심부정맥 혈전증에서 유로키나제를 이용한 카테터 혈전 용해술
Catheter-directed Thrombolysis with Urokinase in Deep Venous Thrombosis
이정훈, 김종원, 이기문, 하종원, 정진욱, 박재형, 김상준,
소속 상세정보
이정훈 ( Lee Jeong-Hoon )
서울대학교 의과대학 외과학교실
김종원 ( Kim Jong-Won )
서울대학교 의과대학 외과학교실
이기문 ( Lee Gee-Mun )
서울대학교 의과대학 외과학교실
하종원 ( Ha Jong-Won )
서울대학교 의과대학 외과학교실
정진욱 ( Chung Jin-Wook )
서울대학교 의과대학 방사선과학교실
박재형 ( Park Jea-Hyung )
서울대학교 의과대학 방사선과학교실
김상준 ( Kim Sang-Joon )
서울대학교 의과대학 외과학교실
KMID : 0371320040670020135
Abstract
PURPOSE: To evaluate the efficacy of catheter-directed thrombolysis in treating symptomatic deep venous thrombosis (DVT) in lower limbs.
METHODS: Between Jan. 1999 and Dec. 2002, 29 consecutive patients with DVT had received thrombolytic therapy. The male:female ratio was 6:23 and the mean age was 50.3+/-13.5 years. The mean duration of symptom was 9.9+/-22.1 days. Catheter-directed infusions of urokinase were administrated via ipsilateral popliteal veins and the angioplasty and stent placement performed after the thrombolytic procedure. The mean dosage of urokinase and duration of thrombolysis were 2,435,000+/-887,000 units and mean duration of thrombolysis was 36.8+/-17.9 hours. Oral medication of warfarin continued at least six months or more. To evaluate the venous patency, duplex ultrasonography or CT venography were performed.
RESULTS: Lysis was complete in 17 patients (58.6%, all acute DVT), partial in 11 (37.9%), with only one patient failing. Iliac vein stenosis had shown in 16 patient after thrombdysis. Which were treated with balloon angioplasty and stent insertion. As a postprocedural complication, vaginal bleeding occurred in two patients; one was treated with transfusion but the other stopped without treatment.
CONCLUSION: Catheter-directed thrombolysis with urokinase is effective for the treatment of DVT in lower limbs. However further study will be reguired to evaluate the relationship between the incidence of postthrombotic syndrome and thrombolytic therapy alone.
키워드
심부정맥 혈전증; 혈전용해술; 유로키나제; Deep vein thrombosis; Thrombolysis; Urokinase
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