Midterm Outcomes of Pharmacomechanical Thrombectomy in the Treatment of Lower Extremity Deep Vein Thrombosis With a Rotational Thrombectomy Device

Yüksel, Ahmet; Tüydeş, Oktay

doi:10.1177/1538574417708726

Cited by 13 publications

(5 citation statements)

References 30 publications

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“…2 Treatment options for IFDVT have developed with the increasing utilization of catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT). 3,4 Catheter-directed thrombolysis is a therapy that the guidewire passed through the thrombus lesion under the assistance of a supporting catheter, followed by a multiple-sidehole infusion catheter. The catheter was placed within the thrombosed vessel and secured in place.…”

Section: Introductionmentioning

confidence: 99%

Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

Tang

Chen

et al. 2019

Clin Appl Thromb Hemost

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Early catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT) can reduce postthrombotic morbidity. Pharmacomechanical thrombolysis (PMT) is a new therapy that can be selected for the treatment of iliofemoral deep vein thrombosis (IFDVT). We performed a meta-analysis of clinical trials comparing PMT versus CDT for treatment of acute IFDVT. Literature on this topic published between January 1, 1990, and June 1, 2018, was identified using PubMed, Embase, Cochrane Library, and Web of Science. Six trials were included in the meta-analysis. Compared to CDT, PMT significantly reduced the Villalta score ( P = .007; I 2 = 0%), thrombus score ( P = .01; I 2 = 0%), the duration in the hospital ( P = .03; I 2 = 64%), and thrombolysis time ( P < .00001, I 2 = 0%). There was no significant difference in valvular incompetence events ( P = .21; I 2 = 0%), minor bleeding events ( P = .59; I 2 = 0%), stent events ( P = .09; I 2 = 24%), and clot reduction grade I events ( P = .16; I 2 = 43%) between PMT and CDT. Subgroup analysis was performed by dividing the clot reduction grade I events group into PMT plus CDT versus CDT group and significant differences were found ( P = .03, I 2 = 0%) as well as for PMT alone versus CDT group ( P = .88, I 2 = 37%). This meta-analysis shows that PMT reduces the severity of postthrombotic syndrome (PTS), thrombus score, duration in hospital, and thrombolysis time compared to CDT. More specifically, PMT plus CDT reduces clot reduction grade I events. No significant difference in valvular incompetence events, stent events, and minor bleeding events were found when PMT was compared to CDT.

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Section: Introductionmentioning

confidence: 99%

Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

Tang

Chen

et al. 2019

Clin Appl Thromb Hemost

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“… 11 The most well-known factors in the etiology of lower-extremity deep vein thrombosis are genetic predisposition, malignancy, history of surgical operation, immobilization, trauma, bone fractures, long journeys and oral contraceptive use. 12 Nevertheless, there may also be other factors that play a role in the etiopathogenesis of deep vein thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study

Korkmaz

Ersoy²,

Yüksel

et al. 2021

Sao Paulo Med. J.

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INTRODUCTIONVitamin D is a fat-soluble vitamin that is synthesized non-enzymatically in the skin and metabolized in the liver and kidneys. It arranges the immune response of the body, acts as a steroid hormone and plays a crucial role in mineral homeostasis and skeletal health. 1 Serum vitamin D levels in the range 30-60 ng/ml (75-150 nmol/l) are considered normal.Deficiency of vitamin D is associated with a variety of bone disorders (rickets, osteoporosis or osteomalacia), skin diseases and autoimmune disorders. 1,2 It also causes increased risk of cardiovascular diseases such as myocardial infarction (MI), heart failure and coronary artery disease. 2-5 Furthermore, deficiency of vitamin D has been reported in arterial diseases, including aortic aneurysm, peripheral arterial disease, arterial calcification and hypertension. [6][7][8][9] Deep vein thrombosis (DVT) is characterized by thrombus formation, usually in the lower-extremity deep venous system, which causes obstruction or occlusion of blood flow in veins. It is considered to be the third most common cardiovascular disease, after ischemic heart diseases and cerebrovascular events. 10 Although the medical and interventional treatment options for deep vein thrombosis have improved nowadays, it continues to pose a serious problem, especially in cases with inadequate treatment. It can lead to pulmonary thromboembolism, venous gangrene, chronic venous insufficiency and post-thrombotic syndrome. 11 The most well-known factors in the etiology of lower-extremity deep vein thrombosis are genetic predisposition, malignancy, history of surgical operation, immobilization, trauma, bone fractures, long journeys and oral contraceptive use. 12 Nevertheless, there may also be other factors that play a role in the etiopathogenesis of deep vein thrombosis.

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“…While commonly used, a paucity of data currently exists on this device for arteriovenous access maintenance, with only a handful of published studies which are limited to its use in deep vein thrombosis. [10][11][12] This study therefore aimed to assess the safety and efficacy of arteriovenous dialysis shunt thrombectomy utilizing the Cleaner ® rotational thrombectomy device in patients with pseudoaneurysms and clotted accesses refractory to conventional thrombectomy methods.…”

Section: Introductionmentioning

confidence: 99%

Dialysis Shunt Thrombectomy Utilizing a Rotational Thrombectomy Device in Patients with Pseudoaneurysms

Webb

Zacharias

Ciolek

et al. 2020

The Arab Journal of Interventional Radiology

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Aims: To assess the safety and efficacy of dialysis shunt thrombectomy utilizing a rotational thrombectomy device in patients with pseudoaneurysms refractory to declot by conventional treatments. Methods: Between July 2016 and August 2019, 34 dialysis shunt thrombectomies were retrospectively examined in 29 individual patients. All patients presented with pseudoaneurysms and clotted accesses that were refractory to angioplasty balloon sweeps ("push-pull") to restore patency. The Cleaner ® rotational thrombectomy device was used as a bail-out in an attempt to restore patency to the clotted shunt. Procedure success, complications, primary patency, primary-assisted patency, secondary patency, average number of shunt pseudoaneurysms, and average pseudoaneurysm size were documented and analyzed. Results: Thirty-three of the 34 (97%) thrombectomies were successful in restoring patency and facilitating same-day hemodialysis. An average of 1.5 pseudoaneurysms were present per patient (range 1-3 pseudoaneurysms, standard deviation [SD] 0.65 pseudoaneurysms), with an average size of 15.0 mm (range 9.4-31.1 mm, SD 4.87 mm). Postprocedural complications occurred in 14.7% of the cases, none of which were definitively device related. Primary patency to the time of data collection was achieved in 29% of the cases, and the average primary patency for these cases was 124.5 days (range 10-946 days, SD 186.9 days). The average primary-assisted patency was 126.8 days (range 1-564 days, SD 169.8 days). Dialysis accesses were eventually abandoned or surgically revised in ten instances, resulting in an average secondary patency of 157.5 days (range 6-712 days, SD 257 days). Conclusions: In patients with pseudoaneurysms, rotational thrombectomy with the Cleaner ® device appeared to be a safe and effective option for restoring patency to thrombosed dialysis accesses refractory to standard pushpull techniques with angioplasty balloons.

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Midterm Outcomes of Pharmacomechanical Thrombectomy in the Treatment of Lower Extremity Deep Vein Thrombosis With a Rotational Thrombectomy Device

Abstract: Cleaner rotational thrombectomy system appears to be safe and effective in the treatment of lower extremity DVT. Further larger randomized studies are needed to determine the long-term outcomes of this treatment modality.

Cited by 13 publications

References 30 publications

Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study

Dialysis Shunt Thrombectomy Utilizing a Rotational Thrombectomy Device in Patients with Pseudoaneurysms

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