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PubMed · 2096872

Peripheral arterial thrombolytic therapy.

Abstract

The management of the patient with an acute arterial occlusion or pulmonary embolus presents many challenges. Thrombolytic therapy offers a treatment option that was not available in the past. We now have several nonsurgical options for treating patients with both peripheral arterial and pulmonary arterial occlusions. There are choices as to the appropriate drug as well as the route, dose, and length of administration. The work underway is aimed at refining technique. Studies that are ongoing now focus on which drug and mode of delivery benefits certain groups of patients. Although each clinical situation is unique, the guidelines to be established through further investigations will aid clinicians in selecting the appropriate therapeutic modality.

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BibTeXRIS

M L Bilodeau, V Curtin Capasso. 1990. Peripheral arterial thrombolytic therapy.. https://pubmed.ncbi.nlm.nih.gov/2096872/

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Pulmonary arterial reconstruction for pulmonary coarctation in early infancy.

BACKGROUND: Pulmonary atresia with pulmonary coarctation may complicate diminished and unbalanced pulmonary development. The aim of this study is to assess the outcome of pulmonary arterial reconstruction with cardiopulmonary bypass in early infancy for sufficient and balanced pulmonary development. METHODS: We performed a retrospective review of 15 patients with pulmonary coarctation younger than 4 months of age who underwent pulmonary arterial reconstruction between 2001 and 2005. The mean age and weight were 42.2 days and 3.62 kg, respectively. The patient population included 5 biventricular repair candidates and 10 Fontan candidates. To evaluate the pulmonary arterial development, the preoperative and postoperative pulmonary arterial index and minimum diameter of the pulmonary artery were compared. RESULTS: No early or in-hospital deaths occurred, and there was no nonconfluent pulmonary artery development or segmental mal-development after a mean follow-up period of 14.9 months. Immediate pulmonary flow regulation was required in 2 patients because of excessive pulmonary flow. The mean pulmonary arterial index increased significantly from 103 mm2/m2 to 343 mm2/m2, and the mean minimum diameter of the pulmonary artery increased significantly from 2.02 mm to 4.45 mm. Four biventricular repair candidates completed definitive repair, and 2 required surgical reintervention in the pulmonary artery. Six Fontan candidates completed the Glenn procedure, and 1 completed the Fontan procedure. Three required surgical reintervention in the pulmonary artery. Two late deaths occurred after the Glenn procedure because of ventricular dysfunction and respiratory infection. CONCLUSIONS: Pulmonary arterial reconstruction in early infancy provides sufficient and balanced pulmonary arterial development for pulmonary atresia with pulmonary coarctation.

Arterial Occlusive Diseases↗