Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma

Giuseppe M. Raffa; Giuseppe D'Ancona; Sergio Sciacca; Astrid Pietrosi; Cesar M. Hernandez Baravoglia; Marco Turrisi; Giuseppe Romano; Alessandro Armaro; Vincenzo Stringi; Francesco Clemenza; Michele Pilato

doi:10.1111/aor.12423

Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma

Giuseppe M. Raffa, Giuseppe D'Ancona, Sergio Sciacca, Astrid Pietrosi, Cesar M. Hernandez Baravoglia, Marco Turrisi, Giuseppe Romano, Alessandro Armaro, Vincenzo Stringi, Francesco Clemenza, Michele Pilato

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Research output: Contribution to journal › Article › peer-review

Abstract

Endoventricular thrombolytic procedure (ETP) has been used to treat continuous-flow left ventricle assist device (CF-LVAD) thrombosis. The study aims to investigate the occurrence of complications after ETP. Data were retrospectively reviewed and analyzed in a series of patients who underwent CF-LVAD followed by ETP. Since November 2010, 20 patients underwent HeartWare CF-LVAD implantation at our institute. Four patients (20%) developed pump thrombosis and underwent a total of nine ETPs with tissue plasminogen activator infused into the left ventricle. The mean age was 60.2±9 years. ETP was performed via either the femoral (n=6) or radial artery (n=3). Five ETPs (55.5%) were complicated by left and right radial artery occlusion, two by groin hematomas, and one by femoral artery false aneurysm. ETP carries a strong risk of vascular access complications that, in CF-LVAD patients, may add to the already complex clinical profile and economic burden; thus, a less invasive treatment is advisable whenever required.

Original language	English
Pages (from-to)	526-529
Number of pages	4
Journal	Artificial Organs
Volume	39
Issue number	6
DOIs	https://doi.org/10.1111/aor.12423
Publication status	Published - Jun 1 2015

Keywords

Continuous-flow pump
Thrombolysis
Vascular access-site complications

ASJC Scopus subject areas

Biomaterials
Biomedical Engineering
Bioengineering
Medicine (miscellaneous)

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10.1111/aor.12423

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title = "Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma",

abstract = "Endoventricular thrombolytic procedure (ETP) has been used to treat continuous-flow left ventricle assist device (CF-LVAD) thrombosis. The study aims to investigate the occurrence of complications after ETP. Data were retrospectively reviewed and analyzed in a series of patients who underwent CF-LVAD followed by ETP. Since November 2010, 20 patients underwent HeartWare CF-LVAD implantation at our institute. Four patients (20%) developed pump thrombosis and underwent a total of nine ETPs with tissue plasminogen activator infused into the left ventricle. The mean age was 60.2±9 years. ETP was performed via either the femoral (n=6) or radial artery (n=3). Five ETPs (55.5%) were complicated by left and right radial artery occlusion, two by groin hematomas, and one by femoral artery false aneurysm. ETP carries a strong risk of vascular access complications that, in CF-LVAD patients, may add to the already complex clinical profile and economic burden; thus, a less invasive treatment is advisable whenever required.",

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author = "Raffa, {Giuseppe M.} and Giuseppe D'Ancona and Sergio Sciacca and Astrid Pietrosi and {Hernandez Baravoglia}, {Cesar M.} and Marco Turrisi and Giuseppe Romano and Alessandro Armaro and Vincenzo Stringi and Francesco Clemenza and Michele Pilato",

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doi = "10.1111/aor.12423",

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T1 - Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis

T2 - A Clinical Dilemma

AU - Raffa, Giuseppe M.

AU - D'Ancona, Giuseppe

AU - Sciacca, Sergio

AU - Pietrosi, Astrid

AU - Hernandez Baravoglia, Cesar M.

AU - Turrisi, Marco

AU - Romano, Giuseppe

AU - Armaro, Alessandro

AU - Stringi, Vincenzo

AU - Clemenza, Francesco

AU - Pilato, Michele

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Endoventricular thrombolytic procedure (ETP) has been used to treat continuous-flow left ventricle assist device (CF-LVAD) thrombosis. The study aims to investigate the occurrence of complications after ETP. Data were retrospectively reviewed and analyzed in a series of patients who underwent CF-LVAD followed by ETP. Since November 2010, 20 patients underwent HeartWare CF-LVAD implantation at our institute. Four patients (20%) developed pump thrombosis and underwent a total of nine ETPs with tissue plasminogen activator infused into the left ventricle. The mean age was 60.2±9 years. ETP was performed via either the femoral (n=6) or radial artery (n=3). Five ETPs (55.5%) were complicated by left and right radial artery occlusion, two by groin hematomas, and one by femoral artery false aneurysm. ETP carries a strong risk of vascular access complications that, in CF-LVAD patients, may add to the already complex clinical profile and economic burden; thus, a less invasive treatment is advisable whenever required.

AB - Endoventricular thrombolytic procedure (ETP) has been used to treat continuous-flow left ventricle assist device (CF-LVAD) thrombosis. The study aims to investigate the occurrence of complications after ETP. Data were retrospectively reviewed and analyzed in a series of patients who underwent CF-LVAD followed by ETP. Since November 2010, 20 patients underwent HeartWare CF-LVAD implantation at our institute. Four patients (20%) developed pump thrombosis and underwent a total of nine ETPs with tissue plasminogen activator infused into the left ventricle. The mean age was 60.2±9 years. ETP was performed via either the femoral (n=6) or radial artery (n=3). Five ETPs (55.5%) were complicated by left and right radial artery occlusion, two by groin hematomas, and one by femoral artery false aneurysm. ETP carries a strong risk of vascular access complications that, in CF-LVAD patients, may add to the already complex clinical profile and economic burden; thus, a less invasive treatment is advisable whenever required.

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KW - Thrombolysis

KW - Vascular access-site complications

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Systemic or Endoventricular Thrombolysis to Treat HeartWare Left Ventricle Assist Device Thrombosis: A Clinical Dilemma

Abstract

Keywords

ASJC Scopus subject areas

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