Mechanical aspiration thrombectomy with catheter-directed thrombolysis for the treatment of upper extremity deep venous thrombosis: a retrospective single-center experience

2017 ◽  
Vol 28 (2) ◽  
pp. S114
Author(s):  
P Park ◽  
S Cole ◽  
J Newsome ◽  
C Gilliland ◽  
Z Bercu
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Single Center ◽  
Aspiration Thrombectomy ◽  
Single Center Experience ◽  
Catheter Directed Thrombolysis

Aspiration thrombectomy for the management of acute deep venous thrombosis in the setting of venous thoracic outlet syndrome

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 183-188
Author(s):  
Katherine Teter ◽  
Frank Arko ◽  
Patrick Muck ◽  
Patrick J Lamparello ◽  
Minhaj S Khaja ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Upper Extremity ◽  
Thoracic Outlet Syndrome ◽  
Technical Success ◽  
Aspiration Thrombectomy ◽  
Venous Involvement ◽  
Acute Thrombosis ◽  
Catheter Directed Thrombolysis

Objectives Venous thoracic outlet syndrome, known by the eponym Paget–Schroetter syndrome, is seen in healthy, young individuals with “effort-induced thrombosis.” Endovascular therapies, including catheter-directed thrombolysis, have been described in the acute management of the upper extremity deep venous thrombosis; however, we assessed the technical success of treating this entity using a mechanical aspiration thrombectomy system. Methods This was a multi-center retrospective review of patients with venous thoracic outlet syndrome with acute thrombosis treated with the Indigo continuous aspiration mechanical thrombectomy system. Charts from patients with venous thoracic outlet syndrome and acute deep venous thrombosis treated with this system at our institution along with three data sharing locations were reviewed for demographics, deep venous thrombosis risk factors, imaging modalities used for diagnosis, extent of axillosubclavian deep venous thrombosis, treatment details, adjunctive therapies, and complications. The primary outcome was technical success (resolution of >70% of thrombus). Results There were 16 patients (50% male) with a mean age of 33 years (range 17–69 years). Six patients had underlying venous thromboembolism risk factors including use of contraceptives ( n = 2), prior deep venous thrombosis ( n = 3), and known thrombophilia ( n = 1). Fifteen patients had complete venous occlusion, and the extent of venous involvement included subclavian ( n = 14), axillary ( n = 16), and brachial ( n = 7). The majority (81.25%) of patients were treated in a single setting, and technical success was achieved in all cases with the use of adjunctive therapies. Only three patients required additional overnight thrombolytic therapy. Conclusions The Penumbra Indigo system, often in combination with adjunctive catheter-directed thrombolysis and venoplasty, is a safe and effective device for the treatment of acute upper extremity deep venous thrombosis in the setting of Paget–Schroetter syndrome. No patients experienced central embolization or post-operative renal insufficiency. One-third of patients avoided any additional catheter-directed thrombolysis exposure, and technical success was achieved in all cases. A single bleeding complication was observed in a patient undergoing overnight adjunctive catheter-directed thrombolysis. All patients maintained patency until time of first rib resection.

scholarly journals Mechanical thrombectomy in deep venous thrombosis: Single center experience

2020 ◽  
Vol 27 (1) ◽  
pp. 5-9
Author(s):  
Mesut ÖZGÖKÇE ◽  
Suat İnce ◽  
HÜSEYIN AKDENIZ ◽  
Ensar TÜRKO ◽  
SAİM TÜRKOĞLU ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Mechanical Thrombectomy ◽  
Single Center ◽  
Single Center Experience

scholarly journals Preliminary results of pharmacomechanical thrombectomy for iliofemoral deep venous thrombosis: A single center experience

2018 ◽  
Vol 7 (3) ◽  
Author(s):  
Mihriban Yalcin ◽  
Eda Godekmerdan Katırcıoglu ◽  
Kamuran Erkoc ◽  
Osman Tiryakioglu
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Balloon Angioplasty ◽  
Vena Cava ◽  
Single Center ◽  
Single Center Experience ◽  
Vena Cava Filters ◽  
Thrombus Removal ◽  
The Right ◽  
Angioplasty And Stenting

Our aim is to explain follow-up in patients treated with pharmacomechanical thrombectomy (PMT) followed by balloon angioplasty for lower extremity deep venous thrombosis (DVT). A total of 19 patients who underwent PMT for DVT were included in the study. The patients underwent PMT with the Cleaner device after insertion of vena cava filters. The mean age was 45 years (range 20-56). The lesions were on the right side in nine patients and on the left side in 10 patients. Complete thrombus removal was achieved in 14 patients and the remaining five patients underwent balloon angioplasty and stenting to achieve significant patency. In conclusion, our single-center experience with short-term results suggests that PMT with the Cleaner device can be used to successfully manage acute and sub acute DVT.

Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis

2020 ◽  
Vol 35 (9) ◽  
pp. 672-678
Author(s):  
Myung Sub Kim ◽  
Hong Suk Park ◽  
Dongho Hyun ◽  
Sung Ki Cho ◽  
Kwang Bo Park ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Stent Placement ◽  
Univariate Analysis ◽  
Duplex Ultrasound ◽  
Venous Obstruction ◽  
Aspiration Thrombectomy ◽  
Post Thrombotic Syndrome ◽  
Catheter Directed Thrombolysis ◽  
Increased Risk

Objective To identify predictors of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis. Methods Fifty-two consecutive patients who underwent catheter-directed thrombolysis were included in this retrospective study. In addition to catheter-directed thrombolysis, aspiration thrombectomy or stent placement was performed if needed. At six months, duplex ultrasound was performed to assess iliofemoral patency and deep venous reflux. Post-thrombotic syndrome was assessed using the clinical, etiologic, anatomic, and pathophysiologic classification (post-thrombotic syndrome present ≥3 on a scale from 0 to 6). Univariate analysis and multivariate logistic regression were used to identify predictors of post-thrombotic syndrome. Results Median follow-up was 52 months and post-thrombotic syndrome developed in nine patients (17.3%). In univariate analysis, stent placement (odds ratio 0.16, p = 0.022) was negatively associated with post-thrombotic syndrome, whereas iliofemoral venous obstruction with reflux at six months (OR 6.08, p = 0.037) was positively associated with post-thrombotic syndrome. Multivariate analysis indicated that stent placement was associated with reduced risk of post-thrombotic syndrome (OR 0.17, p = 0.043), and iliofemoral obstruction with reflux was associated with increased risk (OR 6.67, p = 0.046). Conclusion Stent placement and iliofemoral venous obstruction with reflux, respectively, were important protective and risk factors for post-thrombotic syndrome in patients who underwent catheter-directed thrombolysis.

Single-center retrospective review of ultrasound-accelerated versus traditional catheter-directed thrombolysis for acute lower extremity deep venous thrombosis

Vascular ◽  
2017 ◽  
Vol 25 (5) ◽  
pp. 525-532 ◽  
Author(s):  
Tony Lu ◽  
Thomas M Loh ◽  
Hosam F El-Sayed ◽  
Mark G Davies
Keyword(s):  
Lower Extremity ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Primary Patency ◽  
Secondary Patency ◽  
Single Center ◽  
Kaplan Meier ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Complete Lysis

Objective Systemic anticoagulation remains the standard for acute lower extremity (LE) deep venous thrombosis (DVT), but growing interest in catheter-directed thrombolysis (CDT) and its potential to reduce the incidence of post-thrombotic syndrome (PTS) has led to advent of ultrasound-accelerated CDT (US-CDT). Few studies to date have examined the outcomes of US-CDT against traditional CDT (T-CDT). Methods This is a retrospective, single-center review of all patients treated for acute LE DVT over a five-year period with either US- and T-CDT. Patients were stratified based on demographics, presentation, co-morbidities, risk factors, and peri-procedural data. Results Seventy-six limbs in 67 patients were treated; 51 limbs in 42 patients were treated with US-CDT, and 25 limbs in 25 patients were treated with T-CDT. Adjuncts include: pharmacomechanical thrombolysis ( n = 28 vs. 20, p = 0.04), angioplasty ( n = 22 vs. 18, p = 0.11), stenting ( n = 30 vs. 6, p ≤ 0.001), and IVC filter insertion ( n = 5 vs. 0, p = 0.07). Mean lysis times were 21 ± 1.7 and 24 ± 1.8 h for US- and T-CDT, respectively ( p = 0.26). Thirty (25 ultrasound, 5 traditional) limbs had complete lysis. Thirty-one (22 ultrasound, 9 traditional) limbs had incomplete lysis. Fifteen (4 ultrasound, 11 traditional) limbs had ineffective lysis ( p = 0.002 in favor of ultrasound). Four patients (3 US-CDT, 1 T-CDT) had recurrent ipsilateral thrombosis within 30 days ( p = 0.60). By Kaplan-Meier analysis, there were no significant difference between primary patency, primary-assisted patency, secondary patency, re-thrombosis, and recurrent symptoms at 6, 12, and 24 months. Conclusion US-CDT does not significantly improve mid-term patencies but results in greater acute clot burden reduction in patients with acute LE DVTs compared to T-CDT, which may be beneficial in reducing the long-term incidence of PTS.

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