scholarly journals Single-Session Percutaneous Mechanical Thrombectomy Using the Aspirex®S Device Plus Stenting for Acute Iliofemoral Deep Vein Thrombosis: Safety, Efficacy, and Mid-Term Outcomes

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 544
Author(s):  
Romaric Loffroy ◽  
Nicolas Falvo ◽  
Kévin Guillen ◽  
Christophe Galland ◽  
Xavier Baudot ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Mechanical Thrombectomy ◽  
Therapeutic Option ◽  
Single Session ◽  
Stent Patency ◽  
Fluid Removal ◽  
Venous Stenting ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Deep Vein

To assess the safety, efficacy and mid-term outcomes of single-session percutaneous mechanical thrombectomy (PMT) for acute symptomatic iliofemoral deep vein thrombosis (DVT) using the Aspirex®S device. Retrospective review of 30 patients (women, 23; mean age, 45.5 ± 19.9 years; range, 17–76) who underwent PMT with the 10-French Aspirex®S device (Straub Medical AG, Wangs, Switzerland) for acute DVT between December 2015 and March 2019. Procedures were performed by popliteal (n = 22) or jugular (n = 7) approach, or both (n = 1). Mean time from diagnosis to PMT was 5.5 ± 4.6 days (range, 2–11). Successful thrombus removal and venous patency restoration were achieved in all patients (100%). Fluid removal was 307.8 ± 66.1 mL (range, 190–410). Additional venous stenting rate was 100%. Mean procedural time was 107.3 ± 33.9 min (range, 70–180). No major complication occurred. The patient’s postprocedural course was uneventful in all cases, with hospital discharge within 2 days in 83.3%. Early in-stent rethrombosis occurred within 1 week in 3 patients, successfully managed by endovascular approach. Secondary stent patency rate was 86.7% at a mean follow-up of 22.3 ± 14.2 months (range, 6–48), as assessed by Duplex ultrasound. Single-session of PMT using the Aspirex®S device is a safe and effective therapeutic option in patients presenting with acute symptomatic iliofemoral DVT.

scholarly journals Treatment Failure of Venous Stenting With or Without Direct Oral Anticoagulants (DOAC) / Non-Vitamin K Oral Anticoagulants (NOACs) in Patients With Deep Vein Thrombosis (DVT) in Term of the Stent Patency: Protocol for a Systematic Review

2021 ◽  
Author(s):  
Bahram Mohebbi ◽  
Jamal Moosavi ◽  
Behshid Ghadrdoost ◽  
Ayatollah Bayatian ◽  
Hooman Bakhshandeh ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Treatment Failure ◽  
Vitamin K ◽  
Patency Rate ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Stent Patency ◽  
Venous Stenting ◽  
Vein Thrombosis ◽  
Deep Vein

Abstract Background: Venous stenting plays a significant role in the treatment of acute deep vein thrombosis (DVT). But the adjuvant anti-coagulant therapy could also help to more successful patency rate. We hope to elucidate the differences in the patency rate of venous stenting with or without direct oral anticoagulants (DOAC) / non-vitamin K oral anticoagulants (NOACs). Methods: Studies that work on the stent patency rate in venous stent with or without DOAC / NOAC will be included. The primary studies (Cohort, case control, case-series or randomized/ non-randomized trials) will be included if the participants / patients have had acute or chronic DVT, with venous stenting (at least one study group or all of study subjects) who have received DOAC / NOAC agents. The stent patency rate should be reported in all of study subjects within a follow-up time, minimum for 1 year. We will perform an electronic search on published or in press articles, which have been published in MEDLINE / PubMed, Embase, the online Cochrane database, CENTRAL and searches of clinical trial registries: clinicalTrials.gov, EU Clinical Trials, ISRCTN registry, WHO network registry for trials. PROSPERO databases will be manually searched for protocols.After screening of the relevant articles, selection and data extraction will be conducted in duplicate and independently. Methodological quality of the selected studies will be assessed using the Newcastle Ottawa Scale (NOS) tool. We will use “Hazard Ratio” (HR) as the optimum Effect Size (ES) in this meta-analysis, otherwise we will use or calculate “Risk Ratio” (RR) or “Odds Ratio” (OR) ES measures as the selected study specific ES. Discussion: In this review, we hope to find the treatment failure/ success rate of venous stenting with or without DOAC / NOAC regards to the stent patency rate and will try to provide insights into the right choice of anti-coagulant therapy.Submitted to PROSPERO (20/9/2021): CRD42021274542

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.

scholarly journals Endovascular mechanical thrombectomy versus thrombolysis in patients with iliofemoral deep vein thrombosis – a systematic review and meta-analysis

VASA ◽  
2021 ◽  
Vol 50 (1) ◽  
pp. 59-67
Author(s):  
Michael K. W. Lichtenberg ◽  
Stefan Stahlhoff ◽  
Katarzyna Młyńczak ◽  
Dominik Golicki ◽  
Paul Gagne ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Major Bleeding ◽  
Mechanical Thrombectomy ◽  
Meta Analysis ◽  
Primary Patency ◽  
Percutaneous Mechanical Thrombectomy ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Endovascular Mechanical Thrombectomy

Summary: Background: This study sought to compare effectiveness and safety of percutaneous mechanical thrombectomy (PMT) and thrombolysis alone (THR) in patients with acute or subacute iliofemoral deep vein thrombosis (IfDVT). Patients and methods: Observational and randomized trials, published between January 2001 to February 2019 were identified by searching MEDLINE. Studies on deep venous thrombosis (DVT) treated with either THR or PMT adjunctive to conventional anticoagulation and compressive intervention were included. Meta-analysis of proportions was conducted to assess effectiveness outcomes of successful lysis and primary patency, post-thrombotic syndrome (PTS), valvular reflux, recurrent DVT, as well as safety outcomes of major bleeding, hematuria, and pulmonary embolism. Results: Of 77 identified records, 17 studies including 1417 patients were eligible. Pooled proportion of successful lysis was similar between groups (THR: 95 % [I2 = 68.4 %], PMT 96 %, [I2 = 0 %]; Qbet [Cochran’s Q between groups] 0.3, p = 0.61). However, pooled proportion of 6-month primary patency was lower after THR than after PMT (68 % [I2 = 15.6 %] versus 94 %; Qbet 26.4, p < 0.001). Considerable heterogeneity within groups did not allow for between-group comparison of PTS and recurrent DVT. Major bleeding was more frequent after THR than after PMT (6.0 % [I2 = 0 %] versus 1.0 % [I2 = 0 %]; Qbet 12.3, p < 0.001). Incidence of hematuria was lower after THR as compared to PMT (2 % [I2 = 56 %] versus 91.3 % [I2 = 91.7 %]; Qbet 714, p < 0.001). Incidences of valvular reflux and pulmonary embolism were similar across groups (THR: 61 % versus PMT: 53 %; Qbet 0.7, p = 0.39 and THR: 2 % versus PMT: 1 %; Qbet 1.1, p = 0.30, respectively). Conclusions: In patients with iliofemoral DVT, percutaneous mechanical thrombectomy was associated with a higher cumulative 6-month primary patency and a lower incidence of major bleeding compared to thrombolysis alone. Risk of hemolysis from mechanical thrombectomy needs further consideration.

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