Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: Safety and feasibility study

Bush, Ruth L.; Lin, Peter H.; Bates, Jeffrey T.; Mureebe, Leila; Wei, Zhou; Lumsden, Alan B.

doi:10.1016/j.jvs.2004.08.025

Cited by 131 publications

(103 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…En casos de contraindicación absoluta de uso de trombolíticos, realizamos TM exclusiva, sin la administración de fármacos, como ha sido descrito anteriormente por otros 21 . En comparación con la trombolisis dirigida por catéter, se logra una reducción de la dosis de trombolítico 22 y de su tiempo de administración, lo que permite repermeabilizar segmentos trombosados en forma más rápida y segura, con menor estada en UCI, menos días de hospitalización, menor necesidad de transfusión y mejor costo-efectividad [19][20][21][22][23] ; presentando resultados terapéuticos similares a los de la trombolisis dirigida por catéter, pero con una reducción en las complicaciones hemorrágicas 24 . Los buenos resultados de la TFM reportados en series no prospectivas 16,21,23 la han hecho recomendable por las guías de manejo de TVP de distintas sociedades científicas como la primera línea de tratamiento en TVP ilio-femorales seleccionadas 6,[25][26][27][28][29] , en especial ante flegmasia cerúlea dolens 14 , trombosis aguda de la VCI, progresión proximal rápida a pesar de anticoagulación, trombosis de FVCI y en TVP extensas con ausencia de mejoría de síntomas 5,[26][27][28] , como es el caso de la mayoría de los pacientes de esta serie.…”

Section: Discussionunclassified

See 1 more Smart Citation

Trombolisis mecánica y fármaco-mecánica en el tratamiento de trombosis venosa profunda sin respuesta clínica con tratamiento médico convencional

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionunclassified

“…Esto último hace recomendar el uso rutinario de FVCI transitorios o permanentes 4,7,19,20,23 . Todos nuestros pacientes estaban protegidos de TEP durante la intervención y el retiro de FVCI se realizó solamente en 3 casos de síndrome de May-Thurner.…”

Section: Discussionunclassified

Trombolisis mecánica y fármaco-mecánica en el tratamiento de trombosis venosa profunda sin respuesta clínica con tratamiento médico convencional

et al. 2017

View full text Add to dashboard Cite

show abstract

“…However, even in patients with this rare pathological abnormality, it is not possible to achieve adequate venous patency, with preservation of venous valvular function, using this technique. Acceptable recanalisation rates have been reported using other endovascular therapeutic methods, such as CDT and PMT [7,10,11]. Although CDT is effective, the technique is not used widely because infusion times are long (associated with longer hospital stays) and systemic bleeding complications can occur.…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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

show abstract

“…Thrombectomy combined with thrombolytics can therefore lead to fewer hemorrhagic complications and reduced morbidity (Table 1). 5,6 Several different thrombectomy devices are available on the market, with a range of different mechanisms of action: simple aspiration of thrombi, hydrodynamic (aspiration by negative pressure of saline jets), fragmentation and combination systems. 7 The device used in this case, the Angiojet  (Possis Medical Inc., Mineapolis, MN), has an action based on the Venturi effect.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism and stroke associated with mechanical thrombectomy

Bastianetto

Pinto

2014

J. vasc. bras.

View full text Add to dashboard Cite

Mechanical thrombectomy offers the advantage of rapid removal of venous thrombi. It allows venous obstructions to be removed and requires shorter duration of infusion of thrombolytic agents. However, aspiration of thrombi can lead to complications, particularly pulmonary embolism and hemolysis. The validity of using vena cava filters during thrombectomy in order to avoid embolism has not yet been established. The authors report a case of massive pulmonary embolism associated with ischemic stroke in a patient with a hitherto undiagnosed patent foramen ovale. The patient developed respiratory failure and neurological deficit after thrombectomy. This case raise questions about the value of the thrombectomy for the treatment of proximal vein thrombosis due to the risks of this procedure. The authors also discuss the need for vena cava filters and ruling out a patent foramen ovale in patients undergoing thrombectomy.Keywords: thrombectomy; mechanical thrombolysis; pulmonary embolism; stroke. ResumoA trombectomia mecânica tem a vantagem de levar à rápida remoção dos trombos. Permite a desobstrução venosa e a redução do tempo de infusão de trombolíticos. A aspiração dos trombos pode levar a complicações, principalmente embolia pulmonar e hemólise. Algo que não está definido é a validade do uso de filtros de veia cava durante a trombectomia, com o objetivo de evitar a TEP maciça. Os autores relatam um caso de embolia pulmonar maciça associada a AVC isquêmico, em uma paciente que apresentava forame oval patente. Não havia o diagnóstico prévio da PFO. A paciente evoluiu com insuficiência respiratória e déficit neurológico logo após a trombectomia. Neste caso, questiona-se o valor da trombectomia para o tratamento da trombose venosa proximal, devido aos riscos deste procedimento. Os autores discutem sobre a necessidade de filtro de veia cava e sobre a pesquisa de forame oval nos pacientes que serão submetidos à trombectomia.Palavras-chave: trombectomia; trombólise mecânica; embolia pulmonar; acidente vascular cerebral.

show abstract

Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: Safety and feasibility study

Cited by 131 publications

References 12 publications

Trombolisis mecánica y fármaco-mecánica en el tratamiento de trombosis venosa profunda sin respuesta clínica con tratamiento médico convencional

Trombolisis mecánica y fármaco-mecánica en el tratamiento de trombosis venosa profunda sin respuesta clínica con tratamiento médico convencional

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

Pulmonary embolism and stroke associated with mechanical thrombectomy

Contact Info

Product

Resources

About