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ARTÍCULO DE INVESTIGACIÓN Trombolisis fármaco-mecánica en TVP proximal refractaria - L. Marine et al tratamiento mínimamente invasivo, realizado en intervención única, con buen éxito técnico, de baja morbilidad asociada y con posibilidades de complementarse 70 con otras modalidades de tratamiento endovascular. En casos de TVP proximales que no responden a tratamiento médico habitual puede plantearse como una alternativa terapéutica en etapas precoces, aun en casos de gangrena venosa. Referencias 1. Amin VB, Lookstein RA. Catheter-directed interventions for acute iliocaval deep vein thrombosis. Tech Vasc Interv Radiol 2014; 17 (2): 96-102. 2. Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, et al. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome. Ann Intern Med 2004; 141 (4): 249-56. 3. Tardy B, Moulin N, Mismetti P, Decousus H, Laporte S. Intravenous thrombolytic therapy in patients with phlegmasia caerulea dolens. Haematologica 2006; 91 (2): 281-2. 4. Gasparis AP, Labropoulos N, Tassiopoulos AK, Phillips B, Pagan J, Cheng Lo, et al. Midterm follow-up after pharmacomechanical thrombolysis for lower extremity deep venous thrombosis. Vasc Endovascular Surg 2009; 43 (1): 61-8. 5. Popuri RK, Vedantham S. The role of thrombolysis in the clinical management of deep vein thrombosis. Arterioscler Thromb Vasc Biol 2011; 31 (3): 479-84. 6. Hirsh J, Guyatt G, Albers G, Harrington R, Schunemann H. Antithrombotic and thrombolytic therapy: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Executive summary: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133 (6 suppl): 71S-109S. 7. Comerota AJ, Paolini D. Treatment of acute iliofemoral deep venous thrombosis: a strategy of thrombus removal. Eur J Vasc Endovasc Surg 2007; 33 (3): 351-60. 8. Eklöf B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg 2004; 40 (6): 1248-52. 9. Villalta S, Bagatella P, Piccioli A, Lensing A, Prins M, Prandoni P. Assessment of validity and reproducibility of a clinical scale for the postthrombotic syndrome. Hemostasis 1994; 24: 158a. 10. Mariné L, Sánchez G, Vargas JF, Zúñiga P, Aizman A, Mertens R, et al. Correlación de valores de TTPa con anti factor Xa para establecer rango terapéutico en tratamiento anticoagulante con heparina sódica. Rev Med Chile 2014; 142 (11): 1392-7. 11. Hager E, Yuo T, Avgerinos E, Naddaf A, Jeyabalan G, Marone L, et al. Anatomic and functional outcomes of pharmacomechanical and catheter-directed thrombolysis of iliofemoral deep venous thrombosis. J Vasc Surg Venous Lymphat Disord 2014; 2 (3): 246-52. 12. Weaver FA, Meacham PW, Adkins RB, Dean RH. Phlegmasia cerulea dolens: therapeutic considerations. South Med J 1988; 81 (3): 306-12. 13. Chinsakchai K, Ten Duis K, Moll FL, de Borst GJ. Trends in management of phlegmasia cerulea dolens. Vasc Endovascular Surg 2011; 45 (1): 5-14. 14. Chaer RA, Dayal R, Lin SC, Trocciola S, Morrissey NJ, McKinsey J, et al. Multimodal therapy for acute and chronic venous thrombotic and occlusive disease. Vasc Endovascular Surg 2005; 39 (5): 375-80. 15. Perkins JM, Magee TR, Galland RB. Phlegmasia caerulea dolens and venous gangrene. Br J Surg 1996; 83 (1): 19- 23. 16. Kasirajan K, Gray B, Ouriel K. Percutaneous AngioJet thrombectomy in the management of extensive deep venous thrombosis. J Vasc Interv Radiol 2001; 12 (2): 179-85. 17. Bashir R, Zack CJ, Zhao H, Comerota AJ, Bove AA. Comparative outcomes of catheter-directed thrombolysis plus anticoagulation vs anticoagulation alone to treat lower-extremity proximal deep vein thrombosis. JAMA Intern Med 2014; 174 (9): 1494-501. 18. Tung CS, Soliman PT, Wallace MJ, Wolf JK, Bodurka DC. Successful catheter-directed venous thrombolysis in phlegmasia cerulea dolens. Gynecol Oncol 2007; 107 (1): 140-2. 19. Lin PH, Zhou W, Dardik A, Mussa F, Kougias P, Hedayati N, et al. Catheter-direct thrombolysis versus pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis. Am J Surg 2006 (6); 192: 782-8. 20. Cynamon J, Stein EG, Dym J, Jagust MB, Binkert CA, Baum RA. A new method for aggressive management of deep vein thrombosis: Retrospective study of the power pulse technique. J Vasc Interv Radiol 2006; 17 (6): 1043- 9. 21. Rao AS, Konig G, Leers SA, Cho J, Rhee RY, Makaroun MS, et al. Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis: an alternative in patients with contraindications to thrombolysis. J Vasc Surg 2009; 50 (5): 1092-8. 22. Martínez-Trabal JL, Comerota AJ, LaPorte FB, Kasanjian S, DiSalle RS, Sepanski DM. The quantitative benefit of isolated, segmental, pharmacomechanical Rev Med Chile 2017; 145: 63-71


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