Initial and mid-term outcomes of pulse infusion thrombolysis using a unique pump system and stent placement for deep vein thrombosis

Intern Med. 2008;47(19):1663-7. doi: 10.2169/internalmedicine.47.1024. Epub 2008 Oct 1.

Abstract

Objective: The aim of this study was to evaluate the initial and mid-term results of pulse infusion thrombolysis (PIT) using a unique pump system and stent placement for proximal deep vein thrombosis (DVT) in Japanese.

Methods: Among the patients who were admitted to our institute under diagnosis of proximal DVT between April 2001 and March 2005, 11 patients (4 men, mean age 61 years) who underwent PIT and angioplasty followed by stent placement were enrolled in this retrospective analysis. Urokinase or monteplase was used as a thrombolytic agent. Venous or stent patency was assessed by color Doppler ultrasound or enhanced computed tomography for a mean follow-up duration of 54 months.

Results: Sites of thrombus were left lower limbs in 10 cases and left upper limb in one case. Initial technical (complete venous flow recovery) and clinical (disappearance of pain and swelling of diseased leg or arm) success was achieved in all patients. Two of 11 patients showed stent occlusion with leg swelling and pain one month later and 3 years later, respectively. These patients had associated protein S deficiency.

Conclusion: PIT and stent deployment for DVT is safe and effective with favorable initial and mid-term clinical results and without major complications in Japanese, except for cases of congenital coagulation abnormality.

MeSH terms

  • Adult
  • Aged, 80 and over
  • Angioplasty
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Infusion Pumps
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Thrombolytic Therapy / instrumentation
  • Thrombolytic Therapy / methods*
  • Time Factors
  • Treatment Outcome
  • Venous Thrombosis / therapy*

Substances

  • Fibrinolytic Agents