Related Experiment Video

Updated: Aug 6, 2026

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug
07:50

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug

Published on: June 4, 2021

Adjunctive percutaneous mechanical thrombectomy for lower-extremity deep vein thrombosis: clinical and economic

Hyun S Kim1, Ajanta Patra, Ben E Paxton

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Blalock 545, Baltimore, MD 21287-4010, USA. sikhkim@jhmi.edu

Journal of Vascular and Interventional Radiology : JVIR
|July 27, 2006
PubMed

Insights

Catheter-directed thrombolysis (CDT) with percutaneous mechanical thrombectomy (PMT) is as effective as CDT alone for lower-extremity deep vein thrombosis (DVT). This combined approach reduces treatment time and costs, offering a more efficient treatment option.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Management

Background:

  • Deep vein thrombosis (DVT) is a significant cause of morbidity and mortality.
  • Catheter-directed thrombolysis (CDT) is a common treatment for extensive DVT.
  • Optimizing CDT protocols to improve efficacy and reduce costs is crucial.

Purpose of the Study:

  • To compare the clinical and economic outcomes of CDT alone versus CDT combined with rheolytic percutaneous mechanical thrombectomy (PMT).
  • To evaluate the effectiveness and cost-efficiency of pharmacomechanical thrombolysis for acute iliofemoral DVT.

Main Methods:

  • A retrospective analysis of consecutive patients with acute iliofemoral DVT treated between 1997 and 2003.
  • Patients received either CDT with urokinase alone or CDT with urokinase plus PMT.
  • Clinical outcomes (lysis rates, bleeding, PE) and economic outcomes (costs) were compared.

Main Results:

  • CDT plus PMT demonstrated significantly shorter treatment durations (30.3 vs 56.5 hours) and lower urokinase doses (2.95 vs 6.70 million U).
  • Complete clot lysis rates were similar between the two groups (84.2% vs 80.7%).
  • Major bleeding and pulmonary embolism rates were comparable; however, CDT plus PMT resulted in significantly lower costs ($5,128 vs $10,127).

Conclusions:

  • Percutaneous CDT with rheolytic PMT is a safe and effective alternative to CDT alone for acute iliofemoral DVT.
  • Pharmacomechanical thrombolysis offers reduced treatment time, lower drug utilization, and decreased costs.
  • Further randomized trials are recommended to validate these findings for DVT treatment.
Abstract

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...