Endovascular management of extensive lower extremity acute deep vein thrombosis with AngioJet rheolytic thrombectomy plus catheter-directed thrombolysis from contralateral femoral access

Phlebology. 2019 May;34(4):257-265. doi: 10.1177/0268355518790407. Epub 2018 Jul 27.

Abstract

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). The best results were obtained in patients treated within seven days of symptom onset. During follow-up, well-preserved, competent femoral valves were observed in 86% of the patients, and recanalization of LET III, LET II, and LET I segments was achieved in 100%, 94%, and 91% of the patients, respectively. The post-thrombotic syndrome rate was 17% during a mean 20-month follow-up.

Keywords: Catheter-based interventions; VTE management; thrombolysis; venous disease.

Publication types

  • Clinical Trial

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Catheterization, Peripheral* / instrumentation
  • Catheterization, Peripheral* / methods
  • Endovascular Procedures* / instrumentation
  • Endovascular Procedures* / methods
  • Female
  • Femoral Vein / surgery*
  • Humans
  • Lower Extremity / physiopathology
  • Lower Extremity / surgery*
  • Male
  • Mechanical Thrombolysis* / instrumentation
  • Mechanical Thrombolysis* / methods
  • Middle Aged
  • Retrospective Studies
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / surgery*