DVT Case Study 1

Iliofemoral DVT

Background

A 55 year old woman presented to the emergency room with a massively swollen right leg from an iliofemoral deep vein thrombosis (DVT). Her right leg was severely edematous and painful. The symptoms began three days prior to admission. Ultrasound confirmed an acute femoral deep venous thrombosis extending cranially into the iliac veins.

Procedure

A venogram was performed in the endovascular suite and thrombus was seen in the femoral and iliac veins of the right leg (Figure 1). A Trellis®-8 Peripheral Infusion System was placed and 20mg of t-PA was infused for a total of 40 minutes. The clot was effectively removed and venography confirmed recanalization. An excellent result was obtained (Figure 2).

Conclusion

The patient experienced immediate relief after the procedure, and the edema subsided over the course of 3 days. The patient was discharged the following day. Pharmacomechanical thrombolysis with angioplasty is an effective alternative to systemic anticoagulation in the treatment of deep vein thrombosis. The Trellis-8 catheter is a device which mechanically isolates the clot and dissolves the thrombus with a small amount of lytic agent. As an alternative to anticoagulation, the treatment results in immediate resolution of clot and symptoms. The procedure is underutilized due to the lack of knowledge of its availability and reliance on noninvasive therapies for venous thrombosis treatments.

Courtesy of Charles Thompson, M.D.

Figure 1

Figure 2