Trellis Thrombectomy System for the Treatment of Iliofemoral Deep Venous Thrombosis

2003 ◽  
Vol 10 (3) ◽  
pp. 585-589 ◽  
Author(s):  
Venkatesh Ramaiah ◽  
Peter B. Del Santo ◽  
Julio A. Rodriguez-Lopez ◽  
Ramesh G. Gowda ◽  
Paul E. Perkowski ◽  
...  
Keyword(s):  
Low Dose ◽  
Mechanical Thrombectomy ◽  
Heparin Therapy ◽  
Clot Lysis ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
System A ◽  
Catheter Directed Thrombolysis ◽  
Thrombectomy Device ◽  
Deep Vein

Purpose: To describe the use of a new percutaneous mechanical thrombectomy device to clear thrombus from the iliofemoral vein. Case Report: A 52-year-old woman with non-Hodgkin's lymphoma presented to the emergency room with a posterior tibial vein deep vein thrombosis and a greater saphenous vein thrombosis. Heparin therapy caused the clot to propagate into the iliofemoral vein. Catheter-directed thrombolysis for 36 hours with 24 units of reteplase failed to clear the clot. The Trellis Thrombectomy System, a new percutaneous mechanical thrombectomy device, was used to deliver a low dose of reteplase into the clot. Complete clot lysis was achieved in 45 minutes using only 5 units of reteplase. The patient's symptoms resolved completely, and she continues to be asymptomatic at 6 months with no evidence of residual clot on duplex scans. Conclusions: The Trellis device may be used to rapidly clear thrombus from the iliofemoral vein with a low dose of thrombolytic agent.

The Hemolysis Effect of Rotary Cutting Thrombectomy Device: The CFD and Experimental Study

2020 ◽  
Author(s):  
Xuelian Gu ◽  
Xiaoying Zhang ◽  
Xiaojian Qiu ◽  
Kang Zheng ◽  
Licheng Lu
Keyword(s):  
Mechanical Thrombectomy ◽  
Rotation Speed ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Thrombectomy Device ◽  
Computational Fluid Dynamics Cfd ◽  
Rotary Cutting ◽  
Simulation Results ◽  
Deep Vein ◽  
Hemolysis Rate

Abstract Percutaneous mechanical thrombectomy (PMT) is an efficient way to treat the deep vein thrombosis (DVT). During the course of treatment, blood cell will be destroyed by the component of thrombectomy device, causing hemolysis. In this research, the computational fluid dynamics (CFD) methodology is used to investigate hemolysis effect of rotary cutting thrombectomy device. And a prototype of rotary cutting thrombectomy device is made to carry out two corresponding experiments to verify the simulation results. CFD results indicate that the hemolysis rate increases significantly with the rise of rotation speed of cutting component. The experimental results are in good consistence with the CFD results, and shows that the longer the working time, the higher the hemolysis rate. Thus a rotation speed between 5,000 rpm and 10,000 rpm can be considered reasonable. The results can be served as a helpful guidance for the design of such thrombectomy devices.

Comparison of catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy for subacute iliofemoral deep vein thrombosis

2020 ◽  
Vol 35 (8) ◽  
pp. 589-596
Author(s):  
Yi-Ding Xu ◽  
Bin-Yan Zhong ◽  
Chao Yang ◽  
Xu-Sheng Cai ◽  
Bo Hu ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Mechanical Thrombectomy ◽  
Primary Patency ◽  
Efficacy Rate ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Catheter Directed Thrombolysis ◽  
Primary Endpoints ◽  
Deep Vein

Objective To evaluate and compare the treatment efficacy and safety between catheter-directed thrombolysis monotherapy and catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy for patients with subacute iliofemoral deep vein thrombosis. Methods We conducted a retrospective analysis of a total of 74 subacute iliofemoral deep vein thrombosis patients who underwent catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy. Patients treated with catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy (percutaneous mechanical thrombectomy group, n = 30) or catheter-directed thrombolysis monotherapy (catheter-directed thrombolysis group, n = 44) were included. The primary endpoints were the clinical efficacy rate of thrombolysis, primary patency, and the incidence of post-thrombotic syndrome (at 12 months diagnosed according to the original Villalta score criteria. Secondary endpoints were the total urokinase dose, the thrombolysis time, the detumescence rate and complications. Results The percentage of successful thrombolysis for percutaneous mechanical thrombectomy group was higher than that for catheter-directed thrombolysis group ( P = 0.045). At the 12-month follow-up, there was no difference in the primary patency ( P > 0.05) or the incidence of post-thrombotic syndrome ( P = 0.36). Percutaneous mechanical thrombectomy group had significant advantages in reducing urokinase doses and thrombolysis times compared with catheter-directed thrombolysis group for patients with thrombus clearance levels II and III ( P < 0.05). Conclusion Catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy performs better in removing vein thrombi, reducing urokinase doses, and shortening thrombolysis times.

Quantitation of Venous Clot Lysis With D-Dimer Assay During Catheter-Directed Thrombolysis for Lower Extremity Deep Venous Thrombosis

2016 ◽  
Vol 101 (9-10) ◽  
pp. 487-491 ◽  
Author(s):  
Junjie Zou ◽  
Yuanyong Jiao ◽  
Jun Jiang ◽  
Hongyu Yang ◽  
Hao Ma ◽  
...  
Keyword(s):  
Noninvasive Monitoring ◽  
Fibrinolytic Therapy ◽  
Clot Lysis ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Alternative Approach ◽  
Before And After ◽  
Potential Alternative ◽  
Deep Vein ◽  
D Dimer

This study evaluated whether D-dimer (DD) concentration analysis is a useful approach for noninvasive monitoring of clot lysis during catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT). DD levels have been found to be elevated during fibrinolytic therapy for DVT. Therefore, measuring the level of DD is a potential alternative method to assess the effect of fibrinolytic therapy. From January 2013 to March 2014, 32 patients with symptomatic acute DVT involving the iliac or femoral veins were treated using CDT. Urokinase was the thrombolytic agent. Demographics, procedural details, DD concentration, and thrombus score were recorded before and after the thrombolytic therapy. The peak DD concentration was 35.35 ± 11.18 μg/mL during CDT therapy, and the time-integrated DD concentration was 157.95 ± 69.46 μg·d/mL. The peak DD concentrations were higher in patients with substantial lysis compared with those in patients with minimal or no lysis (40 ± 0 versus 30.7 ± 14.57 μg/mL; P = 0.016). The time-integrated DD concentrations were also higher in patients with substantial lysis compared with those in patients with minimal or no lysis (194.14 ± 37.57 units versus 121.75 ± 75.93 units, P = 0.002). There was a moderate correlation (r = 0.57) between the peak DD level and the lysed clot volume. There was also a correlation between the time-integrated DD and clot lysis (r = 0.65). DD concentration analysis offers an alternative approach to noninvasive monitoring of venous clot lysis during CDT for DVT.

scholarly journals Challenging Management of a Patient With Severe Bilateral Deep Vein Thrombosis

2020 ◽  
Vol 8 ◽  
pp. 232470962091028
Author(s):  
Mohanad Hamandi ◽  
Allison T. Lanfear ◽  
Seth Woolbert ◽  
Madison L. Bolin ◽  
Joy Fan ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Management Strategy ◽  
Standard Treatment ◽  
Mechanical Thrombectomy ◽  
Anticoagulation Therapy ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

Among patients with proximal iliofemoral deep vein thrombosis (DVT) and an elevated Villalta score, anticoagulation therapy alone may not be a sufficient management strategy in select cases. In this article, we report a case of severe bilateral iliofemoral DVT that resisted the standard treatment for DVT, requiring catheter-directed thrombolysis and subsequent mechanical thrombectomy.

scholarly journals Deep vein thrombosis and our treatment applications: 12-year results

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Borulu F ◽  
◽  
Erkut B ◽  
Keyword(s):  
Quality Of Life ◽  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Mechanical Thrombectomy ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction: Deep vein thrombosis is an important health problem that is frequently encountered in the general population and especially in surgical clinics and has a negative impact on quality of life. In this study, treatment options and results of patients with deep vein thrombosis who have been hospitalized for 12 years in Atatürk University and Erzurum Regional Hospital were examined and discussed. Methods: In our clinic, 412 cases of deep vein thrombosis (211 female, 201 male) were hospitalized between 2009 and 2021. The mean age of the patients was 49 ± 19 years. While medical treatment with heparin was given to all 412 patients; thrombolytic therapy, surgical embolectomy (vascular and pulmoner), and pharmaco-mechanical thrombectomy were applied to some of these patients. Results: Deep vein thrombosis was more common in the lower extremity (n=322, 78.2%). All patients had at least one of the complaints of pain, swelling and redness. All cases were diagnosed by color Doppler ultrasonography. Medically, standard and low molecular weight heparin therapy was given to all patients after hospitalization. Thrombolytic therapy was applied to 66 (16,1%) of the cases, pulmonary embolectomy to 8 (1,9%), surgical thrombectomy to 10 (2,4%) and pharmacomechanical thrombectomy to 44 (10,7%) patients. In addition to these 120 patients (29.1%), a vena cava filter was placed for prophylactic purposes. Conclusions: In patients diagnosed with deep vein thrombosis and hospitalized, the diagnosis should be supported by Doppler ultrasound in addition to clinical diagnosis after an etiology investigation. Early diagnosis, rapid and effective treatment methods are important for the subsequent quality of life of patients. In addition to low molecular weight heparins being the first choice agents, standard heparin administration still needs to be applied in some clinical pictures. In addition, we believe that pharmacomechanical thrombectomy can be applied in appropriate acute cases. Keywords: Deep vein thrombosis; anticoagulant treatment; heparin therapy; low-molecular-weight heparin; mechanical thrombectomy.

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