Early clinical outcomes of a novel rheolytic directional thrombectomy technique for patients with iliofemoral deep vein thrombosis.

Dopheide, Jörn F.; Sebastian, Tim; Engelberger, Rolf P; Haine, Axel; Kucher, Nils (2018). Early clinical outcomes of a novel rheolytic directional thrombectomy technique for patients with iliofemoral deep vein thrombosis. Vasa - European journal of vascular medicine, 47(1), pp. 56-62. Huber 10.1024/0301-1526/a000666

[img]
Preview
Text
0301-1526_a000666.pdf - Published Version
Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC).

Download (164kB) | Preview

BACKGROUND Rheolytic thrombectomy (RT) for acute iliofemoral deep vein thrombosis (DVT) with first-generation techniques is often incomplete and adjunctive conventional catheter-directed thrombolysis (CDT) is required in more than half of patients to achieve venous patency. PATIENTS AND METHODS From the prospective Bern Venous Stent Registry, we investigated rates of primary treatment success, primary patency, and post-thrombotic syndrome (PTS) from 40 consecutive patients (mean age 51 ± 19 years, 45 % women) with acute iliofemoral DVT, treated with a novel directional RT technology and stent placement. Overall, 24 patients were treated for native-vessel iliofemoral DVT (11 with single-session RT, 13 with bail-out RT after failed CDT) and 16 for iliofemoral stent thrombosis. Pulse-spray thrombolysis (r-tPA 10 mg) was performed in 29 (73 %) patients. The mean follow-up duration was 193 ± 132 days (minimum 90 days). RESULTS Overall, primary treatment success of RT was 95 %; only two patients required adjunctive CDT to restore patency. In 24 patients with native-vessel DVT, six-month primary patency was 92 % (95 %CI 75-99 %), and 23 patients (96 %) were free from the PTS according to the Villalta score. In 16 patients with stent thrombosis, six-month primary patency was 63 % (95 %CI 35-85 %) and 50 % were free from PTS. Except for transient macroscopic haemoglobinuria in all patients, no other side effects were recorded. CONCLUSIONS In patients with iliofemoral DVT of native or stented vessels, RT followed by stent placement appears to be effective and safe. The novel technique enables single-session DVT treatment in the majority of patients without the need for prolonged CDT.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Dopheide, Jörn Fredrik; Sebastian, Tim and Haine, Axel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0301-1526

Publisher:

Huber

Language:

English

Submitter:

Catherine Gut

Date Deposited:

06 Apr 2018 11:44

Last Modified:

17 Dec 2019 08:28

Publisher DOI:

10.1024/0301-1526/a000666

PubMed ID:

28980513

Uncontrolled Keywords:

AngioJet ZelanteDVT Iliofemoral deep vein thrombosis catheter-directed thrombolysis post-thrombotic syndrome rheolytic thrombectomy

BORIS DOI:

10.7892/boris.108855

URI:

https://boris.unibe.ch/id/eprint/108855

Actions (login required)

Edit item Edit item
Provide Feedback