Pharmacomechanical Thrombolysis for Treatment of Acute DVT in a Patient

with Inferior Vena Cava Atresia

Salman Arain, MD, FACC Assistant Professor of Medicine - Cardiology

University of Texas Health Sciences Center – Houston Texas, USA

LINC 2016 - Global Expert Exchange

Disclosure Speaker name: Salman A. Arain, MD

.................................................................................

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

Other(s)

I do not have any potential conflict of interest

LINC 2016 - Global Expert Exchange

Case History

• 30 year old white female with no known past medical history with a 2 day history of bilateral lower extremity pain and swelling.

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A. D. C. B.

Baseline Angiogram

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A T8-9

L1-L2

Thrombosed Distal IVC

CT on Day 1

B

C

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A B

Day 2 – Initial Angio

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A. D. C. B.

Day 2 – Thrombectomy followed by IVUS

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A. B.

1. 12.0 mm

2. 9.8 mm

Thrombus

Day 2 - IVUS

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Aspirated thrombus from the right iliac veins.

A. C. B. C.

Balloon

Balloon

Trellis Wire

Day 2 – Thrombectomy

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A. D. C. B.

Day 2 - Trellis in the LLE

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A. B. C.

10 x 30 mm SMART Stent

Day 3 – Angio

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Final Angio

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Clinical Follow-up • An extensive workup for hypercoagulability and

malignancy was unremarkable.

• Patient was started on warfarin and bridged to a therapeutic INR with enoxaparin.

• The patient was discharged on day 10 at which time she could ambulate without any difficulty.

• She was asymptomatic at the time of her last follow-up (17 months).

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Thank You

LINC 2016 - Global Expert Exchange

Pharmacomechanical Thrombolysis for Treatment of Acute DVT in a Patient

with Inferior Vena Cava Atresia

Salman Arain, MD, FACC Assistant Professor of Medicine - Cardiology

University of Texas Health Sciences Center – Houston Texas, USA

LINC 2016 - Global Expert Exchange