The efficacy of rotational pharmaco-mechanical thrombectomy in patients with acute iliofemoral deep vein thrombosis: Is the standard treatment of deep vein thrombosis changing?

Abstract

Objective In this study, we aimed to evaluate the efficiency of rotational thrombectomy device in pharmaco-mechanical thrombolysis for symptomatic acute ilio-femoral deep vein thrombosis. Materials and methods Between August 2013 and May 2018,82 patients with acute deep vein thrombosis comprising the iliofemoral segment whom underwent Pharmaco-mechanical thrombolysis were evaluated retrospectively. The Cleaner thrombectomy device was used. The resolution of thrombi was examined and graded. Development of post-thrombotic syndrome was assessed with Villalta scores. Results 75 patients (91.4%) had complete thrombus resolution. Between 50–99% resolution was noted in 6 patients (7.4%) and in one (1.2%) case less than %50 thrombus resolution was obtained. Seventy-five patients (91%) of the cohort could be treated in a single session; 7 patients (8.6%) required reintervention(s). Although improved post-thrombotic syndrome rates were lower at the short term, Villalta scores gradually increased during follow up. Conclusions In conclusion, Pharmaco-mechanical thrombolysis with Cleaner thrombectomy device is a safe and beneficial method for the treatment of acute iliofemoral deep vein thrombosis. Long term follow up data of large volume multicenter studies are warranted.

Pharmaco-Mechanical Thrombectomy vs. Conventional Anticoagulant Management of Acute Lower Extremity Deep Vein Thrombosis - Long-Term Outcomes

“…Large (16-18 mm in diameter) stents (Boston Scientifi c, Natick, Massachusetts) were applied with 1-2 cm distance of stent joints in these cases. 10 Periprocedural IVC fi lters are not necessarily used in PMT; however, retrievable fi lters are effective in preventing pulmonary embolism by capturing the thrombus. In our study, we did not observe severe complications associated with IVC fi lter and hence, our practice evolved to place temporary fi lters routinely.…”

“…The technique of PMT was described previously. 10 A retrievable inferior vena cava (IVC) fi lter (option retrievable vena cava fi lter; Argon Medical Devices, Plano, Texas, US) was inserted through contralateral femoral or internal jugular vein access before the procedure in all patients. All of the procedures were performed with local anesthesia.…”

“…Since PTS is associated with the proximal venous obstructions, these interventional techniques provide the greatest benefi ts for patients with acute presentation of extensive proximal DVT, decreasing the risk of PTS formation and/or the severity of PTS if they ever occur. 4,10 In addition, they play an important role in cases with acute limb threatening conditions due to venous occlusions or severe DVT symptoms.…”

Enfermedad de buerger presentación de caso y revisión de la literatura

“…En el tratamiento endovasuclar de la enfermedad de Buerger, se ha determinado, según varios estudios, que la tasa de éxito técnico es alta, del 87,5% (Firat, 2019), 91% (Kacmaz, 2019), 82% (Uyanik, 2021). Y la tasa de salvamento de la extremidad del 100% (Kacmaz, 2019), 92% (Modaghegh, 2017), 87,5% (Rodoplu, 2020), 93,3 % (Uyanik, 2021.…”

“…6 meses post revascularización. (Rodoplu, 2020). La cicatrización, en los pacientes que continúan fumando, se inhibe y más bien, experimentan isquemias de mayor severidad (P =0,017) (Modaghegh, 2017).…”