Fast-track thrombolysis protocol: A single-session approach for acute iliofemoral deep venous thrombosis

Ascher, Enrico; Chait, Jesse; Pavalonis, Albert; Marks, Natalie; Hingorani, Anil; Kibrik, Pavel

doi:10.1016/j.jvsv.2019.06.018

Cited by 24 publications

(16 citation statements)

References 26 publications

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“… 2 The development of mechanical thrombectomy devices and improvements to the technique have enabled treatment to be completed in a single session, using minimal quantities of thrombolytics, delivering shorter procedure times, shorter hospital stays, and lower treatment costs. 1 , 3 , 6 Thrombosis of the deep femoral vein is linked to the severity of symptoms in both the acute and chronic phases, with a higher incidence of postthrombotic syndrome, and with worse treatment patency outcomes after angioplasty and placement of the stent in the iliofemoral axis. 1 , 7 …”

Section: Discussionmentioning

confidence: 99%

“…Mechanical thrombectomy can be used to treat iliofemoral deep venous thrombosis (DVT) in a single session. 1 - 3 Access is conventionally obtained via veins located in the lower limbs, primarily the popliteal vein, preventing access to the ipsilateral deep femoral vein, which, in turn, is consistently involved in severe cases. Although contralateral puncture enables access to the deep femoral vein, it prevents angioplasty and stent deployment in the great majority of cases, when there is an obstruction in the iliocaval segment.…”

Section: Introductionmentioning

confidence: 99%

“…A trombectomia mecânica permite o tratamento da trombose venosa profunda (TVP) ilíaco-femoral em uma única sessão 1 - 3 . O acesso convencionalmente é obtido em veias localizadas nos membros inferiores, principalmente na veia poplítea, o que impede o acesso à veia femoral profunda ipsilateral, que, por sua vez, é constantemente envolvida nos casos graves.…”

Section: Introductionunclassified

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Trombectomia em caso grave de trombose venosa iliofemoral afetando a veia femoral profunda pela técnica de punção e sessão única realizada pela veia jugular: relato de caso e descrição da técnica

Rossi

2022

J. vasc. bras.

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Resumo A trombectomia mecânica venosa ilíaca geralmente é realizada por acesso em veias localizadas nos membros inferiores, o que impossibilita o tratamento da veia femoral profunda, que, por sua vez, é uma importante via de influxo ao stent venoso ilíaco. Descrevemos um caso clínico em que foi aplicada a técnica inédita de trombectomia percutânea, angioplastia e implante de stent, realizada por sessão e acesso único, obtido na veia jugular interna.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

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Trombectomia em caso grave de trombose venosa iliofemoral afetando a veia femoral profunda pela técnica de punção e sessão única realizada pela veia jugular: relato de caso e descrição da técnica

Rossi

2022

J. vasc. bras.

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“…En este trabajo, reportamos el primer paciente tratado por nuestro grupo en León, Guanajuato utilizando dicho protocolo y se revisan los detalles técnicos que permiten reproducir los buenos resultados obtenidos por el grupo de Ascher. 9 Aunque es una técnica que tiene en función al menos nueve años, y que al menos en los últimos dos años ya se cuenta con un catéter más potente para ser utilizado en venas de mayor calibre, no se había utilizado en la localidad.…”

Section: Discussionunclassified

Trombectomía fármaco-mecánica en trombosis venosa profunda aguda con el método de Ascher en el Hospital Médica Campestre de León, Guanajuato

Flores

Villalobos

Carrillo

2021

Acta Médica Grupo Ángeles

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“…Stenting rates performed for patients in whom there is residual thrombus after CDT and/or PMT or those with anatomical risk factors appeared to vary widely in the literature, ranging from 16% to 79%. [18][19][20] Stenting was performed selectively at our institution with 45.0% of patients receiving thrombolysis also receiving venous stenting. However, the rate of stenting over the years has remained largely unchanged.…”

Section: Discussionmentioning

confidence: 99%

Ten-year trends in iliofemoral deep vein thrombosis treatment and referral pathways

et al. 2020

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Objectives Iliofemoral deep venous thrombosis is associated with an increased risk of developing post-thrombotic syndrome resulting in reduced quality of life. As there is debate about best management practices, this study aimed to examine the referral and treatment pathways for patients presenting with iliofemoral deep venous thrombosis over an 11-year period at our institution. Methods We conducted a retrospective review of patients diagnosed with lower limb deep vein thrombosis between 2010 and 2020. Ultrasound report findings were reviewed for the presence of iliofemoral deep venous thrombosis with acute, occlusive, or proximal clot. Multiple factors were extracted, including patient demographics, risk factors, diagnostic methods, interventions, referrals, and details of follow-up. The CaVenT and ATTRACT trials studied the benefit of thrombolysis in the early phase of iliofemoral deep venous thrombosis management as compared to anticoagulation alone. An analysis was conducted of patients requiring thrombolysis to determine whether these trials impacted physician practice patterns for thrombolysis. Data were organized and examined by year for trends in treatment and referral pathways. Results The review yielded 2792 patients assessed for lower limb deep venous thrombosis by ultrasound. Four hundred and sixty-seven (16.7%) patients were confirmed to have an occlusive iliofemoral deep venous thrombosis. The average age was 62.7 years (18–101 years). Half (50.4%) of the patients were male. The most common etiology for clot was malignancy-induced hypercoagulable state (39.0%). There was no difference in incidence of iliofemoral deep venous thrombosis diagnosed by ultrasound per year, with an average of 42.5 per year and a peak of 61. There was a trend towards increased rates of computed tomography imaging, ranging between 9.1% and 52.9%. The rate thrombolysis per year ranged between 1.8% and 8.9%, with a range of 4.3% ( n = 20) to 8.9% ( n = 5) in 2018. The use of pharmacomechanical thrombolysis increased, from 25% ( n = 1) in 2010–2012 to 87.5% ( n = 7) in 2018–2020. The rate of inferior vena cava filter insertion alone decreased from 18.2% in 2010 ( n = 4) to 5.9% ( n = 1) in 2020. The length of thrombolysis treatment also decreased, from 100% of patients ( n = 4) receiving treatment duration greater than 24 h in 2010–2012 to 0% ( n = 0) in 2018–2020. About 45% of patients receiving thrombolysis ( n = 9) had venous stenting. No difference in treatment outcomes were observed, with greater than 87.5% of patients reaching intermediate to full resolution of clot burden. No patients experienced intracranial hemorrhage. Conclusions The results of this analysis highlight the change in practice in our institution over time. The low rate of intervention likely reflects the current lack of consensus in published guidelines. It is important for future work to elicit the most appropriate management pathways for patients with iliofemoral deep venous thrombosis.

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Fast-track thrombolysis protocol: A single-session approach for acute iliofemoral deep venous thrombosis

Cited by 24 publications

References 26 publications

Trombectomia em caso grave de trombose venosa iliofemoral afetando a veia femoral profunda pela técnica de punção e sessão única realizada pela veia jugular: relato de caso e descrição da técnica

Trombectomia em caso grave de trombose venosa iliofemoral afetando a veia femoral profunda pela técnica de punção e sessão única realizada pela veia jugular: relato de caso e descrição da técnica

Trombectomía fármaco-mecánica en trombosis venosa profunda aguda con el método de Ascher en el Hospital Médica Campestre de León, Guanajuato

Ten-year trends in iliofemoral deep vein thrombosis treatment and referral pathways

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