title: Early Outcomes of Pharmacomechanical Thrombectomy in Acute Deep Vein Thrombosis Patients.
abstract: BACKGROUND
  Acute lower extremity deep vein thrombosis (DVT) occurs due to obstruction of large veins by thrombus and its clinical findings are pain and swelling. If not treated, it can cause morbidity and mortality. Oral warfarin or low molecular weight heparin are applied in traditional treatment. However, recently, endovascular procedures have gained increasing popularity in deep vein thrombosis. In this study we aimed to compare our early results of pharmacomechanical thrombectomy (PMT) versus oral anticoagulation for acute deep vein thrombosis.
  
  
  METHODS
  We comprised 50 patients presented with acute DVT between January 2013 and June 2014, who received either adjusted subcutaneous low molecular weight heparin (LMWH) or PMT followed by intravenous unfractionated heparin (UFH) for 5 days. Warfarin was administered to PMT patients for 3 months and at least 6 months for the control group.
  
  
  RESULTS
  Median follow-up was 14 months (6-18 months). Recanalization within 6 months was found in 84.0%, femoral venous insufficiency was found in 36.0%, and postthrombotic syndrome (PTS) was found in 28.0% of the patients who received PMT treatment. The mean duration of symptoms was 11.0 days (range, 3-20 days). The mean duration of the procedure was 78.1 minutes (range, 55-100 min).
  
  
  CONCLUSIONS
  In contrast to medical therapy in the treatment of deep vein thrombosis, usage of catheter-directed thrombolysis experienced early recanalization with higher thrombus resolution. PMT with adjunctive thrombolytic therapy is an effective treatment modality in patients with significant DVT. Also, early thrombus removal in patients with acute DVT prevents development of postthrombotic morbidity. We believe that the efficacy and usage will increase with the experience of surgeons in the future.
authors.affiliation: Cardiovascular Surgery Department, Antakya State Hospital, Antakya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ezelsoy
authors.affiliation: Internal Medicine Department, Istanbul University, Istanbul, Turkey.
authors.forename: Gorkem
authors.initials: G
authors.lastname: Turunc
authors.affiliation: Cardiovascular Surgery Department, Istanbul Mehmet Akif Ersoy Hospital, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Bayram
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D061185:Mechanical Thrombolysis; D008875:Middle Aged; D012189:Retrospective Studies; D020246:Venous Thrombosis / Q000188:drug therapy / Q000628:therapy*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin; D006493:Heparin