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Updated: May 25, 2026
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Safety and efficacy of catheter-directed thrombolysis
N Bækgaard1, L Klitfod, R Broholm
1Gentofte Hospital, Niels Andersensvej 65, DK-2900 Hellerup, Denmark. baekgaard@dadlnet.dk
Insights
Catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT) is a safe and effective treatment. This procedure demonstrates durable long-term efficacy in restoring vein patency and function.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Thrombosis Management
Background:
- Iliofemoral deep venous thrombosis (DVT) poses significant risks.
- Catheter-directed thrombolysis (CDT) offers a minimally invasive approach.
- Popliteal vein access is a viable route for CDT.
Purpose of the Study:
- To evaluate the safety and efficacy of catheter-directed thrombolysis (CDT) for iliofemoral DVT.
- To describe the mechanism and outcomes of CDT via popliteal vein access.
- To assess long-term vein patency and valve function post-CDT.
Main Methods:
- Retrospective analysis of 89 patients (91 extremities) with iliofemoral DVT treated between 1999-2006.
- Systematic registration of risk factors and peri/post-procedure complications.
- Yearly follow-up with ultrasonography to assess vein patency and valve function.
Main Results:
- CDT was performed without mortality or pulmonary embolism.
- Major bleeding occurred in 2% of patients; minor bleeding in 30%.
- At six years, 86% of patients maintained competent iliofemoral and popliteal veins.
Conclusions:
- Catheter-directed thrombolysis (CDT) is a safe procedure for iliofemoral DVT.
- Patients can be managed in a clinical vascular ward setting.
- Long-term efficacy of CDT is durable, maintaining competent veins.
Objective:
To describe the background for--and mechanism of--catheter-directed thrombolysis (CDT) for iliofemoral deep venous thrombosis (DVT) accessed via the popliteal vein. Focus is on safety and efficacy.
Method:
From the Copenhagen experience we have looked into the systematically registrated risk factors, peri- and postprocedure complications for patients consecutively treated from 1999 to 2006. The patients were treated in a clinical ward. The patients were followed yearly with ultrasonography for assessment of patency and valve function. Inclusion and exclusion criteria have been published earlier.
Results:
A total of 89 patients with 91 extremities with iliofemoral DVT were included (70 women and 19 men, mean age 29 years [range 14-59]). Only 11% of the patients were without any risk factor for DVT. CDT was performed without mortality and pulmonary embolism. Major bleeding occurred in two patients and minor bleeding in 27 patients, mostly from the puncture site. Stenting was necessary in 54 limbs. Five stents revealed occlusion, three procedural (2 reopened) and two late. The median follow-up was 87 months (range 17-148). At six years, 86% had competent iliofemoral (and popliteal) vein segment.
Conclusion:
CDT of iliofemoral DVT is a safe procedure. The patients can stay in a clinical vascular ward. The long-term efficacy is still durable in producing competent veins as concluded in our earlier published results.
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