J Korean Surg Soc.  2004 Aug;67(2):135-141.

Catheter-directed Thrombolysis with Urokinase in Deep Venous Thrombosis

• Lee J
• Kim J
• Lee K
• Ha J
• Chung J
• Park J
• Kim SJ

Abstract

PURPOSE
To evaluate the efficacy of catheter-directed thrombolysis in treating symptomatic deep venous thrombosis (DVT) in lower limbs. METHODS: Between Jan. 1999 and Dec. 2002, 29 consecutive patients with DVT had received thrombolytic therapy. The male: female ratio was 6: 23 and the mean age was 50.3+/-13.5 years. The mean duration of symptom was 9.9+/-22.1 days. Catheter-directed infusions of urokinase were administrated via ipsilateral popliteal veins and the angioplasty and stent placement performed after the thrombolytic procedure. The mean dosage of urokinase and duration of thrombolysis were 2, 435, 000+/-887, 000 units and mean duration of thrombolysis was 36.8+/-17.9 hours. Oral medication of warfarin continued at least six months or more. To evaluate the venous patency, duplex ultrasonography or CT venography were performed. RESULTS: Lysis was complete in 17 patients (58.6%, all acute DVT), partial in 11 (37.9%), with only one patient failing. Iliac vein stenosis had shown in 16 patient after thrombdysis. Which were treated with balloon angioplasty and stent insertion. As a postprocedural complication, vaginal bleeding occurred in two patients; one was treated with transfusion but the other stopped without treatment. CONCLUSION: Catheter-directed thrombolysis with urokinase is effective for the treatment of DVT in lower limbs. However further study will be reguired to evaluate the relationship between the incidence of postthrombotic syndrome and thrombolytic therapy alone.

Keyword

Deep vein thrombosis; Thrombolysis; Urokinase

MeSH Terms

Angioplasty
Angioplasty, Balloon
Constriction, Pathologic
Female
Humans
Iliac Vein
Incidence
Lower Extremity
Male
Phlebography
Popliteal Vein
Postthrombotic Syndrome
Stents
Thrombolytic Therapy
Ultrasonography
Urokinase-Type Plasminogen Activator*
Uterine Hemorrhage
Venous Thrombosis*
Warfarin
Urokinase-Type Plasminogen Activator
Warfarin