Catheter-directed thrombolysis (CDT) with assisted mechanical thrombolysis is now considered as the standard of medical care for deep vein thrombosis (DVT). The study was conducted to describe the immediate and long-term (6 months) safety and effectiveness of CDT in patient with lower limb DVT compared with the routine anticoagulation alone. All 12 to 85 years old patients with recent (0?8 weeks) DVT were included. In CDT group, thrombus was aspirated mechanically and streptokinase (STK) was given along with unfractionated heparin (UFH). After 6 months, deep venous patency and postthrombotic syndrome (PTS) was assessed by using duplex ultrasound and Villalta scale, respectively. Among 51 patients with completed data, 25 patients were allocated additional CDT given for a mean duration of 108???32 hours and 26 patients were allocated standard treatment alone. Grade III (complete) lysis was achieved in 37% patients and grade II (50?90%) lysis in 63% of patients. Patients with partial lysis underwent percutaneous transluminal angioplasty and/or venous stenting. After 6 months, iliofemoral patency was found in 20 (80%) in the CDT group versus 7 (23%) in anticoagulation alone group (p?

openAccessArticle: TruePage Range: 368a-368adoi: 10.1016/j.bpj.2011.11.2012Harvest Date: 2016-01-12 15:10:22issueName:cover date: 2012-01-31pubType

No abstract

May-Thurner syndrome is a rare condition that results from narrowing of the left common iliac vein (CIV) lumen due to pulsatile compression from the right common iliac artery (CIA) as it crosses anterior to it. We present a case of 24-years old female with left lower limb deep venous thrombosis (DVT). Duplex ultrasonography revealed extensive left-sided DVT. Magnetic resonance venogram suggested DVT with left CIV being compressed by right CIA. Pharmaco-mechanical catheter directed thrombolysis-thrombectomy followed by left iliac vein stent placement restored patency to the venous system, with resolution of symptoms.

These results suggest that a 24-hour infusion regimen of STK is as effective as bolus TNK in the treatment of patients with APE in countries with limited resources.