Pharmacomechanical Thrombolysis of Symptomatic Acute and Subacute Deep Vein Thrombosis with a Rotational Thrombectomy Device |
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| Affiliation: | 1. Division of Vascular Surgery, Ankara University, Ankara;2. Department of Radiology, Ankara University, Ankara;3. Department of Cardiovaseular Surgery, Kayseri Training and Research Hospital, Kayseri;4. Department of Cardiovaseular Surgery, Kafkas University, Kars;5. Department of Cardiovaseular Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey;1. Cardiology Division, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan;2. Nursing Department, National Taiwan University Hospital Hsinchu Branch, No. 25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 300, Taiwan;3. College of Medicine, National Taiwan University, Far Eastern Memorial Hospital, Taipei, Taiwan;4. School of Medicine, National Yang-Ming University, Far Eastern Memorial Hospital, Taipei, Taiwan;5. Nuclear Medicine and Cardiovascular Center, Far Eastern Memorial Hospital, Taipei, Taiwan;1. Division of Cardiovascular Surgery, Far East Memorial Hospital, Taipei, Taiwan;2. Institute of Clinical Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan;3. Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan;4. National Defense Medical Center, Taipei, Taiwan;1. Vascular Interventional Radiology , Christiana Care Health Services, Suite 1E20, 4755 Ogletown-Stanton Rd., Newark, DE 1 3 x. ?9708;2. Department of Interventional Radiology, Mount Sinai Medical Center, New York, New York;3. Department of Interventional Cardiology, Phoenix Heart, Glendale, Arizona;4. Department of Vascular Surgery (A.A.), Reading Hospital, Reading, Pennsylvania;5. Heart and Vascular Institute (E.J.S.), Penn State Hershey Medical Center, Hershey, Pennsylvania;6. Department of Interventional Cardiology (L.R.B.), Chilton Memorial Medical Center, Pompton Plains, New Jersey;7. Department of Interventional Cardiology (P.A.S), Miriam Hospital/Rhode Island Hospital, Providence, Rhode Island. |
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| Abstract: | PurposeTo retrospectively evaluate the efficacy and safety of pharmacomechanical thrombolysis (PMT) with the use of a rotational thrombectomy device for symptomatic deep vein thrombosis (DVT).Materials and MethodsBetween July 2012 and August 2013, 41 patients with acute or subacute DVT underwent PMT. The Cleaner thrombectomy device was used in a single-session technique for patients with lower-extremity DVT. Based on contrast venography, the extent of lysis was graded from I (< 50%) to III (complete).ResultsSixteen patients (39.0%) had a femoropopliteal thrombosis and 25 (61.0%) had an iliofemoral venous thrombosis. The mean duration of symptoms was 11.0 days (range, 3–25 d). The mean quantity of tissue plasminogen activator was 20.7 mg (range, 10–50), and the mean duration of the procedure was 74.3 minutes (range, 30–240 min). At the end of the PMT procedure, 29 patients (70.7%) had complete (grade III) thrombus resolution. Grade I and II lysis were noted in one (2.4%) and 11 (26.8%) patients, respectively. Thirty-eight of the 41 patients were treated with PMT in a single session, and three (7.3%) 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 73.2% (n = 30), 22.0% (n = 9), and 4.9% (n = 2), respectively. There was no mortality.ConclusionsUse of the Cleaner thrombectomy device is a promising alternative to current treatment modalities for the management of DVT in a single session of PMT. |
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