Thrombectomy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A thrombectomy is the excision of an abnormal or dangerous thrombus (blood clot). It is performed intraluminally (meaning directly in the cavity of a vessel) using a balloon catheter. The thrombus is then either pressed against the walls in order to restore at least part of the natural lumen; or the balloon is 'opened' after the thrombus and then carefully moved retrogradely so that the clot can be drawn out of the vessel.
Thrombectomies usually occur as a result of thrombosis or a blood clot in a vein or artery. Thrombectomies can be used to clear a blockage in a fistula (AV fistulas used for dialysis kidney treatment).
Indications
- An unsuccessful treatment with fibrinolysis
- The occurrence of a mobile thrombosis
- Phlegmasia coerulea dolens
Types
Catheter Thrombectomy: which is of further divided into
- Balloon Thrombectomy
- Aspiration Thrombectomy
Surgical Thrombectomy
Video explaining Thrombectomy
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2013 Revised ACCF/AHA Guidelines for the Management of ST-Elevation Myocardial Infarction and 2011, 2009 and 2005 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1][2][3][4]
| Class IIa |
| "4. Manual aspiration thrombectomy is reasonable for patients undergoing primary PCI. [5][6][7][8](Level of Evidence: B)" |
2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[2]
Thrombectomy (DO NOT EDIT)[2]
| Class IIa |
| "1. Aspiration thrombectomy is reasonable for patients undergoing primary PCI.[7][6][5] (Level of Evidence: B)" |
References
- ↑ O'Gara PT, Kushner FG, Ascheim DD; et al. (2012). "2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e3182742c84. PMID 23247303. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 2.2 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter
|month=ignored (help) - ↑ Kushner FG, Hand M, Smith SC, King SB, Anderson JL, Antman EM, Bailey SR, Bates ER, Blankenship JC, Casey DE, Green LA, Hochman JS, Jacobs AK, Krumholz HM, Morrison DA, Ornato JP, Pearle DL, Peterson ED, Sloan MA, Whitlow PL, Williams DO (2009). "2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Journal of the American College of Cardiology. 54 (23): 2205–41. doi:10.1016/j.jacc.2009.10.015. PMID 19942100. Retrieved 2011-12-06. Unknown parameter
|month=ignored (help) - ↑ Smith SC, Feldman TE, Hirshfeld JW, Jacobs AK, Kern MJ, King SB; et al. (2006). "ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention)". Circulation. 113 (7): e166–286. doi:10.1161/CIRCULATIONAHA.106.173220. PMID 16490830.
- ↑ 5.0 5.1 Bavry AA, Kumbhani DJ, Bhatt DL (2008). "Role of adjunctive thrombectomy and embolic protection devices in acute myocardial infarction: a comprehensive meta-analysis of randomized trials". Eur. Heart J. 29 (24): 2989–3001. doi:10.1093/eurheartj/ehn421. PMID 18812323. Unknown parameter
|month=ignored (help) - ↑ 6.0 6.1 Vlaar PJ, Svilaas T, van der Horst IC; et al. (2008). "Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study". Lancet. 371 (9628): 1915–20. doi:10.1016/S0140-6736(08)60833-8. PMID 18539223. Unknown parameter
|month=ignored (help) - ↑ 7.0 7.1 Sardella G, Mancone M, Bucciarelli-Ducci C; et al. (2009). "Thrombus aspiration during primary percutaneous coronary intervention improves myocardial reperfusion and reduces infarct size: the EXPIRA (thrombectomy with export catheter in infarct-related artery during primary percutaneous coronary intervention) prospective, randomized trial". J. Am. Coll. Cardiol. 53 (4): 309–15. doi:10.1016/j.jacc.2008.10.017. PMID 19161878. Unknown parameter
|month=ignored (help) - ↑ Stone GW, Maehara A, Witzenbichler B; et al. (2012). "Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction: the INFUSE-AMI randomized trial". JAMA. 307 (17): 1817–26. doi:10.1001/jama.2012.421. PMID 22447888. Unknown parameter
|month=ignored (help)