Safety and Efficacy of Catheter-directed Thrombolysis

Bækgaard, N; Klitfod, Lotte; Broholm, Rikke

doi:10.1258/phleb.2012.012s15

Cited by 18 publications

(19 citation statements)

References 21 publications

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“…Stock solutions of 2.5 or 5x10 5 units urokinase were diluted to a final volume of 500 ml in 0.9% physiological saline and infused continuously at 20 ml/h. CDT was discontinued upon major bleeding (16,17). CDT was temporarily suspended upon minor bleeding (1,17).…”

Section: Methodsmentioning

confidence: 99%

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Feasibility of continuous, catheter-directed thrombolysis using low-dose urokinase in combination with low molecular-weight heparin for acute iliofemoral venous thrombosis in patients at risk of bleeding

Chen

Shi

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to examine the feasibility of catheter-directed thrombolysis (CDT) using continuous infusion of low-dose urokinase in combination with low molecular weight heparin (LMWH) for acute iliofemoral venous thrombosis. This retrospective analysis included patients with symptomatic acute iliofemoral venous thrombosis who received CDT using continuous infusion of low-dose urokinase in combination with LMWH within the past four years. Urokinase was administered at 1x10 4 U/h and 2x10 4 U/h in patients at high-risk and low-risk of bleeding, respectively. Measurements included urokinase dosage, duration, clinical outcomes and CDT-related complications. A total of 46 patients were included (high-risk, n=17; low-risk, n=29). In the high-risk patients, 64.7% experienced dissolution of ≥50% thrombi after a median CDT duration of 8 days (range, 6-10 days) and median total urokinase dose of 1.92x10 6 units (range, 1.44-2.4x10 6 units). In the low-risk patients, 82.8% achieved dissolution of ≥50% thrombi after a median CDT duration of 7 days (range, 4-10 days) and a median total urokinase dose of 3.36x10 6 units (range, 1.92-4.80x10 6 units). Remission of clinical symptoms after CDT was achieved in 15 (88.2%) and 28 (96.6%) cases in high-risk and low-risk patients, respectively. No treatment-associated pulmonary embolism or major bleeding was observed. Three (6.5%) subjects (high-risk, n=1; low-risk, n=2) experienced minor bleeding. In conclusion, continuous infusion of low-dose urokinase via CDT in combination with LMWH is effective and safe for acute iliofemoral venous thrombosis in patients with one or more risk factor for bleeding.

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Section: Methodsmentioning

confidence: 99%

“…CDT was discontinued upon major bleeding (16,17). CDT was temporarily suspended upon minor bleeding (1,17). If the minor bleeding was solved the following day, CDT was resumed at a reduced dosage (50%); if the bleeding continued, CDT was discontinued permanently.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of continuous, catheter-directed thrombolysis using low-dose urokinase in combination with low molecular-weight heparin for acute iliofemoral venous thrombosis in patients at risk of bleeding

Chen

Shi

et al. 2017

Experimental and Therapeutic Medicine

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show abstract

“…222,223 Major bleeding rates with CDT are reported to range from 2.2% to 3.3%. 222,224 The occurrence of peri-procedural PE does not seem to be a major concern. 172,222,223,225,226 In two studies including 108 patients treated with CDT and 69 patients treated with CDT and other thrombus removal procedures, respectively, no PEs were identified when using a symptom based investigation protocol.…”

Section: Treatment Of Deep Vein Thrombosis: Early Thrombus Removal Anmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis

Kakkos

Gohel²,

Bækgaard

et al. 2021

European Journal of Vascular and Endovascular Surgery

349

323

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“…Information on minor bleedings varies, depending on the accuracy of observations. In our centre there was a 26% minor bleeding rate, and this included even a tiny oozing to the dressing at the access site, which is of no practical clinical relevance [31]. Reporting the clinical outcome of CDT, including information of a fully recanalised vein with undamaged valves, is of a great importance, especially taking into account the deleterious action of residual thrombi.…”

Section: Results Of the Trialsmentioning

confidence: 97%

State of the art of catheter-directed thrombolysis for iliofemoral venous thrombosis

Bækgaard¹

2016

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Safety and Efficacy of Catheter-directed Thrombolysis

Abstract: CDT of iliofemoral DVT is a safe procedure. The patients can stay in a clinical vascular ward. The long-term efficacy is still durable in producing competent veins as concluded in our earlier published results.

Cited by 18 publications

References 21 publications

Feasibility of continuous, catheter-directed thrombolysis using low-dose urokinase in combination with low molecular-weight heparin for acute iliofemoral venous thrombosis in patients at risk of bleeding

Feasibility of continuous, catheter-directed thrombolysis using low-dose urokinase in combination with low molecular-weight heparin for acute iliofemoral venous thrombosis in patients at risk of bleeding

Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis

State of the art of catheter-directed thrombolysis for iliofemoral venous thrombosis

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