J Korean Radiol Soc.  2004 Jul;51(1):39-44. 10.3348/jkrs.2004.51.1.39.

Efficacy and Safety of Rotating Pigtail Catheter: Lower Extremity Deep Vein Thrombosis of May-Thurner Syndrome

Affiliations
  • 1Department of Diagnostic Radiology, Mokdong Hospital, Medical College of Ewha Womans University, Korea. kangbc@ewha.ac.kr
  • 2Department of Diagnostic Radiology, Medical College of Seoul National University, Korea.

Abstract

PURPOSE: The purpose of this study was to evaluate the efficacy and safety of mechanical fragmentation of iliofemoral deep vein thromboses (DVTs) with a rotating pigtail catheter followed by aspiration thrombectomy.
MATERIALS AND METHODS
Ten patients (eight females, two males, 56.8 +/- 21.37 years) with iliofemoral DVT underwent treatment for a total of ten affected limbs. Approximately 5-10 min after infusing 400,000-700,000 IU urokinase (UK) into the thrombosed deep veins, the thromboses were fragmented by the mechanical action of the rotating pigtail catheter tip. Following their fragmentation, the fragmented thromboses were aspirated. After completion of the above procedure, a stent was inserted if iliac vein stenosis was demonstrated. We evaluated the total procedure time, volume of thrombolytic agent (urokinase), valvular injury, symptom-free time interval and success rate (primary patency rate).
RESULTS
In all 10 patients, the iliofemoral deep vein thrombosis was successfully fragmented and aspirated using the combination method of a rotating pigtail catheter and aspiration thrombectomy (clinical and technical success rate, 100%). The thromboses were declotted by means of a rotating pigtail catheter with an average treatment time of 5.7 minutes. The average duration of the total intervention was 108 min. The mean primary patency was approximately 4 months with no recurrence. The total UK dose was 890,000 IU on average. There were no major complications, such as pulmonary embolism or cerebral hemorrhage, while performing the thrombus-fragmentation procedure using the rotating pigtail catheter.
CONCLUSION
The combination method of a rotating pigtail catheter and aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis was found to be rapid, safe and effective for accomplishing recanalization in all cases without complication. Therefore, this procedure constitutes a potential treatment option in patients presenting with iliofemoral vein thrombosis.

Keyword

Veins, thrombosis ; Thrombolysis ; Thrombectomy

MeSH Terms

Catheters*
Cerebral Hemorrhage
Constriction, Pathologic
Extremities
Female
Humans
Iliac Vein
Lower Extremity*
Male
May-Thurner Syndrome*
Pulmonary Embolism
Recurrence
Stents
Thrombectomy
Thrombosis
Urokinase-Type Plasminogen Activator
Veins
Venous Thrombosis*
Urokinase-Type Plasminogen Activator
Full Text Links
  • JKRS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr