导管接触性溶栓联合髂静脉支架治疗下肢深静脉血栓形成的疗效及预后分析

目的 比较导管接触性溶栓联合髂静脉支架植入与外周溶栓治疗下肢深静脉血栓合并髂静脉狭窄的疗效.方法 回顾性分析2014年12月-2019年12月于安徽医科大学附属第四医院普外科就诊的下肢深静脉血栓合并髂静脉狭窄患者,42例患者中15例行外周溶栓术(系统溶栓组),27例行导管接触性溶栓或联合髂静脉支架植入术(导管溶栓组),...

Efficacy and prognosis of catheter-directed thrombolysis combined with iliac vein stenting for deep vein thrombosis

  Objective  To compare the efficacy between catheter-directed thrombolysis combined with iliac vein stent implantation and peripheral thrombolysis in the treatment of lower extremity deep vein thrombosis with iliac vein stenosis.   Methods  A retrospective analysis was performed on patients diagnosed with deep vein thrombosis combined with iliac vein stenosis in our institution from December 2014 to December 2019. A total of 42 cases were included in this study, 15 of which underwent peripheral thrombolysis (systematic thrombolysis group) and 27 of which received catheter-directed thrombolysis combined with iliac vein stenting (catheter-directed thrombolysis group). Clinical data including complications, effective rate of thrombolysis and incidence of post-thrombotic syndrome were collected and compared between the two groups.   Results  The thrombolytic doses of the systemic thrombolysis group and catheter-directed thrombolysis group were (3.35±1.34) and (3.04±1.16) million U, respectively. Three patients in the systematic thrombolysis group and two patients in the catheter-directed thrombolysis group had complications. No significant difference was observed in the thrombolytic dose and complication rate between the two groups (all P>0.05); the effective rate of thrombolysis in the systemic thrombolytic group was 53.33%, whilst the rate was 88.89% in the catheter-directed thrombolysis group, which was higher than that in the systematic thrombolysis group (P < 0.05). The average Villalta score of the systematic thrombolysis group was 2.53 points, and that of the catheter-directed thrombolysis group was 1.77 points. The incidence of post-thrombotic syndrome was lower in the catheter-directed thrombolysis group than in the systematic thrombolysis group (P < 0.01). In addition, the VEINES-QOL/Sym scores in the systematic thrombolysis group were 35.33 and 32.67 points, whilst those in the catheter-directed thrombolysis group were 49.00 and 45.67 points. The scores were significantly higher in the catheter-directed thrombolysis group than in the systematic thrombolysis group (P < 0.01).   Conclusion  Catheter-directed thrombolysis combined with iliac vein stent has a better curative effect for patients with deep vein thrombosis of lower extremities with iliac vein stenosis.