WITHDRAWN: Percutaneous mechanical thrombectomy combined with cathether-directed thrombolysis for lower-extremity deep venous thrombosis.

abstract Article history:Received 22 July 2009Received in revised form 21 November 2009Accepted 23 November 2009Available online xxxxKeywords:Deep venous thrombosisPercutaneous mechanical thrombectomyCatheter-directed thrombolysis Purpose: To evaluate the clinical efficacy of percutaneous mechanical thrombectomy (PMT) using theAmplatz Thrombectomy Device (ATD) combined with catheter-directed thrombolysis (CDT) in patients withsymptomatic lower extremity deep venous thrombosis (DVT).Materials: From January 2005 to October 2007, acute DVT in 40 limbs (left, 29 limbs; right, 11 limbs) of 36patients were enrolled. After prophylactic placement of inferior vena cava filters (IVCFs), ATD and CDT wereperformed in all patients. Complementary therapy included percutaneous transluminal venous angioplastyand/or stent placement. Oral anticoagulation (warfarin, 2-5 mg/day) was administered for at least 6 months.Results: Successful placement of the IVCFs was achieved in 100% of patients. The mean urokinase dose duringthrombolysiswas3.5 millionIU(range2.2-5.3 millionIU).Thecatheterwasdeployedintheaffectedextremitiesfora mean duration of 23.1 h (range 13-44 h). Complete thr ombus removal was achieved in 32 of 40 treated limbs(80.0%);therateofpartialsuccesswas20.0%.Immediatec linicalimprovementoccurredin33treatedlimbs(82.5%).The meanhospitalstaywas4.1 days. There wasnomajorhem orrhageatthevenousaccesssiteandnotransfusionswere required.During mean follow-up visits of 18 months (range 12-47 months), the primary patency rates at 1, 6and 12 months were 100%, 90% and 81%, respectively.Conclusions: PMT with CDT seems to be an effective and safe treatment for systematic DVT. It requires signi ficantlyshorter treatment duration and lower lytic doses than CDT alone.© 2009 Elsevier Ltd. All rights reserved.