Clinical Study Of Catheter-directed Thrombolytic Therapy For Acute Deep Vein Thrombosis With Pulmonary Embolism

Objective To evaluate the clinical value of catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremities with pulmonary embolism.Materials and methods A total of 189 patients with deep venous thrombosis(DVT)were enrolled in our hospital from 2014.01 to 2015.12,and 80 patients with pulmonary embolism(PE).All patients were diagnosed by deep vein venous doppler ultrasonography or deep vein angiography.The diagnosis of pulmonary artery was confirmed by pulmonary artery CTA angiography.Of the 80 patients with PE,32 patients(group A)were treated with anticoagulation alone,48 patients were treated with anticoagulation and inferior vena cava filter(IVCF)and catheter-directed thrombolysis(group B),and 18 cases of iliac vein compression Syndrome patients with interventional therapy,the follow-up follow-up of patients with 3 to 12 month.Results In this study,the incidence of pulmonary embolism was 42.3%(80/189)in patients with DVT,and the majority was 45.25 years(91.25%),with an average age of 63.75 ± 12.36 years.96.25%(77/80)patients had risk factors for pathogenesis,Among them,cardiovascular disease(48.9%),smoking(33.8%),infection(32.4%),bed restraint(30.6%),surgical trauma(16.4%)and tumor(13.2%)were the main pathogenic factors.The incidence of concurrent PE in the right lower limb DVT was 82.3%,which was higher than that of the left lower limb 31.2%.In the central type(iliac-femoral-popliteal vein)DVT patients,the number of pulmonary embolism was 77 cases,significantly higher than the calf vein(peripheral type)complicated with pulmonary embolism.In the treatment group,5 patients underwent pulmonary embolism with simple anticoagulation group A and 1 patient with pulmonary artery embolization in anticoagulation + IVCF + catheter-directed thrombolysis(CDT).Transcatheter contact with thrombolytic therapy DVT,in the limb swelling rate,the average rate ofintravenous patency,the recent effect is better.catheter thrombolytic therapy before,contralateral,calf circumference difference were(4.26 ± 2.75)cm,(3.22±1.63)cm,and the diameter of the calf of the contralateral thighs was(1.0±0.90)cm,(0.90±0.80)cm,respectively.Conclusion(1)Catheter-directed thrombolysis for the treatment of DVT patients safe and reliable,simple and easy,can quickly reduce limb edema..(2)CDT combined with inferior vena cava filter can effectively control the risk of concurrent risk of PE in high risk groups.(3)CTPA can significantly reduce the missed diagnosis of pulmonary embolism,is now the primary method of diagnosis of PE.