Clinical Control Study Of Angio Jet Pharmacomechanical Thrombectomy Contact Catheter-directed Thrombolysis And Catheter-directed Thrombolysis Alone In The Treatment Of Acute Central Lower Extremity Deep Venous Thrombosis

Objective:There are many kinds of endovascular treatment methods for acute central lower extremity deep venous thrombosis(LEDVT),but the efficacy of different treatment methods has not been determined.The purpose of this study was to compare the efficacy of AngioJet pharmacomechanical thrombectomy(PCDT)and catheter-directed thrombolysis(CDT).Methods:A retrospective analysis was conducted on all patients with acute central LEDVT who received thrombolytic therapy between 2020 and 2022.The measurements included the incidence of postthrombotic syndrome(PTS),thrombus clearance rate,limb swelling rate,surgical indicators,and incidence of complications.All patients were followed up for 1 year.Results:Seventy-six patients with a total of 76 limbs treated were included.The number of limbs treated by CDT was 44 and the number of limbs treated by PCDT was 32.Baseline data were consistent between the two groups of patients,and the incidence of PTS was comparable at one year(PCDT: 28.1% vs CDT: 41.9%,p<0.05),and the difference in the incidence of moderate to severe PTS was not statistically significant(PCDT: 9.3% vs CDT: 23.3%,p>0.05);the difference in the rate of swelling reduction in the affected limbs was significant between the two groups(PCDT: 0.74± 0.18 vs CDT: 0.68±0.17,p<0.001);no significant difference was seen in the rate of class III thrombus clearance between the two groups of patients(PCDT: 81.3% vs CDT: 68.2%,p>0.05);patients in the two groups showed a significant difference in urokinase use(WU)(PCDT: 104.17±71.16 vs CDT: 253.33± 124.85,p<0.05),thrombolysis time(h)(PCDT: 8.44±9.35 vs.CDT: 21.14±10.18,p<0.05),and hospital stay(d)(PCDT:13.88±1.84 vs.CDT: 12.00±3.69,p<0.05),and no serious complications(loss of limb)were observed in either group.complications occurred(limb loss,gastrointestinal bleeding,retroperitoneal hematoma,intracranial hemorrhage,severe pulmonary embolism)in both groups.Conclusion:This study found that both PCDT and CDT are safe and effective methods for the treatment of acute central LEDVT.PCDT is superior to CDT in the incidence of PTS,urokinase dosage,thrombolysis time and hospitalization time at 1 year after operation,which is worthy of clinical promotion.