J Vasc Surg Venous Lymphat Disord. 2021 Dec 6:S2213-333X(21)00594-1. doi: 10.1016/j.jvsv.2021.11.006. Online ahead of print.
ABSTRACT
OBJECTIVES: To evaluate the effect of the learning curve on percutaneous thrombectomy (PT) outcomes for the treatment of lower extremity deep vein thrombosis (DVT).
METHODS: The study was conducted between October 2019 and September 2020, with patients who had undergone PT due to lower extremity DVT (common iliac, external iliac, common femoral, femoral and popliteal veins). For thrombectomy, aspiration and mechanical thrombectomy procedures were performed until the thrombus was completely dissolved by Dovi (aspiration system) and MANTIS (mechanical thrombectomy system) (INVAMED, Ankara, Turkey). A total of 80 patients were divided equally into 4 groups, with the first 20 cases in Group 1, the second group being the subsequent 20 cases and the final 20 cases in Group 4. Groups were compared for demographic characteristics, intraoperative outcomes, complication rate, and success of procedures.
RESULTS: All demographic parameters were similar between groups. The mean operation time was 139.3 min for group 1, 134.8 min for group 2, 111.3 min for group 3 and 106.7 min for group 4, and statistical analysis revealed that operation time was significantly shorter for group 3 and group 4 in comparison with group 1 and group 2. In addition, fluoroscopy time was significantly decreased in group 3 and group 4 (p= 0.001). Complication rate was similar between the groups (p= 0. 899). However, success was significantly increased after 20 cases, and the other three groups had significantly higher success rate in comparison with group 1 (70% for group 1, 90% for group 2, 95% for group 3 and 100% for group 4, p= 0.024).
CONCLUSION: Success in performance of percutaneous thrombectomy for treatment of acute lower extremity deep vein thrombosis reaches satisfactory levels after 20 cases. Additionally, operation time and fluoroscopy time are significantly decreased after 40 cases and then start plateau.
PMID:34883270 | DOI:10.1016/j.jvsv.2021.11.006
