Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background:Despite major advances during recent years, complications in peripheral vascular interventions remain a major issue. Because angioplasty for most entities of peripheral vascular disease does not generally have a more durable result than surgical reconstruction, its use is justified mainly by its reduced risk combined with a reasonable likelihood for success. Among the most serious complications are the embolization and distal trashing, which can be a devastating complication of endovascularprocedures. It can transform a relatively straightforward procedureperformed for claudication into a complex high-risk limb salvageendeavor. Objective: Todescribe a bailout technique for the management of distal trashing/ acute thrombosis in patients undergoing angioplasty for peripheral arterialocclusive diseaseusing Tirofiban infusion and anticoagulation. Methods: This is a Nonrandomized single arm clinical trial describing a bailout technique for the management of distal trashing/ acute thrombosis in patients undergoing angioplasty for peripheral arterial occlusive disease.The study was conducted at Cairo university hospitals (KasrAlainy), vascular surgery department, in the period between April 2019 and August 2020.Forty-three patients with peripheral arterial disease undergoing angioplasty complicated; interprocedurally; by distal trashing/ acute thrombosis were included.Results: Clinical success defined asRestoration of palpable pulse or triphasic flow by duplex was met in thirty-nine (90.7%) cases. Failure cases had established non- salvageable limbs, ended by above knee amputation

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