Successful treatment of massive deep vein thrombosis using catheter‐directed thrombolysis and inferior vena cava filter in a puerperal woman

Virkus, Rie Adser; Jørgensen, Marie Birk; Broholm, Rikke; Bergholt, Thomas

doi:10.1111/j.1600-0412.2011.01294.x

Cited by 3 publications

(12 citation statements)

References 6 publications

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“…Although conventional heparin therapy is effective in preventing PE, immediate complete lysis of thrombus occurs in only 4% patients, partial lysis in 14% and the remainder have no clearing of thrombus 1. About two-thirds of women with pregnancy-related DVT develop deep vein insufficiency in the affected leg 3. The advantages of CDT include a high local concentration of thrombolytic agents; resulting in rapid lysis and decreased risk of systemic bleeding complications 2.…”

Section: Discussionmentioning

confidence: 99%

“…Few patients with extensive proximal lower limb DVT may needs inferior vena cava filter (IVCF) implantation to prevent pulmonary embolism (PE) 2. Oral anticoagulant-induced skin necrosis is very rare, seen in 0.01–0.1% of patients 3. We are presenting a very unusual case of post-partum DVT treated with CDT and mechanical thromboaspiration with IVCF implantation.…”

Section: Introductionmentioning

confidence: 99%

“…VTE is more common in post-partum period than antenatal period 2. Acute deep venous thrombosis (DVT) is associated with significant morbidity due to development of post-thrombotic syndrome (PTS) 3. Till recently anticoagulation with heparin, low-molecular-weight heparin (LMWH) and warfarin was primary mode of treatment of DVT 1.…”

Section: Introductionmentioning

confidence: 99%

“…Till recently anticoagulation with heparin, low-molecular-weight heparin (LMWH) and warfarin was primary mode of treatment of DVT 1. But, catheter-directed thrombolysis (CDT) is the recent advancement in treatment of DVT as it can restore patency of vein and decrease the incidence of morbidity due to PTS 3. Only few reports are available of its use in puerperal DVT 3.…”

Section: Introductionmentioning

confidence: 99%

“…But, catheter-directed thrombolysis (CDT) is the recent advancement in treatment of DVT as it can restore patency of vein and decrease the incidence of morbidity due to PTS 3. Only few reports are available of its use in puerperal DVT 3. Few patients with extensive proximal lower limb DVT may needs inferior vena cava filter (IVCF) implantation to prevent pulmonary embolism (PE) 2.…”

Section: Introductionmentioning

confidence: 99%

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Successful catheter directed thrombolysis in postpartum deep venous thrombosis complicated by nicoumalone-induced skin necrosis and failure in retrieval of inferior vena caval filter

2013

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Venous thromboembolism is an important cause for maternal morbidity and mortality in postpartum period. Though catheter-directed thrombolysis (CDT) is now considered as a safe and effective therapy for the management of deep venous thrombosis (DVT) but still it is not indicated in postpartum DVT. We are presenting a case of 22-year-old female patient who presented with post-partum lower limb DVT and managed successfully with CDT by using injection streptokinase and temporary inferior vena caval filter was inserted as prophylactic for pulmonary embolism as she had extensive DVT extending into inferior vena cava (IVC). During follow-up, she developed large skin necrosis in left lower limb which was managed by adding injection low-molecular-weight heparin. IVC filter also could not be retrieved even after trying all manoeuvres during follow-up after 2 weeks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Successful catheter directed thrombolysis in postpartum deep venous thrombosis complicated by nicoumalone-induced skin necrosis and failure in retrieval of inferior vena caval filter

2013

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Catheter-directed thrombolysis in management of postpartum lower limb deep venous thrombosis – A case series

Srinivas

Patra

Nagesh

et al. 2015

Indian Heart Journal

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Deep vein thrombosis (DVT) is a major health problem in pregnancy and postpartum period. Catheter-directed thrombolysis (CDT) is safe and effective in the management of symptomatic DVT. Value of CDT in postpartum DVT is not fully evaluated. We describe five patients presenting with acute iliofemoral DVT in their early postpartum period who were treated with mechanical thromboaspiration and CDT. The CDT was done using streptokinase infusion and unfractionated heparin. Percutaneous angioplasty was done in patients with symptomatic residual lesion following thrombolysis. Patients were discharged with oral anticoagulant and compression stockings. This approach was successful in all five cases. Percutaneous endovascular therapy using CDT, mechanical thromboaspiration, and balloon angioplasty is safe and effective in iliofemoral DVT in postpartum period.

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Catheter-Directed Thrombolysis Is a Safe and Alternative Therapeutic Approach in the Management of Postpartum Lower Limb Deep Venous Thrombosis

et al. 2014

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Deep vein thrombosis (DVT) and venous thromboembolism (VTE) are major health problems with high mortality and morbidity in pregnancy and postpartum period worldwide. 1 The high incidence of DVT and risk of VTE during pregnancy and postpartum period occurs due to hypercoagulable state. 2 Catheter-directed thrombolysis (CDT) is a safe and effective in management of symptomatic DVT by lysing the thrombus and restoring the patency of the veins in proximal DVT. 3 It reduces the incidence of postthrombophlebitic syndrome (PTS) and improves the quality of life. 3 Pregnancy and the postpartum period are considered as relative contraindications for thrombolysis. 4 However, CDT of DVT may reduce long-term sequelae in these young patients by restoring early patency of veins. 4 We share our experience of safety and efficacy of CDT in the treatment of proximal DVT in postpartum period. Case ReportA total of eight patients were admitted to our hospital with proximal DVT in postpartum period in the past year. Among them, five patients were treated with CDT and remaining three patients were treated with low-molecular-weight heparin and oral anticoagulant. The mean age of these patients was 22 (AE 3.5) years. The mean onset of symptoms before presentation was 9 (AE 4) days. Three patients had right lower limb DVT, one patient had left lower limb DVT, and another patient had bilateral lower limb DVT. Four patients had normal vaginal delivery, whereas one patient had second trimester abortion following trauma. All these patients were primigravida and there was no family history of thrombotic disorder. Two patients had history of using oral contraceptive pills in the past. Body mass index was low or in normal range in these patients. All patients had iliofemoral DVT, three patients had extension into inferior vena cava (IVC) and one had additional renal vein thrombosis (RVT). The mean duration of CDT was 128 (AE 16) hours. Three patients had complete resolution of clot and another case had partial resolution. One case has received infusion of urokinase after giving 2 days of streptokinase infusion as there was no significant improvement after giving streptokinase. In the patient with RVT with mild renal AbstractDeep vein thrombosis (DVT) is a major health problem in pregnancy and postpartum period. Catheter-directed thrombolysis (CDT) is safe and effective in management of symptomatic DVT. Value of CDT in postpartum DVT is not fully evaluated. We describe five patients presenting with acute iliofemoral DVT in their early postpartum period who were treated with mechanical thromboaspiration and CDT. The CDT was done using streptokinase infusion and unfractionated heparin. Percutaneous angioplasty was done in patients with symptomatic residual lesion following thrombolysis. Patients were discharged with oral anticoagulant and compression stockings. This approach was successful in all four cases. Percutaneous endovascular therapy using CDT, mechanical thromboaspiration, and balloon angioplasty is safe and effective in iliofemoral DVT i...

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Successful treatment of massive deep vein thrombosis using catheter‐directed thrombolysis and inferior vena cava filter in a puerperal woman

Cited by 3 publications

References 6 publications

Successful catheter directed thrombolysis in postpartum deep venous thrombosis complicated by nicoumalone-induced skin necrosis and failure in retrieval of inferior vena caval filter

Successful catheter directed thrombolysis in postpartum deep venous thrombosis complicated by nicoumalone-induced skin necrosis and failure in retrieval of inferior vena caval filter

Catheter-directed thrombolysis in management of postpartum lower limb deep venous thrombosis – A case series

Catheter-Directed Thrombolysis Is a Safe and Alternative Therapeutic Approach in the Management of Postpartum Lower Limb Deep Venous Thrombosis

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