Catheter-directed thrombolysis combined with manual aspiration thrombectomy for acute inferior vena cava filter thrombosis.

BACKGROUND The occurrence of inferior vena cava (IVC) filter thrombosis has been reported, however, the optimal treatment of IVC thrombosis has not been established yet. The aim of this study was to assess the results of catheter-directed thrombolysis (CDT) combined with aspiration thrombectomy (AT) in the treatment for IVC filter thrombosis. METHODS A total of 35 consecutive patients received endovascular treatment with CDT alone or CDT with AT for IVC filter thrombosis at Second Affiliated Hospital of Suzhou University from May 2009 to May 2014 were included in this study. The procedure, complications and clinical outcome between these two groups were retrospectively reviewed. RESULTS The mean age of patients was 44.7±15.8 years (range: 17-74 years). The patients were consisted of 21 males and 14 females. CDT alone and CDT with AT were performed in 16 and 19 patients, respectively. The mean procedural time in the group receiving CDT alone group was longer than in the group receiving CDT with AT (99.5±51.4 vs. 64.9±35.9 hours, P<0.05) and the dose of urokinase used during the procedure was significantly lower in the CDT + AT group (2.1±1.1 vs. 1.5±0.6 million IU, P<0.05). Besides, total number of complications in the CDT + AT group was smaller than in the group treated with CDT alone (9 vs. 4 cases, P<0.05). CONCLUSIONS Our results confirmed that CDT with AT was a safe and effective method in the treatment of acute IVC filter thrombosis. Compared with CDT alone, it was better performing thanks to a shorter thrombolysis time and a lower urokinase dose required. In addition, it may decrease the occurrence of complications.