Meta-analysis Of The Efficacy And Safety Of Percutaneous Mechanical Thrombectomy And Catheter Directed Thrombolysis In Acute Lower Limb Ischemia

Objective Efficacy and safety of percutaneous mechanical thrombectomy with or without catheter directed thrombolysis(PMT±CDT)and catheter directed thrombolysis(CDT)in the treatment of acute lower ischemia(ALI).Methods PubMed,EMBASE,Cochrane library,China knowledge Network(CNKI),WanFang Database,VIP Database(VIP)were searched systematically from the database establishment to April 2020.All studies comparing PMT ± CDT and CDT in the treatment of ALI were included.The quality of the study was evaluated according to the MINORS rating scale,the data were merged and publication bias was detected by Revman5.3 software,and the factors were merged and analyzed by fixed or random effect model.Results A total of 515 cases were included in 5 retrospective studies,including 298 cases in the PMT±CDT group and 217 cases in the CDT group,Meta-analysis showed that the risk of bleeding in PMT±CDT group was significantly lower than that in CDT group [OR=0.30,95%CI(0.10,0.88),P=0.03],the adverse events of vascular in the PMT±CDT group was higher than that in the CDT group,but there was no significant difference [OR=1.71,95%CI(0.62,4.73),P=0.3],there was no significant difference in the operative success rate,30-day amputation rate,and 30-day mortality between the two groups.Conclusion Current evidence suggests that percutaneous mechanical thrombolysis(PMT)with or without catheter directed thrombolysis(CDT)is safe and effective in the treatment of acute limb ischemia(ALI),PMT with or without CDT reduces the risk of bleeding.