Endovascular Thrombolysis Using Monteplase for Non-chronic Deep Venous Thrombosis
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This study was designed to evaluate the usefulness of endovascular thrombolysis using monteplase for deep venous thrombosis (DVT). Between December 2005 and October 2009, at our institution nine endovascular thrombolysis treatments with monteplase were performed for symptomatic DVT in eight patients (6 women, 2 men; mean age, 56 (range, 15–80) years). In all, systemic anticoagulation administered by the peripheral intravenous route with heparin and/or thrombolysis with urokinase followed by anticoagulation with orally administered warfarin had been performed, and subsequently six endovascular treatments without monteplase were administered. However, DVT persisted, and endovascular treatments with monteplase were tried. In six (67%) of the nine procedures, DVT completely or almost completely disappeared after endovascular thrombolysis with monteplase. Mean dose of monteplase used was 2,170,000 IU. There was only one procedure-related complication. In one patient, just after thrombolysis with monteplase, bleeding at the puncture site and gingival bleeding occurred. Bleeding was stopped by manual astriction only. Endovascular thrombolysis with monteplase may be an effective treatment for DVT, even in cases resistant to traditional systemic anticoagulation and thrombolysis and endovascular procedures without monteplase.
KeywordsDeep venous thrombosis Catheter-directed thrombolysis Monteplase
- 3.Meissen MW, Seabrook GR, Meissener MH et al (1999) Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. Radiology 211:39–49Google Scholar
- 7.Benenati J, Shlansky-Goldberg R, Meglin A et al (2001) Thrombolytic and antiplatelet therapy in peripheral vascular disease with the use of reteplase and/or abciximab. The SCVIR Consultants’ Conference; May 22, 2000, Orlando FL. Society for Cardiovascular and Interventional Radiology. J Vasc Interv Radiol 12:795–805Google Scholar
- 18.Kawai C, Hosoda S, Kimata S et al (1994) Coronary thrombolysis in acute myocardial infarction of E6010 (novel modified t-PA): a multicenter, double-blind, dose-findings study. Jpn Pharmacol Ther 22:3925–3950Google Scholar
- 19.Kawai C, Yui Y, Hosoda S et al (on behalf of the E 6010 Study Group) (1997) A prospective, randomized, double-blind multicenter trial of single bolus injection of the novel modified t-PA E 6010 in the treatment of acute myocardial infarction: comparison with native t-PA. J Am Coll Cardiol 29:1447–1453Google Scholar