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Thony F, Pernes JM, Menez C, Quesada JL, Heautot JF, Thouveny F, Monnin-Bares V, Bellier A, David A, Lablee A, Bouvier A, Vernhet-Kovacsik H, Douane F, Del Giudice C, Sapoval M, Guillen K, Loffroy R, Finas M, Rodiere M. Endovascular Thrombectomy for Acute Iliofemoral Deep Venous Thrombosis Through a Jugular Approach with a Rotational Device. Cardiovasc Intervent Radiol 2023; 46:1684-1693. [PMID: 37596417 DOI: 10.1007/s00270-023-03529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/25/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To report the effectiveness of pharmacomechanical catheter-directed thrombolysis (PCDT) in the management of acute iliofemoral deep venous thrombosis (DVT) via the jugular vein using a slow rotation and large-tip device (SRD) in a large cohort of patients. MATERIAL AND METHODS From 2011 to 2021, 277 patients (mean age 45 years, 59.2% women) were treated in 6 centres with PCDT for ilio-fémoral DVT. PCDT was performed via the jugular vein and consisted of one session of fragmentation-fibrinolysis, aspiration and, if needed, angioplasty with stenting. The aim of PCDT was to achieve complete clearance of the venous thrombosis and to restore iliofemoral patency. Residual thrombotic load was assessed by angiography, venous patency by duplex ultrasound and clinical effectiveness by the rate of post-thrombotic syndrome (Villalta score > 4). RESULTS All patients were treated via the jugular vein using an SRD, and all but one were treated with fibrinolysis. Angioplasty with stenting was performed in 84.1% of patients. After the procedure, the residual thrombotic load at the ilio-fémoral region was < 10% in 96.1% of patients. The rate of major complications was 1.8% (n = 5), the rate of minor complications was 4% (n = 11), and one patient died from pulmonary embolism (0.4%) At a median follow-up of 24 months, primary and secondary iliofemoral patency was 89.6% and 95.8%, respectively. The rate of PTS was 13.8% at 12 months. CONCLUSION PCDT via the jugular vein using an SRD is an efficient treatment for acute iliofemoral DVT and results in high long-term venous patency and low PTS rates. Level of evidence Level 4, Case series.
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Affiliation(s)
- Frederic Thony
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France.
| | - Jean-Marc Pernes
- Cardio-Vascular and Interventional Department, Antony Private Hospital, Antony, France
| | - Caroline Menez
- University Grenoble Alpes, Department of Vascular Medicine, CHU Grenoble Alpes, Grenoble, France
| | - Jean-Louis Quesada
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | | | | | - Valerie Monnin-Bares
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Alexandre Bellier
- University Grenoble Alpes, Clinical Investigation Center, CHU Grenoble Alpes, Grenoble, France
| | - Arthur David
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | - Alexandre Lablee
- Radiology Department, University Hospital Pontchaillou, Rennes, France
| | | | - Helene Vernhet-Kovacsik
- Department of Imaging and Interventional Radiology, Montpellier University Hospital, Montpellier, France
| | - Frederic Douane
- Department of Radiology, Nantes University Hospital, University of Medicine, Nantes, France
| | | | - Marc Sapoval
- Vascular and Oncological Interventional Radiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Paris, France
| | - Kevin Guillen
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Romaric Loffroy
- Department of Radiology, Section of Vascular and Image-Guided Therapy, François-Mitterrand University Hospital, Dijon, France
| | - Mathieu Finas
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
| | - Mathieu Rodiere
- University Grenoble Alpes, Department of Imaging and Interventional Radiology, CHU Grenoble Alpes, Grenoble, France
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Jenab Y, Tofighi S, Navid H, Riazi H, Samimi S. Hematuria during the right heart catheterization procedure: Renal perforation as a very rare complication. Clin Case Rep 2023; 11:e7014. [PMID: 36852127 PMCID: PMC9958245 DOI: 10.1002/ccr3.7014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/24/2023] [Accepted: 02/13/2023] [Indexed: 02/27/2023] Open
Abstract
The occurrence of hematuria during a right heart catheterization can be a sign of renal perforation, a rare but life-threatening complication that could be developed due to the misdirection of wire into the abdominopelvic venous plexus. We showed this complication could be managed with venoplasty of the common iliac vein.
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Affiliation(s)
- Yaser Jenab
- Tehran Heart CenterTehran University of Medical SciencesTehranIran
| | - Saeed Tofighi
- Tehran Heart CenterTehran University of Medical SciencesTehranIran
| | - Hossein Navid
- Tehran Heart CenterTehran University of Medical SciencesTehranIran
| | - Homan Riazi
- Academic Educational Hospital of Duisburg‐Essen UniversityDuisburgGermany
| | - Sahar Samimi
- Tehran Heart CenterTehran University of Medical SciencesTehranIran
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Lee M, Sa YK, Park MW. Case 1: A 44-Year-Old Woman Presented With Unexplained Painful Left Leg Swelling. J Korean Med Sci 2022; 37:e194. [PMID: 35726146 PMCID: PMC9247728 DOI: 10.3346/jkms.2022.37.e194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Myunhee Lee
- Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea
| | - Young Kyoung Sa
- Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Mahn-Won Park
- Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
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Ji L, Yang F, Chen X, Chen J, Cheng X, Yin J, Qin Y, Yang S. Case Report: Rare Iliac Vein Compression (May-Thurner) Syndrome in a Pediatric Patient. Front Pediatr 2021; 9:694782. [PMID: 34336743 PMCID: PMC8319599 DOI: 10.3389/fped.2021.694782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/11/2021] [Indexed: 11/30/2022] Open
Abstract
Iliac vein compression syndrome (IVCS) or May-Thurner syndrome occurs predominantly in young to middle-aged women. Here we reported a case of IVCS in a 5-year-old boy. The child was admitted to our vasculocardiology department with left lower extremity that had been swollen for 1 month. Blood tests revealed coagulation routine and platelets in the normal ranges. Computer tomography angiography (CTA) and magnetic resonance imaging (MRI) showed the left common iliac vein had become narrow before it entered the right common iliac vein. To further clarify, we performed angiography, which clearly showed the stenosis and the blood return of the left common iliac vein. So IVCS was diagnosed. What is more, we found the aorta descended to the right of the spine, and this may be the reason for the apparent compression of the left common iliac vein. Given the young age and mild symptoms of the child, the treatment was conservative mainly including elevation of the affected limb, wearing medical elastic socks, and short-term oral aspirin for anticoagulation. Meanwhile, the boy is being followed up closely. If the swelling of the left lower extremity significantly increases, stent placement may need to be considered in the future.
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Affiliation(s)
- Lianfu Ji
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Fan Yang
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xuan Chen
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jinlong Chen
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xueying Cheng
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Yin
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yuming Qin
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Shiwei Yang
- Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China
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