Role of Catheter Directed Thrombolytic Therapy in Acute Iliofemoral Deep Venous Thromboembolism
Keywords:
Iliofemoral deep venous thromboembolism DVT, catheter-directed thrombolysis CDT, recombinant tissue plasminogen activator TPAAbstract
Background: IlioFemoral Deep Venous Thromboembolism )DVT( accounts for around one-fourth of all instances of DVT . An endovascular treatment with minimally invasive procedures is catheter-directed thrombolysis CDT restoring venous patency, hastening the recovery of acute symptoms.
Objectives: to assess short term outcome of catheter directed thrombolytic therapy in acute ilioFemoral DVT treatment regarding improvement of clinical condition, assessment of benefits and hazards regarding utilizing CDT.
Methods: Clinically: evaluation of limb state tenderness, pain, edema during the hospitalized period. Radiologically: lower limb venous duplex to follow up the venous state and the time of thrombolytic therapy of the affected veins on admission and will be repeated after 1and 6 month Venography under C-arm after completion of recombinant tissue plasminogen activator (TPA) injection to follow up any residual part of DVT and assess vein patency after 2 days. Total 28 patients of acute (ilioFemoral DVT) was included in this study.
Results: This study showed that CDT is effective in treatment ilioFemoral DVT and giving better results than anticoagulant therapy. 92.6% of our patients had thrombus lysis while our bleeding complication rate of 17.9% with no mortality. Cases.
Conclusion: The early use of CDT immediately after onset of ilioFemoral DVT associated with satisfactory results in restoring normal venous patency and significant lowering post thrombotic complication
Downloads
Metrics
References
Minko P, Bücker A, Laschke M. , Menger M, Bohle R, Katoh M ; Mechanical Thrombectomy of Iliac Vein Thrombosis in a Pig Model Using the Rotarex and Aspirex Catheters . Cardiovasc Intervent Radiol (2014) 37:211–217.
AhmadGuni, Matthew Machin, Sarah Onida, Joseph Shalhoub, Alun H Davies (2021(Acute iliofemoral DVT–What evidence is required to justify catheter-directed thrombolysisPhlebology 36 (5), 339-3413. American Diabetes Association 2010
Kahn SR, Partsch H, Vedantham S, Prandoni P, Kearon c (2009) Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J ThrombHaemost. 2009;7(5):879-883.
PC Wong, YC Chan, Y Law, Stephen WK Cheng (2019) Percutaneous mechanical thrombectomy in the treatment of acute iliofemoral deep vein thrombosis: a systematic review. Hong Kong Medical Journal 25 (1), 48, 2019
Susan R Kahn, Jean-Philippe Galanaud, Suresh Vedantham, Jeffrey S Ginsberg (2016). Guidance for the prevention and treatment of the post-thrombotic syndrome,Journal of thrombosis and thrombolysis 41 (1), 144-153, 2016
Hiroaki Nakamura, Hitoshi Anzai, Makoto Kadotani (2021)Less frequent post-thrombotic syndrome after successful catheter-directed thrombolysis for acute iliofemoral deep vein thrombosisCardiovascular intervention and therapeutics 36 (2), 237-245, 2021
Petroula Nana, Efthymios Avgerinos, Konstantinos Spanos, Athanasios Giannoukas, NicosLabropoulos(2022)Gaps arising from randomized controlled trials on thrombolysis for proximal deep vein thrombosis of the lower limb .Journal of Vascular Surgery: Venous and Lymphatic Disorders 10 (1), 196-199. E2, 2022
Sharifi M, Mehdipour M, Bay C, et al. Endovenous therapy for deep venous thrombosis: the TORPEDO trial. Catheter Cardiovasc Interv. 2010;76(3):316–25
.9. Granziera S, Hasan A, Cohen AT. Direct oral anticoagulants and their use in treatment and secondary prevention of acute symptomatic venous thromboembolism. Clin Appl ThrombHemost. 2016;22(3):209–21.
Vedantham, Suresh, Samuel Z. Goldhaber, Jim A. Julian, Susan R. Kahn, Michael R. Jaff, David J. Cohen, Elizabeth Magnuson et al. "Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis." New England Journal of Medicine 377, no. 23 (2017): 2240-2252.
Enden T, Haig Y, Kløw NE, Slagsvold CE, Sandvik L, Ghanima W. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 2012;379:31–38.
Enden T, Wik HS, Kvam AK, Haig Y, Klow NE, Sandset PM. Health-related quality of life after catheter-directed thrombolysis for deep vein thrombosis: secondary outcomes of the randomised, non-blinded, parallel-group CaVenT study. BMJ Open. 2013;3:e002984. Doi: 10.1136/bmjopen-2013002984.
Vedantham, Suresh, Samuel Z. Goldhaber, Jim A. Julian, Susan R. Kahn, Michael R. Jaff, David J. Cohen, Elizabeth Magnuson et al. "Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis." New England Journal of Medicine 377, no. 23 (2017): 2240-2252.
Engelberger RP, Kucher N. Management of deep vein thrombosis of the upper extremity. Circulation. 2012;126(6):768–73
Dumantepe M, Tarhan A, Yurdakul İ, et al. US-accelerated catheter-directed thrombolysis for the treatment of deep venous thrombosis. DiagnIntervRadiol. 2013;19(3):251–8
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
