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Published on: April 13, 2018
Temporary vena cava filters and ultrahigh streptokinase thrombolysis therapy: a clinical study
H Lorch1, M Zwaan, H J Siemens
1Department of Radiology, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany. lorch@medinf.mu-luebeck.de
Purpose:
To assess the efficacy of temporary vena cava filters in patients undergoing ultrahigh-dose streptokinase thrombolysis for iliocaval thrombosis and to determine therapy success and filter and therapy complications.
Methods:
Forty-five patients were studied regarding extension and characteristics of thrombosis, duration, success, and complications of thrombolysis therapy, filter type, access route, pulmonary embolisms, and filter complications.
Results:
Complete recanalization was achieved in 57% of cases. Filters were inserted predominantly via a transbrachial route. One fatal pulmonary embolism (2%) occurred 1 day after starting thrombolysis. No other pulmonary embolism was noted. Other complications were induced by thrombolysis alone (n = 12), thrombolysis and filter (n = 9), and filter alone (n = 11).
Conclusion:
Fatal pulmonary embolisms as a complication of ultrahigh-dose treatment of pelvic or caval thrombosis can not safely be prevented by the temporary vena cava filters currently available. Filter design needs to be improved.
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