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Multimodal percutaneous intervention for critical venous occlusive disease
Rajeev Dayal1, Joshua Bernheim, Daniel G Clair
1Department of Surgery, The New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY 10021, USA.
Annals of Vascular Surgery
|March 17, 2005
Summary
Multimodal percutaneous therapy effectively treats critical venous thrombosis and occlusion, resolving symptoms in 72% of patients. This approach offers a vital solution for severe venous disease, improving limb salvage and quality of life.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Cardiology
Background:
- Critical deep venous thrombosis and occlusion represent a severe subset of venous disease.
- Patients often present with debilitating symptoms impacting quality of life and limb viability.
Purpose of the Study:
- To evaluate the efficacy of multimodal percutaneous therapy for complex critical venous thrombotic and occlusive disease.
- To assess symptom resolution and treatment outcomes in a cohort of severely affected patients.
Main Methods:
- A cohort of 25 patients with critical venous thromboses or occlusions underwent multimodal percutaneous therapy.
- Therapies included thrombolysis, mechanical thrombectomy, venoplasty, stenting, and IVC filtration, guided by ultrasound.
- Venous access was tailored to lesion location, with long-term anticoagulation initiated.
Main Results:
- Symptom resolution was achieved in 18 patients (72%), with partial resolution in 4 (16%).
- Treatment failure occurred in 3 patients (12%).
- Life and limb-threatening conditions, including phlegmasia cerulea dolens and SVC syndrome, showed positive responses.
Conclusions:
- Multimodal percutaneous treatment is a viable and effective strategy for acute critical venous thrombotic and occlusive disease.
- This approach successfully alleviates severe symptoms and addresses acute, life- and limb-threatening venous conditions.