An assesment of early and mid-term results of patients admitted with an acute-subacute iliofemoral venous thrombosis and treated with pharmacomechanic thrombolozis

The importance of deep vein thrombozis (DVT) cannot be overemphasized, not only because DVT can have lethal consequences such as pulmonary embolism, but also because of the potential for chronic postthrombotic sequelae. The incidence of postthrombotic syndrome (PTS) ranged from % 20 to % 50, and is most frequently associated with iliofemoral venous thrombosis. DVT is the most common cardiovascular pathology, after coronary artery disease and stroke. In the United Kingdom, 1 in 1000 people develop DVT each year. DVT cause significant morbidity and mortality in the general population. Oral anticoagulation therapy may reduce thrombus propagation but does not cause clot lysis and therefore does not prevent postthrombotic syndrome (PTS). Pharmacomechanic thrombolizis can be used to treat DVT' s as an adjunct to medical therapy, but there is no consensus defining exact indications. Current evidences suggests that pharmacomechanic thrombolizis can reduce clot burden and DVT recurrence and consequently prevents the formation of PTS compared with systemic anticoagulation. Appropriate indications include younger individuals with acute proximal thromboses, a long life exexpectancy, and relatively few comorbidities. Limbthreatening thromboses may also be treated wih pharmacomechanic thrombolizis. Recently reports suggest that venous patency and valvular function are better maintained after pharmacomechanic thrombolizis, compared with anticoagulation alone. Patients admitted with an acute/subacute iliofemoral venous thrombosis and treated with pharmacomechanic thrombolizis at Erzincan Binali Yıldırım University Medicine Faculty Hospital from 2013-2017 were invited to participite. The study included 40 patients. Each patient completed the disease- spesific Venous Insufficiency Epidemiological and Economic Study (VEINESS) – Quality of Life (QOL) / Symptoms (Sym), questionnaires to assess QOL. PTS was assessed using the Villalte scale. PTS was associated with worse QOL, although only a few patients developed PTS after pharmachomechanic thrombolisis. We propose that early and thorough removal of thrombus, using PMT, is beneficial to prevent PTS. Key Words: Farmachomechanic thrombolizis, İliofemoral acut-subacut deep venous thrombozis, Postthrombotic syndrome, Quality of life.