Catheter-Directed Thrombectomy for Highly Symptomatic Patients with Iliofemoral Deep Venous Thrombosis not Responsive

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Daniel Kuetting1, Julian Luetkens2, Karsten Wolter2

  • 1Department of Radiology, University of Bonn, Venusberg Campus 1, 53127, Bonn, Germany. daniel.kuetting@ukbonn.de.

Cardiovascular and Interventional Radiology
|January 25, 2020
PubMed

Insights

Pharmacomechanical thrombectomy offers rapid pain relief for iliofemoral deep venous thrombosis (DVT) patients unresponsive to conservative care. This interventional technique demonstrates high patency rates and lasting symptom improvement, supported by angioplasty and stenting.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Cardiovascular Medicine

Background:

  • Iliofemoral deep venous thrombosis (DVT) can cause significant morbidity.
  • Conservative treatment is often insufficient for severe symptomatic cases.
  • Pharmacomechanical thrombectomy remains under-investigated for refractory iliofemoral DVT.

Purpose of the Study:

  • To evaluate the technical and clinical outcomes of pharmacomechanical thrombectomy for symptomatic iliofemoral DVT.
  • To assess complications associated with the procedure.
  • To compare outcomes with existing literature.

Main Methods:

  • Retrospective analysis of 19 patients with iliofemoral DVT treated between 2013-2019.
  • Pharmacomechanical thrombectomy ± thrombolysis was performed.
  • Patients were followed for 12 months, assessing pain and Villalta scores.

Main Results:

  • Successful thrombectomy in all 19 patients; no major complications.
  • Significant reduction in pain (87%) and Villalta scores at 1 year.
  • High iliofemoral vein patency (15/17) post-procedure with angioplasty and stenting.

Conclusions:

  • Catheter-directed thrombectomy provides rapid, long-lasting pain relief for refractory iliofemoral DVT.
  • Angioplasty and venous stenting post-thrombectomy achieve high patency rates.
  • Pharmacomechanical thrombectomy is a viable option for severe iliofemoral DVT.
Abstract

Keywords:
Catheter directed thrombectomyIliofemoral thrombosisPost-thrombotic syndromeVenous stenting

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