Comparison of catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy for subacute iliofemoral deep vein thrombosis. (September 2020)

• Record Type: Journal Article
• Authors: Xu, Yi-Ding; Zhong, Bin-Yan; Yang, Chao; Cai, Xu-Sheng; Hu, Bo; Wang, Xiao-Yun; Fan, Bao-Rui; Jin, Yong-Hai; Ni, Cai-Fang; Duan, Peng-Fei
• Is Part Of: Phlebology. Volume 35:Number 8(2020)
• Page Start: 589
• Page End: 596
• Publication Date: 2020-09
• Subjects: Subacute -- iliofemoral -- deep vein thrombosis -- percutaneous mechanical thrombectomy -- catheter-directed thrombolysis; Veins -- Diseases -- Periodicals; 616.14
• DOI: 10.1177/0268355520919201
• Languages: English
• ISSNs: 0268-3555

Abstract

Objective: To evaluate and compare the treatment efficacy and safety between catheter-directed thrombolysis monotherapy and catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy for patients with subacute iliofemoral deep vein thrombosis. Methods: We conducted a retrospective analysis of a total of 74 subacute iliofemoral deep vein thrombosis patients who underwent catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy. Patients treated with catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy (percutaneous mechanical thrombectomy group, n = 30) or catheter-directed thrombolysis monotherapy (catheter-directed thrombolysis group, n = 44) were included. The primary endpoints were the clinical efficacy rate of thrombolysis, primary patency, and the incidence of post-thrombotic syndrome (at 12 months diagnosed according to the original Villalta score criteria. Secondary endpoints were the total urokinase dose, the thrombolysis time, the detumescence rate and complications. Results: The percentage of successful thrombolysis for percutaneous mechanical thrombectomy group was higher than that for catheter-directed thrombolysis group ( P = 0.045). At the 12-month follow-up, there was no difference in the primary patency ( P > 0.05) or the incidence of post-thrombotic syndrome ( P = 0.36). Percutaneous mechanical thrombectomy group had significant advantages in reducing urokinase doses and thrombolysis times compared with catheter-directed thrombolysis group for patients with thrombus clearance levels II and III ( P < 0.05). Conclusion: Catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy performs better in removing vein thrombi, reducing urokinase doses, and shortening thrombolysis times.