Systematic review of percutaneous mechanical thrombectomy in the treatment of acute iliofemoral deep vein thrombosis

Abstract

Aim: To review the clinical efficacy and safety of per-cutaneous mechanical thrombectomy (PMT ) againstcatheter-directed thrombolysis (CDT) in the treatmentof acute iliofemoral DVT. Method: This review was conducted in accordancewith the Preferred Reporting Items for Sys tematicReviews and Meta-analysis (PRISMA) statement.Three hundred and sixty-nine articles were identifiedthrough screening in the PubM ed, EMBASE andCochrane database from Jan 2006 to Dec 2016. Results: Fifteen retrospective studies and one pro-spective registry, totaling 1170 patients, wererecruited into qualitative synthesis. The venouspatency rate ranged from 75-100% with a meanfollow-up of 12.3 months. The rate of PTS and recur-rent DVT were less than 17% and 15% respectively.The overall mortality rate was 0.26%. Compared withCDT, PMT was shown to reduce PTS at 1 year (Villalta scale 2.1+/-3.0 in PMT group and 5.1+/-4.1 inCDT group, p = 0.03) and bleeding complications(Packed cells transfusion 0.2+/-0.3 units in Pharmaco-mechanical thrombectomy group and 1.2+/-0.7 unitsin CDT group, p <0.05). Conclusion: PMT appeared to be a safe and effec-tive treatment for acute iliofemoral DVT in terms ofrestoration of venous patency, prevention of DVTrecurrence and PTS. Compared with CDT alone, PMToffered lower risk of PTS and bleeding complications.