A Comparative Study Of Different Endovascular Volume Reduction Methods Versus ACT Alone In The Treatment Of LEDVT

Purpose:To compare and analyze the efficacy of two endovascular volume reduction modalities,percutaneous mechanical thrombus removal and catheter contact thrombolysis,and traditional anti coagulation in the treatment of acute lower limb deep vein thrombosis,to analyze the advantages and disadvantages of each,and to explore a more reasonable clinical treatment plan;to explore the impact of different treatment modalities on the incidence of post-thrombotic syndrome.Methods:Retrospective analysis was performed on the clinical data of 88 patients with DVT(disease course ≤14 days,excluding contraindications to anticoagulant thrombolysis)clearly diagnosed by imaging examination in our hospital from October 2020 to October 2021(inclusion criteria referred to the《Guidelines for Diagnosis and Treatment of Deep Vein Thrombosis,3rd Edition》).According to the study objectives,the patients were grouped according to different treatment modalities:group A was treated with ACT alone,19 patients;group B was treated with ACT combined with CDT,33 patients;group C was treated with ACT combined with PMT,36 patients.Baseline data,surgical efficacy and postoperative complications of patients with study significance were counted.Statistical analysis was performed using SPSS software(version 25.0).The X2 test was used for comparison between groups of count data,and n(%)was used;one-way ANOVA was used for measurement data,and the mean ± standard deviation(x±s)was used;p<0.05 differences were statistically significant(p<0.05,*;p<0.01,**;p<0.001,***;p<0.0001,****).Perioperative detection indexes,incidence and severity of complications within 6 months were compared between different treatment methods,so as to provide guidance and reference for clinical treatment according to the needs of different types of patients,so as to provide personalized treatment programs.Results:1.A total of 88 cases were included in this study,and statistical analysis of age,gender,onset time,etiology,distribution of affected limbs and other aspects of patients in the three groups showed no statistical significance(P>0.05),indicating that patient data among the three groups were comparable.None of the patients died during hospitalization or 6 months after operation.2.There were statistically significant differences in urokinase usage and blood loss between the two groups after surgery(P<0.05).There were significant differences in thrombus clearance rate,detumescence rate,length of hospital stay and venous patency rate at discharge among the three groups(P<0.05).There was no difference in perioperative complications among the three groups(P>0.05).3.The 6-month follow-up after discharge showed no difference in the incidence of PTS among the three groups(P>0.05).Villalta score and patency rate were different among the three groups(P<0.05).Conclusion:1.The two groups treated with endovascular volume reduction had significant advantages over anti coagulation alone(group A)in terms of thrombus clearance rate,swelling rate of the affected limb,hospital stay,and short-term venous patency rate.2.The perioperative thrombus clearance rate,detumescence rate and venous patency rate of PMT were better than those of CDT,but there was no significant difference in venous patency rate at 6 months after operation..3.The endovascular volume reduction treatment group could significantly reduce the Villalta score compared with the anticoagulation-only group,but there was no difference between the surgical treatment groups,and no significant difference in the incidence of PTS was found between the three groups at the 6-month follow-up period.