EKOS™ ultrasound - accelerated catheter - directed thrombolysis for acutely occluded femoro-popliteal graft.

Acute limb ischemia due to bypass thrombotic occlusion may occur in patients with poor collateral circulation. It constitutes a medical emergency with increased morbidity, mortality and risk for limb amputation. Although the management of acute limb ischemia due to native artery occlusion is well studied, the optimal approach of acute bypass graft failure resulting in acute limb ischemia is uncertain. We present a case of acute limb ischemia in a patient with femoro-femoral and femoro-popliteal graft who presented with acute limb ischemia due to acute thrombotic occlusion of his femoro-popliteal graft. The patient was successfully managed with ultrasound-enhanced catheter-directed thrombolysis using the EkoSonic® endovascular system with excellent clinical and angiographic results. To our knowledge this is the first published report of the use of the EkoSonic® system for this indication.