심부정맥혈전증 환자에서 1차적 치료방법으로 카테터를 이용한 혈전 용해술의 유용성

Abstract

Purpose: Untreated deep vein thrombosis (DVT) is associated with morbidity and mortality, such as pulmonary embolism and post-thrombotic syndrome. Anticoagulation therapy is efficient for reducing thrombus propagation but is insufficient for clot lysis or preventing post thrombotic syndrome. Current catheter-directed thrombolysis is an important DVT treatment. We compared the outcomes between anticoagulation therapy and DVT catheter-directed thrombolysis. The purpose of this study was to evaluate treatment outcomes in patients with symptomatic DVT who had undergone catheter-directed thrombolysis. Methods: From January 2003 to January 2009, we retrospectively reviewed 91 patients who had been admitted and treated for DVT in our hospital. We divided 91 patients into two groups according to treatment method; 42 patients (46.2%) were treated with only anticoagulation, and 49 patients (53.8%) were treated with catheter-directed thrombolysis. We compared the results of the two treatments groups. The results included gender, symptom onset, age, location, complications, risk factors, days to improved patient symptoms and patency. All patients underwent Doppler sonography or CT-venography at 3 and 6 months to evaluate venous patency after treatment. Results: 49 patients who underwent catheter-directed thrombolysis for DVT had more symptom-relief days (25.00 days, P＜0.001). The 43 patients (88%) of the catheter-directed thrombolysis group showed more complete resolution on Doppler sonography or CT-venography after 6 months (P=0.001). We obtained better clinical outcomes in the catheter-directed thrombolysis group than in the anticoagulation only group. Conclusion: Catheter-directed thrombolysis is an effective treatment for acute DVT.