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KMID : 1103720080580020121
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Journal of the Korean Society of Radiology
2008 Volume.58 No. 2 p.121 ~ p.125
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Catheter-directed Thrombolysis of Below-Knee Deep Venous Thrombosis of the Lower Extremities
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Roh Byung-Suk
Park Seong-Hoon
Lee Young-Hwan
Sohn Young-Jun
Heo Eun-A
Cho Hyun-Sun
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Abstract
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Purpose: To evaluate the technical feasibility and clinical efficacy of the use of local thrombolysis for below-knee deep vein thrombosis (DVT).
Materials and Methods: From a population of 41 patients with a lower extremity DVT, the prospective clinical trial included 11 patients (7 female, 4 male, average age 61.4 years) treated with catheter-directed thrombolysis with urokinase for below-knee DVT. After removal of the proximal ilofemoral DVT, additional interventional procedures to remove the residual thrombus and restore the venous flow from the below-knee vein were performed in cases of continuous occlusion of venous flow from the popliteal and tibial veins. Under ultrasound (US) guidance, catheter-directed thrombolysis with urokinase was performed through the ipsilateral popliteal vein. After administration of oral anticoagulation therapy, CT and venography were performed to identify patency and the presence of a recurrent thrombosis.
Results: Successful removal of the thrombus and restoration of venous flow were achieved in all of the patients (100%). Restoration of flow with a residual thrombus occurred in one case. Focal venous stenosis was discovered in four cases. The duration of urokinase infusion was 1-4 days (average 2.36 days), which was considered long. For 15.2 months, the venous lumen of all cases was preserved without a recurrent thrombosis.
Conclusion: Catheter-directed thrombolysis is an effective procedure for recanalization of below-knee DVT in patients with a lower extremity DVT.
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KEYWORD
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Venous thrombosis, Thrombolytic therapy, Lower extremity
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