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Deep vein thrombosis and catheter directed thrombolysis

Chengyan Zhu, Huawei Zhuo, Yi Qin, Weiwei Zhang, Junlan Qiu, Feng Ran
OBJECTIVE: To compare the therapeutic effects of ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity. METHODS: From August 2015 to April 2016, 60 patients with lower extremity deep venous thrombosis were randomly divided into two groups ( n = 30 for each) to receive catheter-directed thrombolysis. Group A was treated under the ultrasound guidance, while Group B was treated without guidance...
November 20, 2018: Vascular
Xiangdong Liu, Pengkai Cao, Yunsong Li, Jianing Zhao, Liang Li, Haitao Li, Yanrong Zhang
To evaluate the safety and efficacy of pharmacomechanical thrombolysis (PMT) performed for patients with relative contraindications.From June 2014 to December 2016, 112 patients with acute or subacute proximal deep vein thrombosis (DVT) were enrolled in this study. 60 patients (including 27 acute DVT patients and 33 subacute DVT patients) were treated with catheter-directed thrombolysis (CDT), and 52 patients with relative contraindications (including 25 acute DVT patients and 27 subacute DVT patients) with PMT...
October 2018: Medicine (Baltimore)
Anthony J Comerota
Systemically delivered pharmacologic thrombolysis for acute deep vein thrombosis long ago gave way to catheter delivery of plasminogen activators within the clot. This simple concept resulted in markedly improved efficacy and safety. In an effort to accelerate thrombus dissolution or extraction, mechanical methods were developed, but the initial techniques left substantial residual thrombus that required subsequent catheter-directed thrombolysis (CDT). It was soon observed that combined pharmacomechanical thrombolysis was more effective than either one alone...
July 2018: Methodist DeBakey Cardiovascular Journal
Nuh Atas, Özkan Varan, Hakan Babaoglu, Reyhan B Salman, Hasan Satıs, Abdullah Ozer, Abdurrahman Tufan
No abstract text is available yet for this article.
November 5, 2018: International Journal of Rheumatic Diseases
Meng Liu, Fuxian Zhang
Background: Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Catheter-directed thrombolysis (CDT) is a preferred treatment for DVT patients. The aim of this study is to evaluate the thrombolytic effect of CDT with pro-urokinase (pro-UK) in different administration routes. Methods: An inferior vena cava (IVC) model was induced in 36 New Zealand white rabbits by catheter injury and placement of IVC filter. The animals were divided into 6 groups with 6 rabbits in each group: group A: systemic thrombolysis with intravenous injection; group B: CDT with pump infusion; group C: CDT with pulse injection; group D: CDT with combination of pump infusion and pulse injection; group E: catheter-directed aspiration thrombectomy; group F: mechanical thrombectomy...
August 2018: Annals of Translational Medicine
Wenda Wang, Rui Sun, Yuexin Chen, Changwei Liu
OBJECTIVE: The objective of this review was to evaluate the efficacy and safety of percutaneous mechanical thrombectomy (PMT) with or without catheter-directed thrombolysis (CDT) in the treatment of lower extremity deep venous thrombosis (DVT). METHODS: We searched PubMed for clinical trials and prospective or retrospective case series (comparative or single-arm studies) that focused on PMT ± CDT in the treatment of DVT, published before March 2, 2017. We meta-analyzed perioperative outcomes and complications and long-term outcomes of this procedure...
November 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Tomoya Hasegawa, Hiroaki Tabata, Mitsuru Kagoshima
Although upper-extremity deep vein thrombosis (UEDVT) is considered rare, its prevalence appears to be increasing, and this may be related to expanding indications for catheter-based interventions. In contrast, few cases have been reported related to strenuous exercise, especially in healthy young adults with thoracic outlet syndrome (Paget-Schroetter syndrome). In contrast to lower-extremity DVT, optimal treatment strategies for UEDVT have not been robustly studied. In this report, we describe a 56-year-old man with primary UEDVT presenting with left arm swelling, paresthesia, and visible collateral veins around the shoulder...
December 2017: Journal of Cardiology Cases
Haiyang Wang, Xiaotong Qi, Hailong Luo, Qian Zhang, Yikuan Chen, Jianming Sun
OBJECTIVE: The objective of this study was to evaluate the feasibility, efficacy, and safety of catheter-directed thrombolysis (CDT) through an anterior tibial vein approach for acute extensive lower extremity deep venous thrombosis (DVT). METHODS: There were 125 consecutive patients with acute extensive lower extremity DVT who received CDT through an anterior tibial vein approach between October 2014 and June 2017. The patients with iliac vein compression syndrome were treated with balloon dilation and stent implantation after CDT...
November 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Cassius Iyad Ochoa Chaar, Afsha Aurshina
The surgical treatment of deep venous thrombosis (DVT) has significantly evolved and is focused on different strategies of early thrombus removal in the acute phase and deep venous recanalization or bypass in the chronic phase. Along with the use of anticoagulation agents, endovascular techniques based on catheter-directed thrombolysis and pharmacomechanical thrombectomy have been increasingly used in patients with acute extensive DVT. Patient selection is crucial to provide optimal outcomes and minimize complications...
September 2018: Clinics in Chest Medicine
Ashraf Odeh Alshabatat, Mohammad Esmaeil Barbati, Omran Alzoubi, Houman Jalaie, Cees H A Wittens
BACKGROUND: May-Thurner syndrome (MTS) leads to an increased incidence of deep vein thrombosis (DVT). Early thrombus removal decreases the post-thrombotic morbidities. Our aim was to better elucidate the relationship between MTS and venous patency after catheter-directed thrombolysis (CDT). METHODS: The medical records of all patients who underwent CDT from January 2005 to December 2011 due to acute DVT were reviewed retrospectively. Patient characteristics and clinical variables were evaluated to determine association with vein patency...
August 6, 2018: Annals of Vascular Surgery
Ronald S Winokur, Akhilesh K Sista
PURPOSE OF REVIEW: Patients suffering from acute lower extremity deep vein thrombosis (DVT) are at risk for developing chronic limb pain, heaviness, and fatigue, known as the post-thrombotic syndrome (PTS). RECENT FINDINGS: Although several studies have shown that catheter-directed therapy reduces clot burden and may improve clinical outcomes, the multicenter randomized controlled ATTRACT trial showed no difference in PTS or quality of life at 2 years between patients treated with pharmacomechanical catheter-directed thrombolysis (PCDT) and those treated with anticoagulation alone, and a higher major bleeding rate in the PCDT group...
August 6, 2018: Current Treatment Options in Cardiovascular Medicine
Sidra Khalid, Aariez Khalid, Tessy Meridores, Hamed Daw
May-Thurner syndrome (MTS) is a medical condition where the left iliac vein is compressed by the right iliac artery, which in turn predisposes patients to deep venous thrombosis (DVT). We present a case of a 67-year-old female who had pain and swelling of the left leg. Ultrasound of the deep veins of the leg revealed DVT of the distal external iliac vein. She was treated with catheter-directed thrombolysis and stent placement. Finally, she was discharged on long-term anticoagulation with warfarin. The purpose of presenting this case is to highlight the clinical presentation, diagnosis, and treatment of MTS...
May 29, 2018: Curēus
Guang Liu, Zhen Zhao, Chaoyi Cui, Kaichuang Ye, Minyi Yin, Xaiobing Liu, Jinbao Qin, Xintian Huang, Min Lu, Mier Jiang, Weimin Li, Xinwu Lu
Purpose The aim of the present study was to report the clinical outcomes of endovascular treatment for extensive lower limb deep vein thrombosis with AngioJet rheolytic thrombectomy (ART) plus catheter-directed thrombolysis (CDT) using a contralateral femoral approach. Methods A retrospective analysis of consecutive ART+CDT treatments in 38 deep vein thrombosis patients (LET I-III, from September 2014 to March 2016) was performed. Results The technical success rate was 100%. Complete lysis was achieved in 82% of LET III segments (calf veins), 87% of LET II segments (popliteal-femoral veins), and 90% of LET III segments (iliac veins)...
July 27, 2018: Phlebology
Arina J Ten Cate-Hoek
<AbstractText>Post thrombotic syndrome (PTS) is a common chronic complication of deep vein thrombosis of the leg (DVT). Treatment options are limited therefore emphasis is placed on its prevention. Several risk factors have been recognized, but were so far not used for risk stratification or translation into prediction models. Early interventions did not yet result in more successful preventive treatment strategies; for the acute phase of DVT there is equipoise on the value of elastic compression, as well as on catheter directed thrombolysis...
April 2018: Research and practice in thrombosis and haemostasis
Jacqueline N Poston, David A Garcia
No abstract text is available yet for this article.
July 24, 2018: Blood Advances
Thita Chiasakul, Adam Cuker
No abstract text is available yet for this article.
July 24, 2018: Blood Advances
Othman S Akhtar, Vladimir Lakhter, Chad J Zack, Hafiz Hussain, Vikas Aggarwal, Estefania Oliveros, Yevgeniy Brailovsky, Huaqing Zhao, Ravi Dhanisetty, Resmi A Charalel, Matthew Zhao, Riyaz Bashir
OBJECTIVES: The aim of this study was to investigate the contemporary trends and comparative effectiveness of adjunctive inferior vena cava filter (IVCF) placement in patients undergoing catheter-directed thrombolysis (CDT) for treatment of proximal lower extremity or caval deep vein thrombosis. BACKGROUND: CDT is being increasingly used in the management of proximal deep vein thrombosis. Although a significant number of patients treated with CDT undergo adjunctive IVCF placement, the benefit of this practice remains unknown...
July 23, 2018: JACC. Cardiovascular Interventions
Gudula Boon, L F Van Dam, F A Klok, M V Huisman
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most frequent cardiovascular disease besides myocardial infarction and stroke. Because DVT may cause life-threatening conditions, treatment should be started as soon as possible. This comprises certain challenges in special populations. Areas covered: In cancer-associated VTE, current treatment is different from non-cancer VTE due to disease-related interventions and higher bleeding risks. In the treatment of patients with extensive DVT, the role of catheter-directed thrombolysis has been investigated in two randomized trials, but results do not yield a recommendation for standard thrombolysis...
September 2018: Expert Review of Hematology
Young-Ah Kim, Shin-Seok Yang, Woo-Sung Yun
Purpose: The aim of this study is to identify risk factors of postthrombotic syndrome (PTS) and evaluate the efficacy of catheter-directed thrombolysis (CDT) for preventing the development of PTS in patients with lower extremity deep vein thrombosis (DVT). Materials and Methods: From 2005 January to 2013 December, 139 limbs of 126 patients were included in this study who had the first episode of proximal DVT at the affected limb and who had visited our out-patient clinic...
June 2018: Vascular Specialist International
Wang Li, Zhang Chuanlin, Mu Shaoyu, Chao Hsing Yeh, Chen Liqun, Zhang Zeju
OBJECTIVES: To evaluate case series studies that quantitatively assess the effects of catheter-directed thrombolysis (CDT) and compare the efficacy of CDT and anticoagulation in patients with acute lower extremity deep vein thrombosis (DVT). METHODS: Relevant databases, including PubMed, Embase, Cochrane, Ovid MEDLINE and Scopus, were searched through January 2017. The inclusion criteria were applied to select patients with acute lower extremity DVT treated with CDT or with anticoagulation...
June 21, 2018: Revista Latino-americana de Enfermagem
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