The efficacy of rotational pharmaco-mechanical thrombectomy in patients with acute iliofemoral deep vein thrombosis: Is the standard treatment of deep vein thrombosis changing?

Phlebology. 2021 Mar;36(2):119-126. doi: 10.1177/0268355520966880. Epub 2020 Oct 22.

Abstract

Objective: In this study, we aimed to evaluate the efficiency of rotational thrombectomy device in pharmaco-mechanical thrombolysis for symptomatic acute ilio-femoral deep vein thrombosis.

Materials and methods: Between August 2013 and May 2018,82 patients with acute deep vein thrombosis comprising the iliofemoral segment whom underwent Pharmaco-mechanical thrombolysis were evaluated retrospectively. The Cleaner thrombectomy device was used. The resolution of thrombi was examined and graded. Development of post-thrombotic syndrome was assessed with Villalta scores.

Results: 75 patients (91.4%) had complete thrombus resolution. Between 50-99% resolution was noted in 6 patients (7.4%) and in one (1.2%) case less than %50 thrombus resolution was obtained. Seventy-five patients (91%) of the cohort could be treated in a single session; 7 patients (8.6%) required reintervention(s). Although improved post-thrombotic syndrome rates were lower at the short term, Villalta scores gradually increased during follow up.

Conclusions: In conclusion, Pharmaco-mechanical thrombolysis with Cleaner thrombectomy device is a safe and beneficial method for the treatment of acute iliofemoral deep vein thrombosis. Long term follow up data of large volume multicenter studies are warranted.

Keywords: Deep vein thrombosis; pharmaco-mechanical thrombolysis; post-thrombotic syndrome.

MeSH terms

  • Femoral Vein
  • Humans
  • Iliac Vein* / diagnostic imaging
  • Retrospective Studies
  • Thrombectomy
  • Thrombolytic Therapy
  • Treatment Outcome
  • Vascular Patency
  • Venous Thrombosis* / drug therapy