Cüneyt Köksoy1, M Fatih Yilmaz2, H Serdar Başbuğ3, Eyüp Serhat Calik4, Bilgehan Erkut4, Mehmet Ali Kaygın4, Ahmet Peker5, Umman N Sanlıdilek5. 1. Division of Vascular Surgery, Ankara University, Ankara. Electronic address: cuneytkoksoy@hotmail.com. 2. Department of Cardiovaseular Surgery, Kayseri Training and Research Hospital, Kayseri. 3. Department of Cardiovaseular Surgery, Kafkas University, Kars. 4. Department of Cardiovaseular Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey. 5. Department of Radiology, Ankara University, Ankara.
Abstract
PURPOSE: To 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 METHODS: Between 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). RESULTS: Sixteen 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. CONCLUSIONS: Use of the Cleaner thrombectomy device is a promising alternative to current treatment modalities for the management of DVT in a single session of PMT.
PURPOSE: To 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 METHODS: Between 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). RESULTS: Sixteen 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. CONCLUSIONS: Use of the Cleaner thrombectomy device is a promising alternative to current treatment modalities for the management of DVT in a single session of PMT.
Authors: Maureen P Kohi; Ryan Kohlbrenner; Kanti P Kolli; Evan Lehrman; Andrew G Taylor; Nicholas Fidelman Journal: Cardiovasc Diagn Ther Date: 2016-12
Authors: Seung-Kee Min; Young Hwan Kim; Jin Hyun Joh; Jin Mo Kang; Ui Jun Park; Hyung-Kee Kim; Jeong-Hwan Chang; Sang Jun Park; Jang Yong Kim; Jae Ik Bae; Sun Young Choi; Chang Won Kim; Sung Il Park; Nam Yeol Yim; Yong Sun Jeon; Hyun-Ki Yoon; Ki Hyuk Park Journal: Vasc Specialist Int Date: 2016-09-30