Pharmacomechanical treatment in patients with acute and subacute deep vein thrombosis and comparison of early and mid-term results of patients receiving catheter-mediated thrombolytic therapy along with pharmacomechanical treatment

Deep vein thrombosis (DVT) is a clinical condition resulting from the formation of clots in the deep venous system due to risk factors such as stasis, endothelial damage, and hypercoagulability. If not treated early, it can lead to complications such as pulmonary embolism, post-thrombotic syndrome, and chronic venous insufficiency. Medical treatment options such as heparin, oral anticoagulants and new oral anticoagulants cannot eliminate the clot in the venous system early because they do not have thrombolytic effects. Hence, endovascular interventions have been developed. In this study, we compared the early and mid-term results of patients with acute and subacute DVT in the iliofemoral venous structures who underwent pharmomechanical treatment (PMT) with the AngioJet catheter, a method frequently used in our clinic, and catheter-directed thrombolytic treatment after pharmomechanical treatment (PMT+CAT). Our retrospective study included 30 patients in each group. Physical examinations and Doppler ultrasonography results at the 1st, 6th, and 12th-month outpatient follow-ups, as well as venous patency rates, venous reflux flows, and post-thrombotic syndrome development rates based on the Villalta score, were analyzed. There was no significant difference in demographics between the two groups. Venous patency rates in the PMT+CAT group were significantly higher than those in the PMT group at each follow-up (p<0.05). While no significant difference was detected in reflux flows between the two groups, the development of post-thrombotic syndrome at the 12th month was significantly lower in the PMT+CAT group compared to the PMT group (p<0.05) based on the Villalta scoring. The results of our study indicate that combined pharmomechanical thrombectomy and catheter-directed thrombolysis treatment is a superior method compared to pharmomechanical thrombectomy alone.