International Journal of Vascular Medicine

Volume 2011, Issue 1 264053

Case Report

Open Access

Acute Arterial Thrombosis after Covered Stent Exclusion of Bleeding Mycotic Pseudoaneurysm: Treatment Using Catheter-Directed Thrombolysis

Sarah Palestrant

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

M. Grace Knuttinen,

M. Grace Knuttinen

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

Ron C. Gaba,

Corresponding Author

Ron C. Gaba

[email protected]

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

James T. Bui,

James T. Bui

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

Charles A. Owens,

Charles A. Owens

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

Sarah Palestrant,

Sarah Palestrant

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

M. Grace Knuttinen,

M. Grace Knuttinen

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

Ron C. Gaba,

Corresponding Author

Ron C. Gaba

[email protected]

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

James T. Bui,

James T. Bui

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

Charles A. Owens,

Charles A. Owens

Section of Interventional Radiology, Department of Radiology, University of Illinois at Chicago, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA uic.edu

Search for more papers by this author

First published: 28 April 2011

https://doi.org/10.1155/2011/264053

Academic Editor: Mark D. Morasch

Share a link

Email
Wechat
Bluesky

Abstract

Conventional absolute contraindications to catheter-directed thrombolysis include active or recent hemorrhage and the presence of local vascular infection, both of which increase the risk of procedure-related complications such as bleeding and systemic sepsis. For this reason, lytic therapy of arterial thromboembolism under these circumstances is generally precluded. Herein, we describe a unique case of safe catheter-directed lysis of an acutely thrombosed iliac artery following covered stent placement for treatment of an actively bleeding infected pseudoaneurysm. Our management approach is discussed.

References

1 Razavi M. K., Lee D. S., and Hofmann L. V., Catheter-directed thrombolytic therapy for limb ischemia: current status and controversies, Journal of Vascular and Interventional Radiology. (2003) 14, no. 12, 1491–1501, 2-s2.0-0345167837.
Google Scholar
2 Semba C. P., Murphy T. P., Bakal C. W., Calis K. A., Matalon T. A. S., Chopra P., Cole P. E., Comerota A. J., Connors B., Cynamon J., Grubbs G. E., Haskal Z., Herbst S. L. V., Hunter D. W., Phelps K., Stump D., Thomas S., Warner D. L., and Zemel G., Thrombolytic therapy with use of alteplase (rt-PA) in peripheral arterial occlusive disease: review of the clinical literature, Journal of Vascular and Interventional Radiology. (2000) 11, no. 2 I, 149–161, 2-s2.0-0034001707.
Google Scholar
3 Sebastian A. J., Robinson G. J., Dyet J. F., and Ettles D. F., Long-term outcomes of low-dose catheter-directed thrombolytic therapy: a 5-year single-center experience, Journal of Vascular and Interventional Radiology. (2010) 21, no. 7, 1004–1010, 2-s2.0-77953870817, https://doi.org/10.1016/j.jvir.2010.03.018.
Google Scholar
4 Roberts A., S. Baum and M. S. Pentecost, Thrombolysis: clinical applications, Abrams’ Angiography Interventional Radiology, 2006, 2nd edition, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 233–256.
Google Scholar
5 Thrombolysis in the management of lower limb peripheral arterial occlusion—a consensus document, Journal of Vascular and Interventional Radiology. (2003) 14, no. 9, S337–S349.
Google Scholar
6 Davis G. B., Dowd C. F., and Bookstein J. J., Thrombosed dialysis grafts: efficacy of intrathrombic deposition of concentrated urokinase, clot maceration, and angioplasty, American Journal of Roentgenology. (1987) 149, no. 1, 177–181, 2-s2.0-0023188353.
Google Scholar
7 Razavi M. K. and Razavi M. D., Stent-graft treatment of mycotic aneurysms: a review of the current literature, Journal of Vascular and Interventional Radiology. (2008) 19, no. 6, S51–S56, 2-s2.0-43849103923, https://doi.org/10.1016/j.jvir.2008.02.012.
Google Scholar
8 Lupattelli T., Garaci F. G., Basile A., Minnella D. P., Casini A., and Clerissi J., Emergency stent grafting after unsuccessful surgical repair of a mycotic common femoral artery pseudoaneurysm in a drug abuser, CardioVascular and Interventional Radiology. (2009) 32, no. 2, 347–351, 2-s2.0-67649128515, https://doi.org/10.1007/s00270-008-9401-x.
Google Scholar
9 Kan C. D., Lee H. L., and Yang YU. J., Outcome after endovascular stent graft treatment for mycotic aortic aneurysm: a systematic review, Journal of Vascular Surgery. (2007) 46, no. 5, 906–912, 2-s2.0-35549000946, https://doi.org/10.1016/j.jvs.2007.07.025.
Google Scholar
10 Lee W. K., Mossop P. J., Little A. F., Fitt G. J., Vrazas J. I., Hoang J. K., and Hennessy O. F., Infected (Mycotic) aneurysms: spectrum of imaging appearances and management, Radiographics. (2008) 28, no. 7, 1853–1868, 2-s2.0-58149385847, https://doi.org/10.1148/rg.287085054.
Google Scholar
11 Cable D. G. and Cherry K. J., Systemic thrombolytic therapy after recent abdominal aortic aneurysm repair: an absolute contraindication?, Mayo Clinic Proceedings. (2003) 78, no. 1, 99–102, 2-s2.0-0037215072.
Google Scholar
12 Pilloud J., Rimensberger P. C., Humbert J., Berner M., and Beghetti M., Successful local low-dose urokinase treatment of acquired thrombosis early after cardiothoracic surgery, Pediatric Critical Care Medicine. (2002) 3, 355–357.
Google Scholar

All articles

Acute Arterial Thrombosis after Covered Stent Exclusion of Bleeding Mycotic Pseudoaneurysm: Treatment Using Catheter-Directed Thrombolysis

Abstract

References

Figures

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Acute Arterial Thrombosis after Covered Stent Exclusion of Bleeding Mycotic Pseudoaneurysm: Treatment Using Catheter-Directed Thrombolysis

Abstract

References

Figures

References

Related

Information