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• W2982156722 abstract "Catheter-directed thrombolysis (CDT) is a recommended method for acute deep venous thrombosis with the advantage on enhancing thrombus removal of lower extremities, reducing the post-thrombotic syndrome and the risk of threatened limb loss. Recently, the mechanical devices combined with CDT treatment have shown its advantage over CDT alone in some reports. Fibrinogen levels are typically serially monitored during the infusion period and used as a surrogate marker for impending bleeding. We aimed to demonstrate the advantage of catheter and aspiration thrombectomy (CAT) over CDT on the changes of fibrinogen level. There were 32 patients with acute deep venous thrombosis from January 2018 to July 2019 who were studied in a retrospective manner, and serial fibrinogen levels were monitored. Based on the treatments, patients were divided into three categories: systemic thrombolysis, CDT, and CAT group. In all groups, low-molecular-weight heparin (200 IU/kg) was used initially, then combined with urine kinase (250,000 IU, twice daily). When the fibrinogen level fell to 1.5 g/L, the dose of thrombolysis would be readjusted or suspended. The effect of treatment was evaluated by the clot burden reduction score and lysis grade through venography after thrombolysis. The data were reviewed qualitatively, and the t-test or analysis of variance was used to determine the statistically significant relationship of intergroups. The data showed that the fibrinogen level was significantly lower and the D-dimer level higher in the CDT group compared with the CAT and systemic thrombolysis groups during treatment. Both interventional groups (CDT and CAT group) decreased significantly in clot burden reduction The CAT group was correlated with the invariable fibrinogen level during urine kinase thrombolysis, which may contribute to lower the potential bleeding risk during thrombolysis, although the result in our study did not show it.TableComparison of systemic thrombolysis (ST), catheter-directed thrombolysis (CDT), and catheter and aspiration thrombectomy (CAT)DemographicsEntire cohortP valueST (n = 11)CDT (n = 10)CAT (n = 11)Age, years63.857.663.654Female, %63.608066.70.363Fibrinogen, g/L Baseline3.62 ± 61.233.46 ± 1.183.73 ± 1.25.789 Lowest2.63 ± 0.731.33 ± 0.47a3.09 ± 0.690D-dimer, mg/L Baseline6.17 ± 4.83b47.69 ± 49.14b25.16 ± 31.49.035 Lowest6.76 ± 9.4112.08 ±103.1a51.13 ± 85.5.005Lysis grade achieved.371 Grade I (<50%)20% (2)0% (0) Grade II (>50%-99%)70% (7)81% (10) Grade III (100%)10% (1)9% (1)Mean clot burden reduction Iliac vein, before2.40 ± 0.702.67 ± 0.58.563 Iliac vein, after1.90 ± 0.881.33 ± 1.53.419P value, iliac vein.175.013 Femoral vein, before2.60 ± 0.702.00 ± 1.10.257 Femoral vein, after0.40 ± 0.520.037P value, femoral vein0.026Rate of bleeding0% (0)10% (1)9% (1).230Continuous data are shown as mean ± standard deviation.aST and CAT groups show significant difference with CDT group.bST and CDT groups have significant difference. Open table in a new tab" @default.
• W2982156722 created "2019-11-01" @default.
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• W2982156722 date "2019-11-01" @default.
• W2982156722 modified "2023-10-14" @default.
• W2982156722 title "FJVIS 39. Catheter-Directed Thrombolysis Plus Aspiration Thrombectomy Treatment Shows an Invariable Fibrinogen Level During Thrombolysis" @default.
• W2982156722 doi "https://doi.org/10.1016/j.jvs.2019.08.223" @default.
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