Clinical StudiesPercutaneous AngioJet Thrombectomy in the Management of Extensive Deep Venous Thrombosis
Section snippets
MATERIALS AND METHODS
Patients were identified from a computer registry maintained by the Department of Vascular Surgery at our institution. We retrospectively reviewed the medical records of all patients who underwent PMT for extensive DVT over a period of 37 months. Patient demographics, risk factors for DVT, periprocedural complications, and mortality were tabulated. The initial diagnosis was made by complete duplex US in all patients with extremity DVT and by MR imaging or CT in patients with intracavitary
RESULTS
Only two patients had objective evidence of earlier DVT. Risk factors for DVT are shown in the Table. There was no statistically significant association among these results and the outcome of PMT. However, because of the small sample size, there is very little power in the statistical tests to detect anything but a very strong association. Success, defined as .90% clearance of thrombus (Fig 1), was achieved in only four of 17 patients (23.5%). None of these patients subsequently received lytic
DISCUSSION
The goals of therapy in patients with DVT include prevention of pulmonary embolism, restoration of unobstructed venous return, prevention of recurrent DVT, and preservation of venous valve function. Numerous therapeutic options are currently available but not one has been proved to be superior to the other. These modalities include systemic anticoagulation, catheter-directed thrombolysis, surgical thrombectomy (with creation of arteriovenous fistula), and percutaneous mechanical or rheolytic
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