Comparison Of The Clinical Effect Of Catheter Directed Thrombolysis And Thrombectomy From Femoral Artery On Lower Extremity Arteriosclerosis Obliterans With Acute Thrombosis

Objective:In this study,we compared the clinical effect of catheter contact thrombolysis and thrombectomy from femoral artery in the treatment of lower extremity arteriosclerosis obliterans with acute thrombosis,and discussed the advantages and disadvantages of the two methods.It provides a basis for clinical treatment of lower limb arteriosclerosis obliterans with acute thrombosis.Mehtods:Between January 2011 and January 2018,in the Department of Cardiothoracic Surgery,Qinghai University Affiliated Hospital,83 patients were diagnosed as lower extremity arteriosclerosis obliterans with acute thrombosis,catheter directed thrombolysis group consisted of 43 cases,thrombectomy from femoral artery group consisted of 40 cases.The general condition before operation,ankle-brachial index 3 days after operation,foot skin temperature,vascular conditions,pain relief and ankle-brachial index 30 days after operation,foot skin temperature,complications,amputation rate and mortality were compared between the two groups.Results:1.There were no significant differences in general situation of preoperative,ABI,foot skin temperature,vascular patency,and pain relief between the two groups at 3-day postoperative,P>0.05.2.Catheter directed thrombolysis group:3-day postoperative ankle-brachial index(0.84±0.16)and 30-day postoperative ankle-brachial index(0.82±0.12)were both higher than the preoperative ankle-brachial index(0.31±0.11),P<0.05.3-day postoperative foot skin temperature(27.2℃±1.6℃)and 30-day postoperative foot skin temperature(27.0℃±1.9℃)were both higher than the preoperative foot skin temperature(18.0℃±1.0℃),P<0.05.Thrombectomy from femoral artery group:3-day postoperative ankle-brachial index(0.80±0.21)and 30-day postoperative ankle-brachial index(0.73±0.14)were both higher than the preoperative ankle-brachial index(0.30±0.14),P<0.05.3-day postoperative foot skin temperature(26.8℃±2.1℃)and 30-day postoperative foot skin temperature(25.6℃±1.5℃)were both higher than the preoperative foot skin temperature(18.1℃±1.3℃),P<0.05.3.30-day postoperative ankle-brachial index: catheter directed thrombolysis group was higher than thrombectomy from femoral artery group,P<0.05.30-day postoperative foot skin temperature:catheter directed thrombolysis group was higher than thrombectomy from femoral artery group,P<0.05.4.Postoperative complications:4 cases(9.30%)in the catheter directed thrombolysis group were lower than 11 cases(11.50%)in the thrombectomy from femoral artery group,P<0.05.5.30-days amputation rate:4 cases(9.30%)in the catheter-contact thrombolysis group and 6 cases(15.00%)in the thrombectomy from femoral artery group,the difference was not statistically significant,P>0.05.6.30-day mortality: 1 case(2.32%)in the catheter-contact thrombolysis group was lower than 6 cases(27.50%)in the thrombectomy from femoral artery group,P<0.05.Conclusions:Two operation methods are effective for the treatment of lower limb arteriosclerosis obliterans with acute thrombosis.Catheter-contact thrombolysis has a better long-term effect and a lower incidence of postoperative complications and mortality,but it is not suitable for patients with bleeding risk.