The Efficacy and Safety of Pharmacomechanical Thrombolysis and Medical Therapy for Symptomatic Deep Venous Thrombosis

Objective: To prospectively compare the efficacy and safety of pharmacomechanical thrombolysis (PMT) and medical therapy for symptomatic deep venous thrombosis (DVT). Material and Methods: Between January 2015 and July 2016, 69 patients with a history of lower extremity DVT symptoms less than 21 days were managed either with a rotational thrombectomy device (ReyaThrombectomy ® Biolas FG Grup, Ankara, Turkey) or medical therapy including anticoagulation and compression stocking. Degree of lysis, symptomatic relief and patency were analyzed. Results: Thirty-four (47.9.0%) of the patients had a ilio-femoral thrombosis. The mean duration of the symptoms was 6.8 (2-20) days. Fourty-four and twenty-five patients were managed with PMT and medical therapy, respectively. At the end of the PMT procedure, 36 patients (81.8%) had a complete (Grade III) thrombus resolution. Grade II lysis was noted in 8 (18.2%) of the patients. One patient developed access site hematoma. There was no mortality. At third month, the venous obstruction was observed in 7 (15.9%) and 11 (44%) of patients in PMT and medical therapy groups, respectively (p<0.05). There was a significant clinical improvement in PMT group as evaluated by clinical symptom score. (1.6±0.8 vs. 2.1±0.8, p=0.02). Conclusion: The rotational thrombectomy is safe, fast and more effective alternative to current medical therapy for the management of DVT.