Pulsatile injections versus continuous infusion in catheter-directed thrombolysis for proximal iliofemoropopliteal deep vein thrombosis | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 40, Issue 2, April 2021 PDF (2.77 MB) | ||||
| DOI: 10.4103/ejs.ejs_28_21 | ||||
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| Author | ||||
| Mohamed Gamal Abdulrahman | ||||
| Abstract | ||||
| Context The yearly incidence of first attack of symptomatic deep vein thrombosis (DVT) in adults varies from 50 to 100 per 100 000 population. Catheter-directed thrombolysis (CDT) involves the administration of a thrombolytic drug through a numerous side-holes catheter placed straight into the vein. The intrathrombus delivery can be done either as pulsatile injections (PI) or continuous infusion (CI). Aims The objective of this study was to compare the delivery of the recombinant tissue-plasminogen activator drug by PIs versus CI in CDT for iliofemoropopliteal DVT in terms of clinical and hemodynamic outcome. Settings and design This was a single-center retrospective study done between February 2017 to February 2020. A total of 29 patients were treated by CDT for proximal iliofemoral DVT. Patients and methods Patients were randomly divided into two groups: group A had the drug delivered by the PI, and group B had it delivered by CI. Statistical analysis used Statistical Package for the Social Sciences (SPSS) 15.0 was used. Values were compared with a paired sample test. values less than 0.05 were considered significant. Results It had clearly showed that PI patients had better results regarding grade of thrombus lysis as well as duplex scan assessment of lumen narrowing, collateralization, and reflux. Moreover, PI patients had statistically better scores regarding Charing Cross Venous Ulceration Questionnaire, Venous Segmental Disease Score, Venous Clinical Severity Score, Villalta score, and 36-Item Short Form Health Survey for quality of life. Conclusions CDT delivered by the PI technique is safe and effective in treating proximal leg DVT when compared with the CI technique. | ||||
| Keywords | ||||
| catheter-directed thrombolysis; proximal iliofemoropopliteal deep vein thrombosis; Venous Thromboembolism | ||||
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