[Endovascular treatment of acute iliofemoral deep venous thrombosis - our results with catheter-directed thrombolysis and AngioJet]

Magy Seb. 2017 Mar;70(1):24-31. doi: 10.1556/1046.70.2017.1.4.
[Article in Hungarian]

Abstract

Introduction: Most of the patients with iliofemoral thrombosis treated with anticoagulants only are affected with postthrombotic syndrome (PTS) that worsens the patients' quality of life. In the acute phase of proximal deep venous thrombosis (DVT) catheter-directed (CDT) and pharmacomechanical thrombolysis may be a reasonable alternative therapeutic method. Our aim was to summarize our results using these methods.

Methods: Since 2009 twenty-four patients with iliofemoral DVT were treated with these endovascular procedures and with stenting at our Institution.

Results: The median age of the patients was 35.83 ± 15.9 years, the female: male ratio was approximately 2:1. The mean time between the onset of the symptoms and the procedures was eleven days. CDT alone was performed in 8 patients, thrombus aspiration in addition to CDT using AngioJet device in 16 patients; in 19 cases the procedure was completed with venous stenting. During the follow-up we performed US examinations and estimated the severity of PTS by Villalta-scale. The total recanalization-rate was more than 50%, which even improved during the follow-up. The total lysis time and the amount of used recombinant tissue plasminogen activator decreased significantly by applying the AngioJet. We did not find any severe PTS among our patients during the follow-up visits.

Conclusion: Our data suggests that these methods can be used efficiently and safely in the treatment of acute iliofemoral DVT.

Keywords: catheter-directed thrombolysis; iliofemoral deep venous thrombosis; lokális katéteres lysis; pharmacomechanical thrombectomy; postthrombotic syndrome; postthromboticus szindróma; proximális mélyvénás thrombosis; thrombusaspiráció; venous stenting; vénás stent.

MeSH terms

  • Catheterization, Peripheral*
  • Endovascular Procedures / methods*
  • Female
  • Femoral Vein / diagnostic imaging
  • Femoral Vein / physiopathology
  • Femoral Vein / surgery*
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Iliac Vein / diagnostic imaging
  • Iliac Vein / physiopathology
  • Iliac Vein / surgery*
  • Male
  • Postthrombotic Syndrome / prevention & control
  • Quality of Life
  • Stents*
  • Thrombectomy
  • Thrombolytic Therapy / adverse effects*
  • Thrombolytic Therapy / methods
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*
  • Vascular Patency / drug effects
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / therapy*

Substances

  • Fibrinolytic Agents