Percutaneous mechanical thrombectomy for treatment of acute iliofemoral vein thrombi / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the efficacy and safety of percutaneous mechanical thrombectomy (PMT) in treatment of acute iliofemoral vein thrombi. Methods: PMT using Aspirex catheter was performed in 21 patients of acute iliofemoral vein thrombi after placement of inferior vena cava filter. Angiography was performed to evaluate thrombi clearance after PMT. Patients with residual thrombi were treated with adjunctive catheter directed thrombolysis (CDT) and reexamined with angiography every day. After thrombi removal, balloon dilatation and stent implantation were performed if severe stenosis or occlusion of iliac vein was found. Then inferior vena cava filter was retrieved. The complications of interventional therapy, the effect of thrombi removal and the improvement of symptoms were observed. The patency of deep vein and the Villalta scoring system were evaluated for assessment of the incidence of post-thrombotic syndrome 1, 3 and 6 months after the procedures. Results: All 21 patients were successfully treated with PMT. Eight patients had grade III thrombectomy (complete removal).The other 13 patients had grade Ⅱ thrombectomy (partial removal), and the residual thrombi were cleared with CDT. Balloon dilation and stent placement were performed in 13 patients with severe stenosis or occlusion of left iliac vein. The venous blood flow restored and symptoms of lower limb swelling and pain alleviated in all 21 patients after therapy. There was no death nor serious complication related to the procedures. No thrombosis recurrence was found, and all stents kept patent during the follow-up. One patient with 5 points of Villalta score developed mild post thrombotic syndrome 6 months after procedure. Conclusion: PMT is effective and safe for treatment of acute iliofemoral vein thrombi.