title: Catheter-directed thrombolysis of proximal lower extremity deep vein thrombosis: a prospective trial with venographic and clinical follow-up.
abstract: OBJECTIVE
  To prospectively evaluate the primary and long-term venographic and clinical results of catheter-directed thrombolysis in the treatment of proximal deep vein thrombosis (DVT) of lower extremity.
  
  
  METHODS
  Fifty-six patients with mean age of 48 (range 15-81) years with acute DVT (symptom duration of less than 2 weeks), extending to high femoral (16 patients) or iliac vein (40 patients) were treated with selective catheter-directed thrombolysis. The mean total dose of 3.8 (range 1.0-8.1) million units of urokinase was administered during a mean of 39 (range 6-72) hours. Endovascular stenting was performed in 9 of the iliac DVT patients.
  
  
  RESULTS
  Complete procedural venographic success was achieved in 79% of patients. Major complications were noted in 7% of patients and the total rate of complications was 13%. Mean venographic follow-up was 3.5 years (range 3 months to 9.6 years); well preserved femoral vein valves and fully recanalized deep crural veins were observed in 83% and 57% of patients. Normal clinical findings in the affected limb were noted during the latest follow-up visit in 67% of patients. Clinical post-thrombotic syndrome occurred in 9% of patients.
  
  
  CONCLUSIONS
  Catheter-directed thrombolysis achieves good primary success with acceptable complication rate and effectively reduces prevalence of post-thrombotic syndrome.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Digital Imaging Centre, Kuopio, Finland. hannu.manninen@kuh.fi
authors.forename: Hannu
authors.initials: H
authors.lastname: Manninen
authors.forename: Auni
authors.initials: A
authors.lastname: Juutilainen
authors.forename: Erkki
authors.initials: E
authors.lastname: Kaukanen
authors.forename: Seppo
authors.initials: S
authors.lastname: Lehto
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage; D002406:Catheterization, Peripheral; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator