The efficacy of rotational pharmaco-mechanical thrombectomy in patients with acute iliofemoral deep vein thrombosis: Is the standard treatment of deep vein thrombosis changing?

2020 ◽  
pp. 026835552096688
Author(s):  
Orhan Rodoplu ◽  
Cenk Eray Yildiz ◽  
Didem Melis Oztas ◽  
Metin Onur Beyaz ◽  
Mustafa Ozer Ulukan ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Mechanical Thrombolysis ◽  
Multicenter Studies ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Long Term Follow Up ◽  
Thrombectomy Device ◽  
Deep Vein

Objective In this study, we aimed to evaluate the efficiency of rotational thrombectomy device in pharmaco-mechanical thrombolysis for symptomatic acute ilio-femoral deep vein thrombosis. Materials and methods Between August 2013 and May 2018,82 patients with acute deep vein thrombosis comprising the iliofemoral segment whom underwent Pharmaco-mechanical thrombolysis were evaluated retrospectively. The Cleaner thrombectomy device was used. The resolution of thrombi was examined and graded. Development of post-thrombotic syndrome was assessed with Villalta scores. Results 75 patients (91.4%) had complete thrombus resolution. Between 50–99% resolution was noted in 6 patients (7.4%) and in one (1.2%) case less than %50 thrombus resolution was obtained. Seventy-five patients (91%) of the cohort could be treated in a single session; 7 patients (8.6%) required reintervention(s). Although improved post-thrombotic syndrome rates were lower at the short term, Villalta scores gradually increased during follow up. Conclusions In conclusion, Pharmaco-mechanical thrombolysis with Cleaner thrombectomy device is a safe and beneficial method for the treatment of acute iliofemoral deep vein thrombosis. Long term follow up data of large volume multicenter studies are warranted.

Long-term follow-up of patients with suspected deep vein thrombosis of the upper extremity: survival, risk factors and post-thrombotic syndrome

2004 ◽  
Vol 15 (8) ◽  
pp. 503-507 ◽  
Author(s):  
Henk J. Baarslag ◽  
Maria M.W. Koopman ◽  
Barbara A. Hutten ◽  
May W. Linthorst Homan ◽  
Harry R. Büller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Upper Extremity ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Long Term Follow Up ◽  
Survival Risk ◽  
Deep Vein

scholarly journals Predictors of long-term post-thrombotic syndrome following high proximal deep vein thrombosis: a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Marit Engeseth ◽  
Tone Enden ◽  
Per Morten Sandset ◽  
Hilde Skuterud Wik
Keyword(s):  
Deep Vein Thrombosis ◽  
Proximal Deep Vein Thrombosis ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Younger Age ◽  
Deep Vein

Abstract Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006–09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (> 1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results Eighty-eight patients (52%) were included 8–10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93–0.99), and 1.23 (95% CI, 1.02–1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments. Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.

scholarly journals Russian Experience in Rational Thromboprophylaxis in Traumatology and Orthopaedics

2015 ◽  
pp. 36-42 ◽  
Author(s):  
S. A. Firsov ◽  
A. G. Levshin ◽  
R. P. Matveev
Keyword(s):  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Safety And Efficacy ◽  
Vein Thrombosis ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Clinically Significant ◽  
Deep Vein

Analysis of safety and efficacy of the currently marked peroral anticoagulants was performed in long term follow up of patients after large joints arthroplasty. Total number of 5025 patients after total knee arthroplasty and 5216 patients after total hip arthroplasty were examined. All patients were divided into groups depending on the prescribed anticoagulant. The course of anticoagulant therapy made up 35 days and 6 weeks after surgery, respectively. US examination of the veins of lower extremities was performed to all patients prior to and on day 5 after operation. In patients on Dabigatran the rate of clinically significant deep vein thrombosis was lower than in group of patients on Rivaroxaban and Apixaban, but the rate of postoperative hematomas in lust two groops was higher.

Midterm Outcomes of Pharmacomechanical Thrombectomy in the Treatment of Lower Extremity Deep Vein Thrombosis With a Rotational Thrombectomy Device

2017 ◽  
Vol 51 (5) ◽  
pp. 301-306 ◽  
Author(s):  
Ahmet Yuksel ◽  
Oktay Tuydes
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Postthrombotic Syndrome ◽  
Technical Success Rate ◽  
Vein Thrombosis ◽  
Rotational Thrombectomy ◽  
Thrombectomy Device ◽  
Deep Vein

Background: The purpose of this study was to assess the safety and efficacy with midterm outcomes of pharmacomechanical thrombectomy (PMT) performed by using a relatively new thrombectomy device in the treatment of lower extremity deep vein thrombosis (DVT). Methods: Between February 2014 and February 2016, a total of 46 patients with lower extremity DVT were treated with PMT by using Cleaner rotational thrombectomy system. Preprocedural, intraprocedural, postprocedural, and follow-up records of patients were collected and retrospectively analyzed. Results: Mean age of patients was 50.5 (14.8) years, and 58.7% of them were female. Technical success rate of procedure was 91.3%. Mean procedure time was 81.8 (40.3) minutes. Early clinical improvement was observed in all patients with successful treatment. No serious adverse event related to procedure and mortality was observed. Mean follow-up time was 16.0 (7.9) months. Reocclusion was observed in 7 (17.5%) patients during the follow-up period. Venous patency rates of patients at 1-, 3-, 6-, and 12-month follow-up visits were 95%, 92.5%, 89.7%, and 79.5%, respectively. Mild, moderate, and severe postthrombotic syndrome were observed in 8 (20%) patients, 4 (10%) patients, and 1 (2.5%) patient, respectively. Postthrombotic syndrome–free survival rate was 67.5%. Conclusion: Cleaner rotational thrombectomy system appears to be safe and effective in the treatment of lower extremity DVT. Further larger randomized studies are needed to determine the long-term outcomes of this treatment modality.

scholarly journals Quality of Life in Patients With Cancer Under Prolonged Anticoagulation for High-Risk Deep Vein Thrombosis: a Long-Term Follow-Up

2020 ◽  
Vol 26 ◽  
pp. 107602962091829 ◽  
Author(s):  
Mariasanta Napolitano ◽  
Maria Francesca Mansueto ◽  
Simona Raso ◽  
Sergio Siragusa
Keyword(s):  
Quality Of Life ◽  
Deep Vein Thrombosis ◽  
Anticoagulant Treatment ◽  
Vein Thrombosis ◽  
Patients With Cancer ◽  
Long Term Follow Up ◽  
Deep Vein

Current guidelines recommend to prolong anticoagulant treatment in patients with cancer with venous thromboembolism (VTE); only few studies evaluated other parameters than cancer itself for selecting patients at higher risk of recurrent VTE. Long-term management of VTE is thus challenged by several controversies mainly for patients compliance. We here report results of a long-term follow-up in patients with deep vein thrombosis under anticoagulant treatment with low-molecular-weight heparin (LMWH) for residual vein thrombosis (RVT) detected at compression ultrasonography (CUS), 6 months after standard anticoagulant treatment. Patients with RVT were deemed at high risk of recurrences and included in the current observational study. They continued LMWH (reduced at 75% standard dose) for further additional 2 years after enrolment or until death. Patients were followed up every 3 months or earlier, if needed. Among ancillary study end points, there was the assessment of patients’ quality of life during daily treatment with subcutaneous injections. Quality of life was determined by the EORTC-C30 questionnaire, administered by a skilled psychologist at enrolment and every 6 months follow-up visits. Overall, 128 patients were evaluated during follow-up. Mean global EORTC-C30 score at enrollment and at 6, 12 and 24 months follow-up were 52.1, 51.4, 50.8 and 50.1, respectively. There were no statistically significant differences between scores at enrolment and at the last available follow-up (P = .1). Long-term treatment with LMWH resulted, effective and safe, it was globally well tolerated and exempt of negative impact on quality of life of the enrolled patients. Reported results support long-term anticoagulant treatment with LMWH in cancer patients at risk of recurrent VTE.

scholarly journals Predictors of long-term post-thrombotic syndrome following high proximal deep vein thrombosis: a cross-sectional study

2020 ◽  
Author(s):  
Marit Engeseth ◽  
Tone Enden ◽  
Per Morten Sandset ◽  
Hilde Skuterud Wik
Keyword(s):  
Deep Vein Thrombosis ◽  
Proximal Deep Vein Thrombosis ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Younger Age ◽  
Deep Vein

Abstract Background Post-thrombotic syndrome (PTS) is a frequent chronic complication of proximal deep vein thrombosis (DVT) of the lower limb, but predictors of PTS are not well established. We aimed to examine predictors of PTS in patients with long-term PTS following proximal DVT. Methods During 2006-09, 209 patients with a first time acute upper femoral or iliofemoral DVT were randomized to receive either additional catheter-directed thrombolysis or conventional therapy alone. In 2017, the 170 still-living participants were invited to participate in a cross-sectional follow-up study. In the absence of a gold standard diagnostic test, PTS was defined in line with clinical practice by four mandatory, predefined clinical criteria: 1. An objectively verified DVT; 2. Chronic complaints (>1 month) in the DVT leg; 3. Complaints appeared after the DVT; and 4. An alternative diagnosis was unlikely. Possible predictors of PTS were identified with multivariate logistic regression. Results 88 patients (52%) were included 8-10 years following the index DVT, and 44 patients (50%) were diagnosed with PTS by the predefined clinical criteria. Younger age and higher baseline Villalta score were found to be independent predictors of PTS, i.e., OR 0.96 (95% CI, 0.93-0.99), and 1.23 (95% CI, 1.02-1.49), respectively. Lack of iliofemoral patency at six months follow-up was significant in the bivariate analysis, but did not prove to be significant after the multivariate adjustments.Conclusions In long-term follow up after high proximal DVT, younger age and higher Villalta score at DVT diagnosis were independent predictors of PTS.

scholarly journals Russian Experience in Rational Thromboprophylaxis in Traumatology and Orthopaedics

2015 ◽  
Vol 22 (2) ◽  
pp. 36-42
Author(s):  
S. A Firsov ◽  
A. G Levshin ◽  
R. P Matveev
Keyword(s):  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Safety And Efficacy ◽  
Vein Thrombosis ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Clinically Significant ◽  
Deep Vein

Analysis of safety and efficacy of the currently marked peroral anticoagulants was performed in long term follow up of patients after large joints arthroplasty. Total number of 5025 patients after total knee arthroplasty and 5216 patients after total hip arthroplasty were examined. All patients were divided into groups depending on the prescribed anticoagulant. The course of anticoagulant therapy made up 35 days and 6 weeks after surgery, respectively. US examination of the veins of lower extremities was performed to all patients prior to and on day 5 after operation. In patients on Dabigatran the rate of clinically significant deep vein thrombosis was lower than in group of patients on Rivaroxaban and Apixaban, but the rate of postoperative hematomas in lust two groops was higher.

scholarly journals Characteristics of Upper and Lower Extremity Deep Vein Thrombosis and Predictors of Post-Thrombotic Syndrome in Children

2021 ◽  
Author(s):  
Laura Avila ◽  
Nour Amiri ◽  
Riddhita De ◽  
Jennifer Vincelli ◽  
Eleanor M Pullenayegum ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Venous Catheter ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Early Predictors ◽  
Therapeutic Anticoagulation ◽  
Long Term Follow Up ◽  
Deep Vein

Background/aims: Our understanding of predictors of post-thrombotic syndrome (PTS) in children is evolving. The present study aimed to investigate differences in patient- and DVT-related characteristics between central venous catheter (CVC) and non-CVC-related thrombosis in children and to study early PTS predictors. Methods: Children aged 0-18 years were recruited ≥6 months after imaging-proven upper (UE) or lower extremity (LE) DVT. PTS was measured using CAPTSure©. Early predictors included age at DVT diagnosis, symptoms, DVT burden, and days on therapeutic anticoagulation within 30 days post-DVT. Analysis of predictors was stratified in CVC and non-CVC-related thrombosis. Generalized estimating equations were used for data analyses. Results: In total, 313 DVT-affected extremities of 256 patients were assessed; 275 (88%) DVT were CVC-related. Patients with non-CVC-related thrombosis were older (median 5.8 years, 25th-75th percentile 4.9-6.4 vs. 3.5 months, 25th-75th percentile 0.7-18.7, p<0.001), and had positive thrombophilia (64% vs 22%, p<0.001) and obesity (30% vs. 13%, p=0.01) more frequently than patients with CVC-related thrombosis. PTS CAPTSure© scores were 9.5 points higher (standard error 3.0, p=0.02) in the non-CVC-related thrombosis stratum. Age at the time of DVT predicted PTS in both strata; DVT burden and time from DVT diagnosis to PTS assessment predicted PTS in CVC-related thrombosis. Conclusions: PTS severity was higher in non-CVC-related than in CVC-related thrombosis. Increasing age at the time of DVT is associated with higher PTS severity. DVT burden and time from DVT diagnosis to PTS assessment are significant PTS predictors in CVC-related thrombosis, indicating that long-term follow up of these children is important.

Post-thrombotic syndrome – a position paper from European Society of Vascular Medicine

VASA ◽  
2021 ◽  
pp. 1-10
Author(s):  
Adriana Visonà ◽  
Isabelle Quere ◽  
Lucia Mazzolai ◽  
Maria Amitrano ◽  
Marzia Lugli ◽  
...  
Keyword(s):  
Adverse Event ◽  
Deep Vein Thrombosis ◽  
Venous Insufficiency ◽  
Position Paper ◽  
Vascular Medicine ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Deep Vein

Summary: Post-thrombotic syndrome (PTS) is a chronic venous insufficiency manifestation following an episode of deep-vein thrombosis (DVT). It is an important and frequent long-term adverse event of proximal DVT affecting 20–50% of patients. This position paper integrates data guiding clinicians in deciding PTS diagnosis, treatment and follow-up.

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