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http://dx.doi.org/10.5090/kjtcs.2010.43.3.266

The Efficacy of Endovascular Treatment for Deep Vein Thrombosis  

Kim, Seon-Hee (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University)
Chung, Sung-Woon (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University)
Kim, Chang-Won (Department of Radiology, School of Medicine, Pusan National University)
Publication Information
Journal of Chest Surgery / v.43, no.3, 2010 , pp. 266-272 More about this Journal
Abstract
Background: Deep vein thrombosis (DVT) is a serious disease that causes life-threatening pulmonary embolism and chronic venous insufficiency. Anticoagulation is the standard therapy for DVT. However, the results of standard anticoagulation for treating DVT have been disappointing, so endovascular treatment is commonly performed nowadays. The aim of this study was to evaluate the efficacy of an endovascular procedure for treating patients with DVT. Material and Method: We retrospectively evaluated the clinical data of 29 DVT patients who underwent an endovascular procedure between December 2006 and July 2008. We compared the results of the 29 patients with the results of another 45 patients who were treated with only aspirin and heparin. Result: The patient’s mean age was 55.4 years in the intervention group and 53.7 years in the control group. DVT occurred more frequently in the females. Catheter-directed thrombolysis was performed in 22 patients (75.8%). Aspiration thrombectomy was performed in 18 patients (62%) and a endovascular stent was placed in 25 patients (86.2%). Fifteen patients (51.7%) underwent percutaneous insertion of a retrievable IVC filter for the prevention of pulmonary embolism. In the control group, thirty nine patients (86.7%) were treated with low-molecular heparin, and seven patients (15.6%) who were contraindicated for warfarin were treated with aspirin. No bleeding complications occurred during thrombolysis or anticoagulation. We analyzed the statistical data according to recurrence of DVT and the incidence of post-thrombotic syndrome (PTS) during the follow-up period. The intervention group had a significantly lower incidence of PTS (p-value=0.008), but they had the same result as the control group for the recurrence of DVT. In addition, death from the DVT did not occur in the intervention group. Thus, we obtained better clinical outcomes in the intervention group as compared to those in the anticoagulation only group. Conclusion: Endovascular procedures are effective alternative modalities, as compared to systemic anticoagulation, for the treatment of DVT. But more studies are needed to determine the specific indications and to validate the long-term efficacy of endovascular procedures for the treatment of DVT.
Keywords
Thrombosis; Deep vein thrombosis; Endovascular techniques;
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1 Heit JA, Silverstein MD, Mohr DN, et al. The epidemiology of venous thromboembolism in the community. Thromb Haemost 2001;86:452-63   PUBMED
2 Edwards EA, Edwards JE. The effect of thrombophlebitis on the venous valve. Surg Gynecol Obstet 1987;65:310-20
3 O'sullivan GJ, Semba CP, Bittner CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol 2000;11:823-36   DOI   ScienceOn
4 Virchow R. Neuer fall von todlicher emboli der lungenaterie. Arch Pathol Anat 1856;10:225   DOI
5 Neglen P, Berry MA, Raju S. Endovascular surgery in the treatment of chronic primary and post-thrombotic iliac vein obstruction. Eur J Vasc Endovasc Surg 2000;20:560-71   DOI   ScienceOn
6 Prandoni P, Lensing AW, Prins MH, et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med 2002;137:955-60   DOI   PUBMED   ScienceOn
7 Semba CP, Dake MD. Iliofemoral deep venous thrombosis: aggressive therapy with catheter-directed thrombolysis. Radiology 1994;191:487-94   PUBMED
8 Meissner MH. Thrombolytic therapy for acute deep vein thrombosis and the venous registry. Rev Cardiovasc Med 2002;3:S53-60   PUBMED
9 Meissner MH, Manzo R, Bergelin RO, Markel A, Strandness DE. Propagation, rethrombosis, and new thrombus formation after deep vein thrombosis. J Vasc Surg 1995;22:558   DOI   ScienceOn
10 Douketis JD, Crowther MA, Foster GA, Ginsberg JS. Dose the location of thrombosis determine the risk of disease recurrence in patients with proximal deep vein thrombosis? Am J Med 2001;l10:515-9   DOI   ScienceOn
11 Sinderman KW, Bonder L, Saddekni S, Srur M, Sos TA. Percutaneous embolectomy by transcatheter aspiration. Work in progress. Radiology 1984;150:357-61   DOI   PUBMED
12 Santamaria MG, Agenlli G, Taliani MR, et al. Warfarin Optimal Duration Italian Trial (WODIT) Investigators. Thrombophilic abnormalities and recurrence of venous thromboembolism in patients treated with standardized anticoagulant treatment. Thromb Res 2005;116:301-6   DOI   ScienceOn
13 Yosida S, Akiba H, Tamakawa M, Yama N, Takeda M, Hareyama M. Spiral CT venography of the lower extremities by injection via arm vein in patients with leg swelling. Br J Radiol 2001;74:1013-6   DOI   PUBMED