Comparative Study Of AngioJet Mechanical Thrombectomy And Catheter Thrombolysis For Acute Deep Venous Thrombosis Of Lower Extremities

Research purpose:The clinical value of AngioJet percutaneous mechanical thrombectomy(PMT)versus catheter-directed thrombolysis(CDT)in the treatment of acute lower extremity deep venous thrombosis was evaluated.Materials and Methods:A retrospective analysis of patients with proximal or mixed acute lower extremity deep venous thrombosis diagnosed in the vascular surgery department of the First Affiliated Hospital of Chengdu Medical College from June 2017 to June 2019.To compare the efficacy and safety indicators of AngioJet percutaneous mechanical thrombectomy(PMT group: n=32)and Catheter-directed thrombolysis(CDT group:n=72).Result:In terms of efficacy indicators,there was no statistical difference in the total incidence of PTS between the PMT group and the CDT group during the follow-up period of 6-16 months(Median 9 months and 10 months)(21.9% vs 33.3%,P=0.238),but the follow-up at 6,12,and 16 months after operation showed that the Villalta score of the PMT group was lower than that of the CDT group,which were [3(2.25,4)vs 4(4,4.75),P<0.001],[3(3,5)vs 4(4,5),P=0.002],[4(3,5)vs 4(4,6),P=0.014];there was no statistical difference in the thrombotic clearance rate between the two groups after venography evaluation [85%(68%,100%)vs 70%(50%,100%),P=0.093],similarly the PMT group achieved grade ? and above thrombectomy clearance levels were comparable to the CDT group(90.6% vs 76.4%,P=0.089),but the dose of urokinase,thrombolytic time,and length of hospital stay in the PMT group were significantly lower than those in the CDT group [4(3,19)million U vs 27(20,33)million U,0.78±0.08 h vs 64.82±11.02 h,7.91±2.115 d vs 11.46±4.867d](all P<0.05).The patients in the PMT group had better tolerance to surgery than the CDT group(P<0.05).In terms of safety indicators,the incidence of major and minor bleeding was not statistically different between the two groups(all P>0.05).Conclusion:This study found that AngioJet percutaneous mechanical thrombectomy and CDT are both effective and safe thrombectomy strategies for the treatment of acute deep venous thrombosis of the lower extremity,but PMT is superior to CDT in the relief of lower extremity symptoms,urokinase dosage,duration of thrombolytic therapy,length of hospital stay,Villalta score,and surgical tolerance,the curative effect is good,the safety is good,and it is worthy of widespread clinical application.