급성/아 급성 하지 심부 정맥 혈전증의 치료에 있어서 단독 흡인 혈전 제거술의 중 장기 임상적 결과
Aspiration Thrombectomy as the Sole Treatment for Acute and Sub-acute Deep Venous Thrombosis (DVT) of the Lower Extremity: mid and long-term clinical results
- 주제(키워드) deep vein thrombosis , thrombectomy , thrombolysis , May Thurner syndrome , catheter
- 발행기관 아주대학교
- 지도교수 원제환
- 발행년도 2012
- 학위수여년월 2012. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000012199
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
- ABSTRACT - Aspiration Thrombectomy as the Sole Treatment for Acute and Sub-acute Deep Venous Thrombosis (DVT) of the Lower Extremity: Mid and Long-term Clinical Results Purpose: To determine the feasibility of aspiration thrombectomy as the sole treatment for acute and sub-acute deep vein thrombosis of the lower extremity by evaluating the mid and long-term clinical results of aspiration thrombectomy treatment. Patients and methods: During a five year period (2005-2010), 108 patients with acute and sub-acute DVT of the lower-extremity underwent aspiration thrombectomy with 9-10 guiding catheters, after insertion of a temporary inferior vena cava (IVC) filter. The inclusion criteria were patients with acute or sub-acute iliofemoral or femoropopliteal DVT of less than 4 weeks duration, with or without IVC extension. If post procedure venography demonstrated persistent stenosis or residual thrombosis, adjunctive therapy was performed by balloon angioplasty, or stent placement. The aspirate was filtered and the amount of aspirated blood separated from the clot was measured. Adjuvant thrombolysis with urokinase was performed when the aspirated blood was over 400 ml or when the aspiration thrombectomy was incomplete. Results: Anatomical success was achieved in 92/108 (85%) patients after aspiration thrombectomy treatment of the thrombosed veins. In 16 patients with residual thrombosis after thrombectomy (grade I to grade II lysis), additional thrombolysis was performed using urokinase. Seventy nine of 108 (73%) patients had residual venous stenoses post aspiration thrombectomy that were treated with stent placement and balloon angioplasty. There was no mortality associated with the procedure. On mid-term follow up, 61/75 patients (81.3%) had no recurrence of DVT and 14 patients (18.7%) demonstrated DVT recurrence. Fifty five patients (73.3%) were asymptomatic on mid-term follow-up and 20/75 (26.6%) had symptoms related to DVT. In the 52 patients who remained during long-term follow up, 41/52 (78.8%) had no recurrence of DVT and DVT recurrence was seen in 11/52 (21.1%). Thirty seven patients (71.1%) were asymptomatic on long-term follow-up and 15/52 (28.8%) were symptomatic. Conclusion: Aspiration thrombectomy is a safe, effective and economic treatment for acute proximal DVT. It showed similar clinical results with other treatment methods in mid and long term follow-up without any major complications. Keywords: Deep venous thrombosis, Thrombolysis, thrombectomy, catheter, May Thurner syndrome
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TABLE OF CONTENTS
ABSTRACT i
TABLE OF CONTENTS iii
LIST OF FIGURES iv
LIST OF TABLES v
ABBREVIATIONS vi
Ⅰ. INTRODUCTION 1
Ⅱ. MATERIALS AND METHODS 7
A. MATERIALS 7
1. Study population 7
B. METHODS 10
1. Procedure notes 11
2. Definitions and statistical analysis 16
3. Follow up 16
Ⅲ. RESULTS 17
Ⅳ. DISCUSSION 23
Ⅴ. CONCLUSION 30
REFERENCES 31
국문요약 36
