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364571

Acute iliofemoral deep vein thrombosis: does catheter-directed thrombolysis affect outcomes?

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Last updated: 05 Jan 2025

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Abstract

Purpose
The aim was to assess the role of catheter-directed thrombolysis (CDT) in improving patency of the treated venous segments and to examine the correlation of residual thrombus with post-thrombotic syndrome (PTS).
Background
Iliofemoral deep vein thrombosis (DVT) is associated with severe post-thrombotic morbidity when treated with anticoagulation alone. CDT allows early removal of thrombus and reduce valvular reflux and PTS.
Patients and methods
This prospective randomized controlled two-arm study was conducted on 42 patients with iliofemoral DVT. The patients were randomly allocated into two groups according to the intervention performed. Group A: CDT followed by oral anticoagulants [=21 (50%)], group B: standard DVT therapy [=21 (50%)]. The follow-up period was 24 months.
Results
Patients of group A complained of less pain at 10 and 30 days (=0.02 and 0.04, respectively). Also, there was significant decrease in leg circumference in group A at 10 and 30 days (=0.001 and 0.03, respectively). A total of three (15%) clinically relevant nonmajor bleeding complications were reported in the CDT group. Using CDT is associated with less PTS at sixth month, 1 year, and 2 years; six (27.3%), seven (31.8%), and nine (40.9%), respectively, as compared with group B; 11 (47.8%), 13 (56.5%), and 15 (65.2%), respectively (=0.024, 0.017, and 0.035, respectively).
Conclusion
Addition of CDT in the treatment of acute iliofemoral DVT was safe and tolerated by most of the patients with better effect to reduce leg pain and circumference. It was considered a protecting weapon to prevent PTS and thereby improving the quality of life and was related to achievement of higher iliac vein patency and less reflux.

DOI

10.4103/ejs.ejs_209_19

Keywords

catheter-directed thrombolysis, iliofemoral venous thrombosis, post-thrombotic syndrome, standard anticoagulation

Authors

First Name

El-Sayed A.

Last Name

Abd El-Mabood

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Orcid

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First Name

Waleed A.

Last Name

Sorour

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Volume

39

Article Issue

2

Related Issue

48960

Issue Date

2020-04-01

Receive Date

2019-11-26

Publish Date

2020-04-27

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_364571.html

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https://ejsur.journals.ekb.eg/service?article_code=364571

Order

364,571

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

Acute iliofemoral deep vein thrombosis: does catheter-directed thrombolysis affect outcomes?

Details

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Article

Created At

21 Dec 2024