Cardiovascular Surgery and Interventions
2014, Vol 1, Num 2 Page(s): 049-052
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Upper extremity deep vein thrombosis after in vitro fertilization treated with ultrasound accelerated catheter directed thrombolysis
Mert Dumantepe,1 Osman Fazlıoğulları,1 Mustafa Seren,2 İbrahim Uyar3
1Department of Cardiovascular Surgery, Medical Park Gebze Hospital, Kocaeli, Turkey
2Department of Cardiovascular Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
3Akut Cardiovascular Hospital, İzmir, Turkey
Keywords: Catheter directed thrombolysis; deep vein thrombosis; in vitro fertilization; ultrasound
Upper extremity deep vein thrombosis (UEDVT) is an important clinical entity, presenting with an increased risk for developing fatal pulmonary thromboembolism. A 32-year-old woman was admitted to our hospital complaining swelling and pain of the right upper extremity for five days. The patient was diagnosed as primary infertility and underwent in vitro fertilization after stimulation with gonadotropin-releasing hormone analog one month prior to her admission. An ultrasound scan showed thrombosis of the right brachiocephalic and subclavian veins with partial obstruction of the lumen. The patient was successfully treated with EkoSonic® Mach4e Endovascular device with an overnight infusion of recombinant human tissue plasminogen activator. Catheter-directed thrombolysis may represent a potential therapeutic alternative for patients with severe UEDVT, particularly in those in whom medical management fails or conventional thrombolytic therapy and surgical thrombectomy are contraindicated or considered extremely risky.
Mert Dumantepe,1 Osman Fazlıoğulları,1 Mustafa Seren,2 İbrahim Uyar3
1Department of Cardiovascular Surgery, Medical Park Gebze Hospital, Kocaeli, Turkey
2Department of Cardiovascular Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
3Akut Cardiovascular Hospital, İzmir, Turkey
Keywords: Catheter directed thrombolysis; deep vein thrombosis; in vitro fertilization; ultrasound
Upper extremity deep vein thrombosis (UEDVT) is an important clinical entity, presenting with an increased risk for developing fatal pulmonary thromboembolism. A 32-year-old woman was admitted to our hospital complaining swelling and pain of the right upper extremity for five days. The patient was diagnosed as primary infertility and underwent in vitro fertilization after stimulation with gonadotropin-releasing hormone analog one month prior to her admission. An ultrasound scan showed thrombosis of the right brachiocephalic and subclavian veins with partial obstruction of the lumen. The patient was successfully treated with EkoSonic® Mach4e Endovascular device with an overnight infusion of recombinant human tissue plasminogen activator. Catheter-directed thrombolysis may represent a potential therapeutic alternative for patients with severe UEDVT, particularly in those in whom medical management fails or conventional thrombolytic therapy and surgical thrombectomy are contraindicated or considered extremely risky.
DOI : 10.5606/e-cvsi.2014.266
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