Clinical Comparison Of AngioJet Mechanical Thrombectomy And Catheter-directed Thrombolysis For Acute Lower Extremity Deep Venous Thrombosis

Objective:The purpose of this study was to investigate and compare the clinical efficacy of AngioJet mechanical thrombectomy(percutaneous mechanical thrombectomy,PMT)and catheter-directed thrombolysis(CDT)in the treatment of acute lower extremity deep venous thrombosis(LEDVT).Methods:89 patients with acute LEDVT admitted from February 2016 to March 2018 were selected as the study objects.Comprehensive consideration of the patient's condition,economic conditions and their own wishes,They were divided into AngioJet mechanical thrombectomy group 51 cases(PMT group)and catheter-directed thrombolysis therapy group 38 cases(CDT group).The efficacy and safety of the two groups were analyzed and compared.The indexes of therapeutic effect include the circumference difference of the thigh between affected side and healthy side before and after treatment,the circumference difference of the calf,the circumference difference of the affected side thigh,the circumference difference of the affected side calf,and the venous patency score before and after treatment;The venous patency rate after treatment,the detumescence rate of the affected limb,total dose of urokinase,thrombolysis time,hospital stays,the Villalta PTS score and the incidence of PTS;clinical efficacy,etc.The safety index mainly refer to the occurrence of complications in the two groups.Results:After treatment,the circumference difference of the thigh and calf between affected side and healthy side were significantly decreased in both groups,the circumference difference of the PMT group was smaller than that of the CDT group,and the difference was statistically significant(p<0.05).On the 1st day after treatment,there was no significant difference between the two groups in the circumference difference of the affected side thigh and calf before and after treatment(p>0.05).On the 3rd and 5th day after treatment,the circumference difference of the affected side thigh and calf increased significantly before and after treatment in both groups,while the circumference difference in the PMT group was greater than that in the CDT group(p<0.05).After treatment,the venous patency scores of the two groups were significantly reduced,the venous patency score of the PMT group on the 1st and 3rd day was lower than that in the CDT group(p<0.05),and there was no significant difference in the venous patency score and venous patency rate between the two groups on the 5th day after treatment(p>0.05).The detumescence rate of the affected limb in the PMT group was higher than that in the CDT group(p<0.05),the total dose of urokinase was lesser than that in the CDT group(p<0.05),the thrombolysis time and hospitalization time were shorter than those in the CDT group(p<0.05).The thrombus clearance rate of grade ? in the PMT group was better than that in the CDT group,and there were no significant difference in the thrombus clearance rate between different grades(p>0.05).No serious complications occurred in the two groups,and there was no significant difference in the incidence of complications(p>0.05).At the last follow-up,the Villalta PTS score in the PMT group was lower than that in the CDT group,and the difference was statistically significant(p<0.05).The incidence of PTS was lower in the PMT group than that in the CDT group,but there was no statistical difference between the two groups.(p>0.05).Conclusion:AngioJet mechanical thrombectomy and catheter-directed thrombolysis have significant curative effect in the treatment of acute LEDVT,and the safety is similar.AngioJet mechanical thrombectomy had better short-term thrombus clearance effect,which improved the detumescence rate and venous patency rate of the affected limb,significantly reduced the dosage of thrombolytic drugs,shortened the time of thrombolysis and hospitalization,and Reduced the Villalta PTS score of the affected limb.The clinical efficacy of recent follow-up is good,which can be used as an ideal method for clinical treatment of acute LEDVT.