Mechanical thrombectomy for DVT.

Deep venous thrombosis is a common source of morbidity and mortality in the United States. Complications include pulmonary embolism and chronic post-thrombotic syndrome. Chronic post-thrombotic syndrome is characterized by extremity pain, edema, venous claudication, skin changes, and skin ulceration. This syndrome is attributed to venous obstruction and valvular damage due to thrombus. The standard treatment of deep venous thrombosis consists of medical management with anticoagulation. Anticoagulation has proven efficacy in prevention of thrombus extension, pulmonary embolus, and re-thrombosis. The role of anticoagulation in post-thrombotic syndrome is unclear. Aggressive endovascular techniques for managing DVT have evolved as a result. Catheter-directed thrombolysis was the first such procedure with demonstrated efficacy, however its acceptance has been limited by perceived risks, time to lysis, and cost. As a result, alternative measures for managing DVT have evolved including mechanical thrombectomy. Mechanical thrombectomy for DVT has the potential to shorten the time for lysis, reduce the risk of thrombolytic agents, and potentially impact cost savings.

[1]  M. A. Samphilipo,et al.  Evaluation of venous injury caused by a percutaneous mechanical thrombolytic device , 1995, CardioVascular and Interventional Radiology.

[2]  D. Hovsepian,et al.  Lower extremity venous thrombolysis with adjunctive mechanical thrombectomy. , 2002, Journal of vascular and interventional radiology : JVIR.

[3]  M. Heller,et al.  In vitro effectiveness of mechanical thrombectomy devices for large vessel diameter and low-pressure fluid dynamic applications. , 2002, Journal of vascular and interventional radiology : JVIR.

[4]  S. Trerotola,et al.  Mechanical thrombolysis of venous thrombosis in an animal model with use of temporary caval filtration. , 2001, Journal of vascular and interventional radiology : JVIR.

[5]  K. Ouriel,et al.  Percutaneous AngioJet thrombectomy in the management of extensive deep venous thrombosis. , 2001, Journal of vascular and interventional radiology : JVIR.

[6]  S. Trerotola,et al.  The effects of a mechanical thrombolytic device on normal canine vein valves. , 2001, Journal of vascular and interventional radiology : JVIR.

[7]  W. Ambrosius,et al.  Preclinical in vivo testing of the Arrow-Trerotola percutaneous thrombolytic device for venous thrombosis. , 2001, Journal of vascular and interventional radiology : JVIR.

[8]  J. Douketis,et al.  A meta-analysis comparing low-molecular-weight heparins with unfractionated heparin in the treatment of venous thromboembolism: examining some unanswered questions regarding location of treatment, product type, and dosing frequency. , 2000, Archives of internal medicine.

[9]  G. Seabrook,et al.  Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. , 1999, Radiology.

[10]  J. Tacke,et al.  Experimental treatment of early chronic iliac vein thrombosis with a modified hydrodynamic thrombectomy catheter: preliminary animal experience. , 1999, Journal of vascular and interventional radiology : JVIR.

[11]  G. Simonetti,et al.  Percutaneous ilio-caval thrombectomy with the Amplatz device: preliminary results , 1999, European Radiology.

[12]  R. Uflacker Mechanical thrombectomy in acute and subacute thrombosis with use of the Amplatz device: arterial and venous applications. , 1997, Journal of vascular and interventional radiology : JVIR.

[13]  K. Amplatz,et al.  Acute and delayed outcomes of mechanical thrombectomy with use of the steerable Amplatz thrombectomy device in a model of subacute inferior vena cava thrombosis. , 1997, Journal of vascular and interventional radiology : JVIR.

[14]  J. Morris,et al.  Rheolytic thrombectomy with use of the AngioJet-F105 catheter: preclinical evaluation of safety. , 1997, Journal of vascular and interventional radiology : JVIR.

[15]  Paolo Prandoni,et al.  The Long-Term Clinical Course of Acute Deep Venous Thrombosis , 1996, Annals of Internal Medicine.

[16]  A. Nicolaides,et al.  New insights into the pathophysiologic condition of venous ulceration with color-flow duplex imaging: implications for treatment? , 1995, Journal of vascular surgery.

[17]  D. E. Strandness,et al.  Relationship between changes in the deep venous system and the development of the postthrombotic syndrome after an acute episode of lower limb deep vein thrombosis: a one- to six-year follow-up. , 1995, Journal of vascular surgery.

[18]  H. Wellens,et al.  In vivo evaluation of the Hydrolyser hydrodynamic thrombectomy catheter. , 1994, Journal of vascular and interventional radiology : JVIR.

[19]  P. Stonebridge,et al.  Venous function and clinical outcome following deep vein thrombosis , 1994, The British journal of surgery.

[20]  D. E. Strandness,et al.  Deep venous insufficiency: the relationship between lysis and subsequent reflux. , 1993, Journal of vascular surgery.

[21]  G. Simonneau,et al.  Subcutaneous low-molecular-weight heparin compared with continuous intravenous unfractionated heparin in the treatment of proximal deep vein thrombosis. , 1993, Archives of internal medicine.

[22]  J. Hirsh Low molecular weight heparin , 2007 .

[23]  M. Monreal,et al.  Venographic assessment of deep vein thrombosis and risk of developing post‐thrombotic syndrome: a prospective study , 1993, Journal of internal medicine.

[24]  G. Raskob,et al.  Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis. , 1992, The New England journal of medicine.

[25]  H. Büller,et al.  Comparison of subcutaneous low-molecular-weight heparin with intravenous standard heparin in proximal deep-vein thrombosis , 1992, The Lancet.

[26]  D. E. Strandness,et al.  Valvular reflux after deep vein thrombosis: incidence and time of occurrence. , 1992, Journal of vascular surgery.

[27]  K. Beach,et al.  Spontaneous lysis of deep venous thrombi: rate and outcome. , 1989, Journal of vascular surgery.

[28]  K. Beach,et al.  An objective assessment of the physiologic changes in the postthrombotic syndrome. , 1985, Archives of surgery.

[29]  D. Strandness,et al.  Long-term sequelae of acute venous thrombosis. , 1983, JAMA.

[30]  A. Nicolaides,et al.  Significance of popliteal reflux in relation to ambulatory venous pressure and ulceration. , 1979, Archives of surgery.

[31]  J. Keller,et al.  Venous Thromboembolism and Other Venous Disease in the Tecumseh Community Health Study , 1973, Circulation.

[32]  A. Lansing,et al.  Five‐Year Follow‐Up Study of Iliofemoral Venous Thrombectomy , 1968, Annals of surgery.