Different Approaches For Catheter-directed Thrombolysis For Lower-extremity Acute Deep Venous Thrombosis

Purpose:To compare the efficacy of catheter-directed thrombolysis through popliteal vein,tibial vein and small saphenous vein in the treatment of lower-extremity acute deep vein thrombosis.Methods:According to the vascular approach route,subjects were divided into the popliteal vein group,tibial vein group and small saphenous vein group.One-way ANOVA and chi-square test were used to compare the baseline data between the three groups,and one-way ANOVA was used to compare the limb detumescence rate and vein patency rate among the three groups.Results:A total of 80 patients with lower-extremity acute deep vein thrombosis were enrolled in this study,including 32 males and 48 females.The mean age was 58.90±13.61 years old.All patients had unilateral limb onset,including 54 cases on the left side and 26 cases on the right side.Among them,38 cases had obvious inducement.Patients were divided into three groups according to the vascular approach route:popliteal vein group(15 cases),tibial vein group(43 cases),and small saphenous vein group(22 cases).There were no statistically significant differences in age,sex ratio,proportion of affected limb,course of disease,presence or absence of any cause,difference in circumference of the thigh before catheter-directed thrombolysis,and venous patency score among the groups.The limb detumescence rate after catheter contact thrombolysis was(74.28±9.95)%in the popliteal vein group,(76.43±17.27)%in the tibial vein group,and(70.62±25.11)%in the small saphenous vein group.There was no statistically significant difference among the groups(one-way ANOVA F=0.70,P=0.50).The vein patency rate after catheter contact thrombolysis was(55.51±20.84)%in the popliteal vein group,(59.74±17.92)%in the tibial vein group,and(64.00±17.51)%in the small saphenous vein group.There was no statistically significant difference among the groups(one-way ANOVA F=0.97,P=0.38).The percentage of bleeding at puncture point was 26.67%in the popliteal vein group,9.30%in the tibial vein group,and 27.27%in the small saphenous vein group.Conclusion:The popliteal vein approach,the tibial vein approach and the small saphenous vein approach for catheter-directed thrombolysis show no significant difference in the treatment efficacy for lower-extremity acute deep vein thrombosis.However,the percentage of bleeding at puncture point in the popliteal vein group and that in the small saphenous vein group were higher than that in the tibial vein group.