The Clinical Analysis Of The Treatment In Lower Limbs Of Deep Vein Thrombosis

Objective To evaluate the efffectiveness of treatment of deep venous thrombosis(DVT).Methods To analyse the clinical data of 102 cases(107 limbs)with DVT being treated in vascular surgery of our hospital from November of 2008 to November of 2010, including the popliteal vein Catheterized thrombolysis + anticoagulant therapy in 61 cases(63 limbs), systemic thrombolysis + anticoagulant therapy in 35 cases(37 limbs), only anticoagulant therapy in 6 cases(7 limbs), Iliac vein balloon angioplasty and stent placement for iliac vein stenosis or occlusion in 11 cases.Results Majority of the 102 DVT patients aged over 40-year-old, accounts for 83.3%. Majority of patients(95.11%) had DVT risk factors, of which surgery was the most important risk factor.The number of risk factors increased with the growth of age.DVT affected the common parts of the left lower extremity vein (83.3%),while central type was dominant. Seventy-one cases were followed up for 4-28 months, average 14.38±7.15 months. Sisty-one cases(63 limbs)receiving popliteal vein Catheterized thrombolytic therapy had improved significantly by the average venography score of 3.4±2.68 and the average venous patency rate of 75.0%. Forty-three patients were followed up for an average month 14.23±7.28 of symptoms resolved in 67.4%, 9.3% patients suffered from post-thrombotic syndrome(PTS). Thirty-four cases reviewed by venography or ultrasonography which showed 23 patients with vascular patency, 7 cases with rough vascular wall,and 4 cases with residual thrombus.Clinical picture in 35 cases(37 limbs)receiving systemic thrombolysis improved by the average venography score of 10.6±5.46,and the average venous patency rate of 23.0%. Twenty-three patients followed up for an average of 14.83±7.04 months, showed that symptoms resolved in 34.8%, 17.4% left with PTS. Eighteen cases reviewed by venography or ultrasonography,revealed 6 cases with residual thrombus,12 cases with a large number of thrombosis and luminal occlusion.We placed inferior vena cavafilter to successfully block off blood clots in 8 of 65 cases, and to prevent 20 cases from pulmonary embolism, filter migration, perforation and other complications affer 18.05±6.25 months of following up.Iliac vein balloon angioplasty and stenting for iliac vein stenosis or occlusion in 11 cases demonstrated that vein was patent, no stent migration, deformation, perforation,and one in ten patients reoccured within 8.80±4.44 months of following up.Conclusion Genetic factors, acquired risk factors may cause deep vein thrombosis,while surgery is an important risk factor.This possibility increases with aging.The majority of lower extremity deep vein thrombosis patients can be treated by anticoagulation, thrombolytic therapy and other approaches based on early diagnosis. Catheterized thrombolysis is more effective compared with systemic thrombolysis.The placement of the inferior vena cavafilter may prevent patient from pulmonary embolism in Catheterized thrombolysis. Iliac vein balloon dilatation and stenting in the treatment of iliac vein stenosis or occlusion can significantly improve the venous return and prevent recurrence of blood clots and PTS.Long-term anticoagulant therapy may prevent recurrent thrombosis.