초록접수 현황
| 14F-032 | 구연 발표 |
Comparison of the Clinical Results between Thrombectomy and Medical Treatment as a Primary Therapy in Patients of Deep Vein Thrombosis Extending Iliofemoral Vein
조원민, 황진욱, 민병주, 신재승, 이인성
고려대학교 의과대학 안산병원 흉부외과학교실
Background : As a primary treatment for deep vein thrombosis (DVT), conventional anticoagulation therapy has been used widely. However, if the DVT affect the iliofemoral vein, this therapy has not been associated with rapid resolution of symptoms or recanalization of venous occlusion. And it also has been associated with long-term disability known as post thrombotic syndrome. For more rapid resolution of DVT, several modalities such as surgical thrombectomy and catheter-directed thrombolysis/thrombectomy have been introduced. Although many of studies for the clinical effect of catheter directed thrombolysis were revealed, but there’s a few of reports for the clinical result of catheter-directed thrombectomy. Therefore, the aim of our study is to analyze the clinical effectiveness of the catheter-directed thrombectomy compare to conventional anticoagulant treatment for iliofemoral venous thrombosis.
Methods : We reviewed DVT patient, from January, 2004 to December, 2013. Among them, 102 consecutive patients with extensive iliofemoral venous thrombosis were enrolled to our study. We performed conventional treatment in 46 patients (ACA group) and catheter-directed thrombectomy in 56 patients (CDT group). Medical records of these patients were reviewed retrospectively.
Results : There’s statistical difference in age for both groups (ADA mean age = 52±18 years old, CDT mean age = 59.0±17 years old, P value =0.03). Other demographic characteristics and risk factors for DVT such as female gender, obesity, DM, smoking, malignancy, hematologic disease were not different between two groups , statistically. During the follow up period, 1 patient of ACA and 5 patients in CDT were treated additional thrombectomy with/without angioplasty or stent insertion. Duration of medication was comparable between two groups. Kaplan-Meire analysis showed primary iliofemoral patency rates at 1, 3 and 5 years of 79.1%, 68.0%, 47.1% for ACA group and 79.8%, 73.8%, 73.8% for CDT group (P value = 0.27). Post thrombotic syndrome-free rates showed 1, 3, and 5 years of 93%, 75.8%, 36.2% for ACA group and 92.2%, 89.4%, 89.4% for CDT groups (p value = 0.01). Re-admission rate, recurrence rate and bleeding tendency during follow up were revealed no statistical differences.
Conclusion : In this study, catheter directed thrombectomy obtained better result in postthrombotic syndrome. Therefore, we concluded that catheter directed thrombectomy may play a important role as effective modality for prevent postthrombotic syndrome in iliofemoral DVT.
Methods : We reviewed DVT patient, from January, 2004 to December, 2013. Among them, 102 consecutive patients with extensive iliofemoral venous thrombosis were enrolled to our study. We performed conventional treatment in 46 patients (ACA group) and catheter-directed thrombectomy in 56 patients (CDT group). Medical records of these patients were reviewed retrospectively.
Results : There’s statistical difference in age for both groups (ADA mean age = 52±18 years old, CDT mean age = 59.0±17 years old, P value =0.03). Other demographic characteristics and risk factors for DVT such as female gender, obesity, DM, smoking, malignancy, hematologic disease were not different between two groups , statistically. During the follow up period, 1 patient of ACA and 5 patients in CDT were treated additional thrombectomy with/without angioplasty or stent insertion. Duration of medication was comparable between two groups. Kaplan-Meire analysis showed primary iliofemoral patency rates at 1, 3 and 5 years of 79.1%, 68.0%, 47.1% for ACA group and 79.8%, 73.8%, 73.8% for CDT group (P value = 0.27). Post thrombotic syndrome-free rates showed 1, 3, and 5 years of 93%, 75.8%, 36.2% for ACA group and 92.2%, 89.4%, 89.4% for CDT groups (p value = 0.01). Re-admission rate, recurrence rate and bleeding tendency during follow up were revealed no statistical differences.
Conclusion : In this study, catheter directed thrombectomy obtained better result in postthrombotic syndrome. Therefore, we concluded that catheter directed thrombectomy may play a important role as effective modality for prevent postthrombotic syndrome in iliofemoral DVT.
책임저자: 조원민
고려대학교 의과대학 안산병원 흉부외과학교실
연락처 : 조원민, Tel: 031-412-5060 , E-mail : jowonmin@korea.ac.kr
