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Catheter-directed thrombolysis for treatment of deep venous thrombosis in the upper extremities

Anders Vik1, Pål Andre Holme, Kulbir Singh

  • 1Department of Medicine, University Hospital of North Norway, Tromsø, Norway. anders.vik@unn.no

Cardiovascular and Interventional Radiology
|July 31, 2009
PubMed

Insights

Catheter-directed thrombolysis (CDT) effectively treats upper extremity deep venous thrombosis (UEDVT), restoring venous drainage and significantly reducing the risk of postthrombotic syndrome (PTS). Early CDT intervention is crucial for preventing complications.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Hematology

Background:

  • Traditional anticoagulation for upper extremity deep venous thrombosis (UEDVT) has a high incidence of postthrombotic syndrome (PTS).
  • Catheter-directed thrombolysis (CDT) offers a potential alternative for efficient thrombus removal and reduced PTS.
  • Understanding the efficacy and long-term outcomes of CDT for UEDVT is critical.

Purpose of the Study:

  • To evaluate the primary efficacy, complications, and long-term results of catheter-directed thrombolysis (CDT) in patients with upper extremity deep venous thrombosis (UEDVT).
  • To assess the incidence of postthrombotic syndrome (PTS) following CDT for UEDVT.
  • To identify factors influencing bleeding complications and treatment outcomes.

Main Methods:

  • Retrospective cohort study of 30 patients with UEDVT treated with CDT between 2002 and 2007.
  • Assessment of PTS using a modified Villalta scale.
  • Analysis of thrombolysis duration, rt-PA dosage, and bleeding complications.

Main Results:

  • Successful thrombolysis (Grade II or III) was achieved in 97% of patients.
  • Major bleeding occurred in 9% of patients; early intervention (<7 days) was associated with fewer bleeding complications.
  • At long-term follow-up (median 21 months), 62% of patients had patent veins, and only 21% experienced mild PTS, with no severe cases.

Conclusions:

  • Catheter-directed thrombolysis (CDT) is an effective treatment for UEDVT, restoring venous drainage and leading to a low frequency of mild postthrombotic syndrome (PTS).
  • Early initiation of CDT is associated with reduced bleeding complications.
  • CDT represents a valuable therapeutic option for UEDVT, improving patient outcomes and preventing severe PTS.

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