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Single-session Aspiration Thrombectomy of Lower Extremity Deep Vein Thrombosis Using Large-size Catheter without Pharmacologic Thrombolysis

Authors
 Sung Il Park  ;  Myungsu Lee  ;  Mu Sook Lee  ;  Man Deuk Kim  ;  Jong Yun Won  ;  Do Yun Lee 
Citation
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.37(2) : 412-419, 2014 
Journal Title
 CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 0174-1551 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Catheters* ; Cohort Studies ; Endovascular Procedures/instrumentation* ; Endovascular Procedures/methods ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Middle Aged ; Phlebography/methods ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Suction/instrumentation ; Thrombectomy/methods* ; Thrombolytic Therapy ; Time Factors ; Treatment Outcome ; Vascular Patency/physiology ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/surgery*
Keywords
Deep vein thrombosis (DVT) ; Endovascular treatment ; Thrombectomy ; Thrombolysis ; Venous intervention
Abstract
PURPOSE: To retrospectively evaluate the efficacy of single-session aspiration thrombectomy using large catheters without pharmacologic thrombolysis to treat acute and subacute lower extremity deep vein thrombosis (DVT). METHODS: From January 2008 to December 2011, single-session aspiration thrombectomy using large, 11F introducer catheters to treat acute and subacute lower extremity DVT was performed in 74 limbs of 74 patients (M/F = 23/51, age range 36-88 years), and clinical and imaging follow-up of over 6 months were obtained in 26 patients. Causes of DVT were May-Thurner syndrome (n = 65), malignancy related (n = 6), and pelvic mass (n = 3). A 14F introducer sheath was inserted through the popliteal vein, followed by rotational thrombus maceration and aspiration thrombectomy. Angioplasty and stent placement were performed when needed. Radiological images and medical records were reviewed for immediate and midterm results, complications, and recurrences. RESULTS: Initial technical success rate was 89.2% (66 patients). Stenting was performed in 55 patients. The failures were due to underlying chronic thrombi/DVT (n = 7) and stent failure due to huge pelvic mass (n = 1). There was no procedure-related complication. In the 26 midterm follow-up patients for a duration of 6-48 months, there was no recurrence (n = 20), stent occlusion (n = 3), or femoral vein occlusion (n = 3). One-year primary patency rate in stent/iliac vein, femoral vein, and popliteal/infrapopliteal vein were 88.5, 88.5, and 96.2%, respectively. CONCLUSION: Single-session aspiration thrombectomy for acute and subacute lower extremity DVT using large introducer catheters without pharmacologic thrombolysis is feasible with acceptable immediate and midterm results, excluding complications related to pharmacologic thrombolysis.
Full Text
http://link.springer.com/article/10.1007%2Fs00270-013-0676-1
DOI
10.1007/s00270-013-0676-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100353
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