Endovascular Treatment for Acute Deep Vein Thrombosis

Abstract

Background: Deep vein thrombosis is a serious disease that causes complications such as pulmonary embolism and post-thrombotic syndrome (PTS). Generally Although thrombolytic therapy and anticoagulation therapy is performed, treatment for patients drug is not effective has not been established. Here, we investigated the effect of endovascular treatment for anti-thrombotic therapy resistance of subacute deep vein thrombosis. Methods: The target is 11 people who resisted the drug treatment have symptoms such as swelling and pain by the proximal portion deep vein thrombosis (4 male, mean 55.5 years). From onset until the endovascular treatment, an average of 16 days had passed. Until endovascular treatment is performed, unfractionated heparin, warfarin, Xa inhibitor, urokinase was administered. Before performing endovascular treatment, IVC filter was placed to prevent pulmonary embolism in all cases. The sheath (6-8 Fr) is inserted into the popliteal vein or contralateral femoral vein and passed through a wire in the blood vessel. We repeated the aspiration of thrombus using a guide catheter 6-8 Fr. After removal of the thrombus, urokinase was administered using a Fountain-infusion catheter, balloon dilation was performed for venous stenosis. After endovascular treatment, we examined the therapeutic effect in the image examination and clinical findings. Results: Improved blood flow to the inferior vena cava is obtained in all cases, and needed to balloon dilation in 6 cases, stents were not used. Pulmonary embolism after endovascular treatment did not occur. Edema was improved in all patients, but the recurrence of thrombosis within one week was observed in two cases. Other cases did not develop PTS after more than 6 months. Conclusions: Endvascular treatment for subacute deep vein thrombosis is an effective therapy for venous patency.