title: Pharmacomechanical thrombolysis in the management of acute inferior vena cava filter occlusion using the Trellis-8 device.
abstract: OBJECTIVE
  To evaluate the performance and safety of the Trellis-8 system, a pharmacomechanical thrombolysis infusion catheter, and adjunctive therapies in the treatment of symptomatic inferior vena cava (IVC) filter-related acute thrombotic occlusion.
  
  
  METHODS
  Eight consecutive patients (6 men; mean age 57.4 years, range 34-78 years) with acute thrombotic occlusion of the IVC in the presence of an IVC filter underwent percutaneous venous thrombectomy using the Trellis-8 thrombectomy system and adjunctive techniques between January 2009 and November 2013. Demographics, clinical data, procedures, and outcomes were retrospectively reviewed. All patients had clinical signs of lower extremity venous hypertension on presentation. The median time between IVC filter placement and occlusion was 25 months. Patients were followed for the development of thromboembolic complications to the last clinic visit or until they died.
  
  
  RESULTS
  The procedure was technically successful in 6 patients, whereas it could not be performed in 2 due to failure to cross the occlusion. The median follow-up period was 7.8 months, at which time all patients undergoing successful Trellis-8 thrombectomy had relief of symptoms without thromboembolic or bleeding complications.
  
  
  CONCLUSIONS
  In this limited performance and safety evaluation, the Trellis-8 thrombectomy system combined with adjunctive therapies, such as mechanical thrombectomy and balloon angioplasty, was effective in 75% of patients with IVC filter-related acute caval occlusion.
authors.affiliation: University of Arizona, Tucson, AZ, USA.
authors.forename: Bernardino C
authors.initials: BC
authors.lastname: Branco
authors.affiliation: University of Arizona, Tucson, AZ, USA Tucson Medical Center, Tucson, AZ, USA.
authors.forename: Miguel F
authors.initials: MF
authors.lastname: Montero-Baker
authors.affiliation: Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Espinoza
authors.affiliation: Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru.
authors.forename: Maite
authors.initials: M
authors.lastname: Gamero
authors.affiliation: Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Zea
authors.affiliation: Stonybrook Medical Center, Long Island, NY, USA.
authors.forename: Nicos
authors.initials: N
authors.lastname: Labropoulos
authors.affiliation: University of Arizona, Tucson, AZ, USA Tucson Medical Center, Tucson, AZ, USA Universidad Peruana Cayetano Heredia, San Martin de Porres, Lima, Peru lleon@pimavascular.com.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Leon
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015912:Thrombolytic Therapy / Q000379:methods; D016896:Treatment Outcome; D016306:Vena Cava Filters / Q000009:adverse effects*; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
chemical_list: D005343:Fibrinolytic Agents
keywords: IVC filter; deep vein thrombosis; endovascular treatment; inferior vena cava; occlusion; pharmacomechanical thrombolysis; thrombectomy; thrombosis