Case Study – Case Report: Trellis Peripheral infusion system thrombolysis of an extensive DVT

Case Report: Trellis Peripheral infusion system thrombolysis of an extensive DVT

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A previously well 55 year old lady presented to the Royal Free Hospital Vascular Service following a long aircraft flight with a markedly swollen tender leg.

Duplex ultrasound of the popliteal and calf veins showed extensive thrombosis, mainly low echoreflectivity fresh clot. The short saphenous was also thrombosed.

A Cook Celect temporary infrarenal ivc-incertion

caval filter was inserted.
The popliteal vein was punctured under USS, and a 10fr sheath inserted.
8000u heparin was given.
Venogram show fresh clot extending the full length of the lower limb vessels trelis-2

Catheter and wire crossed the thrombosed segment, and Trellis-8 pharmacomechanical thrombectomy (PMT) performed of the iliac and femoral segments. 20mg RTPA (confined by the balloons therefore not systemic) given over 20mins,

The Trellis® Peripheral Infusion System is an  Isolated Thrombolysis catheter with two occluding balloons, drug infusion holes between the balloons, and mechanical drug dispersion capabilities. This pharmaco-mechanical combination provides focused treatment of thrombus within vessel




PMTachieved good thrombus clearance



A venous stenosis was identified in the iliac system and a  16×90 and 14×90 Wallstents deployed across
the CIA/IVCjunction ballooned to 12mm with Conquest.

Post procedure flowtron boots and thigh length stockings were used; the patient was mobilise early and LMW Heparin was given   A duplex in 48h showed good flow across the iliacs The IVC filter was removed after 2 weeks


Daryll Baker is a Consultant Vascular Surgeon at the Royal Free Hospital London and Clinical Lead for North Central Region Vascular Services.

He read Medicine at Oxford University and trained in Vascular Surgery in Nottingham, London and Edinburgh. He obtained his research PhD from the University of Wales.


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