Feasibility and safety of percutaneous hydrodynamic thrombolysis techniques in management of acute proximal lower limb deep vein thrombosis

Abstract

Introduction Currently, there are different treatment options of deep vein thrombosis (DVT) available, and all of which have their own associated adverse effects. Pharmacomechanical thrombolysis (PMT) is a minimally invasive catheter-based intervention that uses a retrograde-directed saline jet under pressure to fragment, macerate, or disrupt the occlusive venous thrombus after lacing it with thrombolytic drugs followed by aspiration of the thrombus material. Patients and methods This is a prospective study examining the use of PMT in management of unilateral acute lower limb DVT for some cohort of patients with no contraindication to thrombolysis who presented to our vascular surgery units in the period from December 2019 to June 2020. Results A total of 25 patients with acute proximal lower limb DVT were selected for PMT, with an average age of 43.2 years (range: 27–53 years). There were 13 (52%) females and 12 (48%) males. PMT was found to be successful in 21 (84%) patients. The procedure time ranged from 28 to 55 min (average 45 min), and in all patients, the access was gained via the ipsilateral popliteal vein. At first month, the patency rate was found to be 84% (21/25) and 76% at the sixth month (19/25). Conclusion In selected group of patients with no contraindications to thrombolysis, PMT can be safely used with good results in terms of patency and lower incidence of developing postthrombotic limb symptoms.