Keywords:
Arteries / Aorta, Artificial Intelligence, Interventional vascular, Catheter arteriography, CT-Angiography, MR, Thrombolysis, Angioplasty, Catheters, Aneurysms, Blood, Embolism / Thrombosis
Authors:
L. S. P. Karanam, S. R. BADDAM, N. R. Busireddy, R. Polavarapu, V. Pamidimukkala; Guntur/IN
DOI:
10.26044/ecr2019/C-1074
Methods and materials
A total of 14(9 female and 5 male) patients presented with acute limb following TKR to us from April 2013 to march 2018.
Preliminary bed side Doppler is done in all the patients which identified the occlusion in these cases.One patient,
64 year male who underwent unilateral TKR,
presented on 3rd post operative day (late onset) with pulselessness,
paresthesias and changes of early ischemia in the toes.
All the patients underwent CT
angiogram and shifted immediately to cath suite.
The patient who presented with late onset changes underwent endovascular procedure on the 4th postoperative day.
Femoral access was used in all the cases.
Cross over balkin sheath is placed in the thrombotic limb from the contra lateral side.
Intravenous heparin is given to maintain the activated clotting time >250.
The
thrombus is reached with 4F glide catheter and 0.025 terumo combination and 2–5 mg tissue plasminogen activator (tpa) was given.
Thromboaspiration is done with export catheter (Medtronic).
Balloon angioplasty is then done with 2.5 × 80 and 5 × 100 mm peripheral balloons (Cook).
Ante grade flow is established and documented till the ankle.