Endovasküler Yöntemlerle Tedavi Ettiğimiz Akut Alt Ekstremite Emboli Deneyimlerimiz

Amaç: Çalışmada akut femoro-popliteal baypas greft oklüzyonunda reolitik trombektomi veya kateter aracılı trombolitik infüzyon tedavisi ile endovasküler tedavinin 1 yıllık sonuçlarını retrospektif olarak değerlendirmeyi amaçladık. Yöntem: 2016-2018 yılları arasında daha önceden femoropopliteal baypas operasyonu geçiren ve takipleri sırasında ipsilateral akut ekstremite iskemisi tanısı alan 13 hasta çalışmaya dahil edildi. Hastalar tedavi yöntemlerine göre iki ayrı gruba ayrıldı. Bulgular: İki grup arasında demografik veriler ve Rutherford emboli sınıflaması açısından anlamlı fark yoktu. Reolitik trombektomi ve kateter aracılı trombolitik infüzyon tedavi gruplarında primer patensi 6 ay için sırasıyla %87,5 ve %80, 12 ay için %75 ve %60 idi. Sekonder patensi her iki grupta 6 ay için %100, 12 ay için sırasıyla %87,5 ve %80 bulundu. Primer ve sekonder patensi açısından iki grup arasında anlamlı fark saptanmadı. Sonuçlar :Akut femoropopliteal greft oklüzyonu tedavisinde cerrahiye göre daha invaziv olması ve erken mobilizasyon, düşük mortalite ve morbidite oranları nedeniyle seçilmiş hasta grubunda endovasküler tedavi tercih edilebilir.

Anahtar Kelimeler:

akut ekstremite iskemisi, kateter aracılı trombolitik, reolitik trombektomi

Our Experiences in Acute Arterial Embolism Treatment with Endovascular Techniques in Lower Extremity

Objectives: The study aims to retrospectively evaluate the 1-year results of endovascular treatment with rheolytic thrombectomy(TR) or catheter-directed thrombolytic(CDT) infusion therapy in acute femoro-popliteal bypass graft occlusion. Methods: The patients who had a history of femoro-popliteal by-pass operation and during their follow-up diagnosed with ipsilateral acute limb ischemia between 2016 and 2018 were included. The total of 13 patients were included and they were divided into two groups according to their treatment methods (RT, n=8 vs CDT, n=5). Results: There was no statistically significant difference between the two groups in terms of demographic data and Rutherford embolism classification. Reolitic thrombectomy and catheter-directed thromolytic infusion primary patency values were 87.5% and 80% for 6 months, 75% and 60% for 12 months, respectively. Secondary patency values were found to be 100% in both groups for 6 months, and 87.5% and 80% for 12 months, respectively. There was no significant difference between the two groups in terms of primer and sekonder patency. Conclusion:Endovascular therapy can be preferred in the treatment of acute femoro-popliteal by-pass graft occlusion in selected patient groups due to its less invasiveness, early mobilization, and low mortality and morbidity rates compared to surgery,

Keywords:

acute limb ischemia, catheter-directed thrombolytic therapy, rheolytic thrombectomy,

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