Evaluation On Therapeutic Effect Of Different Infusion Modes For Thrombolysis In Acute Iliofemoral Vein Thrombosis

Objective:To observe the therapeutic effect of different catheter-directed thrombolysis (CDT) infusion modes in the treatment of acute iliofemoral vein thrombosis (IFVT).Methods:Firstlt,the iliac-femoral vein of 17 dogs hind leg were isolated,and then,the thrombosis model were established by infusing the thrombin after breaking endangium.The recanalization of thrombosis was assessed by antegrade venography and CTV.One of them was executed and the iliac-femoral vein was taken out for pathological study.16 dogs were randomly divided into 2 groups which received CDT with pulse-spray thrombolysis and CDT with continuous infusion separatedly after one week.The venography was taken by infusion-catheter to observe the recanalization of iliac-femoral vein at the end of 1 hour,2 hour and 3 hour.Totally 65 patients with IFVT were divided into three groups randomly before operation. Group A: 21 patients received CDT with pulse-spray thrombolysis. Group B: 22 patients received CDT with continuous infusion. Group C: 22 patients received CDT with pulse-spray thrombolysis, followed by continuous infusion. Urokinase of the same dosage was administrated within 72 hours in all groups. Venography was performed during thrombolysis to observe the effect and incidence of complications.Results:The iliofemoral venous thrombosis on experimental side was formed in all 17 dogs.The filling defect was shown by antegrade venography and CTV in the iliac-femoral vein.The pathology also confirmed thrombosis in the iliac-femoral vein.Animal thrombolysis experiment showed that thrombolytic effect in CDT with pulse-spray thrombolysis was significantly better than that of CDT with continuous infusion.The clinical studies showed that the total effective rate of group A, B and C was 71.43%, 63.64% and 77.27% respectively. The limbs edema reduction rate was (80.00±22.10)%,(67.50±16.40)% and (92.30±15.80)%, respectively, while the rate of venous recanalization was(57.80±18.70)%,(55.60±19.30)% and (70.20±19.80)%, respectively. The total effective rate, the limbs edema reduction rate and the rate of venous recanalization of group C was significantly higher than group A and B (all P<0.01). The complications showed no significant difference among three groups (P>0.05).Conclusions:The pulse-spray thrombolysis followed by continuous infusion mode may be the preferable treatment of acute IFVT.