Catheter-directed Thrombolysis for Deep Venous Thrombosis of the Lower Limbs

Abstract

Eight limbs of seven patients with deep venous thrombosis were treated by direct thrombolytic therapy using pulsed infusion catheters. The catheters were inserted via the common femoral, the popliteal, the short saphenous, the posterior tibial or the Cockett’s perforating veins. Urokinase was manually sprayed and then continuously injected using a infusion pump for 2～14 days. The total dose of urokinase was 1.08～3.12 million IU. Symptoms were immediately subsided in all limbs and completely disappeared in 5 limbs. Efficient thrombolysis was more observed than conventional systemic thrombolytic therapy on follow-up phlebography. In two limbs Palmaz stents were inserted in the left common iliac vein after PTA.

Catheter-directed thrombolysis could be the first choice of treatment for deep venous thrombosis. However, there are some problems in this therapeutic maneuver concerning the effect to old thrombus, insertion site of catheters, suitable duration of the treatment and prevention of pulmonary embolism.