Clinical Control Study Of Angiojet Assisted Catheter-directed Thrombolysis Contact Catheter-directed Thrombolysis Alone In The Treatment Of Acute Lower Extremities Deep Venous Thrombosis

OBJECTIVE This study was to explore Angiojet rheolytic thrombectomy(ART)assisted catheter-directed thrombolysis(CDT)contact with pure catheter-directed thrombolysis(CDT)in acute lower extremity deep vein thrombosis(LEDVT)in the process of clinical therapeutic effect and safety of differences.Methods A retrospective analysis was performed on 91 patients with acute LEDVT admitted to the department of vascular surgery,the second affiliated hospital of soochow university from January 2016 to December 2017,among which 30 were in the ART+CDT group and 61 were in the CDT group.Analysis and comparison of two groups of patients,treatment,efficacy,and safety evaluation indicators include:two groups of total dose urokinase thrombolysis time,length of hospital stay,combined iliac vein stenosis or occlusion surgery,the thrombus clearance and the occurrence of postoperative complications,Villalta score and chronic venous insufficiency quality of life questionnaire(CIVIQ).Results This study of the communist party of China into the case 91 examples,limb deep vein were opened,two groups of surgical success rate 100%,two groups of postoperative follow-up each 1 case death,two groups of postoperative line after thrombolysis treatment,ART+CDT used amount of urokinase group is significantly below the CDT(u)group,two groups was statistically difference(194±94.99 vs.352.5±145.08,P<0.05),thrombolysis time(d)ART+CDT group significantly shorter than the CDT(4.03±2.27 vs.6.07±2.29,P<0.05).(d)the length of stay was significantly shorter in the ART+CDT group than in the CDT group(10.3±3.47 vs.12.68±3.69,P<0.05).ART+CDT group before and after treatment of the lateral thigh weeks radius(cm)is significantly higher than the CDT group,two groups was statistically difference(3.5±0.731 vs.2.75±0.745,P<0.05),two groups of limb swelling rate(%)ART+ CDT group was significantly higher than that of CDT(84.63±1.098 vs.79.20±2.971,P<0.05),the thrombus removal surgery,ART+CDT group in the popliteal,and Grade Ⅲ level of iliac vein thrombosis clearance there exists significant difference compared with the CDT group,According to the post-treatment follow-up of the two groups,the incidence of PTS in the ART+CDT group was lower than that in the CDT group,but the difference was not statistically significant(P>0.05).Line after thrombolysis treatment in both groups,ART+CDT venous patency score significantly lower than that of CDT group,two groups was statistically difference(1.07±5.83 vs.1.59±0.990,P<0.05),two groups of venous patency rate ART+CDT group was significantly higher than that of CDT(87.27±6.01 vs.83.48±6.30,P<0.05),with ART+CDT and CDT after surgery,After two years of follow-up after ART+CDT and CDT surgery,the postoperative cumulative patency rate of patients was different,with ART+CDT being 83.3%.CDT group alone was 68.85%,but the difference was not statistically significant(Log Rank test value P was 0.87),two groups of patients after surgery,postoperative hemoglobinuria ART+CDT group obviously higher than that of the CDT,statistically significant difference(100%vs.11.48%,P<0.05),the symptom of pulmonary embolism,gastrointestinal bleeding and other complications in the two groups had no significant statistical difference(P>0.05).Conclusion Both ART+CDT and CDT can achieve good surgical results,and the risk of postoperative complications is low.ART+CDT has the advantages of rapidly reducing the thrombus load of the affected limb,shortening the thrombolytic time,reducing the total amount of urokinase and the length of hospital stay,improving the thrombus clearance rate of the affected limb,and reducing the incidence of PTS,which can be a better choice for the clinical treatment of acute LEDVT.