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Erschienen in: CardioVascular and Interventional Radiology 6/2006

01.12.2006 | CLINICAL INVESTIGATION

Catheter-Directed Thrombolysis with Percutaneous Rheolytic Thrombectomy Versus Thrombolysis Alone in Upper and Lower Extremity Deep Vein Thrombosis

verfasst von: Hyun S. Kim, Ajanta Patra, Ben E. Paxton, Jawad Khan, Michael B. Streiff

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 6/2006

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Abstract

Purpose

To compare the efficacy of catheter-directed thrombolysis (CDT) alone versus CDT with rheolytic percutaneous mechanical thrombectomy (PMT) for upper and lower extremity deep vein thrombosis (DVT).

Methods

A retrospective cohort of consecutive patients with acute iliofemoral or brachiosubclavian DVT treated with urokinase CDT was identified, and a chart review was conducted. Demographic characteristics, treatment duration, total lytic dose, clot lysis rates and complications were compared in patients treated with urokinase CDT alone or combined CDT and rheolytic PMT.

Results

Forty limbs in 36 patients were treated with urokinase CDT alone. Twenty-seven limbs in 21 patients were treated with urokinase CDT and rheolytic PMT. The mean treatment duration for urokinase CDT alone was 48.0 ± 27.1 hr compared with 26.3 ± 16.6 hr for urokinase CDT and rheolytic PMT (p = 0.0004). The mean urokinase dose required for CDT alone was 5.6 ± 5.3 million units compared with 2.7 ± 1.8 million units for urokinase CDT with rheolytic PMT (p = 0.008). Complete clot lysis was achieved in 73% (29/40) of DVT treated with urokinase CDT alone compared with 82% (22/27) treated with urokinase CDT with rheolytic PMT.

Conclusion

Percutaneous CDT with rheolytic PMT is as effective as CDT alone for acute proximal extremity DVT but requires significantly shorter treatment duration and lower lytic doses. Randomized studies to confirm the benefits of pharmacomechanical thrombolysis in the treatment of acute proximal extremity DVT are warranted.
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Metadaten
Titel
Catheter-Directed Thrombolysis with Percutaneous Rheolytic Thrombectomy Versus Thrombolysis Alone in Upper and Lower Extremity Deep Vein Thrombosis
verfasst von
Hyun S. Kim
Ajanta Patra
Ben E. Paxton
Jawad Khan
Michael B. Streiff
Publikationsdatum
01.12.2006
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 6/2006
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-005-0341-4

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