Risks and benefits of transcatheter thrombolytic therapy in patients with splanchnic venous thrombosis

SummaryTranscatheter local thrombolytic therapy in patients with acute, extended splanchnic venous thrombosis is controversial. Here we present our single-center experience with transcatheter thrombolytic therapy in these patients. All consecutive patients (n=12) with acute,extended splanchnic venous thrombosis who underwent transcatheter thrombolytic therapy in our hospital, were included in this study. Thrombolytic therapy was successful for three thrombotic events and partially successful for four thrombotic events.Two patients developed minor procedure-related bleeding (17%).Six patients (50%) developed major procedure-related bleeding, with a fatal outcome in two. Transcatheter thrombolytic therapy in patients with acute, extended splanchnic vein thrombosis is found to be associated with a high rate of procedure-related bleeding. Therefore, thrombolysis should be reserved for patients in whom the venous flow cannot be restored by using conventional anticoagulant therapy or stent placement across the thrombosed vessel segment.H.L.A. Janssen and F.W.G. Leebeek are both Clinical Fellows of the Netherlands Organisation for Scientific Research (NWO).

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Endovascular Local Thrombolytic Therapy of Ileofemoral and Inferior Caval Vein Thrombosis

Seminars in Vascular Medicine ◽

10.1055/s-2001-14549 ◽

2001 ◽

Vol 01 (01) ◽

pp. 123-128 ◽

Cited By ~ 12

Author(s):

Raymond Verhaeghe ◽

Geert Maleux

Keyword(s):

Thrombolytic Therapy ◽

Caval Vein ◽

Vein Thrombosis ◽

Inferior Caval Vein ◽

Local Thrombolytic Therapy

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Local Thrombolytic Therapy for Primary Axillosubclavian Vein Thrombosis

JRSM Short Reports ◽

10.1258/shorts.2009.090393 ◽

2010 ◽

Vol 1 (1) ◽

pp. 1-2

Author(s):

Isabella Maund ◽

Edward Banham-Hall ◽

Robert Mallinson

Keyword(s):

Thrombolytic Therapy ◽

Vein Thrombosis ◽

Local Thrombolytic Therapy

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The risk of lower-limb superficial vein thrombosis relative to lower-limb venous thrombotic events is not increased in winter months

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519896729 ◽

2020 ◽

Vol 35 (7) ◽

pp. 533-537

Author(s):

Samir Henni ◽

Pierre Ramondou ◽

Guillaume Duval ◽

Jean Picquet ◽

Georges Leftheriotis ◽

...

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Lower Limb ◽

Homogeneous Distribution ◽

Superficial Vein ◽

Chi Square ◽

Venous Flow ◽

Vein Thrombosis ◽

Superficial Vein Thrombosis ◽

Chi Square Test

Objectives Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superficial venous thrombosis + deep venous thrombosis). Methods We retrospectively analyzed the results of venous ultrasound investigations performed among 11,739 patients (aged 67 ± 19 years old, 56.1% males) referred for suspected lower-limb thrombotic events over a 12-year period. Chi-square test was used to compare the superficial venous thrombosis/lower-limb thrombotic events ratio observed by trimesters to a homogeneous distribution. Results The proportion of lower-limb thrombotic events were 30.7%, 28.8%, 31.1%, and 31.4% (Chi2: 0.133; p = 0.987) of total investigations, while that of superficial venous thrombosis among all lower-limb venous thrombotic events were 27.2%, 30.0%, 31.4%, and 31.0%, for the first, second, third, and fourth trimesters respectively (Chi2: 0.357; p: 0.949). Conclusion No trimestral variation of the superficial venous thrombosis/lower-limb venous thrombotic events ratio was observed.

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Portal Vein Thrombosis after Laparoscopic Colectomy: Thrombolytic Therapy via the Superior Mesenteric Vein

The American Surgeon ◽

10.1177/000313480507101013 ◽

2005 ◽

Vol 71 (10) ◽

pp. 856-860 ◽

Cited By ~ 10

Author(s):

George A. Poultsides ◽

W. Cannon Lewis ◽

Robert Feld ◽

David L. Walters ◽

David A. Cherry ◽

...

Keyword(s):

Portal Vein ◽

Thrombolytic Therapy ◽

Venous Thrombosis ◽

Portal Vein Thrombosis ◽

Superior Mesenteric Vein ◽

Right Hemicolectomy ◽

Published Data ◽

Mesenteric Vein ◽

Vein Thrombosis ◽

Laparoscopic Assisted

Portal vein thrombosis is a rare but well-reported complication after laparoscopic surgery. We present a case of portomesenteric venous thrombosis that occurred 8 days after a laparoscopic-assisted right hemicolectomy. Systemic anticoagulation failed to improve symptoms. The early postoperative state precluded the use of transarterial thrombolytic therapy. Transjugular intra-hepatic catheter-directed infusion of urokinase into the superior mesenteric vein resulted in clearance of thrombus and resolution of symptoms. The published data on laparoscopy-induced splanchnic venous thrombosis and transjugular intrahepatic intramesenteric thrombolysis are discussed.

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Success Rate Of Fibrinolytic Therapy In Fresh And Old Deep Vein Thrombosis

10.1055/s-0038-1652473 ◽

1981 ◽

Author(s):

W Theiss ◽

A Wirtzfeld ◽

P Maubach

Keyword(s):

Deep Vein Thrombosis ◽

Thrombolytic Therapy ◽

Venous Thrombosis ◽

Success Rate ◽

A Priori ◽

Fibrinolytic Therapy ◽

Time Limit ◽

Vein Thrombosis ◽

The Third ◽

Deep Vein

It is still a wide-held belief that fibrinolytic therapy can clear thrombi from deep veins only while they are fresh. We have therefore analysed retrospectively the phlebographic results obtained in 85 patients, all of whom had fibrinolytic therapy for thrombosis of the iliac and/or femoral veins with symptoms present for 1 day to 8 weeks prior to treatment. Streptokinase (n=46), urokinase (n=9), or both drugs successively (n=30) were administered according to our guidelines as recently outlined in detail (Klin. Wschr. 58:521, 1980; Med. Klin. 75:580, 1980) particular emphasis being placed on sufficient duration of thrombolytic therapy with no a priori time limit.Thus, S.C. administration of heparin seems to be as efficient and safe as administration of heparin I.V. in the treatment of patients with acute DVT.The number of cases grouped according to the lenghth of their history and their respective phlebographic outcome as well as the duration of thrombolytic therapy are listed in the table.It can be seen that the success rate was good, when the patient presented with a delay of up to 2 weeks; even during the third or fourth week of the thrombotic episode two thirds of the patients could still be improved. Thereafter the results were uniformly poor.Conclusion: Iliofemoral venous thrombosis can be treated successfully with fibrinolytic drugs for much longer after its onset than is generally accepted.

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Local thrombolytic therapy for subclavian and axillary vein thrombosis. Treatment of the thoracic inlet syndrome.

Radiology ◽

10.1148/radiology.149.2.6622685 ◽

1983 ◽

Vol 149 (2) ◽

pp. 419-423 ◽

Cited By ~ 72

Author(s):

G J Becker ◽

R W Holden ◽

F E Rabe ◽

W R Castaneda-Zuniga ◽

N Sears ◽

...

Keyword(s):

Thrombolytic Therapy ◽

Axillary Vein ◽

Thoracic Inlet ◽

Vein Thrombosis ◽

Axillary Vein Thrombosis ◽

Local Thrombolytic Therapy ◽

Thoracic Inlet Syndrome

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Local Thrombolytic Therapy as Part of a Multidisciplinary Approach to Acute Axillosubclavian Vein Thrombosis (Paget-Schroetter Syndrome)

Journal of Vascular and Interventional Radiology ◽

10.1016/s1051-0443(97)70551-7 ◽

1997 ◽

Vol 8 (2) ◽

pp. 253-260 ◽

Cited By ~ 36

Author(s):

Sean R. Sheeran ◽

Michael J. Hallisey ◽

Timothy P. Murphy ◽

Robert S. Faberman ◽

Stuart Sherman

Keyword(s):

Thrombolytic Therapy ◽

Multidisciplinary Approach ◽

Vein Thrombosis ◽

Local Thrombolytic Therapy

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Evaluation of Catheter Directed Thrombolytic Therapy versus Systemic Anticoagulant Therapy of Acute Ilio-Femoral Deep Vein Thrombosis

QJM ◽

10.1093/qjmed/hcab097.049 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Samy Gamil Akhnoukh ◽

Ramez Monuir Wahba ◽

Nabil Gamal Abd Elnaser Mahmoud

Keyword(s):

Deep Vein Thrombosis ◽

Thrombolytic Therapy ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Anticoagulant Therapy ◽

Vein Thrombosis ◽

Phlegmasia Alba ◽

Venous Gangrene ◽

Deep Vein

Abstract Background Deep venous thrombosis (DVT) is a major cause of morbidity and mortality all-over the world. Complications include pulmonary embolism (PE), post-thrombotic syndrome (PTS), phlegmasia alba dolens, phlegmasia cerulea dolens and venous gangrene. The PTS is the most common cause of long-term morbidity and disability among the previous complications. Aim of the Work The aim of this work is evaluation of the regional catheter-directed thrombolytic therapy versus standard systemic anticoagulant therapy in cases of acute ilio-femoral deep vein thrombosis as regard to efficacy, safety as well as complications. Patients and Methods This study was conducted on 30 patients presented to the vascular surgery unit of Ahmed Maher Teaching Hospital between February, 2019 and August, 2019 with acute iliofemoral deep venous thrombosis (less than two weeks duration). Of the 30 patients, 18 were females and 12 were males. The age of the patients ranged between 22 and 55 years. Results The outcome results of early Follow up of the thrombolytic therapy was complete recanalization in 30.7% of the cases, partial re-canalization in 53.8% of the cases and poor recanalization in the remaining cases15.3%.While the follow up results of anticoagulant therapy was complete re-canalization in 6.7% of the cases, partial re-canalization in 60% of cases and poor recanalization in the remaining cases 33.3% Conclusion Catheter directed thrombolytic therapy using streptokinase, as a lytic agent in the treatment of acute ilio-femoral DVT is a safe and efficient technique.

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