Deep Vein Thrombosis Research Today is a free monthly online journal that collates and summarizes the latest research about Deep Vein Thrombosis, including details on dvt, prevention, effects, causes, air travel, blood clots.

Pulse-spray pharmacomechanical thrombolysis for proximal deep vein thrombosis.

Yamada N, Ishikura K, Ota S, Tsuji A, Nakamura M, Ito M, Isaka N, Nakano T

First Department (Cardiovascular Division) of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan. n-yamada@clin.medic.mie-u.ac.jp

OBJECTIVE: The aim of this study was to evaluate the efficacy, safety, and feasibility of pulse-spray pharmacomechanical thrombolysis to treat proximal deep vein thrombosis (DVT) in conjunction with the placement of a non-permanent IVC filter. METHODS: We studied 31 consecutive patients with acute proximal DVT defined as the inferior vena cava (IVC), iliac vein and/or femoral vein, who were diagnosed using duplex ultrasonography and/or contrast venography. All were treated with pulse-spray urokinase. Early success was assessed by comparing the pre- and post-treatment venographic severity score. Non-permanent IVC filters were used to reduce the risk of pulmonary thromboembolism. RESULTS: The average total urokinase dose was 1.71 million IU (range: 0.72-3.6 million IU) and the average duration of therapy was 2.4 days. The average percentage of thrombus lysed was 85% (range: 22-100%). A large thrombus trapped by the filter was detected using cavography before extraction of the filter in one patient. There was no major treatment-related adverse event. CONCLUSION: The combination of pulse-spray pharmacomechanical thrombolysis and the prophylactic use of a non-permanent IVC filter was a safe and effective approach for treating acute proximal DVT.

Published 17 January 2006 in Eur J Vasc Endovasc Surg, 31(2): 204-11.
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