Treatment of acute limb ischemia with focus on endovascular techniques
Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE)...
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| Veröffentlicht in: | VASA 2009-05, Vol.38 (2), p.123-133 |
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| creator | ZELLER, T TEPE, G |
| description | Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis. |
| doi_str_mv | 10.1024/0301-1526.38.2.123 |
| format | Article |
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Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.</description><identifier>ISSN: 0301-1526</identifier><identifier>EISSN: 1664-2872</identifier><identifier>DOI: 10.1024/0301-1526.38.2.123</identifier><identifier>PMID: 19588300</identifier><identifier>CODEN: VASAAH</identifier><language>eng</language><publisher>Bern: Huber</publisher><subject>Acute Disease ; Arterial Occlusive Diseases - therapy ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Equipment Design ; Extremities - blood supply ; Fibrinolytic Agents - administration & dosage ; Humans ; Ischemia - therapy ; Limb Salvage ; Medical sciences ; Pharmacology. Drug treatments ; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors ; Randomized Controlled Trials as Topic ; Thrombectomy - instrumentation ; Thrombectomy - methods ; Thrombolytic Therapy - methods ; Ultrasonography, Interventional ; Vasodilator agents. 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Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.</description><subject>Acute Disease</subject><subject>Arterial Occlusive Diseases - therapy</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Equipment Design</subject><subject>Extremities - blood supply</subject><subject>Fibrinolytic Agents - administration & dosage</subject><subject>Humans</subject><subject>Ischemia - therapy</subject><subject>Limb Salvage</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Thrombectomy - instrumentation</subject><subject>Thrombectomy - methods</subject><subject>Thrombolytic Therapy - methods</subject><subject>Ultrasonography, Interventional</subject><subject>Vasodilator agents. Cerebral vasodilators</subject><issn>0301-1526</issn><issn>1664-2872</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkD1PwzAURS0EoqXwBxiQF9gS_J4dxx5RRQGpEkuZLcdx1KB8lDgB8e9J1KhMbzn33qdDyC2wGBiKR8YZRJCgjLmKMQbkZ2QJUooIVYrnZHkCFuQqhE_GEBSIS7IAnSjFGVuSza7ztq9909O2oNYNvadVWWe0DG7v69LSn7Lf06J1Q6BtQ32Tt982uKGyHe292zfl1-DDNbkobBX8zXxX5GPzvFu_Rtv3l7f10zZyXIo-cjkiz3IEpiDh4MAjS0Wu0kIxzYo81SrNNCJAAiJjMlMOhJY5815laCVfkYdj76Frp93e1OOjvqps49shGJkKqROZjiAeQde1IXS-MIeurG33a4CZyZ6Z5JhJjuHKoBntjaG7uX3Iap__R2ZdI3A_A6MCWxWdbVwZThxCIrRmCf8Dtct2Gg</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>ZELLER, T</creator><creator>TEPE, G</creator><general>Huber</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>Treatment of acute limb ischemia with focus on endovascular techniques</title><author>ZELLER, T ; TEPE, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c364t-cd223bd21081531c1e2074d87f8090fd7987b92211514b06b8c1496d0ee8b2a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute Disease</topic><topic>Arterial Occlusive Diseases - therapy</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Equipment Design</topic><topic>Extremities - blood supply</topic><topic>Fibrinolytic Agents - administration & dosage</topic><topic>Humans</topic><topic>Ischemia - therapy</topic><topic>Limb Salvage</topic><topic>Medical sciences</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Thrombectomy - instrumentation</topic><topic>Thrombectomy - methods</topic><topic>Thrombolytic Therapy - methods</topic><topic>Ultrasonography, Interventional</topic><topic>Vasodilator agents. Cerebral vasodilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ZELLER, T</creatorcontrib><creatorcontrib>TEPE, G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>VASA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ZELLER, T</au><au>TEPE, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of acute limb ischemia with focus on endovascular techniques</atitle><jtitle>VASA</jtitle><addtitle>Vasa</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>38</volume><issue>2</issue><spage>123</spage><epage>133</epage><pages>123-133</pages><issn>0301-1526</issn><eissn>1664-2872</eissn><coden>VASAAH</coden><abstract>Acute limb ischemia is still the most frequent cause of major limb loss. Timely and fast revascularization is the key for limb salvage and patient survival. Large randomized trials showed equivalency of surgical and endovascular revascularization by means of local lysis with urokinase (TOPAS, STILE). New lytic agents and their modified application such as via a pulse spray catheter or combined with an ultrasound catheter and the combination with glycoprotein IIb/IIIa receptor antagonists have increased the efficacy and speed of thrombolysis. Recently, mechanical thrombectomy devices have become more widespread because intervention time and bleeding complications can be reduced. This review article summarizes the clinical presentation of and the treatment options for acute arterial occlusive disease caused either by embolism or local thrombosis.</abstract><cop>Bern</cop><pub>Huber</pub><pmid>19588300</pmid><doi>10.1024/0301-1526.38.2.123</doi><tpages>11</tpages></addata></record> |
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| ispartof | VASA, 2009-05, Vol.38 (2), p.123-133 |
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| language | eng |
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| source | MEDLINE; Hogrefe eContent |
| subjects | Acute Disease Arterial Occlusive Diseases - therapy Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular system Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Equipment Design Extremities - blood supply Fibrinolytic Agents - administration & dosage Humans Ischemia - therapy Limb Salvage Medical sciences Pharmacology. Drug treatments Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors Randomized Controlled Trials as Topic Thrombectomy - instrumentation Thrombectomy - methods Thrombolytic Therapy - methods Ultrasonography, Interventional Vasodilator agents. Cerebral vasodilators |
| title | Treatment of acute limb ischemia with focus on endovascular techniques |
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