Catheter-directed thrombolysis combined with manual aspiration thrombectomy for acute inferior vena cava filter

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Wen D Li1, Cheng L Li, Ai M Qian

  • 1Department of Vascular Surgery, Second Affiliated Hospital, Soochow University, Soochov, China - vasculars@126.com.

International Angiology : a Journal of the International Union of Angiology
|November 19, 2015
PubMed

Insights

Catheter-directed thrombolysis combined with aspiration thrombectomy is a safe and effective treatment for inferior vena cava filter thrombosis. This combined approach reduces treatment time and complication rates compared to catheter-directed thrombolysis alone.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Thrombosis Management

Background:

  • Inferior vena cava (IVC) filter thrombosis is a recognized complication.
  • Optimal treatment strategies for IVC filter thrombosis remain to be established.
  • This study investigates a combined endovascular approach.

Purpose of the Study:

  • To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT) combined with aspiration thrombectomy (AT) for IVC filter thrombosis.
  • To compare the outcomes of CDT alone versus CDT with AT.
  • To assess procedural time, urokinase dosage, and complication rates.

Main Methods:

  • Retrospective review of 35 patients treated for IVC filter thrombosis between May 2009 and May 2014.
  • Patients received either CDT alone or CDT with AT.
  • Outcomes including procedure details, complications, and clinical results were analyzed.

Main Results:

  • The combined CDT with AT group (19 patients) showed a significantly shorter procedural time (64.9±35.9 hours) than the CDT alone group (99.5±51.4 hours).
  • The CDT with AT group required a lower dose of urokinase (1.5±0.6 million IU) compared to CDT alone (2.1±1.1 million IU).
  • Fewer complications were observed in the CDT with AT group (4 cases) versus the CDT alone group (9 cases).

Conclusions:

  • Catheter-directed thrombolysis with aspiration thrombectomy is a safe and effective treatment for acute IVC filter thrombosis.
  • The combined approach offers advantages over CDT alone, including reduced thrombolysis time and lower urokinase usage.
  • CDT with AT may lead to a decreased incidence of procedural complications.
Abstract

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