Endovascular Treatment Outcomes in Acute and Subacute Deep Vein Thrombosis: A Single-Center Experience

Abstract

Objective: The aim of this study was to evaluate technical and clinical success rates, procedure-related complications, and recurrence rates during follow-up in patients with acute and subacute deep vein thrombosis (DVT) who underwent endovascular treatment. Material and Methods: In this retrospective, single-center study, patients aged ≥18 years who underwent endovascular treatment for acute or subacute DVT were included. Cases of isolated distal DVT and chronic DVT were excluded. Patient demographics, thrombosis location, endovascular treatment modality, use of thrombolytic agents, inferior vena cava filter placement, and stent deployment were recorded. Technical success was defined as achieving complete or clinically meaningful recanalization in the target venous segment. Clinical success was assessed based on marked improvement in limb pain and edema. Results: A total of 18 patients were included. The mean age was 48.3±15.1 years, and 66.7% were female. Concomitant pulmonary embolism was detected in 4 patients (22.2%). The mean symptom duration was 15.7±8.6 days. Ultrasound-assisted catheter-directed thrombolysis was performed in 66.6% of patients, thrombolysis via a multi-side-hole infusion catheter in 27.8%, and mechanical aspiration in 5.6%. Thrombolytic therapy was used in 17 patients overall. After endovascular intervention, complete recanalization was achieved in 55.6% and partial recanalization in 44.4%. The clinical success rate was 94.4%. During a mean follow-up of 13.2±6.2 months, no recurrence was observed in the treated limb. No major complications occurred; minor complications developed in 2 patients (11.1%). Conclusion: In selected patients with acute and subacute DVT—particularly involving the iliofemoral segment—endovascular treatment appears to be an effective and safe therapeutic option, with high technical and clinical success rates and an acceptable complication profile.

Keywords

• Deep vein thrombosis
• tissue plasminogen activator
• endovascular procedures
• mechanical thrombolysis
• ultrasonography

AKUT VE SUBAKUT DERİN VEN TROMBOZUNDA ENDOVASKÜLER TEDAVİ SONUÇLARI: TEK MERKEZ DENEYİMİ

Abstract

Amaç: Bu çalışmanın amacı, akut ve subakut derin ven trombozu (DVT) tanısı ile endovasküler tedavi uygulanan hastalarda teknik ve klinik başarı oranlarını, işlemle ilişkili komplikasyonları ve takip süresince gelişen rekürrens oranlarını değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmaya akut ve subakut DVT tanısı ile endovasküler tedavi uygulanan ve yaşı ≥18 olan hastalar dâhil edildi. İzole distal ve kronik DVT olguları çalışma dışı bırakıldı. Hastaların demografik özellikleri, tromboz lokalizasyonu, uygulanan endovasküler tedavi yöntemi, trombolitik ajan kullanımı, vena kava filtresi yerleştirilmesi ve stentleme durumu kaydedildi. Teknik başarı, hedef ven segmentinde tam veya anlamlı rekanalizasyon sağlanması olarak tanımlandı. Klinik başarı ise, ekstremite ağrısı ve ödeminde belirgin gerileme ile değerlendirildi. Bulgular: Çalışmaya toplam 18 hasta dâhil edildi. Hastaların yaş ortalaması 48,3±15,1 yıl olup, %66,7’si kadındı. Dört hastada (%22,2) eşlik eden pulmoner emboli saptandı. Ortalama semptom süresi 15,7±8,6 gün idi. Hastaların %66,6’sına ultrason destekli kateter yönlendirmeli tromboliz, %27,8’ine çok delikli infüzyon kateteri ile tromboliz ve %5,6’sına mekanik aspirasyon uygulandı. Toplam 17 hastada trombolitik tedavi kullanıldı. Endovasküler girişim sonrası %55,6 oranında tam, %44,4 oranında parsiyel rekanalizasyon sağlandı. Klinik başarı oranı %94,4 idi. Ortalama 13,2±6,2 aylık takip süresince işlem uygulanan ekstremitede rekürrens izlenmedi. Majör komplikasyon saptanmazken, iki hastada (%11,1) minör komplikasyon gelişti. Sonuç:Akut ve subakut, özellikle iliofemoral segmenti tutan DVT olgularında endovasküler tedavi, seçilmiş hastalarda yüksek teknik ve klinik başarı oranları ve kabul edilebilir komplikasyon profili ile etkili ve güvenli bir tedavi seçeneğidir.

Keywords

• Derin ven trombozu
• doku plazminojen aktivatörü
• endovasküler prosedürler
• mekanik tromboliz
• ultrason

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