title: Bilateral catheter-directed thrombolysis in a patient with deep venous thrombosis caused by a hypoplastic inferior vena cava.
abstract: BACKGROUND
  Deep venous thrombosis treatment using catheter-directed thrombolysis is advocated over systemic thrombolysis because it reduces bleeding complications. With the development of a catheter that combines ultrasound vibrations and the local delivering of thrombolytics, new and safer treatments appear that are suitable for more complex problems.
  
  
  METHODS
  An adolescent male presented with bilateral iliofemoral thrombosis based on a hypoplastic inferior vena cava that had existed for more than two weeks. He was successfully treated by bilateral ultrasound-accelerated catheter-directed thrombolysis using EkoSonic® (Small Vessel) Endovascular System (EKOS) and stenting of the inferior vena cava. After eight months of follow-up, the inferior vena cava is still patent.
  
  
  CONCLUSIONS
  EKOS thrombolysis of longer existing bilateral deep venous thrombosis in the central venous system is a successful treatment modality in congenital inferior vena cava anomalies.
authors: Department of General Surgery, University Medical Center, Groningen, the Netherlands.
authors: S
authors: S
authors: Sloot
authors: Department of Cardiology, Diakonessenhuis, Utrecht, the Netherlands.
authors: J Van
authors: JV
authors: Nierop
authors: Department of Trauma Surgery, University Medical Center Groningen, the Netherlands.
authors: J J
authors: JJ
authors: Kootstra
authors: Department of Vascular Surgery, UMC Maastricht, Maastricht, the Netherlands.
authors: C
authors: C
authors: Wittens
authors: Department of Vascular Surgery, Isala Klinieken, Zwolle, the Netherlands w.m.fritschy@isala.nl.
authors: W M
authors: WM
authors: Fritschy
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D007084:Iliac Vein / Q000000981:diagnostic imaging; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation / Q000379:methods*; D059408:Pain Management; D010690:Phlebography; D013163:Splenomegaly / Q000209:etiology; D015912:Thrombolytic Therapy; D018084:Ultrasonography, Interventional; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000188:drug therapy / Q000628:therapy*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014568:Urokinase-Type Plasminogen Activator
keywords: Deep venous thrombosis; EKOS; inferior vena cava anomalies; post-thrombotic stress syndrome; ultra-sound catheter-directed thrombolysis