Pharmacomechanical Thrombectomy for Acute Symptomatic Lower Extremity Deep Venous Thrombosis

Background: The purpose of this study was to evaluate the efficacy and safety of pharmacomechanical thrombectomy performed by using a rotational thrombectomy device for the treatment of deep vein thrombosis. Methods: Between April 2012 and November 2014, 17 patients with acute deep vein thrombosis underwent pharmacomechanical thrombolysis. The thrombectomy device was used in a single-session technique for patients with lower-extremity deep vein thrombosis. After the procedure, the effect of thrombolysis was evaluated in 3 grades venographically. Grade I showed lysis of under 50%, and grade III showed complete lysis. Results: Ten patients (58.8%) had an iliofemoral thrombosis and 7 (41.2%) had a femoropopliteal venous thrombosis. At the end of the pharmacomechanical thrombectomy procedure, 12 patients (70%) had complete (grade III) thrombus resolution. Grade I and II lysis were noted in 2 (12%) and 3 (18%) patients, respectively. Additionally, four (23.5%) required an additional lytic infusion as a result of residual thrombi. The overall grade III, II, and I thrombus resolution rates, including the supplemental thrombolysis, were 82.2% (n = 14), 12% (n = 2), and 5.8% (n = 1), respectively. There was no mortality. Conclusion: Based on the present data, use of the Cleaner thrombectomy device may prove to be a safe and feasible single-session pharmacomechanical thrombectomy method for the treatment of acute deep vein thrombosis. To prove the effectiveness of this type treatment, a more extensive large-scale studies are needed.

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Technical Success and Short-Term Results From Mechanical Thrombectomy for Lower Extremity Iliofemoral Deep Vein Thrombosis Using a Computer aided Mechanical Aspiration Thrombectomy Device

Journal of Vascular Surgery Venous and Lymphatic Disorders ◽

10.1016/j.jvsv.2021.11.002 ◽

2021 ◽

Author(s):

Brent Robertson ◽

Evan Neville ◽

Audrey Muck ◽

Mark Broering ◽

Aaron Kulwicki ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Mechanical Thrombectomy ◽

Technical Success ◽

Short Term ◽

Aspiration Thrombectomy ◽

Vein Thrombosis ◽

Computer Aided ◽

Thrombectomy Device ◽

Deep Vein

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

Acta Radiologica ◽

10.3109/02841850903536078 ◽

2010 ◽

Vol 51 (3) ◽

pp. 248-255 ◽

Cited By ~ 14

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.

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Catheter-Directed Thrombolysis for Lower Extremity Deep Venous Thrombosis; Short Term Results of Catheter-Directed Thrombolysis for Deep Vein Thrombosis

Damar Cerrahi Dergisi ◽

10.9739/uvcd.2012-33483 ◽

2013 ◽

Vol 22 (1) ◽

pp. 124-129

Author(s):

Evren ÖZÇINAR ◽

Fatih GÖKALP

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Short Term ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Deep Vein

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

Vascular and Endovascular Surgery ◽

10.1177/1538574417708726 ◽

2017 ◽

Vol 51 (5) ◽

pp. 301-306 ◽

Cited By ~ 2

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.

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