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    • Catheter-Directed Venous Thrombolysis in Acute Iliofemoral Vein Thrombosis, a Prospective Randomized Controlled Trial

    1Amr Saleh El Bahaey, 2Ahmed Balboula
    1Lecturer of Vascular Surgery, 2Assistant Lectuer of Vascular Surgery Faculty of Medicine, Cairo University

    Objectives: To compare catheter directed thrombolysis plus standard anticoagulation with anticoagulation alone in patients who have acute iliofemoral vein thrombosis.Patients and Methods: Fifty patients with acute iliofemoral DVT were randomized in a 1:1 ratio to either CDT followed by anticoagulation (CDT group) or to anticoagulation alone (control group). Duplex ultrasound was used to assess patency and reflux of treated venous segment as well as to diagnose recurrence. Villalta score was used to assess the development of PTS. Results: After a mean follow-up duration of 10.78 months, data were available for 45 patients (22 patients had CDT plus anticoagulation, and 23 had anticoagulation alone). Four bleeding episodes were reported in relation to the 22 CDT procedures (18.18%) compared to two (8.7%) in the control group (P=0.09). Patients in the CDT group, when compared to the control group had significantly higher iliac vein patency rate (86.36% vs. 56.52%, P=0.027), and significantly less venous reflux (54.55% vs. 86.96%, P=0.016). The risk for the development of PTS was reduced by 20.36% (31.82% vs. 52.17%, P=0.016). In the CDT group, two patient (9.09%) suffered recurrent DVT, compared to a single patient (4.35%) in the control group (P=0.608). Conclusion: In acute Iliofemoral DVT, the addition of CDT to standard anticoagulation compared to anticoagulation alone is safe and tolerated by most of the patients. It resulted in better venous patency and competence. Yet, it did not appear to have an additional protection against re-thrombosis. Key Words: Thrombolysis, Iliofemoral, Thrombosis.

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