Learning curve for percutaneous thrombectomy in treatment of acute lower extremity deep vein thrombosis

Abstract

ObjectiveWe evaluated the effect of the learning curve on percutaneous thrombectomy (PT) outcomes for the treatment of lower extremity deep vein thrombosis (DVT). MethodsThe present study was conducted between October 2019 and September 2020 and included 80 patients who had undergone PT to treat lower extremity DVT of the common iliac, external iliac, common femoral, femoral, and popliteal veins. For thrombectomy, aspiration and mechanical thrombectomy procedures were performed until the thrombus had completely dissolved using the Dovi aspiration system and Mantis mechanical thrombectomy system (Invamed, Ankara, Turkey). A total of 80 patients were divided equally into four groups, with the first 20 cases in group 1, the second 20 cases in group 2, the third 20 cases in group 3, and the final 20 cases in group 4. The groups were compared for the demographic characteristics, intraoperative outcomes, complication rates, and procedure success. ResultsAll demographic parameters were similar between the four groups. The mean operative time was 139.3 minutes for group 1, 134.8 minutes for group 2, 111.3 minutes for group 3, and 106.7 minutes for group 4. Statistical analysis revealed that the operative time was significantly shorter for groups 3 and 4 compared with that for groups 1 and 2. In addition, the fluoroscopy time was significantly decreased in groups 3 and 4 (P = .001). The complication rate was similar between the four groups (P = .899). However, success was significantly increased after the first 20 cases, and the remaining three groups had a significantly higher success rate compared with group 1 (70% for group 1, 90% for group 2, 95% for group 3, and 100% for group 4; P = .024). ConclusionsSuccess in the performance of PT for the treatment of acute lower extremity DVT reaches satisfactory levels after 20 cases. Additionally, operation time and fluoroscopy time are significantly decreased after 40 cases and then start plateau.