Endovascular Thrombectomy for Acute Iliofemoral Deep Venous Thrombosis Through a Jugular Approach with a Rotational Device.
Arrow-Trerotola PTD
Deep vein thrombosis
Pharmacomechanical catheter-directed thrombolysis
Post-thrombotic syndrome
Venous thrombosis
Journal
Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
14
05
2023
accepted:
25
07
2023
medline:
5
12
2023
pubmed:
19
8
2023
entrez:
18
8
2023
Statut:
ppublish
Résumé
To report the effectiveness of pharmacomechanical catheter-directed thrombolysis (PCDT) in the management of acute iliofemoral deep venous thrombosis (DVT) via the jugular vein using a slow rotation and large-tip device (SRD) in a large cohort of patients. From 2011 to 2021, 277 patients (mean age 45 years, 59.2% women) were treated in 6 centres with PCDT for ilio-fémoral DVT. PCDT was performed via the jugular vein and consisted of one session of fragmentation-fibrinolysis, aspiration and, if needed, angioplasty with stenting. The aim of PCDT was to achieve complete clearance of the venous thrombosis and to restore iliofemoral patency. Residual thrombotic load was assessed by angiography, venous patency by duplex ultrasound and clinical effectiveness by the rate of post-thrombotic syndrome (Villalta score > 4). All patients were treated via the jugular vein using an SRD, and all but one were treated with fibrinolysis. Angioplasty with stenting was performed in 84.1% of patients. After the procedure, the residual thrombotic load at the ilio-fémoral region was < 10% in 96.1% of patients. The rate of major complications was 1.8% (n = 5), the rate of minor complications was 4% (n = 11), and one patient died from pulmonary embolism (0.4%) At a median follow-up of 24 months, primary and secondary iliofemoral patency was 89.6% and 95.8%, respectively. The rate of PTS was 13.8% at 12 months. PCDT via the jugular vein using an SRD is an efficient treatment for acute iliofemoral DVT and results in high long-term venous patency and low PTS rates. Level of evidence Level 4, Case series.
Identifiants
pubmed: 37596417
doi: 10.1007/s00270-023-03529-4
pii: 10.1007/s00270-023-03529-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1684-1693Informations de copyright
© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Références
Comerota AJ, Gravett MH. Iliofemoral venous thrombosis. J Vasc Surg. 2007;46:1065–76.
doi: 10.1016/j.jvs.2007.06.021
pubmed: 17980295
AbuRahma AF, Perkins SE, Wulu JT, Ng HK. Iliofemoral deep vein thrombosis: conventional therapy versus lysis and percutaneous transluminal angioplasty and stenting. Ann Surg. 2001;233:752–60.
doi: 10.1097/00000658-200106000-00004
pubmed: 11371733
pmcid: 1421317
Comerota AJ, Kearon C, Gu C-S, Julian JA, Goldhaber SZ, Kahn SR, et al. Endovascular thrombus removal for acute iliofemoral deep vein thrombosis. Circulation. 2019;139:1162–73.
doi: 10.1161/CIRCULATIONAHA.118.037425
pubmed: 30586751
pmcid: 6389417
Enden T, Haig Y, Kløw N-E, Slagsvold C-E, Sandvik L, Ghanima W, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet. 2012;379:31–8.
doi: 10.1016/S0140-6736(11)61753-4
pubmed: 22172244
Karthikesalingam A, Young EL, Hinchliffe RJ, Loftus IM, Thompson MM, Holt PJE. A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg Off J Eur Soc Vasc Surg. 2011;41:554–65.
doi: 10.1016/j.ejvs.2011.01.010
Wang W, Sun R, Chen Y, Liu C. Meta-analysis and systematic review of percutaneous mechanical thrombectomy for lower extremity deep vein thrombosis. J Vasc Surg Venous Lymphat Disord. 2018;6:788–800.
doi: 10.1016/j.jvsv.2018.08.002
pubmed: 30336908
Go C, Saadeddin Z, Pandya Y, Chaer RA, Eslami MH, Hager ES, et al. Single- versus multiple-stage catheter-directed thrombolysis for acute iliofemoral deep venous thrombosis does not have an impact on iliac vein stent length or patency rates. J Vasc Surg Venous Lymphat Disord. 2019;7:781–8.
doi: 10.1016/j.jvsv.2019.05.010
pubmed: 31495769
pmcid: 7917433
Kuetting D, Luetkens J, Wolter K, Faron A, Kania A, Thomas D. Catheter-directed thrombectomy for highly symptomatic patients with iliofemoral deep venous thrombosis not responsive to conservative treatment. Cardiovasc Intervent Radiol. 2020;43:556–64.
doi: 10.1007/s00270-020-02415-7
pubmed: 31974743
Dexter DJ, Kado H, Schor J, Annambhotla S, Olivieri B, Mojibian H, et al. Interim outcomes of mechanical thrombectomy for deep vein thrombosis from the all-comer CLOUT registry. J Vasc Surg Venous Lymphat Disord. 2022;10:832-840.e2.
doi: 10.1016/j.jvsv.2022.02.013
pubmed: 35218955
Loffroy R, Falvo N, Guillen K, Galland C, Baudot X, Demaistre E, et al. Single-session percutaneous mechanical thrombectomy using the Aspirex
Kahn SR. Measurement properties of the Villalta scale to define and classify the severity of the post-thrombotic syndrome. J Thromb Haemost JTH. 2009;7:884–8.
doi: 10.1111/j.1538-7836.2009.03339.x
pubmed: 19320818
Arnoldussen CWKP, Wittens CHA. An imaging approach to deep vein thrombosis and the lower extremity thrombosis classification. Phlebology. 2012;27(Suppl 1):143–8.
doi: 10.1258/phleb.2012.012s25
pubmed: 22312082
Stevens PE, Levin A. Kidney disease: improving global outcomes chronic kidney disease guideline development work group members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158:825–30.
doi: 10.7326/0003-4819-158-11-201306040-00007
pubmed: 23732715
Vedantham S, Sista AK, Klein SJ, Nayak L, Razavi MK, Kalva SP, et al. Quality improvement guidelines for the treatment of lower-extremity deep vein thrombosis with use of endovascular thrombus removal. J Vasc Interv Radiol JVIR. 2014;25:1317–25.
doi: 10.1016/j.jvir.2014.04.019
pubmed: 25000825
Giri J, Sista AK, Weinberg I, Kearon C, Kumbhani DJ, Desai ND, et al. Interventional therapies for acute pulmonary embolism: current status and principles for the development of novel evidence: a scientific statement from the American heart association. Circulation. 2019;140:e774-801.
doi: 10.1161/CIR.0000000000000707
pubmed: 31585051
Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40:1141–6.
doi: 10.1007/s00270-017-1703-4
pubmed: 28584945
Abramowitz SD, Kado H, Schor J, Annambhotla S, Mojibian H, Marino AG, et al. Six-month deep vein thrombosis outcomes by chronicity: analysis of the real-world clotTriever outcomes registry. J Vasc Interv Radiol JVIR. 2023;34:879-887.e4.
doi: 10.1016/j.jvir.2022.12.480
pubmed: 37105663
Bashar K, Shalan A, Sharafat Ali S, Tang T, Tiwari A. Endovascular versus medical treatment of venous compression syndrome of the iliac vein—a systematic review. VASA Z Gefasskrankheiten. 2021;50:22–9.
doi: 10.1024/0301-1526/a000911
Aludin S, Schäfer PJ, Borzikowsky C, Jansen O, Pfarr J, Berndt R, et al. Experimental evaluation of the effectiveness of aspiration-based techniques to treat different types of acute thromboembolic occlusions in the femoropopliteal vascular system using an in vitro flow model. Cardiovasc Intervent Radiol. 2022;45:228–35.
doi: 10.1007/s00270-021-03024-8
pubmed: 34921347
Park K-M, Moon IS, Kim JI, Yun S-S, Hong KC, Jeon YS, et al. Mechanical thrombectomy with Trerotola compared with catheter-directed thrombolysis for treatment of acute iliofemoral deep vein thrombosis. Ann Vasc Surg. 2014;28:1853–61.
doi: 10.1016/j.avsg.2014.06.056
pubmed: 25011091
Lee K-H, Han H, Lee KJ, Yoon C-S, Kim SH, Won JY, et al. Mechanical thrombectomy of acute iliofemoral deep vein thrombosis with use of an Arrow-Trerotola percutaneous thrombectomy device. J Vasc Interv Radiol JVIR. 2006;17:487–95.
doi: 10.1097/01.RVI.0000202611.93784.76
pubmed: 16567673
Köksoy C, Yilmaz MF, Başbuğ HS, Calik ES, Erkut B, Kaygın MA, et al. Pharmacomechanical thrombolysis of symptomatic acute and subacute deep vein thrombosis with a rotational thrombectomy device. J Vasc Interv Radiol JVIR. 2014;25:1895–900.
doi: 10.1016/j.jvir.2014.08.018
pubmed: 25282676
O’Sullivan GJ, de Graaf R, Black SA. Just how attractive is the ATTRACT trial? Cardiovasc Intervent Radiol. 2018;41:1313–7.
doi: 10.1007/s00270-018-2016-y
pubmed: 29946944