This journal is
indexed in Scopus
Year 2015 Vol. 23 No 2
EXCHANGE OF EXPERIENCE
EFFICACY OF CATHETER-DIRECTED THROMBOLYSIS IN TREATMENT OF PHLEBOTHROMBOSIS
SE "Institute of General and Emergency Surgery named after V.T. Zaitsev of NAMS of Ukraine", Kharkov,
Objectives. To evaluate the effectiveness of catheter-directed thrombolysis (CDT) in the treatment of patients with acute deep vein thrombosis of the lower extremities and pelvis.
Methods. The study analyzes the results of the examination and treatment of 80 patients with acute deep vein thrombosis. Patients were divided into two groups. The first group consisted of 37 patients subjected to catheter-directed thrombolysis (Streptokinase: initial dose of 250,000 IU/h, total: 1,5-3,0 IU; Alteplase: initial dose of 5 mg bolus, total: 25-75 mg.) The second group included 43 patients subjected to anticoagulant therapy (ACT) as a choice of treatment.
Results. In the patients treated by CDT application a rapid regression of the main clinical signs of acute iliofemoral venous thrombosis had been observed by the end of the first day. In ultrasound and angiographic study a complete (100%) lysis of blood clots was registered in 25 (67,6%) patients, partial lysis (from 99% to 50%) in 8 (21,6%) patients and lysis of blood clots less than 50% – in 4 (10,8%) cases. Severe hemorrhagic complications were observed in 4 (10,8%) cases, lesser – in 11 (29,7%). No various complications such as pulmonary embolism (PE) as well as lethal outcomes were noted in both groups of patients. Recurrence of venous thrombosis after CDT was observed in 2 (5,4%) patients and after ACT in 5 (11,6%) patients.
Conclusion. Restoration of patency in iliofemoral deep vein thrombosis with catheter-directed is considred to be an effective method.
- Hilper P, Kotelis D, Attigah N, Hyhlik-Dit A, Böckler D. Longterm results after surgical thrombectomy and simultaneous stenting for symptomatic iliofemoral venous thrombosis. 2010 Mar;39(3):349-55. doi: 10.1016/j.ejvs.2009.09.028
- Enden T, Kløw NE, Sandvik L, Slagsvold CE, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM; CaVenT study group.Catheter-directed thrombolysis vs. anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency. J Thromb Haemost. 2009 Aug;7(8):1268-75. doi: 10.1111/j.1538-7836.2009.03464.x.
- Savel'ev VS. /red. Flebologiia [Phlebology]. Rukovodstvo dlia vrachei. Moscow, RF: Meditsina. 2001. 664 p.
- Baekgaard N. Benefit of catheter-directed thrombolysis for acute iliofemoral DVT: myth or reality? Eur J Vasc Endovasc Surg. 2014 Oct;48(4):361-62. doi: 10.1016/j.ejvs.2014.04.032.
- Comerota AJ, Trabal JLM. Catheter-directed thrombolysis for treatment of acute deep vein thrombosis. In: ed./ Gloviczki P. Handbook of venous disorders. London: Edward Arnold Ltd. 2009:239-54. Available from: http://www.veinforum.org/patients/vein-handbook.
- Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Lamping DL, Johri M, Ginsberg JS.Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis. Ann Intern Med. 2008 Nov 18;149(10):698-707.
- Baekgaard N, Broholm R, Just S, Jørgensen M, Jensen LP. Long-term results using catheter-directed thrombolysis in 103 lower limbs with acute iliofemoral venous thrombosis. Eur J Vasc Endovasc Surg. 2010 Jan;39(1):112-7. doi: 10.1016/j.ejvs.2009.09.015.
- Engelberger RP, Fahrni J, Willenberg T, Baumann F, Spirk D, Diehm N, Do DD, Baumgartner I, Kucher N1Fixed low-dose ultrasound-assisted catheter-directed thrombolysis followed by routine stenting of residual stenosis for acute ilio-femoral deep-vein thrombosis. Thromb Haemost. 2014 Jun;111(6):1153-60. doi: 10.1160/TH13-11-0932.
61103, Ukraina, g. Harkov, v'ezd Balakireva, d. 1,
GU "Institut obschey neotlozhnoy khirurgii
im. V.T. Zaytseva NAMNU",
otdelenie ostroy patologii sosudov,
tel.: 380 50 212-48-82,
Mishenina Ekaterina Vladimirovna
Mishenina E.V. A post-graduate student of SE "Institute of General and Emergency Surgery named after V.T. Zaitsev of NAMS of Ukraine", Kharkov.