| Objective: We sought to evaluate the effectiveness and safety of AngioJet in the treatment of acute mixed deep vein thrombosis of lower extremity,as well as the feasibility and effectiveness of AngioJet surgery via anterior tibial vein approach.Methods : 51 patients(24 patients received CDT treatment(group A)and 27 patients received AngioJet treatment(group B))with acute mixed deep venous thrombosis of lower extremity were collected from the Department of Vascular Surgery of The Second Affiliated Hospital of Anhui Medical University from August 2018 to August2020.The general clinical data of patients were collected,limb swelling rate,patency rate of veins,urokinase usage,hemoglobin,fibrinogen,serum creatinine values,hospitalization days,hospitalization cost,the main anomalies and short-term follow-up results were collected and compared between group A and group B.Using SPSS20.0statistical software for data analysis,P< 0.05 was considered statistically significant.Results :(1)There was no statistically significant difference in the basic data between group A and group B(P>0.05).(2)the detumescence rates of affected limbs in group A and group B were 72.63%±8.74% and 76.07%±7.62%,respectively,P<0.05;the swelling reduction rates of group A and group B were 72.63% ± 8.74% and 76.07% ±7.62%,respectively,P < 0.05;The patency rate of veins of the two groups were 75.46%± 17.19% and 84.67% ± 13.53%,P < 0.05;the dosage of urokinase in group A(717,500±319,000U)was significantly higher than that in group B(300,000±114,300U),P <0.05;the Villalta score of the two groups were 1.37 ± 1.40 and 1.33 ± 1.46,P > 0.05.(3)There were no differences in hemoglobin(117.58±17.89 g/L and 111.08±15.12 g/L)and creatinine values(63.13 ± 21.32μmol/L and 60.33 ± 19.39μmol/L)in group A before surgery and postoperative(P>0.05),The fib of the first day after surgery was2.17±1.07 g/L,significantly lower than that before surgery(3.31±0.96 g/L),P<0.05;There were no differences in FIB(3.47±0.90 and 3.30±1.33g/L)and creatinine(64.33±18.27μmol/L and 62.81±23.91μmol/L)in group B preoperative and postoperative(P>0.05);preoperative and postoperative hemoglobin was 121.07±9.94g/L and 110.52±10.07 g/L,respectively,P<0.05,but it was mild anemia after surgery(normal value: 115-150 g/L).(4)The hospitalization days in group A(11.70 ± 4.91days)was significantly higher than that in group B(7.48 ± 3.5 days),P < 0.05;The total hospitalization cost of group B(50789.45±19357.02 yuan)was significantly higher than that of group A(68624.81±14332.04 yuan),P<0.01;However,the number of stents placed in group B(n=17)was significantly higher than that in group A(n=5),P<0.05;the laboratory diagnosis cost of group A(3017.62±1099.77 yuan)was significantly higher than that of group B(1689.22±609.73 yuan),P<0.01.(4)(5)In group A,6patients had abnormal conditions,including 2 cases of fever,3 cases of allergy,2 cases of bleeding and 4 cases of bleeding at puncture point;in group B,25 patients had soy sauce colored urine after operation,in addition,5 patients had abnormal conditions,including 1 case of gingival bleeding,2 cases of fever and 2 cases of allergy.There was no oliguria or anuria in both groups.Conclusion:(1)Compared with CDT,the Angiojet system can rapidly reduce the thrombosis burden in the treatment of acute mixed lower extremity deep vein thrombosis;(2)Compared with CDT,Angiojet system can achieve higher rate of venous recanalization and primary stent placement,and has a better effect on the treatment of iliac vein stenosis.(3)Angiojet anterior tibial vein approach dose not increase the incidence of postoperative serious complications and maintain good safety. |
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