Percutaneous AngioJet thrombectomy for acute iliofemoral deep venous thrombosis

Abstract

Objective To evaluate the clinical value of percutaneous AngioJet thrombectomy for acute iliofemoral deep venous thrombosis . Methods 50 patients were divided into AngioJet thrombectomy group(25 cases)compared with bolus injection of urokinase through catheter in control group(25 cases). When the thrombosis was completely dissolved, the PTA and stents were implanted in those patients presenting May-Thurner syndrome in both groups. Inferior vena cava filter was retrieved from the patients and the thrombolytic therapy was discontinued. The patency rate of iliofemoral venous was assessed by CTA at 1 and 6 months after the procedure. Results The average dosage of urokinase in AngioJet patients was (880 000±354 000) units.The mean duration time of catheter-directed thrombolysis was (42.2±16.7) hours and the average hospitalization time is (3.8±0.8) days. Grade Ⅲ thrombolysis was achieved in 18 limbs and grade Ⅱ lysis in 6 limbs, grade Ⅰ lysis in 1 limb. The mean duration time of catheter-directed thrombolysis was (129.6±32.2) hours. The average dose of urokinase was (4 100 000±1 060 000) units and the average hospitalization time was (7.9±1.4) days in control group. Grade Ⅲ thrombolysis was achieved in 10 limbs, grade Ⅱ lysis in 9 limbs and grade Ⅰ lysis in 6 limbs. The dosage of urokinase, duration time of catheter-directed thrombolysis, time in hospital and clinical effects were statistically different between the two groups (all P<0.05). There were no recurrent thrombosis in all the patients after 6 months of treatment. Venous patency was maintained in all patients with implanted stent. Conclusions Percutaneous AngioJet thrombectomy with adjunctive thrombolytic therapy is an effective, safe treatment modality in patients with acute iliofemoral vein thrombosis. Key words: Deep vein thrombosis; Radiology, interventional; Catheter-directed thrombolysis; Percutaneous mechanical thrombectomy