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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2016 Sep 07

language: English

Pharmacomechanical thrombectomy of upper extremity deep vein thrombosis

Evren OZCINAR, Nur DIKMEN YAMAN, Mehmet CAKICI, Cagdas BARAN, Mustafa B. INAN, Serkan DURDU, Ahmet R. AKAR, Mustafa SIRLAK

Department of Cardiovascular Surgery, Ankara University, Faculty of Medicine, Ankara, Turkey


BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the treatment of upper extremity deep vein thrombosis (UEDVT).
METHODS: We conducted a prospective, observational cohort study of consecutive patients with acute UEDVT with low-dose UACDT using the Ekosonic® Endovascular System, EKOS Corporation, Bothell, WA, USA at a single center from September 2012 until October 2014. Overall, sixteen patients(11 males and 6 females, age range 18 to 70 years, mean age, 45.6 years) were included in the study protocol. The primary efficacy outcome was complete thrombus clearance. The primary safety outcomes were recurrence of thrombosis within the follow-up visit and major bleeding within 96 hours of the procedure initiation.
RESULTS: The median tissue plasminogen activator (tPA) dose for all patients in our study was 16.81±2.51 mg( range 15 to 28 mg) and the median infusion time was 15 hours. Complete thrombus clearance was achieved in 11( 68.8%) patients, and partial clearance was detected in 3 (18.8%) patients. Of 16 patients with UEDVT, two had gastrointestinal bleeding, and two had puncture site bleeding.
CONCLUSIONS: This prospective study demonstrates effectiveness and safety of ultrasound accelerated thrombolysis in patients with UEDVT.

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