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

Fifty-three patients were examined because of suspected deep venous thrombosis, by means of clinical examination, Doppler ultrasound and venography. Eighty-two legs were examined with all three methods. Venography was positive in 40 and normal in 42. The clinical examination was false positive in 4 legs and false negative in 6. The Doppler ultrasound studies gave false positive results in 3 legs and false negative results in 6. These results are better than those reported in the literature probably because the thrombosis extended to the popliteal vein or the more proximal veins in 38 of the 40 legs with deep vein thrombosis. This high percentage of upper leg vein thrombosis can be explained by the fact that 47 of the 53 patients were ambulant when they developed the signs and symptoms of thrombosis. It is concluded, that the clinical examination and Doppler ultrasonography can be used to diagnose deep vein thrombosis in ambulant patients in our clinic. We presume that the findings reported in the literature cannot be used indiscriminately as a basis for diagnostic strategies in other hospitals because of widely varying categories of patients, referral patterns and diagnostic criteria that are virtually impossible to standardize.

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CONTEMPORARY NATIONAL TRENDS AND OUTCOMES OF CATHETER-DIRECTED THROMBOLYSIS IN PATIENTS WITH PROXIMAL LOWER EXTREMITY DEEP VEIN THROMBOSIS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(14)62128-8 ◽

2014 ◽

Vol 63 (12) ◽

pp. A2125

Author(s):

Michael Andrew Lashner ◽

Harish Jarrett ◽

Chad Zack ◽

Huaqing Zhao ◽

Eric Choi ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Lower Extremity ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

National Trends ◽

Deep Vein

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Evaluation of Acute Deep Venous Thrombosis of the Lower Limb, Using an Automated Venous Occlusion Plethysmograph

Phlebology The Journal of Venous Disease ◽

10.1177/026835559100600407 ◽

1991 ◽

Vol 6 (4) ◽

pp. 241-248 ◽

Cited By ~ 2

Author(s):

Håkan Ahlström ◽

Stefan Nilsson ◽

Göran Hellers

Keyword(s):

Deep Vein Thrombosis ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Strain Gauge ◽

Lower Limb ◽

False Negative ◽

Venous Occlusion ◽

Vein Thrombosis ◽

Deep Vein

One-hundred-and-eleven consecutive patients who were referred for routine phlebography because of clinically suspected deep vein thrombosis (DVT) were also investigated with a new, simplified, computerized strain-gauge plethysmograph (Phlebotest, Eureka AB). An occlusion plethysmograph curve was obtained from each leg simultaneously. Four different numerical parameters were defined and determined from this curve. These parameters were correlated with the phlebographic diagnosis. Three of the parameters of the plethysmograph curve correlated well with the phlebographic diagnosis, which proved correct in 54 patients without DVT, including two false negative cases, and in 12 patients with thrombosis. In 45 patients, plethysmography alone was not sufficient to establish a diagnosis. The plethysmograph described is easy to handle and is suggested for use in selecting those patients, with or without thrombosis, who do not require supplementary phlebography.

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

Vascular ◽

10.1177/1708538119877322 ◽

2019 ◽

Vol 28 (2) ◽

pp. 177-182 ◽

Cited By ~ 2

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.

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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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