A new modality in the treatment of deep vein thrombosis: catheter-directed ultrasound-accelerated thrombolysis

Background To evaluate the efficacy and safety of pharmacomechanical thrombectomy using a new rotational thrombectomy device with additional thrombus-removal methods for deep venous thrombosis. Methods A total of 91 patients admitted to our tertiary center with symptomatic iliac, ilio-femoral, femoro-popliteal deep venous thrombosis and who underwent hybrid pharmacomechanical thrombectomy constituted the study group. Postinterventional color Doppler ultrasonography was repeated at 1st, 6th, and 12th months. Villalta scoring system was used to evaluate the patients for the development of post-thrombotic syndrome after deep venous thrombosis. The patient-reported severity of pain in the index leg was measured on a Likert scale. Results Of the 91 patients whose charts were reviewed, the location of thrombus was iliofemoral in 60 (65.9%) and femoropopliteal in 31 (34.1%) patients, respectively. Duration of symptoms was 5.62 ± 3.43 (range, 2–15) days. Technical success was observed in 82 patients (90.1%) at 3 months, in 77 patients (84.6%) at 6 months, and in 74 patients (81.3%) at 12 months. Villalta score was over 10 points in 15 of 17 patients whose Doppler US revealed venous occlusions, at 12 months, and in 8 patients with recurrent deep venous thrombosis. Post-thrombotic syndrome was detected in 18 patients in our study. Twelve (13.2%) of these 18 patients had mild, 5 (5.5%) moderate, and 1 (1.1%) severe PTS. In predicting predisposing factors in 18 patients with PTS, 13 patients (72.2%) had a Villalta score ≥10, 10 patients (55.6%) had experienced a delayed endovascular procedure (≥10 days), and 8 patients (44.4%) had recurrent deep venous thrombosis. Conclusion The endovenous pharmacomechanical thrombectomy with the Mantis thrombectomy device in the treatment of acute and subacute iliofemoral deep venous thrombosis is a promising approach in terms of efficacy and safety in the early period regarding reasonable and long-term prevention of post-thrombotic syndrome, development of pulmonary thromboembolism, and adequate venous system patency.

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“…However, these costly and relatively invasive procedures can be applied only to selected patients that constitute their disadvantages. 7–10…”

Section: Discussionmentioning

confidence: 99%

Initial experience with a new pharmacomechanical thrombectomy device for deep venous thrombosis: Report of 91 cases

Bozok

Tayfur

2019

Phlebology

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“…However, anticoagulation has no direct thrombolytic effect. [7] As a result, anticoagulation-based DVT treatments often do not restore the venous patency, causing permanent damage to the venous valves. [5] In addition, eventual venous stenoses are predisposed to recurrent thrombosis and may cause May-Thurner syndrome if left untreated.…”

Section: Discussionmentioning

confidence: 99%

Iliac vein perforation caused by an ultrasound-accelerated thrombolysis catheter: An unusual complication of EKOS EndoWave

Başbuğ¹

2016

Cardiovasc Surg Int

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EKOS EndoWave system is an ultrasound-accelerated catheter-directed thrombolysis device designed for the treatment of deep vein thrombosis. This system acts by emitting ultrasonic waves that enhance the diffusion of the simultaneously administered thrombolytic infusion inside the clot. EKOS operates inside the thrombosed veins and is categorized as such among the group of pharmaco-mechanical thrombolysis devices. In this article, we present a case of an iliac vein perforation and extravasation of the EKOS EndoWave system that has not been encountered in the current practice thus far.

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A new modality in the treatment of deep vein thrombosis: catheter-directed ultrasound-accelerated thrombolysis

Cited by 2 publications

References 7 publications

Initial experience with a new pharmacomechanical thrombectomy device for deep venous thrombosis: Report of 91 cases

Initial experience with a new pharmacomechanical thrombectomy device for deep venous thrombosis: Report of 91 cases

Iliac vein perforation caused by an ultrasound-accelerated thrombolysis catheter: An unusual complication of EKOS EndoWave

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