{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:29:43Z","timestamp":1755800983428,"version":"3.44.0"},"reference-count":27,"publisher":"SMC Media","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>This is a report of a patient who presented with iliofemoral deep vein thrombosis, and was treated with pharmaco-invasive and pharmaco- mechanic methods using coronary balloon and mechanical disruption of clots with coronary 014 wire. A 65-year-old male presented with acute deep vein thrombosis extending from the left common iliac to the popliteal vein. The patient had signi cant swelling and pain. An inferior vena cava (IVC) lter was inserted, and catheter-directed thrombolysis was planned. A technical difficulty was encountered entering the proximal common iliac vein. Hence, a 014 balance middle weight (BMW) wire with coronary balloon support was introduced through a Cordis\u00ae 6 F. diagnostic catheter, and the 014 wire was advanced with guitaring technique up to the femoral vein. Thereafter, the coronary balloon was ruptured at high pressure, and thrombolysis using streptokinase was performed along the balloon tract up to the ostium of the common iliac vein. The patient symptomatically improved signi cantly and is currently on anticoagulants. Follow-up after one year showed minimal residual oedema, and less pain in the ankle region. Pharmaco-mechanical treatment is possible using coronary balloon dilatations and thrombolysis through a ruptured coronary balloon. Mechanical disruption of clots to some extent is feasible using 014 wire by a guitaring technique.<\/jats:p>","DOI":"10.12890\/2023_003710","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T05:34:02Z","timestamp":1673501642000},"source":"Crossref","is-referenced-by-count":0,"title":["Thrombolysis Through Punctured Coronary Balloon and 014 Wire Mediated Guitaring After IVC Filter Insertion in Iliofemoral Deep Vein Thrombosis"],"prefix":"10.12890","volume":"10","author":[{"given":"Mark Christopher","family":"Arokiaraj","sequence":"first","affiliation":[{"name":"Cardiology, Pondicherry Institute of Medical Sciences, Kalapet, Puducherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"<li>Heit JA. Epidemiology of venous thromboembolism. <em>Nat Rev Cardiol<\/em>.2015;<strong>12<\/strong>:464-474. doi:10.1038\/nrcardio.2015.83.<\/li>","key":"10.12890\/2023_003710_ref1","DOI":"10.1038\/nrcardio.2015.83"},{"doi-asserted-by":"crossref","unstructured":"<li>Cushman M. Epidemiology and risk factors for venous thrombosis. <em>Semin Hematol. 2007<\/em>;<strong>44<\/strong>:62-69. doi:10.1053\/j.seminhematol.2007.02.004<\/li>","key":"10.12890\/2023_003710_ref2","DOI":"10.1053\/j.seminhematol.2007.02.004"},{"doi-asserted-by":"crossref","unstructured":"<li>Goldhaber SZ, Bounameaux H. Pulmonary embolism and deep vein thrombosis. <em>Lancet<\/em>. 2012;<strong>379<\/strong>:1835-1846. doi: 10.1016\/S0140-6736(11)61904-1. Epub 2012 Apr 10.PMID: 22494827.<\/li>","key":"10.12890\/2023_003710_ref3","DOI":"10.1016\/S0140-6736(11)61904-1"},{"unstructured":"<li>Patterson BO, Hinchliffe R, Loftus IM, Thompson MM, Holt PJE. Indications for catheter-directed thrombolysis in the management of acute proximal deep venous thrombosis.","key":"10.12890\/2023_003710_ref4"},{"unstructured":"<em>Arterioscler Thromb Vasc Biol<\/em>. 2010;<strong>30<\/strong>:669-674.<\/li>","key":"10.12890\/2023_003710_ref5"},{"doi-asserted-by":"crossref","unstructured":"<li>Liu D, Peterson E, Dooner J, Baerlocher M, Zypchen L, Gagnon J, et al. Diagnosis and management of iliofemoral deep vein thrombosis: Clinical practice guideline. <em>CMAJ<\/em>.2015;<strong>187<\/strong>:1288-1296. doi:10.1503\/cmaj.141614.<\/li>","key":"10.12890\/2023_003710_ref6","DOI":"10.1503\/cmaj.141614"},{"doi-asserted-by":"crossref","unstructured":"<li> Kahn SR. The post-thrombotic syndrome. <em>Hematology Am Soc Hematol Educ Program<\/em>. 2016;<strong>2016<\/strong>:413-418. doi:10.1182\/asheducation-2016.1.413<\/li>","key":"10.12890\/2023_003710_ref7","DOI":"10.1182\/asheducation-2016.1.413"},{"unstructured":"<li>Fleck D, Albadawi H, Shamoun F, Knuttinen G, Naidu S, Oklu R. Catheter-directed thrombolysis of deep vein thrombosis: Literature review and practice considerations.","key":"10.12890\/2023_003710_ref8"},{"doi-asserted-by":"crossref","unstructured":"<em>Cardiovasc Diagn Ther<\/em>. 2017;<strong>7<\/strong>(Suppl 3):S228-S237. doi:10.21037\/cdt.2017.09.15<\/li>","key":"10.12890\/2023_003710_ref9","DOI":"10.21037\/cdt.2017.09.15"},{"unstructured":"<li>Arokiaraj M, Guerrero L, Levine R, Palacios I. Simultaneous thrombolysis and venous angioplasty in acute ilio-femoral thrombosis after IVC lter insertion and novel balloon","key":"10.12890\/2023_003710_ref10"},{"unstructured":"catheter models. <em>J Clin Exp Cardiolog<\/em>. 2013;<strong>4<\/strong>:240. doi:10.4172\/2155-9880.1000240<\/li>","key":"10.12890\/2023_003710_ref11"},{"doi-asserted-by":"crossref","unstructured":"<li>Elbasty A, Metcalf J. Safety and ef cacy of catheter direct thrombolysis in management of acute iliofemoral deep vein thrombosis: A systematic review. <em>Vasc Specialist Int.<\/em>2017;<strong>33<\/strong>:121-134. doi:10.5758\/vsi.2017.33.4.121.<\/li>","key":"10.12890\/2023_003710_ref12","DOI":"10.5758\/vsi.2017.33.4.121"},{"doi-asserted-by":"crossref","unstructured":"<li>Vedantham S, Goldhaber SZ, Julian JA, Kahn SR, Jaff MR, Cohen DJ, et al. Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis. <em>N Engl J Med.<\/em>2017;<strong>377<\/strong>:2240-2252.doi 10.1056\/NEJMoa1615066<\/li>","key":"10.12890\/2023_003710_ref13","DOI":"10.1056\/NEJMoa1615066"},{"doi-asserted-by":"crossref","unstructured":"<li>Craig P, Zuchowski A, Young S, Lunos S, Golzarian J, Rosenberg M. Results of endovascular management of May-Thurner syndrome in the acute, subacute, and chronic setting.<em>J Vasc Interv Radiol.<\/em> 2017;<strong>28<\/strong>:S113.<\/li>","key":"10.12890\/2023_003710_ref14","DOI":"10.1016\/j.jvir.2016.12.869"},{"unstructured":"<li>Seager MJ, Busuttil A, Dharmarajah B, Davies AH. Editor's Choice\u2014A systematic review of endovenous stenting in chronic venous disease secondary to iliac vein obstruction.","key":"10.12890\/2023_003710_ref15"},{"doi-asserted-by":"crossref","unstructured":"<em>Eur J Vasc Endovasc Surg.<\/em> 2016;<strong>51<\/strong>:100-120. doi: 10.1016\/j.ejvs.2015.09.002. 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A guitaring technique with 035 wire and perforated coronary balloon for thrombolysis in the treatment of acute deep vein thrombosis. <em>Journal of Cardiovascular","key":"10.12890\/2023_003710_ref20"},{"unstructured":"Emergencies.<\/em> 2019;<strong>5<\/strong>:104-107.<\/li>","key":"10.12890\/2023_003710_ref21"},{"unstructured":"<li>Bikdeli B, Chatterjee S, Desai NR, Kirtane AJ, Desai MM, Bracken MB, et al. Inferior vena cava lters to prevent pulmonary embolism: Systematic review and meta-analysis. <em>J","key":"10.12890\/2023_003710_ref22"},{"doi-asserted-by":"crossref","unstructured":"Am Coll Cardiol.<\/em> 2017;<strong>70<\/strong>:1587-1597. doi: 10.1016\/j.jacc.2017.07.775. PMID: 28935036.<\/li>","key":"10.12890\/2023_003710_ref23","DOI":"10.1016\/j.jacc.2017.07.775"},{"doi-asserted-by":"crossref","unstructured":"<li>Jia Z, Tu J, Zhao J, Ren B, Tian F, Wang K, et al. 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