Observation On The Efficacy Of Catheter-directed Thrombolysis And Transdorsalis Pedis Vein Thrombolysis In The Treatment Of Deep Venous Thrombosis In Inner Mongolia

Objective Deep venous thrombosis of lower extremities refers to the abnormal coagulation of blood in the deep veins of lower extremities to form thrombus masses.Acute thrombus reflux to the pulmonary artery can easily lead to pulmonary embolism;Poor patency of blood vessels in chronic phase is prone to post-thrombotic syndrome.Implantation of inferior vena cava filter reduces the incidence of PE and early removal of thrombus can reduce the incidence of PTS.Early thrombolysis strategies include catheter-directed thrombolysis,systemic thrombolysis and transdorsalis pedis vein thrombolysis.By comparing the efficacy of CDT and DPVT in the treatment of acute DVT patients in Inner Mongolia,we hope to provide advice for early thrombolysis strategies for DVT patients in this area.Methods We collected 73 patients with acute DVT who were treated in Inner Mongolia Autonomous region people’s Hospital from January 2017 to March 2021,including CDT group(n=33)and DPVT group(n=40).In addition to the general data of two groups,We also analyzed the date related to treatment effects such as the detumescencec and the thrombolysis rate of the affected limb,the recovery rate of patients at 6 months and the incidence and severity of PTS at 12 months,and the safety index such as the incidence of PE and hemorrhage.According to the guidelines,the Villalta scale was used in the diagnosis of PTS,and the correlation between the severity of PTS and the recovery of patients was analyzed.Results After the treatment,the rate of detumescence and thrombolysis of the affected limb in the CDT group were higher than those in the DPVT group,and the difference was statistically significant(P<0.05).The recovery of patients in CDT group was better than that in DPVT group at 6 months and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of PTS between the two groups at 12months(P>0.05),but the distribution of PTS severity has statistically difference(P<0.05).The correlation analysis between the recovery of patients and the severity of PTS showed that there was a positive correlation(rs=0.460,P< 0.05).There was no PE in both groups,but the incidence of bleeding in the CDT group was lower than that in the DPVT group and the difference was statistically significant(P<0.05).Conclusion The thrombus of patients with acute DVT should be removed early.Compared with DPVT,CDT can remove thrombus to the maximum extent,improve the prognosis of DVT and reduce the incidence of bleeding.For patients with acute DVT in Inner Mongolia,CDT did not reduce the incidence of PTS and just decrease the severity of PTS,therefore patient management after thrombolysis should be strengthened.