title: Pharmacomechanical thrombolysis of symptomatic acute and subacute deep vein thrombosis with a rotational thrombectomy device.
abstract: OBJECTIVE
  To retrospectively evaluate the efficacy and safety of pharmacomechanical thrombolysis (PMT) with the use of a rotational thrombectomy device for symptomatic deep vein thrombosis (DVT).
  
  
  METHODS
  Between July 2012 and August 2013, 41 patients with acute or subacute DVT underwent PMT. The Cleaner thrombectomy device was used in a single-session technique for patients with lower-extremity DVT. Based on contrast venography, the extent of lysis was graded from I (< 50%) to III (complete).
  
  
  RESULTS
  Sixteen patients (39.0%) had a femoropopliteal thrombosis and 25 (61.0%) had an iliofemoral venous thrombosis. The mean duration of symptoms was 11.0 days (range, 3-25 d). The mean quantity of tissue plasminogen activator was 20.7 mg (range, 10-50), and the mean duration of the procedure was 74.3 minutes (range, 30-240 min). At the end of the PMT procedure, 29 patients (70.7%) had complete (grade III) thrombus resolution. Grade I and II lysis were noted in one (2.4%) and 11 (26.8%) patients, respectively. Thirty-eight of the 41 patients were treated with PMT in a single session, and three (7.3%) required an additional lytic infusion as a result of residual thrombi. The overall grade III, II, and I thrombus resolution rates, including the supplemental thrombolysis, were 73.2% (n = 30), 22.0% (n = 9), and 4.9% (n = 2), respectively. There was no mortality.
  
  
  CONCLUSIONS
  Use of the Cleaner thrombectomy device is a promising alternative to current treatment modalities for the management of DVT in a single session of PMT.
authors.affiliation: Division of Vascular Surgery, Ankara University, Ankara. Electronic address: cuneytkoksoy@hotmail.com.
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Köksoy
authors.affiliation: Department of Cardiovaseular Surgery, Kayseri Training and Research Hospital, Kayseri.
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Yilmaz
authors.affiliation: Department of Cardiovaseular Surgery, Kafkas University, Kars.
authors.forename: H Serdar
authors.initials: HS
authors.lastname: Başbuğ
authors.affiliation: Department of Cardiovaseular Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey.
authors.forename: Eyüp Serhat
authors.initials: ES
authors.lastname: Calik
authors.affiliation: Department of Cardiovaseular Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Erkut
authors.affiliation: Department of Cardiovaseular Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Kaygın
authors.affiliation: Department of Radiology, Ankara University, Ankara.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Peker
authors.affiliation: Department of Radiology, Ankara University, Ankara.
authors.forename: Umman N
authors.initials: UN
authors.lastname: Sanlıdilek
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005268:Femoral Vein; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007084:Iliac Vein; D008297:Male; D008875:Middle Aged; D011152:Popliteal Vein; D012189:Retrospective Studies; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000601:surgery*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator