Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

Oğuzkurt, Levent; Özkan, Uğur; Gülcan, Öner; Koca, Nihal; Gür, Serkan

doi:10.4261/1305-3825.dir.5175-11.1

Cited by 27 publications

(35 citation statements)

References 26 publications

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“…Recently, percutaneous thrombectomy methods alone or combined with CDT have been widely used as an effective endovascular method for thrombus removal. Compared with CDT, percutaneous thrombectomy methods are able to remove the thrombus more rapidly without the risk of bleeding complication (17,(20)(21)(22)(23)(24)(26)(27)(28)(29). Vedantham et al (20) found that the use of adjunctive percutaneous mechanical thrombectomy to augment CDT provides comparable procedural success and may reduce thrombolytic dose requirements and infusion times.…”

Section: Discussionmentioning

confidence: 99%

“…A preponderance of the evidence in patients with lower extremity DVT suggests a strategy of early thrombus elimination for fast symptom relief and restoration of venous patency to protect valve function and prevent development of the PTS (4)(5)(6)(7)(8)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Alternative treatment options have been used to remove thrombus from deep veins because of the disappointing results with anticoagulation therapy (16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

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Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

Gedikoglu¹,

Oğuzkurt²

2017

Diagn Interv Radiol

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P regnancy is a risk factor for venous thromboembolism (VTE) and the risk is highest in the postpartum period (1, 2). Anticoagulants are very effective in the prevention of pulmonary embolism (PE) and recurrent thrombosis, but the treatment of deep vein thrombosis (DVT) remains a challenge, because lysis of the thrombus formed in the deep veins is slow and frequently inadequate as a therapy (3, 4). Complete or significant lysis occurs only in 4% of patients treated with heparin alone (3). Persistence of thrombus within deep veins leads to venous hypertension, which is ultimately the cause of post-thrombotic syndrome (PTS) and late disability in 20% to 50% of patients. PTS is a conglomerate of lifestyle-limiting symptoms that commonly includes chronic leg pain and swelling, heaviness, and/or fatigue, venous claudication, stasis dermatitis, and in advanced cases skin ulcerations due to valvular incompetence accompanied by persistent venous outflow obstruction (4-8). Pregnant women are generally younger than other women in the general population, and they likely suffer a more severe form of PTS for a much longer time.Anticoagulants have been the standard therapy of DVT in pregnant women because of concerns related to administering contrast agent, exposing the fetus to radiation during interventional radiologic procedures, and bleeding complication associated with thrombolysis (9). Nonetheless, there are a few publications describing thrombolytic therapy of DVT with good success during pregnancy and peri-or postpartum period (10-13). In a previous study (14), a pregnant woman with DVT was treated using percutaneous mechanical thrombectomy under venographic guidance with contrast agent. Percutaneous aspiration thrombectomy (PAT) with or without fluoroscopy guidance in preg- 71From the Department of Radiology (M.G. 

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

Gedikoglu¹,

Oğuzkurt²

2017

Diagn Interv Radiol

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“…No standardised PAT aspiration method has yet been developed. However, Oguzkurt et al [14] have described a thrombectomy method (''to and fro'' manipulation while aspiration) affording rapid and effective aspiration of thrombi. We used this technique in our interventions.…”

Section: First Monthmentioning

confidence: 99%

Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

Çakır

Gülcü

Akay

et al. 2014

Cardiovasc Intervent Radiol

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Purpose The purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis. Methods In this randomised, prospective study, 42 patients with acute proximal iliofemoral deep vein thrombosis documented via Doppler ultrasound examination, were separated into an interventional treatment group (16 males, 5 females, average age 51 years) and a medical treatment group (13 males, 8 females, average age 59 years). In the interventional group, PAT with largelumen 9-F diameter catheterisation was applied, after initiation of standard anticoagulant therapy. Balloon angioplasty (n 19) and stent implementation (n: 14) were used to treat patients with residual stenosis ([50 %) after PAT. Prophylactic IVC filters were placed in two patients. The thrombus clearance status of the venous system was evaluated by venography. In both the medical and interventional groups, venous patency rates and clinical symptom scores were evaluated at months 1, 3, and 12 after treatment.Results Deep venous systems became totally cleared of thrombi in 12 patients treated with PAT. The venous patency rates in month 12 were 57.1 and 4.76 % in the interventional and medical treatment groups, respectively. A statistically significant improvement was observed in clinical symptom scores of the interventional group (PAT) with or without stenting (4.23 ± 0.51 before treatment; 0.81 ± 0.92 at month 12) compared with the medical treatment group (4.00 ± 0.63 before treatment; 2.43 ± 0.67 at month 12). During follow-up, four patients in the medical treatment and one in the interventional group developed pulmonary embolisms. Conclusions For treatment of acute deep vein thrombosis, PAT with or without stenting is superior to anticoagulant therapy alone in terms of both ensuring venous patency and improving clinical symptoms. PAT is a safe, inexpensive, and easily performed method of endovascular treatment

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“…High success rates of clot lysis have been reported in studies assessing the effect of combining CDT with PMT, balloon maceration, or aspiration thrombectomy [161][162][163][164][165][166][167]. Although these methods are generally considered as safe treatments with lower dose and shorter treatment time, they have not been documented by large randomized controlled trials.…”

Section: Recommendationmentioning

confidence: 99%

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

Kim

Min

Kang

et al. 2016

J Korean Soc Radiol

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Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis using manual aspiration thrombectomy: long-term result of 139 patients from a single center

Cited by 27 publications

References 26 publications

Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

Endovascular treatment of iliofemoral deep vein thrombosis in pregnancy using US-guided percutaneous aspiration thrombectomy

Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

Diagnosis and Treatment of Lower Extremity Deep Vein Thrombosis: Korean Practice Guidelines

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