Catheter-directed thrombolysis and/or thrombectomy with selective endovascular stenting as alternatives to systemic anticoagulation for treatment of acute deep vein thrombosis |
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Authors: | Jackson La Scienya M Wang Xiu-Jie Dudrick Stanley J Gersten Gregory D |
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Institution: | Department of Surgery, St. Mary's Hospital, 56 Franklin St., Waterbury, CT 06706, USA. lascienyajackson@hotmail.com |
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Abstract: | PURPOSE: To evaluate thrombolysis and/or thrombectomy and selective endovascular stent placement in treating acute deep vein thrombosis (DVT). METHODS: During a 5-year period, 28 patients were treated with catheter-directed thrombolytics and/or thrombectomy with endovascular stent placement. Seventy-two percent (n = 20) of patients had symptoms for less < or = 14 days; 14% (n = 4) had symptoms for > 14 days. Fourteen percent (n = 4) had recurrent symptoms; 43% (n = 12) had ileofemoral DVT, and 57% (n = 16) had common femoral, superficial femoral, and/or popliteal DVT; and 11% (n = 3) had thrombus extending into the inferior vena cava. RESULTS: Eighteen percent (n = 5) of patients had complete thrombolysis of the thrombus; 72% (n = 20) had partial thrombolysis. Twenty-two stents were also placed in 12 patients. Average follow-up was 15.5 months; 80% had long-term patency. CONCLUSIONS: Catheter-directed thrombolysis and/or thrombectomy and selective stent placement are effective alternatives to systemic anticoagulation in the treatment of DVT. More studies are needed to determine specific indications and to validate long-term efficacy. |
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Keywords: | Catheter-directed thrombolysis Deep vein thrombosis Thrombectomy Venous stents |
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