Safety of catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis

Wang, Li; Zhang, Chuanlin; Mu, Shaoyu; Yeh, Chao Hsing; Chen, Liqun; Zhang, Zeju; Wang, Xueqin

doi:10.1097/md.0000000000007922

Cited by 20 publications

(5 citation statements)

References 47 publications

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“…The hemorrhagic complications of thrombolytic therapy for acute DVT management are formidable (approximately three times higher than that of anticoagulant therapy) and include the small, but potentially fatal, risk of intracerebral hemorrhage. 16 In our cohort of patients with acute IF-DVT, no major bleeding episodes occurred with the use of the ClotTriever thrombectomy catheter. This is in contrast to the reported results from other thrombolytic-based treatment strategies and, we believe, is a significant advantage to a purely thrombectomy approach.…”

Section: Discussionmentioning

confidence: 64%

“…This is in contrast to the reported results from other thrombolytic-based treatment strategies and, we believe, is a significant advantage to a purely thrombectomy approach. 5,16 Finally, thrombolytic-based strategies can often require monitoring in an ICU setting, taxing both patients and healthcare resources. In our cohort of patients with acute IF-DVT, the ClotTriever thrombectomy system achieved "single-session" procedural success requiring no ICU stay.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes from a tertiary care center using a catheter thrombectomy system for managing acute iliofemoral deep vein thrombosis

Jolly¹,

Shah²,

Huff³

et al. 2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Outcomes from a tertiary care center using a catheter thrombectomy system for managing acute iliofemoral deep vein thrombosis

Jolly¹,

Shah²,

Huff³

et al. 2022

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…Urokinase is a commonly used drug in thrombolytic therapy. 1,[14][15][16][17] It can catalyze plasminogen into plasmin, and plasmin can cleave fibrin (the major structure in the thrombus) to D-D. D-D is the final product of the plasminmediated degradation of crosslinked fibrin. 5 The concentration of D-D in plasma increases in patients with acute VTE.…”

Section: Discussionmentioning

confidence: 99%

The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis

et al. 2023

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Background During catheter-directed thrombolysis (CDT), D-dimer (D-D) are generated in large quantities and fibrinogen (FIB) is continuously consumed. Reduction of FIB increases the risk of bleeding. However, there are currently few studies on the relationship between D-D and FIB concentrations during CDT. Objectives To evaluate the relationship of D-D and FIB concentrations during CDT with urokinase for deep venous thrombosis (DVT). Method 17 patients with lower limb DVT were enrolled and treated with CDT. The concentrations of plasma D-D and FIB were measured every 8 h during thrombolysis. The degree of thrombolysis was evaluated, the change rules of D-D and FIB concentrations were analyzed, and the change curve graphs were drawn. The “thrombus volume,” “thrombolysis time,” “thrombolysis ratio,” “D-D peak,” “D-D rising speed,” “FIB falling speed,” and “duration of D-D elevation” were calculated in each patient. The mixed model was used to simulate the time change trend of the plasma D-D and FIB concentrations. Pearson method and linear regression were used to analyze the correlation and linear relationship, respectively. Results The D-D concentration first increased rapidly and then decreased gradually, and the FIB concentration continued to decrease during thrombolysis. The rate of the decline of FIB varies with the urokinase dose. The thrombus volume is positively correlated with D-D rising speed, duration of D-D elevation, D-D peak, and FIB falling speed; the D-D rising speed is positively correlated with the D-D peak and FIB falling speed; and the D-D peak is positively correlated with the FIB falling speed. The correlation coefficients were all statistically significant ( p < 0.05). Efficacy reached level I–II in 76.5% patients. No major bleeding occurred in any of the patients. Conclusion During CDT with urokinase for DVT, the concentrations of D-D and FIB show specific changes, and there are some specific relationships between each other. Understanding these changes and relationships may be helpful to adjust the thrombolysis time and urokinase dose more rationally.

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“…Furthermore, the treatment did not result in major haemorrhage, which is a concern in IBD patients. Nonetheless, it is important to be aware of thrombolysis-related complications such as minor and major bleeding, pulmonary embolism, and puncture site complications [16].…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Iliofemoral Deep Venous Thrombosis in Inflammatory Bowel Disease – Transitioning From Conservative Management to Early Intervention

Badesha¹,

Tamber²,

Powezka³

et al. 2021

Cureus

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Deep vein thrombosis (DVT) is a frequent complication in patients suffering from inflammatory bowel disease (IBD), especially in those with frequent relapses of the disease or extensive inflammatory lesions. The aetiology for the increased risk is multifactorial. Current evidence on management of acute iliofemoral DVT in IBD patients is scarce. This case series highlights two cases of active IBD, who developed acute iliofemoral DVTs and were treated with catheter-directed thrombolysis (CDT). This report demonstrates that CDT is effective in clearing the clot burden and producing significant symptomatic improvement in the absence of major complications. An individualised approach must be taken for the management of IBD patients with acute iliofemoral DVT.

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Safety of catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis

Cited by 20 publications

References 47 publications

Outcomes from a tertiary care center using a catheter thrombectomy system for managing acute iliofemoral deep vein thrombosis

Outcomes from a tertiary care center using a catheter thrombectomy system for managing acute iliofemoral deep vein thrombosis

The role of D-dimer and fibrinogen testing in catheter-directed thrombolysis with urokinase for deep venous thrombosis

Management of Acute Iliofemoral Deep Venous Thrombosis in Inflammatory Bowel Disease – Transitioning From Conservative Management to Early Intervention

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