Deep vein thrombosis surgery: Difference between revisions
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==Fibrinolysis== | ==Fibrinolysis== | ||
In many patients of arterial and venous thrombosis, fibrinolysis alone is the main mode of treatment. It | In many patients of arterial and venous thrombosis, fibrinolysis alone is the main mode of treatment. It should not be used in following conditions: | ||
*In patient who have undergone recent surgery or trauma involving central nervous system. | *In patient who have undergone recent surgery or trauma involving central nervous system. | ||
*In patient with extensive or bulk thrombosis. | *In patient with extensive or bulk thrombosis. | ||
Revision as of 13:45, 9 September 2011
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Overview
Percutaneous transcatheter treatment of patients with deep venous thrombosis (DVT) includes:
- Thrombus removal with catheter-directed thrombolysis,
- Mechanical thrombectomy,
- Angioplasty,
- Stenting of venous obstructions
Fibrinolysis
In many patients of arterial and venous thrombosis, fibrinolysis alone is the main mode of treatment. It should not be used in following conditions:
- In patient who have undergone recent surgery or trauma involving central nervous system.
- In patient with extensive or bulk thrombosis.
Mechanical thrombectomy
It should be considered in patients with proximal occlusive DVT, which is associated with significant swelling and symptoms or phlegmasia cerulea dolens. This procedure must be carried out carefully to avoid dislodging the clot or breaking it into small fragments because it may lead to pulmonary embolus.
Inferior vena cava filter
Inferior vena cava filter reduces pulmonary embolism[1] and is an option for patients with an absolute contraindication to anticoagulant treatment (e.g., cerebral hemorrhage) or those rare patients who have objectively documented recurrent PEs while on anticoagulation, an inferior vena cava filter (also referred to as a Greenfield filter) may prevent pulmonary embolisation of the leg clot. However these filters are themselves potential foci of thrombosis,[2] IVC filters are viewed as a temporary measure for preventing life-threatening pulmonary embolism.[3]
References
- ↑ Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, Laporte S, Faivre R, Charbonnier B, Barral F, Huet Y, Simonneau G (1998). "A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. Prévention du Risque d'Embolie Pulmonaire par Interruption Cave Study Group". N Engl J Med. 338 (7): 409–15. PMID 9459643.
- ↑ "Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism: the PREPIC (Prevention du Risque d'Embolie Pulmonaire par Interruption Cave) randomized study". Circulation. 112 (3): 416–22. 2005. PMID 16009794.
- ↑ Young T, Aukes J, Hughes R, Tang H (2007). "Vena caval filters for the prevention of pulmonary embolism". Cochrane database of systematic reviews (Online) (3): CD006212. doi:10.1002/14651858.CD006212.pub2. PMID 17636834.