Comparative Analysis For Trans-catheter Directed Thrombolysis By Small Saphenous Vein And Trans-Dorsal Venous Thrombolysis In Treatment For Acute Central Venous Thrombosis Under The Protection Of Temporary Inferior Vena Cava Filter

Objective To investigate the efficacy of trans-catheter directed thrombolysis by small Saphenous Vein in treatment for acute central venous thrombosis of lower limbs and as compared with Trans-Dorsal Venous Thrombolysis.Methods:There were 52 patients with deep venous thrombosis admittded from September 2013 to January 2016 in Anqing Municipal Hospital.The cases were divided into two groups by therapy procedures.The patients in group A were treated bysmallsaphenouslveincatheter-directedanticoagulationand thrombolysis,including a total number of 28 patients,28 temporary inferior vena cava filters were implanted.Twenty four patients were included in group B with anticoagulation and thrombolysis through dorsal venous,10 temporary inferior vena cava filters were implanted.The effects of the two groups were compared by observing the clinical symptoms,the changes of the lower limb circumference,the complications of thrombolysis,the patency rate of the vein and the valve function.Results:After 24 hours of Catheter directed thrombolysis,the patient’s limb swelling in the group A began to relieve,3 to 5 days later,the symptoms of lower limb pain,swelling were significantly reduced,and all the symptoms subsided after 7days.48 to 72 hours after treatment,the group B began to take effect,and the symptoms were significantly reduced after 10 days.The total amount of urokinase in the group A was(320±100)×10~4U,the total duration of treatment was 4~7 days.The total amount of urokinase in the group B was(460±120)×10~4U,and the total treatment period was 6~10 days.After catheter directed thrombolysis,the swelling rate of large and lower limbs was(90.12+6.15)%and(86.74±7.24)%,via dorsal vein thrombolysis treatment after,the swelling rate of large and lower limbs was(85.71±5.54)%and(85.16±6.57)%.Grade III of the thrombus dissolution rate of patients in the group A was 82.1%,but the group B was 50%,between the two groups compared the differences were statistically significant(P<0.05).Conclusion:Undeysis with short course,quick effect,less complications and postoperar the protection of temporary inferior vena cava filter,via the small saphenous vein catheter thromboltive follow-up of the incidence of the post-thrombotic syndrome(PTS)is low,catheter directed thrombolysis is better than thrombolytic therapy through dorsal venous,worthy of clinical application.