Abstract
Background: To investigate the potential role of balloon mediated thrombolysis and venous angioplasty in acute ileofemoral thrombosis and to develop novel balloon catheter models for the same purpose. Methods: 2 patients and 1 patient on followup with extensive acute ileofemoral and popliteal vein thrombosis and partially extending into the inferior venacava (IVC) with diffuse swelling of lower limb and gluteal region were studied. The second patient stopped anticoagulation and presented with ileofemoral thrombosis in contralateral limb on followup. In both patients Gunther Tulip (Cook) IVC filter was placed. A 5F Multipurpose catheter with sideholes was placed in common iliac vein bifurcation and thrombolysis was done for 18 hours with streptokinase at 5000U/hr. Post thrombolysis IVC angiogram showed mild recanalisation of left common iliac veins leaving a stump. On the next day, the left common iliac vein was cannulated through a 5F Torcon catheter and a Terumo 035 J tipped wire was advanced through the clots. A 5cm x 4mm peripheral balloon was advanced and balloon directed 24 hour thrombolysis with streptokinase was done at 5000U/hr. The balloon was pulled back and multiple serial dilatations were done in femoral, internal iliac and common iliac veins. In both patients thrombolysis was started on the third day after the onset of symptoms. Results: Post procedure the venous channels were opened and were draining adequately. Limb edema subsided and there was no bleeding or embolic complications. Both patients are on oral anticoagulation and now on follow-up for 8 months being asymptomatic at present. Based on these interventions two novel balloon models to thrombolyse and to perform venous angioplasty simultaneously in a single procedure was developed. The first is a piggyback model which has a side port attached to the shaft of the balloon (5cm length and 4mm breath). The other model is a horse shoe balloon catheter which has a 14cm long and 4mm wide compliant balloon with 0.75mm diameter side port for thrombolysis till the balloon tip and on cross section gives a horse shoe appearance. Conclusion: Balloon mediated thrombolysis and venous angioplasty after IVC filter insertion is useful and novel balloon catheter models may be used in ileofemoral venous thrombosis.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Arteriosclerosis, Thrombosis, and Vascular Biology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
