Erhard Starck

Percutaneous aspiration thromboembolectomy (PAT): An alternative to surgical balloon techniques for clot retrieval☆

Percutaneous aspiration thromboembolectomy (PAT) is an angiographic technique that can be used to remove thromboembolic debris from the distal lower extremity circulation. This procedure employs a specially designed catheter-sheath system, which can be used alone or in combination with balloon angioplasty or thrombolytic drugs (streptokinase 10,000 U/hr or urokinase 100,000 U/hr for 6 hours) to remove thromboembolic material. PAT is best suited for treating iatrogenic emboli resulting from intra-arterial catheterization or balloon angioplasty but can be used as a supplement to Fogarty embolectomy when retained distal clot cannot be retrieved by surgical means and for removal of primary distal emboli of peripheral vascular or cardiac origin. PAT was used in 42 patients with acute threatening limb ischemia. Successful clot retrieval and limb salvage were achieved in 40 of the 42 patients (95%). The major complication was groin hematoma (7 of 42 patients, 17%) and one death occurred as a result of myocardial infarction (2.4%). PAT enhances the therapeutic role of angiography and can be used as an alternative to surgical embolectomy in selected patients.

Road map application to the pulseless common femoral artery

There are several approaches to the catheterization of the pulseless common femoral artery. The road map technique is another approach that lends aid in juncturing the pulseless common femoral artery.

DSA evaluation of indwelling central venous catheters

Indwelling central venous catheters are widely used for the management of many disorders but have a high incidence of dislodgement, thrombosis, or occlusion. Contrast studies of these complications are hampered by difficulty injecting contrast through the catheters or peripheral veins. Use of digital subtraction angiography allows adequate visualization with small amounts of contrast and greatly facilitates the study of these catheters and the surrounding venous system.