AngioJet rheolytic thrombectomy coupled with dose-reduced rt-PA for massive inferior vena cava filter-related thrombosis: A single-center retrospective study.
Asian J Surg
; 47(1): 263-268, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37798188
ABSTRACT
OBJECTIVE:
To evaluate the efficacy and safety of AngioJet rheolytic thrombectomy (ART) coupled with dose-reduced rt-PA, compared to catheter-directed thrombolysis (CDT) alone, for the treatment of massive inferior vena cava filter (IVCF)-related thrombosis.METHODS:
We conducted a retrospective analysis of 40 patients who received either ART or CDT alone as the first-line endovascular therapy (ET) between January, 2016 and September, 2022. The data on demographics, clinical characteristics, technical success, clinical success, complications, and early follow-up were reviewed.RESULTS:
Of the 40 included patients, 24 received ART and 16 received CDT alone. The demographics, presentation, lesion characteristics, comorbidities and risk factors were comparable (all p > .05). Technical success rates were 100% in both groups. The total CDT time and infusion agent dosage were lower in the ART group than those in the CDT group (both p < .05). At the end of CDT, clinical success was 81.8% in the ART group, which was slightly higher than that of 70.8% in the CDT group (p > .05). At the 6-month follow-up, the incidences of recurrent thrombosis in the two groups were 6.9% and 15.8%, respectively, and the incidence of post-thrombotic syndrome was 10.3% and 21.1%, respectively. However, these differences were not statistically significant (p > .05). No major complications were noted in either group, ART seemed to have slightly higher risk of transient macroscopic hemoglobinuria and recoverable acute kidney injury, but with a lower minor bleeding incidence when compared with CDT alone (4.2 vs. 31.3%, p < .05).CONCLUSIONS:
ART or CDT alone as the first-line ET for IVCF-related thrombosis has comparable outcomes but with different adverse event profiles. Both modalities are safe and effective in patients with massive IVCF-related thrombosis.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Filtros de Veia Cava
/
Trombose Venosa
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article