Safety, procedural success and outcome of the Aspirex®S endovascular thrombectomy system in the treatment of iliofemoral deep vein thrombosis – data from the Arnsberg Aspirex registry

VASA ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 341-346 ◽  
Author(s):  
Michael Lichtenberg ◽  
Wilhelm Friedrich Stahlhoff ◽  
Ahmet Özkapi ◽  
Rick de Graaf ◽  
Frank Breuckmann
Keyword(s):  
Deep Vein Thrombosis ◽  
Endovascular Treatment ◽  
Mechanical Thrombectomy ◽  
Clinical Severity ◽  
Short Term ◽  
Access Site Complication ◽  
Vein Thrombosis ◽  
Venous Clinical Severity Score ◽  
Thrombectomy Device ◽  
Deep Vein

Summary. Background: Percutaneous mechanical thrombectomy (PMT) represents a treatment option in addition to conventional therapy for patients with iliofemoral deep vein thrombosis (DVT). We sought to determine the safety, patency and short-term outcome of the Aspirex®S catheter as a rotational mechanical thrombectomy device in the endovascular treatment of iliofemoral DVT. Patients and methods: 56 patients (66 % female, median age 51 years) undergoing mechanical thrombectomy with the Aspirex®S catheter for endovascular treatment of iliofemoral DVT were included in the analysis. Device- and procedure-related complications, prevention of post-thrombotic syndrome (PTS) and patency rates were determined at baseline and at 1, 6 and 12 months after intervention. Results: No device-related complications or malfunction occurred. Procedure-related complications (rehospitalization, re-occlusion of target vein, prolonged hospitalization resulting from access site complication) were seen in 14 % of patients. PMT was followed by implantation of a dedicated venous stent in all patients. Low PTS reflected by a revised venous clinical severity score (rVCSS) of < 3 and a clinical, etiologic, anatomic and pathophysiologic (CEAP) score of < 3 were achieved in 64 % of the patients at 12 months. Patency was 95 % after 1 month, 94 % after 6 months and 87 % after 12 months. Conclusions: Even though long-term studies are missing, PMT of iliofemoral DVT using the Aspirex®S rotational thrombectomy device as a standalone approach exhibited an excellent patency at short term associated with substantial prevention of moderate to severe PTS and low device-related complications including bleeding.

scholarly journals Long-term recurrence of venous thromboembolism after short-term treatment of symptomatic isolated distal deep vein thrombosis: A cohort study

2017 ◽  
Vol 22 (6) ◽  
pp. 518-524 ◽  
Author(s):  
Marco P Donadini ◽  
Francesco Dentali ◽  
Samuela Pegoraro ◽  
Fulvio Pomero ◽  
Chiara Brignone ◽  
...  
Keyword(s):  
Cohort Study ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Term Treatment ◽  
Short Term ◽  
Short Term Treatment ◽  
Vein Thrombosis ◽  
Recurrent Vte ◽  
Deep Vein

Isolated distal deep vein thrombosis (IDDVT) is a common clinical manifestation of venous thromboembolism (VTE). However, there are only scant and heterogeneous data available on the long-term risk of recurrent VTE after IDDVT, and the optimal therapeutic management remains uncertain. We carried out a retrospective cohort study of consecutive patients diagnosed with symptomatic IDDVT between 2004 and 2011, according to a predefined short-term treatment protocol (low molecular weight heparin (LMWH) for 4–6 weeks). The primary outcome was the occurrence of recurrent VTE. A total of 321 patients were enrolled. IDDVT was associated with a transient risk factor or cancer in 165 (51.4%) and 56 (17.4%) patients, respectively. LMWH was administered for 4–6 weeks to 280 patients (87.2%), who were included in the primary analysis. Overall, during a mean follow-up of 42.3 months, 42 patients (15%) developed recurrent VTE, which occurred as proximal DVT or PE in 21 cases. The recurrence rate of VTE per 100 patient-years was 3.5 in patients with transient risk factors, 7.2 in patients with unprovoked IDDVT, and 5.9 in patients with cancer ( p=0.018). At multivariable analysis, unprovoked IDDVT and previous VTE were significantly associated with recurrent VTE (HR 2.16, 95% CI 1.12–4.16 and HR 1.97, 95% CI 1.01–3.86, respectively). In conclusion, the long-term risk of recurrent VTE after IDDVT treated for 4–6 weeks is not negligible, in particular in patients with unprovoked IDDVT or cancer. Further studies are needed to clarify whether a longer, but definite treatment duration effectively prevents these recurrences.

scholarly journals Diabetes and Risk of Post-Fragility Hip Fracture Outcomes in Elderly Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Wenqing Tian ◽  
Jueli Wu ◽  
Tao Tong ◽  
Lu Zhang ◽  
Aiguo Zhou ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Urinary Tract ◽  
Hip Fracture ◽  
Recovery Of Function ◽  
Diabetic Patients ◽  
Short Term ◽  
Fragility Hip Fracture ◽  
Vein Thrombosis ◽  
Tract Infections ◽  
Deep Vein

Objective. To explore the effect of diabetes on short-term (30 days after fracture) and 1-year outcomes for fragility hip fracture patients. Methods. We conducted a retrospective cohort study involving 161 diabetic hip fracture patients (older than 60 years) and 483 nondiabetic hip fracture patients. Patients were followed up on day 30 and 1 year after fracture. The short-term outcome was complications that occurred within 30 days after hip fracture and length of stay. The 1-year outcomes were postfracture functional outcomes and reduced activity level and mortality rate within 1 year after fracture. The clinical characteristics and outcomes of patients were analyzed. Results. Compared with nondiabetic patients, diabetic patients had a longer length of awaiting surgery (6.0 vs. 5.0 days, P=0.031) and a longer length of total hospital stay (17 vs. 15 days, P<0.001). Furthermore, compared with nondiabetic patients, diabetic patients have higher costs (P=0.011), in addition to being more prone to developing urinary tract infections (6.2% vs. 1.7%, P=0.002) and deep vein thrombosis (4.3% vs. 1.4%, P=0.029) complications. However, at one-year follow-up, no differences in recovery of function and mortality were observed between the two groups. Conclusions. Diabetic patients are at an increased risk of urinary tract infections and deep vein thrombosis complications but have similar recovery of function and 1-year mortality compared to nondiabetic patients.

Single-session endovascular treatment for symptomatic lower extremity deep vein thrombosis: a feasibility study

2010 ◽  
Vol 51 (3) ◽  
pp. 248-255 ◽  
Author(s):  
Byung Joon Kim ◽  
Hwan Hoon Chung ◽  
Seung Hwa Lee ◽  
Bo Kyung Je ◽  
Young Heon Lee ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Endovascular Treatment ◽  
Stent Placement ◽  
Thrombolytic Agent ◽  
Clinical Success ◽  
Single Session ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

Background: The risk of complications and discomfort in patients who undergo prolonged infusion of a thrombolytic agent is significant when conventional catheter-directed thrombolysis is used to treat lower extremity deep vein thrombosis (DVT). Purpose: To evaluate the feasibility and safety of single-session endovascular treatment for symptomatic lower extremity DVT. Material and Methods: Single-session endovascular treatment for lower extremity DVT was performed on 29 limbs in 26 patients diagnosed with acute DVT in our institution. Nine patients were male and 17 female, with a mean age of 64 years (range 28–82 years). At 5–10 min after the locoregional injection of the thrombolytic agent (urokinase) via a 5-Fr catheter to soften the thrombus, aspiration thrombectomy was performed with a large-bore sheath. In patients with an underlying anatomical stenosis or obstruction, combined angioplasty with or without stent placement was performed immediately after the complete removal of the thrombus. We then evaluated the technical and clinical outcomes of the procedure, along with any complications or recurrences of DVT. Results: Technical success was achieved in 24 procedures (82.8%) of single-session endovascular treatment for lower extremity DVT, and clinical success was achieved in 22 (75.9%) of these single-session procedures. Additional catheter-directed thrombolysis procedures were performed on five limbs after repeated aspiration thrombectomies failed to completely remove thrombi in those limbs. Stenotic or occlusive lesions were revealed in 24 limbs and percutaneous angioplasty procedures with or without stent placement were performed in these cases. No major complications resulted from the procedure. Conclusion: Single-session endovascular treatment is a feasible technique that provides acceptable technical and clinical success with excellent safety for treating symptomatic lower extremity DVT.

OP-151 Catheter-directed Thrombolysis and Endovascular Treatment in Lower Extremity Deep Vein Thrombosis

2015 ◽  
Vol 115 ◽  
pp. S66
Author(s):  
Kemal Karaarslan ◽  
Gökhan Albayrak ◽  
Burçin Abud ◽  
Mahir Yıldırım ◽  
Mustafa Karaçelik ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Endovascular Treatment ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein
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