Comparison of the efficacy of catheter-directed thrombolysis via anterior tibial vein and popliteal vein approaches in the treatment of acute lower extremity deep vein thrombosis
10.12025/j.issn.1008-6358.2026.20251604
- VernacularTitle:经胫前静脉与经腘静脉入路行导管接触性溶栓治疗急性下肢深静脉血栓的疗效比较
- Author:
Hao JI
1
;
Yachao WANG
2
;
Luyi SI
1
;
Zhuxin GU
1
;
Yuanyuan KONG
1
;
Haijun MEI
1
Author Information
1. Department of Interventional and Vascular Surgery, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu, China.
2. Department of Interventional Vascular Surgery, Nantong Tongzhou District People’s Hospital, Nantong 226300, Jiangsu, China.
- Publication Type:Originalarticle
- Keywords:
acute lower extremity deep vein thrombosis;
catheter-directed thrombolysis;
anterior tibial vein;
popliteal vein
- From:
Chinese Journal of Clinical Medicine
2026;33(2):260-269
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical efficacy, safety, and patient’ prognosis of catheter-directed thrombolysis (CDT) via anterior tibial vein and popliteal vein approaches in the treatment of acute lower extremity deep vein thrombosis (DVT). Methods A retrospective analysis was conducted on the clinical data of 195 patients diagnosed with acute mixed lower extremity DVT and treated with CDT in the Department of Interventional and Vascular Surgery, Affiliated Hospital of Nantong University from January 2020 to December 2023. Patients were divided into an observation group (anterior tibial vein approach, n＝97) and a control group (popliteal vein approach, n＝98) according to the puncture route. Baseline data, thrombolysis-related indices (urokinase dosage, coagulation function indices), efficacy measures (degree of thrombus dissolution, leg circumference difference, visual analogue scale [VAS] score, venous clinical severity score [VCSS]), recovery parameters (time to ambulation, length of hospital stay), complication rates, and long-term prognosis measures (Villalta score, incidence of post-thrombotic syndrome [PTS]) were compared between the two groups. Results There was no statistically significant difference in urokinase dosage and levels of coagulation function indices between the two groups. Postoperatively, the leg circumference difference at 15 cm below the knee, VAS score, and VCSS score were significantly lower in the observation group than in the control group (P＝0.001). The observation group had higher grade Ⅲ dissolution rates in the popliteal and anterior tibial veins compared to the control group (P＜0.05), while differences of dissolution rates in the iliac and femoral veins were not statistically significant. The observation group had shorter length of hospital stay and earlier ambulation times than the control group (P＝0.001). There were no significant differences in complication rates, Villalta scores, or PTS incidence between the two groups. Conclusions CDT via the anterior tibial vein puncture approach for acute mixed lower extremity DVT is superior to the popliteal vein approach in promoting resolution of lower extremity swelling, alleviating pain, improving venous clinical symptoms, and achieving higher thrombus dissolution rates in the popliteal and anterior tibial veins. It also enables faster recovery and demonstrates good safety.
