Year 2015 Vol. 23 No 2

EXCHANGE OF EXPERIENCE

E.V. MISHENINA

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,
Ukraine

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.

Keywords: deep vein thrombosis, lower extremities, ultrasonography, thrombolysis, anticoagulation, post-thrombotic syndrome, recurrence
p. 231-236 of the original issue
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Address for correspondence:
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,
e-mail: dr.mishenina@gmail.com
Mishenina Ekaterina Vladimirovna
Information about the authors:
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.
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