Original Research

Venous function after pharmacomechanical thrombolysis for extensive iliofemoral deep vein thrombosis

Wim Greeff, Ali Reza Dehghan-Dehnavi, Jacobus van Marle
South African Journal of Radiology | Vol 21, No 1 | a1214 | DOI: https://doi.org/10.4102/sajr.v21i1.1214 | © 2017 Wim Greeff, Ali Reza Dehghan-Dehnavi, Jacobus van Marle | This work is licensed under CC Attribution 4.0
Submitted: 19 May 2017 | Published: 29 August 2017

About the author(s)

Wim Greeff, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, South Africa
Ali Reza Dehghan-Dehnavi, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, South Africa
Jacobus van Marle, Unitas Hospital, Department of Surgery, Sefako Makgatho Health Sciences University, South Africa


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Abstract

Background: Chronic venous insufficiency is an important complication following iliofemoral deep venous thrombosis. Early thrombus removal may preserve venous function and prevent this complication. This study represents the largest reported South African series of pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis to date.

Objective: To evaluate the long-term outcome following pharmacomechanical thrombolysis for proximal and extensive deep venous thrombosis in a private, specialist vascular unit.

Methods: All patients who underwent pharmacomechanical thrombolysis for iliofemoral deep venous thrombosis between August 2009 and January 2016 were invited to return for clinical assessment and venous ultrasound. Clinical findings were recorded according to the Villalta score and clinical, etiology, anatomic and pathology (CEAP) classification. The quality of life (QoL) was assessed utilising the VEINES-QoL/Sym questionnaire, providing two scores per patient, one describing the QoL and the other symptom severity (Sym).

Results: Thirty two patients (35 legs) were evaluated. There were 25 females and 7 males, with a mean age of 33.5 years (±14 years). The mean follow-up period was 31 months (range 3 months – 80 months). Results of the CEAP classification were C0 = 24 (75%), C1 = 1 (4%), C2 = 2 (6%), C3 = 2 (6%) and C4 = 3 (9%). Thirty-one (97%) patients had Villalta scores from 0 to 4, indicating no or mild evidence of venous disease. One patient (3%) had a Villalta score of 6, indicating post-thrombotic syndrome. The mean QoL score was 87% (±12) and the mean Sym score was 86% (±14). Twenty-four (75%) patients had no abnormality on ultrasound, with fibrosis the most observed abnormality.

Conclusion: Most patients who had undergone pharmacomechanical thrombolysis for extensive iliofemoral deep venous thrombosis showed few significant clinical signs of chronic venous insufficiency, had excellent function on venous ultrasound and reported excellent QoL.


Keywords

venous function; pharmacomechanical thrombolysis; proximal deep venous thrombosis; quality of life

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