Document Detail


Pharmaco-mechanical thrombectomy for early thrombus removal.
MedLine Citation:
PMID:  22312084     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: To review the current literature on the outcomes of pharmaco-mechanical thrombectomy (PMT) for early thrombus removal in patients with venous thromboembolism (VTE).
METHODS: We searched the MEDLINE database and performed a manual search of the references of selected articles to select reports reporting the outcomes of PMT alone and PMT compared to catheter-direct thrombolysis (CDT). Outcomes of interest included clot lysis rate, incidence of pulmonary embolism, major bleeding, recurrent deep vein thrombosis, number of venograms needed and amount of lytic utilized.
RESULTS: We found nine articles that reported outcomes of PMT. Three devices were utilized for PMT, the Angiojet, Trellis and Helix. Different thrombolytics were used to facilitate thrombus removal including urokinase, reteplase, tecneteplase, and tissue plasminogen activator (t-PA). Complete and partial thrombus removal were achieved in up to 84% and 64% and 81% and 59% of the limbs treated with PMT and CDT alone, respectively. Data on PE and bleeding risk after PMT compared to CDT are scarce. The duration of the thrombolysis process, amount of lytics and number of venograms were substantially reduced in the patients who had PMT compared to those who underwent CDT alone. Two articles evaluated the obstacles that limit the indication of PMT in patients with VTE.
CONCLUSION: VTE is a prevalent burden in Western societies. The rationale of early thrombus is to reduce valvular damage and improve venous patency in order to reduce the risk of PTS. PMT is a feasible, safe and faster alternative to expedite the thrombolysis process in patients with VTE.
Authors:
R D Malgor; A P Gasparis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Phlebology / Venous Forum of the Royal Society of Medicine     Volume:  27 Suppl 1     ISSN:  1758-1125     ISO Abbreviation:  Phlebology     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012921     Medline TA:  Phlebology     Country:  England    
Other Details:
Languages:  eng     Pagination:  155-62     Citation Subset:  IM    
Affiliation:
Department of Surgery, Stony Brook Vein Center, HSC T19 Rm90, Stony Brook University Medical Center, Stony Brook, NY 11794-8191, USA. antonios.gasparis@sbumed.org.
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