摘要
Background： Catheter-directed thrombolysis （CDT） has been a mainstay in treating deep venous thrombosis （DVT）. However, the optimal dosage ofa thrombolytic agent is still controversial. The goal of this study was to evaluate the safety and efficacy of low dosage urokinase with CDT for DVT. Methods： A retrospective analysis was perfornaed using data from a total of 427 patients with DVT treated with CDT in our single center between July 2009 and December 2012. Early efficacy of thrombolysis was assessed with a thrombus score based on daily venography. The therapeutic safety was evahmted by adverse events. A venography or duplex ultrasound was performed to assess the outcome at 6 months, 1 year and 2 years postoperatively. Results： The mean total dose of 3.34 （standard deviation [SD] 1.38） million units of urokinase was administered during a mean of 5.18 （SD 2.28） days. Prior to discharge, Grade Ⅲ （complete lysis） was achieved in 154 （36%） patients; Grade II （50-99% lysis） in 222 （52%）： and Grade I （50%~ lysis） in 51 （12%）. The major complications included one intracranial hemorrhage, one henaatochezia, five gross hematuria, and one pulmonary embolism. Moreover, no death occurred in the study. Conclusions： Treatment of low-dose catheter-directed thrombosis is an efficacious and safe therapeutic approach in patients with DVT offering good long-term outcomes and minimal complications.
Background： Catheter-directed thrombolysis （CDT） has been a mainstay in treating deep venous thrombosis （DVT）. However, the optimal dosage ofa thrombolytic agent is still controversial. The goal of this study was to evaluate the safety and efficacy of low dosage urokinase with CDT for DVT. Methods： A retrospective analysis was perfornaed using data from a total of 427 patients with DVT treated with CDT in our single center between July 2009 and December 2012. Early efficacy of thrombolysis was assessed with a thrombus score based on daily venography. The therapeutic safety was evahmted by adverse events. A venography or duplex ultrasound was performed to assess the outcome at 6 months, 1 year and 2 years postoperatively. Results： The mean total dose of 3.34 （standard deviation [SD] 1.38） million units of urokinase was administered during a mean of 5.18 （SD 2.28） days. Prior to discharge, Grade Ⅲ （complete lysis） was achieved in 154 （36%） patients; Grade II （50-99% lysis） in 222 （52%）： and Grade I （50%~ lysis） in 51 （12%）. The major complications included one intracranial hemorrhage, one henaatochezia, five gross hematuria, and one pulmonary embolism. Moreover, no death occurred in the study. Conclusions： Treatment of low-dose catheter-directed thrombosis is an efficacious and safe therapeutic approach in patients with DVT offering good long-term outcomes and minimal complications.
