Catheter-Directed Thrombolysis in Patient with Acute Limb Ischemia Grade IIB
Abstract
Acute limb ischemia was defined as sudden decrease in limb perfusion of less than 14 days duration, resulting in variable ischaemic clinical manifestation and potential risk of limb loss. We reported a case female 64 years old with sudden onset of right leg pain in last 3 days with history of hipertension, Diabetes Mellitus and heart failure. From physical examination of lower extremity was found pulselessness, pallor, paresthesi, poikilothermia, paralysis, and pain at the level of A. Poplitea dextra. Diagnosis was confirmed with Duplex Ultrasonography. From arteriography we found thrombus with subtotal occlusion at proximal a. Femoralis dextra and diffuse stenosis at the distal. Operation was not carried out as the request of the patient and it was decided to performed Catheter-directed Thrombolysis. In evaluation there was flow improvement at a. Femoralis dextra but it did not reach peripheral perfussion due to reperfussion injury.Downloads
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References
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2. Zhang D, Lou W, Chen G, Yin X, Gu J. Endovascular Treatment Options of Acute Limb Ischemia. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology. 2013; 2(01):39.
3. Creager M, Beckman JA, Loscalzo J. Vascular medicine: a companion to Braunwald’s heart disease. Philadelphia: Elsevier Health Sciences; 2013.
4. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, et al. ACC/AHA 2005 practice guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic) Circulation. 2006; 113(11):e463-654.
5. Creager MA, Kaufman JA, Conte MS. Acute limb ischemia. New England Journal of Medicine. 2012; 366(23):2198-2206.
6. Mansour MA, Labropoulos N. Vascular diagnosis. 1 ed. Philadelphia: Elsevier Saunders; 2005.
7. Heuser RR, Henry M. Textbook of peripheral vascular interventions. 2nd ed. London: Taylor & Francis US; 2008.
8. Graor RA, Comerota AJ, Douville Y, Turpie AGG, Froehlich J, Hosking JD, et al. Result of A Prospective Randomized Trial Evaluating Surgery versus Thrombolysis for Ischemia of the Lower-Extremity -The STILE Trial. Annals of Surgery. 1994; 220(3):251-268.
9. Norgren L, Hiatt WR, Dormandy JAa, Nehler MR, Harris KA, Fowkes FGR, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). European Journal of Vascular and Endovascular Surgery. 2007; 33(1):S1-S75.
10. Ouriel K, Veith FJ, Sasahara AA. A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs. New England Journal of Medicine. 1998; 338(16):1105-1111.
11. Ouriel K, Veith FJ, Sasahara AA. Thrombolysis or peripheral arterial surgery: phase I results. Journal of vascular surgery. 1996; 23(1):64-75.
12. van den Berg JC. Thrombolysis for acute arterial occlusion. Journal of vascular surgery. 2010; 52(2):512-515.
13. Working Party on Thrombolysis in the Management of Limb I. Thrombolysis in the management of lower limb peripheral arterial occlusion : a consensus document. Journal of Vascular and Interventional Radiology. 2003; 14(9):S337-S349.
Published
2016-02-16
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How to Cite
Indrayana, Y., & Sargowo, D. (2016). Catheter-Directed Thrombolysis in Patient with Acute Limb Ischemia Grade IIB. Indonesian Journal of Cardiology, 36(2), 88-93. https://doi.org/10.30701/ijc.v36i2.463
Section
Case Reports
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