The Catheter-Directed Endovascular Treatment of Deep Vein Thrombosis of Lower Extremity

Cho, Tae Ho; Kwon, Oh Jung; Song, Soon Yong; Lee, Jong Hoon

Abstract

PURPOSE: The current standard of treatment of deep vein thrombosis is anticoalgulation therapy. However, this treatment does not rapidly relieve the clot burden and clinical symptoms. In this article, we evaluate the results of thrombolysis and thrombectomy with selective endovascular stent placement for treating acute and chronic deep vein thrombosis (DVT). METHOD: During a 30 months period, 15 patients were treated with catheter-directed thrombolysis and thrombectomy with/or selective endovascular stent placement. 14 patients had symptoms for less than 14 days, 1 patient had symptoms for 28 days, 1 patient had recurrent symptoms and 10 patients had iliac vein stenosis. The primary end points of treatment was angiographic evidence of restoration of venous patency at completion of the procedure. Oral anticoagulation was continued for at least six month or longer.
RESULTS
All the patients were treated with catheter directed thrombolysis and thrombectomy. In addition, endovascular stent were placed in 10 patients who had proximal venous stricture, expecially in the left common iliac vein. All patients achieved complete restoration of venous patency and there was no abnormality on blood flow. One patients was retreated with thrombolysis due to remnant thrombus, 2 patients had recurrence, and they was re-treated with conventional oral anticoagulation.
CONCLUSION
Catheter-directed thrombolysis and/or thrombectomy with/or selective endovascular stent placement are effective alternatives to systemic anticoagulation for the treatment of acute and chronic DVT. More studies are needed to determine the specific indications and to validate the long-term efficacy.