Efficacy Analysis Of AngioJet Combined With Catheter-directed Thrombolysis In The Treatment Of Deep Venous Thrombosis

ObjectiveTo analyze the early and mid-term effects of AngioJet thrombus removal device combined with catheter thrombolysis in the treatment of acute deep vein thrombosis of lower extremities.MethodRetrospectively analyzed 97 patients with acute deep venous thrombosis of lower extremity who were treated in the Vascular Surgery Department of the Fifth Affiliated Hospital of Zhengzhou University from October 2017 to October 2020.According to different surgical methods,they were divided into AngioJet mechanical thrombus removal device combined with catheterization thrombolysis group(PMT+CDT group)and catheterization thrombolysis group(CDT group).Observation and comparison of the perioperative period of the two groups of patients in the thrombus clearance rate of the affected limb,the rate of swelling of the affected limb,the total dosage of urokinase,the number of days of thrombolysis,the length of stay and the occurrence of complications,and the incidence of PTS and recurrence of thrombus at 12 months.ResultThe operation was successfully completed in both groups,with a success rate of100%.The postoperative thrombus fraction in PMT+CDT group was lower than that in CDT group(1.24±1.83 vs 1.67±2.09),and there was no significant difference between the two groups(P>0.05).The clearance rate of venous thrombosis in PMT+CDT group was significantly higher than that in CDT group(88.64±7.38 vs82.71±6.48),but there was no significant difference between the two groups(P>0.05).In comparison of the percentage of thrombus clearance after operation,the effective thrombolysis ratio of PMT+CDT group and CDT group was 97.1%(33/34)and 84.1%(53/63),respectively,and there was no significant difference between the two groups(P>0.05).The proportion of thrombolysis reachedⅢgrade was 61.8%(21/34)and 38.1%(24/63),respectively.The proportion of PMT+CDT group was significantly higher than that of CDT group,and the difference was statistically significant(P<0.05).Comparison of the detumescence rate of thigh swelling between the two groups was(72.06±10.20)%vs(71.41±13.67)%,and the difference was not statistically significant(P>0.05);the detumescence rate of the lower leg of the two groups was(62.37±18.03)%vs(59.86±17.21)%,the difference was not statistically significant(P>0.05).The total amount of urokinase(10~4 U),thrombolysis days(d)and hospitalization days(d)in PMT+CDT group were significantly lower than those in CDT group(177.44±89.92 vs 304.40±134.98,4.12±2.17 vs 5.96±2.57,9.32±2.25vs 11.89±2.29),and the difference was statistically significant(P<0.05).After 12months of follow-up,the incidence of PTS in the two groups was 8.8%(3/34)and15.9%(10/63),respectively,and there was no significant difference between the two groups(P>0.05).There was no recurrent thrombus in the PMT+CDT group,and 1patient in the CDT group,the difference was not statistically significant(P>0.05).No serious complications,such as pulmonary embolism or intracranial hemorrhage,occurred in 2 patients in the PMT+CDT group and 8 patients in the CDT group,and there was no statistical significance between the two groups(P>0.05).ConclusionAngioJet mechanical thrombolysis clearance device combined with catheter thrombolysis combined with the advantages of mechanical thrombolysis and catheter thrombolysis,is safe and effective in the treatment of acute deep venous thrombosis of lower extremities,with satisfactory early and mid-term results,and can be used as an effective option for the endovascular treatment of acute deep venous thrombosis of lower extremities...