medigraphic.com
Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2016, Number 3

Next >>

Rev Mex Angiol 2016; 44 (3)

Trombosis venosa profunda masiva. Manejo con trombólisis, ultrasonido endovascular y filtro de vena cava recuperable

Carpio-Cancino OG, Vallejo-Bravo EK, García-Galán JE, Balice-Olguín O, Navarro-Sánchez D

Language: Spanish
References: 10
Page: 88-92
PDF size: 185.51 Kb.


ABSTRACT

Introduction. Deep venous thrombosis could have a very extensive appearance, affecting a great proportion on deep venous system. One of the available treatments with better results is the pharmacomechanical thrombolysis.
Material and methods. We present the clinical case of a postpartum woman with thrombosis and occlusion from her juxta-renal cava vein to both popliteal veins, which was initially treated by means of thrombolysis with catheter and afterwards with thrombolysis enhanced with endovascular ultrasound and recoverable cava vein filter.
Results. The initial lysis achieved with catheter was 40%, increasing to 90% by means of endovascular ultrasound. The fibrinogen level diminished to 49 mg/dL. We found the patient positive to a lupus anticoagulant.
Conclusions. The initial thrombolysis performed with catheter had a partial result, and its application combined with endovascular ultrasound allowed a more complete lysis, reducing the total thrombolytic dose, which is the main factor to avoid bleeding complications.


REFERENCES

  1. Meissner MH, et al. Fisiopatología y evolución natural de la trombosis venosa profunda aguda. En: Cronenwett, Gloviczki, Johnston, Krupski, Ouriel, Sidawy (eds.). Rutherford Cirugía Vascular. 6a Ed. Madrid: Elsevier Saunders; 2006, pp. 2124-42.

  2. Blum AS, et al. Endovascular management of deep vein thrombosis. J Interven Cardiol 2006; 19: S97-S101.

  3. Lin PH, et al. Comparision of percutaneous ultrasoundaccelerated thrombolysis versus catheter-directed thrombolysis in patients with acute massive pulmonary embolism. Vascular 2009; 17: S137-S147.

  4. Giugliano RP, McCabe CH, Antman EM, et al. Thrombolysis in Miocardial Infarction (TIMI) Investigators: Lower-dose heparin with fibrinolysis is associated with lower rates of intracranial hemorrage. Am Heart J 2001; 141: 742-50.

  5. Stump DC, Califf RM, Topol EJ, et al. Pharmacodynamics of thrombolysis with recombinant tissue-type plasminogen activator. Correlation with characteristics and clinical outcomes in patients with acute myocardial infarction. Circulation 1989; 80: 1222-30.

  6. Marder VJ. Thrombolytic therapy. En: Kitchens, Kessler, Konkle (eds.). Consultative hemostasis and thrombosis. 3rd Ed. Philadelphia: Elsevier Saunders; 2013, pp. 526-37.

  7. Jacob H. Rand MD, Lucia R, Wolgart MD. Antiphospholi pid syndrome: Pathogenesis clinical presentation, diagnosis and patient management. En: Kitchens, Kessler, Konkle (eds.). Consultative hemostasis and thrombosis 3rd ed. Philadelphia: Elsevier Saunders; 2013, pp. 324-41.

  8. Dake MD, et al. Tratamiento endovascular de las oclusiones de la vena cava. En: Cronenwett, Gloviczki, Johnston, Krupski, Ouriel, Sidawy (eds.). Rutherford Cirugía Vascular. 6a Ed. Madrid: Elsevier Saunders; 2006, pp. 2332-44.

  9. Comerota AJ, Aldridge SC. Thrombolytic therapy for deep venous thrombosis: A clinical review. Can J Surg 1993; 36: 359-64.

  10. Heit JA. Thrombophilia: Clinical and laboratory assessment and management. En: Kitchens, Kessler, Konkle (eds.). Consultative hemostasis and thrombosis. 3rd Ed. Philadelphia: Elsevier Saunders; 2013, pp. 205-39.




2020     |     www.medigraphic.com