The Clinical Application Of Angiojet Rheolytic Thrombectomy Under Ultrasound Guidance Combines With Catheter-directed Thrombolysis In The Treatment Of Acute And Subacute Lower Extremity Deep Venous Thrombosis

Objective:To investigate the efficacy and safety of AngioJet coupling catheter-directed thrombolysis(CDT)in the treatment of acute and subacute lower extremity deep venous thrombosis(LEDVT).Methods:The clinical data of 24 patients with acute LEDVT(<14 d)and 15 patients with subacute LEDVT(15 to 30 d),during the period from December 2014 to December2017,were retrospectively analyzed.To evaluate the rate of instant venous patency,,the rate of stenosis(>50%)of the iliac femoral vein,the total used amount of urokinase,hospitalization time and occurrence of complications during the treatment.After discharge,patients'symptoms and signs and quality of life were regularly followed up in the outpatient department or by telephone,and Villalta and VEINS-QOL scores were used for statistical analysis.Results:In group acute and subacute,the rate of instant venous patency were(73.65±9.01)%and(62.36±16.17)%respectively,and the rate of stenosis(>50%)of the iliac femoral vein were 50%(12/24)and 86.67%(13/15)respectively;the differences in the above indexes between the two groups were statistically significant(P=0.02 and P=0.02 respectively);the total used dosages of urokinase were(153.92±70.12)x10~4U and(207.73±169.49)x10~4U respectively,the hospitalization days were(8.67±1.55)days and(9.60±5.53)days respectively,the occurrences of complications were 12.5%(3/24)and33.33%(5/15)respectively,the average time of last follow-up were(24.71±8.58)m and(17.91±10.30)m respectively,the Villalta score at the last follow-up were(1.43±2.44)and(2.27±2.80)respectively,the rate of PTS at the last follow-up were 9.5%(2/21)and27.3%(3/11)respectively,and the VEINES-QOL quality of life score at the last follow-up were(13.52±2.77)and(12.91±3.39)respectively,the differences between the two groups were not statistically significant(all P>0.05).Conclusion:The way for curing acute and subacute LEDVT by AngioJet combined with CDT under the guidance of ultrasound can effectively and quickly remove thrombus,it is worthy of promotion.Then it is more suitable for acute LEDVT,can get higher rate of instant venous patency,and reduce the incidence of iliac femoral vein stenosis caused by thrombosis,so as to reduce the incidence of valve insufficiency and obtain the long-term low incidence of PTS and higher quality of life.