Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis

Robertson, Lindsay; Burdess, Anne; McBride, Olivia

doi:10.1002/14651858.cd011536

Cited by 9 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We identified 3 systematic reviews 119,212,213 and 5 controlled trials (n 5 427). 142,[214][215][216][217] Trials included individuals with objectively confirmed symptomatic proximal DVT.…”

Section: Summary Of the Evidencementioning

confidence: 99%

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

Ortel

Neumann

Ageno³

et al. 2020

Blood Advances

705

708

View full text Add to dashboard Cite

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), occurs in ∼1 to 2 individuals per 1000 each year, corresponding to ∼300 000 to 600 000 events in the United States annually. Objective: These evidence-based guidelines from the American Society of Hematology (ASH) intend to support patients, clinicians, and others in decisions about treatment of VTE. Methods: ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and adult patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 28 recommendations for the initial management of VTE, primary treatment, secondary prevention, and treatment of recurrent VTE events. Conclusions: Strong recommendations include the use of thrombolytic therapy for patients with PE and hemodynamic compromise, use of an international normalized ratio (INR) range of 2.0 to 3.0 over a lower INR range for patients with VTE who use a vitamin K antagonist (VKA) for secondary prevention, and use of indefinite anticoagulation for patients with recurrent unprovoked VTE. Conditional recommendations include the preference for home treatment over hospital-based treatment for uncomplicated DVT and PE at low risk for complications and a preference for direct oral anticoagulants over VKA for primary treatment of VTE.

show abstract

“…We identified 3 systematic reviews 119,212,213 and 5 controlled trials (n 5 427). 142,[214][215][216][217] Trials included individuals with objectively confirmed symptomatic proximal DVT.…”

Section: Summary Of the Evidencementioning

confidence: 99%

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

Ortel

Neumann

Ageno³

et al. 2020

Blood Advances

705

708

View full text Add to dashboard Cite

show abstract

“…Su aparición se debe a factores que inducen hipercoagulabilidad, estasis o daño de la pared vascular 4,5 . La TVP iliofemoral no tratada representa un riesgo cercano al 50% de desarrollar TEP sintomático en los siguientes tres meses 6 y puede llevar al síndrome postrombótico (SPT) que puede ser grave en el 5% al 10% de los casos 7 .…”

Section: Introductionunclassified

“…El tratamiento habitual ha sido la anticoagulación sumada a medias elastocompresivas y deambulación temprana; sin embargo, son medidas que no modifican directamente al trombo y la carga generada sobre la vena 6 . En la década de 1980 surgió como opción terapéutica la trombólisis sistémica, que mejoró la eliminación de coágulos y redujo la extensión de la trombosis, pero con mayor riesgo de sangrados mayores 8 .…”

Section: Introductionunclassified

“…Han aparecido nuevas técnicas para inyectar el trombolítico directamente en el trombo a través de un catéter, lo que reduce la dosis del fármaco y por ende el riesgo de sangrado. Están disponibles también nuevos dispositivos que emplean la trombectomía mecánica con catéter 6 , lo que facilita el uso de la angioplastia cuando persisten obstrucciones venosas que pueden predisponer a TVP recurrente 9 . Las guías internacionales 10,11 y el consenso colombiano de fibrinólisis selectiva con catéter en la enfermedad vascular tromboembólica 9 recomiendan la trombólisis localizada farmacológica o mecánica en pacientes con TVP iliofemoral; por lo tanto, el propósito fue describir los desenlaces de los pacientes con TVP de miembros inferiores tratados con técnicas endovasculares guiadas por catéter con o sin angioplastia, en una clínica de tercer nivel de la ciudad de Popayán.…”

Section: Introductionunclassified

See 1 more Smart Citation

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

Granobles-Molina¹,

Tobar²,

Chaves³

et al. 2021

RMA

View full text Add to dashboard Cite

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.

show abstract

“…Early thrombus removal techniques have been advocated in patients with iliofemoral DVT to improve vein patency, prevent valvular dysfunction, and reduce future complications, such as post-thrombotic syndrome and venous ulceration. 1 The likelihood of PTS development is around 50% despite anticoagulant therapy in proximal DVT patients. 2,3 Small-sized randomized studies suggest that the removal of an acutely formed thrombus prevents the development of PTS by preserving venous functions based on the open vein hypothesis.…”

Section: Introductionmentioning

confidence: 99%

Effects of pharmacomechanical therapy on late complications in deep venous thrombosis

Azboy¹,

Temizturk²,

Türker³

2020

JCCR

View full text Add to dashboard Cite

Introduction:We investigated the effects of pharmacomechanical therapy (PMT) on postthrombotic syndrome; which is a late complication in patients with acute and subacute iliofemoral deep venous thrombosis (DVT).Method: A total of 25 (14 males, 11 females) patients; who were diagnosed with acute and subacute iliofemoral DVT and treated in the cardiovascular surgery clinic of Elazığ Training and Research Hospital from September 2016 to November 2018, were evaluated retrospectively by using data in the hospital's digital archiving system. The effects of PMT applied to the patients were evaluated on the development of post-thrombotic syndrome and venous reflux as the late complications.Results: No complications occurred in patients during the intervention and therapeutic processes. After the treatment, patency and flow were achieved in 92% of the patients and significant reductions in the subjective complaints were observed in 88% of the patients. Maintained patency ratios of 92%, 84%, and 80% were confirmed in the first month, the first year, and the second year, respectively, by venous doppler ultrasonography. Postthrombotic syndrome did not develop in 80% of the patients clinically.Discussion: We suggest that PMT is a favourable treatment option for the prevention of the development of post-thrombotic syndrome and venous reflux as the late complications in acute and subacute proximal DVT patients.

show abstract

Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis

Abstract: This is a repository copy of Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis.

Cited by 9 publications

References 15 publications

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism

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

Effects of pharmacomechanical therapy on late complications in deep venous thrombosis

Contact Info

Product

Resources

About