Yonsei Med J.  2010 Mar;51(2):197-201. 10.3349/ymj.2010.51.2.197.

Catheter-Directed Thrombolysis with Conventional Aspiration Thrombectomy for Lower Extremity Deep Vein Thrombosis

• Jeon YS
• Yoon YH
• Cho JY
• Baek WK
• Kim KH
• Hong KC
• Kim JT

• KMID: 1126017
• DOI: http://doi.org/10.3349/ymj.2010.51.2.197

Abstract

PURPOSE
The purpose of this study is to evaluate treatment outcomes in patients with symptomatic deep vein thrombosis (DVT) who had undergone a catheter-directed thrombolysis with conventional aspiration thrombectomy for the treatment of lower extremity deep vein thrombosis.
MATERIALS AND METHODS
The authors retrospectively reviewed the records of 74 patients (mean age 61 +/- 15) that underwent a catheter-directed thrombolysis with conventional aspiration thrombectomy. A retrieval inferior vena cava (IVC) filter was placed to protect against a pulmonary embolism in 60 patients (81%). Stenting and balloon angioplasty were performed in 37 patients (50%) under the left common iliac vein compression.
RESULTS
Sixty-seven patients (91%) showed a clinical improvement within 48 hours, but seven patients (9%) showed no improvement. Multi detector computerized tomographic venography (MDCT venography) at discharge showed no thrombus in 15 patients (20%) and partial thrombus in 52 (70%). Twenty-eight patients (38%) developed post-thrombotic syndrome at 3.0 +/- 4.2 months postoperatively. Six patients (8%) were admitted due to DVT recurrence at a mean of 5.6 +/- 7.4 months postoperatively. Sixty-nine patients underwent follow up MDCT venography at 5.7 +/- 5.6 months. fifty (72%) of these showed no thrombus, 15 (22%) partial thrombus, and 4 (6%) showed obstruction. Twentyeight of 61 (46%) were asymptomatic, twentyeight (46%) had moderate improvement, and four (6%) were mildly improved by a telephone interview (81%) at 22.8 +/- 10.7 months postoperatively.
CONCLUSION
Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results.

Keyword

Thrombolysis; thrombectomy; deep vein thrombosis; catheter

MeSH Terms

Aged
*Catheterization
Female
Humans
Male
Middle Aged
Thrombectomy/*methods
Thrombolytic Therapy/*methods
Venous Thrombosis/*therapy

Figure

• 

  Fig. 1 MDCT angiograms showing complete thrombus removal (A), partial thrombus removal (B), and treatment failure (C). Each A-1, B-1, C-1 are in an axial view before thrombolysis at the level above the iliac vein (arrow), and A-2, B-2, C-2 are in an axial view after thrombolysis at the level of the superficial femoral vein (arrow). MDCT, multi detector computerized tomographic.

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