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Single-session Aspiration Thrombectomy of Lower Extremity Deep Vein Thrombosis Using Large-size Catheter without Pharmacologic Thrombolysis

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Abstract

Purpose

To retrospectively evaluate the efficacy of single-session aspiration thrombectomy using large catheters without pharmacologic thrombolysis to treat acute and subacute lower extremity deep vein thrombosis (DVT).

Methods

From January 2008 to December 2011, single-session aspiration thrombectomy using large, 11F introducer catheters to treat acute and subacute lower extremity DVT was performed in 74 limbs of 74 patients (M/F = 23/51, age range 36–88 years), and clinical and imaging follow-up of over 6 months were obtained in 26 patients. Causes of DVT were May–Thurner syndrome (n = 65), malignancy related (n = 6), and pelvic mass (n = 3). A 14F introducer sheath was inserted through the popliteal vein, followed by rotational thrombus maceration and aspiration thrombectomy. Angioplasty and stent placement were performed when needed. Radiological images and medical records were reviewed for immediate and midterm results, complications, and recurrences.

Results

Initial technical success rate was 89.2 % (66 patients). Stenting was performed in 55 patients. The failures were due to underlying chronic thrombi/DVT (n = 7) and stent failure due to huge pelvic mass (n = 1). There was no procedure-related complication. In the 26 midterm follow-up patients for a duration of 6–48 months, there was no recurrence (n = 20), stent occlusion (n = 3), or femoral vein occlusion (n = 3). One-year primary patency rate in stent/iliac vein, femoral vein, and popliteal/infrapopliteal vein were 88.5, 88.5, and 96.2 %, respectively.

Conclusion

Single-session aspiration thrombectomy for acute and subacute lower extremity DVT using large introducer catheters without pharmacologic thrombolysis is feasible with acceptable immediate and midterm results, excluding complications related to pharmacologic thrombolysis.

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Acknowledgments

The authors thank Professor Yoon Chul Rhim, Yonsei University College of Engineering, for his contributions and comments.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Sung Il Park, Man Deuk Kim, Jong Yun Won & Do Yun Lee

  2. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

    Myungsu Lee

  3. Department of Radiology, Jeju National University Hospital, Aran 13gil 15 (Ara-1 Dong), Jeju, 690-767, Republic of Korea

    Mu Sook Lee

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  1. Sung Il Park
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  2. Myungsu Lee
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Correspondence to Do Yun Lee.

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Park, S.I., Lee, M., Lee, M.S. et al. Single-session Aspiration Thrombectomy of Lower Extremity Deep Vein Thrombosis Using Large-size Catheter without Pharmacologic Thrombolysis. Cardiovasc Intervent Radiol 37, 412–419 (2014). https://doi.org/10.1007/s00270-013-0676-1

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  • DOI: https://doi.org/10.1007/s00270-013-0676-1

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