Percutaneous mechanical thrombectomy for extensive acute lower-extremity deep venous thrombosis in a patient after double-lung transplantation.
Venous thromboembolism, which includes deep venous thrombosis (DVT) and pulmonary embolism (PE), has been estimated to affect 25% of patients after major surgery; however, the literature on venous thromboembolism after thoracic transplantation and optimal approach remains limited. We report the status of a 67-year-old female who developed massive right lower-extremity DVT after double-lung transplantation. Because her surgery had taken place a week before this event, it was decided that pharmaco-thrombolysis was contraindicated due to the high risk of bleeding complications in a fresh double-lung transplant recipient. The patient was taken emergently to the operating room for percutaneous mechanical thrombectomy, which provided grade III (complete lysis) and restored venous patency in the affected extremity. This report highlights the successful use of purely percutaneous mechanical thrombectomy for acute DVT in a double-lung recipient, and also advocates inferior vena cava filter placement to prevent embolic events during the mechanical thrombectomy.
Department of Cardiovascular Surgery, Methodist DeBakey Heart and Vascular Center, The Methodist Hospital Research Institute, Houston, TX 77030, USA.
Jose E
JE
Telich-Tarriba
Javier E
JE
Anaya-Ayala
Mark G
MG
Davies
Hosam F
HF
El-Sayed
D000208:Acute Disease; D000368:Aged; D005260:Female; D005268:Femoral Vein; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D061185:Mechanical Thrombolysis / Q000379:methods*; D010690:Phlebography; D011183:Postoperative Complications; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*