In Reply to: Case 697 05 -- Lower extremity venous thrombolysis posted by Editor on June 24, 1997 at 17:07:28:
It is hard to argue with success; however, the clinical sequelae of calf DVT that does not involve the popliteal vein is not post phlebitic syndrome. The 1 year outcome in your patient may be similar to treatment with standard anticoagulation. Seven million units of urokinase costs our patients more than $22,0000. Until 5 year data is available that demonstrates the clinical benefit of regional lytic therapy for ileofemoral DVT, I would recommend the restriction of its use to patients with iliac DVT, ileofemoral DVT, multisegment DVT, or patients with severe symptoms.