Pharmaco-mechanical Thrombectomy and Stent Placement in Patients with May-Thurner Syndrome and Lower Extremity Deep Venous Thrombosis / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 757-762, 2009.
Article
in Korean
| WPRIM
| ID: wpr-203866
ABSTRACT
BACKGROUND:
Compression of the left common iliac vein by the overriding common iliac artery is frequently combined with acute deep vein thrombosis in patients with May-Thurner Syndrome. We evaluate the results of treatment with thrombolysis and thrombectomy followed by stenting in 34 patients with May-Thurner Syndrome combined with lower extremity deep venous thrombosis. MATERIAL ANDMETHOD:
The authors retrospectively reviewed the records of 34 patients (mean age 65+/-14 year old) who had undergone stent insertion for acute deep vein thrombosis that was caused by May-Thurner syndrome. After thrombectomy and thrombolysis, insertion of a wall stent and balloon angioplasty were performed to relieve the compression of the left common iliac vein. Urokinase at a rate of 80,000 to 120,000 U/hour was infused into the thrombosed vein via a multi-side hole thrombolysis catheter. A retrieval inferior vena cava (IVC) filter was placed to protect against pulmonary embolism in 30 patients (88%). Oral anticoagulation with warfarin was maintained for 3 months, and follow-up Multi Detector Computerized Tomography (MDCT) angiography was done at the date of the patients' hospital discharge and at the 6 months follow-up.RESULT:
The symptoms of deep venous thrombosis disappeared in two patients (4%), and there was clinical improvement within 48 hours in twenty eight patients (82%), but there was no improvement in four patients (8%). The MDCT angiography at discharge showed no thrombus in 9 patients (26%) and partial thrombus in 21 (62%), whereas the follow-up MDCT at 6.4+/-5.5 months (32 patients) revealed no thrombus in 23 patients (72%), and partial thrombus in 9 patients (26%). Two patients (6%) had recurrence of DVT, so they underwent retreatment.CONCLUSION:
Stent insertion with catheter-directed thrombolysis and thrombectomy is an effective treatment for May-Thurner syndrome combined with acute deep vein thrombosis in the lower extremity.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pulmonary Embolism
/
Recurrence
/
Thrombosis
/
Veins
/
Vena Cava, Inferior
/
Warfarin
/
Angiography
/
Urokinase-Type Plasminogen Activator
/
Stents
/
Retrospective Studies
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
The Korean Journal of Thoracic and Cardiovascular Surgery
Year:
2009
Type:
Article
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