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Randomized study of different approaches for catheter-directed thrombolysis for lower-extremity acute deep venous

Peng-Fei Duan1, Cai-Fang Ni1

  • 1Department of Interventional Radiology, The First Affiliated Hospital of Soo Chow University, Suzhou, China.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|August 1, 2015
PubMed

Insights

Catheter-directed thrombolysis (CDT) effectively treats acute deep venous thrombosis (DVT). The great saphenous vein approach offers the lowest complication rate compared to small saphenous or popliteal vein routes.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Management

Background:

  • Acute lower-extremity deep venous thrombosis (DVT) poses significant risks.
  • Catheter-directed thrombolysis (CDT) is a treatment option for DVT.
  • Evaluating different vascular access routes for CDT is crucial.

Purpose of the Study:

  • To assess the feasibility, effectiveness, and complications of CDT for acute lower-extremity DVT.
  • To compare three distinct vascular access routes: small saphenous vein, great saphenous vein, and popliteal vein.
  • To identify the optimal approach for CDT in DVT management.

Main Methods:

  • A prospective study involving 106 patients with acute DVT.
  • Patients were divided into three groups based on vascular access: small saphenous vein (n=41), great saphenous vein (n=35), and popliteal vein (n=30).
  • Iliac vein interventions (balloon dilation and stenting) were performed in 65 patients.

Main Results:

  • No significant difference in limb edema reduction or thrombolysis rates among the three groups.
  • Procedure duration was shorter for great saphenous and popliteal vein approaches.
  • The small saphenous vein group had the highest complication rate; the great saphenous vein group had the lowest.

Conclusions:

  • CDT is a viable and effective treatment for acute DVT.
  • The great saphenous vein approach is recommended due to its lower complication rate.
  • Long-term follow-up showed positive outcomes with minimal rethrombosis.
Abstract

Keywords:
catheter-directed thrombolysissaphenous veinstentsvenous thrombosis

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