Short Term Results of Endovenous Treatment with Pharmacomechanic Thrombectomy in Acute Iliofemoral Deep Vein Thrombosis: A Single Center Experience

Objective: Deep vein thrombosis has life-threatening complications, and it is one of the most common preventable causes of in-hospital mortality. In this study, we aimed to present short term results of pharmacomechanic thrombectomy procedures in patients with acute ileofemoral deep vein thrombosis (DVT). Material and Methods: Thirty patients (16 males, 14 females; mean age 54.4±14.8 years, range. 29-82 years) who had pharmacomechanic thrombectomy with rotational thrombectomy catheter together with endovenous recombinant human tissue plasminogen activator between December 2012-November 2014 were analyzed retrospectively, and included in the study. Acute DVT patients were included in the study only in the first 15 days of the disease. A temporary vena cava filter was placed in all patients to prevent pulmonary embolism. Patients were administered warfarin after the operation, and the ones with an INR level of 2-3 were discharged. Results: No major complications or mortality were observed except 2 patients who developed hematoma at intervention site after the procedure. Patients were followed up with Doppler ultrasonography at postoperative 1st, 3rd, 6th months, and then once a year. At the end of 1st year, the patency rate was 97%. Conclusion: Anticoagulants are the first line treatment for acute DVT, however anticoagulant treatment does not have a thrombolytic effect and recanalization depends only on the efficiency of endovenous thrombolytic system. We think that pharmacomechanic thrombectomy methods are advantageous for almost complete disappearance of thrombus in particularly acute thrombosis, they reduce the risk of complications related to thrombosis, and shorten hospital stay.