Tong Guo Si MD, Presenter: Nothing to Disclose

Zhi Guo MD, PhD, Abstract Co-Author: Nothing to Disclose

Xishan Hao, Abstract Co-Author: Nothing to Disclose

To assess the feasibility and effect of regional artery thrombolysis for symptomatic peripheral deep vein thrombosis in patients with cancers.

this group include 34 cancer patients(man 21, woman 13, average 63.7 years old), the history of swelling and pain in lower extremities(19 left, 15 right) ranged from 7days to 32 days. Peripheral deep vein thrombosis was confirmed by phlebography. A 4F catheter was introduced, and retained in ipsilateral distal femoral artery, urokinase was infused continuously at 20,000U/Hr through the catheter until the swelling and pain relieved. Then phlebography was repeated. Low molecular weight heparin (LMWH) was given subcutaneouly for 2 weeks. In addition, elastic compression stockings were used for compression therapy at least 3 months. Technically complete success was defined as restoration of antegrade flow and removal of more than 90% of thrombus. Partial success was defined as removal of 50%-90% of thrombus. Removal of less than 50% of thrombus defined as unsuccessful. Clinical success was defined as resolution or improvement in extremity pain and swelling.

Technically complete success was achieved in 85%(29/34), partial success in 15%(5/34). Clinical success was achieved in 100%. The mean duration of thrombolysis treatment was50.2 hours ± 14.3 (range, 24-72h), with total urokinase doses of 1.01±0.29 million Unite (range，0.48-1.44). Only one patient suffered hematoma in the puncture site, no other complication was found. During the follow-up of 6-30 months with clinical examination and doppler ultrasound, 1 patients suffered a recurrent local thrombosis in popliteal vein after 3 months due to a interruption of elastic stockings.

In this initial study, for cancer patients, it is an effective method to infuse urokinase in distal femoral artery for treatment of peripheral DVT. And elastic stocking may also prevent recurrent thrombosis without anticoagulation drugs.

Regional artery thrombolysis could be applied for symptomatic peripheral deep vein thrombosis in patients with cancers

Si, T, Guo, Z, Hao, X, Regional Artery Thrombolysis for Symptomatic Peripheral Deep Vein Thrombosis in Patients with Cancers.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010805.html