title: Single-session endovascular treatment for symptomatic lower extremity deep vein thrombosis: a feasibility study.
abstract: 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.
authors.affiliation: Department of Radiology, Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Byung Joon
authors.initials: BJ
authors.lastname: Kim
authors.forename: Hwan Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Seung Hwa
authors.initials: SH
authors.lastname: Lee
authors.forename: Bo Kyung
authors.initials: BK
authors.lastname: Je
authors.forename: Young Heon
authors.initials: YH
authors.lastname: Lee
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Seo
authors.forename: Baek Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Cha
mesh_terms: 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*
chemical_list: D005343:Fibrinolytic Agents; D012965:Sodium Chloride; D014568:Urokinase-Type Plasminogen Activator