| Objective:To explore the short-term effect of catheter-based contact thrombolysis and one-stage angioplasty in the treatment of acute left lower extremity iliofemoral vein thrombosis with left iliofemoral vein compression syndrome.It provides some reference for the clinical treatment of this type of patientsMethod:From October 2017 to March 2019,30 patients with acute left lower extremity iliofemoral vein thrombosis and left iliofemoral vein compression syndrome diagnosed by deep venography were selected in this study.Inferior vena cava filter was inserted during the operation,and the clinical general data and clinical effect were evaluated after 7 days of catheter contact thrombolysis and one-stage angioplasty.During the follow-up period,the occurrence and severity of post thrombosis syndrome were assessed by Villalta scale and VCSs scale,and the patency of iliac vein stent was assessed by color Doppler ultrasound or deep venography.Result1.Curative effect analysisAfter treatment,the swelling of the affected limb subsided obviously,and the difference of the peripheral diameter of the big and small legs decreased significantly(P<0.05)on the 7th and 14th day,and the swelling rate of the big and small legs was as high as(78.0 ± 6.24)%and(80.37 ± 7.03)%on the 14th day.Before and after treatment,the score of patency of vein was(6.8 ± 1.3)and(1.9 ± 0.7)(P<0.05),and the patency of vein was(72.22 ± 8.50)%.The curative effect was excellent in 22 cases(73.33%),the clinical cure rate was 73.33%,and the total effective rate was 100%.During thrombolysis,the average values of D-dimer and fibrinogen were plotted into a thrombolysis trend chart.Fibrinogen concentration continued to decrease during treatment.The average concentration of fibrinogen was 1.71 g/l(>1.0g/l of the end of thrombolysis observation index)after 7 days of thrombolysis.The re angiography after the end of thrombolysis indicated that the thrombus was effectively dissolved.The above shows the thrombolysis treatment approach,thrombolysis time and thrombolysis time we used The choice and dosage of drugs are correct and effective.The average time of thrombolysis was(12.2 ± 2.1)days,and the time of thrombolysis was 6.8 ± 0.7)days.The incidence of PTS was 6.67%(2/30)in Villalta score,16.67%(5/30)in 12 months,and was mild to moderate.In VCSs score,the score was(2.6 ± 1.4)in 6 months and(4.2 ± 2.7)in 12 months The difference was statistically significant(P<0.05)2.SecurityNo Fatal pulmonary embolism or symptomatic pulmonary embolism,IVCF and stent related adverse time occurred in all patients.In the course of thrombolysis,5 patients had mild bleeding symptoms of skin and mucous membrane,which were improved after active treatment.The success rate of IVC retrievable filter was 84.21%(16/19)All patients were successfully performed left iliac vein disease segment plasty,the technical success rate was 100%.In the follow-up of 12 months,30 patients had no stent thrombosis,no recurrence of thrombus in the affected limb,no thrombosis in the opposite limbConclusion1.Combined with the inferior vena cava filter,the thrombus was removed by catheter thrombolysis technology.The thrombus removal effect was accurate,the complications were less,and it was safer.Before thrombolysis,8 mm small balloon pre expansion was used to enhance the thrombolysis effect2.After thrombolysis,one-stage angioplasty and stent placement were performed to treat acute iliofemoral segment venous thrombosis with left iliofemoral vein compression syndrome,which corrected the anatomic stenosis of iliofemoral vein,reduced the probability of thrombus recurrence,and obtained better short-term effect It should be popularized in clinical practice3.For acute iliofemoral segment venous thrombosis,individualized treatment should be carried out according to the actual clinical situation of patients,combined with a variety of interventional technology comprehensive treatment provides a new idea for the treatment of deep vein thrombosis. |
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