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Zacà S, Ramundo RM, Desantis C, Di Stefano L, Pulli R, Angiletta D. Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection. Vasc Endovascular Surg 2023:15385744231154333. [PMID: 36704834 DOI: 10.1177/15385744231154333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To describe a case of endovascular bailout strategy during stent-graft thrombotic complication in an endovascular procedure for complex TASC II D aortoiliac lesion. A 77-year-old patient was admitted at our institution with bilateral lower limb rest pain due to aortoiliac obstructive disease in a previous aortobifemoral bypass grafting with an asymptomatic Sars-CoV-2 infection. We planned an anatomic reconstruction of the aortoiliac segment with an unimodular bifurcated stent-graft. During the procedure, we observed a preocclusive thrombosis of the aortic portion requiring endovascular thrombectomy with vacuum assisted system followed by a successfully kissing-stent endolining. The post-operative period was uneventful and patient was discharged on the 14th post-operative day. Endovascular thrombectomy may be a helpful strategy during thrombotic complication of complex reconstructions of obstructive aortoiliac disease avoiding surgical conversion to laparotomy.
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Affiliation(s)
- Sergio Zacà
- Vascular and Endovascular Surgery, Department of Emergency and Organs Transplantation (DETO), 579980"Aldo Moro" University of Bari School of Medicine, Bari, Italy
| | - Roberto Maria Ramundo
- Vascular and Endovascular Surgery, Department of Emergency and Organs Transplantation (DETO), 579980"Aldo Moro" University of Bari School of Medicine, Bari, Italy
| | - Claudio Desantis
- Vascular and Endovascular Surgery, Department of Emergency and Organs Transplantation (DETO), 579980"Aldo Moro" University of Bari School of Medicine, Bari, Italy
| | - Lucia Di Stefano
- Vascular and Endovascular Surgery, Department of Emergency and Organs Transplantation (DETO), 579980"Aldo Moro" University of Bari School of Medicine, Bari, Italy
| | - Raffaele Pulli
- Department of Vascular Surgery, Careggi University Hospital, Florence, Italy
| | - Domenico Angiletta
- Vascular and Endovascular Surgery, Department of Emergency and Organs Transplantation (DETO), 579980"Aldo Moro" University of Bari School of Medicine, Bari, Italy
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Zheng X, Pan Y, Zhang Y, Meng K, Zhou J, Wang X, Cui Y, Li J, Li Y, Chen H. Interventional Microbubble Enhanced Sonothrombolysis on Left Ventricular Assist Devices. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201291. [PMID: 35615977 PMCID: PMC9313509 DOI: 10.1002/advs.202201291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/27/2022] [Indexed: 06/15/2023]
Abstract
The left ventricular assist device (LVAD) is often used in the treatment of heart failure. However, 4% to 9% implanted LVAD will have thrombosis problem in one year, which is fatal to the patient's life. In this work, an interventional sonothrombolysis (IST) method is developed to realize the thrombolysis on LVAD. A pair of ultrasound transducer rings is installed on the shell of LVAD, and drug-loaded microbubbles are injected into the LVAD through the interventional method. The microbubbles are adhere on the thrombus with the coated thrombus-targeted drugs, and the thrombolytic drugs carried by the bubbles are brought into the thrombus by the cavitation of bubbles under the ultrasound. In a proof-of-concept experiment in a live sheep model, the thrombus on LVAD is dissolved in 30 min, without damages on LVADs and organs. This IST exhibits to be more efficient and safer compared with other thrombolysis methods on LVAD.
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Affiliation(s)
- Xiaobing Zheng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yunfan Pan
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yuan Zhang
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kuilin Meng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Jianye Zhou
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Xin Wang
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Yongchun Cui
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Jiang Li
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yongjian Li
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Haosheng Chen
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
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