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Catheter-directed thrombolysis in the treatment of iliofemoral venous thrombosis. A review

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  1. Mitochondrial dysfunction in calf muscles of patients with combined peripheral arterial disease and diabetes type 2

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  2. Deep venous thrombosis of the upper extremity. A review

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  3. Does patency after a vein collar and PTFE-bypass depend on sex and age? Re-analysis of a randomised trial

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  4. The effect on patency of type, shape and volume of a vein collar used at the distal anastomis of PTFE-bypass to arteries below-knee

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  5. The vein collar: an anastomotic servant or a patency promoter? Re-analysis of a randomized trial

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  1. An acoustic myography functional assessment of cerebral palsy subjects compared to healthy controls during physical exercise

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  2. Significance of Partial or Complete Thrombosis of the Common and Deep Femoral Vein in Patients With Deep Vein Thrombosis

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  3. Evaluation of Peak Reflux Velocities with Vector Flow Imaging and Spectral Doppler Ultrasound in Varicose Veins

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  4. Respiratory variability of peak velocities in the common femoral vein estimated with vector flow imaging and Doppler ultrasound

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Patients with acute iliofemoral venous thrombosis treated with anticoagulation only are at high risk of developing postthrombotic syndrome. Immediate removal of the thrombus by catheter-directed thrombolysis (CDT) may increase patency, prevent damage of the venous valves, and prevent reflux and PTS. However, the indications for its use are not well established because of lack of data from randomised controlled trials. Aim of this review was to describe the treatment of iliofemoral venous thrombosis with CDT and to evaluate the effectiveness of this therapy. An electronic literature search was performed in the PubMed, EMBASE, and Cochrane Library on the largest studies (more than 40 legs treated) concerning catheter-directed thrombolysis of iliofemoral venous thrombosis. A total of 236 publications were identified but only 11 studies met the inclusion criteria with a total of 979 lower limbs. Early patency from 6-12 months was 60-95% and patency after six years was 82%, reported in one study. Mortality of up to 1% was reported in two studies. Major complications such as hematomas requiring surgery were observed in 1-11% whereas minor complications, mostly bleeding from the puncture site, were seen in up to 18%. CDT seems to be effective in the treatment of iliofemoral venous thrombosis and results are promising. Studies are, however, characterized by heterogeneity and are difficult to compare. Only one study reports long-term follow-up and incidence of postthrombotic syndrome is not reported. Further studies regarding the use of CDT, both alone and in combination with mechanical thrombectomy are needed.
Original languageEnglish
JournalInternational Angiology
Volume29
Issue number4
Pages (from-to)292-302
Number of pages11
ISSN0392-9590
Publication statusPublished - 1 Aug 2010

ID: 31021698