Vascular intervention

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Rationale for thrombus fragmentation Mechanical fragmentation and peripheral dispersion of clots is likely to reduce PAP and increase perfusion
Endovascular mechanical INDICATION fragmentation 1) Patients with massive pulmonary embolism and with contraindication for thrombolysis 2) Patients with massive pulmonary embolism after failure of thrombolysis
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Historic Highlights of Intervention
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Father of IR PTA
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“A A cardiac catheter can be more
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June 1963
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INTERVENTION RADIOLOGY The procedu
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Interventional Suit Design
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1953 I Seldiger: : Percutaneous cat
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January 16, 1964
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Balloon Angioplasty 1975 A. Grüntz
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PTA Indications (extremity PTA) 1.
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Team cooperation angiologist vascul
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Stent Design Stents (a form of scaf
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Balloon Expandable Stent 1985 J. Pa
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Self-Expanding Medinvent Stent 1985
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Categories of catheter- based tools
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Levels of clinical evidence and Lev
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Categories of chronic limb ischemia
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11,3 mm 10,7 mm
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ILIAC ARTERIES PTA vs Surgery ↓lo
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FEMOROPOPLITEAL ARTERIES Indicatio
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FEMOROPOPLITEAL ARTERIES PTA vs Sur
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INFRAPOPLITEAL ARTERIES PTA vs Surg
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COMBINATION OF FEMOROPOPLITEAL BYPA
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IKEM clinical c follow ow up No.of
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Case - SIR AFS + a. fibularis, ipsi
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CTA za 12 měsíců
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CTA after 1 y
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PTRA Aim: to open stenotic/ occlude
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STENT IMPLANTATION ● PTRA complic
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Stentgraft A/V shunt pseudoaneurysm
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Type B aortic dissection
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Stentgraft
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Stentgraft
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Catheter-directed thrombolysis
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Acute critical ischemia percutaneo
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Pulse-spray pharmacomechanical thro
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Pulse-spray pharmacomechanical thro
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Acute critical ischemia thrombolys
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veckebauer4bo veckebauer4co
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48 mg rt-PA
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Deep vein thrombosis = DVT DVT is s
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DVT Risk factors: 8. Oral contracep
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Diagnosis of suspected (symptomatic
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Therapy of DVT • Standard heparin
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Thrombolytic therapy The resulting
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Catheter-directed thrombolysis for
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Catheter-directed thrombolysis A ca
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Inferior vena cava filters 1. Free
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Case • 25 y.o. female • 11 days
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Pulsed - spray technique (rt-PA)
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MRV follow-up 12 months
Page 137 and 138: Percutaneous mechanical thrombectom
Page 139 and 140: Rotarex - fragmentation
Page 141 and 142: Cavography Left iliofemoral thrombo
Page 143 and 144: Procedure pics
Page 145 and 146: Residual clots in filter
Page 147 and 148: Result after stents placement Smart
Page 149 and 150: Dialysis graft occlusion
Page 151 and 152: 3,8 mg rt-PA
Page 153 and 154: Chronic occlusion
Page 155: Basic CEAP classification of chroni
Page 160 and 161: Wallstent 14 x 60 mm Wallstent 12 x
Page 162: CTF
Page 165 and 166: 12 mm x 4 cm
Page 167 and 168: Wallstent 14 mm x 6 cm 18 mm x 9 cm
Page 169 and 170: ILIAC VEIN COMPRESSION SYNDROME = M
Page 171: ILIAC VEIN COMPRESSION SYNDROME = M
Page 174 and 175: Case Aplasia VCI lTL 1 mg rt-PA/h
Page 176 and 177: CTF after 3 days
Page 178 and 179: Case Balloon 12 x 40 mm
Page 183 and 184: CONCLUSION Catheter-directed throm
Page 185 and 186: CONCLUSION Any hemodynamically sig
Page 187: Endovascular treatment of massive p
Page 191 and 192: PTD (Roček M, et al. Eur Radiol 19
Page 193 and 194: TIPS - Transjugular intrahepatic po
Page 195 and 196: Clinical TIPS 1988 G. Richter
Page 197 and 198: TIPS
Page 199 and 200: TIPS + embolization
Page 201 and 202: TIPS
Page 203 and 204: Coils = many types and sizes are av
Page 205 and 206: non-detachable coils detachable co
Page 207 and 208: Indications peripheral arterial an
Page 209 and 210: Catheters Diagnostic catheters (4,
Page 211: Peripheral Hydrocoil It is offering
Page 216 and 217: OCCLUDERS Amplatzer septal occlude
Page 218 and 219: Amplatzer vascular plugs A single d
Page 220 and 221: efore after cause: hemodialysis cat
Page 222: A-V V pulmonary malformation after
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Vascular intervention

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