Mid-term follow-up of transluminal endovascular graft placement with INOUE stent graft for aortic aneurysms and dissection: single center experience

Abstract

Background: SW have been mainly developed for the treatment of kidney stones. Vascular applications have recently been proposed and ‘non-invasive venous shock wave thrombolysis” (NISWT) has been recently achieved in selected cases using a modified lithotripter coupled to a focusing ultrasound system which probe is inserted within the SWs reflector. Methods: Twenty patients with acute thrombosis (ecolucent thrombi) of the femoral artery and critical limb ischemia were included in a randomized study. 9 patients were treated with NISWT and 11 were used as controls. SWs were used at the dosage of 600 shots. The SWs reflector was coupled to the skin with a silicon water cushion. All patients received treatment with PGEl according to the short term infusion protocol and were under oral anticoagulant (INR 2-3) for the follow-up period of 6 months. Results: NISWT was possible in all attempted cases. No pain was observed. No side effects were reported at 6 months. Two patiens in each group were treated with surgery and therefore considered as drop-out. In the SWs treated patients the femoral artery had visible flow (color duplex), thrombus breaks and perfusion were visible. In the control gryoup thombi appeared solid, without flow and the segment was not pelfused. After 6 months in the treated group limb flow measured by strain-gauge plethysmography was on average 90% (range 15.265%) higher than in controls and no limb underwent amputation (3 minor amputations in the control group). Conclusions:NISWT has been achieved extracorporeally in arterial thrombosis. Its clinical value should be assessed in a larger study.