Journal: |
The Egyptian Journal of Surgery
Wolters Kluwer - Medknow
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Abstract: |
Purpose
The aim was to compare the effectiveness of catheter directed thrombolysis (CDT)
and pharmacomechanical catheter-directed thrombolysis (PCDT) in the treatment
of acute, massive iliofemoral deep vein thrombosis.
Patients and methods
A prospective study was conducted on 50 patients in Zagazig University Hospitals
between March 2014 and April 2018. The patients were randomized into two
groups. Group A underwent CDT and group B underwent PCDT (ASPIREX).
Primary end points were venous patency, complication rate, patient satisfaction,
and quality of life Chronic Venous Insufficiency Questionnaire-20. Secondary end
points were recurrence and occurrence of post-thrombotic syndrome (PTS), (the
Villalta score and revised Venous Clinical Severity Score) within 24 months.
Results
Aspirex was successful in the majority of patients and grade III, II, and I
thrombolysis was achieved in 56, 32, and 12% of patients, respectively, while in
the CDT group of patients achieved 44, 36, and 20%, respectively. Recanalization
was achieved in 88% patients. At 24 months 32% patients who received CDT
presented with PTS compared with 20.83% in the PCDT group after exclusion of
one patient who died. Three cases of severe PTS were reported in the CDT group.
There was statistically significant difference in PTS at 6 months between the two
groups. When comparing Chronic Venous Insufficiency Questionnaire-20 scores
between the two groups, there was statistically significant difference between them
at 6, 12, and 24 months with more improvement in Aspirex group.
Conclusion
Aspirex is an effective treatment for lower limb deep vein thrombosis, and the
clinical results achieved were superior in comparison with CDT alone.
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