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Kim and Roh: Intra-Arterial Thrombolysis for Deep Vein Thrombosis of the Lower Extremity: Case Report
Interventional Radiology
Case Report

Journal of the Korean Society of Radiology 2011; 65(3): 235-240.

Published online: 30 September 2011

DOI: https://doi.org/10.3348/jksr.2011.65.3.235

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

Moo Sang Kim, MD, Byung-Suk Roh, MD

Department of Radiology, Wonkwang University School of Medicine, Iksan, Korea.

Corresponding author: Byung-Suk Roh, MD. Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan 570-711, Korea. Tel. 82-63-859-1922, Fax. 82-63-851-4749, bsroh@wonkwang.ac.kr

Received 28 September 2010       Accepted 5 July 2011

Copyright © 2011 The Korean Society of Radiology

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.

Keywords: Venous Thrombosis, Thrombolytic Therapy, Radiography, Interventional, Lower Extremity

Figures and Tables

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.
jksr-65-235-g001
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.
jksr-65-235-g002

Notes

This paper was supported by the research fund of Wonkwang University in 2009.

References

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