title: Use of the trellis device in the management of deep vein thrombosis: a retrospective single-center experience.
abstract: OBJECTIVE
  The Trellis thrombectomy system (Covidien) is one of the newer devices that incorporates isolated pharmacomechanical thrombectomy and thrombolysis (PMT) for treatment of deep venous thrombosis (DVT). We conducted a retrospective review of patients with upper- and lower-extremity DVT managed with the Trellis thrombectomy system at our center.
  
  
  METHODS
  All patients with symptomatic DVT who presented to our center between April 2010 and April 2011 who underwent PMT by the Trellis device were included in this retrospective review.
  
  
  RESULTS
  Twenty-eight patients (mean age, 46.4 ± 21.2 years) presented with symptoms with a mean duration of 1.3 ± 1.8 months. Eighty-six percent had 100% occlusion on admission, while 14.3% had 70%-90% stenosis. The mean lytic dose used was tPA 20.7 ± 12 mg. The mean Trellis treatment time was 25.1 ± 11.5 minutes. Grade 3 lysis was achieved in 23 of 28 patients (85.8%), while grade 2 lysis was achieved in 14.2%. Mean total hospital stay was 2.6 ± 2.7 days. Postprocedure symptom resolution was 100%, and there was no reocclusion in 78.6% of patients at 1 year. At 12 months, the patency rate (primary or secondary) was 80% as determined by Doppler ultrasound.
  
  
  CONCLUSIONS
  In patients with DVT involving the ilio-femoral and the upper-extremity vessels, the use of the Trellis device was associated with a high technical success rate as well as a satisfactory 12-month patency rate. Moreover, this strategy was associated with reduced lytic dose, shorter treatment time and hospital stay, and no bleeding complications.
authors.affiliation: Scripps Green Hospital, Department of Cardiology, Heart Failure Recovery and Research, 10666 North Torrey Pines Road, La Jolla, CA 92037 USA. dralichaudhry@hotmail.com
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Chaudhry
authors.forename: Reji
authors.initials: R
authors.lastname: Pappy
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hennebry
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D004864:Equipment and Supplies / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000601:surgery*