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Case Reports
. 2021 Jun 8;16(8):2086-2090.
doi: 10.1016/j.radcr.2021.05.012. eCollection 2021 Aug.

Catheter-directed intra-arterial thrombolysis in the treatment of acute thrombosis of below-the-knee arteries

Tran Minh Bao Luan  1   2 , Ho Tat Bang  1   3 , Nguyen Minh Tan  1 , Luong Viet Thang  1 , Nguyen Vo Tan Danh  2 , Lam Thao Cuong  1   2 , Le Phi Long  1 , Tran Thanh Vy  1   2
Affiliations
Case Reports

Catheter-directed intra-arterial thrombolysis in the treatment of acute thrombosis of below-the-knee arteries

Tran Minh Bao Luan et al. Radiol Case Rep. .

Abstract

Selecting treatment options in acute arterial thrombosis of the lower extremity, which threatens limb viability, is still a challenge for vascular surgeons. Early restoration of blood flow is crucial and is conducted by surgical thrombectomies or endovascular procedures, depending on patient condition. Catheter-directed thrombolysis with or without percutaneous mechanical thrombectomy for acute limb ischemia has been widely implemented from the early 1990s. Here, we present 2 cases of acute thrombosis of below-the-knee arteries, where we successfully saved the involved limbs using catheter-directed thrombolysis and thrombus aspiration.

Keywords: Acute lower limb ischemia; Catheter-directed thrombolysis.

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Figures

Fig. 1 –
Fig. 1
(Case 1) (A) The condition of the left foot before treatment; (B) Computed tomography angiography showing the obstruction in the middle third segment of the anterior tibial artery, posterior tibial artery, and peroneal artery.
Fig. 2 –
Fig. 2
(Case 1) DSA shows the total occlusion of below-the-knee arteries.
Fig. 3 –
Fig. 3
(Case 1) Post-procedure DSA shows the revascularisation of below-the-knee arteries.
Fig. 4 –
Fig. 4
(Case 1) The foot of the patient at 1 day (A) and 1 month (B) after the procedure.
Fig. 5 –
Fig. 5
(Case 2) The condition of the right foot before treatment
Fig. 6 –
Fig. 6
(Case 2) The DSA figures confirmed the occlusion of right popliteal and below-the-knee arteries.
Fig. 7 –
Fig. 7
(Case 2) The post-procedure figures of DSA showed the revascularisation of popliteal and below-the-knee arteries.
Fig. 8 –
Fig. 8
(Case 2) The foot at (A) 1 day and (B) 1 month after the procedure, respectively.
See this image and copyright information in PMC

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