SpringerLink
Log in

Real clinical practice of catheter therapy for deep venous thrombosis: periprocedural and 6-month outcomes from the EDO registry

  • Original Article
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

A recent national study in Japan indicated that 5.8 % of deep venous thrombosis (DVT) patients were treated using endovascular procedures, 83 % of which included catheter-directed thrombolysis (CDT). However, the details of these endovascular procedures and their outcomes have not yet been fully evaluated. Using DVT data from the EDO registry (EnDOvascular treatment registry) database, a total of 35 symptomatic iliac or femoral DVT patients who received endovascular treatment (54.3 % male, age 64.7 ± 15.1) were analyzed. The dominant patient risks were being bedridden (22.9 %) and May–Thurner syndrome (25.7 %). Approximately 77.1 % of patients were treated using an antegrade approach, and CDT and other endovascular procedures were performed in 82.9 and 57.1 % of patients, respectively. A periprocedural inferior vena cava (IVC) filter was used in 94.1 % of patients, which remained implanted in 37.1 and 20.0 % of patients after discharge and 6 months after hospitalization, respectively. After 6 months of treatment, 2.9 % of patients experienced a recurrence of DVT and 5.7 % suffered revascularization, but no patient had a recurrence of pulmonary embolism. Subjective symptoms improved in 80.0 % of patients, while 2.9 % of patients felt worse at 6 months after treatment. Postthrombotic syndrome-related symptoms were observed in seven patients (19.4 %), and edema was most frequently observed (71.4 %). The details of CDT procedures, such as approach site and the removal of the IVC filter, varied among hospitals. Despite improved symptoms, further procedural standardization and data collection should be conducted to reduce complications and improve outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. JCS Joint Working Group. Guidelines for the diagnosis, treatment and prevention of pulmonary thromboembolism and deep vein thrombosis (jcs 2009). Circ J. 2011;75:1258–81.

    Article  Google Scholar 

  2. Comerota AJ, Grewal N, Martinez JT, Chen JT, Disalle R, Andrews L, Sepanski D, Assi Z. Postthrombotic morbidity correlates with residual thrombus following catheter-directed thrombolysis for iliofemoral deep vein thrombosis. J Vasc Surg. 2012;55:768–73.

    Article  PubMed  Google Scholar 

  3. Enden T, Haig Y, Klow NE, Slagsvold CE, Sandvik L, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the cavent study): a randomised controlled trial. Lancet. 2012;379:31–8.

    Article  PubMed  Google Scholar 

  4. Strijkers RHW, Grommes J, Arnoldussen CWKP, de Graaf R, ten Cate AJ, Wittens CHA. Ultrasound-accelerated catheter-directed thrombolysis in acute iliofemoral deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2013;1:225–30.

    Article  Google Scholar 

  5. Nakamura M, Miyata T, Ozeki Y, Takayama M, Komori K, Yamada N, Origasa H, Satokawa H, Maeda H, Tanabe N, Unno N, Shibuya T, Tanemoto K, Kondo K, Kojima T. Current venous thromboembolism management and outcomes in japan. Circ J. 2014;78:708–17.

    Article  PubMed  Google Scholar 

  6. Enden T, Klow NE, Sandvik L, Slagsvold CE, Ghanima W, Hafsahl G, Holme PA, Holmen LO, Njaastad AM, Sandbaek G, Sandset PM. Catheter-directed thrombolysis vs anticoagulant therapy alone in deep vein thrombosis: results of an open randomized, controlled trial reporting on short-term patency. J Thromb Haemost. 2009;7:1268–75.

    Article  CAS  PubMed  Google Scholar 

  7. Shi HJ, Huang YH, Shen T, Xu Q. Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of symptomatic lower extremity deep venous thrombosis. Eur J Radiol. 2009;71:350–5.

    Article  PubMed  Google Scholar 

  8. Kahn SR, Partsch H, Vedantham S, Prandoni P, Kearon C. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost. 2009;7:879–83.

    Article  CAS  PubMed  Google Scholar 

  9. Heit JA, Mohr DN, Silverstein MD, Petterson TM, O’Fallon WM, Melton LJ 3rd. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med. 2000;160:761–8.

    Article  CAS  PubMed  Google Scholar 

  10. Yamada N, Ishikura K, Ota S, Tsuji A, Nakamura M, Ito M, Isaka N, Nakano T. Pulse-spray pharmacomechanical thrombolysis for proximal deep vein thrombosis. Eur J Vasc Endovasc Surg. 2006;31:204–11.

    Article  CAS  PubMed  Google Scholar 

  11. Oguzkurt L, Ozkan U, Gulcan O, Koca N, Gur S. Endovascular treatment of acute and subacute iliofemoral deep venous thrombosis by using manual aspiration thrombectomy: long-term results of 139 patients in a single center. Diagn Interv Radiol. 2012;18:410–6.

    PubMed  Google Scholar 

  12. Budnur SC, Singh B, Mahadevappa NC, Reddy B, Nanjappa MC. Endovascular treatment of iliac vein compression syndrome (may-thurner). Cardiovasc Interv Ther. 2013;28:101–5.

    Article  PubMed  Google Scholar 

  13. Liu Z, Gao N, Shen L, Yang J, Zhu Y, Li Z, Si Y. Endovascular treatment for symptomatic iliac vein compression syndrome: a prospective consecutive series of 48 patients. Ann Vasc Surg. 2014;28:695–704.

    Article  PubMed  Google Scholar 

  14. Xue GH, Huang XZ, Ye M, Liang W, Zhang H, Zhang JW, Zhang BG. Catheter-directed thrombolysis and stenting in the treatment of iliac vein compression syndrome with acute iliofemoral deep vein thrombosis: outcome and follow-up. Ann Vasc Surg. 2014;28:957–63.

    Article  PubMed  Google Scholar 

  15. Chang R, Cannon RO 3rd, Chen CC, Doppman JL, Shawker TH, Mayo DJ, Wood B, Horne MK 3rd. Daily catheter-directed single dosing of t-pa in treatment of acute deep venous thrombosis of the lower extremity. J Vasc Interv Radiol. 2001;12:247–52.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Vedantham S, Vesely TM, Parti N, Darcy M, Hovsepian DM, Picus D. Lower extremity venous thrombolysis with adjunctive mechanical thrombectomy. J Vasc Interv Radiol. 2002;13:1001–8.

    Article  PubMed  Google Scholar 

  17. Rigatelli G, Cardaioli P, Roncon L, Giordan M, Milan T, Zonzin P. Combined percutaneous aspiration thrombectomy and rheolytic thrombectomy in massive subacute vena cava thrombosis with ivc filter occlusion. J Endovasc Ther. 2006;13:373–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to extend our profound gratitude to Norihiro Yamada, Yoshinori Nagashima, Tetsuo Yamanaka, and Yuichi Suzuki for correcting our data and improving our discussions.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, St. Luke’s International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan

    Atsushi Mizuno

  2. Department of Cardiology, Ota Memorial Hospital, Gunma, Japan

    Hitoshi Anzai

  3. Department of Cardiology, Tokyo Rosai Hospital, Tokyo, Japan

    Makoto Utsunomiya

  4. Department of Cardiology, The Cardiovascular Institute, Tokyo, Japan

    Junji Yajima, Yasufumi Yuzawa & Hidehiro Kaneko

  5. Department of Cardiology, Itabashi Chuo Medical Center, Tokyo, Japan

    Hiroshi Ohta & Shunsuke Ozaki

  6. Department of Cardiology, Kasukabe Chuo General Hospital, Saitama, Japan

    Hiroshi Ando & Hiroshi Sakamoto

  7. Department of Cardiology, Japanese Red Cross Musashino Hospital, Tokyo, Japan

    Tomoyuki Umemoto

  8. Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan

    Michiaki Higashitani

  9. Department of Cardiology, Tokyo Women’s Medical University, Tokyo, Japan

    Masashi Nakao

  10. Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan

    Masato Nakamura

Authors
  1. Atsushi Mizuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hitoshi Anzai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Makoto Utsunomiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Junji Yajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroshi Ohta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroshi Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tomoyuki Umemoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michiaki Higashitani
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Shunsuke Ozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroshi Sakamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Masashi Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yasufumi Yuzawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hidehiro Kaneko
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Masato Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

EDO registry investigators

Corresponding author

Correspondence to Atsushi Mizuno.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mizuno, A., Anzai, H., Utsunomiya, M. et al. Real clinical practice of catheter therapy for deep venous thrombosis: periprocedural and 6-month outcomes from the EDO registry. Cardiovasc Interv and Ther 30, 251–259 (2015). https://doi.org/10.1007/s12928-014-0314-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-014-0314-0

Keywords

Search

Navigation