Pharmacomechanical thrombectomy for acute symptomatic lower extremity deep venous thrombosis.
BACKGROUND
The purpose of this study was to evaluate the efficacy and safety of pharmacomechanical thrombectomy performed by using a rotational thrombectomy device for the treatment of deep vein thrombosis.


METHODS
Between April 2012 and November 2014, 17 patients with acute deep vein thrombosis underwent pharmacomechanical thrombolysis. The thrombectomy device was used in a single-session technique for patients with lower-extremity deep vein thrombosis. After the procedure, the effect of thrombolysis was evaluated in 3 grades venographically. Grade I showed lysis of under 50%, and grade III showed complete lysis.


RESULTS
Ten patients (58.8%) had an iliofemoral thrombosis and 7 (41.2%) had a femoropopliteal venous thrombosis. At the end of the pharmacomechanical thrombectomy procedure, 12 patients (70%) had complete (grade III) thrombus resolution. Grade I and II lysis were noted in 2 (12%) and 3 (18%) patients, respectively. Additionally, four (23.5%) 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 82.2% (n = 14), 12% (n = 2), and 5.8% (n = 1), respectively. There was no mortality.


CONCLUSIONS
Based on the present data, use of the Cleaner thrombectomy device may prove to be a safe and feasible single-session pharmacomechanical thrombectomy method for the treatment of acute deep vein thrombosis. To prove the effectiveness of this type treatment, a more extensive large-scale studies are needed.
Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Eyup Serhat
ES
Calik
Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Ozgur
O
Dag
Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Mehmet Ali
MA
Kaygin
Department of Cardiovascular Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Oruc Alper
OA
Onk
Department of Cardiovascular Surgery, Erzincan University Medical Faculty, Erzincan, Turkey.
Bilgehan
B
Erkut
D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D061185:Mechanical Thrombolysis / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*