caa a22 4500 44582400X CHVBK 20180317145253.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00246-011-9968-x doi (NATIONALLICENCE)springer-10.1007/s00246-011-9968-x An Institutional Approach to Interventional Strategies for Complete Vascular Occlusions [Elektronische Daten] [Philip Thrush, Chad Mackman, Paul Lawrence, Aymen Naguib, Andrew Yates, Stephen Cassidy, Joanne Chisolm, Sharon Hill, John Cheatham, Ralf Holzer] Complete vascular occlusions are rare but potentially lethal. Reports on transcatheter therapy are limited to solitary case reports. The study was conducted as a single-center retrospective chart review. Between January 2003 and December 2009, 26 patients underwent cardiac catheterizations for either a known complete thoracic vascular occlusion or for incidental complete vascular occlusion that was noted during cardiac catheterization. Procedural technique, risk factors, and outcomes are reviewed. Median age at the time of diagnosis was 13.3years (range 2months to 54years). In 6 of 26 (23%) patients, the vascular occlusion was of acute onset. Ninety-two percent of patients had at least 1 known risk factor for vascular occlusion, whereas 54% of patients had ≥2 risk factors. Successful rehabilitation was achieved in 19 patients, with direct catheter and/or wire manipulation being used to cross the occluded vessel in 15 (75%) patients, radiofrequency (RF) perforation in 3 patients, and perforation with Brockenbrough needle in 1 patient. Subsequent techniques included AngioJet (n=2), balloon angioplasty and/or stent implantation (n=18), and adjuvant local administration of recombinant tissue-plasminogen activator (n=3). Reinterventions were required in 5 patients, and 8 patients died during the study period from causes unrelated to the catheterization procedure(s). Median follow-up of patients after successful recanalization was 12.6months (range 1day to 64months), and the median duration of survival free from reintervention was 11.8months (range 1day to 64months). In most patients, risk factors can be identified that are associated with the occurrence of a complete vascular occlusion. Different treatment strategies are used in patients having chronic compared with acute occlusions. Residual vascular lesions (hypoplasia or stenosis) are often associated with occurrence of reobstructions and should therefore be treated to prevent such an occurrence. Postprocedural anticoagulation is important in maintaining vascular patency. Springer Science+Business Media, LLC, 2011 Vascular occlusion nationallicence Thrombosis nationallicence Congenital heart disease nationallicence Transcatheter therapy nationallicence Thrush Philip The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Mackman Chad The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Lawrence Paul The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Naguib Aymen The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Yates Andrew The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Cassidy Stephen The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Chisolm Joanne The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Hill Sharon The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Cheatham John The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Holzer Ralf The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut Pediatric Cardiology Springer-Verlag 32/6(2011-08-01), 713-723 0172-0643 32:6<713 2011 32 246 https://doi.org/10.1007/s00246-011-9968-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9968-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Thrush Philip The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Mackman Chad The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Lawrence Paul The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Naguib Aymen The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Yates Andrew The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Cassidy Stephen The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Chisolm Joanne The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Hill Sharon The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Cheatham John The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 700 1- Holzer Ralf The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, 43205, Columbus, OH, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/6(2011-08-01), 713-723 0172-0643 32:6<713 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer