scholarly journals Pharmacomechanical Catheter Directed Thrombolysis for Pregnancy Related Proximal Lower Extremity Deep Venous Thrombosis: Effectiveness in the Prevention of Post Thrombotic Syndrome

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1448-1448
Author(s):  
Galia Spectre ◽  
Allan Bloom ◽  
Batia Roth ◽  
David Varon ◽  
Yosef Kalish ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Conflicts Of Interest ◽  
First Trimester ◽  
Control Group ◽  
Study Group ◽  
Vein Thrombosis ◽  
Post Thrombotic Syndrome ◽  
Reduced Frequency ◽  
Catheter Directed Thrombolysis ◽  
Deep Vein

Abstract Pharmacomechanical catheter-directed thrombolysis (PCDT) reduces the incidence of post thrombotic syndrome (PTS) after proximal deep vein thrombosis (DVT); however its efficacy in PTS prevention for pregnancy related DVT is unknown. Most of the patients with DVT in pregnancy present with femoral or iliofemoral involvement and the prevalence after of PTS after pregnancy related DVT in the lower extermity is 42%. The purpose of this study is to compare PTS outcome in women with pregnancy related DVT with and without PCDT. Methods: Women with pregnancy related proximal (femoral/iliofemoral) DVT who underwent PCDT and anticoagulation or anticoagulation alone, were evaluated for PTS using the Villalta scale and VEINES-QOL/Sym questionnaire. Results: Eleven women with iliofemoral DVT underwent PCDT and anticoagulation, two during the first trimester and nine postpartum. Eighteen women (13 with iliofemoral DVT) were treated with anticoagulation only. There was no difference in age, number of pregnancies, trimester, duration of anticoagulation or thrombophilia between the groups. The time between DVT diagnosis and study inclusion was longer in the control group - median 50.5 (range 16-120) months , compared to study group: median 27 (range 11-64) months. None of the women in the study group developed PTS. Six of 18 patients in the control group developed PTS (33.3%) P=0.03, four of whom developed severe PTS (Villalta scale ≥15). One patient in each group developed recurrent DVT, and one patient in the study group developed a calf hematoma. A reduced frequency of lower extremity symptoms was observed in the study group by VEINES-Sym questionnaire P=0.01, but there was no difference in VEINES-QOL questionnaire (p=0.11) Conclusion: This study suggests a reduction in PTS in women with pregnancy related proximal DVT who were treated with PCDT and anticoagulation compared to women who were treated with anticoagulation alone Disclosures No relevant conflicts of interest to declare.

A case-controlled study on AngioJet rheolytic thrombectomy and catheter-directed thrombolysis in the treatment of acute lower extremity deep venous thrombosis

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Jun Zhu ◽  
Cai-Fang Ni ◽  
Zhen-Yu Dai ◽  
Li-Zheng Yao ◽  
Wen-Hui Li
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Rheolytic Thrombectomy ◽  
Thrombus Removal ◽  
The Mean ◽  
Deep Vein

Objective This study aims to compare the efficacy and safety of AngioJet rheolytic thrombectomy vs. catheter-directed thrombolysis in patients with acute lower extremity deep vein thrombosis. Methods Between the period of February 2015 and October 2016, 65 patients with documented acute lower extremity deep vein thrombosis were treated with catheter-directed intervention. These patients were divided into two groups: AngioJet group and catheter-directed thrombolysis group. Comparisons were made with regard to efficacy and safety between these two groups. Results In the AngioJet group, complete or partial thrombus removal was accomplished in 23 (72%) and 3 (9%) patients, respectively. In the catheter-directed thrombolysis group, complete or partial thrombus removal was accomplished in 27 (82%) patients and 1 (3%) patient, respectively. In the AngioJet group, the perimeter difference between the suffered limb and healthy one declined from 5.1 ± 2.3 cm to 1.4 ± 1.2 cm ( P <  0.05). In the catheter-directed thrombolysis group, the perimeter difference declined from 4.7 ± 1.6 cm to 1.5 ± 0.9 cm ( P <  0.05). The mean urokinase dose was 0.264 ± 0.135 million units in the AngioJet group and 1.869 ± 0.528 million units in the catheter-directed thrombolysis group ( P <  0.05). The duration of thrombolysis was 4.2 ± 1.7 h in the AngioJet group and 73.6 ± 18.3 h in the catheter-directed thrombolysis group ( P <  0.05). The occurrence of complications in these two groups was 19% and 18%, respectively (not significant). Conclusion AngioJet rheolytic thrombectomy is a new, safe and effective approach for treating acute lower extremity deep vein thrombosis. When compared to catheter-directed thrombolysis, this treatment provides similar success with lower urokinase dosage and shorter duration of thrombolysis.

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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