Abstract
PURPOSE: To prospectively evaluate the angiographic and clinical results of using catheter-directed thrombolytic therapy for the treatment of acute iliofemoral deep venous thrombosis (IFDVT). MATERIALS AND METHODS: All consecutive patients with acute IFDVT referred for thrombolytic treatment from July 1990 to December 1995 were included in this clinical data analysis. Infusions of urokinase were administered via a multisidehole infusion catheter. Angioplasty, stent placement, mechanical thrombectomy, and other procedures were often performed in conjunction with the thrombolytic procedure. RESULTS: Seventy-seven patients and 87 limbs were treated. The overall technical success rate was 79%, and was 86% for iliac veins and 63% for femoral veins. The primary and secondary patency rates at 1 year were 63% and 78%, respectively, for the iliac veins, and 40% and 51%, respectively, for the femoral veins. Patients with malignant disease fared worse. Patients requiring stent placement appeared to have inferior outcomes. A previous history of DVT did not appear to affect the results. Bleeding requiring transfusion and hematomas were the major complications encountered. Pulmonary embolus was not a significant problem. Technical success rates were lower in patients who had symptoms for more than 4 weeks compared to those who had a more recent onset of symptoms. CONCLUSIONS: Current data suggest that catheter-directed thrombolytic therapy is safe and effective in achieving intermediate-term venous patency. The long-term clinical benefits of this procedure remain, however, to be established.
Original language | English (US) |
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Pages (from-to) | 405-418 |
Number of pages | 14 |
Journal | Journal of Vascular and Interventional Radiology |
Volume | 8 |
Issue number | 3 |
DOIs | |
State | Published - 1997 |
Keywords
- Femoral veins, thrombosis
- Iliac veins, thrombosis
- Thrombolysis
- Thrombosis, venous
- Urokinase