Single-session endovascular treatment for symptomatic lower extremity deep vein thrombosis: a feasibility study.
BACKGROUND
The risk of complications and discomfort in patients who undergo prolonged infusion of a thrombolytic agent is significant when conventional catheter-directed thrombolysis is used to treat lower extremity deep vein thrombosis (DVT).


OBJECTIVE
To evaluate the feasibility and safety of single-session endovascular treatment for symptomatic lower extremity DVT.


METHODS
Single-session endovascular treatment for lower extremity DVT was performed on 29 limbs in 26 patients diagnosed with acute DVT in our institution. Nine patients were male and 17 female, with a mean age of 64 years (range 28-82 years). At 5-10 min after the locoregional injection of the thrombolytic agent (urokinase) via a 5-Fr catheter to soften the thrombus, aspiration thrombectomy was performed with a large-bore sheath. In patients with an underlying anatomical stenosis or obstruction, combined angioplasty with or without stent placement was performed immediately after the complete removal of the thrombus. We then evaluated the technical and clinical outcomes of the procedure, along with any complications or recurrences of DVT.


RESULTS
Technical success was achieved in 24 procedures (82.8%) of single-session endovascular treatment for lower extremity DVT, and clinical success was achieved in 22 (75.9%) of these single-session procedures. Additional catheter-directed thrombolysis procedures were performed on five limbs after repeated aspiration thrombectomies failed to completely remove thrombi in those limbs. Stenotic or occlusive lesions were revealed in 24 limbs and percutaneous angioplasty procedures with or without stent placement were performed in these cases. No major complications resulted from the procedure.


CONCLUSIONS
Single-session endovascular treatment is a feasible technique that provides acceptable technical and clinical success with excellent safety for treating symptomatic lower extremity DVT.
Kim
Byung Joon
BJ
Department of Radiology, Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
Chung
Hwan Hoon
HH
Lee
Seung Hwa
SH
Je
Bo Kyung
BK
Lee
Young Heon
YH
Seo
Bo Kyoung
BK
Kim
Baek Hyun
BH
Cha
Sang Hoon
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods; D003251:Constriction, Pathologic / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012965:Sodium Chloride / Q000008:administration & dosage; D015607:Stents; D013396:Suction / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*
D005343:Fibrinolytic Agents; D012965:Sodium Chloride; D014568:Urokinase-Type Plasminogen Activator