Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(03): 184-191
DOI: 10.1055/s-0044-1786369
Original Article

Efficacy of Mechanical Thrombectomy in Preventing Post-Thrombotic Syndrome in Acute DVT: A Retrospective Study

Vinoth Kumar Philip 
1   Department of Plastic and Microvascular Surgery, VJ Hospital, Tirunelveli, Tamil Nadu, India
,
Mohamed B. Yasir 
1   Department of Plastic and Microvascular Surgery, VJ Hospital, Tirunelveli, Tamil Nadu, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Lower limb deep vein thrombosis (DVT) is associated with significant morbidity and death. DVT can result in complications such as postphlebitic syndrome, pulmonary embolism, and death. Combining pretest probability, D-dimer testing, and compression ultrasound imaging enables a safe and convenient study of suspected lower-extremity thrombosis. This study aimed to assess the expanding body of research supporting thrombectomy as a form of DVT therapy.

Materials and Methods A retrospective study was performed on individuals with venous Doppler-confirmed DVT and occlusive thrombus. Four-hundred fifty-one consecutive patients were selected for the study based on the inclusion and exclusion criteria. In this investigation, thrombectomy was the preferred therapeutic approach.

Results The study reports a male predominance of 56.1%. Most patients (25.7%) were between the age of 51 and 60, with 84.7% reporting pain and lower-extremity swelling as the two most common clinical symptoms. The femoral vein was noted as the most frequent site of thrombus in the current research (51.0%), with acute DVT accounting for most cases (85.1%). Most of the patients (97.3%) were primarily asymptomatic after one year of follow-up.

Conclusion Thrombectomy is a reliable treatment modality for DVT patients in regaining venous patency, preventing DVT recurrence, treating post-thrombotic syndrome, and preventing pulmonary embolism.

Keywords

deep vein thrombosis - pulmonary embolism - post-thrombotic syndrome - thrombectomy

Authors' Contributions

V.K.P. was involved in conceptualization and designing and critical revision of the study. M.Y. contributed to analysis and interpretation, data collection, and writing of the article. All the authors provided final approval of the article.


Supplementary Material



Publication History

Article published online:
30 May 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Karthikesalingam A, Young EL, Hinchliffe RJ, Loftus IM, Thompson MM, Holt PJ. A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis. Eur J Vasc Endovasc Surg 2011; 41 (04) 554-565
    CrossrefPubMedGoogle Scholar
  • 2 Di Nisio M, van Es N, Büller HR. Deep vein thrombosis and pulmonary embolism. Lancet 2016; 388 (10063): 3060-3073
    CrossrefPubMedGoogle Scholar
  • 3 Oger E. Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 2000; 83 (05) 657-660
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Huynh N, Fares WH, Brownson K. et al. Risk factors for presence and severity of pulmonary embolism in patients with deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2018; 6 (01) 7-12
    CrossrefPubMedGoogle Scholar
  • 5 Agarwala S, Bhagwat AS, Wadhwani R. Pre and postoperative DVT in Indian patients-Efficacy of LMWH as a prophylaxis agent. Ind J Orth 2005; 39 (01) 55 https://www.researchgate.net/publication/26489193_Pre_and_postoperative_DVT_in_Indian_patients_-_Efficacy_of_LMWH_as_a_prophylaxis_agent
    Google Scholar
  • 6 Wigle P, Hein B, Bernheisel CR. Anticoagulation: updated guidelines for outpatient management. Am Fam Physician 2019; 100 (07) 426-434
    PubMedGoogle Scholar
  • 7 Peuster M, Bertram H, Windhagen-Mahnert B, Paul T, Hausdorf G. Mechanische Rekanalisation einer Venenthrombose und Lungenembolie mit dem Clotbuster-Thrombektomie-System bei einem 12 Jahre alten Jungen. [Mechanical recanalization of venous thrombosis and pulmonary embolism with the Clotbuster thrombectomy system in a 12-year-old boy] Z Kardiol 1998; 87 (04) 283-287
    CrossrefPubMedGoogle Scholar
  • 8 Comerota AJ. The current role of operative venous thrombectomy in deep vein thrombosis. Semin Vasc Surg 2012; 25 (01) 2-12
    CrossrefPubMedGoogle Scholar
  • 9 Arko FR, Davis III CM, Murphy EH. et al. Aggressive percutaneous mechanical thrombectomy of deep venous thrombosis: early clinical results. Arch Surg 2007; 142 (06) 513-518 , discussion 518–519
    CrossrefPubMedGoogle Scholar
  • 10 Koopmann MC, McLafferty RB. Advances in operative thrombectomy for lower extremity venous thrombosis. Surg Clin North Am 2018; 98 (02) 267-277
    CrossrefPubMedGoogle Scholar
  • 11 Kearon C, Kahn SR. Long-term treatment of venous thromboembolism. Blood 2020; 135 (05) 317-325
    CrossrefPubMedGoogle Scholar
  • 12 Prandoni P, Lensing AW, Prins MH. et al. The impact of residual thrombosis on the long-term outcome of patients with deep venous thrombosis treated with conventional anticoagulation. Semin Thromb Hemost 2015; 41 (02) 133-140
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Wong PC, Chan YC, Law Y, Cheng SWK. Percutaneous mechanical thrombectomy in the treatment of acute iliofemoral deep vein thrombosis: a systematic review. Hong Kong Med J 2019; 25 (01) 48-57
    PubMedGoogle Scholar
  • 14 Huang CY, Hsu HL, Kuo TT, Lee CY, Hsu CP. Percutaneous pharmacomechanical thrombectomy offers lower risk of post-thrombotic syndrome than catheter-directed thrombolysis in patients with acute deep vein thrombosis of the lower limb. Ann Vasc Surg 2015; 29 (05) 995-1002
    CrossrefPubMedGoogle Scholar
  • 15 Popuri RK, Vedantham S. The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol 2011; 31 (03) 479-484
    CrossrefPubMedGoogle Scholar
  • 16 Chiasakul T, Bauer KA. Thrombolytic therapy in acute venous thromboembolism. Hematology (Am Soc Hematol Educ Program) 2020; 2020 (01) 612-618
    CrossrefPubMedGoogle Scholar
  • 17 Needleman L, Cronan JJ, Lilly MP. et al. Ultrasound for lower extremity deep venous thrombosis: multidisciplinary recommendations from the Society of Radiologists in Ultrasound Consensus Conference. Circulation 2018; 137 (14) 1505-1515
    CrossrefPubMedGoogle Scholar
  • 18 Murphy KD. Mechanical thrombectomy for DVT. Tech Vasc Interv Radiol 2004; 7 (02) 79-85
    CrossrefPubMedGoogle Scholar
  • 19 Mewissen MW, Seabrook GR, Meissner MH, Cynamon J, Labropoulos N, Haughton SH. Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry. [published correction appears in Radiology 1999 Dec;213(3):930] Radiology 1999; 211 (01) 39-49
    CrossrefPubMedGoogle Scholar
  • 20 Garcia MJ, Lookstein R, Malhotra R. et al. Endovascular management of deep vein thrombosis with rheolytic thrombectomy: final report of the prospective multicenter PEARL (Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths) Registry. J Vasc Interv Radiol 2015; 26 (06) 777-785 , quiz 786
    CrossrefPubMedGoogle Scholar
  • 21 Murguia AR, Prakash S, Segovia F. et al. Prevalence and clinical significance of deep vein thrombosis in Hispanic patients with acute pulmonary embolism. Angiology 2023; 33197231194234
    CrossrefPubMedGoogle Scholar