不同自然病程下肢深静脉血栓溶栓治疗的疗效观察：附146例报告

目的探讨下肢深静脉血栓溶栓治疗的方法和效果。方法回顾分析下肢深静脉血栓146例的临床资料,其中男87例,女59例;平均年龄49.7岁。根据其自然病程将上述患者按症状出现时间(而不是栓龄)分为3组:急性组40人(0～7d),亚急性组70例(8～30d)和慢性组36例(30d以上者)。分别对各组溶栓治疗前后股静脉流速峰值、内径变化,腘静脉流速峰值、内径变化,以及大、小腿周径改变等进行比较。结果溶栓治疗后患者股、腘静脉流速峰增加,增加最多的是急性组,其次为亚急性组,最少的是慢性组;溶栓治疗后患者股、腘静脉内径和大、小腿周径减少,减少最多的是急性组,其次为亚急性组,最少的是慢性组(均P0.01)。结论下肢深静脉血栓溶栓治疗实施越早效果越好。积极的溶栓可以改善静脉梗阻和降低瓣膜破坏程度及减轻血栓后遗症的程度。     

导管溶栓联合滤器置入治疗急性下肢深静脉血栓形成

目的：评价导管溶栓联合滤器置入治疗急性下肢深静脉血栓形成临床效果。 方法：84例急性下肢深静脉血栓形成患者随机分成联合组（n=42）和静脉溶栓组（n=42）,联合组采取导管溶栓联合经下腔静脉滤器置入,静脉溶栓组采取经外周静脉溶栓治疗,记录两组患者治疗时间和药物使用情况,比较两组患者临床溶栓效果和治疗前后双侧下肢周径差,随访6个月,记录两组患者不良反应发生情况。 结果：联合组患者治疗起效时间（16.9±6.2）h和总溶栓时间（74.8±26.4）h均短于静脉溶栓组（P<0.05）,尿激酶用量（312.5±121.7）万U亦少于静脉溶栓组（P<0.05）;联合组总有效率95.2%,高于静脉溶栓组的73.8%（P<0.05）;治疗后联合组患者大腿周径差（1.5±0.9）cm和小腿周径差（1.3±1.0）cm均小于静脉溶栓组（P<0.05）;联合组总不良反应发生率为9.5%,远低于静脉溶栓组的31.0%（P<0.05）。 结论：导管溶栓联合滤器置入治疗急性下肢深静脉血栓形成作用迅速,药物用量少,临床疗效显著,不良反应少,值得在临床推广使用。

     

经大隐静脉入路行导管溶栓治疗急性下肢深静脉血栓的可行性

目的评估经大隐静脉入路行急性下肢深静脉血栓置管溶栓治疗的可行性。方法收集70例急性下肢深静脉血栓患者,随机分为A、B两组,A组为实验组(n=35),采用大隐静脉入路置管溶栓,B组为对照组(n=35),采用传统腘静脉入路置管溶栓。评估A、B两组患肢的消肿率、溶栓率、并发症发生率、手术时间。结果 70例均为单侧下肢急性深静脉血栓,A、B两组的患肢消肿率分别为(80.11±4.02)%、(81.70±6.13)%,差异无统计学意义(F=0.723,P=0.89);溶栓率分别为(84.91±3.40)%、(87.72±4.73)%,差异无统计学意义(F=0.685,P=0.71);手术时间分别为(3.91±0.74)min、(4.31±1.13)min,并发症发生率分别为2.86%(1/35)、5.71%(2/35),差异均无统计学意义(P均0.05),A组1例出现隐神经损伤,B组2例并发腘窝血肿。结论经大隐静脉入路置管溶栓治疗急性下肢深静脉血栓可行,可作为常规腘静脉入路的有益补充。     

急性混合型下肢深静脉血栓综合介入治疗与系统溶栓疗效的比较

目的：比较综合介入治疗与系统溶栓治疗对急性混合型下肢深静脉血栓（LEDVT）的疗效。方法：回顾分析12年间收治的229例急性混合型LEDVT患者的临床资料。122例采用血栓碎吸、溶栓等综合介入治疗（A组）,其中合并髂静脉狭窄或闭塞53例,采取腔内血管成形术（PTA）和支架植入辅助处理,术后辅以小剂量尿激酶溶栓、肝素抗凝治疗;另107例（B组）行尿激酶,肝素抗凝等系统溶栓治疗。结果：平均住院天数A组（6.2±2.2）d,B组（10.5±2.4）d;2周后复查,A,B两组的治愈率和有效率分别为40.98%,14.02%和96.72%,77.57%,差异均有统计学意义（均P<0.05）。随访12~85个月,患肢膝下15 cm处周径差A组为（0.53±0.42）cm,B组为（1.42±1.35）cm;水肿、色素沉着、溃疡等后遗症发生率A组分别23.15%,9.26%和0,B组分别为50.51%,80.81%和9.09%,A组静脉通畅率为81.48%,静脉瓣膜功能正常率为57.41%,B组为65.66%和15.15%,差异均有统计学意义（P<0.05）。结论：综合介入治疗对急性混合型LEDVT的近期、中远期疗效均优于系统溶栓,尤其在保护静脉瓣膜功能方面明显优于系统溶栓。

     

置管溶栓联合血管腔内成形术治疗合并下腔或下肢静脉血栓的布加综合征

目的探讨置管溶栓联合血管腔内成形术治疗合并下腔或下肢静脉血栓的布加综合征(BCS)的应用价值。方法全组29例BCS,造影发现下腔静脉(IVC)肝段上方狭窄或闭塞,同时伴有IVC血栓形成,部分伴有单侧或双侧下肢深静脉血栓。经腘静脉置管溶栓后,其中25例二期行血管腔内成形术。结果 18例血栓基本消失或明显缩小、管腔通畅,其中6例单纯行球囊扩张术,12例行球囊扩张加支架成形术;9例患者溶栓后陈旧性血栓范围仍然广泛,其中7例行腔内治疗后症状明显缓解。2例有明显出血倾向后停药,闭塞范围仍然广泛,无肺栓塞发生。25例随访2～62个月,平均31个月,21例临床症状和体征明显缓解,2例明显缓解后复发,2例未缓解,治疗总有效率为84.0%。结论腘静脉置管溶栓治疗BCS合并下腔或下肢静脉血栓的溶栓效果优于全身用药,溶栓后介入治疗微创,疗效好,可作为此类疾病的常规治疗。     

置管溶栓与系统溶栓对下肢深静脉血栓形成的疗效比较

目的 :比较置管溶栓与系统溶栓对下肢深静脉血栓形成的临床疗效。方法 :选择2013年2月—2015年7月在我院接受治疗的单侧下肢深静脉血栓形成患者102例,以数字表法随机分为观察组及对照组各51例。其中对照组患者行系统溶栓治疗,观察组患者行置管溶栓治疗。对所有患者进行随访,对比两组临床效果。结果:观察组大腿消肿率、小腿消肿率、静脉通畅率、溶栓率均显著高于对照组;观察组溶栓时间为(5.2±1.7)d,显著低于对照组的(6.8±2.1)d,差异有统计学意义(t=4.229,P=0.000);观察组血管通畅例数占比显著高于对照组,而残留大量血栓例数占比明显低于对照组,差异均有统计学意义(均P<0.05)。结论:置管溶栓治疗下肢深静脉血栓形成效果显著,能缩短血流恢复时间,且深静脉通畅率远优于系统溶栓治疗。     

不同方法静脉给药溶栓治疗下肢深静脉血栓效果观察

目的 探讨不同方法静脉给药对下肢深静脉血栓形成溶栓效果.方法 将90例下肢深静脉血栓形成患者随机分为对照组、观察1组、观察2组,每组各30例.三组患者于患肢末梢静脉给药溶栓治疗;在此基础上观察1组采用止血带压迫浅静脉;观察2组采用弹力绷带压迫浅静脉.结果 对照组总有效率63.3%,观察1组96.7%,观察2组93.3%,观察1、2组与对照组比较,差异有显著性意义(均P＜0.01);观察1、2组比较,差异无显著性意义(P＞0.05).结论 压迫浅静脉行患肢末梢静脉给药治疗下肢深静脉血栓效果显著.而用止血带压迫浅静脉行患肢末梢静脉给药溶栓治疗,因其护理观察直接,操作方法简单、取材经济方便,且可根据需要随时调节,是一种理想的静脉给药的辅助溶栓治疗方法.     

下肢深静脉血栓形成介入溶栓治疗的疗效北大核心CSCD

目的探讨下肢深静脉血栓形成（deep venous thrombosis）介入溶栓治疗的疗效。方法 2012年2月~2014年10月101例DVT可回收型下腔静脉滤器置入后经腘静脉顺行穿刺,置入溶栓导管,经溶栓导管尿激酶进行溶栓,通过溶栓导管造影了解血栓溶解情况,决定溶栓时间及尿激酶剂量。结果术后1周溶栓效果Ⅰ级87例（87/101,86.1%）,Ⅱ级8例（8/101,8.0%）,Ⅲ级6例（6/101,5.9%）;痊愈80例（80/101,79.2%）,有效21例（21/101,20.8%）。术后2周溶栓效果Ⅰ级95例（95/101,94.1%）,Ⅱ级6例（6/101,5.9%）;痊愈90例（90/101,89.1%）,有效11例（11/101,10.9%）。5例复发2~3次,其中出院后1个月内3例复发,1~2个月内3例复发（1例第2次复发）,2~3个月复发3例（1例第2次复发）,3~6个月复发3例（2例第2次复发,1例第3次复发）,以上5例考虑为易栓症,每次溶栓后治愈,长期口服华法林,并坚持定期门诊复查。截止2014年10月,101例随访3~30个月,平均10.7月,均未见支架移位、支架内血栓形成、狭窄、闭塞等。结论介入溶栓治疗具有有效预防肺栓塞、创伤小、痊愈快、卧床时间短及血栓后遗症明显减少等优点。     

下肢深静脉血栓形成患者非手术治疗后的近期生存质量研究

目的：观察下肢深静脉血栓形成（DVT）患者非手术治疗后的近期生存质量情况。方法：选取符合条件的50例下肢DVT患者,采用SF-36量表对入选患者治疗前与治疗后不同时间（1,2,3个月及4个月以上）的生理机能（PF）、生理职能（RP）、一般健康状况（GH）、情感职能（RE）、社会功能（SF）、躯体疼痛（BP）、精力（VT）及精神健康（MH）8个维度进行评分并比较。结果：患者在不同阶段的基线资料分布均衡可比,平均随访时间（3.82±1.84）个月,量表总Cronbach α系数为0.8652。患者在规范治疗前后的不同阶段8个维度评分差异均有统计学意义（均P<0.001）,治疗后不同阶段各维度评分明显高于治疗前,且随时间逐渐增高。治疗后各阶段间除PF在治疗后1个月与治疗后4个月以上的评分间差异有统计学意义（P=0.01）,所有维度评分的变化差异均无统计学意义（均P>0.05）。结论：下肢DVT患者经非手术治疗后近期生存质量明显好转并进入平台期,可恢复至健康人水平,患者生存质量的拐点出现的时间至少在治疗后4个月以上。

     

经腘静脉置管溶栓治疗下肢深静脉血栓形成

目的初步探讨经腘静脉置管溶栓治疗下肢深静脉血栓(DVT)的临床应用价值。方法67例下肢深静脉血栓形成患者,在B超引导下行经腘静脉置入溶栓导管,以输液泵经溶栓导管持续泵入溶栓药物10~14d,同时行抗凝治疗。结果所有病人均置管成功,其中3例未能通过髂静脉;治疗后临床表现均有不同程度的好转,出院前均行影像学检查,治愈11例,其中8例病程≤10d,显效42例,有效16例,有效率100%;其中5例接受髂静脉球囊扩张术,3例行髂静脉支架置入术,1例行耻骨上静脉转流术。结论经腘静脉置管溶栓术治疗下肢深静脉血栓可以延长尿激酶溶栓时间窗,减少尿激酶用量,减少出血并发症,并为后续治疗提供机会。     

Low dose systemic thrombolytic therapy for treatment of deep venous thrombosis

BACKGROUND: Thrombolytic therapy is still not used widely for treatment of deep vein thrombosis despite its known efficacy. This reluctance to use it stems from worries about its hemorrhagic complications. METHODS: In a 4-year period 97 patients with deep vein thrombosis diagnosed by duplex study were enrolled into the study. Fifty patients received streptokinase as a bolus of 250,000 units followed by 100,000 units/hr with a maximum of 4,000,000 units and 47 patients received anticoagulation with heparin. RESULTS: Minor hemorrhagic complications occurred in 2 patients (4%) in the thrombolytic therapy group. An improvement in the control duplex study was observed in 56% of the patients in the thrombolytic therapy group compared to 5% in the heparin group (p=0.000). The patients treated within 4 days of onset of symptoms had significantly higher success rates compared to those treated later (p=0.000). Higher success rates were obtained for those with either femoral vein or more distal venous thrombosis compared to those with iliac vein and vena cava thrombosis (p=0.007). These results show that systemic low dose streptokinase achieves significantly higher recanalization rates compared to heparin alone. CONCLUSIONS: Hemorrhagic complications at these dose levels are within acceptable ranges. Low dose streptokinase regimen could be beneficial in patients who present within 4 days of femoral or more distal venous thrombosis.     

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溶栓及抗凝迄今仍是我们治疗深静脉血栓形成(DVT)的主要方法。虽然DVT在急性期也可手术治疗 ,但我们认为绝大多数DVT病人经溶栓及抗凝等药物治疗均可获得满意疗效 ,关键在于早诊断早治疗。本文对这两种方式的作用、效果 ,以及药物的种类、给药途径、剂量、副作用等进行介绍 ,还涉及目前尚存争论的一些问题。文中所及的剂量等用药方法只是北京安贞医院血管外科的使用习惯 ,仅供参考。1　抗凝治疗1 1　肝素治疗肝素治疗DVT有着重要和显著的效果 ,这一结论已经几十年的临床实践所证明。肝素可避免新的血栓形成 ,并促进病人自身机体纤溶系…     

抗凝溶栓治疗对急性下肢深静脉血栓形成预后的影响

Objective To explore the effect of anticoagulant thrombolytic therapy on acute deep venous thrombosis (DVT) and the incidence and severity of post-thrombotic syndrome (PTS). Method A total of 111 patients (113 limbs) with central or mixed types of deep venous thrombosis admitted from March 2003 to November 2008 were analyzed. The patients were divided into 3 groups by different therapies:anticoagulant group (41 limbs) , thrombolysis group (27 limbs), and catheter-directed thrombolysis group (45 limbs). In the follow-up, patients' swelling of lower extremity and recanalization of vein were found out by physical examination and venous ultrasound Duplex through following-up. The Villalta and VCSS marking scales were used in rating the incidence and severity of PTS, discussing treatments for acute phase as well as adjuvant treatment for chronic phase and the correlation between the incidence and severity of PTS. Results The average time of follow-up were (41±19) months in anticoagulant group, (52±1) months in thrombolysis group, and (26 ±10) months in catheter-directed thrombolysis group. According to the consequences from Villalta and VCSS rating scales, the incidences of PTS in the three groups were 58. 5% (24/41), 55.6% (15/27), and 35.6% (16/45), in which 20.8% (5/24), 3/15, and 1/16 were severe. The the catheter-directed thrombolysis group had a better consequence than the other two groups in reducing incidence and severity of PTS ( P ＜ 0. 05 ). The differences of circumferences of lower extremities of all patients had obvious improvement compared to that before the treatments. For patients who were treated by catheter-directed thrombolysis, the thigh circumference difference and calf circumference difference were (0. 5 ±1. 0) cm and (0. 7±1. 0) cm, which were more obvious compared to other two groups (P ＜0. 05).Most patients had their external-iliac and common-femoral veins recanalized. Using anticoagulant Pharmaceuticals and compression stockings can lead to a reduction in the incidence of PTS. Conclusions The incidences and symptoms of PTS and swelling of limbs can be significantly moderated by catheterdirected thrombolysis based on anticoagulating in the acute phase of DVT. Consequently, it would be the most efficient way in decreasing the occurrences of PTS and moderating the severities of PTS with the aids of regular anticoagulating and compression stockings.     

抗凝溶栓治疗对急性下肢深静脉血栓形成预后的影响

目的 探讨抗凝溶栓治疗对急性下肢深静脉血栓形成的疗效及其对下肢深静脉血栓形成后综合征(PTS)的发生率及严重程度的影响.方法 回顾性选择2003年3月至2008年12月收治的急性下肢深静脉血栓形成(中央型及混合型)患者共111例(113条肢体).分别采用单纯抗凝(41条肢体)、系统溶栓(27条肢体)或导管溶栓(45条肢体)三种不同治疗方法,在随访期末收集下肢肿胀及静脉冉通情况,使用Villaha及VCSS评分表评判PTS的发生率及严重程度.结果 单纯抗凝组、系统溶栓组和导管溶栓组平均随访时间分别为(41±19)、(52±11)和(26±10)个月.三组PTS的发生率分别为58.5%(24/41)、55.6%(15/27)和35.6%(16/45),其中重度PTS的比例分别为20.8%(5/24)、3/15和1/16;导管溶栓组的PTS发生率和重度PTS比例低于其余两组(P＜0.05).三组患者双下肢周径差较治疗前均有明显改善(P＜0.05);导管溶栓组随访时的大腿周径差为(0.5 4±1.0)cm,小腿周径差为(0.7±1.0)cm,低于其余二组(P＜0.05).长期使用抗凝药物及弹力袜的患者,PTS发生率较低.结论 深静脉血栓形成急性期在抗凝基础上采用导管溶栓治疗,可降低PTS的发生率并减轻其严重程度,明显改善肢体肿胀.辅以规律抗凝及弹力袜支持,可进一步改善疗效.

Abstract：

Objective To explore the effect of anticoagulant thrombolytic therapy on acute deep venous thrombosis (DVT) and the incidence and severity of post-thrombotic syndrome (PTS). Method A total of 111 patients (113 limbs) with central or mixed types of deep venous thrombosis admitted from March 2003 to November 2008 were analyzed. The patients were divided into 3 groups by different therapies:anticoagulant group (41 limbs) , thrombolysis group (27 limbs), and catheter-directed thrombolysis group (45 limbs). In the follow-up, patients' swelling of lower extremity and recanalization of vein were found out by physical examination and venous ultrasound Duplex through following-up. The Villalta and VCSS marking scales were used in rating the incidence and severity of PTS, discussing treatments for acute phase as well as adjuvant treatment for chronic phase and the correlation between the incidence and severity of PTS. Results The average time of follow-up were (41±19) months in anticoagulant group, (52±1) months in thrombolysis group, and (26 ±10) months in catheter-directed thrombolysis group. According to the consequences from Villalta and VCSS rating scales, the incidences of PTS in the three groups were 58. 5% (24/41), 55.6% (15/27), and 35.6% (16/45), in which 20.8% (5/24), 3/15, and 1/16 were severe. The the catheter-directed thrombolysis group had a better consequence than the other two groups in reducing incidence and severity of PTS ( P ＜ 0. 05 ). The differences of circumferences of lower extremities of all patients had obvious improvement compared to that before the treatments. For patients who were treated by catheter-directed thrombolysis, the thigh circumference difference and calf circumference difference were (0. 5 ±1. 0) cm and (0. 7±1. 0) cm, which were more obvious compared to other two groups (P ＜0. 05).Most patients had their external-iliac and common-femoral veins recanalized. Using anticoagulant Pharmaceuticals and compression stockings can lead to a reduction in the incidence of PTS. Conclusions The incidences and symptoms of PTS and swelling of limbs can be significantly moderated by catheterdirected thrombolysis based on anticoagulating in the acute phase of DVT. Consequently, it would be the most efficient way in decreasing the occurrences of PTS and moderating the severities of PTS with the aids of regular anticoagulating and compression stockings.     

抗凝溶栓治疗对急性下肢深静脉血栓形成预后的影响

Objective To explore the effect of anticoagulant thrombolytic therapy on acute deep venous thrombosis (DVT) and the incidence and severity of post-thrombotic syndrome (PTS). Method A total of 111 patients (113 limbs) with central or mixed types of deep venous thrombosis admitted from March 2003 to November 2008 were analyzed. The patients were divided into 3 groups by different therapies:anticoagulant group (41 limbs) , thrombolysis group (27 limbs), and catheter-directed thrombolysis group (45 limbs). In the follow-up, patients' swelling of lower extremity and recanalization of vein were found out by physical examination and venous ultrasound Duplex through following-up. The Villalta and VCSS marking scales were used in rating the incidence and severity of PTS, discussing treatments for acute phase as well as adjuvant treatment for chronic phase and the correlation between the incidence and severity of PTS. Results The average time of follow-up were (41±19) months in anticoagulant group, (52±1) months in thrombolysis group, and (26 ±10) months in catheter-directed thrombolysis group. According to the consequences from Villalta and VCSS rating scales, the incidences of PTS in the three groups were 58. 5% (24/41), 55.6% (15/27), and 35.6% (16/45), in which 20.8% (5/24), 3/15, and 1/16 were severe. The the catheter-directed thrombolysis group had a better consequence than the other two groups in reducing incidence and severity of PTS ( P ＜ 0. 05 ). The differences of circumferences of lower extremities of all patients had obvious improvement compared to that before the treatments. For patients who were treated by catheter-directed thrombolysis, the thigh circumference difference and calf circumference difference were (0. 5 ±1. 0) cm and (0. 7±1. 0) cm, which were more obvious compared to other two groups (P ＜0. 05).Most patients had their external-iliac and common-femoral veins recanalized. Using anticoagulant Pharmaceuticals and compression stockings can lead to a reduction in the incidence of PTS. Conclusions The incidences and symptoms of PTS and swelling of limbs can be significantly moderated by catheterdirected thrombolysis based on anticoagulating in the acute phase of DVT. Consequently, it would be the most efficient way in decreasing the occurrences of PTS and moderating the severities of PTS with the aids of regular anticoagulating and compression stockings.     

抗凝溶栓治疗对急性下肢深静脉血栓形成预后的影响

Objective To explore the effect of anticoagulant thrombolytic therapy on acute deep venous thrombosis (DVT) and the incidence and severity of post-thrombotic syndrome (PTS). Method A total of 111 patients (113 limbs) with central or mixed types of deep venous thrombosis admitted from March 2003 to November 2008 were analyzed. The patients were divided into 3 groups by different therapies:anticoagulant group (41 limbs) , thrombolysis group (27 limbs), and catheter-directed thrombolysis group (45 limbs). In the follow-up, patients' swelling of lower extremity and recanalization of vein were found out by physical examination and venous ultrasound Duplex through following-up. The Villalta and VCSS marking scales were used in rating the incidence and severity of PTS, discussing treatments for acute phase as well as adjuvant treatment for chronic phase and the correlation between the incidence and severity of PTS. Results The average time of follow-up were (41±19) months in anticoagulant group, (52±1) months in thrombolysis group, and (26 ±10) months in catheter-directed thrombolysis group. According to the consequences from Villalta and VCSS rating scales, the incidences of PTS in the three groups were 58. 5% (24/41), 55.6% (15/27), and 35.6% (16/45), in which 20.8% (5/24), 3/15, and 1/16 were severe. The the catheter-directed thrombolysis group had a better consequence than the other two groups in reducing incidence and severity of PTS ( P ＜ 0. 05 ). The differences of circumferences of lower extremities of all patients had obvious improvement compared to that before the treatments. For patients who were treated by catheter-directed thrombolysis, the thigh circumference difference and calf circumference difference were (0. 5 ±1. 0) cm and (0. 7±1. 0) cm, which were more obvious compared to other two groups (P ＜0. 05).Most patients had their external-iliac and common-femoral veins recanalized. Using anticoagulant Pharmaceuticals and compression stockings can lead to a reduction in the incidence of PTS. Conclusions The incidences and symptoms of PTS and swelling of limbs can be significantly moderated by catheterdirected thrombolysis based on anticoagulating in the acute phase of DVT. Consequently, it would be the most efficient way in decreasing the occurrences of PTS and moderating the severities of PTS with the aids of regular anticoagulating and compression stockings.     

Heparin therapy for deep venous thrombosis

One hundred fifty-six cases of deep venous thrombosis were reviewed. A previous episode of thrombosis, seen in 47 percent of the patients, was the most common predisposing factor. Medical illness, operation and local trauma were other important predisposing factors. Treatment consisted of continuous intravenous heparin therapy monitored by the activated coagulation time of whole blood (ACT). Thirty-three patients with an average ACT greater than 180 seconds had a more rapid recovery and had no recurrent deep venous thrombosis, embolism or failure to improve. Recurrent thrombosis, embolism or failure to improve was seen in 7 of 65 patients with an average ACT below 180 seconds. Major bleeding, defined as life-threatening bleeding or bleeding requiring transfusion, was not increased when the ACT was over 180 seconds, although minor bleeding was increased. Bleeding was also increased in women, elderly and postoperative patients. We advocate the use of higher doses of heparin to treat most patients with deep venous thrombosis because of the more rapid and complete recovery.     

A venous thrombosis technique for experimental thrombolytic therapy.

A technique for the experimental creation of a venous thrombus in the rat is described. This technique involves a circumferential stretching of the intima, which maximizes intraluminal collagen exposure without complete separation of the vessel wall. This thrombotic method was 94.4% effective at complete vessel occlusion after 24 hours in 40 treated veins. This model is of particular interest in the in vivo evaluation of thrombolytic agents in the laboratory setting and as an adjunct to thrombotic complications in microsurgery.