JET2019

講演情報

Presentation Awards

[L2-2] Presentation Awards
Heat-4 Acute limb ischemia

2019年2月22日(金) 10:30 〜 12:00 HallL-2 (Nexus)

Moderator: Masatsugu Nakano(Tokyo general hospital),Ehrin J. Armstrong(Denver VA Medical Center)
Panelist: Tsuyoshi Shibata(Hakodate Municipal Hospital),Atsuichiro Shigenaga(Yokohama City University Hospital)

[MO-23] Presentation Awards

Efficacy of a novel strategy for Acute limb ischemia

Yousuke Komatsu

Background: In Endovascular therapy (EVT) for acute limb ischemia (ALI), it was difficult to perform thrombectomy and remove thrombus completely. The surgical removal of a thrombus was standard strategy for ALI. However it was difficult to remove thrombus at the below the knee (BTK) artery. Our aim was to evaluate the efficacy of a novel strategy for ALI cases.

Method: Between January 2017 and November 2018, we performed 18 cases of EVT for ALI cases. We performed a novel strategy for ALI cases. 10Fr. Sheath was inserted and the thrombectomy was performed with a guiding catheter (GC) (Britetip10 Fr. ST) which tip was cut originally. If there was thrombus at BTK, a 20G needle was inserted with the ultrasound guided. The urokinase was administrated locally from this needle. The dose of urokinase was 48,000 U/day. Post EVT 1 or 2 days,

angiography was performed. And we performed EVT for BTK lesions. We evaluated the result of the procedure, clinical outcome and safety.

Result: The mean age was 75.4±6.7 years old, female was 9 cases. The cases of successful thrombectomy was all cases. The cases of local administration of urokinase at the dorsal artery were 15 cases and at the planter artery were 2 cases. The cases of successfully thrombolysis were all cases. In complication, the anemia was occurred in 14 cases. The major bleeding was no case. The major amputation was performed 2 cases.

Conclusion: A novel strategy which was used 10 Fr. GC thrombectomy and the local urokinase administration at below the ankle for ALI cases might be useful and safety.