J Korean Soc Vasc Surg.  2004 May;20(1):100-105.

Efficacy and Safety of Rotating Pigtail Catheter: Lower Extremity Deep Vein Thrombosis of May-Thurner Syndrome

• Chung KY
• Yom CK
• Lee JH
• Kang BC

Abstract

PURPOSE
The purpose of this study was to evaluate the efficacy and safety of mechanical fragmentation of iliofemoral deep vein thromboses (DVT) with rotating pigtail catheter followed by aspiration thrombectomy. METHOD: Thirteen patients (nine females, four males, 59.9+/-21.37 years old) with iliofemoral DVT underwent treatment for thirteen affected limbs. About 5~10 min after infusing 400,000~700,000 IU urokinase into the thrombosed deep veins, thromboses were fragmented by the mechanical action of the rotating pigtail catheter tip. After fragmentation of the thromboses, we aspirated the fragmented thromboses. Stent insertion or balloon angioplasty was applied if iliac vein stenosis was demonstrated after the above procedure was completed. We evaluated the total procedure time, volume of thrombolytic agent (urokinase), valvular injury, symptom-free time interval and success rate (primary patency rate). RESULT: In all 13 patients, iliofemoral DVT was successfully fragmented and aspirated using a combination method of rotating pigtail catheter and aspiration thrombectomy (clinical and technical success rate, 100%). The thromboses were declotted by rotating pigtail catheter in an average time of 5.7 minutes. Average duration of the total intervention was 108 min. Mean primary patency was about 4 months and there was no recurrence. Total UK average dose was 890,000 IU. There was no major complication such as pulmonary embolism or cerebral hemorrhage while the thrombus-fragmentation procedure was performed using rotating pigtail catheter.
CONCLUSION
The combination method of rotating pigtail catheter and aspiration thrombectomy for treatment of iliofemoral DVT achieved rapid, safe, and effective recanalization in all cases without complication. Therefore, this procedure is a potential option in patients presenting with iliofemoral vein thrombosis.

Keyword

Deep veins thrombosis; Thrombolysis; Thrombectomy

MeSH Terms

Angioplasty, Balloon
Catheters*
Cerebral Hemorrhage
Constriction, Pathologic
Extremities
Female
Humans
Iliac Vein
Lower Extremity*
Male
May-Thurner Syndrome*
Pulmonary Embolism
Recurrence
Stents
Thrombectomy
Thrombosis
Urokinase-Type Plasminogen Activator
Veins
Venous Thrombosis*
Urokinase-Type Plasminogen Activator