Catheter-directed thrombolysis with conventional aspiration thrombectomy for lower extremity deep vein thrombosis.

ABSTRACT

PURPOSE: The purpose of this study is to evaluate treatment outcomes in patients with symptomatic deep vein thrombosis (DVT) who had undergone a catheter-directed thrombolysis with conventional aspiration thrombectomy for the treatment of lower extremity deep vein thrombosis. MATERIALS AND METHODS: The authors retrospectively reviewed the records of 74 patients (mean age 61 +/- 15) that underwent a catheter-directed thrombolysis with conventional aspiration thrombectomy. A retrieval inferior vena cava (IVC) filter was placed to protect against a pulmonary embolism in 60 patients (81%). Stenting and balloon angioplasty were performed in 37 patients (50%) under the left common iliac vein compression. RESULTS: Sixty-seven patients (91%) showed a clinical improvement within 48 hours, but seven patients (9%) showed no improvement. Multi detector computerized tomographic venography (MDCT venography) at discharge showed no thrombus in 15 patients (20%) and partial thrombus in 52 (70%). Twenty-eight patients (38%) developed post-thrombotic syndrome at 3.0 +/- 4.2 months postoperatively. Six patients (8%) were admitted due to DVT recurrence at a mean of 5.6 +/- 7.4 months postoperatively. Sixty-nine patients underwent follow up MDCT venography at 5.7 +/- 5.6 months. fifty (72%) of these showed no thrombus, 15 (22%) partial thrombus, and 4 (6%) showed obstruction. Twenty-eight of 61 (46%) were asymptomatic, twenty-eight (46%) had moderate improvement, and four (6%) were mildly improved by a telephone interview (81%) at 22.8 +/- 10.7 months postoperatively. CONCLUSION: Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results.