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British Journal of Radiology (2003) 76, 380-384
© 2003 British Institute of Radiology
doi: 10.1259/bjr/47736122
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Full Paper

Deep venous thrombosis associated with protein C and/or S deficiency: management with catheter-directed thrombolysis

Y P Cho, MD 1 H J Jang, MD 1 D H Lee, MD 2 J Ahn, MD 2 M S Han, MD 1 J S Kim, MD 1 Y H Kim, MD 1 and S G Lee, MD 3

Department of 1 Surgery and 2 Diagnostic Radiology, Gangneung Asan Hospital, 415 Bangdong-ri, Sacheon-myeon, Gangneung and 3 Department of Surgery, Seoul Asan Hospital, 388-1 Poongnap-dong, Songpa-Gu, Seoul, Republic of Korea

Correspondence: Yong Pil Cho, Department of Surgery, University of Ulsan College of Medicine, Gangneung Asan Hospital, 415 Bangdong-ri, Sacheon-myeon, Gangneung-si, Gangwon-do, Republic of Korea, 210-711

We performed this study to evaluate the efficacy of catheter-directed thrombolysis with urokinase in treating acute symptomatic iliofemoral deep venous thrombosis associated with protein C and/or S deficiency. A total of 42 consecutive patients with deep venous thrombosis were seen between September 2000 and August 2002. Of these, catheter-directed thrombolysis via the popliteal vein was performed in 5 patients (11.9%) with acute iliofemoral deep venous thrombosis associated with protein C and/or S deficiency. Average duration of symptoms was 4.2 days (range, 1–7 days). The average urokinase dose was 2.7 million IU (range, 0.6 million to 7.0 million IU) infused over an average of 33.1 h (range, 16–67 h). Lysis was complete in all five treated cases. Two cases had underlying iliac venous stenoses (>50%) that were treated with angioplasty and stent placement. In one patient in whom recanalization of a right iliac vein occlusion was successful, thrombosis occurred in the treated vein within 3 weeks of intervention despite full anticoagulation therapy, and further intervention was required. There were no complications or clinically detectable pulmonary emboli. The technical and clinical success rates were 100%. This initial experience suggests that catheter-directed thrombolysis for treatment of acute symptomatic iliofemoral deep venous thrombosis associated with protein C and/or S deficiency is safe and effective.




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Y P Cho, T-W Kwon, J-H Ahn, G H Kang, M S Han, Y H Kim, J H Kwak, and S G Lee
Protein C and/or S deficiency presenting as peripheral arterial insufficiency
Br. J. Radiol., July 1, 2005; 78(931): 601 - 605.
[Abstract] [Full Text] [PDF]


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