Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-152
Successful Treatment of Subclavian Artery Thrombosis by Catheter-Based Thrombus Aspiration and Thrombolytic Therapy: A Case Report.
By A P M Sohrabuzzaman, Shiblee Sadik Pathan, Md Mohasin Uddin, Mohammad Abul Khayer, Rashiduz Zaman, Asifudduza Asif, Rakibul hasan, Fahmida Zaman
Presenter
Shiblee Sadik Pathan
Authors
A P M Sohrabuzzaman1, Shiblee Sadik Pathan1, Md Mohasin Uddin1, Mohammad Abul Khayer1, Rashiduz Zaman1, Asifudduza Asif1, Rakibul hasan1, Fahmida Zaman1
Affiliation
Labaid Cardiac Hospital, Bangladesh1,
View Study Report
TCTAP C-152
ENDOVASCULAR - Peripheral Vascular Disease and Intervention
Successful Treatment of Subclavian Artery Thrombosis by Catheter-Based Thrombus Aspiration and Thrombolytic Therapy: A Case Report.
A P M Sohrabuzzaman1, Shiblee Sadik Pathan1, Md Mohasin Uddin1, Mohammad Abul Khayer1, Rashiduz Zaman1, Asifudduza Asif1, Rakibul hasan1, Fahmida Zaman1
Labaid Cardiac Hospital, Bangladesh1,
Clinical Information
Patient initials or Identifier Number
BP 45323/22
Relevant Clinical History and Physical Exam
A 55 Y / Female
C/C : Pain, numbness ,cold sensation & weakness of left upper limb for 2 hours.
Risk Factor : Hypertension , diabetes mellitus
O/E : Pale , cold and absent of radial, ulnar, brachial pulse of left upper limb. Muscle power 3/5 left side. So2 86%, BP undetectable. Right upper limb were normal. BP 160/90 mm of hg, pules : 112 b/min, RR : 26/min. Body Temperature 37.5 C
Relevant Test Results Prior to Catheterization
CBC : WBC 7450, HB % 10.8 g/dl, ESR 20mm in 1st hour, Platelets : 262000, SARS Cov2 Antigen : Negative
PT 14.3 sec, INR : 1.07APTT : 32.4 sec .blood group: O positive Serum Creatinine : 1.1 mg/dlPlasma glucose 9.7 mmmol/lHIV Ab : Negative HBs Ag : Negative Anti-HCV : Negative Urine R/E : Normal lipid profile : Cholesterol 280mg/dl Vascular duplex ultrasound of left upper limb : A dilated echogenic thrombus had blocked the left subclaviav artery lumen.
PT 14.3 sec, INR : 1.07APTT : 32.4 sec .blood group: O positive Serum Creatinine : 1.1 mg/dlPlasma glucose 9.7 mmmol/lHIV Ab : Negative HBs Ag : Negative Anti-HCV : Negative Urine R/E : Normal lipid profile : Cholesterol 280mg/dl Vascular duplex ultrasound of left upper limb : A dilated echogenic thrombus had blocked the left subclaviav artery lumen.
Relevant Catheterization Findings
Conventional angiography with the lowest amountof contrast agent through the right femoral artery, revealed that left subclavianartery thrombosis with total occlusion distal to Left internal mammary artery.
Interventional Management
Procedural Step
A5Fr MPA catheter with side holes was negotiated through a right femoral sheath and was placed in the left subclavian artery. Initially thrombus aspiration was done with Eliminate aspiration catheter (TERUMO) with no success. Then suction was done with the MPA catheter itself with partial removal of thrombus. Then a 5Fr Pigtail catheter was placed inside the thrombus and kept in situ. For residual thrombus 250,000u of Inj. Streptokinase as a thrombolytic drug was given through the Pigtail catheter as bolus over 30 min. The maintenance dose 100,000 u per hour was given over 24 hours through the Pigtail catheter via infusion pump.
Case Summary
Catheter-based thrombus aspiration and thrombolytic therapy is primarily reserved for patients with acute viable limb ischemia. As observed in the presented case, thrombus aspiration and thrombolytic therapy is recommended to be considered as an alternative therapeutic method for patients with arterial thrombosis due to the rapid response, shorter treatment time and lower cost, compared to common and sometimes unsuccessful therapies.