The Clinical Study Of Catheter-directed Thrombolysis Combined With Percutaneous Transluminal Angioplasty For Acute Lower Extremity Deep Venous Thrombosis

Objective:To evaluate the efficacy and safety of catheter-directedthrombolysis combined with percutaneous transluminal angioplasty foracute lower extremity deep venous thrombosis.Methods: The clinical data of78acute DVT patients from October2009to March2012were retrospectively analyzed. Group A(n=42) receivedCDT combined with PTA,Group B(n=36) underwent systemicthrombolytic therapy via dorsalis pedis vein.The circumference differenceson the calf pre-and post-treatment，the venous patency score，vein patencyrate，the incidence of bleeding and pulmonary embolism were recorded inthe two groups.Result：1.There was no significant difference for the circumferencedifferences on the calf between Group A and Group B pre-treatment.Thecircumference differences on the calf in A group are lower than those in Bgroup post-treatment day7,month6and month12(P<0.05).2. There was no significant difference for the venous patency scorebetween Group A and Group A pre-treatment.The venous patency score ofgroup A after thrombolysis treatment is significantly lower than that ofgroup B(P<0.05).3. The symptomatic pulmonary embolism incidence of Group B was11.1%（4/36），while the Group A was0%(0/42). Group A compared with Group B, the symptomatic pulmonary embolism incidence waslower.(P<O．05).The bleeding incidence of Group A was11.9%(5／42)，while Group B was30.6%(11／36)，with significant difference.(P<0．05)4. After discharge6months, the vein patency rate of Group A andGroup B were77.8％（28/36） and37.9％(11/29) respectedly. Afterdischarge12months, the vein patency rate of Group A and Group Bwere83.3％(30/36) and41.4％(12/29) respectedly. The deep vein patencyrate of Group A were much higher than those of Group B after discharge6months and12months，with significant difference(P<O．05).Conclusion:1.Current and long-term efficacy of CDT combined with PTA aresuperiorer than systemic thrombolytic therapy via dorsalis pedis vein.2. CDT combined with PTA is a safe and effective treatment for acuteDVT and worth popularizing in the clinical.