J Korean Soc Radiol.  2011 Sep;65(3):235-240.

Intra-Arterial Thrombolysis for Deep Vein Thrombosis of the Lower Extremity: Case Report

• Kim MS
• Roh BS

Abstract

If the appropriate catheterization of the affected vein was not possible because of a narrowed or thrombus-filled venous lumen, successful treatment gets into trouble during catheter directed regional thrombolysis for treatment of deep vein thrombosis. In this situation, intra-arterial thrombolysis can be considered as an alternative treatment, but to the best of our knowledge, only two reports have been described. We present here cases of successful intra-arterial thrombolysis in patients with deep vein thrombosis.

MeSH Terms

Catheterization
Catheters
Humans
Lower Extremity
Radiography, Interventional
Thrombolytic Therapy
Veins
Venous Thrombosis

Figure

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  Fig. 1 67-year-old male with deep vein thrombosis of the right lower extremity. A. CT angio venography showed thrombotic occlusion of right femoral vein (arrow). Catheterization into popliteal vein was failed due to narrowed, thrombus-filled lumen. Alternatively, infusion catheter was located into the right popliteal artery. Catheter-directed thrombolysis with urokinase (50,000 IU/hr) was attempted. B. Initial Venography showed nearly obliterated right iliofemoral vein. Venous drainage of deep femoral and saphenous vein was relatively prominent (arrow). C. After 44 hours of urokinase infusion, venography showed patency of iliofemoral segment (arrow). D. Follow up venography showed good patency of right iliofemoral and popliteal veins after 7 days.

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  Fig. 2 33-year-old female with deep vein thrombosis of the left lower extremity. A. CT angio venography showed multiple thrombotic occlusion of left femoral, popliteal and tibial veins with enhanced thick wall and collapsed lumen (arrow). B, C. After 2 days of urokinase infusion, venography showed faint drainage flow of superficial femoral and popliteal veins (arrow). D. Follow-up CT angio venography after 3.5 years showed good patency of both iliofemoral and popliteal veins.

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