The effect of catheter-directed thrombolysis with a low dose of urokinase for deep vein thrombosis

Purpose: We evaluated the effect of catheter-directed thrombolysis with a low dose of urokinase (UK) for deep vein thrombosis (DVT). Method: A popliteal vein was used for the access site of the catheter. UK pulse-infusion (about 240,000 units) followed by continuous infusion of UK (240,000 units/day) was performed via a multihole catheter placed directly within the thrombus. If mechanical stenosis existed, an easywall stent was placed. The degree of lysis was classified into three groups: grade 1 for lysis less than 50%, grade 2 for lysis of 50 to 99% and grade 3 for 100% lysis. Results: Nine patients were treated. UK infusion was performed in 7 patients and UK infusion with endoluminal stenting was performed in 2 patients from 20±23 days after the occurrence of DVT symptoms and UK infusion was continued for 4.8±1.8 days. Total dose of UK was 1410,000±480,000 units. The degree of lysis was 2.8±0.4 and symptoms disappeared without any complications. Conclusion: Endovascular management of iliofemoral DVT is safe and effective.