The Clinical Study Of Single-session Protocol Treatment For Acute Deep Vein Thrombosis

Objective To investigate the feasibility,safety,and effectiveness of single-session endovascular treatment for acute deep vein thrombosis.Method 121 patients from Jul 2014 to Mar 2017 with acute deep vein thrombosis were retrospectively analysed.According to different treatment,patients were divided into3groups,includingcatheter-directedthrombolysis(groupA),AngioJet thrombectomy(group B),modified AngioJet thrombectomy(group C).The circumference difference between normal and affected limbs,detumescence rate,thrombus removal score,thrombus removal rate,complications were collected into statistical analysis.Result The circumference difference between pre-treatment and pro-treatment in each of 3 groups was significant different,respectively(P<0.05).Mean thighs detumescence rate were 67.3±43.6%?69.5±32.6%?72.4±27.1%,median thrombus removal rate were 100.0%(83.0%,100.0%)?100.0%(83.3%,100.0%)?100.0%(94.4%,100.0%),main bleeding complications were 4.6%?2.7%?5.0%.Among 3 groups,the comparison of the circumference difference,detumescence rate,thrombus removal score,thrombus removal rate,main bleeding complications were analysed with no significant difference(P>0.05).Immediate thrombus removal score and thrombus removal rate after procedure between B group and C group were 2.0(0.0,3.0),1.0(0.0,2.0),83.3%(77.8%,100.0%),92.8%(85.8%,100.0%),with significant difference retrospectively(Z=3.843,P=0.050,Z=4.650,P=0.031).The dose of urokinase in 3 groups were(292.95±131.89)*10~4U?(214.59±109.13)*10~4U?(139.89±62.50)*10~4U,with significant difference among 3groups(H=33.465,P=0.000)and between every two groups.The trombolytic time in 3groups were(5.03±2.07)d?(3.28±2.20)d?(1.84±0.98)d,with significant difference among3 groups(H=42.423,P=0.000)and between every two groups.All filters were removed successfully.A and B group were removed after thrombolysis,while latest 23 patients of C group were planned to remove in the same setting and succeeded in 16(16/23,69.6%).Illiac vein stents were performed in 26?19?34 of three groups.3 of B group and all in C group were stenting in the same setting.Conclusion Compared to catheter-directed thrombolysis,both AngioJet thrombectomy and modified AngioJet thrombectomy are effective in thrombus removal and relieving symptoms,with the advantage of reducing thrombolic agents and trombolytic time.Modified AngioJet thrombectomy is more efficient than AngioJet thrombectomy in thrombus removal and reducing thrombolic agents and trombolytic time.When combining iliac vein stenting and removing filter in the same setting,single-session protocol with Angiojet Device for treatment of acute deep vein thrombosis can be achieved.