Pharmacomechanical thrombectomy of upper extremity deep vein thrombosis.
BACKGROUND
This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the treatment of upper extremity deep vein thrombosis (UEDVT).


METHODS
We conducted a prospective, observational cohort study of consecutive patients with acute UEDVT with low-dose UACDT using the Ekosonic® Endovascular System (EKOS Corporation, Bothell, WA, USA) at a single center from September 2012 until October 2014. Overall, sixteen patients (11 males and 6 females, age range 18 to 70 years, mean age, 45.6 years) were included in the study protocol. The primary efficacy outcome was complete thrombus clearance. The primary safety outcomes were recurrence of thrombosis within the follow-up visit and major bleeding within 96 hours of the procedure initiation.


RESULTS
The median tissue plasminogen activator (tPA) dose for all patients in our study was 16.81±2.51 mg (range 15 to 28 mg) and the median infusion time was 15 hours. Complete thrombus clearance was achieved in 11 (68.8%) patients, and partial clearance was detected in 3 (18.8%) patients. Of 16 patients with UEDVT, two had gastrointestinal bleeding, and two had puncture site bleeding.


CONCLUSIONS
This prospective study demonstrates effectiveness and safety of ultrasound accelerated thrombolysis in patients with UEDVT.
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey - evrenozcinar@gmail.com.
Evren
E
Ozcinar
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Nur D
ND
Yaman
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Mehmet
M
Cakici
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Cagdas
C
Baran
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
M Bahadir
MB
Inan
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Serkan
S
Durdu
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Ruchan
R
Akar
Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey.
Mustafa
M
Sirlak
D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D061185:Mechanical Thrombolysis; D008875:Middle Aged; D054070:Postthrombotic Syndrome / Q000517:prevention & control; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014421:Turkey; D018084:Ultrasonography, Interventional; D056824:Upper Extremity Deep Vein Thrombosis / Q000150:complications* / Q000628:therapy*; D014654:Vascular Patency; D055815:Young Adult
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator