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Titolo:
Percutaneous transluminal thrombus fragmentation and catheter directed thrombolysis in iliofemoral and caval thrombosis
Autore:
Grohmann, G; Stille-Siegener, M; Vonhof, S; Grumbach, IM; Figulla, HR;
Indirizzi:
Univ Jena, Innere Med Klin 3, D-07740 Jena, Germany Univ Jena Jena Germany D-07740 Innere Med Klin 3, D-07740 Jena, Germany
Titolo Testata:
PERFUSION
fascicolo: 8, volume: 12, anno: 1999,
pagine: 312 -
SICI:
0935-0020(199908)12:8<312:PTTFAC>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
DEEP VENOUS THROMBOSIS; VEIN-THROMBOSIS; FIBRINOLYTIC THERAPY; STREPTOKINASE; UROKINASE;
Keywords:
venous thrombosis; thrombus fragmentation; thrombolysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Grohmann, G Univ Jena, Innere Med Klin 3, D-07740 Jena, Germany Univ JenaJena Germany D-07740 Klin 3, D-07740 Jena, Germany
Citazione:
G. Grohmann et al., "Percutaneous transluminal thrombus fragmentation and catheter directed thrombolysis in iliofemoral and caval thrombosis", PERFUSION, 12(8), 1999, pp. 312

Abstract

Background The outcome of systemic thrombolysis in deep iliac venous thrombosis are unsatisfactory, especially in patients with old thrombosis (olderthan one week) and extensively occluded veins, The aim of this study was to achieve a higher patency rate in deep venous thrombosis by a preceding mechanical fragmentation of thrombus mass and a subsequent catheter directed thrombolysis. Patients and methods: 12 patients (3 males, 9 females; mean age 36.1 years) suffering from thrombosis of pelvic veins were treated by means of the percutaneous transluminal thrombus fragmentation and catheter directed thrombolysis. In addition, in two patients a total and in one patient a partial occlusion of the inferior vena cava was found. The median of duration of symptoms before fragmentation by a balloon catheter (8-12 mm) was 6.5 days (1-28 days). In seven patients preceding systemic thrombolytic therapy had failed. A temporary vena cava filter was placed below the renal veins before fragmentation to prevent pulmonary embolism. Results: The thrombotic area was passed by guide-wire in all cases. After thrombolysis with urokinase (50-150,000 U/h) for a mean of 4,3 days an anterograde flow (TIMI II-III) was reestablished in 10 out of 12 patients. In two out of three patients with vena cava involvement, venous flow was successfully reestablished; in the third patient an early reocclusion occurred because of a heparin associated thrombocytopenia syndrome. In 5/12 patients blood transfusions were necessary. In two patients bleeding complication wasdirectly related to the interventional procedure. Conclusions Percutaneous transluminal thrombus fragmentation and subsequent thrombolysis represent an efficient procedure after unsuccessful systemiclysis in venous iliac thrombosis and a primary therapeutical option in vena cava thrombosis.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/12/20 alle ore 16:08:42