Early results of rheolytic thrombectomy in patients with proximal deep vein thrombosis.

BACKGROUND The utility of rheolytic thrombectomy as a treatment for proximal deep vein thrombosis (DVT) is not well understood. METHODS AND RESULTS Patients with proximal DVT were treated with rheolytic thrombectomy, and the safety and efficacy of the procedure were evaluated. The improvement of venous thrombi was assessed using the venographic segment (VS) score. The rheolytic rate was defined as the percentage thrombus aspiration achieved. We also evaluated whether there were differences in age, aspiration time, D-dimer concentration, or the duration from onset to therapy between the high and low rheolytic rate groups. The mean VS score before thrombectomy was 28.8 ± 7.9 points, and the mean VS score after thrombectomy was 10.4 ± 7.1 points (ie, the VS score was significantly decreased after thrombectomy). There were no major treatment-related adverse complications. The mean duration from onset to rheolytic therapy in the 4 patients with a low rheolytic rate was 13.5 ± 13.2 days, which was much longer than for the 9 patients with a high rheolytic rate (mean duration: 4.0 ± 2.2 days: P = 0.045). CONCLUSIONS Rheolytic thrombectomy is safe and effective for treating proximal DVT. The duration from onset to therapy was the only factor that was significantly predictive of the outcome of rheolytic thrombectomy. Rheolytic thrombectomy was especially effective when performed within 1 week of onset.