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| Application evaluation of different approaches for catheter-directed thrombolysis in acute lower-extremity deep venous thrombosis |
| ZHANG Qingyun1 DING Meng2 CHEN Lei1 GAO Jianguo1 ZHANG Hong1 YANG Zhi1 |
1.Department of Vascular Surgery, Affiliated Hospital of Chengde Medical College, Hebei Province, Chengde 067000, China;
2.Department of Laboratory, Affiliated Hospital of Chengde Medical College, Hebei Province, Chengde 067000, China |
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Abstract Objective To investigate the effect of different approaches for catheter-directed thrombolysis (CDT) in the treatment of acute lower-extremity deep venous thrombosis (DVT). Methods Sixty patients with acute lower-extremity DVT admitted to the Vascular Surgery Department of Affiliated Hospital of Chengde Medical College from January 2013 to January 2016 were selected. All patients were divided into three groups according to the random number table method, each group of 20 cases. The retrograde thrombolysis of the contralateral femoral vein was group A, arranged thrombolysis by ipsilateral popliteal vein was group B, stomach thrombolysis by ipsilateral foot vein was group C. Recent and long-term efficacy of each group was compared. Results After treatment, circumference differences between uninjured limb and injured limb in two groups were less than before treatment, the differences were statistically significant (P < 0.01). After treatment, circumference differences between uninjured limb and injured limb in group A and B were less than those in group C, the differences were statistically significant (P < 0.01). After treatment, thrombosis score of each group was lower than before treatment, the difference was statistically significant (P < 0.05). After treatment, thrombosis scores in group A and B were lower than those in group C, the differences were statistically significant (P < 0.05). The recanalization rates of injured limb in group A and B were higher than those in group C, the differences were statistically significant (P < 0.05). Follow up for 1 year, there were significant differences in preservation rate of deep venous valve in each group (P < 0.05). The incidence of Villalta and PTS in group A and B were significantly lower than those in group C (P < 0.01), there was no significant difference between group A and group B (P > 0.05). Conclusion CDT is an effective method to manage acute DVT. In the three routes tested, lateral popliteal vein route is more safe and effective.
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