Iliofemoral deep venous thrombosis: Aggressive therapy with catheter- directed thrombolysis

C. P. Semba, M. D. Dake

Research output: Contribution to journalArticle

349 Scopus citations

Abstract

PURPOSE: To evaluate the efficacy of catheter-directed thrombolysis with urokinase in treating symptomatic iliofemoral deep venous thrombosis (DVT). MATERIALS AND METHODS: Twenty-one consecutive patients with iliofemoral DVT underwent treatment for 27 affected limbs (acute DVT, n = 20; chronic DVT, n = 7). The average urokinase dose was 4.9 million IU (range, 1.4 million to 16.0 million IU) infused over an average of 30 hours (range, 15-74 hours). RESULTS: Lysis was complete in 18 (72%), partial in five (20%), and not achieved in two (8%) of 25 treated limbs. Two chronically occluded iliac veins could not be crossed with a guide wire and did not receive urokinase. Sixteen limbs had underlying venous stenoses (>50%) that were treated with angioplasty (n = 2) or angioplasty and stent placement (n = 14). There were no major complications or clinically detectable pulmonary emboli. The technical and clinical success rates were 85%. CONCLUSION: This initial experience suggests that catheter-directed thrombolysis with urokinase for treatment of symptomatic iliofemoral DVT is safe and effective.

Original languageEnglish (US)
Pages (from-to)487-494
Number of pages8
JournalRadiology
Volume191
Issue number2
DOIs
Publication statusPublished - Jan 1 1994
Externally publishedYes

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Keywords

  • Extremities, thrombosis
  • Interventional procedures, experimental
  • Thrombolysis
  • Thrombosis, venous

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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