Assessment of residual thrombus after venous thrombolytic regimens

Raju, Seshadri; Davis, Micah; Martin, A.

doi:10.1016/j.jvsv.2013.08.011

Cited by 30 publications

(14 citation statements)

References 31 publications

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“…Conventional treatment with systemic anticoagulation was found to result in problems with residual thrombus, and so the treatment standard was changed to combination therapy with CDT 21 . Combined treatment with systemic anticoagulation and CDT resulted in fewer remaining thrombi and reduced the recurrence of thrombosis, while at the same time decreasing the prevalence of PTS 22 . Fleck et al proposed that combined therapy with CDT is more advantageous in younger patients and those with a more substantial thrombus load 7 .…”

Section: Discussionmentioning

confidence: 94%

Anatomical Consideration of Deep Calf Veins: Application to Catheter-Directed Thrombolysis

Kim

2021

Preprint

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An antegrade approach is frequently used in catheter-directed thrombolysis to remove deep-vein thrombosis. However, the antegrade approach is difficult when accessing veins with small diameters, therefore, understanding the variation of deep calf vein is important. This study measured the diameters and surface areas of the proximal and distal posterior tibial vein, peroneal vein, and anterior tibial vein in order to determine which are preferable for venous access. This study dissected 132 legs from Korean and Thai cadavers. The proximal and distal posterior tibial vein, peroneal vein, and anterior tibial vein were scanned and measured. The mean diameter and surface area were largest for the proximal tibial vein, at 6.34 mm and 0.312 cm2, respectively, followed by the anterior tibial vein (5.22 mm and 0.213 cm2), distal posterior tibial vein (3.29 mm and 0.091 cm2), and peroneal vein (3.43 mm and 0.081 cm2). The proximal posterior tibial vein and anterior tibial vein have large diameters and surface areas, which make them ideal for applying an antegrade approach in catheter-directed thrombolysis. The distal posterior tibial vein and peroneal vein are not recommended due to their smaller surface areas and also the anatomical variations therein.

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Section: Discussionmentioning

confidence: 94%

Anatomical Consideration of Deep Calf Veins: Application to Catheter-Directed Thrombolysis

Kim

2021

Preprint

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“…As part of the thrombectomy procedure, we recommend the use of a prophylactic vena cava filter, as 17% of patients treated suffered asymptomatic PE demonstrated on computed tomography scans 34 . These filters should be removed as soon as possible 35 . When DVT occurs in the left iliac vein, we encourage the use of intravascular ultrasound to diagnose iliac compression (May-Thurner syndrome) 36 .…”

Section: Dvt Thrombolysis and Percutaneous Thrombectomymentioning

confidence: 99%

The Hospital Zambrano Hellion venous thromboembolism rapid response team (PREVENTION-team): Improving pulmonary embolism and deep venous thrombosis patient care

Toro-Mijares¹,

Jerjes‐Sánchez²,

Rodríguez³

et al. 2020

ACME

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Background: Fast-track worldwide reperfusion programs improve outcomes in ST-elevation myocardial infarction and stroke. Similar programs called Program Evaluation and Review Technique (PERT) focus on submassive and massive pulmonary embolism (PE) excluding deep venous thrombosis (DVT). Methods: PREVENTION-team (Hospital Zambrano Hellion Venous Thromboembolism [VTE] Rapid Response). Primary objective: diagnostics, to improve proximal DVT and submassive and massive PE patients care. Secondary objectives: Increase diagnosis rate of low-risk PE and distal DVT; exploration of cause; long-term anticoagulation; identify high-risk profile for chronic complications; community-based support groups and patient education to extend the concept of the thrombosis-free hospital to thrombosis-free home. Structure and organization: The team includes cardiologists, vascular medicine, angiologist, echocardiographer, cardiovascular imaging, and interventional cardiologists. The team will be accessible 24 h a day, 7 days a week, 365 days a year, and base on previous national experience. The cardiology fellow on call will be responsible for activation and evaluation. We will design several tools to accelerate these processes. Risk stratification and therapeutic approach will be based on clinical presentation, echocardiogram, and biomarkers findings. According to PERT stratification based on resources and medical specialties, Hospital Zambrano Hellion has level 1 PERT. PREVENTION-team links physicians with different expertise, provide fast, efficient, and time-saving treatment, potentially saving lives and reducing bleeding and chronic complications in VTE patients. Finally, establishing a network in our hospital and health system to improve VTE patients care. To the best of our knowledge, this is the first rapid response team focused on VTE in Mexico.

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“…The use of intravascular ultrasound (IVUS) is questioned for this category of patients like stenting for symptomatic patients with non-thrombotic iliac venous lesions (NIVL) or PTS. Only one paper has highlighted the value of IVUS and not venogram for intraprocedural evaluation and to decide continuing thrombolysis (20).…”

Section: Absolute Contraindicationsmentioning

confidence: 99%

Update on early thrombus removal for iliofemoral deep vein thrombosis

Bækgaard

2019

Phlebologie

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Thrombus removal has for many years been attractive to investigate. The reasons were to relieve the acute symptoms with painful swelling and even to avoid tissue loss, but also with focus to decrease the incidence of late complications. Surgical procedures in the beginning and systemic thrombolysis years later were practiced in few dedicated centers. The breakthrough came 30 years ago in order to concentrate the lysis procedure directly into the thrombus material. This minimal invasive catheter-directed procedure was soon combined with stenting of the well-known iliac vein compression syndrome. Further development of this modality has taken place with some adjunctive mechanical devices primarily to minimize bleeding, which is the major concern of the methods. Less than ten RCT’s have been published over time, but conclusively supporting the rationale of early thrombus removal for iliofemoral DVT with reduction of PTS.

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Assessment of residual thrombus after venous thrombolytic regimens

Cited by 30 publications

References 31 publications

Anatomical Consideration of Deep Calf Veins: Application to Catheter-Directed Thrombolysis

Anatomical Consideration of Deep Calf Veins: Application to Catheter-Directed Thrombolysis

The Hospital Zambrano Hellion venous thromboembolism rapid response team (PREVENTION-team): Improving pulmonary embolism and deep venous thrombosis patient care

Update on early thrombus removal for iliofemoral deep vein thrombosis

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