thrombectomy
Jump to navigation
Jump to search
Indications
- venous thrombosis
- arterial thrombosis
- acute stroke, large vessel within 6 hours or radiographic mismatch within 6-24 hours[3]*
- complicated PCI for STEMI
- thrombosed arteriovenous fistula
* a small infarct core & greater amount of tissue at risk[3]
Contraindications
Benefit/risk
- patients with large cerebral infarctions have better functional outcomes with endovascular thrombectomy than with medical care alone but have more intracranial hemorrhages
Procedure
- removal of a thrombus; distinguish from thrombolysis
- adjunct intra-arterial alteplase following successful thrombectomy of large vessel occlusion acute ischemic stroke results in increased likelihood of favorable neurological outcomes[4]
Radiology
- computed tomography suggesting a small infarct core & greater amount of tissue at risk (radiologic mismatch)[3]
More general terms
More specific terms
References
- ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 19992
- ↑ 2.0 2.1 Kaltoft A et al, Routine thrombectomy in percutaneous coronary intervention for acute ST-segment-elevation myocardial infarction: a randomized, controlled trial. J Am Coll Cardiol 2006, 48:244 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16801464
Ali A et al, for the AIMI Investigators Rheolytic thrombectomy with percutaneous coronary intervention for infarct size reduction in acute myocardial infarction: 30-day results from a multicenter randomized study. J Am Coll Cardiol 2006, 48:244 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16843170 - ↑ 3.0 3.1 3.2 3.3 Nogueira RG, Jadhav AP, Haussen DC et al Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 2017 Nov 11; PMID: https://www.ncbi.nlm.nih.gov/pubmed/29129157 Free Article
Hacke W. A new DAWN for imaging-based selection in the treatment of acute stroke. N Engl J Med 2017 Nov 11 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29129127 Free Article - ↑ 4.0 4.1 Renu A, Millan M, San Roman L et al Effect of Intra-arterial Alteplase vs Placebo Following Successful Thrombectomy on Functional Outcomes in Patients With Large Vessel Occlusion Acute Ischemic Stroke. The CHOICE Randomized Clinical Trial. JAMA. 2022;327(9):826-835 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35143603 PMCID: PMC8832304 (available on 2022-08-10) https://jamanetwork.com/journals/jama/fullarticle/2789098
- ↑ Yoshimura S, Sakai N, Yamagami H et al. Endovascular therapy for acute stroke with a large ischemic region. N Engl J Med 2022 Feb 9; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35138767 https://www.nejm.org/doi/10.1056/NEJMoa2118191
- ↑ Wikipedia: Pulmonary thrombectomy http://en.wikipedia.org/wiki/Pulmonary_thrombectomy
- ↑ AngioJet<TM> Mechanical Thrombectomy http://www.dvtanswers.com/Treatments/thrombectomy.html
- ↑ Drexel Cardiology - Thrombectomy http://www.drexelmed.edu/Home/DrexelUniversityPhysicians/MedicalPractices/Cardiology/Treatments/Thrombectomy.aspx