Two-year Follow-up Results Of Catheter-directed Thrombolysis Combined With AngioJet And Balloon Maceration In Treatment Of Acute Deep Venous Thrombosis Of Lower Extremities

Objective To study the two-year resluts of catheter-directed thrombolysis combined with AngioJet and balloon maceration in the treatment of proximal and mixed acute deep venous thrombosis of the lower extremities.Method Patients with proximal and mixed acute lower limb DVT treated in our department from January 2015 to January 2018 were screened out and divided into four groups according to different treatment methods.A total of 89 cases completed the follow-up process for two years with complete clinical data,including 21 patients treated with CDT alone(group A),24 patients treated with CDT combined with balloon maceration(group B),21 patients treated with CDT combined with AngioJet(group C),and 23 patients treated with CDT combined with AngioJet and balloon maceration(group D).Statistics and comparative analysis of the perioperative data(thrombolytic dose,thrombolytic time,preoperative and postoperative thrombus score,the degree of thrombus removal,perioperative complications and other interventional treatment),two-year follow-up data(incidence and severity of PTS,iliofemoral vein patency rate,quality of life score,follow-up anticoagulation and compression,follow-up complications and reinterventional therapy)of each group were provided.Result Differences of thrombolytic dose and thrombolytic time among the four groups were statistically significant(P<0.05),and pairwise comparison between every two groups was statistically significant except for group B and group C,group C and group D(P<0.05).There were no statistically significant differences in preoperative and postoperative thrombus score,the degree of thrombus removal,perioperative complications,inferior vena cava filter and iliac vein stent placement among the four groups(P>0.05).There was no statistically significant difference in intraoperative thrombus aspiration time between group C and group D(P>0.05).The incidence of moderate-severe PTS within 2 years between group A and group D were statistically significant(P<0.0083).The difference value between quality of life score at the 2nd year after discharge and that at the time of admission between group A and group C,group A and group D were statistically significant(P<0.05).There were no statistically significant differences among the four groups in two-year ulcer rate and cumulative PTS rate,iliofemoral vein patency rate before and 6 months after discharge,follow-up of anticoagulation and compression,incidence of complications and reintervention rate during follow-up(P>0.05).Conclusion Compared to CDT alone in the treatment of proximal and mixed acute of the lower extremities,combined with AngioJet(with balloon maceration or not)could improve the mid-long-term quality of life during follow-up.CDT combined with balloon maceration and AngioJet could reduce the incidence of medium-severe PTS within two years compared to CDT alone.CDT combined with balloon maceration does not increase the risk of PTS within 2 years,and can reduce the dose of thrombolytic drugs and shorten the duration of thrombolysis during treatment.