[Pharmacomechanical thrombectomy for total-subtotal deep vein thrombosis]

To improve treatment outcomes in patients with late stages of total-subtotal deep vein thrombosis using pharmacomechanical thrombectomy.

We compared treatment outcomes in 2 homogeneous groups of patients with deep vein thrombosis and severe acute venous insufficiency. Standard anticoagulation (apixaban) was performed in the first group (n=20), endovascular treatment was applied in the second group (n=20). Regional catheter thrombolysis was performed at the first stage, and percutaneous mechanical thrombectomy was performed at the second stage. Incidence of hemorrhagic syndrome was assessed. The results were evaluated after one year considering patency of deep veins and severity of venous outflow disorders.

Hemorrhagic complications occurred in 15% and 25% of patients, respectively. This required discontinuation of anticoagulation throughout the treatment and subsequent appointment of minimum doses of apixaban. Complete restoration of vein patency was observed in 20% and 55%, partial recanalization - 45% and 25%, minimal recovery - in 35% and 20% of patients, respectively. In the first group, venous outflow disorders were absent in 20% of patients, mild disorders were registered in 45%, moderate - 20%, severe - 15% of patients. In the second group, these values were 55%, 25%, 20% and 0% of patients, respectively.

Pharmacomechanical thromboectomy can improve treatment outcomes.