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Rottional pharmacho-mechanical thrombectomy for iliofemoral deep vein thrombosis

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    By Julio Gutierrez Alvarado, MD, Contributor to Vein News and www.VeinsVeinsVeins.com

    Orhan Rodoplu have published a study investigsting the role of a rotational thrombectomy device for the pharmaco-mechanical thrombolysis for symptomatic acute ilio-femoral deep vein thrombosis.

    The study is published in Phlebolgy, volue 36 (full reference below). 

    Where was the study done ?

    Department of Cardiovascular Surgery, Istanbul University Cerrahpasa, Institute of Cardiology, Istanbul, Turkey;  Cardiovascular Surgery Clinic, Bagcilar Education and Research Hospital, Istanbul, Turkey;  Department of Cardiovascular Surgery, Istanbul Medipol University Medical Faculty, Istanbul, Turkey; Cardiovascular Surgery Clinic, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey;  Department of Cardiology, Near East University, North Nicosia, North Cyprus; Cardiovascular Surgery Clinic, Kadikoy Medicana Hospital, Istanbul, Turkey.

    • Whar was the study method ? 


    Retrospective analysis for 82 patients treated between 2013 and 2018.


    What are the study Population ? 

    82 patients with acute deep vein thrombosis comprising the iliofemoral segment whom underwent Pharmaco-mechanical thrombolysis were evaluated.

    What device/technique was used in this study ?

    The Cleaner thrombectomy device was used.

    What was measured and what assessements were made for this study ?

    The resolution of thrombi was examined and graded. Development of post-thrombotic syndrome was assessed with Villalta scores.

    What are the results of this study ? 

    75 patients (91.4%) had complete thrombus resolution.

    Between 50-99% resolution was noted in 6 patients (7.4%) and in one (1.2%) case less than 50% thrombus resolution was obtained.

    Seventy-five patients (91%) of the cohort could be treated in a single session; 7 patients (8.6%) required reintervention.

    Improved post-thrombotic syndrome rates were lower at the short term, Villalta scores gradually increased during follow up.

    What are the conclusions of this study ?

    Pharmaco-mechanical thrombolysis with the Cleaner thrombectomy device is a safe and beneficial method for the treatment of acute iliofemoral deep vein thrombosis. The authors concluded thst long term follow up data of large volume multicenter studies are warranted.

    Reference:  Rodoplu O, Yildiz CE, Ostaz OM, Beyaz MO, Ulukan MO, Unai O, Conkdayir C, Ugurlucan M.  The efficacy of rotational pharmaco-mechanical thrombectomy in patients with with acute iliofemoral deep vein thrombosis: Is the standard of deep vein thrombosis changing ?  Phlebology 2021; 36: 119-126.