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Home > Vascular Annual Meeting^® > VS2. Effective Treatment of DVT with Isolated...

VS2. Effective Treatment of DVT with Isolated Pharmacomechanical Thrombolysis: A Single Center Report Author

Mark Gazall, Kettering Medical Centers
Grandview Medical Center, Dayton, OH

OBJECTIVES: Video is used to demonstrate the single-setting isolated pharmacomechanical thrombolysis endovascular technique to remove multi-aged thrombus that can comprise DVT. The purpose is to consider this technique as the primary treatment for those whose life quality may be compromised by DVT.

METHODS: Demographic, thrombus characterization, procedural and short-term follow-up data were collected for 36 patients. The Trellis Peripheral Infusion System, tissue plasminogen activator and adjunctive procedures were used to restore flow to IVC and improve symptoms.

RESULTS: Thirty-five of 36 patients (97.2%) were treated with the Trellis System. Thirty-five limbs in 35 patients were treated, 31 lower (88.6%) and 4 upper (11.4%) extremities. Average dose of rt-PA was 11.1mg (0-18mg) in two Trellis System treatments. Grade II/III lysis was achieved in 34 patients (97.1%) and Grade I in one. One major bleeding complication (access site bleeding), and no symptomatic pulmonary embolic events occurred. Average of 62 day short term follow-up displayed symptoms improved or resolved, 34 of 35 (97.1%) veins patent/compressible with 1
rethrombosis.

CONCLUSIONS: Isolated pharmacomechanical thrombolysis should be considered as the primary DVT treatment. It delivers safe, effective single-setting thrombolysis. Early follow-up demonstrates rapid symptom resolution and sustained venous patency, that may be prognostic of PTS retardation.

AUTHOR DISCLOSURES: M. Gazall, None.