Percutaneous Endovenous Intervention Plus Anticoagulation versus Anticoagulation Alone for Treating Patients with Proximal Deep Vein Thrombosis: A Meta-analysis and Systematic Review

Wang, Chao-Nan; Deng, Hong-ru

doi:10.1016/j.avsg.2017.09.027

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…Según Xue, et al, el síndrome de May-Thurner se considera una de las principales causas de TVP iliofemoral aguda 26 . Algo similar encontró Wang, al publicar una incidencia del síndrome de May-Thurner de 33% a 67% en pacientes con TVP 27 . Sin embargo, esto no siempre es así, ya que en el estudio PEARL 21 sólo 9% de la población tenía el síndrome.…”

Section: Discussionunclassified

“…Los autores identificaron complicaciones graves como requerimiento de transfusión de hemocomponentes secundario a descenso de hemoglobina o aparición de hematoma retroperitoneal en casi 10% de sus pacientes. Tang, et al en 2019 también reconocieron este fenómeno, pues la intervención endovascular percutánea + anticoagulación incrementó la aparición de episodios de sangrado mayor 27 ; y Haig, et al publicaron tasas similares de complicaciones hemorrágicas graves (10.6%) 32 . En un paciente (3.5%) se presentó un episodio de TEP secundario al procedimiento endovascular, muy inferior al informe de un metaanálisis de 2019, con tasas de TEP posterior al procedimiento de 9.5% 31 .…”

Section: Discussionunclassified

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Tratamiento farmacomecánico dirigido por catéter de la trombosis venosa profunda: informe de casos

Granobles-Molina¹,

Tobar²,

Chaves³

et al. 2021

RMA

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Describir los desenlaces en pacientes con trombosis venosa profunda de miembros inferiores a quienes se les realizó trombectomía o trombólisis con y sin angioplastia con y sin filtro de vena cava inferior. Resultados: Se incluyeron a 28 pacientes, en su mayoría mujeres (71.4%), con edad promedio de 46.7 años, que recibieron tratamiento con trombólisis + trombectomía mecánica, que a su vez se relacionó con mayor permanen cia en cuidados intensivos (p = 0.023). Los principales factores de riesgo fueron diabetes mellitus/HTA, TVP previa y operación ortopédica. El segmento venoso comprometido con mayor frecuencia fue el iliofemoral, que se vinculó con antecedente quirúrgico (p = 0.027), compresión venosa ilíaca (p = 0.044) y uso de filtro de vena cava inferior (p = 0.044), pero no con complicaciones (p = 0.089). Hasta 30% de los pacientes presentó retrombosis seis meses después del primer procedimien to; 7% de los pacientes tuvo síndrome postrombótico grave. Conclusiones: Este registro sugiere que el tratawmiento farma comecánico dirigido por catéter es seguro y efectivo en la TVP y reduce los tiempos de estancia hospitalaria, aparición y gravedad del síndrome postrombótico.

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Section: Discussionunclassified

Tratamiento farmacomecánico dirigido por catéter de la trombosis venosa profunda: informe de casos

Granobles-Molina¹,

Tobar²,

Chaves³

et al. 2021

RMA

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“…2 Endovascular intervention has been shown to attain better outcomes in terms of patency and reduction in the risk of postthrombotic syndrome as compared with patients treated with anticoagulation alone. 2,4,[6][7][8] To prevent recurrence and stent thrombosis poststenting, patients are started on anticoagulation, the duration of which is guided by underlying thrombotic risk factors and risk of bleeding on anticoagulation. 9,10 There is no common consensus for an optimal duration of anticoagulation therapy poststenting due to lack of adequate evidence, 1,9 even though the American College of Chest Physicians (ACCP) recommend at least a 3month duration of anticoagulation in patients with unprovoked DVT.…”

Section: Discussionmentioning

confidence: 99%

“…lower limb DVT, the incidence of MTS was found to be 33 to 67%. 4 This case report describes a patient with MTS who was successfully treated with pharmacomechanical catheterdirected therapy followed by anticoagulation using rivaroxaban, a nonvitamin K oral anticoagulant (NOAC).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Deep Vein Thrombosis in May–Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report

Han

Sule

2018

Int J Angiol

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May–Thurner's syndrome (MTS) is an anatomical variant where the left common iliac vein (CIV) is compressed by the overlying right common iliac artery and the underlying lumbar vertebrae, leading to stenosis in the left CIV. Endovascular intervention followed by anticoagulation currently constitute the mainstay of management of MTS associated with recurrent deep vein thrombosis (DVT).Warfarin appears to be the anticoagulant of choice in most studies conducted in patients with MTS. There is little evidence of treatment using nonvitamin K oral anticoagulants. This case report serves to describe a patient with MTS who was successfully treated with catheter-directed therapy followed by anticoagulation using rivaroxaban.A 64-year-old women presented with left lower limb swelling. Her duplex ultrasound and computed tomography (CT) showed extensive DVT and underlying narrowing of the left CIV, respectively.She underwent catheter-directed therapy, involving stent placement in the left CIV, and was subsequently started on rivaroxaban. She developed partial thrombosis of the external iliac vein at 5 months postprocedure and partial stent thrombosis at 1 year postprocedure while on rivaroxaban, requiring repeat stenting and continuation of anticoagulation. On follow-up, there was no recurrence of symptoms related to MTS, no postthrombotic syndrome, and no clinically significant bleeding as a side effect of rivaroxaban.This case report shows that rivaroxaban is a safe agent that can be successfully used in the treatment of MTS after stenting.

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“…Acute deep vein thrombosis (DVT) continues to be a major health issue in the United States, with approximately half a million new cases annually 1 . Intervention is considered in patients with severely symptomatic proximal DVT, usually by using combined mechanical and pharmacologic methods to remove thrombus 2, 3. Recent bleeding events or high-risk surgery can be prohibitive to the use of thrombolytic agents.…”

mentioning

confidence: 99%

Percutaneous thrombectomy using a novel single-session device for acute ilio-caval deep vein thrombosis

Crowner

Marston

2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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A 53-year-old man developed acute left leg pain and edema 2 weeks after lumbar interbody fusion. A computed tomography venogram demonstrated acute thrombosis extending from the deep veins of the calf all the way to and including the common iliac vein owing to external compression of common iliac vein secondary to extruded bone graft material. Endovascular intervention without the use of thrombolysis was performed using a novel percutaneous mechanical thrombectomy system (ClotTriever, Inari Medical, Irvine, Calif), allowing clot removal in single session. Clot removal and stenting were performed with resolution of symptoms and only mild swelling with prolonged standing at the 6-month follow-up.

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Percutaneous Endovenous Intervention Plus Anticoagulation versus Anticoagulation Alone for Treating Patients with Proximal Deep Vein Thrombosis: A Meta-analysis and Systematic Review

Cited by 18 publications

References 30 publications

Tratamiento farmacomecánico dirigido por catéter de la trombosis venosa profunda: informe de casos

Tratamiento farmacomecánico dirigido por catéter de la trombosis venosa profunda: informe de casos

Treatment of Deep Vein Thrombosis in May–Thurner's Syndrome with a Novel Oral Anticoagulant: A Case Report

Percutaneous thrombectomy using a novel single-session device for acute ilio-caval deep vein thrombosis

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