Comparison of mechanical thrombectomy with transcatheter thrombolysis for acute iliac femoral venous thrombosis.
- Author:
Xiaoliang YIN
1
;
Dehai LANG
1
;
Di WANG
1
Author Information
1. Department of Vascular Surgery, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang Province, China.
- Publication Type:Journal Article
- MeSH:
Catheterization, Peripheral;
Fibrinolytic Agents;
therapeutic use;
Humans;
Iliac Vein;
pathology;
surgery;
Retrospective Studies;
Thrombectomy;
Thrombolytic Therapy;
Treatment Outcome;
Venous Thrombosis;
surgery;
therapy
- From:
Journal of Zhejiang University. Medical sciences
2018;47(6):588-594
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare the efficacy of mechanical thrombectomy with transcatheter thrombolysis in the treatment of acute iliac femoral venous thrombosis.
METHODS:The clinical data of 170 patients with acute iliac venous thrombosis treated in Ningbo No.2 Hospital from September 2015 to September 2017 were retrospectively reviewed. Among them, 94 cases were treated with AngioJet mechanical thrombolysis or additional thrombolysis for residual thrombus (PMT group) and 76 cases were treated with catheter-directed thrombolysis(CDT group). After thrombolytic treatment if there was stenosis of iliac vein, the transluminal angioplasty was also performed. The clearance of thrombus and safety were evaluated and compared between two groups.
RESULTS:In PMT group there were 86 cases (91.5%) with grade Ⅲ, 5 cases (5.3%) with grade Ⅱ, 3 cases (3.2%) with grade Ⅰ clearance of thrombus; while in CDT group, there were 63 cases (82.9%) with grade Ⅲ, 7 cases (9.2%) with grade Ⅱ and 6 cases (7.9%) with grade Ⅰ clearance of thrombus (>0.05). The differences of diameter of two lower extremities 15 cm above knee after treatment in PMT and CDT groups were (2.3±0.9) cm and (2.5±1.1) cm, respectively (>0.05). The time of thrombolysis in group PMT was significantly shorter than that in group CDT[(2.6±1.2) d vs. (5.3±1.5) d, <0.05]. The dosage of urokinase in PMT group was significantly lower than that in CDT group[(15.0±5.0)×10 U vs. (26.5±7.5)×10 U, <0.05]. Hemoglobin decrease was observed in both groups, which was more significant in PMT group (<0.01). During the following period, there was no significant difference in the incidence of recurrence and post-thrombosis syndrome in two groups (all >0.05).
CONCLUSIONS:Both PMT and CDT have good thrombus clearance effect in the treatment of acute iliac femoral venous thrombosis, however, PMT has the advantages of short thrombolytic time and less urokinase.
