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Tatalaksana kasus trombosis vena dalam iliofemoral akut dengan sistem trombektomi aspirasi mekanik Indigo CAT8



Abstract

Introduction: Acute deep vein thrombosis is a common cause of morbidity and mortality. Venous thrombosis commonly involves the lower extremities, including the iliac veins, femoral veins and vena cava. Optimal therapy of deep vein thrombosis, both ileofemoral and central can prevent complications.

Case Presentation: A 51 years old man complained of swelling of his right leg accompanied by acute pain. On duplex ultrasonography examination, there was a venous thrombosis in the iliofemoral area descending from the common iliac vein to the deep femoral vein. Endovascular venous mechanical thrombectomy was immediately performed because the symptoms were acute, and signs of swelling and pain intensity did not improve. An 8-F catheter was inserted into the patient's right distal superficial femoral vein under ultrasound guidance after administration of intravenous heparin. The CAT8 was inserted through the 8-F sheath and found the thrombus, then vacuum thrombectomy was performed. Swelling and pain disappeared a few hours after the procedure, and the patient was discharged 2 days later.

Conclusion: The Indigo CAT 8 mechanical aspiration thrombectomy system can be an effective treatment modality for patients with acute iliofemoral or central deep vein thrombosis.

 

Latar Belakang: Trombosis vena dalam akut adalah penyebab umum morbiditas dan mortalitas. Trombosis vena umumnya melibatkan ekstremitas bawah, termasuk vena iliaka, vena femoralis, dan vena cava. Terapi optimal trombosis vena dalam, baik ileofemoral maupun sentral dapat mencegah komplikasi.

Presentasi Kasus: Seorang laki-laki 51 tahun mengeluh kaki kanan bengkak disertai nyeri akut. Pada pemeriksaan ultrasonografi dupleks, terdapat trombosis vena di daerah iliofemoral turun dari vena iliaka komunis ke vena femoralis dalam. Trombektomi mekanik vena endovaskular segera dilakukan karena gejalanya akut, dan tanda pembengkakan serta intensitas nyeri tidak membaik. Kateter 8-F dimasukkan ke dalam vena femoralis superfisial distal kanan pasien di bawah panduan ultrasonografi setelah pemberian heparin intravena. Kateter CAT8 dimasukkan melalui selubung 8-F dan ditemukan trombus, kemudian dilakukan trombektomi vakum. Bengkak dan nyeri menghilang beberapa jam setelah prosedur, dan pasien dipulangkan 2 hari kemudian.

Simpulan: Sistem trombektomi aspirasi mekanik Indigo CAT 8 dapat menjadi modalitas pengobatan yang efektif untuk pasien dengan trombosis vena dalam sentral atau iliofemoral akut.

Keywords: trombosis vena dalam akut iliofemoral trombektomi mekanik vena endovaskular

References

  1. Ismail U, Rowe RA, Cashin J, Genin GM, Zayed MA. Multimodal thrombectomy device for treatment of acute deep venous thrombosis. Sci Rep. 2022 Mar 28;12(1):5295.
  2. Robert-Ebadi H, Righini M. Should we diagnose and treat distal deep vein thrombosis? Hematology Am Soc Hematol Educ Program. 2017 Dec 8;2017(1):231-236.
  3. Kabashneh S, Singh V, Alkassis S. A Comprehensive Literature Review on the Management of Distal Deep Vein Thrombosis. Cureus. 2020 May 10;12(5):e8048.
  4. Stone J, Hangge P, Albadawi H, Wallace A, Shamoun F, Knuttien MG, Naidu S, Oklu R. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther. 2017 Dec;7(Suppl 3):S276-S284.
  5. Shah KJ, Roy TL. Catheter-Directed Interventions for the Treatment of Lower Extremity Deep Vein Thrombosis. Life (Basel). 2022 Nov 27;12(12):1984.
  6. Nathan AS, Giri J. Reexamining the Open-Vein Hypothesis for Acute Deep Venous Thrombosis. Circulation. 2019 Feb 26;139(9):1174-1176.
  7. Patterson BO, Hinchliffe R, Loftus IM, Thompson MM, Holt PJ. Indications for catheter-directed thrombolysis in the management of acute proximal deep venous thrombosis. Arterioscler Thromb Vasc Biol. 2010 Apr;30(4):669-74.
  8. Goldhaber SZ, Magnuson EA, Chinnakondepalli KM, Cohen DJ, Vedantham S. Catheter-directed thrombolysis for deep vein thrombosis: 2021 update. Vasc Med. 2021 Dec;26(6):662-669.
  9. Lopez R, DeMartino R, Fleming MM, Bjarnason H, Neisen M. Aspiration thrombectomy for acute iliofemoral or central deep venous thrombosis. J. Vasc. Surg. Venous Lymphat. Disord , 2019;7(2):1-7.
  10. Robertson B, Neville E, Muck A, Broering M, Kulwicki A, Kuhn B, et al. Technical success and short-term results from mechanical thrombectomy for lower extremity iliofemoral deep vein thrombosis using a computer aided mechanical aspiration thrombectomy device. J. Vasc. Surg. Venous Lymphat. Disord. 2022;10:594–601.
  11. Saleem T, Fuller R, Raju S. Aspiration mechanical thrombectomy for treatment of acute iliofemoral and central deep venous thrombosis. Annals of Vascular Surgery - Brief Reports and Innovations. 2021;1(2):1-5.

How to Cite

Wiradana, A. A. G. A. A. A. ., Wibawa, I. G. A. B. K., & Budiarta, I. B. (2023). Tatalaksana kasus trombosis vena dalam iliofemoral akut dengan sistem trombektomi aspirasi mekanik Indigo CAT8. Intisari Sains Medis, 14(1), 346–349. https://doi.org/10.15562/ism.v14i1.1685
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Anak Agung Gde Agung Anom Arie Wiradana
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I Gusti Agung Bagus Krisna Wibawa
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Ida Bagus Budiarta
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