Abstract No. 65: Catheter Thrombolysis in Thrombocytopenic Cancer Patients with Deep Vein Thrombosis

Abstract

Thrombocytopenia is not an uncommon finding in cancer patients. On the other hand, cancer is a well known risk factor for deep vein thrombosis. In this abstract we study 17 cancer patients with thrombocytopenia who presented with DVT and underwent catheter directed thrombolysis as a treatment. Between July 2005 and September 2007, seventeen patients with cancer (Twelve with leukemia, four with lymphoma and one with prostate cancer) presented with either upper extremity or lower extremity DVT. Blood analysis revealed thrombocytopenia in all patients (Average platelets count: 32,000 per micro liter). Patients were found by interventional radiology to be good candidates for thrombolysis using catheter directed TPA infusion. All patients were followed up 24hours after TPA infusion. Of the seventeen patients ten had totally resolved clots. Six of the seventeen patients needed further intervention by either increasing the rate of infusion, venoplasty and/or stent placement (two patients) or mechanical thrombectomy (four patients). Only one patient failed to benefit from thrombolytic infusion secondary to an occluded catheter and the procedure was aborted. There were no thrombolysis related complications. In particular, bleeding was not an issue during thrombolytic therapy. Catheter directed thrombolysis is an effective treatment in thrombocytopenic cancer patients presenting with DVT. While interventionalists typically avoid thrombolysis on these patients, bleeding was not a complication in our series.