Interventional Radiology :: Case Studies :: Vascular

Interventional Radiology :: Case Studies :: Vascular :: Thrombolysis for DVT

Case Study

Vascular

Thrombolysis for DVT

Case Study Details

A 43-year-old male , presented to the hospital with swelling in the left leg for the last 7 days. Ultrasound and Doppler showed findings consistent with DVT extending from the common iliac to the tibial veins.

Heparin by itself has shown poor results in preventing post thrombotic syndrome(a condition associated with severe swelling of the legs , varicose veins and ulceration) which is secondary to the poor recanalization rates with anti-coagulants. Regional thrombolysis in these cases is a far better option.

Under ultrasound guidance the popliteal vein was punctured and a catheter was navigated under fluoroscopic guidance into the popliteal vein. The catheter had multiple side holes for about 40 cm.

Venography before lysis shows poor flow in the femoral veins with multiple filling defects.

Urokinase was injected at the rate of 100,000 units /hour.

In the next 48 hours there was significant lysis of the thrombus. Postprocedure venography showed excellent results.

The patient continues do well 2 years following the procedure. Regional thrombolysis for DVT is considered the best form of treatment today to prevent post thrombotic syndrome .

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