Trans-jugular AngioJet rheolytic thrombectomy for acute deep vein thrombosis: Alternative to overcome the limitation of patient's position.
BACKGROUND
To introduce a transjugular retrograde approach for AngioJet rheolytic thrombectomy (RT) just after transjugular placement of inferior vena cava filter (IVCF) to treat acute deep vein thrombosis (DVT).


METHODS
From September 2018 to April 2019, transjugular Angiojet RT using pulse spray method was performed just after transjugular placement of IVCF in five patients (M:F = 3:2, mean age 70 years). Patients less than 165 cm in height with acute (<14 days) iliofemoral DVT were unable to assume a prone position. All patients underwent pre- and postprocedural venography to estimate thrombus reduction grade. Computed tomography angiograms at 3 and 6 months postoperative were compared with baseline scans. Post-thrombotic syndrome (PTS) symptoms were evaluated according to Villalta score during 12-month follow-up.


RESULTS
Mean procedure time for all procedures was 1.4 h. Thrombus was completely reduced in three patients and 50% to 99% reduction was noted in the other two. No patients had major complications during the hospital stay and follow-up period. Distal migration of IVCF occurred in one patient during the procedure and immediate IVCF repositioning was performed. No DVT remained in follow-up computed tomography scans of all patients. PTS did not develop in any patients during the follow-up period.


CONCLUSION
In patients who are unable to assume a prone position, a transjugular retrograde approach with AngioJet RT just after transjugular placement of IVCF to treat acute lower extremity DVT was a time-saving and easy alternative. During the procedure, attention to the guiding catheter position and AngioJet device movement was required to avoid affecting the IVCF.
['Jung|Sang-Hoon|SH|https://orcid.org/0000-0003-2473-6453', 'Son|Rak Chae|RC|', 'Kim|Hyun Kyu|HK|']
D006801:Humans D054070:Postthrombotic Syndrome D012189:Retrospective Studies D017131:Thrombectomy D015912:Thrombolytic Therapy D016896:Treatment Outcome D016306:Vena Cava Filters D020246:Venous Thrombosis
rheolytic thrombectomy transjugular Lower extremity retrograde venous access venous thrombosis