Celalettin KARATEPE, Bayer ÇINAR, Cem LALE, Onur GÖKSEL

Derin Ven Trombozunda Ultrasonik Tomboliz Kateter Tedavisi

Amaç: Biz çalışmamızda derin ven trombozunda (DVT) Ultrasonik Tromboliz Kateterinin (UTK) kullanılabilirliğini ve etkinliğini değerlendirmeyi amaçladık.Materyal ve Metod: Mart 2011 ile Eylül 2013 tarihleri arasında Ultrasonografi (USG) ile DVT tanısı konmuş ve UTK tedavisi uygulanmış hastalar retrospektif olarak değerlendirildi. UTK tedavisinde rekombinant insan doku plazminojen aktivatörü (alteplase) ve EKOS EkoSonic® Endovascular System (EKOS Corporation, Bothell, Washington, USA) kullanıldı. İşlem sonrasında tedavi venografi ve venöz doppler ultrasonografi (USG) ile değerlendirildi.Bulgular: UTK tedavisi uygulanan 22 hastanın %77.3’ünde (n=17) tromboz femoral vende, %18.2’sinde (n=4) iliak vende, %4.5’inde (n=1) vena kava inferiorda idi. Semptomların başlama zamanı ortalama 21.8 gün (3-72 ) idi. Hastaların %77.3’ünde (n=17) tromboliz başarılı oldu. Hastaların %50’sinde (n=11) tam tromboliz sağlanırken, %27,3 (n=6) hastada kısmi tromboliz elde edildi. Hiç bir hastada pulmoner emboli gözlenmedi. 2 hastada kateter takılma yerinde kanama gözlendi.Sonuç: UTK tedavisi tromboliz infüzyon miktarını, zamanını ve buna bağlı olarak kanama komplikasyonu oranını azaltır ve erken ve etkili tromboliz sağlamasından dolayı venöz kapak hasarını önleyerek DVT'nin geç dönem komplikasyonu olan Post Trombolitik Sendromun (PTS) gelişmesini azaltır. Sonuç olarak DVT’de UTK tedavisi kullanımı kolay, sistemik ve lokal komplikasyonları az, etkili, başarı oranı yüksek bir tedavi seçeneğidir.

Anahtar Kelimeler:

Derin, Ven, Trombozunda

Ultrasonic Thrombolysis Catheter Treatment in Deep Vein Thrombosis

Purpose: The study aimed to evaluate the utility and effectiveness of Ultrasonic Thrombolysis Catheter (UTC) in deep vein thrombosis (DVT). Material and Method: Recombinant human tissue plasminogen activator (alteplase) and EKOS EkoSonic® Endovascular System (EKOS Corporation, Bothell, Washington, USA) were used for the UTC treatment. Afterthe procedure, the treatment was evaluated with Venography and venous Doppler Ultrasonography (USG).Results: Twenty-two patients who underwent UTC due to DVT were evaluated retrospectively. Thrombosis was in the femoral vein in 77.3 % (n=17) of the patients, in the iliac vein in 18.2% (n=4) and in the inferior Vena cava in 4.5% (n=1).The mean onset time for the symptoms was 21.8 days (range 3-72). Thrombolysis was successful in 77.3% (n=17) of the patients. In 50% (n=11) of the patients, full thrombolysis was achieved, and partial thrombolysis was achieved in 27.3% (n=6). None of the patients developed pulmonary embolism. In 2 patients, bleeding wasobserved at the site of catheterization.Conclusion: UTC treatment reduces the amount and duration of thrombolysis infusion and thus reduces the bleeding complications and prevents venous valve damage by ensuring early and effective thrombolysis. Consequently, it reduces the development of Post Thrombolytic Syndrome (PTS), which is a late complication of DVT. In conclusion, UTC is an easy-to-use choice of treatment with less systemic and local complications and higher success rate and effectiveness

Keywords:

Ultrasonic, Thrombolysis, Catheter,

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Mustafa Kemal Üniversitesi Tıp Dergisi-Cover

ISSN: 2149-3103
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2010
Yayıncı: Hatay Mustafa Kemal Üniversitesi Tıp Fakültesi Dekanlığı

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