Our Early Results for the Treatment of Acute and Subacute Iliofemoral Deep Vein Thrombosis with Rotational Thrombectomy Catheter

Objective: In our study, we aimed to present our initial experience and early outcomes in patients who were treated with pharmacomechanical thrombectomy by endovascular intervention using Cleaner rotational thrombectomy catheter with tPA due to acute/subacute iliofemoral deep vein thrombosis. Material and Methods: Between February -May 2014, 20 patients (11 males, 9 females; mean age 53.4±18.5 years) treated with pharmacomechanical thrombectomy by endovascular intervention using Cleaner rotational thrombectomy catheter with tPA, were retrospectively reviewed in two different centers. Before pharmacomechanical thrombectomy, temporary vena cava filters were inserted in all patients to prevent pulmonary embolism thay may appear due to this procedure. After this procedure, patients received anticoagulant therapy and had a close follow-up for possible complications. Patients were assessed in our department 1 month after hospital discharge. They filled in a form about their complaints and venous Doppler ultrasonography (USG) was performed in all patients. Results: In the early postoperative period, hematoma or/and bleeding were observed at access site in 3 patients. Major complications or mortality were not seen in any patients. On follow up 1 month later, the average complaint score was 2.35 out of 10. Venous Doppler USG showed near complete patency of iliac and femoral veins in 85% of the patients. Conclusion: The traditional treatment of DVT is usually incapable of curing the disease due to the fact that trombus does not completely disappear, and it does not reduce the risk of postthrombotic syndrome.This is why the endovenous treatment procedures became popular and preferable. Therefore, early use of endovenous pharmacomechanic thrombectomy performed by Cleaner rotational thrombectomy catheter, a new method of acute and subacute DVT treatment, is a convenient method according to its efficiency and reliability. In medium and long term, the process of endovenous pharmacomechanic thrombectomy can be seen as a promising alternative treatment since it avoids the development of post-thrombotic syndrome and pulmonary thromboembolism, and it provides a sufficient venous system. We think that , these catheters are more successful, reliable, and easyto- use in deep vein thrombosis compared to medical treatment. Use and efficiency of these catheters will increase as with the experience of surgeons increase.