Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Short-Term Catheter-Directed Thrombolysis with Low-Dose Urokinase Followed by Aspiration Thrombectomy for Treatment of Symptomatic Lower Extremity Deep Venous Thrombosis

저용량 유로키나제를 이용한 단기간 혈전용해술과 혈전흡입술을 시행한 하지 심부정맥혈전증 환자의 치료 효과

  • Jung, Se-Hee (Department of Radiology, Chonnam National University Hospital) ;
  • Kim, Jae-Kyu (Department of Radiology, Chonnam National University Hospital) ;
  • Chang, Nam-Kyu (Department of Radiology, Chonnam National University Medical School) ;
  • Lim, Jae-Hoon (Department of Radiology, Chonnam National University Hospital) ;
  • Lim, Nam-Yeul (Department of Radiology, Chonnam National University Hospital) ;
  • Song, Jang-Hyeon (Department of Radiology, Chonnam National University Hospital) ;
  • Choi, Soo-Jin-Na (Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Chung, Sang-Young (Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School)
  • 정세희 (전남대학교병원 영상의학과) ;
  • 김재규 (전남대학교병원 영상의학과) ;
  • 장남규 (전남대학교 의과대학 영상의학과학교실) ;
  • 임재훈 (전남대학교병원 영상의학과) ;
  • 임남열 (전남대학교병원 영상의학과) ;
  • 송장현 (전남대학교병원 영상의학과) ;
  • 최수진나 (전남대학교 의과대학 전남대학교병원 외과학교실) ;
  • 정상영 (전남대학교 의과대학 전남대학교병원 외과학교실)
  • Published : 2011.10.01
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Abstract

Purpose: To evaluate the venous patency in patients treated by catheter-directed thrombolysis with low-dose urokinase (UK) for symptomatic lower extremity deep venous thrombosis (DVT). Materials and Methods: Eighty-nine consecutive patients (46 women and 43 men; mean age, 58.1 years), treated by catheter-directed thrombolysis with low-dose UK were included in this study. Immediate venous patency was evaluated in terms of technical success (successful restoration of antegrade in-line flow in the treated vein with residual stenosis rate of less than 30%) and clinical success (significant reduction of clinical symptoms before hospital discharge). Late venous patency was evaluated in terms of primary patency rate and clinical success. Results: Immediate technical success was achieved in all patients and immediate clinical success in 80 (90%) patients. There was no major systemic bleeding complication. The primary patency rate at 6 months and 12 months was 84% and 79%, respectively. Fifty-six (63%) patients were asymptomatic after a median clinical follow-up of 18 months, eleven (12%) patients improved moderately, seven (8%) patients remained unchanged, and fifteen (17%) patients had no clinical follow-up. Conclusion: Short-term catheter-directed thrombolysis with low-dose UK can be an effective, safe method to manage DVT of the lower extremities.

목적: 저용량 유로키나제를 이용하여 단기간 혈전용해술을 시행한 유증상 하지 심부정맥혈전증 환자의 정맥 개통성에 대해 알아본다. 대상과 방법: 2006년 1월부터 2010년 4월까지 저용량 유로키나제를 이용하여 혈전용해술을 시행한 89명을 대상으로 하였다. 즉각 정맥 개통성은 기술적인 측면과 임상적인 측면에서 평가하였고 후기 정맥 개통성은 일차 혈관 개통률 측면과 임상적인 측면에서 평가하였다. 일차 혈관 개통률은 시술 6개월과 12개월 이후에 정맥혈관조영술을 시행한 환자를 대상으로 하였다. 결과: 즉각적인 기술적 및 임상적 성공률은 각각 100%, 90%이며 시술 중 또는 시술 직후에 발생한 주요 합병증은 없었다. 추적기간 동안에 6개월과 12개월의 일차 혈관 개통률은 각각 84%와 79%였다. 18개월의 중앙추적기간 동안 무증상은 63%, 중등도의 증상 개선은 12%, 변화 없는 경우는 8%였으며 17%의 환자가 임상적으로 추적 관찰되지 않았다. 결론: 저용량 유로키나제를 이용한 단기간 혈전용해술은 하지 심부정맥혈전증의 치료에 효과적이고 안전한 치료방법이다.

Keywords

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