A new method for aggressive management of deep vein thrombosis: retrospective study of the power pulse technique.
Failure to treat deep vein thrombosis (DVT) is associated with significant morbidity and mortality. Anticoagulation, although effective at preventing clot progression, is not able to prevent postthrombotic syndrome. Catheter-directed thrombolysis is a more aggressive alternative, with some small studies suggesting a better long-term outcome, but the associated risks are significant, and the treatment can require 2-3 days in a monitored setting. This report describes the power pulse technique, in which mechanical thrombectomy is combined with thrombolytic agents to maximize the effectiveness of the treatment and reduce the need for prolonged infusion and its associated risks. A 24-patient retrospective study showed complete thrombus removal (>90%) in 12 patients, substantial thrombus removal (50%-90%) in seven patients, and partial thrombus removal (<50%) in five patients. All 24 patients had resolution of presenting symptoms. Only two patients required blood transfusion, and one patient experienced temporary nephropathy.
Cynamon
Jacob
J
Department of Radiology, Division of Vascular Radiology, Montefiore Medical Center, University Hospital for the Albert Einstein College of Medicine, 111 East 210th Street, Bronx, New York 10467-2490, USA.
Stein
Evan G
EG
Dym
R Joshua
RJ
Jagust
Marcy B
MB
Binkert
Christoph A
CA
Baum
Richard A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein; D011186:Postphlebitic Syndrome / Q000517:prevention & control; D011677:Punctures; D019233:Retreatment; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D020246:Venous Thrombosis / Q000628:therapy*