Fellow President & Senior Consultant Week of October 29, 2018 Mesenteric Arteriogram & Thrombectomy/Thrombolysis
More informationSelection and work up for the right patients suspected of deep venous disease
Selection and work up for the right patients suspected of deep venous disease R A G H U K O L L U R I, M S, M D, R V T S Y S T E M M E D I C A L D I R E C T O R V A S C U L A R M E D I C I N E / V A S
More informationVenous thrombosis is common and often occurs spontaneously, but it also frequently accompanies medical and surgical conditions, both in the community
Venous Thrombosis Venous Thrombosis It occurs mainly in the deep veins of the leg (deep vein thrombosis, DVT), from which parts of the clot frequently embolize to the lungs (pulmonary embolism, PE). Fewer
More informationManagement of Acute DVT Extending From the Tibial Veins to the Common Iliac Vein Using the AngioJet Thrombectomy System
FEATURED TECHNOLOGY: ANGIOJET THROMBECTOMY SYSTEM Sponsored by Boston Scientific Corporation Management of Acute DVT Extending From the Tibial Veins to the Common Iliac Vein Using the AngioJet Thrombectomy
More informationImproved clinical outcomes Evidence on venous thrombectomy followed by stenting
Improved clinical outcomes Evidence on venous thrombectomy followed by stenting Michael K. W. Lichtenberg, MD, FESC Vascular Centre Arnsberg, Germany Venous Centre Arnsberg, Germany Disclosure Speaker
More informationN/A Site #2. N/A Site #3 Total
Aneurysm-Repair Open Rep Infrarenal A-I Aneur, Endovas Rep Abd Aort/Iliac Endovas Rep of Iliac Artery Rep Suprarenal Aortic Aneurysm Rep Thoracic Aortic Aneurysm Endovas Rep Thora Aortic Rep Thoracoabd
More informationSAMPLE CHAPTERS UNESCO-EOLSS MANAGEMENT OF SUBCLAVIAN VEIN THROMBOSIS KNOWN AS PAGET-SCHROETTER SYNDROME
MANAGEMENT OF SUBCLAVIAN VEIN THROMBOSIS KNOWN AS PAGETSCHROETTER SYNDROME J. Ernesto Molina University of Minnesota, Minneapolis, Minnesota, U.S.A. Keywords: Thoracic outlet, Venous disease Contents 1.
More informationEmerging Tools for Lytic-Free, Single-Session Treatment of Venous Thromboembolic Disease
FEATURED TECHNOLOGY THE CLOTTRIEVER AND FLOWTRIEVER SYSTEMS Emerging Tools for Lytic-Free, Single-Session Treatment of Venous Thromboembolic Disease The ClotTriever Outcomes (CLOUT) registry principal
More informationInnovative Endovascular Approach to Pulmonary Embolism by Ultrasound Enhanced Thrombolysis. Prof. Ralf R.Kolvenbach MD,PhD,FEBVS
Innovative Endovascular Approach to Pulmonary Embolism by Ultrasound Enhanced Thrombolysis Prof. Ralf R.Kolvenbach MD,PhD,FEBVS Catheter-based thrombolysis Local administration of lytic agent Higher local
More informationPopliteal Aneurysm: When is surgical therapy indicated? PROF. GRZEGORZ OSZKINIS
Popliteal Aneurysm: When is surgical therapy indicated? PROF. GRZEGORZ OSZKINIS Asymptomatic mass - 38-40%will develop symptoms at a rate of 14%/yr Intermittent claudic ation (chronic ischemia) - 25%-40%
More informationDOPPLER ULTRASOUND OF DEEP VENOUS THROMBOSIS
TOKUDA HOSPITAL SOFIA DOPPLER ULTRASOUND OF DEEP VENOUS THROMBOSIS MILENA STANEVA, MD, PhD Department of vascular surgery and angiology Venous thromboembolic disease continues to cause significant morbidity
More informationMAY-THURNER SYNDROME A CONTROVERSIAL VASCULAR ANOMALY
Medical interventions MAY-THURNER SYNDROME A CONTROVERSIAL VASCULAR ANOMALY Shepherd E Alexandra 1, Shepherd S Caterina 1 1. BSc, University College London, UK Corresponding author: aeshep@gmail.com The
More informationThe hallmark of percutaneous thrombus management
Treating Venous Thromboembolism Without Lytic Medications What the present and the near future will bring in terms of techniques and devices to remove venous thrombus. BY CONSTANTINO S. PEÑA, MD; RIPAL
More informationCURRENT & FUTURE THERAPEUTIC MANAGEMENT OF VENOUS THROMBOEMBOLISM. Gordon Lowe Professor of Vascular Medicine University of Glasgow
CURRENT & FUTURE THERAPEUTIC MANAGEMENT OF VENOUS THROMBOEMBOLISM Gordon Lowe Professor of Vascular Medicine University of Glasgow VENOUS THROMBOEMBOLISM Common cause of death and disability 50% hospital-acquired
More informationUse of EKOS Catheter in the management of Venous Mr. Manoj Niverthi, Mr. Sarang Pujari, and Ms. Nupur Dandavate, The GTF Group
Use of EKOS Catheter in the management of Venous Thromboembolism @ Mr. Manoj Niverthi, Mr. Sarang Pujari, and Ms. Nupur Dandavate, The GTF Group Introduction Georgia Thrombosis Forum (GTF, www.gtfonline.net)
More informationThe Therapeutic Approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a Systematic Review REVIEW
International Medical Society http://imedicalsociety.org International Archives of Medicine The Therapeutic Approach of the May-Thurner Syndrome without Deep Venous Thrombosis: a Systematic Review REVIEW
More informationVenous stent experience in Arnsberg Michael K. W. Lichtenberg MD, FESC
Venous stent experience in Arnsberg Michael K. W. Lichtenberg MD, FESC IMPORTANT INFORMATION: These materials are intended to describe common clinical considerations and procedural steps for the on-label
More informationThrombolysis versus thrombectomy in acute deep vein thrombosis
review Thrombolysis versus thrombectomy in acute deep vein thrombosis Deep vein thrombosis (DVT) is a significant health problem leading to the admission of over 250,000 Americans each year. Its most serious
More informationACUTE LIMB ISCHEMIA Table of Contents
ACUTE LIMB ISCHEMIA Table of Contents PERIPHERAL ARTERIAL DISEASE (PAD)... 1 INTERMITTENT CLAUDICATION (IC)... 1 CRITICAL LIMB ISCHEMIA (CLI)... 1 ACUTE LIMB ISCHEMIA (ALI)... 2 Risk Factors...2 Associated
More informationHow long to continue anticoagulation after DVT?
How long to continue anticoagulation after DVT? Dr. Nihar Ranjan Pradhan M.S., DNB (Vascular Surgery), FVES(UK) Consultant Vascular Surgeon Apollo Hospital, Jubilee Hills, Hyderabad (Formerly Faculty in
More informationTreatment of Acute Iliofemoral Deep Venous Thrombosis: A Strategy of Thrombus Removal
Eur J Vasc Endovasc Surg 33, 351e360 (2007) doi:10.1016/j.ejvs.2006.11.013, available online at http://www.sciencedirect.com on Treatment of Acute Iliofemoral Deep Venous Thrombosis: A Strategy of Thrombus
More informationSurgical Options for revascularisation P E T E R S U B R A M A N I A M
Surgical Options for revascularisation P E T E R S U B R A M A N I A M The goal Treat pain Heal ulcer Preserve limb Preserve life The options Conservative Endovascular Surgical bypass Primary amputation
More information2017 Florida Vascular Society
Current Management of Venous Leg Ulcers: How to Identify Patients with Correctable Venous Disease and Interventional Procedures to Heal and Prevent Recurrence 2017 Florida Vascular Society Bill Marston
More informationThrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)
Dialysis Vascular Access Coverage, Coding and Reimbursement Overview Hospital Outpatient 2019 Edition All Reimbursement Amounts are Listed at ational Unadjusted Medicare Rates and Do ot Include the 2%
More informationCHALLENGING ILIAC ACCESSES AND THROMBOSIS PREVENTION
CHALLENGING ILIAC ACCESSES AND THROMBOSIS PREVENTION ARMANDO MANSILHA MD, PhD, FEBVS UNIVERSITY HOSPITAL - PORTO Disclosure of Interest Speaker name: ARMANDO MANSILHA I have the following potential conflicts
More informationReducing Thrombotic Burden in Arterial Interventions. Mario Galli, MD Cardiovascular Interventional Unit S. Anna Hospital, Como, Italy
Reducing Thrombotic Burden in Arterial Interventions Mario Galli, MD Cardiovascular Interventional Unit S. Anna Hospital, Como, Italy Disclosure Speaker name: Mario Galli... I have the following potential
More information